An experimental platform for laser-driven ion (sub-MeV) acceleration and potential applications was commissioned at the HiLASE laser facility. The auxiliary beam of the Bivoj laser system operating ...at a GW level peak power (~10 J in 5–10 ns) and 1–10 Hz repetition rate enabled a stable production of high-current ion beams of multiple species (Al, Ti, Fe, Si, Cu, and Sn). The produced laser–plasma ion sources were fully characterized against the laser intensity on the target (1013–1015 W/cm2) by varying the laser energy, focal spot size, and pulse duration. The versatility and tuneability of such high-repetition-rate laser–plasma ion sources are of potential interest for user applications. Such a statistically accurate study was facilitated by the large amount of data acquired at the high repetition rate (1–10 Hz) provided by the Bivoj laser system.
An experimental platform for laser-driven ion (sub-MeV) acceleration and potential applications was commissioned at the HiLASE laser facility. The auxiliary beam of the Bivoj laser system operating ...at a GW level peak power (~10 J in 5–10 ns) and 1–10 Hz repetition rate enabled a stable production of high-current ion beams of multiple species (Al, Ti, Fe, Si, Cu, and Sn). The produced laser–plasma ion sources were fully characterized against the laser intensity on the target (10sup.13–10sup.15 W/cmsup.2) by varying the laser energy, focal spot size, and pulse duration. The versatility and tuneability of such high-repetition-rate laser–plasma ion sources are of potential interest for user applications. Such a statistically accurate study was facilitated by the large amount of data acquired at the high repetition rate (1–10 Hz) provided by the Bivoj laser system.
We report on recent progress in deploying a continuous solid hydrogen ribbon as a debris-free and renewable laser-driven source of pure proton beams generated by a 30-fs laser with ∼1-J laser energy ...focused on target at relativistic intensities of ∼10
19
W/cm
2
and repetition rate of 0.1 Hz. The stability of the ribbon position versus the laser interaction point and maximum repetition rate was tested up to 3.3 Hz. The acceleration of protons with cut-off energies up to 1.5 MeV is demonstrated using a 100-μm thick hydrogen ribbon as proof-of-principle capability of the relatively thick target delivery system. The laser-target geometry presented demonstrates an experimental technique that can potentially enables the operation of a laser–plasma source at Hz-level repetition rate.
In this study, we aimed to investigate whether peroneal electrical Transcutaneous Neuromodulation invented for overactive bladder (OAB) treatment elicits activation in brain regions involved in ...neural regulation of the lower urinary tract.
Among 22 enrolled healthy female volunteers, 13 were eligible for the final analysis. Functional magnetic resonance imaging (fMRI) (Siemens VIDA 3T; Erlangen, Germany) was used to compare the brain region activation elicited by peroneal electrical Transcutaneous Neuromodulation with the activation elicited by sham stimulation. Each subject underwent brain fMRI recording during eight 30-second periods of rest, alternating with 30-second periods of passive feet movement using the sham device, mimicking the motor response to peroneal nerve stimulation. Subsequently, fMRI recording was performed during the analogic "off-on" stimulation paradigm using peroneal electrical transcutaneous neuromodulation. Magnetic resonance imaging data acquired during both paradigms were compared using individual and group statistics.
During both peroneal electrical Transcutaneous Neuromodulation and sham feet movements, we observed activation of the primary motor cortex and supplementary motor area, corresponding to the cortical projection of lower limb movement. During peroneal electrical Transcutaneous Neuromodulation, we observed significant activations in the brain stem, cerebellum, cingulate gyrus, putamen, operculum, and anterior insula, which were not observed during the sham feet movement.
Our study provides evidence that peroneal electrical Transcutaneous Neuromodulation elicits activation of brain structures that have been previously implicated in the perception of bladder fullness and that play a role in the ability to cope with urinary urgency. Our data suggest that neuromodulation at the level of supraspinal control of the lower urinary tract may contribute to the treatment effect of peroneal electrical Transcutaneous Neuromodulation in patients with OAB.
Adherence to European Association of Urology guidelines to refrain from giving neoadjuvant androgen deprivation therapy (ADT) before prostate cancer surgery is variable, especially in high-risk ...subgroups. Inappropriate ADT use may cause serious harm to patients and the consequences are burdensome and costly for health care providers and payers.
Evidence-practice gaps exist in urology. We previously surveyed European Association of Urology (EAU) guidelines for strong recommendations underpinned by high-certainty evidence that impact patient experience for which practice variations were suspected. The recommendation “Do not offer neoadjuvant androgen deprivation therapy (ADT) before surgery for patients with prostate cancer” was prioritised for further investigation. ADT before surgery is neither clinically effective nor cost effective and has serious side effects. The first step in improving implementation problems is to understand their extent. A clear picture of practice regarding ADT before surgery across Europe is not available.
To assess current ADT use before prostate cancer surgery in Europe.
This was an observational cross-sectional study. We retrospectively audited recent ADT practices in a multicentre international setting. We used nonprobability purposive sampling, aiming for breadth in terms of low- versus high-volume, academic, versus community and public versus private centres.
Our primary outcome was adherence to the ADT recommendation. Descriptive statistics and a multilevel model were used to investigate differences between countries across different factors (volume, centre type, and funding type). Subgroup analyses were performed for patients with low, intermediate, and high risk, and for those with locally advanced prostate cancer. We also collected reasons for nonadherence.
We included 6598 patients with prostate cancer from 187 hospitals in 31 countries from January 1, 2017 to May 1, 2020. Overall, nonadherence was 2%, (range 0–32%). Most of the variability was found in the high-risk subgroup, for which nonadherence was 4% (range 0–43%). Reasons for nonadherence included attempts to improve oncological outcomes or preoperative tumour parameters; attempts to control the cancer because of long waiting lists; and patient preference (changing one’s mind from radiotherapy to surgery after neoadjuvant ADT had commenced or feeling that the side effects were intolerable). Although we purposively sampled for variety within countries (public/private, academic/community, high/low-volume), a selection bias toward centres with awareness of guidelines is possible, so adherence rates may be overestimated.
EAU guidelines recommend against ADT use before prostate cancer surgery, yet some guideline-discordant ADT use remains at the cost of patient experience and an additional payer and provider burden. Strategies towards discontinuation of inappropriate preoperative ADT use should be pursued.
Androgen deprivation therapy (ADT) is sometimes used in men with prostate cancer who will not benefit from it. ADT causes side effects such as weight gain and emotional changes and increases the risk of cardiovascular disease, diabetes, and osteoporosis. Guidelines strongly recommend that men opting for surgery should not receive ADT, but it is unclear how well the guidance is followed. We asked urologists across Europe how patients in their institutions were treated over the past few years. Most do not use ADT before surgery, but this still happens in some places. More research is needed to help doctors to stop using ADT in patients who will not benefit from it.
This paper deals with a design of a electromechanical actuator (EMA) control system with advanced safety requirements. Based on the Failure Mode and Effects Analysis (FMEA), a redundant structure of ...sensors and electronic control units (ECUs) is proposed. Following the compromise between safety and simplicity, only two channels (sensors and ECUs) are used. A Voter (hardware which routes the output signals from ECUs to power electronics) is implemented on a complex programmable logic device (CPLD) using hardware description language (HDL). As a case study, the proposed system structure is implemented on a self-balancing vehicle control system. The Model Based Design (MBD) approach is applied during the system development and testing. ECUs are based on dsPIC Microchip devices and programmed using automatically generated C code.
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