secondary results of a randomized phase III trial (SAKK 10/94)

Background To analyze the impact of weight loss before and during chemoradiation on survival outcomes in patients with locally advanced head and neck cancer. Methods From 07/1994-07/2000 a total of 224 patients with squamous cell carcinoma of the head and neck were randomized to either hyperfractionated radiation therapy alone or the same radiation therapy combined with two cycles of concomitant cisplatin. The primary endpoint was time to any treatment failure (TTF); secondary endpoints were locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS) and overall survival (OS). Patient weight was measured 6 months before treatment, at treatment start and treatment end. Results The proportion of patients with >5% weight loss was 32% before, and 51% during treatment, and the proportion of patients with >10% weight loss was 12% before, and 17% during treatment. After a median follow-up of 9.5 years (range, 0.1 – 15.4 years) weight loss before treatment was associated with decreased TTF, LRRFS, DMFS, cancer specific survival and OS in a multivariable analysis. However, weight loss during treatment was not associated with survival outcomes. Conclusions Weight loss before and during chemoradiation was commonly observed. Weight loss before but not during treatment was associated with worse survival

Beyond Einstein-Cartan gravity: Quadratic torsion and curvature invariants with even and odd parity including all boundary terms

Recently, gravitational gauge theories with torsion have been discussed by an increasing number of authors from a classical as well as from a quantum field theoretical point of view. The Einstein-Cartan(-Sciama-Kibble) Lagrangian has been enriched by the parity odd pseudoscalar curvature (Hojman, Mukku, and Sayed) and by torsion square and curvature square pieces, likewise of even and odd parity. (i) We show that the inverse of the so-called Barbero-Immirzi parameter multiplying the pseudoscalar curvature, because of the topological Nieh-Yan form, can only be appropriately discussed if torsion square pieces are included. (ii) The quadratic gauge Lagrangian with both parities, proposed by Obukhov et al. and Baekler et al., emerges also in the framework of Diakonov et al.(2011). We establish the exact relations between both approaches by applying the topological Euler and Pontryagin forms in a Riemann-Cartan space expressed for the first time in terms of irreducible pieces of the curvature tensor. (iii) Only in a Riemann-Cartan spacetime, that is, in a spacetime with torsion, parity violating terms can be brought into the gravitational Lagrangian in a straightforward and natural way. Accordingly, Riemann-Cartan spacetime is a natural habitat for chiral fermionic matter fields.Comment: 12 page latex, as version 2 an old file was submitted by mistake, this is now the real corrected fil

Randomized Comparison of a Polymer-Free Sirolimus-Eluting Stent Versus a Polymer-Based Paclitaxel-Eluting Stent in Patients With Diabetes Mellitus The LIPSIA Yukon Trial

ObjectivesThe objective of the study was to assess noninferiority of the polymer-free sirolimus-eluting Yukon Choice stent (Translumina GmbH, Hechingen, Germany) compared with the polymer-based Taxus Liberté stent (Boston Scientific, Natick, Massachusetts) with regard to the primary endpoint, in-stent late lumen loss, at 9 months in patients with diabetes mellitus.BackgroundThe Yukon Choice stent has been evaluated in several randomized controlled trials before, albeit to date, there has been no trial that exclusively enrolled patients with diabetes mellitus.MethodsPatients with diabetes mellitus undergoing percutaneous coronary intervention for clinically significant de novo coronary artery stenosis were randomized 1:1 to receive either the polymer-free sirolimus-eluting Yukon Choice stent or the polymer-based paclitaxel-eluting Taxus Liberté stent.ResultsA total of 240 patients were randomized. Quantitative coronary angiography was available for 79% of patients. Mean in-stent late lumen loss was 0.63 ± 0.62 mm for the Yukon Choice stent and 0.45 ± 0.60 mm for the Taxus Liberté stent. Based on the pre-specified margin, the Yukon Choice stent failed to show noninferiority for the primary endpoint. During follow-up, there were no significant differences between groups regarding death, myocardial infarction, stent thrombosis, target lesion revascularization, target vessel revascularization, or nontarget vessel revascularization.ConclusionsCompared with the Taxus Liberté stent, the polymer-free sirolimus-eluting Yukon Choice stent failed to show noninferiority with regard to the primary endpoint, in-stent late lumen loss, in patients with diabetes mellitus after 9-month follow-up. Both stents showed comparable clinical efficacy and safety. (Yukon Choice Versus Taxus Liberté in Diabetes Mellitus; NCT00368953

The Next-to-Minimal Supersymmetric Standard Model

We review the theoretical and phenomenological aspects of the Next-to-Minimal Supersymmetric Standard Model: the Higgs sector including radiative corrections and the 2-loop beta-functions for all parameters of the general NMSSM; the tadpole and domain wall problems, baryogenesis; NMSSM phenomenology at colliders, B physics and dark matter; specific scenarios as the constrained NMSSM, Gauge Mediated Supersymmetry Breaking, U(1)'-extensions, CP and R-parity violation.Comment: 144 pages, 11 figures, corrections in Eqs.(2.2), (2.21), (B.9

Comparative analysis of the lambda-interferons IL-28A and IL-29 regarding their transcriptome and their antiviral properties against hepatitis C virus.

Specific differences in signaling and antiviral properties between the different Lambda-interferons, a novel group of interferons composed of IL-28A, IL-28B and IL-29, are currently unknown. This is the first study comparatively investigating the transcriptome and the antiviral properties of the Lambda-interferons IL-28A and IL-29. Expression studies were performed by microarray analysis, quantitative PCR (qPCR), reporter gene assays and immunoluminometric assays. Signaling was analyzed by Western blot. HCV replication was measured in Huh-7 cells expressing subgenomic HCV replicon. All hepatic cell lines investigated as well as primary hepatocytes expressed both IFN-λ receptor subunits IL-10R2 and IFN-λR1. Both, IL-28A and IL-29 activated STAT1 signaling. As revealed by microarray analysis, similar genes were induced by both cytokines in Huh-7 cells (IL-28A: 117 genes; IL-29: 111 genes), many of them playing a role in antiviral immunity. However, only IL-28A was able to significantly down-regulate gene expression (n = 272 down-regulated genes). Both cytokines significantly decreased HCV replication in Huh-7 cells. In comparison to liver biopsies of patients with non-viral liver disease, liver biopsies of patients with HCV showed significantly increased mRNA expression of IL-28A and IL-29. Moreover, IL-28A serum protein levels were elevated in HCV patients. In a murine model of viral hepatitis, IL-28 expression was significantly increased. IL-28A and IL-29 are up-regulated in HCV patients and are similarly effective in inducing antiviral genes and inhibiting HCV replication. In contrast to IL-29, IL-28A is a potent gene repressor. Both IFN-λs may have therapeutic potential in the treatment of chronic HCV

A passenger flow oriented security and safety approach in international railway stations

TRA 2018, 7th Transport Research Arena, Vienne, AUTRICHE, 16-/04/2018 - 19/04/2018; In the context of the Franco-German research project Re(h)strain, this work focuses on a global system analysis integrating both safety and security analysis of international and/or urban railway stations. The Re(h)strain project focuses on terrorist attacks on high speed train systems and investigates prevention and mitigation measures to reduce the overall vulnerability and strengthen the system resilience. One main criterion regarding public transport issues is the number of passengers. For example, the railway station of Paris 'Gare du Nord' deals with a bigger number of passengers than the biggest airport in the world (SNCF open Data 2014), the Atlanta airport, but in terms of passengers, it is only around the 23rd rank railway station in the world. Due to the enormous mass of people, this leads to the system approach of breaking out the station into several classes of zones, e.g. entrance, main hall, quays, trains, etc. All classes are analysed considering state-of-the-art parameters, like targets attractiveness, feasibility of attack, possible damage, possible mitigation and defences. Then, safety incidence of security defence is discussed in order to refine security requirement with regard to the considered zone. Finally, global requirements of security defence correlated to the corresponding class of zones are proposed. A case study based on the works in Re(h)strain is used as an illustration to demonstrate how the above-mentioned security and safety requirements may be implemented and handled at train stations. Therefore, the different security measures proposed for an unaffected flow of passengers are correlated to existing ones, such as video surveillance and security personal patrolling. The results of sensor set-ups realised within the project and tested in real environment show new ways of implementing innovative techniques to security applications. Depending on the technology, sensor portals at the entrances of train stations or sensor nodes distributed throughout the station increase the level of protection achievable for the detection of threats as part of preventive security concepts. The fusion of data gained by different sensor systems, including person-tracking by non-visual object recognition and trailing, enables a core function of a security assistance system. This assistance system makes security personnel aware of threats and the location of possible carriers of suspicious material as a prior condition to successful intervention measures. The high level of automation reduces human intervention to a minimum. In the conclusion it will be recommended to think of international railway stations as complex interconnected systems which are made for sharing traffic flows. It means that thinking about local solutions may produce safety problems to connected zones due to possible overcrowding. Document type: Conference objec

Genetic effects on gene expression across human tissues

Characterization of the molecular function of the human genome and its variation across individuals is essential for identifying the cellular mechanisms that underlie human genetic traits and diseases. The Genotype-Tissue Expression (GTEx) project aims to characterize variation in gene expression levels across individuals and diverse tissues of the human body, many of which are not easily accessible. Here we describe genetic effects on gene expression levels across 44 human tissues. We find that local genetic variation affects gene expression levels for the majority of genes, and we further identify inter-chromosomal genetic effects for 93 genes and 112 loci. On the basis of the identified genetic effects, we characterize patterns of tissue specificity, compare local and distal effects, and evaluate the functional properties of the genetic effects. We also demonstrate that multi-tissue, multi-individual data can be used to identify genes and pathways affected by human disease-associated variation, enabling a mechanistic interpretation of gene regulation and the genetic basis of disease.Postprint (published version

Understanding and Visualizing Droplet Distributions in Simulations of Shallow Clouds

Thorough analysis of local droplet-level interactions is crucial to better understand the microphysical processes in clouds and their effect on the global climate. High-accuracy simulations of relevant droplet size distributions from Large Eddy Simulations (LES) of bin microphysics challenge current analysis techniques due to their high dimensionality involving three spatial dimensions, time, and a continuous range of droplet sizes. Utilizing the compact latent representations from Variational Autoencoders (VAEs), we produce novel and intuitive visualizations for the organization of droplet sizes and their evolution over time beyond what is possible with clustering techniques. This greatly improves interpretation and allows us to examine aerosol-cloud interactions by contrasting simulations with different aerosol concentrations. We find that the evolution of the droplet spectrum is similar across aerosol levels but occurs at different paces. This similarity suggests that precipitation initiation processes are alike despite variations in onset times.Comment: 4 pages, 3 figures, accepted at NeurIPS 2023 (Machine Learning and the Physical Sciences Workshop

Assessing the efficacy and tolerability of PET-guided BrECADD versus eBEACOPP in advanced-stage, classical Hodgkin lymphoma (HD21): a randomised, multicentre, parallel, open-label, phase 3 trial

Background Intensified systemic chemotherapy has the highest primary cure rate for advanced-stage, classical Hodgkin lymphoma but this comes with a cost of severe and potentially life long, persisting toxicities. With the new regimen of brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine, and dexamethasone (BrECADD), we aimed to improve the risk-to-benefit ratio of treatment of advanced-stage, classical Hodgkin lymphoma guided by PET after two cycles. Methods This randomised, multicentre, parallel, open-label, phase 3 trial was done in 233 trial sites across nine countries. Eligible patients were adults (aged ≤60 years) with newly diagnosed, advanced-stage, classical Hodgkin lymphoma (ie, Ann Arbor stage III/IV, stage II with B symptoms, and either one or both risk factors of large mediastinal mass and extranodal lesions). Patients were randomly assigned (1:1) to four or six cycles (21-day intervals) of escalated doses of etoposide (200 mg/m2 intravenously on days 1–3), doxorubicin (35 mg/m2 intravenously on day 1), and cyclophosphamide (1250 mg/m2 intravenously on day 1), and standard doses of bleomycin (10 mg/m2 intravenously on day 8), vincristine (1·4 mg/m2 intravenously on day 8), procarbazine (100 mg/m2 orally on days 1–7), and prednisone (40 mg/m2 orally on days 1–14; eBEACOPP) or BrECADD, guided by PET after two cycles. Patients and investigators were not masked to treatment assignment. Hierarchical coprimary objectives were to show (1) improved tolerability defined by treatment-related morbidity and (2) non-inferior efficacy defined by progression-free survival with an absolute non-inferiority margin of 6 percentage points of BrECADD compared with eBEACOPP. An additional test of superiority of progression-free survival was to be done if non-inferiority had been established. Analyses were done by intention to treat; the treatment-related morbidity assessment required documentation of at least one chemotherapy cycle. This trial was registered at ClinicalTrials.gov (NCT02661503). Findings Between July 22, 2016, and Aug 27, 2020, 1500 patients were enrolled, of whom 749 were randomly assigned to BrECADD and 751 to eBEACOPP. 1482 patients were included in the intention-to-treat analysis. The median age of patients was 31 years (IQR 24–42). 838 (56%) of 1482 patients were male and 644 (44%) were female. Most patients were White (1352 [91%] of 1482). Treatment-related morbidity was significantly lower with BrECADD (312 [42%] of 738 patients) than with eBEACOPP (430 [59%] of 732 patients; relative risk 0·72 [95% CI 0·65–0·80]; p<0·0001). At a median follow-up of 48 months, BrECADD improved progression-free survival with a hazard ratio of 0·66 (0·45–0·97; p=0·035); 4-year progression-free survival estimates were 94·3% (95% CI 92·6–96·1) for BrECADD and 90·9% (88·7–93·1) for eBEACOPP. 4-year overall survival rates were 98·6% (97·7–99·5) and 98·2% (97·2–99·3), respectively. Interpretation BrECADD guided by PET after two cycles is better tolerated and more effective than eBEACOPP in first-line treatment of adult patients with advanced-stage, classical Hodgkin lymphoma