Revisiting the use of the EORTC QLQ-STO22 to assess health-related quality of life of patients with gastric cancer: incorporating updated treatment options and cross-cultural perspectives.

BACKGROUND: The EORTC QLQ-STO22 (QLQ-STO22) is a firmly established and validated measure of health-related quality of life (HRQoL) for people with gastric cancer (GC), developed over two decades ago. Since then there have been dramatic changes in treatment options for GC. Also, East Asian patients were not involved in the development of QLQ-STO22, where GC is most prevalent and the QLQ-STO22 is widely used. A review with appropriate updating of the measure was planned. This study aims to capture HRQoL issues associated with new treatments and the perspectives of patients and health care professionals (HCPs) from different cultural backgrounds, including East Asia. METHODS: A systematic literature review and open-ended interviews were preformed to identify potential new HRQoL issues relating to GC. This was followed by structured interviews where HCPs and patients reviewed the QLQ-STO22 alongside new issues regarding relevance, importance, and acceptability. RESULTS: The review of 267 publications and interviews with 104 patients and 18 HCPs (48 and 9 from East Asia, respectively) generated a list of 58 new issues. Three of these relating to eating small amounts, flatulence, and neuropathy were recommended for inclusion in an updated version of the QLQ-STO22 and covered by five additional questions. CONCLUSIONS: This study supports the content validity of the QLQ-STO22, suggesting its continued relevance to patients with GC, including those from East Asia. The updated version with additional questions and linguistic changes will enhance its specificity, but further testing is required.

T-wave inversion through inhomogeneous voltage diffusion within the FK3V cardiac model.

The heart beats are due to the synchronized contraction of cardiomyocytes triggered by a periodic sequence of electrical signals called action potentials, which originate in the sinoatrial node and spread through the heart's electrical system. A large body of work is devoted to modeling the propagation of the action potential and to reproducing reliably its shape and duration. Connection of computational modeling of cells to macroscopic phenomenological curves such as the electrocardiogram has been also intense, due to its clinical importance in analyzing cardiovascular diseases. In this work, we simulate the dynamics of action potential propagation using the three-variable Fenton-Karma model that can account for both normal and damaged cells through a the spatially inhomogeneous voltage diffusion coefficient. We monitor the action potential propagation in the cardiac tissue and calculate the pseudo-electrocardiogram that reproduces the R and T waves. The R-wave amplitude varies according to a double exponential law as a function of the (spatially homogeneous, for an isotropic tissue) diffusion coefficient. The addition of spatial inhomogeneity in the diffusion coefficient by means of a defected region representing damaged cardiac cells may result in T-wave inversion in the calculated pseudo-electrocardiogram. The transition from positive to negative polarity of the T-wave is analyzed as a function of the length and the depth of the defected region.

Quantum neural networks for the discovery and implementation of quantum error-correcting codes.

We implement and use quantum neural networks that exploit bit-flip quantum error-correcting codes that correct bit-flip errors in arbitrary logical qubit states. We introduce conjugate layer quantum autoencoders and use them in order to restore states impacted by amplitude damping through the utilization of an approximative four-qubit error-correcting codeword. Our specific implementation avoids barren plateaus of the cost function and improves the training time. Moreover, we propose a strategy that allows one to discover new encryption protocols tailored for specific quantum channels. This is exemplified by learning to generate logical qubits explicitly for the bit-flip channel. Our modified quantum neural networks consistently outperform the standard implementations across all tasks.

Analysis of chaotic dynamical systems with autoencoders.

We focus on chaotic dynamical systems and analyze their time series with the use of autoencoders, i.e., configurations of neural networks that map identical output to input. This analysis results in the determination of the latent space dimension of each system and thus determines the minimal number of nodes necessary to capture the essential information contained in the chaotic time series. The constructed chaotic autoencoders generate similar maximal Lyapunov exponents as the original chaotic systems and thus encompass their essential dynamical information.

Axitinib as a third or further line of treatment in renal cancer: a single institution experience.

BACKGROUND: Kidney cancer is a lethal neoplasm that affects several thousands of people every year. Renal cell carcinoma (RCC) is the most common histologic type. Recent developments in the therapeutic approach include antiangiogenic targeted approaches and Immunotherapy. Thus, the therapeutic algorithm of RCC patients and the survival outcomes have changed dramatically. METHODS: Herein we present a retrospective study of the patients treated in our Department with an antiangiogenic agent -Axitinib, a tyrosine kinase inhibitor- as a third or further line treatment. Statistical analysis was performed with SPSS, including the available clinicopathological data of the patients included. RESULTS: Axitinib was found to be active in patients who received this treatment beyond second line. The toxicity profile of this regimen did not reveal any unknown adverse events. CONCLUSIONS: Our real world data reflect that axitinib is a safe and effective option, even beyond the second line.

Pattern formation and chimera states in 2D SQUID metamaterials.

The Superconducting QUantum Interference Device (SQUID) is a highly nonlinear oscillator with rich dynamical behavior, including chaos. When driven by a time-periodic magnetic flux, the SQUID exhibits extreme multistability at frequencies around the geometric resonance, which is manifested by a "snakelike" form of the resonance curve. Repeating motifs of SQUIDs form metamaterials, i.e., artificially structured media of weakly coupled discrete elements that exhibit extraordinary properties, e.g., negative diamagnetic permeability. We report on the emergent collective dynamics in two-dimensional lattices of coupled SQUID oscillators, which involves a rich menagerie of spatiotemporal dynamics, including Turing-like patterns and chimera states. Using Fourier analysis, we characterize these patterns and identify characteristic spatial and temporal periods. In the low coupling limit, the Turing-like patterns occur near the synchronization-desynchronization transition, which can be related to the bifurcation scenarios of the single SQUID. Chimeras emerge due to the multistability near the geometric resonance, and by varying the dc component of the external force, we can make them appear and reappear and, also, control their location. A detailed analysis of the parameter space reveals the coexistence of Turing-like patterns and chimera states in our model, as well as the ability to transform between these states by varying the system parameters.

Estimating the infection horizon of COVID-19 in eight countries with a data-driven approach.

The COVID-19 pandemic has affected all countries of the world producing a substantial number of fatalities accompanied by a major disruption in their social, financial and educational organization. The strict disciplinary measures implemented by China were very effective and thus were subsequently adopted by most world countries to various degrees. The infection duration and number of infected persons are of critical importance for the battle against the pandemic. We use the quantitative landscape of the disease spreading in China as a benchmark and utilize infection data from eight countries to estimate the complete evolution of the infection in each of these countries. The analysis predicts successfully both the expected number of daily infections per country and, perhaps more importantly, the duration of the epidemic in each country. Our quantitative approach is based on a Gaussian spreading hypothesis that is shown to arise as a result of imposed measures in a simple dynamical infection model. This may have consequences and shed light in the efficiency of policies once the phenomenon is over.

Cutaneous toxicities of antineoplastic agents: data from a large cohort of Greek patients.

PURPOSE: Cutaneous toxicities from novel anticancer treatments are an emerging problem in dermato-oncology. However, the prevalence of those toxicities and necessity of skin consultations are currently unknown. The purpose of our study was to perform an epidemiologic analysis of cutaneous toxicities that were referred to our cutaneous toxicity clinic in Athens, Greece. METHODS: All patients examined at the oncodermatology department over a 42-month period were included. Gender, age, type of cancer, type of antineoplastic treatment, and type of toxicity were recorded and analyzed. RESULTS: Four hundred fifty-nine patients (182 males, 277 females) with mean age (SD) 60.6 years (13.05) were included in the analysis. Six hundred seventy-two cutaneous toxicities were recorded. Chemotherapy-induced toxicities were the most commonly recorded incidents, with taxanes being the most commonly involved agent. Immune-related adverse events (IRAEs) have steadily increased over the past 3 years. Treatment modifications due to skin toxicities were more common in patients treated with targeted agents and immune checkpoint inhibitors than in those treated with chemotherapy. The toxicities that led to the most treatment modifications were acneiform eruptions and perionychias. The most common IRAEs recorded were psoriasis in 11 patients, followed by pruritus, macular rash, and lichenoid-type eruptions. In addition, 4 interesting cases of IRAEs are discussed. CONCLUSION: Antineoplastic treatments can lead to a wide range of cutaneous toxicities. Our study underlines the need for a multidisciplinary approach in oncologic patients. The dermatologists' role is crucial in effectively managing those reactions and preventing antineoplastic drug dose adjustments or discontinuation of treatment.

Flux bias-controlled chaos and extreme multistability in SQUID oscillators.

The radio frequency (rf) Superconducting QUantum Interference Device (SQUID) is a highly nonlinear oscillator exhibiting the rich dynamical behavior. It has been studied for many years and it has found numerous applications in magnetic field sensors, in biomagnetism, in non-destructive evaluation, and gradiometers, among others. Despite its theoretical and practical importance, there is relatively very little work on its multistability, chaotic properties, and bifurcation structure. In the present work, the dynamical properties of the SQUID in the strongly nonlinear regime are demonstrated using a well-established model whose parameters lie in the experimentally accessible range of values. When driven by a time-periodic (ac) flux either with or without a constant (dc) bias, the SQUID exhibits extreme multistability at frequencies around the (geometric) resonance. This effect is manifested by a "snake-like" form of the resonance curve. In the presence of both ac and dc flux, multiple bifurcation sequences and secondary resonance branches appear at frequencies above and below the geometric resonance. In the latter case, the SQUID exhibits chaotic behavior in large regions of the parameter space; it is also found that the state of the SQUID can be switched from chaotic to periodic or vice versa by a slight variation of the dc flux.

Gain-driven discrete breathers in PT-symmetric nonlinear metamaterials.

We introduce a one-dimensional parity-time- (PT-)symmetric nonlinear magnetic metamaterial consisting of split-ring dimers having both gain and loss. When nonlinearity is absent we find a transition between an exact to a broken PT phase; in the former, the system features a two band gapped spectrum with shape determined by the gain and loss coefficients as well as the interunit coupling. In the presence of nonlinearity, we show numerically that as a result of the gain and dissipation matching a novel type of long-lived stable discrete breathers can form below the lower branch of the band with no attenuation. In these localized modes the energy is almost equally partitioned between two adjacent split rings on the one with gain and the other one with loss.

Quantum targeted energy transfer through machine learning tools.

In quantum targeted energy transfer, bosons are transferred from a certain crystal site to an alternative one, utilizing a nonlinear resonance configuration similar to the classical targeted energy transfer. We use a computational method based on machine learning algorithms in order to investigate selectivity as well as efficiency of the quantum transfer in the context of a dimer and a trimer system. We find that our method identifies resonant quantum transfer paths that allow boson transfer in unison. The method is readily extensible to larger lattice systems involving nonlinear resonances.

Nonlinear scattering by non-Hermitian multilayers with saturation effects.

We theoretically investigate the optical properties of a one-dimensional non-Hermitian dispersive layered system with saturable gain and loss. We solve the nonhomogeneous Helmholtz equation perturbatively by applying the modified transfer matrix method and we obtain closed-form expressions for the reflection or transmission coefficients for TM incident waves. The nonreciprocity of the scattering process can be directly inferred from the analysis of the obtained expressions. It is shown that by tuning the parameters of the layers we can effectively control the impact of nonlinearity on the scattering characteristics of the non-Hermitian layered structure. In particular, we investigate the asymmetric and nonreciprocal characteristics of the reflectance and transmittance of multilayered parity-time (PT)-symmetric slab. We demonstrate that incident electromagnetic wave may effectively tunnel through the PT-symmetric multilayered structures with zero reflection. The effect of nonlinearity to the scattering matrix eigenvalues is systematically examined.

Extreme events in discrete nonlinear lattices.

We perform statistical analysis on discrete nonlinear waves generated through modulational instability in the context of the Salerno model that interpolates between the integrable Ablowitz-Ladik (AL) equation and the nonintegrable discrete nonlinear Schrödinger equation. We focus on extreme events in the form of discrete rogue or freak waves that may arise as a result of rapid coalescence of discrete breathers or other nonlinear interaction processes. We find power law dependence in the wave amplitude distribution accompanied by an enhanced probability for freak events close to the integrable limit of the equation. A characteristic peak in the extreme event probability appears that is attributed to the onset of interaction of the discrete solitons of the AL equation and the accompanied transition from the local to the global stochasticity monitored through the positive Lyapunov exponent of a nonlinear map.

Compact Localized States in Engineered Flat-Band [Formula: see text] Metamaterials.

The conditions leading to flat dispersionless frequency bands in truly one-dimensional parity-time ([Formula: see text]) symmetric metamaterials comprised of split-ring resonators (SRRs) arranged in a binary pattern are obtained analytically. In this paradigmatic system, in which the SRRs are coupled through both electric and magnetic dipole-dipole forces, flat-bands may arise from tailoring its natural parameters (such as, e.g., the coupling coefficients between SRRs) and not from geometrical effects. For sets of parameters which values are tailored to flatten the upper band of the spectrum, the solution of the corresponding quadratic eigenvalue problem reveals the existence of compact, two-site localized eigenmodes. Numerical simulations confirm the existence and the dynamic stability of such modes, which can be formed through the evolution of single-site initial excitations without disorder or nonlinearity.

Magnetoinductive breathers in metamaterials.

The existence and stability of discrete breathers (DBs) in one- and two-dimensional magnetic metamaterials (MMs), which consist of periodic arrangements (arrays) of split-ring resonators (SRRs), are investigated numerically. We consider different configurations of the SRR arrays, which are related to the relative orientation of the SRRs in the MM, in both one and two spatial dimensions. In the latter case we also consider anisotropic MMs. Using standard numerical methods we construct several types of linearly stable breather excitation in both Hamiltonian and dissipative MMs (dissipative breathers). The study of stability in both cases is performed using standard Floquet analysis. In both cases we find that the increase of dimensionality from one to two spatial dimensions does not destroy the DBs, which may also exist in the case of moderate anisotropy (in two dimensions). In dissipative MMs, the dynamics is governed by a power balance between the mainly Ohmic dissipation and driving by an alternating magnetic field. In that case it is demonstrated that DB excitation locally alters the magnetic response of MMs from paramagnetic to diamagnetic. Moreover, when the frequency of the applied field approaches the SRR resonance frequency, the magnetic response of the MM in the region of the DB excitation may even become negative (extremely diamagnetic).

Left-handed metamaterials with saturable nonlinearity.

The left-handed properties of metamaterials with saturable nonlinearity are analyzed with respect to their electromagnetic response as a function of externally varying parameters. We demonstrate that the response of the medium is strongly affected by the saturation of the nonlinear effects. The last can be exploited to modulate the amplitude or tune the frequency of the response. Moreover, the existence of bistability regions in large parts of the external parameter space allows for switching between different magnetization states, with either positive or negative response. The stability issue of multiple possible states is addressed through modulational instability analysis of plane wave envelopes in each of those states.

Multistable dissipative breathers and collective states in SQUID Lieb metamaterials.

A SQUID (Superconducting QUantum Interference Device) metamaterial on a Lieb lattice with nearest-neighbor coupling supports simultaneously stable dissipative breather families which are generated through a delicate balance of input power and intrinsic losses. Breather multistability is possible due to the peculiar snaking flux amplitude-frequency curve of single dissipative-driven SQUIDs, which for relatively high sinusoidal flux field amplitudes exhibits several stable and unstable solutions in a narrow frequency band around resonance. These breathers are very weakly interacting with each other, while multistability regimes with a different number of simultaneously stable breathers persist for substantial intervals of frequency, flux field amplitude, and coupling coefficients. Moreover, the emergence of chimera states as well as temporally chaotic states exhibiting spatial homogeneity within each sublattice of the Lieb lattice is demonstrated. The latter of the states emerge through an explosive hysteretic transition resembling explosive synchronization that has been reported before for various networks of oscillators.

Self-focusing and envelope pulse generation in nonlinear magnetic metamaterials.

The self-modulation of waves propagating in nonlinear magnetic metamaterials is investigated. Considering the propagation of a modulated amplitude magnetic field in such a medium, we show that the self-modulation of the carrier wave leads to a spontaneous energy localization via the generation of localized envelope structures (envelope solitons), whose form and properties are discussed. These results are also supported by numerical calculations.

Nonreciprocal nonlinear wave scattering by loss-compensated active hyperbolic structures.

The combinatorial frequency generation (CFG) in active periodic semiconductor-dielectric structures has been explored through illumination by a pair of pump waves with dissimilar frequencies and incidence angles. We study the influence of gain on linear refraction properties of the stack and on the efficiency of the mixing processes by the system with the resistive character of nonlinearity. We demonstrate that the introduction of gain dielectric material inside the stack not only compensates for losses caused by the collisions of the electrons in semiconductor media but also improves the efficiency of the CFG. We show that in systems with weak asymmetry of linear response we can get significant nonreciprocity of nonlinear interaction.

Turbulent chimeras in large semiconductor laser arrays.

Semiconductor laser arrays have been investigated experimentally and theoretically from the viewpoint of temporal and spatial coherence for the past forty years. In this work, we are focusing on a rather novel complex collective behavior, namely chimera states, where synchronized clusters of emitters coexist with unsynchronized ones. For the first time, we find such states exist in large diode arrays based on quantum well gain media with nearest-neighbor interactions. The crucial parameters are the evanescent coupling strength and the relative optical frequency detuning between the emitters of the array. By employing a recently proposed figure of merit for classifying chimera states, we provide quantitative and qualitative evidence for the observed dynamics. The corresponding chimeras are identified as turbulent according to the irregular temporal behavior of the classification measure.