There is a widespread belief that outcomes of cancer patients treated within clinical trials might not be representative of the outcomes obtained within standard clinical settings. We sought to ...investigate the effect of trial participation on biochemical recurrence (BCR) in localised, D'Amico intermediate- and high-risk prostate cancer patients treated with external beam radiotherapy (EBRT).
We relied on a study population treated with EBRT between January 2001 and January 2021 at a single tertiary care centre, stratified according to trial enrolment. Separate Kaplan–Meier and multivariable Cox regression models tested BCR-free survival at 60 months within intermediate- and high-risk EBRT patients, after adjustment for covariables. Additionally, the analyses were refitted after inverse probability treatment weighting was performed separately for both risk subgroups.
Of 932 eligible patients, 635 (68%) and 297 (32%) had intermediate- and high-risk prostate cancer, respectively. Overall, 53% of patients were trial participants. BCR rates were 11 versus 5% (P = 0.27) and 12 versus 14% (P = 0.08) in trial participants versus non-participants for intermediate- and high-risk subgroups, respectively. Differences in patient and clinical characteristics were recorded. Trial participation status failed to reach predictor status in multivariable Cox regression models for BCR in both intermediate-risk (hazard ratio 1.34; 95% confidence interval 0.71–2.49; P = 0.4) and high-risk patients (hazard ratio 1.03; 95% confidence interval 0.45–2.34; P = 0.9). Virtually the same results were recorded in inverse probability treatment weighting cohorts.
Relying on a large cohort of EBRT-treated intermediate- and high-risk patients, no BCR differences were recorded between trial participants and non-participants after accounting for confounders.
•The trial effect is not apparent in prostate cancer patients treated with radiotherapy.•Trial participants receive lower radiation doses than non-participants.•High-risk trial participants receive longer ADT than non-participants.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Well-controlled quantum devices with their increasing system size face a new roadblock hindering further development of quantum technologies. The effort of quantum tomography-the reconstruction of ...states and processes of a quantum device-scales unfavourably: state-of-the-art systems can no longer be characterized. Quantum compressed sensing mitigates this problem by reconstructing states from incomplete data. Here we present an experimental implementation of compressed tomography of a seven-qubit system-a topological colour code prepared in a trapped ion architecture. We are in the highly incomplete-127 Pauli basis measurement settings-and highly noisy-100 repetitions each-regime. Originally, compressed sensing was advocated for states with few non-zero eigenvalues. We argue that low-rank estimates are appropriate in general since statistical noise enables reliable reconstruction of only the leading eigenvectors. The remaining eigenvectors behave consistently with a random-matrix model that carries no information about the true state.
Natural deep eutectic solvents (NADES) have shown to be promising sustainable media for a wide range of applications. Nonetheless, very limited data is available on the properties of these solvents. ...A more comprehensive body of data on NADES is required for a deeper understanding of these solvents at molecular level, which will undoubtedly foster the development of new applications. NADES based on choline chloride, organic acids, amino acids and sugars were prepared, and their density, thermal behavior, conductivity and polarity were assessed, for different NADES compositions. The NADES studied can be stable up to 170°C, depending on their composition. The thermal characterization revealed that all the NADES are glass formers and some, after water removal, exhibit crystallinity. The morphological characterization of the crystallizable materials was performed using polarized optical microscopy which also provided evidence of homogeneity/phase separation. The conductivity of the NADES was also assessed from 0 to 40°C. The more polar, organic acid-based NADES presented the highest conductivities. The conductivity dependence on temperature was well described by the Vogel–Fulcher–Tammann equation for some of the NADES studied.
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•Natural deep eutectic solvents were synthesized.•Physical properties, such as density, viscosity and polarity were determined.•The systems were characterized in terms of thermal analysis.•Morphological analysis was carried out by polarized light microscopy.•Conductivity measurements were performed and the systems fully characterized.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
PURPOSE:This study aimed to assess the role of coronary computed tomography-angiography (CCTA) in the workflow of competitive sports eligibility in a cohort of athletes with anomalous origin of the ...left-coronary artery (AOLCA)/anomalous origin of the right-coronary artery (AORCA) in an attempt to outline relevant computed tomography features likely to impact diagnostic assessment and clinic management.
MATERIALS AND METHODS:Patients with suspected AOLCA/AORCA at transthoracic echocardiography or with inconclusive transthoracic echocardiography underwent CCTA to rule out/confirm and characterize the anatomic findingspartially interarterial course or full-INT, high-take-off, acute-take-off-angle (ATO), slit-like origin, intramural course (IM), interarterial-course-length, and lumen-reduction/hypoplasia (HYPO).
RESULTS:CCTA identified 28 athletes6 AOLCA (3 males; 20.3±11.0 y) and 22 AORCA (18 males; 29.1±16.5 y). Symptoms were present only in 13 athletes (46.4%; 10 AORCA). Four patients (3 AORCA) had abnormal rest electrocardiogram, 11 (40.7%; 9 AORCA) had abnormal stress-electrocardiogram. The INT course was observed in 15 athletes (53.6%)6/6 AOLCA and 9/22 AORCA (40.9%). Slit-like origin was present in 7/22 AORCA (31.8%) and never in AOLCA. Suspected IM resulted in 3 AOLCA (50%), always with HYPO/ATO, and in 6/22 AORCA (27.3%) with HYPO. No statistically significant differences were found between asymptomatic/symptomatic patients in the prevalence of partially INT/INT courses, high-take-off/ATO, and slit-like ostium. A slightly significant relationship between suspected proximal-IM (r=0.47, P<0.05) and proximal-HYPO of anomalous vessel (r=0.65, P<0.01) resulted in AORCA and was confirmed on AOLCA/AORCA pooled analysis (r=0.58, P<0.01 for HYPO). All AOLCA/AORCA athletes were disqualified from competitive sports and warned to avoid vigorous physical efforts. Surgery was recommended to all AOLCA athletes and to 13 AORCA (3 asymptomatic), but only 6 underwent surgery. No major cardiovascular event/ischemic symptoms/signs developed during a mean follow-up of 49.6±39.5 months.
CONCLUSION:CCTA provides essential information for safe/effective clinical management of athletes, with important prognostic/sport-activity implications.
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