ImportanceEarly results at 3 years from the PRODIGE 24/Canadian Cancer Trials Group PA6 randomized clinical trial showed survival benefits with adjuvant treatment with modified FOLFIRINOX vs gemcitabine in patients with resected pancreatic ductal adenocarcinoma; mature data are now available.ObjectiveTo report 5-year outcomes and explore prognostic factors for overall survival.Design, Setting, and ParticipantsThis open-label, phase 3 randomized clinical trial was conducted at 77 hospitals in France and Canada and included patients aged 18 to 79 years with histologically confirmed pancreatic ductal adenocarcinoma who had undergone complete macroscopic (R0/R1) resection within 3 to 12 weeks before randomization. Patients were included from April 16, 2012, through October 3, 2016. The cutoff date for this analysis was June 28, 2021.InterventionsA total of 493 patients were randomized (1:1) to receive treatment with modified FOLFIRINOX (oxaliplatin, 85 mg/m2 of body surface area; irinotecan, 150-180 mg/m2; leucovorin, 400 mg/m2; and fluorouracil, 2400 mg/m2, every 2 weeks) or gemcitabine (1000 mg/m2, days 1, 8, and 15, every 4 weeks) as adjuvant therapy for 24 weeks.Main Outcomes and MeasuresPrimary end point was disease-free survival. Secondary end points included overall survival, metastasis-free survival, and cancer-specific survival. Prognostic factors for overall survival were determined.ResultsOf the 493 patients, 216 (43.8%) were women, and the mean (SD) age was 62.0 (8.9) years. At a median of 69.7 months’ follow-up, 367 disease-free survival events were observed. In patients receiving chemotherapy with modified FOLFIRINOX vs gemcitabine, median disease-free survival was 21.4 months (95% CI, 17.5-26.7) vs 12.8 months (95% CI, 11.6-15.2) (hazard ratio [HR], 0.66; 95% CI, 0.54-0.82; P < .001) and 5-year disease-free survival was 26.1% vs 19.0%; median overall survival was 53.5 months (95% CI, 43.5-58.4) vs 35.5 months (95% CI, 30.1-40.3) (HR, 0.68; 95% CI, 0.54-0.85; P = .001), and 5-year overall survival was 43.2% vs 31.4%; median metastasis-free survival was 29.4 months (95% CI, 21.4-40.1) vs 17.7 months (95% CI, 14.0-21.2) (HR, 0.64; 95% CI, 0.52-0.80; P < .001); and median cancer-specific survival was 54.7 months (95% CI, 45.8-68.4) vs 36.3 months (95% CI, 30.5–43.9) (HR, 0.65; 95% CI, 0.51-0.82; P < .001). Multivariable analysis identified modified FOLFIRINOX, age, tumor grade, tumor staging, and larger-volume center as significant favorable prognostic factors for overall survival. Shorter relapse delay was an adverse prognostic factor.Conclusions and RelevanceThe final 5-year results from the PRODIGE 24/Canadian Cancer Trials Group PA6 randomized clinical trial indicate that adjuvant treatment with modified FOLFIRINOX yields significantly longer survival than gemcitabine in patients with resected pancreatic ductal adenocarcinoma.Trial RegistrationEudraCT: 2011-002026-52; ClinicalTrials.gov Identifier: NCT01526135

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Energy efficiency measures in buildings are essential for climate protection, but are not always recognized by the investor in common profitability calculations. To provide a quantitative scientific base for policymakers, the aim is to identify and quantify the impact of these measures on Germanyâs economy with a static open input-output model. Moreover, this investigation analyses how much the chosen base year affects the calculated macroeconomic impact, to obtain a clearer view of involved dynamics. The energy efficiency measures in buildings and their impact on energy demand and investments were simulated in the bottom-up building model INVERT/EE-Lab up to 2020. The methodological addition of this research is to identify and map the resulting impulses to the according macroeconomic sectors. Based on this stimulus a static input-output analysis is conducted using a range of base years

Global industrial metal markets have experienced a drastic price decline over the past years. In this paper we link the dynamics of raw material markets and commodity price fluctuations to a delayed adjustment of supply. Drawing on the classical cobweb theorem we show how the implementation of this theorem using system dynamics may yield a valuable explanation, not only for the recent price decline, but also for possible future price movements. Starting from a simple cobweb model of general industrial markets, we couple the price‐adjusting mechanics to the global copper market and demonstrate how a simple market model can be merged with a physical material flow model. This model captures both market dynamics and technical aspects of raw material processing, recycling and substitution and adds an explanation for the widely accepted fact that the cost structure of the copper industry cannot explain current price levels. Finally, we compare the system dynamics forecasting model with a traditional econometric forecasting method and found the system dynamics model to be more intuitive and better suited to capture and convey the structural market fundamentals. Copyright © 2017 System Dynamics Society

The X-ray baffle is an important part of the eROSITA mirror assembly as it reduces the stray light caused by single reflections at the Wolter 1 Mirrors by more than 90%. The stray light problem and possible solutions were analyzed by ray-tracing resulting in a trade-off between effective stray light protection and avoidance of vignetting. Possible design alternatives were considered and the influences of manufacturing tolerances were studied. Other than for XMM, the eROSITA X-ray baffle could not be realized as sieve plates; instead a system of co-aligned "baffle rings" was mounted onto each of the mirror modules. The mechanical design is based on concentric Invar foils fixed by an own spider. The complete X-ray baffles were finally mounted to the mirror module while the alignment was controlled by optical means.

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