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Abstract Background Androgen deprivation therapy (ADT) and radiotherapy (RT) are the mainstay treatment for localized prostate cancer and recurrence after surgery. Cardiovascular (CV) toxicity of ADT is increasingly recognized, and the risk relates to pre-existing risk factors and ADT modalities. Despite ethnic differences in the prevalence of CV risk factors and variations of CV mortality, data on ADT-related cardiotoxicities in the Asian population remain inconclusive. Our registry-based study investigated ADT-related major adverse cardiovascular events (MACE) after primary or salvage RT. Methods Our study combined two prospectively established registry databases from National Cancer Center Singapore and National Heart Center Singapore. The primary endpoint is time to first MACE after treatment. MACE is defined as myocardial infarction, stroke, unstable angina, or cardiovascular death. Two types of propensity score adjustments, including ADT propensity score as a covariate in the multivariable regression model and propensity score weighting, were applied to balance baseline features and CV risk factors between RT alone and RT + ADT groups. Results From 2000 to 2019, 1940 patients received either RT alone (n = 494) or RT + ADT (n = 1446) were included. After a median follow-up of 10 years (RT) and 7.2 years (RT+ ADT), the cumulative incidence of MACE at 1, 3 and 9 years was 1.2, 5 and 16.2% in RT group, and 1.1, 5.2 and 17.6% in RT + ADT group, respectively. There were no differences in the incidence of MACE between 2 groups (HR 1.01, 95% CI 0.78–1.30, p = 0.969). Pre-treatment CV risk factors were common (80%), and CV disease (15.9%) was the second leading cause of death after prostate cancer (21.1%). On univariate analysis, older age, Indians and Malays, pre-existing CV risk factors, and history of MACE were associated with higher MACE risk. After propensity score adjustments, there remained no significant differences in MACE risk between RT + ADT and RT group on multivariable analysis. Conclusions In our registry-based study, ADT is not associated with increased risk of major cardiovascular events among Southeast Asian men with prostate cancer after curative radiotherapy.

Abstract This technical evaluation aims to provide practice ‘how to’ guidelines for radiation therapists (RTs) when positioning a transperineal ultrasound (TPUS) probe during prostate radiotherapy. Recommendations and practical tips will be provided for the best practice in TPUS‐guided workflow to obtain optimal ultrasound images for accurate interpretation and registration of the prostate gland. This will assist the RTs in making consistent and accurate clinical decision in an ultrasound‐guided radiotherapy workflow for prostate treatment. The implementation process and the associated successes and challenges will also be described to assist institutions who may be investigating the potential of implementing this system.

Perception of the radiation oncologists (ROs) and radiation therapists (RTTs) on site-specific advanced practice (SSAP) roles for RTTs, the establishment of SSAP in radiotherapy and the possible implication on current services in Singapore were assessed. Opinions of ROs and RTTs on management support, driving forces, restraints and implication upon successful establishment of SSAP were obtained. Main findings include strong RO’s support for SSAP development and RTTs' requisition for fair opportunities on role development. Other potential benefits include RTTs' career advancement, job satisfaction and retention. Enhancement of inter-professional relationship, service quality and patient satisfaction is anticipated with greater communication and collaboration. Keywords: Advanced practice radiation therapist, Site-specific advanced practice, Radiation therapy, APRT, Role expansion

The Asian citrus psyllid (ACP) Diaphorina citri is the main vector of the pathogen Candidatus Liberibacter asiaticus (CLas), which is the causal agent of citrus Huanglongbing disease. Feeding by both ACP nymphs and adults on host plants allows them to obtain nutrition. Therefore, the nutritional content within the plant phloem is of much importance for the development and reproduction of ACP. The infection by pathogenic microbiomes may affect the amino acid contents of their host plants and then indirectly affect the biology of sap-feeding insects. In this study, we investigated the amino acid contents and their proportions in both CLas-infected and CLas-free citrus plants, ACP adults, and also in honeydew produced by ACP nymphs. Results showed that infection by CLas had a large impact on the amino acid species and proportion in all the tested target plants, ACP adults, and in the honeydew of ACP nymphs. The content of total amino acids in CLas-infected citrus was much higher than that of CLas-free citrus. However, CLas infection significantly reduced the proportion of essential amino acids (EAAs) in these plants. When feeding on CLas-infected citrus plants, ACP adults absorbed less total amino acids than those adults feeding on healthy plants, but the proportion of EAAs was significantly higher when they fed on CLas-infected citrus plants. The proportion of EAAs also significantly increased in the honeydew secreted by ACP nymphs that fed on CLas-infected citrus plants. However, EAA detection in the honeydew of ACP nymphs indicated that the utilization rate of EAAs by CLas positive ACP nymphs was reduced. Our study has revealed that CLas infection significantly affects the contents, proportion, and utilization efficiency of different amino acids in citrus plants, ACP adults, and nymphs, leading to a developmental pattern of ACP that is more conducive to CLas transmission.

With the significant growth of the semiconductor industry, creating small devices with powerful processing ability and network capabilities are no longer a dream for engineers. Currently, Internet of Things (IoT) has become one of the hottest topics in both industry and academia of wireless communication field. The idea of the Internet of Things (IoT) is to connect every day physical objects such as microwave, doors, lightings and so on. The technical concept of the IoT is to enables these different physical objects to sense information using sensors and sends this information to a server. Industrial IoT is to integrate various technologies to improve business services in different sectors. It implicitly indicates the behavior of machine-to-machine communications. Each of industrial IoT as service domains has its own communication requirements that are measured differently in both such as reliability, Quality of service (QoS), and privacy. According to the development of industrial automation, the industrial Internet of things (IoT) is widely used in smart factories to capture the data and manage the production. One of the most important components of industrial IoT is the wireless sensor network (WSN), which are easy to deploy and use in indoor industrial environments for a IoT of tasks, such as irrigation, machine condition monitoring, and environment monitoring. There are a IoT of works focusing on the WSN in industrial IoT. For example, in, a WSN-based hidden Markov model is proposed to estimate the occupancy in the building (also see other works [1], [2]). In this paper, the research focus on 3-D mobile robot tracking in 5G wireless communication combine to sensor network and mobile robot path planning. The mobile robot can move fast in the three-dimensional (3-D) indoor industrial environment for many tasks such as the monitoring of possible damages on industrial plants [3], data gathering and transmission from wireless communication [4], transportation [5].

Abstract This paper presents a practicable regional division and cut algorithm for minimizing the sum of linear fractional functions over a polyhedron. In the algorithm, by using an equivalent problem (P) of the original problem, the proposed division operation generalizes the usual standard bisection, and the deleting and reduction operations can cut away a large part of the current investigated region in which the global optimal solution of (P) does not exist. The main computation involves solving a sequence of univariate equations with strict monotonicity. The proposed algorithm is convergent to the global minimum through the successive refinement of the solutions of a series of univariate equations. Numerical results are given to show the feasibility and effectiveness of the proposed algorithm.

Background and purpose: Inconsistent bladder and rectal volumes have been associated with motion uncertainties during prostate radiotherapy. This study investigates the impact of these volumes to determine the optimal bladder volume. Materials and methods: 60 patients from two Asian hospitals were recruited prospectively. 1887 daily cone-beam computed tomography (CBCT) images were analysed. Intra-fraction motion of the prostate was monitored real-time using a four-dimension transperineal ultrasound (4D TPUS) Clarity® system. The impact of planned bladder volume, adequacy of daily bladder filling, and rectum volume on mean intra-fraction motion of the prostate was analysed. Patients’ ability to comply with the full bladder hydration protocol and level of frustration was assessed using a questionaire. Acute side effects were assessed using the Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 and quality of life (QoL) assessed using the International Prostate Symptom Score (IPSS). Results: The mean (SD) bladder and rectum volumes achieved during daily treatment were 139.7 cm3 (82.4 cm3) and 53.3 cm3 (18 cm3) respectively. Mean (SD) percentage change from planned CT volumes in bladder volume was reduced by 8.2% (48.7%) and rectum volume was increased by 12.4% (42.2%). Linear Mixed effect model analysis revealed a reduction in intra-fraction motion in both the Sup/Inf (p = 0.008) and Ant/Post (p = 0.0001) directions when the daily bladder was filled between 82 and 113% (3rd Quartiles) of the planned CT volumes. A reduction in intra-fraction motion of the prostate in the Ant/Post direction (z-plane) (p = 0.03) was observed when the planned bladder volume was greater than 200 ml. Patients complied well with the hydration protocol with minimal frustration (mean (SD) scores of 2.1 (1.4) and 1.8 (1.2) respectively). There was a moderate positive correlation (0.496) between mean bladder volume and IPSS reported post-treatment urinary straining (p = 0.001). Conclusions: A planned bladder volume >200 cm3 and daily filling between 82 and 113%, reduced intra-fraction motion of the prostate. The hydration protocol was well tolerated. Keywords: Prostate radiotherapy, Full bladder hydration protocol, Intra-fraction motion, 4D TPUS clarity, Real-time tracking

Background and purpose: During radiotherapy, prostate motion changes over time. Quantifying and accounting for this motion is essential. This study aimed to assess intra-fraction prostate motion and derive duration-dependent planning margins for two treatment techniques. Material and methods: A four-dimension (4D) transperineal ultrasound Clarity® system was used to track prostate motion. We analysed 1913 fractions from 60 patients undergoing volumetric-modulated arc therapy (VMAT) to the prostate. The mean VMAT treatment duration was 3.4 min. Extended monitoring was conducted weekly to simulate motion during intensity-modulated radiation therapy (IMRT) treatment (an additional seven minutes). A motion-time trend analysis was conducted and the mean intra-fraction motion between VMAT and IMRT treatments compared. Duration-dependent margins were calculated and anisotropic margins for VMAT and IMRT treatments were derived. Results: There were statistically significant differences in the mean intra-fraction motion between VMAT and the simulated IMRT duration in the inferior (0.1 mm versus 0.3 mm) and posterior (−0.2 versus −0.4 mm) directions respectively (p ≪ 0.01). An intra-fraction motion trend inferiorly and posteriorly was observed. The recommended minimum anisotropic margins are 1.7 mm/2.7 mm (superior/inferior); 0.8 mm (left/right), 1.7 mm/2.9 mm (anterior/posterior) for VMAT treatments and 2.9 mm/4.3 mm (superior/inferior), 1.5 mm (left/right), 2.8 mm/4.8 mm (anterior/posterior) for IMRT treatments. Smaller anisotropic margins were required for VMAT compared to IMRT (differences ranging from 1.2 to 1.6 mm superiorly/inferiorly, 0.7 mm laterally and 1.1–1.9 mm anteriorly/posteriorly). Conclusions: VMAT treatment is preferred over IMRT as prostate motion increases with time. Larger margins should be employed in the inferior and posterior directions for both treatment durations. Duration-dependent margins should be applied in the presence of prolonged imaging and verification time. Keywords: Prostate, Intra-fraction movement, 4D Clarity ultrasound system, Real-time tracking, Margins

Huanglongbing, commonly known as citrus greening, is a devastating disease of citrus worldwide. Candidatus liberibacter asiaticus is the putative cause of citrus greening disease in China and is spread through the process of plant grafting and feeding by insect vectors. Asian citrus psyllid (Diaphorina citri) is a destructive pest due to insecticide resistance development and the main cause of dissemination of Huanglongbing. The purpose of this study was to determine the level of Huanglongbing present in Guangdong province and the acquisition of the pathogen by D. citri through feeding. Six different city areas of Guangdong province were sampled. The results demonstrated that Yunfu currently has the highest infestation rate of CLas in Guangdong province, followed by Chaozhou, Jiangmen, and Foshan. In comparison, Zhongshan and Maoming have the lowest infestation rates. Results also showed that CLas acquisition was directly proportional to the insect feeding duration. The longer an insect fed on an infested plant, the more CLas it acquired. The acquisition efficiency of the pathogen was higher at night compared to during the daytime. During the time period of 15:00–07:00 D. citri acquires more pathogens than during the period of 07:00–15:00. This study provides a basic understanding of the feeding pattern of D. citri, which aids in devising a management program for effective control of direct and indirect losses caused by D. citri.

Purpose: Our purpose was to investigate interfraction setup error of the immobilization device required to implement transperineal ultrasound compared with the current, standard immobilization device. Patient comfort and radiation therapist (RT) satisfaction were also assessed. Methods and materials: Cone beam computed tomography images were acquired before 4069 fractions from 111 patients (control group, n = 56; intervention group, n = 55) were analyzed. The intervention group was immobilized using the Clarity Immobilization System (CIS), comprising a knee rest with autoscan probe kit and transperineal ultrasound probe (n = 55), and control group using a leg immobilizer (LI) (n = 56). Interfraction setup errors were compared for both groups. Weekly questionnaires using a 10-point visual analog scale were administered to both patient groups to measure and compare patient comfort. RT acceptance for both devices was also compared using a survey. Results: There was no significant difference in the magnitude of interfraction cone beam computed tomography–derived setup shifts in the lateral and anteroposterior direction between the LI and CIS (P = .878 and .690, respectively). However, a significant difference (P = .003) was observed in the superoinferior direction between the 2 groups of patients. Patient-reported level of comfort and stability demonstrated no significant difference between groups (P = .994 and .132). RT user acceptance measures for the LI and CIS were ease of handling (100% vs 53.7%), storage (100% vs 61.1%), and cleaning of the devices (100% vs 64.8%), respectively. Conclusions: The CIS demonstrated stability and reproducibility in prostate treatment setup comparable to LI. The CIS device had no impact on patient comfort; however, RTs indicated a preference for LI over the CIS mainly because of its weight and bulkiness.

A commercial deep learning (DL)-based automated segmentation tool (AST) for computed tomography (CT) is evaluated for accuracy and efficiency gain within prostate cancer patients. Thirty patients from six clinics were reviewed with manual- (MC), automated- (AC) and automated and edited (AEC) contouring methods. In the AEC group, created contours (prostate, seminal vesicles, bladder, rectum, femoral heads and penile bulb) were edited, whereas the MC group included empty datasets for MC. In one clinic, lymph node CTV delineations were evaluated for interobserver variability. Compared to MC, the mean time saved using the AST was 12 min for the whole data set (46%) and 12 min for the lymph node CTV (60%), respectively. The delineation consistency between MC and AEC groups according to the Dice similarity coefficient (DSC) improved from 0.78 to 0.94 for the whole data set and from 0.76 to 0.91 for the lymph nodes. The mean DSCs between MC and AC for all six clinics were 0.82 for prostate, 0.72 for seminal vesicles, 0.93 for bladder, 0.84 for rectum, 0.69 for femoral heads and 0.51 for penile bulb. This study proves that using a general DL-based AST for CT images saves time and improves consistency.

Wireless Mesh network (WMN) are increasingly becoming popular as low cost alternatives to wired network for providing broadband access to users. A wireless mesh network (WMN) is a communication networks made up of radio nodes organized in a mesh topology. It is also a form of wireless network. Wireless mesh networks often consist of mesh clients, mesh routers and gateways. The mesh clients are often laptops, cell phones and other wireless devices while the mesh routers forward traffic to and from the gateways, which may, but need not, be connected, to the Internet. In this paper, we discuss different radio frequency range in wireless connected to Access Point (AP) and the project from Belarus – China great stone industry park in Mesh network. The China-Belarus industrial park is a territorial entity with the area of approximately 80 sq. km with a special legal status for the provision of comfortable conditions for business conducting. The Park is located in a unique natural complex 25 km far from Minsk, the capital of the Republic of Belarus. It is in close proximity to the international airport, railway lines, a transnational highway Berlin-Moscow. The result of analysis shows distribution of AP and covering services in great stone industry park. Mesh network provides robustness and load balancing in wireless networks communication.

A Mesh network simulation framework which provides a powerful and concise modeling chain for a network structure will be introduce in this report. Mesh networks has a special topologic structure. The paper investigates a message transfer in wireless mesh network simulation and how does it works in cellular network simulation. Finally the experimental result gave us the information that mesh networks have different principle in transmission way with cellular networks in transmission, and multi – hop routing could provide robustness and load balancing to communication in wireless mesh networks.

Multiorgan dysfunction syndrome contributes to adverse outcomes in advanced heart failure (AdHF) patients after mechanical circulatory support (MCS) implantation and is associated with aberrant leukocyte activity. We tested the hypothesis that preoperative peripheral blood mononuclear cell (PBMC) gene expression profiles (GEP) can predict early postoperative improvement or non-improvement in patients undergoing MCS implantation. We believe this information may be useful in developing prognostic biomarkers.We conducted a study with 29 patients undergoing MCS-surgery in a tertiary academic medical center from 2012 to 2014. PBMC samples were collected one day before surgery (day -1). Clinical data was collected on day -1 and day 8 postoperatively. Patients were classified by Sequential Organ Failure Assessment score and Model of End-stage Liver Disease Except INR score (measured eight days after surgery): Group I = improving (both scores improved from day -1 to day 8, n = 17) and Group II = not improving (either one or both scores did not improve from day -1 to day 8, n = 12). RNA-sequencing was performed on purified mRNA and analyzed using Next Generation Sequencing Strand. Differentially expressed genes (DEGs) were identified by Mann-Whitney test with Benjamini-Hochberg correction. Preoperative DEGs were used to construct a support vector machine algorithm to predict Group I vs. Group II membership.Out of 28 MCS-surgery patients alive 8 days postoperatively, one-year survival was 88% in Group I and 27% in Group II. We identified 28 preoperative DEGs between Group I and II, with an average 93% prediction accuracy. Out of 105 DEGs identified preoperatively between year 1 survivors and non-survivors, 12 genes overlapped with the 28 predictive genes.In AdHF patients following MCS implantation, preoperative PBMC-GEP predicts early changes in organ function scores and correlates with long-term outcomes. Therefore, gene expression lends itself to outcome prediction and warrants further studies in larger longitudinal cohorts.

The choice of postpartum care methods has expanded with changes in population structure and social forms. In addition to the traditional provision of postpartum assistance by senior members of the parents’ family, recent years have also seen a rapid growth in care centers and postpartum home visiting services. Postpartum home visiting services combine the features and services of senior family members’ assistance and postpartum care centers. Therefore, special attention has been drawn to the postpartum care service experience. This study conducted a survey among mothers participating in the Postpartum Home Visiting Service Project of the Social Affairs Bureau of Kaohsiung City Government, Taiwan. The effective sample included 43 participants. Partial least squares (PLS) analysis was performed. The results indicated that the service experience model could comprehensively reflect the relation between consumer experience, experiential value, and experience satisfaction. With regard to practical implications, the results provide postpartum home visiting service providers with a better understanding of consumers’ feelings and, thus, put them in a better position to improve experience through appropriate service methods.

This paper presents a global optimization algorithm for solving the signomial geometric programming (SGP) problem. In the algorithm, by the straight forward algebraic manipulation of terms and by utilizing a transformation of variables, the initial nonconvex programming problem (SGP) is first converted into an equivalent monotonic optimization problem and then is reduced to a sequence of linear programming problems, based on the linearizing technique. To improve the computational efficiency of the algorithm, two range reduction operations are combined in the branch and bound procedure. The proposed algorithm is convergent to the global minimum of the (SGP) by means of the subsequent solutions of a series of relaxation linear programming problems. And finally, the numerical results are reported to vindicate the feasibility and effectiveness of the proposed method.

This paper presents a global optimization algorithm for solving globally the generalized nonlinear multiplicative programming (MP) with a nonconvex constraint set. The algorithm uses a branch and bound scheme based on an equivalently reverse convex programming problem. As a result, in the computation procedure the main work is solving a series of linear programs that do not grow in size from iterations to iterations. Further several key strategies are proposed to enhance solution production, and some of them can be used to solve a general reverse convex programming problem. Numerical results show that the computational efficiency is improved obviously by using these strategies.