PURPOSE This guideline provides updated evidence-based recommendations addressing recent developments in the management of patients with brain metastases, including advanced radiation therapy techniques such as stereotactic radiosurgery (SRS) and hippocampal avoidance whole brain radiation therapy and the emergence of systemic therapies with central nervous system activity. METHODS The American Society for Radiation Oncology convened a task force to address 4 key questions focused on the radiotherapeutic management of intact and resected brain metastases from nonhematologic solid tumors. The guideline is based on a systematic review provided by the Agency for Healthcare Research and Quality. Recommendations were created using a predefined consensus-building methodology and system for grading evidence quality and recommendation strength. RESULTS Strong recommendations are made for SRS for patients with limited brain metastases and Eastern Cooperative Oncology Group performance status 0 to 2. Multidisciplinary discussion with neurosurgery is conditionally recommended to consider surgical resection for all tumors causing mass effect and/or that are greater than 4 cm. For patients with symptomatic brain metastases, upfront local therapy is strongly recommended. For patients with asymptomatic brain metastases eligible for central nervous system-active systemic therapy, multidisciplinary and patient-centered decision-making to determine whether local therapy may be safely deferred is conditionally recommended. For patients with resected brain metastases, SRS is strongly recommended to improve local control. For patients with favorable prognosis and brain metastases receiving whole brain radiation therapy, hippocampal avoidance and memantine are strongly recommended. For patients with poor prognosis, early introduction of palliative care for symptom management and caregiver support are strongly recommended. CONCLUSIONS The task force has proposed recommendations to inform best clinical practices on the use of radiation therapy for brain metastases with strong emphasis on multidisciplinary care.
Purpose: The summary presented herein represents Part II of the three-part series dedicated to Clinically Localized Prostate Cancer: AUA/ASTRO Guideline, discussing principles of active surveillance and surgery as well as follow-up for patients after primary treatment. Please refer to Parts I and III for discussion of risk assessment, staging, and risk-based management (Part I), and principles of radiation and future directions (Part III). Materials and Methods: The systematic review utilized to inform this guideline was conducted by an independent methodological consultant. A research librarian conducted searches in Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. The methodology team supplemented searches of electronic databases with the studies included in the prior AUA review and by reviewing reference lists of relevant articles. Results: The Clinically Localized Prostate Cancer Panel created evidence- and consensus-based guideline statements to aid clinicians in the management of patients with clinically localized prostate cancer. Statements regarding active surveillance, surgical management, and patient follow-up are detailed. Conclusion: This guideline aims to inform clinicians treating patients with clinically localized prostate cancer. Continued research and publication of high-quality evidence from future trials will be essential to further improve care for these men.
S. Shaitelman, Bethany M. Anderson, D. Arthur
et al.
PURPOSE This guideline provides evidence-based recommendations on appropriate indications and techniques for partial breast irradiation (PBI) for patients with early-stage invasive breast cancer and ductal carcinoma in situ. METHODS The American Society for Radiation Oncology (ASTRO) convened a task force to address 4 key questions focused on the appropriate indications and techniques for PBI as an alternative to whole breast irradiation (WBI) to result in similar rates of ipsilateral breast recurrence (IBR) and toxicity outcomes. Also addressed were aspects related to the technical delivery of PBI including dose-fractionation regimens, target volumes, and treatment parameters for different PBI techniques. The guideline is based on a systematic review provided by the Agency for Healthcare Research and Quality. Recommendations were created using a predefined consensus-building methodology and system for grading evidence quality and recommendation strength. RESULTS PBI delivered using 3-D conformal radiation therapy, intensity modulated radiation therapy, multicatheter brachytherapy and single-entry brachytherapy result in similar IBR as WBI with long-term follow-up. Some patient characteristics and tumor features were underrepresented in the randomized controlled trials, making it difficult to fully define IBR risks for patients with these features. Appropriate dose-fractionation regimens, target volume delineation, and treatment planning parameters for delivery of PBI are outlined. Intraoperative radiation therapy alone is associated with a higher IBR rate compared to WBI. A daily or every other day external beam PBI regimen is preferred over twice daily regimens due to late toxicity concerns. CONCLUSIONS Based on published data, the ASTRO task force has proposed recommendations to inform best clinical practices on the use of PBI.
In gravitational-wave astronomy, as in other scientific disciplines, ``exceptional'' sources attract considerable interest because they challenge our current understanding of the underlying (astro)physical processes. Crucially, ``exceptionality'' is defined only relative to the rest of the detected population. For instance, among all gravitational-wave events detected so far, GW231123 is the binary black hole with the largest total mass, while GW241110 is the binary black hole with the most strongly misaligned spin relative to the orbital angular momentum. Mandel [Astrophys.J.Lett. 996 (2026) 1, L4] argued that apparent ``exceptionality'' may reflect measurement error rather than an extreme true value, and suggested that the total mass of GW231123 may be significantly overestimated. Here we present a quantitative analysis that supports this conceptual point. We find that claims of ``exceptionality'' obtained under agnostic priors should be critically questioned whenever measurement uncertainties are comparable to the width of the underlying population. Specifically, we find that the total mass of GW231123 is unlikely to be meaningfully affected by this effect while the spin of GW241110 is far less likely to be anti-aligned than initially claimed: about 70% of realizations that appear to yield an ``exceptionally anti-aligned'' spin are in fact consistent with either nonspinning or aligned configurations.
PURPOSE This joint guideline by American Society for Radiation Oncology (ASTRO) and the European Society for Radiotherapy and Oncology (ESTRO) was initiated to review evidence and provide recommendations regarding the use of local therapy in the management of extracranial oligometastatic non-small cell lung cancer (NSCLC). Local therapy is defined as the comprehensive treatment of all known cancer-primary tumor, regional nodal metastases, and metastases-with definitive intent. METHODS ASTRO and ESTRO convened a task force to address 5 key questions focused on the use of local (radiation, surgery, other ablative methods) and systemic therapy in the management of oligometastatic NSCLC. The questions address clinical scenarios for using local therapy, sequencing and timing when integrating local with systemic therapies, radiation techniques critical for oligometastatic disease targeting and treatment delivery, and the role of local therapy for oligoprogression or recurrent disease. Recommendations were based on a systematic literature review and created using ASTRO guidelines methodology. RESULTS Based on the lack of significant randomized phase 3 trials, a patient-centered, multidisciplinary approach was strongly recommended for all decision-making regarding potential treatment. Integration of definitive local therapy was only relevant if technically feasible and clinically safe to all disease sites, defined as 5 or fewer distinct sites. Conditional recommendations were given for definitive local therapies in synchronous, metachronous, oligopersistent, and oligoprogressive conditions for extracranial disease. Radiation and surgery were the only primary definitive local therapy modalities recommended for use in the management of patients with oligometastatic disease, with indications provided for choosing one over the other. Sequencing recommendations were provided for systemic and local therapy integration. Finally, multiple recommendations were provided for the optimal technical use of hypofractionated radiation or stereotactic body radiation therapy as definitive local therapy, including dose and fractionation. CONCLUSIONS Presently, data regarding clinical benefits of local therapy on overall and other survival outcomes is still sparse for oligometastatic NSCLC. However, with rapidly evolving data being generated supporting local therapy in oligometastatic NSCLC, this guideline attempted to frame recommendations as a function of the quality of data available to make decisions in a multidisciplinary approach incorporating patient goals and tolerances.
L. Peyrin-Biroulet, J. Allegretti, S. Danese
et al.
Guselkumab (GUS) is a selective dual-acting IL-23p19 subunit inhibitor that potently blocks IL-23 and binds to CD64, a receptor on cells that produce IL-23. GUS demonstrated efficacy in patients (pts) with ulcerative colitis (UC) who received GUS intravenous (IV) induction and subcutaneous (SC) maintenance (QUASAR). We evaluated the efficacy and safety of GUS SC induction in ASTRO, a phase 3, randomised, double-blind, placebo (PBO)-controlled, parallel-group, multicenter trial in pts with moderately to severely active UC. Eligible pts had a history of inadequate response or intolerance to corticosteroids, immunosuppressants, biologics, Janus kinase inhibitors, and/or sphingosine 1-phosphate inhibitors (BIO/JAKi/S1Pi-IR) or were BIO/JAKi/S1Pi naïve. Randomisation was stratified by baseline (BL) BIO/JAKi/S1Pi status and Mayo endoscopic subscore (MES) with 418 pts allocated 1:1:1 to GUS 400 mg SC q4w (x3)→GUS 200 mg SC q4w (N=140), GUS 400 mg SC q4w (x3)→GUS 100 mg SC q8w (N=139), or PBO (N=139). The primary endpoint was clinical remission (Mayo stool frequency subscore 0/1 not increased from BL, rectal bleeding subscore 0, MES 0/1 with no friability) at week (W) 12. Multiplicity-controlled W12 secondary endpoints are clinical response, symptomatic remission, endoscopic improvement, and histo-endoscopic mucosal improvement (HEMI). The prespecified analysis plan compared the combined GUS 400 mg SC treatment group to PBO at W12, and safety was assessed throughout. BL characteristics were similar across treatment groups (overall mean age, 41.7 years; mean UC duration, 7.6 years; mean modified Mayo score, 6.7; MES=3, 56.0%; BIO/JAKi/S1Pi-IR, 40.2%). The primary endpoint and all secondary endpoints were met. At W12, significantly greater proportions of pts treated with GUS 400 mg SC induction than PBO achieved clinical remission (27.6% vs 6.5%, respectively; adj Δ: 21.1%; P<0.001), clinical response (65.6% vs 34.5%; adj Δ: 31.0%; P<0.001), symptomatic remission (51.3% vs 20.9%; adj Δ: 30.4%; P<0.001), endoscopic improvement (37.3% vs 12.9%; adj Δ: 24.3%; P<0.001), and HEMI (30.5% vs 10.8%; adj Δ: 19.6%; P<0.001). In prespecified analyses of subpopulations defined by prior BIO/JAKi/S1Pi history, greater proportions of GUS-treated versus PBO-treated pts achieved the endpoints (Figure). The proportions of GUS-treated pts with ≥1 adverse event (AE), serious AE, or AE leading to treatment discontinuation were not greater than PBO (Table). ASTRO established the efficacy of GUS SC induction in UC, with no new safety concerns identified. These results build on the QUASAR IV induction data, demonstrating that both GUS IV and SC induction are highly efficacious in pts with moderately to severely active UC.
PURPOSE The central nervous system World Health Organization (WHO) grade 4 adult-type diffuse glioma represents one of the most aggressive and challenging primary brain tumors. This guideline aims to provide evidence-based recommendations for the multidisciplinary management of these tumors, focusing on diagnosis, initial treatment, reirradiation, and health disparities, while acknowledging that present literature primarily represents historical histological grade 4 glioblastoma. METHODS The American Society for Radiation Oncology convened a task force to address 4 key questions focused on indications for radiation therapy (RT) and/or adjunctive therapies (eg, systemic therapy, alternating electric field therapy), appropriate regimens for external beam RT after initial biopsy/resection including variables such as pretreatment characteristics, target volumes, technique, dose, reirradiation indications and techniques, and health disparities. Recommendations are based on a systematic literature review and created using a predefined consensus-building methodology and system for grading evidence quality and recommendation strength. RESULTS Following maximum safe resection, molecular and pathologic diagnosis, and prognostic stratification of WHO grade 4 adult-type diffuse glioma, concurrent RT with temozolomide followed by adjuvant temozolomide is recommended for eligible patients and incorporation of alternating electric field therapy is conditionally recommended. In elderly patients, hypofractionated RT with concurrent and adjuvant temozolomide is conditionally recommended. In frail patients, supportive and palliative care is conditionally recommended following multidisciplinary, patient-centered discussion. Appropriate reirradiation techniques, with or without additional systemic therapies, can be considered and are conditionally recommended in patients following pathologic or advanced imaging confirmation of WHO grade 4 diffuse glioma recurrence. Health disparities exist in patients with WHO grade 4 adult-type diffuse glioma and attention is necessary to improve outcomes and increase clinical trial enrollment for underserved populations. CONCLUSIONS These evidence-based recommendations and current practice adoption patterns inform best clinical practices on the management of WHO grade 4 adult-type diffuse glioma. Future advancements in personalized medicine, biomarker discovery, and novel therapies are essential to improving outcomes. The integration of multidisciplinary care and participation in future clinical trials, especially in underserved populations, is crucial in addressing the poor outcomes among WHO grade 4 adult-type diffuse glioma.
In this work, we are presenting a new database of astrophysical interest, based on calculations performed with the nuclear reaction code TALYS. Four quantities are systematically calculated for over 8000 nuclides: cross sections, reaction rates, Maxwellian Averaged Cross Sections (or MACS) at 30 keV and partition functions. For cross sections and reaction rates, nine reactions are considered, induced by neutron, proton or alpha. The main complement of this database compared to existing ones is that the impact of reaction models ({\it e.g.} level density, gamma strength function, and optical model) is estimated by varying 9 different models, and by proposing calculated values for each of them, together with averages, standard deviations and other statistical quantities. This new database, called TENDL-astro, version 2023, is available online (https://tendl.web.psi.ch/tendl\_2023/astro/astro.html) and linked to the well-known TENDL database, used in a variety of applications.
We introduce ASTRO, the"Autoregressive Search-Taught Reasoner", a framework for training language models to reason like search algorithms, explicitly leveraging self-reflection, backtracking, and exploration in their outputs. Recently, training large language models (LLMs) via reinforcement learning (RL) has led to the advent of reasoning models with greatly enhanced reasoning capabilities. Open-source replications of reasoning models, while successful, build upon models that already exhibit strong reasoning capabilities along with search behavior observed even before RL. As a result, it is yet unclear how to boost the reasoning capabilities of other non-reasoner models including Llama 3. ASTRO teaches such models to internalize structured search behavior through a synthetic dataset derived from Monte Carlo Tree Search (MCTS) over mathematical problem-solving trajectories. By converting search traces into natural language chain-of-thoughts that capture both successes and recoveries from failure, ASTRO bootstraps models with a rich prior for exploration during RL. We finetune our models on these search-derived traces and further improve performance via RL with verifiable rewards. We apply ASTRO to the Llama 3 family of models and achieve absolute performance gains of 16.0% on MATH-500, 26.9% on AMC 2023, and 20.0% on AIME 2024, especially improving upon challenging problems that require iterative correction. Our results demonstrate that search-inspired training offers a principled way to instill robust reasoning capabilities into open LLMs.
PURPOSE This guideline provides evidence-based recommendations on the use of postmastectomy radiation therapy (PMRT) in the treatment of breast cancer. PMRT refers to the treatment of the chest wall and ipsilateral regional nodes, including at-risk axillary, supra/infraclavicular, and internal mammary nodes. Updated recommendations detail indications for PMRT in the upfront surgical setting and after neoadjuvant systemic therapy, and provide guidance on appropriate target volumes, dosing, and treatment techniques. METHODS The American Society for Radiation Oncology, American Society of Clinical Oncology, and the Society of Surgical Oncology convened a multidisciplinary task force to address 4 key questions focused on radiation therapy (RT) in patients with breast cancer who undergo mastectomy including (1) indications for PMRT after upfront surgery, (2) indications for PMRT after neoadjuvant systemic therapy followed by surgery, (3) appropriate PMRT treatment volumes and dose-fractionation regimens, and (4) treatment techniques. Recommendations were based on a systematic literature review and created using a predefined consensus-building methodology and system for quality of evidence grading and strength of recommendation. RESULTS After upfront mastectomy, PMRT is indicated for most patients with node-positive breast cancer and select patients with node-negative disease. PMRT is also recommended after neoadjuvant systemic therapy, both for patients presenting with locally advanced disease and for those with residual nodal disease at the time of surgery. PMRT is conditionally recommended for patients with cT1-3N1 or cT3N0 breast cancer with pathologically negative nodes after neoadjuvant systemic therapy (ypN0). When PMRT is delivered, treatment to the ipsilateral chest wall/reconstructed breast and regional lymphatics is recommended, with moderate hypofractionation preferred, but with conventional fractionation approaches acceptable in rare cases. Computed tomography-based volumetric treatment planning with 3-dimensional conformal RT is recommended, with intensity modulated RT advised when 3-dimensional conformal RT is unable to achieve treatment goals. Deep inspiration breath hold techniques are also recommended for normal tissue sparing. For patients with skin involvement, positive superficial margins, and/or lymphovascular invasion, the use of a bolus is recommended, but the routine use of tissue-equivalent bolus is not recommended. CONCLUSIONS These evidence-based recommendations guide clinical practice on the use of PMRT in patients with breast cancer.
Baptiste Cecconi, L. Debisschop, S'ebastien Derriere
et al.
The astronomy communities are widely recognised as mature communities for their open science practices. However, while their data ecosystems are rather advanced and permit efficient data interoperability, there are still gaps between these ecosystems. Semantic artefacts (SAs) -- e.g., ontologies, thesauri, vocabularies or metadata schemas -- are a means to bridge that gap as they allow to semantically described the data and map the underlying concepts. The increasing use of SAs in astronomy presents challenges in description, selection, evaluation, trust, and mappings. The landscape remains fragmented, with SAs scattered across various registries in diverse formats and structures -- not yet fully developed or encoded with rich semantic web standards like OWL or SKOS -- and often with overlapping scopes. Enhancing data semantic interoperability requires common platforms to catalog, align, and facilitate the sharing of FAIR (Findable, Accessible, Interoperable and Reusable) SAs. In the frame of the FAIR-IMPACT project, we prototyped a SA catalogue for astronomy, heliophysics and planetary sciences. This exercise resulted in improved vocabulary and ontology management in the communities, and is now paving the way for better interdisciplinary data discovery and reuse. This article presents current practices in our discipline, reviews candidate SAs for such a catalogue, presents driving use cases and the perspective of a real production service for the astronomy community based on the OntoPortal technology, that will be called OntoPortal-Astro.
Markus Ahlers, Ingo Allekotte, Jaime Alvarez-Muniz
et al.
After a successful kick-off meeting in 2021. two workshops in 2022 and 2023 on the future Global Cosmic-Ray Observatory (GCOS) focused mainly on a straw man design of the detector and science possibilities for astro- and particle physics. About 100 participants gathered for in-person and hybrid panel discussions. In this report, we summarize these discussions, present a preliminary straw-man design for GCOS and collect short write-ups of the flash talks given during the focus sessions.
Philipp Denzel, Yann Billeter, Frank-Peter Schilling
et al.
We present the first systematic study of multi-domain map-to-map translation in galaxy formation simulations, leveraging deep generative models to predict diverse galactic properties. Using high-resolution magneto-hydrodynamical simulation data, we compare conditional generative adversarial networks and diffusion models under unified preprocessing and evaluation, optimizing architectures and attention mechanisms for physical fidelity on galactic scales. Our approach jointly addresses seven astrophysical domains - including dark matter, gas, neutral hydrogen, stellar mass, temperature, and magnetic field strength - while introducing physics-aware evaluation metrics that quantify structural realism beyond standard computer vision measures. We demonstrate that translation difficulty correlates with physical coupling, achieving near-perfect fidelity for mappings from gas to dark matter and mappings involving astro-chemical components such as total gas to HI content, while identifying fundamental challenges in weakly constrained tasks such as gas to stellar mass mappings. Our results establish GAN-based models as competitive counterparts to state-of-the-art diffusion approaches at a fraction of the computational cost (in training and inference), paving the way for scalable, physics-aware generative frameworks for forward modelling and observational reconstruction in the SKA era.
Tomislav ŠPALDON, Jozef HANČUĽÁK, Oľga ŠESTINOVÁ
et al.
Sulphates occur in waters mainly as a simple anion (SO) 4 2- . In waters with high sulphate concentration also ion associate anions with some cation occurrence is possible. Together with bicarbonates and chlorides they form a major part of anions in natural waters. In common groundwaters and surface waters sulphate content ranges in tens to hundreds of milligrams/liter. Particularly rich in sul - phates are some mineral waters. The article describes options of desulphurisation of real mine water. After the stage of aluminium compound using in previous rese - arch we examined using of barium compounds, namely BaCO 3 and Ba(OH) 2 . After application of these compounds on an artificial model solution we focused on the real mine water from a flooded mine Smolník. The tests were conducted at various values pH, at 12, 8, 4.5 with pre-treated real water and at pH 3.9 with untreated real water. From the results it can be concluded that there was high efficiency of desulphurisation at all levels of pH. In terms of the selection of a particular compound barium hydroxide Ba(OH) 2 was confirmed as the best.
PURPOSE With the results of several recently published clinical trials, this guideline focused update provides evidence-based recommendations for the indications and dose-fractionation regimens for neoadjuvant radiation therapy (RT), optimal sequencing of RT and systemic therapy in the context of total neoadjuvant therapy (TNT), and considerations for selective omission of RT and surgery for rectal cancer. METHODS The American Society for Radiation Oncology convened a multidisciplinary task force to update 3 key questions that focused on the role of RT for patients with operable rectal cancer. The key questions addressed (1) indications for neoadjuvant RT, (2) selection of neoadjuvant regimens, and (3) indications for consideration of a nonoperative management (NOM) or local excision approach after definitive/preoperative chemoradiation. Recommendations were based on a systematic literature review and created using a predefined consensus-building methodology and system for quality of evidence grading and strength of recommendation. RESULTS For patients with stage II-III rectal cancer, neoadjuvant RT was strongly recommended; however, among patients deemed at lower risk of locoregional recurrence, consideration of omission of neoadjuvant RT was conditionally recommended in favor of neoadjuvant chemotherapy with a favorable treatment response or upfront surgery. For patients with T3-T4 and node positive rectal cancer undergoing neoadjuvant RT, a TNT approach was strongly recommended. Among patients with higher risk of locoregional recurrence, TNT with chemotherapy before or after long-course chemoradiation was strongly recommended, whereas TNT with short-course RT followed by chemotherapy was conditionally recommended. For patients with rectal cancer for whom NOM is a priority, concurrent chemoradiation followed by consolidation chemotherapy was strongly recommended. Selection of RT dose-fractionation regimen, sequencing of therapies, and consideration of NOM should be determined by multidisciplinary consensus, and based on disease extent, disease location, patient preferences, and quality of life considerations. CONCLUSIONS The task force has proposed recommendations to inform best clinical practices on the use of RT for rectal cancer with strong emphasis on multidisciplinary care. Future studies should focus on further addressing optimal treatment regimens to allow for more personalized recommendations based on individual risk stratification and patient priorities regarding quality of life.
C. Deville, Sophia C. Kamran, Scott C. Morgan
et al.
PURPOSE Our purpose was to develop a summary of recommendations regarding the management of patients with clinically localized prostate cancer based on the American Urologic Association/ ASTRO Guideline on Clinically Localized Prostate Cancer. METHODS The American Urologic Association and ASTRO convened a multidisciplinary, expert panel to develop recommendations based on a systematic literature review using an a priori defined consensus-building methodology. The topics covered were risk assessment, staging, risk-based management, principles of management including active surveillance, surgery, radiation, and follow-up after treatment. Presented are recommendations from the guideline most pertinent to radiation oncologists with an additional statement on health equity, diversity, and inclusion related to guideline panel composition and the topic of clinically localized prostate cancer. SUMMARY Staging, risk assessment, and management options in prostate cancer have advanced over the last decade and significantly affect shared decision-making for treatment management. Current advancements and controversies discussed to guide staging, risk assessment, and treatment recommendations include the use of advanced imaging and tumor genomic profiling. An essential active surveillance strategy includes prostate-specific antigen monitoring and periodic digital rectal examination with changes triggering magnetic resonance imaging and possible biopsy thereafter and histologic progression or greater tumor volume prompting consideration of definitive local treatment. The panel recommends against routine use of adjuvant radiation therapy (RT) for patients with prostate cancer after prostatectomy with negative nodes and an undetectable prostate-specific antigen, while acknowledging that patients at highest risk of recurrence were relatively poorly represented in the 3 largest randomized trials comparing adjuvant RT to early salvage and that a role may exist for adjuvant RT in selected patients at highest risk. RT for clinically localized prostate cancer has evolved rapidly, with new trial results, therapeutic combinations, and technological advances. The recommendation of moderately hypofractionated RT has not changed, and the updated guideline incorporates a conditional recommendation for the use of ultrahypofractionated treatment. Health disparities and inequities exist in the management of clinically localized prostate cancer across the continuum of care that can influence guideline concordance.
Purpose: The summary presented herein represents Part III of the three-part series dedicated to Clinically Localized Prostate Cancer: AUA/ASTRO Guideline, discussing principles of radiation and offering several future directions of further relevant study in patients diagnosed with clinically localized prostate cancer. Please refer to Parts I and II for discussion of risk assessment, staging, and risk-based management (Part I), and principles of active surveillance and surgery and follow-up (Part II). Materials and Methods: The systematic review utilized to inform this guideline was conducted by an independent methodological consultant. A research librarian conducted searches in Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. The methodology team supplemented searches of electronic databases with the studies included in the prior AUA review and by reviewing reference lists of relevant articles. Results: The Clinically Localized Prostate Cancer Panel created evidence- and consensus-based guideline statements to aid clinicians in the management of patients with clinically localized prostate cancer. Statements regarding management of patients using radiation therapy as well as important future directions of research are detailed herein. Conclusions: This guideline aims to inform clinicians treating patients with clinically localized prostate cancer. Continued research and publication of high-quality evidence from future trials will be essential to further improve care for these men.
Past scholars noted that one of the challenges is education in relation to tourism particularly the aspects of training and curriculum design. Existing literature has explored challenges of customer services education in tourism and suggest measures such as retraining and improving the curricula as a remedy to match the skills needed in the post pandemic for the hospitality and tourism industry. Conversely, there is less attention on other forms of tourism like astro-tourism. Hence, this paper’s aim is to expand literature on education in tourism with the main objective of exploring astro-tourism and education in tourism. Guided by the behaviorist learning theory, the specific objective is to explore the forms of astro-tourism and training programs from the perspective of Kenya and Tanzania. A systematic literature review supplemented by integrative literature review is deployed as a research methodology. A total of 16 papers from journals, conferences and newsflash deemed sufficient for descriptive statistics and literature analysis to avail findings. The findings indicate that although various forms of astro-tourism exist, these are not fully complemented with training programs. Very few public institutions or private enterprises offer astro-tourism programs like astro tour guide. The findings suggest that both higher education institutions and the private sector should continue promoting tourism education that includes training programs aligned with the growing trends in astro-tourism.
The ground-based technique for imaging atmospheric Cherenkov telescopes became a rapidly developing and powerful branch of science. Thanks to this technique, over 250 very high-energy gamma-ray sources of galactic and extragalactic origin have been discovered. Many fundamental questions of astrophysics, astro-particle physics, the physics of cosmic rays and cosmology are the focus of this technique. In the past 33 years since the discovery of the first gamma-ray source, the Crab Nebula, the discipline has made remarkable progress. Today, the technology boasts highly sensitive telescopes capable of detecting a point source 100 times fainter than the standard candle, the Crab Nebula, in 25 hours of observation. Further developments in this technology led to the Cherenkov Telescope Array (CTA), the next-generation large instrument. The sensitivity of CTA will be several times higher than that of the current best instruments. This article presents a brief history of ground-based very high energy gamma-ray astrophysics.