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Purpose: For patients with head and neck squamous cell carcinoma (HNSCC), locoregional failure and second primary tumors are common indications for adjuvant reirradiation (re-RT). Given an absence of clear consensus on the role of adjuvant re-RT, we sought to assess histopathologic risk factors of patients with HNSCC and their resulting outcomes after adjuvant re-RT with proton therapy. Methods and Materials: We conducted a retrospective analysis of patients with HNSCC who underwent salvage surgery at our institution followed by adjuvant re-RT with proton therapy over 1.5 years. All included patients received prior radiation therapy. The Kaplan-Meier method was used to evaluate locoregional recurrence-free survival and overall survival. Results: The cohort included 22 patients, with disease subsites, including oropharynx, oral cavity, hypopharynx, larynx, and nasopharynx. Depending on adverse pathologic features, adjuvant re-RT to 66 Gy (32% of cohort) or 60 Gy (68%), with (59%) or without (41%) concurrent systemic therapy was administered. The majority (86%) completed re-RT with no reported treatment delay; 3 patients experienced grade ≥3 acute Common Terminology Criteria for Adverse Events toxicity and no patient required enteral feeding tube placement during re-RT. Median follow-up was 21.0 months (IQR, 11.7-25.2 months). Five patients had biopsy-proven disease recurrences a median of 5.9 months (IQR, 3.8-9.7 months) after re-RT. Locoregional recurrence-free survival was 95.2%, 70.2%, 64.8% at 6, 12, and 24 months, respectively. OS was 100%, 79.2%, and 79.2% at 6, 12, and 24 months, respectively. Four patients had osteoradionecrosis on imaging a median of 13.2 months (IQR, 8.7-17.4 months) after re-RT, with 2 requiring surgical intervention. Conclusions: Adjuvant re-RT for patients with HNSCC was well-tolerated and offered reasonable local control in this high-risk cohort but appears to be associated with a risk of osteoradionecrosis. Additional study and longer follow-up could help define optimal patient management in this patient population.

Since 2014, American states have had the option to expand their Medicaid programs as part of the Affordable Care Act (ACA), which was signed into law by former President Barack H. Obama in 2010. Emerging research has found that Medicaid expansion has had a significant impact on patients with cancer, who often face significant financial barriers to receiving the care they need. In this review, we aim to provide a comprehensive examination of the research conducted thus far on the impact of Medicaid expansion on patients with cancer. We begin with a discussion of the history of Medicaid expansion and the key features of the ACA that facilitated it. We then review the literature, analyzing studies that have investigated the impact of Medicaid expansion on cancer patients in terms of access to care, quality of care, and health outcomes. Our findings suggest that Medicaid expansion has had a positive impact on patients with cancer in a number of ways. Patients in expansion states are more likely to receive timely cancer screening and diagnoses, and are more likely to receive appropriate cancer-directed treatment. Additionally, Medicaid expansion has been associated with improvements in cancer-related health outcomes, including improved survival rates. However, limitations and gaps in the current research on the impact of Medicaid expansion on patients with cancer exist, including a lack of long-term data on health outcomes. Additionally, further research is needed to better understand the mechanisms through which Medicaid expansion impacts cancer care.

The humanism of criminal law is a principle of criminal policy and postmodern criminal law. It is listed in numerous internal and external sources. An international treaty based on the principle of humanism is the Convention against Torture and Other Inhuman or Degrading Treatment or Punishment, adopted in New York in 1984. The European Court of Human Rights has a rich jurisprudence that sanctions violations of the European Convention (see art. 3) in the field of human rights protection, including in terms of humanism of criminal law.

The advancement of minimally invasive surgery, a clearer definition of the role of radiation therapy, and the incorporation of immunotherapy have changed the management of esophagogastric cancers. Novel agents targeting new pathways continue to move forward. [ABSTRACT FROM AUTHOR]

Background and purpose: Radiation dose to the cardio-pulmonary system is critical for radiotherapy-induced mortality in non-small cell lung cancer. Our goal was to automatically segment substructures of the cardio-pulmonary system for use in outcomes analyses for thoracic cancers. We built and validated a multi-label Deep Learning Segmentation (DLS) model for accurate auto-segmentation of twelve cardio-pulmonary substructures. Materials and methods: The DLS model utilized a convolutional neural network for segmenting substructures from 217 thoracic radiotherapy Computed Tomography (CT) scans. The model was built in the presence of variable image characteristics such as the absence/presence of contrast. We quantitatively evaluated the final model against expert contours for a hold-out dataset of 24 CT scans using Dice Similarity Coefficient (DSC), 95th Percentile of Hausdorff Distance and Dose-volume Histograms (DVH). DLS contours of an additional 25 scans were qualitatively evaluated by a radiation oncologist to determine their clinical acceptability. Results: The DLS model reduced segmentation time per patient from about one hour to 10 s. Quantitatively, the highest accuracy was observed for the Heart (median DSC = (0.96 (0.95–0.97)). The median DSC for the remaining structures was between 0.81 and 0.93. No statistically significant difference was found between DVH metrics of the auto-generated and manual contours (p-value ⩾ 0.69). The expert judged that, on average, 85% of contours were qualitatively equivalent to state-of-the-art manual contouring. Conclusion: The cardio-pulmonary DLS model performed well both quantitatively and qualitatively for all structures. This model has been incorporated into an open-source tool for the community to use for treatment planning and clinical outcomes analysis.

Introduction: High dose radiotherapy (RT) has been associated with unexpectedly short survival times for locally advanced Non-Small Cell Lung Cancer (LA-NSCLC) patients. Here we tested the hypothesis that cardiac substructure dose is associated with electrocardiography (ECG) assessed abnormalities after RT for LA-NSCLC. Materials and methods: Pre- and post-RT ECGs were analyzed for 155 LA-NSCLC patients treated to a median of 64 Gy in 1.8–2.0 Gy fractions using intensity-modulated RT plus chemotherapy (concurrent/sequential: 64%/36%) between 2004 and 2014. ECG abnormalities were classified as new Arrhythmic, Ischemic/Pericardial, or Non-specific (AΔECG, I/PΔECG, or NSΔECG) events. Abnormalities were modeled as time to ECG events considering death a competing risk, and the variables considered for analysis were fractionation-corrected dose-volume metrics (α/β = 3 Gy) of ten cardio-pulmonary structures (aorta, heart, heart chambers, inferior and superior vena cava, lung, pulmonary artery) and 15 disease, patient and treatment characteristics. Each abnormality was modelled using bootstrapping and a candidate predictor was suggested by a median multiple testing-adjusted p-value ≤0.05 across the 1000 generated samples. Forward-stepwise multivariate analysis was conducted in case of more than one candidate. Results: At a median of eight months post-RT, the rate of AΔECG, I/PΔECG, and NSΔECG was 66%, 35%, and 67%. Both AΔECG and I/PΔECG were associated with worse performance status (p = 0.007, 0.03), while a higher superior vena cava minimum dose was associated with NSΔECG (p = 0.002). Conclusion: This study suggests that higher radiation doses to the cardio-pulmonary system lead to non-specific ECG abnormalities. Reducing dose to this system, along with effective tumor control, is likely to decrease radiation-induced cardiac toxicity. Keywords: Radiotherapy, Lung cancer, Cardiac, Dose, Toxicity, Survival

The Law No.31/1990 is a non-criminal law with criminal provisions, as it is mainly aimed at regulating the operation of companies, but it also includes incrimination rules. Thus, Art. 271-279, Art. 2801 and Art. 2803 incriminate several acts through which the legal rules on companies are violated. The incrimination rules included in the Law No.31/1990 are special incrimination rules (derogatory), as compared to the ones existing in the Criminal Code [Art.297 (abuse of office), Art.295 (embezzlement) etc.], because they are applied with priority, except when the penalty provided for in the Criminal Code is more severe (see Art.281 of the Law No.31/1990). The incrimination rules existing in the Law No. 31/1990 apply exclusively to the companies regulated by this law, and not to other types of companies, with or without legal personality.

The academic literature and the case-law are concerned with the relationship between the tax evasion offence and the money laundering offence, when the money laundered come from the first offence. More exactly, the question is whether the penalty of special confiscation of the proceeds from tax evasion may still be imposed on a person who committed both offences and is ordered to pay the tax liabilities. In this article we would like to answer this legal issue, taking into account the relevant legal provisions and caselaw.

Copyright of Revista Română de Drept Maritim is the property of Universul Juridic Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although the new Criminal Code made a series of amendments to the criminal legislation, the regulation of the principle of legality of criminalisation has not been significantly changed, but only from the point of view of the structure of governing rules. Thus, while the previous Criminal Code regulated through a single provision both the legality of criminalisation and the legality of criminal penalties, the new Criminal Code has split the content of the principle of legality of criminalisation and criminal penalties into two principles - the legality of criminalisation and the legality of criminal penalties, by allocating them two separate articles in Chapter I of Title I of the General Part. In this article, we aim to examine the theoretical side of the substance of the principle of legality of criminalisation and to analyse some of the most important legal issues concerning the application of this principle in the case-law.

Extended confiscation is a safety measure introduced in Romanian criminal law in 2012. Romania's Constitutional Court has ruled several decisions in which a question has been raised of whether the legal provisions on extended confiscation are constitutional or not. In the present paper we analyze the extended confiscation in relation to the decisions of the Constitutional Court.

Copyright of Romanian Journal of Intellectual Property Law / Revista Română de Dreptul Proprietăţii Intelectuale is the property of Universul Juridic Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Through Law no. 63/ 2012 for the change and completion of the Criminal code of Romania and of Law no. 286/2009 regarding the Criminal code, in the Romanian criminal law, it has been introduced a new safety measure, that is the extended confiscation. Within the current article, we will analyze the conditions regarding the enforcement of this safety measure. We will also examine if the juridical norms that regulate the extended confiscation, as well as their concordance with the fundamental law – the Constitution.

Through Law no. 286/2009, it was adopted a new Criminal code. The new Criminal code brings more changes both in the General part as well as in the Special part. Through this Criminal code, the Romanian lawgiver mainly pursued: to create a coherent legal framework from the criminal point of view by avoiding the useless overlapping of the norms in force existing in the current Criminal code and in the special laws; to facilitate the quick and unitary enforcement of the criminal legislation in the activity of the judicial organs; to transpose the regulations adopted at the European Union level into the national criminal legislative framework; to harmonize the Romanian criminal law with the systems of the other member states of the European Union. The study proposes to underline the main changes occurred in the General Part of the Criminal code.