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- Thomas, HS, et al.
(author)
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- 2019
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swepub:Mat__t
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| 2. |
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- 2017
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In: Physical Review D. - 2470-0010 .- 2470-0029. ; 96:2
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Journal article (peer-reviewed)
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| 5. |
- de Boniface, J., et al.
(author)
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Omitting axillary dissection in breast cancer with sentinel-node metastases
- 2024
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In: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 390:13, s. 1163-1175
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Journal article (peer-reviewed)abstract
- BACKGROUND Trials evaluating the omission of completion axillary-lymph-node dissection in patients with clinically node-negative breast cancer and sentinel-lymph-node metastases have been compromised by limited statistical power, uncertain nodal radiotherapy target volumes, and a scarcity of data on relevant clinical subgroups.METHODS We conducted a noninferiority trial in which patients with clinically node-negative primary T1 to T3 breast cancer (tumor size, T1, ≤20 mm; T2, 21 to 50 mm; and T3, >50 mm in the largest dimension) with one or two sentinel-node macrometastases (metastasis size, >2 mm in the largest dimension) were randomly assigned in a 1:1 ratio to completion axillary-lymph-node dissection or its omission (sentinel-node biopsy only). Adjuvant treatment and radiation therapy were used in accordance with national guidelines. The primary end point was overall survival. We report here the per-protocol and modified intention-to-treat analyses of the prespecified secondary end point of recurrence-free survival. To show noninferiority of sentinel-node biopsy only, the upper boundary of the confidence interval for the hazard ratio for recurrence or death had to be below 1.44.RESULTS Between January 2015 and December 2021, a total of 2766 patients were enrolled across five countries. The per-protocol population included 2540 patients, of whom 1335 were assigned to undergo sentinel-node biopsy only and 1205 to undergo completion axillary-lymph-node dissection (dissection group). Radiation therapy including nodal target volumes was administered to 1192 of 1326 patients (89.9%) in the sentinel-node biopsy–only group and to 1058 of 1197 (88.4%) in the dissection group. The median follow-up was 46.8 months (range, 1.5 to 94.5). Overall, 191 patients had recurrence or died. The estimated 5-year recurrence-free survival was 89.7% (95% confidence interval [CI], 87.5 to 91.9) in the sentinel-node biopsy–only group and 88.7% (95% CI, 86.3 to 91.1) in the dissection group, with a country-adjusted hazard ratio for recurrence or death of 0.89 (95% CI, 0.66 to 1.19), which was significantly (P<0.001) below the prespecified noninferiority margin.CONCLUSIONS The omission of completion axillary-lymph-node dissection was noninferior to the more extensive surgery in patients with clinically node-negative breast cancer who had sentinel-node macrometastases, most of whom received nodal radiation therapy. (Funded by the Swedish Research Council and others; SENOMAC ClinicalTrials.gov number, NCT02240472.).
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| 6. |
- de Boniface, J., et al.
(author)
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The generalisability of randomised clinical trials: an interim external validity analysis of the ongoing SENOMAC trial in sentinel lymph node-positive breast cancer
- 2020
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In: Breast Cancer Research and Treatment. - : Springer Science and Business Media LLC. - 0167-6806 .- 1573-7217. ; 180:1, s. 167-176
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Journal article (peer-reviewed)abstract
- Purpose None of the key randomised trials on the omission of axillary lymph node dissection (ALND) in sentinel lymph-positive breast cancer have reported external validity, even though results indicate selection bias. Our aim was to assess the external validity of the ongoing randomised SENOMAC trial by comparing characteristics of Swedish SENOMAC trial participants with non-included eligible patients registered in the Swedish National Breast Cancer Register (NKBC). Methods In the ongoing non-inferiority European SENOMAC trial, clinically node-negative cT1-T3 breast cancer patients with up to two sentinel lymph node macrometastases are randomised to undergo completion ALND or not. Both breast-conserving surgery and mastectomy are eligible interventions. Data from NKBC were extracted for the years 2016 and 2017, and patient and tumour characteristics compared with Swedish trial participants from the same years. Results Overall, 306 NKBC cases from non-participating and 847 NKBC cases from participating sites (excluding SENOMAC participants) were compared with 463 SENOMAC trial participants. Patients belonging to the middle age groups (p = 0.015), with smaller tumours (p = 0.013) treated by breast-conserving therapy (50.3 versus 47.1 versus 65.2%, p < 0.001) and less nodal tumour burden (only 1 macrometastasis in 78.8 versus 79.9 versus 87.3%, p = 0.001) were over-represented in the trial population. Time trends indicated, however, that differences may be mitigated over time. Conclusions This interim external validity analysis specifically addresses selection mechanisms during an ongoing trial, potentially increasing generalisability by the time full accrual is reached. Similar validity checks should be an integral part of prospective clinical trials. Trial registration: NCT 02240472, retrospective registration date September 14, 2015 after trial initiation on January 31, 2015
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| 7. |
- Bruhat, Laure, 1987, et al.
(author)
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Circuit QED with a quantum-dot charge qubit dressed by Cooper pairs
- 2018
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In: Physical Review B. - 2469-9969 .- 2469-9950. ; 98:15
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Journal article (peer-reviewed)abstract
- Coupling double-quantum-dot circuits to microwave cavities provides a powerful means to control, couple, and manipulate qubits based on the charge or spin of individual electrons. Here, we revisit this standard configuration by adding superconductivity to the circuit. We combine theory and experiment to study a superconductor-double-quantum-dot circuit coupled to microwave cavity photons. First, we use the cavity as a spectroscopic probe. This allows us to determine the low-energy spectrum of the device and to reveal directly Cooper-pair-assisted tunneling between the two dots. Second, we observe a vacuum Rabi splitting which is a signature of strong charge photon coupling and a premiere with carbon-nanotube-based quantum-dot circuits. We show that our circuit design intrinsically combines a set of key features to achieve the strong coupling regime to the cavity. A low charging energy reduces the device sensitivity to charge noise, while sufficient coupling is provided by the shaping of the spectrum of the double quantum dot by the superconducting reservoir. Our findings could be adapted to many other circuit designs and shed light on the coupling of superconducting nanoscale devices to microwave fields.
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| 8. |
- Cubaynes, T., et al.
(author)
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Highly coherent spin states in carbon nanotubes coupled to cavity photons
- 2019
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In: npj Quantum Information. - : Springer Science and Business Media LLC. - 2056-6387. ; 5
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Journal article (peer-reviewed)abstract
- Spins confined in quantum dots are considered as a promising platform for quantum information processing. While many advanced quantum operations have been demonstrated, experimental as well as theoretical efforts are now focusing on the development of scalable spin quantum bit architectures. One particularly promising method relies on the coupling of spin quantum bits to microwave cavity photons. This would enable the coupling of distant spins via the exchange of virtual photons for two qubit gate applications, which still remains to be demonstrated with spin qubits. Here, we use a circuit QED spin-photon interface to drive a single electronic spin in a carbon nanotube-based double quantum dot using cavity photons. The microwave spectroscopy allows us to identify an electrically controlled spin transition with a decoherence rate which can be tuned to be as low as 250 kHz. We show that this value is consistent with the expected hyperfine coupling in carbon nanotubes. These coherence properties, which can be attributed to the use of pristine carbon nanotubes stapled inside the cavity, should enable coherent spin-spin interaction via cavity photons and compare favorably to the ones recently demonstrated in Si-based circuit QED experiments. Our clean and controlled nano-assembly technique of carbon nanotubes in the cavity could be further improved by purified C-12 growth to get rid of the nuclear spins resulting in an even higher spin coherence.
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| 9. |
- Li, W, et al.
(author)
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Predicting breast cancer response to neoadjuvant treatment using multi-feature MRI: results from the I-SPY 2 TRIAL
- 2020
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In: NPJ breast cancer. - : Springer Science and Business Media LLC. - 2374-4677. ; 6:1, s. 63-
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Journal article (peer-reviewed)abstract
- Dynamic contrast-enhanced (DCE) MRI provides both morphological and functional information regarding breast tumor response to neoadjuvant chemotherapy (NAC). The purpose of this retrospective study is to test if prediction models combining multiple MRI features outperform models with single features. Four features were quantitatively calculated in each MRI exam: functional tumor volume, longest diameter, sphericity, and contralateral background parenchymal enhancement. Logistic regression analysis was used to study the relationship between MRI variables and pathologic complete response (pCR). Predictive performance was estimated using the area under the receiver operating characteristic curve (AUC). The full cohort was stratified by hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status (positive or negative). A total of 384 patients (median age: 49 y/o) were included. Results showed analysis with combined features achieved higher AUCs than analysis with any feature alone. AUCs estimated for the combined versus highest AUCs among single features were 0.81 (95% confidence interval [CI]: 0.76, 0.86) versus 0.79 (95% CI: 0.73, 0.85) in the full cohort, 0.83 (95% CI: 0.77, 0.92) versus 0.73 (95% CI: 0.61, 0.84) in HR-positive/HER2-negative, 0.88 (95% CI: 0.79, 0.97) versus 0.78 (95% CI: 0.63, 0.89) in HR-positive/HER2-positive, 0.83 (95% CI not available) versus 0.75 (95% CI: 0.46, 0.81) in HR-negative/HER2-positive, and 0.82 (95% CI: 0.74, 0.91) versus 0.75 (95% CI: 0.64, 0.83) in triple negatives. Multi-feature MRI analysis improved pCR prediction over analysis of any individual feature that we examined. Additionally, the improvements in prediction were more notable when analysis was conducted according to cancer subtype.
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| 10. |
- Onur, E, et al.
(author)
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Intelligent End-To-End Resource Virtualization Using Service Oriented Architecture
- 2009
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In: 2009 IEEE GLOBECOM Workshops. - 9781424456260 - 9781424456246 ; , s. 345-350
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Conference paper (peer-reviewed)abstract
- Service-oriented architecture can be considered as a philosophy or paradigm in organizing and utilizing services and capabilities that may be under the control of different ownership domains. Virtualization provides abstraction and isolation of lower level functionalities, enabling portability of higher level functions and sharing of physical resources. However, dynamics, environmental conditions and increasing complexity / heterogeneity of underlying resources call for adaptive resource handling. In this view an intelligent distributed architecture that enables dynamic user management and control on network-wide resource sharing by using the service oriented architecture concept is presented. Additionally, the proposed architecture supports trading of resources that will enable the transformation of traditional business models.
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