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Crown Copyright © 2020 Published by Elsevier B.V. on behalf of European Society for Radiotherapy & Oncology.Background and purpose Retroperitoneal sarcoma (RPS) is a rare, complex disease requiring multidisciplinary management. We have previously reported that use of the Revised Edmonton Symptom Assessment Scale (ESAS-r-CSS) allows for proactive symptom management, and we sought to report the results of ESAS-r-CSS screening during pre-operative radiotherapy (RT) for a cadre of patients with RPS. Materials and methods We reviewed records of 47 patients with RPS evaluated at our institution between 2015 and 2018. Of this group, 29 non-metastatic patients were treated with definitive intent neoadjuvant RT with at least 2 weekly ESAS-r-CSS reports. A generalized estimating equation model was used to compare 13 symptoms during weekly on-treatment visits compared to baseline scores at week 1 of RT. Additionally, covariate effects of age, gender, dose, tumor size and location were assessed. Results The population was predominantly male (66%) with median age of 65 years, KPS of 90, and tumor size of 12.8 cm. ESAS scores significantly decreased for anxiety at week 3 (P = 0.01), and pain at week 5 (P = 0.01). Worse constipation was reported at week 2 (P = 0.02). In an exploratory covariate analysis, female gender, age, high dose, and larger tumor size were associated with worse ESAS scores across all time points. Conclusion Patient reporting of symptoms during radiotherapy through weekly ESAS-r-CSS facilitates timely management in patients with this unique tumor type. Sovilnesib inhibitor Expectant care during RT offers the opportunity to minimize symptom progression or treatment interruptions in a population that generally has worsening side effects. © 2020 The Authors.Background Lymphopenia during radiotherapy (RT) may have an adverse effect on treatment outcome. The aim of this study is to investigate associations between lymphopenia and RT parameters in patients with advanced lung cancer. Moreover, to investigate the prognostic role of lymphopenia, blood protein levels, and treatment and patient-related factors. Material and Methods Sixty-two advanced stage non-small cell lung cancer (NSCLC) patients were retrospectively analyzed. Blood counts were available prior to, during, and after RT (3Gyx10). For each patient, a thoracic volume of interest (VOI) -including thoracic soft tissue and trabecular bone- was obtained by applying a CT window of -500 to 1200 HU in the planning CT. Dose parameters from thoracic VOI and other regions including lungs and vertebrae were calculated. Association between risk of lymphopenia ≥ G3 (lymphocytes at nadir according to CTCAE v4.0) and therapeutic parameters was investigated using Logistic regression. Relationships between overall survivc factor of OS in advanced NSCLC receiving palliative RT. © 2020 The Authors.The present question is the possibility of information loss in gene expression? Information loss in the gene expression disrupts the cellular dynamics and can lead to serious defects, including cancer. Using Gottesman and Preskill method for calculating information loss in black holes,a mechanism for calculating the amount of information transformation in gene expression is proposed. In this proposal, there are three different Hilbert spaces that belong to degrees of freedom of DNA, RNA, and protein. The genetic sequence of the DNA is transcribed into protein at two stages. At first stage it is shown that the internal stationary state of the cell can be represented by a maximally entangled two-mode squeezed state of DNA and mRNA.At second stage, the state of the cell is described by a maximally entangled two-mode squeezed state of mRNA and protein. The amount of information transformation can be obtain by projecting the state at first stage on the state at second stage. Evidently for all finite values of the transcription factor concentration y, binding energy E and free energy F of the transcription factor, the information isn't lost in gene expression. © 2020 The Authors.The Lancet Commission on Tuberculosis (TB) set out to establish a roadmap for how high burden countries could get on track to meet the goals established by the UN High Level Meeting (UNHLM) in September 2018. The report sought to answer the question "How should TB high-burden countries and their development partners target their future investments to ensure that ending TB is achieved?" It provides a comprehensive analysis and specific recommendations to address this question and, ultimately, remove the barriers to building a TB-free World. Notably, the report highlights the importance of improving the quality of care as an essential component of ending the epidemic. Strategies for improving quality must be hard-wired into how National TB Programs are organized, to ensure greater equity in TB service provision and implementation of evidence-based practices and clinical guidelines. Investing in TB research and development, especially implementation, policy and programmatic research to determine how to deliver high quality care must also be high priority. In addition, improving the quality of TB programs is contingent on strategies that enhance accountability at all levels, from the level of Head of State to the local TB clinics. To this ends it is essential that TB survivors and their advocates have a voice to raise inconvenient truths and demand improvements in quality. The Commission concludes that the prospect of a TB-free world is a realistic objective that can be achieved with the right commitment of leadership and resources but will only be realized as and when quality of care is prioritized as a central tenet of all TB programs. © 2020 The Authors.Using lightning flash data from the National Lightning Detection Network with an updated lightning nitrogen oxides (NOx) emission estimation algorithm in the Community Multiscale Air Quality (CMAQ) model, we estimate the hourly variations in lightning NOx emissions for the summer of 2011 and simulate its impact on distributions of tropospheric ozone (O3) across the continental United States. We find that typical summer-time lightning activity across the U.S. Mountain West States (MWS) injects NOx emissions comparable to those from anthropogenic sources into the troposphere over the region. Comparison of two model simulation cases with and without lightning NOx emissions show that significant amount of ground-level O3 in the MWS during the summer can be attributed to the lightning NOX emissions. The simulated surface-level O3 from a model configuration incorporating lightning NOx emissions showed better agreement with the observed values than the model configuration without lightning NOx emissions. The time periods of significant reduction in bias in simulated O3 between these two cases strongly correlate with the time periods when lightning activity occurred in the region.

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