bluuebunny/crossref_metadata_2025_split huggingface dataset:
Robust treatment planning with conditional value at risk chance constraints in intensity‐modulated proton therapy
Authors: An Yu , Liang Jianming , Schild Steven E. , Bues Martin , Liu Wei 
Published: January 2017

Background and purposeIntensity‐modulated proton therapy (IMPT) is highly sensitive to range uncertainties and uncertainties caused by setup variation. The conventional inverse treatment planning of IMPT based on the planning target volume (PTV) is not often sufficient to ensure robustness of treatment plans. We applied a probabilistic framework (chance‐constrained optimization) in IMPT planning to hedge against the influence of uncertainties.Material and methodsWe retrospectively selected one patient with lung cancer, one patient with head and neck (H&N) cancer, and one with prostate cancer for this analysis. Using their original images and prescriptions, we created new IMPT plans using two methods: (1) a robust chance‐constrained treatment planning method with the clinical target volume (CTV) as the target; (2) the margin‐based method with PTV as the target, which was solved by commercial software, CPLEX, using linear programming. For the first method, we reformulated the model into a tractable mixed‐integer programming problem and sped up the calculation using Benders decomposition. The dose‐volume histograms (DVHs) from the nominal and perturbed dose distributions were used to assess and compare plan quality. DVHs for all uncertain scenarios along with the nominal DVH were plotted. The width of the “bands” of DVHs was used to quantify the plan sensitivity to uncertainty. The newly developed Benders decomposition method was compared with a commercial solution to demonstrate its computational efficiency. The trade‐off between nominal plan quality and plan robustness was investigated.ResultsOur chance‐constrained model outperformed the PTV method in terms of tumor coverage, tumor dose homogeneity, and plan robustness. Our model was shown to produce IMPT plans to meet the dose‐volume constraints of organs at risk (OARs) and had better sparing of OARs than the PTV method in the three clinical cases included in this study. The chance‐constrained model provided a flexible tool for users to balance between plan robustness and plan quality. In addition, our in‐house developed method was found to be much faster than the commercial solution.ConclusionWith explicit control of plan robustness, the chance‐constrained robust optimization model generated superior IMPT plans compared to the PTV‐based method.
Overlap‐guided fixed‐patient support positioning optimization for cranial SRT
Authors: MacDonald R. Lee , Robar James L. , Thomas Christopher G. 
Published: January 2017

PurposeTo investigate potential dosimetric improvements through the optimization of fixed‐couch rotational position in cranial cancer stereotactic treatments.MethodsUsing previously delivered cranial stereotactic radiotherapy plans treated at the Nova Scotia Health Authority (NSHA), we have redesigned the treatment arrangement to find the optimal couch rotation positions based on the reduction of overlap between organs‐at‐risk of exposure (OARs) and target volume (PTV). Maintaining the gantry arrangements from the delivered treatment, the couch positions were determined based on a cost function analysis of accumulation of overlap score from an equation developed by Yang et al. and refined by MacDonald et al. The algorithm incorporates factors for radiation dose sensitivities of each OAR, depth of both OARs and target (PTV) volumes, and orthogonality of the 3D vector between OAR and PTV in the case of proximal OAR position.ResultsThe plan evaluation was conducted on 16 acoustic neuroma patients treated with stereotactic radiotherapy plans at the NSHA. Maximum and mean doses to the OARs were reduced by approximately 14.30% ± 2.86% and 19.25% ± 2.10%, respectively, with application of this optimization technique as compared to the delivered treatment plans. In addition, PTV conformity and homogeneity were improved with application of this optimization technique.ConclusionThis variation of the existing delivery techniques with guidance from a PTV‐OAR overlap cost function analysis technique can yield significant dosimetric improvements with no increase to delivery or planning time.
Computer‐aided detection of retained surgical needles from postoperative radiographs
Authors: Sengupta Aunnasha , Hadjiiski Lubomir , Chan Heang‐Ping , Cha Kenny , Chronis Nikolaos , Marentis Theodore C. 
Published: January 2017

PurposeForeign objects, such as surgical sponges, needles, sutures, and other surgical instruments, retained in the patient's body can have dire consequences in terms of patient mortality as well as legal and financial penalties. We propose computer‐aided detection (CAD) on postoperative radiographs as a potential solution to reduce the chance of retained foreign objects (RFOs) after surgery, thus alleviating one of the major concerns for patient safety in the operation room. A CAD system can function as a second pair of eyes or a prescreener for the surgeon and radiologist, depending on the CAD system design and the workflow. In this work, we focus on the detection of surgical needles on postoperative radiographs. As needles are frequently observed RFOs, a CAD system that can offer high sensitivity and specificity toward detecting surgical needles will be useful.MethodsOur CAD system incorporates techniques such as image segmentation, image enhancement, feature analysis, and curve fitting to detect surgical needles on radiographs. A dataset consisting of 108 cadaver images with a total of 116 needles and 100 cadaver “normal” images without needles was acquired with a portable digital x‐ray system. A reference standard was obtained by marking the needle locations using an in‐house developed graphical user interface. The 108 cadaver images with the needles were partitioned into a training set containing 53 cadaver images with 59 needles and a test set containing 55 cadaver images with 57 needles. All of the 100 cadaver normal images were reserved as a part of the test set and used to estimate the false‐positive detection rate. Two operating points were chosen from the CAD system such that it can be operated in two modes, one with higher specificity (mode I) and the other with higher sensitivity (mode II).ResultsFor the training set, the CAD system with the rule‐based classifier achieved a sensitivity of 74.6% with 0.15 false positives per image (FPs/image) in mode I and a sensitivity of 89.8% with 0.36 FPs/image in mode II. For the test set, the CAD system achieved a sensitivity of 77.2% with 0.26 FPs/image in mode I and a sensitivity of 84.2% with 0.6 FPs/image in mode II. For comparison, the CAD system with the neural network classifier achieved a sensitivity of 74.6% with 0.08 FPs/image in mode I and a sensitivity of 88.1% with 0.28 FPs/image in mode II for the training set, and a sensitivity of 75.4% with 0.23 FPs/image in mode I and a sensitivity of 86.0% with 0.57 FPs/image in mode II for the test set.ConclusionA novel CAD system has been developed for automated detection of needles inadvertently left behind in a patient's body from postsurgery radiographs. The pilot system offers reasonable performance in both the high sensitivity and high specificity modes. This preliminary study shows the promise of CAD as a low‐cost and efficient aid for reducing retained surgical needles in patients.
Vitamin D levels are associated with gross motor function in amyotrophic lateral sclerosis
Authors: Paganoni Sabrina , Macklin Eric A. , Karam Chafic , Yu Hong , Gonterman Fernando , Fetterman K. Ashley , Cudkowicz Merit , Berry James , Wills Anne‐Marie 
Published: January 2017

ABSTRACTIntroductionThe objective of this study was to determine whether serum vitamin D [25(OH)D] levels are associated with disease progression in amyotrophic lateral sclerosis (ALS).Methods25(OH)D was measured in subjects enrolled in a multicenter study for validation of ALS biomarkers. Baseline 25(OH)D levels were correlated with baseline ALSFRS‐R scores. Average 25(OH)D levels from baseline and month 6 visits (seasonally asynchronous) were used to predict subsequent rate of change in ALSFRS‐R from month 6 to month 18.ResultsMost subjects had either insufficient or deficient 25(OH)D levels. Lower 25(OH)D was associated with lower ALSFRS‐R gross motor scores, but not lower ALSFRS‐R total scores at baseline. Levels of 25(OH)D were not predictive of disease progression over the next 12 months.Conclusion25(OH)D was associated with baseline gross motor ALSFRS‐R scores but did not predict the rate of disease progression. Vitamin D levels may reflect poor mobility in patients with ALS. Muscle Nerve, 2017 Muscle Nerve 56: 726–731, 2017
The electrodiagnostic natural history of parsonage–turner syndrome
Authors: Feinberg Joseph H. , Nguyen Elizabeth T. , Boachie‐Adjei Kwadwo , Gribbin Caitlin , Lee Steve K. , Daluiski Aaron , Wolfe Scott W. 
Published: January 2017

ABSTRACTIntroductionRecovery from Parsonage–Turner syndrome (PTS) is generally favorable, although recovery times have been shown to vary, in part because there are no universally accepted outcome measures. In this study, we describe the electrodiagnostic natural history of this condition based on objective electrodiagnostic testing, and propose that complete electrodiagnostic recovery can be seen as early as 1 year.MethodsTwenty‐six subjects with 29 affected nerves confirmed as PTS were followed every 3 months for electrodiagnostic testing, or until full reinnervation was confirmed.ResultsTwenty‐three cases (79.3%) demonstrated electrodiagnostic evidence of initial recovery at a mean of 5.8 months. Nine cases (31%) showed complete electrodiagnostic recovery at a mean of 1 year. When excluding cases with <1 year of follow‐up, 52.9% achieved complete electrodiagnostic recovery.ConclusionsIn contrast to previous reports, full electrodiagnostic recovery of PTS was demonstrated at a mean of 1 year in > 50% of patients with longer term follow‐up. Muscle Nerve 56: 737–743, 2017
Structural shape and topology optimization of cast parts using level set method
Authors: Wang Yaguang , Kang Zhan 
Published: January 2017

SummaryThis paper presents a level set‐based shape and topology optimization method for conceptual design of cast parts. In order to be successfully manufactured by the casting process, the geometry of cast parts should satisfy certain moldability conditions, which poses additional constraints in the shape and topology optimization of cast parts. Instead of using the originally point‐wise constraint statement, we propose a casting constraint in the form of domain integration over a narrowband near the material boundaries. This constraint is expressed in terms of the gradient of the level set function defining the structural shape and topology. Its explicit and analytical form facilitates the sensitivity analysis and numerical implementation. As compared with the standard implementation of the level set method based on the steepest descent algorithm, the proposed method uses velocity field design variables and combines the level set method with the gradient‐based mathematical programming algorithm on the basis of the derived sensitivity scheme of the objective function and the constraints. This approach is able to simultaneously account for the casting constraint and the conventional material volume constraint in a convenient way. In this method, the optimization process can be started from an arbitrary initial design, without the need for an initial design satisfying the cast constraint. Numerical examples in both 2D and 3D design domain are given to demonstrate the validity and effectiveness of the proposed method. Copyright © 2017 John Wiley & Sons, Ltd.
Antiepileptic drugs and risk of suicide attempts: a case–control study exploring the impact of underlying medical conditions
Authors: Grimaldi‐Bensouda Lamiae , Nordon Clementine , Rossignol Michel , Jardon Vincent , Boss Virginie , Warembourg Frédérique , Reynolds Robert , Kurz Xavier , Rouillon Frédéric , Abenhaim Lucien ,   for the PROTECT‐WP6 study group
Published: January 2017

AbstractPurposeRandomized‐controlled trials and claims databases suggest that antiepileptic drug (AED) use may increase the risk of suicide attempts (SA). The present case–control study explores the impact of underlying indications on this potential association.MethodsPhysicians collected the medical history; prior 12‐month drug use was obtained from standardized telephone interviews with patients. The association between AED use and SA was explored using multivariate conditional logistic regression. The analyses were replicated after stratification on depression and neurological disorders (epilepsy, migraine, and chronic neuropathic pain).ResultsBetween 2008 and 2012, 506 adults with an incident SA were recruited in suicide treatment centers from across France and socio‐demographically matched to 2829 controls from primary care settings. The association between AED use and odds of SA was not significant overall (odds ratio [OR], 1.5; 95% confidence interval [CI], 0.9–2.4). No association was observed for patients with neurological disorders (OR, 1.1; 95%CI, 0.5–2.4) as opposed to patients with depression (OR, 1.6; 95%CI, 1.0–2.5), but unmeasured confounding was suspected.ConclusionsOur results suggest that the association observed between AED use and increased odds of non‐fatal SA in patients with either a lifetime history of depression or no neurological disorder may be explained by the presence of an underlying psychiatric disorder. Accounting for underlying indications is crucial in drug safety studies, as these can cause a reported association (or lack thereof) to be misleading. This may require the prospective collection of medical data at a patient level. Copyright © 2017 John Wiley & Sons, Ltd.
Quantitative proteomics reveals EVA1A‐related proteins involved in neuronal differentiation
Authors: Zhong Lijun , Zhou Juntuo , Chen Xi , Liu Jiao , Liu Zhen , Chen Yingyu , Bai Yun 
Published: January 2017

EVA1A is an autophagy‐related protein, which plays an important role in embryonic neurogenesis. In this study, we found that loss of EVA1A could decrease neural differentiation in the brain of adult Eva1a−/− mice. To determine the mechanism underlying this phenotype, we performed label‐free quantitative proteomics and bioinformatics analysis using the brains of Eva1a−/− and wild‐type mice. We identified 11 proteins that were up‐regulated and 17 that were down‐regulated in the brains of the knockout mice compared to the wild‐type counterparts. Bioinformatics analysis indicated that biological processes, including ATP synthesis, oxidative phosphorylation, and the TCA cycle, are involved in the EVA1A regulatory network. In addition, gene set enrichment analysis showed that neurodegenerative diseases, such as Alzheimer's disease and Huntington's disease, were strongly associated with Eva1a knockout. Western blot experiments showed changes in the expression of nicotinamide nucleotide transhydrogenase, an important mitochondrial enzyme involved in the TCA cycle, in the brains of Eva1a knockout mice. Our study provides valuable information on the molecular functions and regulatory network of the Eva1a gene, as well as new perspectives on the relationship between autography‐related proteins and neural differentiation.
Network meta‐analysis of probiotics to prevent respiratory infections in children and adolescents
Authors: Amaral Marina Azambuja , Guedes Gabriela Helena Barbosa Ferreira , Epifanio Matias , Wagner Mario Bernardes , Jones Marcus Herbert , Mattiello Rita 
Published: January 2017

SummaryProbiotics have emerged as a promising intervention for the prevention of respiratory tract infections (RTIs) in children. Assess the effect of probiotics on prevention of RTIs in children and adolescents. MEDLINE, EMBASE, LILACS, SCIELO, CINAHL, SCOPUS, and Web of Science. Key words: “respiratory tract infections” AND probiotics. Randomized controlled trials RCT assessing the effect of probiotics on RTIs in children and adolescents were included. Two reviewers, working independently, to identify studies that met the eligibility criteria. Main and secondary outcomes were RTIs and adverse effects, respectively. Twenty‐one trials with 6.603 participants were included. Pairwise meta‐analysis suggested that Lactobacillus casei rhamnosus (LCA) was the only effective probiotic to the rate of RTIs compared to placebo (RR0.38; Crl 0.19–0.45). Network analysis showed that the LCA exhibited 54.7% probability of being classified in first, while the probability of Lactobacillus fermentum CECT5716 (LFC) being last in the ranking was 15.3%. LCA showed no better effect compared to other probiotic strains by indirect analysis. This systematic review found a lack of evidence to support the effect of probiotic on the incidence rate of respiratory infections in children and adolescents. Pediatr Pulmonol. 2017;52:833–843. © 2017 Wiley Periodicals, Inc.
Pilot study of dornase alfa (Pulmozyme) therapy for acquired ventilator‐associated infection in preterm infants
Authors: Scala Melissa , Hoy Deborah , Bautista Maria , Palafoutas Judith Jones , Abubakar Kabir 
Published: January 2017

SumaryObjectiveEvaluate the feasibility, safety, and efficacy of adjunctive treatment with dornase alfa in preterm patients with ventilator‐associated pulmonary infection (VAPI) compared to standard care.Working HypothesisWe hypothesize that therapy with dornase alfa will be safe and well tolerated in the preterm population with no worsening of symptoms, oxygen requirement, or need for respiratory support.Study DesignProspective, randomized, blinded, pilot study comparing adjunctive treatment with dornase alfa to sham therapy. In addition to standard care, infants were randomized to receive dornase alfa 2.5 mg nebulized via endotracheal tube (ETT) every 12 hr for 7 days or sham therapy. ETT secretion gram stain and culture and chest X‐ray (CXR) findings were evaluated. Respiratory support data were downloaded from the ventilator.ResultsFourteen infants developed VAPI between 2012 and 2014; 11 enrolled in the study. Six received dornase alfa and five received sham therapy. Average gestational age at birth was 25 weeks and age at study entry was 31 days. There were no differences in demographics, ETT white blood cell count (WBC), CXR, or mean airway pressure (MAP) between the two groups. There was a trend towards decreased oxygen requirement (FiO2) in the treatment group that did not reach statistical significance. No side effects were observed in the treatment group.ConclusionTreatment with dornase alfa is safe and treated infants had some improvement in FiO2 requirement but no improvement in MAP. A larger randomized trial is needed to evaluate the efficacy of this therapy. Pediatr Pulmonol. 2017; 52:787–791. © 2017 Wiley Periodicals, Inc.
Assessment of Physico‐Thermal Properties, Combustion Performance, and Ignition Delay Time of Dimethyl Amino Ethanol as a Novel Liquid Fuel
Authors: Pakdehi Shahram G. , Keshavarz Mohammad Hossein , Akbari Maryam , Ghorbani Mostafa 
Published: January 2017

AbstractDimethyl amino ethanol (DMAE) contains both hydroxyl and amino functional groups, which may be introduced as a new liquid fuel with high safety and less toxicity with respect to common high performance liquid fuels. Physico‐thermal properties, combustion performance and ignition delay time of DMAE are compared with the usual high performance liquid fuels as well as ethanol and dimethylamine. Combustion performances of DMAE (specific impulse at sea level) with common liquid oxidizers including white fuming nitric acid (WFNA), inhibited red fuming nitric acid (IRFNA), nitrogen tetroxide (N2O4), hydrogen peroxide (H2O2), liquid oxygen (LOX), and the mixed oxides of nitrogen (MON) are also evaluated. Maximum and minimum specific impulses of DMAE are obtained with LOX (299.6 s) and WFNA (262.4 s), respectively. Maximum density‐specific impulse is obtained with DMAE‐N2O4 bipropellant. The ignition delay time of DMAE with several liquid oxidizers are measured with open cup test method. DMAE‐WFNA and DMAE‐IRFNA bipropellants are hypergolic where their ignition delay times are 26 and 42 milliseconds, respectively.
Evaluation of 4‐(Dimethylsilyl) Butyl Ferrocene Grafted HTPB as a Burning Rate Modifier in Composite Propellant Formulation using Bicurative System
Authors: Kurva Ramesh , Gupta Garima , Dhabbe Kashinath I. , Jawale Lalita S. , Kulkarni Prasanth S. , Maurya Mehilal 
Published: January 2017

AbstractHigh burning rate composite propellants are achieved by incorporation of fine particles of oxidizer, transition metal oxides, and liquid ballistic modifiers. However, they pose processing problems, inertness to the composition and migration related issues. To overcome such problems, an attempt was made to incorporate ferrocenyl grafted HTPB as a burning rate modifier by partly replacing HTPB from 10 % to 50 % using TDI/ IPDI bicurative system and to study their processability in terms of viscosity, mechanical, thermal, sensitivity, and ballistic properties. The data on viscosity reveal that there is a marginal enhancement in end of mix viscosity as percentage of ferrocenyl grafted HTPB increases. The mechanical data reveal that tensile strength and elastic modulus increases, whereas percentage elongation decreases compared to base composition. The results on thermal properties infer that, as the percentage of ferrocenyl grafted HTPB increases, onset decomposition temperature decreases. The impact and friction sensitivity data also envisage that sensitivity increases in comparison to base composition. The data on ballistic properties revealed that there is ca. 53 % increase in burning rate, while decrease in “n” value from 0.39 to 0.2 was obtained compared to base composition.
Examining the validity and sensitivity to change of the 5 and 10 sit‐to‐stand tests in people with multiple sclerosis
Authors: Nilsagård Ylva , Andreasson Malin , Carling Anna , Vesterlin Helena 
Published: January 2017

AbstractBackground and PurposeSit‐to‐stand transfers are frequently performed, and transfers have been associated with fall risk among people with multiple sclerosis (PwMS). There is limited research regarding the validity of sit‐to‐stand tests (STSs) in PwMS. The purpose of this study was to investigate the concurrent, divergent, and discriminant validity and sensitivity to change of the 5 and 10 STSs.MethodsA repeated‐measurement design was used, with data collected before and directly after a 7‐week intervention, as well as prospectively reported near‐fall incidents and falls during a 14‐week period. One hundred two PwMS with a limited (≤200 m) but retained (≥20 m) walking ability were identified by physiotherapists at outpatient rehabilitation centres in 5 Swedish County Council areas and invited to participate in an intervention study. Of the 52 participants agreeing to participate and fulfilling the inclusion criteria, 47 managed the tests at baseline, and 39 of these returned complete fall diaries. The main outcomes were the Berg Balance Scale (BBS), Timed Up and Go test (TUG), 10‐m walk test, 2‐min walk test, Fatigue Scale for Motor and Cognitive Function, falls, near‐fall incidents, and use of walking aids.ResultsCorrelations in the total sample were above .60 between the STSs and BBS, TUG, 10‐m walk test, and 2‐min walk test and above .50 between the STSs and total number of falls. Both tests discriminated between those who did and did not use walking aids for the TUG, but not between fallers and nonfallers. There were no significant correlations between the STSs and number of falls or near‐fall incidents. The STSs did not differentiate between participants with changed and unchanged results on the BBS.DiscussionThe 5 and 10 STSs are valid in PwMS with an Expanded Disability Status Scale score ≤6.0 but do not identify fallers and have limited ability to detect change. Copyright © 2017 John Wiley & Sons, Ltd.