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Second primary breast cancers are among the most common risks to female patients who have received radiotherapy for mediastinal lymphoma.
This study aims to audit breast dose in women who received mediastinal radiotherapy for lymphoma and compare the combined dose parameter values measured to those in the literature.
Methods:
Twenty-three patient datasets from 2017 to 2021 were obtained. Inclusion criteria, such as female gender and 30Gy prescription dose, were applied. Target volumes were delineated using involved site radiotherapy and planned on Eclipse (Varian, Palo Alto, CA) using either fixed field or VMAT. Breast contours were retrospectively outlined according to RTOG/EORTC guidance and descriptive statistics were used to compare findings to those from the literature.
Results:
Differences were found in V4gy, V5Gy and mean dose compared to the literature with mean dose being 2Gy in the literature and 4Gy in this audit.
Conclusions:
Breast dose parameter values between patients in this study vary due to multiple factors. These include the treatment delivery method used and the position of the treatment field in relation to the location of breast tissue. Mean dose and V4% and V5% to breast tissue found in this study differ from that found in the literature. This study highlights the importance of accurate contouring and optimising breast tissue when possible.
Let $\Omega _n$ be the ring of polynomial-valued holomorphic differential forms on complex n-space, referred to in physics as the superspace ring of rank n. The symmetric group ${\mathfrak {S}}_n$ acts diagonally on $\Omega _n$ by permuting commuting and anticommuting generators simultaneously. We let $SI_n \subseteq \Omega _n$ be the ideal generated by ${\mathfrak {S}}_n$-invariants with vanishing constant term and study the quotient $SR_n = \Omega _n / SI_n$ of superspace by this ideal. We calculate the doubly-graded Hilbert series of $SR_n$ and prove an ‘operator theorem’, which characterizes the harmonic space $SH_n \subseteq \Omega _n$ attached to $SR_n$ in terms of the Vandermonde determinant and certain differential operators. Our methods employ commutative algebra results that were used in the study of Hessenberg varieties. Our results prove conjectures of N. Bergeron, Colmenarejo, Li, Machacek, Sulzgruber, Swanson, Wallach and Zabrocki.
Clinical outcomes of repetitive transcranial magnetic stimulation (rTMS) for treatment of treatment-resistant depression (TRD) vary widely and there is no mood rating scale that is standard for assessing rTMS outcome. It remains unclear whether TMS is as efficacious in older adults with late-life depression (LLD) compared to younger adults with major depressive disorder (MDD). This study examined the effect of age on outcomes of rTMS treatment of adults with TRD. Self-report and observer mood ratings were measured weekly in 687 subjects ages 16–100 years undergoing rTMS treatment using the Inventory of Depressive Symptomatology 30-item Self-Report (IDS-SR), Patient Health Questionnaire 9-item (PHQ), Profile of Mood States 30-item, and Hamilton Depression Rating Scale 17-item (HDRS). All rating scales detected significant improvement with treatment; response and remission rates varied by scale but not by age (response/remission ≥ 60: 38%–57%/25%–33%; <60: 32%–49%/18%–25%). Proportional hazards models showed early improvement predicted later improvement across ages, though early improvements in PHQ and HDRS were more predictive of remission in those < 60 years (relative to those ≥ 60) and greater baseline IDS burden was more predictive of non-remission in those ≥ 60 years (relative to those < 60). These results indicate there is no significant effect of age on treatment outcomes in rTMS for TRD, though rating instruments may differ in assessment of symptom burden between younger and older adults during treatment.
Political technology' is the means by which the Kremlin achieved a monopoly of political control after the chaos of the 1990s. It then metastasised to take over other areas: civil society, history and foreign policy. Political technology produced the propaganda that produced the war against Ukraine. Political technology will outlive the end of real politics in an increasingly authoritarian Russia; it influences everything else that Russia does.
Trump and Trumpism were more than mere personality politics. He hijacked the system of minority rule and the alternative media reality created by Republicans since the 1990s while adding innovations of his own to create the Big Lie of #StopTheSteal, which is now the tail that wags the Republican party dog. Control of this machine will determine who wins the Republican nomination in 2024.
Ukraine before the current war was another 'hub state'. Russian political technologists were initially the most popular, followed by Americans like Paul Manafort after 2004. But Ukraine has also developed its own characteristic political technologies, many for export to neighbouring states. It remains to be seen how many will survive the war.
The globalisation of political technology techniques happens through the circulation of personnel (like Paul Manafort), distance learning and common technologies. Certain states are hub states, both importing and exporting political technology, like Hungary, the United States and Ukraine. Many political consultancy companies (Cambridge Analytica) or even mercenary groups (Wagner) are in fact political technology wholesalers.
Political technology' is not a term much used in the West. But spin and political consulting are outdated labels. Spin doctors and political consultants do more than spin or consult; they also meet the definition of engineers of the political system. Particularly in the United States, where a different type of political universe has been constructed: Political Action Committees, dark money and astroturfing.
Political technology is defined, not as Russians define it as a synonym for politics, but as the 'supply-side engineering of the political system for partisan advantage'. Such manipulation is now common across many types of regimes: deteriorating democracies, so-called smart authoritarianisms and hybrid regimes, but particularly the latter. Manipulation techniques spread through various types of globalisation. Political manipulation can no longer be orientalised: corruption, judicial capture, propaganda and artificial structures to spread it are also increasingly prevalent in the West.
Hungary is a prime example of how to create an uneven playing field. The opinion polls for the 2022 elections were close - the opposition had no chance to win.
Political technology works. It can create total systems of control. It can give malign actors the edge in political competition. It can create fake political subjects and entire virtual political geometries. It can grow support for fringe and minority politics. And it can be used to reverse lever outsider political takeovers by creating artificial rivals to traditional political structures and then drive them mainstream.
China has little public politics. But political technology overlaps with authoritarian methods of social and information control. In India, the world's biggest democracy, the BJP has developed mass participatory propaganda to build a Hindu national state since 2015.