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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.

The pinning control of complex networks is a hot topic of research in network science. However, most studies on pinning control ignore the impact of external interference on actual control strategies. To more comprehensively evaluate network synchronizability via pinning control in the attack–defense confrontation scenario, the paper constructs an attacker-defender game model. In the model, the attacker needs to control nodes in the network as much as possible. The defender will do their best to interfere with the attacker's control of the network. Through a series of experiments, we find that the random attack strategy is always the dominant strategy of the attacker in various equilibriums. On the other hand, the defender needs to constantly change dominant strategy in equilibrium according to the set of defense strategies and cost constraints. In addition, scale-free networks with different network metrics can also influence the payoff matrix of the game. In particular, the average degree of the network has an obvious impact on the attacker's payoff. Moreover, we further verify the correctness of the proposed attacker-defender game through a simulation based on the specific network synchronization dynamics. Finally, we conduct a sensitivity analysis in different network structures, such as the WS small-world network, the ER random network, and the Google network, to comprehensively evaluate the performance of the model. [ABSTRACT FROM AUTHOR]

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.

COVID-19 has been a global pandemic for three years. Symptoms experienced by patients with this disease include fever, cough, fatigue, muscle pain, and diarrhea as well as mental health issues. The terms "coronasomnia" and "COVID-somnia" emerged in 2021 to describe sleep disorders attributable to stress associated with the COVID-19 pandemic. In this study, the concept analysis method proposed by Walker & Avant (2019) was utilized to define the concept of coronasomnia (Walker & Avant, 2019), with three key attributes identified, including COVID-related anxiety or depression; insomnia that emerges after the pandemic; and experiencing difficulty falling asleep, interrupted sleep, or early morning awakenings accompanied by difficulty returning to sleep. Furthermore, the concept was elucidated in this study using typical, borderline, opposite, and relative cases. Lastly, evidence-based tools for validating the antecedents and consequences of coronasomnia were introduced. We hope the results of this concept analysis enhance nurses' understanding of coronasomnia and facilitate the implementation of clinical care and research in this area. [ABSTRACT FROM AUTHOR]

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.