bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total Marrow Irradiation with Helical Tomotherapy for Bone Marrow Transplantation of Multiple Myeloma: First Experience in Asia
Authors: Shueng Pei-Wei , Lin Shih-Chiang , Chong Ngot-Swan , Lee Hsing-Yi , Tien Hui-Ju , Wu Le-Jung , Chen Chien-An , Lee Jason J. S. , Hsieh Chen-Hsi 
Published: October 2014

Three Asian patients with plasma cell myeloma stage IIIa with IgG predominant were selected for autologous hematopoietic cell transplantation (HSCT). Total marrow irradiation (TMI) tomotherapy planned with melphalan 140 mg/m2 as a preconditioning regimen of HSCT. Two image sets of computed tomography (CT) were scanned with 2.5 mm and 5 mm for the upper and lower part of the plan, respectively. The junction was determined and marked at 15 cm above knee on both thighs for upper and lower part of the plan. The clinical target volume (CTV) included the entire skeletal system. The planning target volume (PTV) was generated with with 0.8 cm for CTVextremities and with 0.5 cm margin for all other bones of CTV. A total dose of 800 cGy (200 cGy/fraction) was delivered to the PTV. Update to presentation, all of three patients post transplant without evidence of active disease were noted. During TMI treatment, one with grade 1 vomiting, two with grade 1 nausea, one with grade 1 mucositis, and three with grade 1 anorexia were noted. Toxicity of treatment was scored according to the Common Terminology Criteria for Adverse Events v3.0 (CTCAE v3.0). The average for upper part versus lower part of PTVBone marrow of CI and H-index were 1.5 and 1.4 versus 1.2 and 1.2, respectively. The dose reduction of TMI tomotherapy to various OARs of head, chest, and abdomen relative to TBI varied from 31% to 74%, 21% to 51%, and 46% to 63%, respectively. The maximum average value of registration for upper torso versus lower extremities in different translation directions were 5.1 mm versus 4.1 mm for pretreatment and 1.5 mm versus 0.7 mm for post-treatment, respectively. The average treatment time for the upper versus lower part in beam-on time, setup time, and MVCT registration time took roughly 49.9, 23.3, and 11.7 min versus 11.5, 10.0, and 7.3 min, respectively. The margin of PTV could be less than 1 cm under good fixation and close position confirmation with MVCT. Antiemetics should be prescribed in the whole course of TMI for emesis prevention. TMI technique replaced TBI technique with 8 Gy as conditioning regiment for multiple myeloma could be acceptable for the Asian and the outcomes were feasible for the Asian.
The Use of Intraoperative MRI for the Treatment of Glioblastoma Multiforme
Authors: Lenaburg Harry J. , Inkabi Kofi E. , Vitaz Todd W. 
Published: October 2014

Outcome for patients with glioblastoma multiforme (GBM) is improved with aggressive surgical resection followed by standard chemotherapy and radiation therapy. Intraoperative MRI (iMRI) is a recent surgical advancement that gives neurosurgeons direct radiographic feedback throughout a surgical procedure and thus enables maximal surgical resection of such lesions. We reviewed our series of 35 cases in 29 patients who underwent surgical resections of their GBM's using iMRI. The average extent of resection was 94% with only three patients having resections of less than 90%. However, even with such technology complete resection may not always be possible because of tumor location near critical brain structure or involvement of surrounding vascular structures. The addition of iMRI to the surgical armamentarium for treatment of patients with GBM improves the degree of tumor resection while minimizing complications and thus may positively impact survival in this patient population.
Megavoltage CT in Helical Tomotherapy — Clinical Advantages and Limitations of Special Physical Characteristics
Authors: Sterzing Florian , Kalz Jörn , Sroka-Perez Gabriele , Schubert Kai , Bischof Marc , Röder Falk , Debus Jürgen , Herfarth Klaus 
Published: October 2014

Helical tomotherapy is a form of image-guided intensity-modulated radiotherapy that introduces the ring gantry concept into radiation oncology. The system is a combination of a therapeutic linear accelerator and a megavoltage CT-scanner. This work describes the clinical experience with megavoltage CT with 456 patients in more than 11000 fractions. It also provides a review of the current literature of the possibilities and limitations of megavoltage CT. Between July 2006 and October 2008 456 patients were treated with helical tomotherapy and a pretreatment megavoltage CT was performed in 98.1% of the 11821 fractions to perform position control and correction. CT image acquisition was done with 3.5 MV x-rays in the helical tomotherapy machine. MVCT was used for dose recalculations to quantify doses distributions in cases of changing geometry, tumor shrinkage or presence of metal implants. Inverse treatment planning for prostate cancer patients with bilateral hip replacements was performed based upon an MVCT. A mean 3D-correction vector of 7.1mm with a considerable variation was detected and immediately corrected. Mean shifts were lateral 0.9mm (sd 5.0mm), mean longitudinal shift 1.0mm (sd 5.1mm) and mean vertical shift 3.2mm (sd 5.2mm). The MVCT enables imaging of anatomical structures in the presence of dental metal or orthopedic implants. Especially in these cases, dose recomputations can increase the precision of dose calculations. Due to a mean 3d correction vector of more than 7mm and a variation of corrections of more than 5mm daily image-guidance is recommended to achieve a precise dose application. The MVCT shows evident advantages in cases with metal implants but has limitations due to a reduced soft tissue contrast. Compared with megavoltage cone-beam-CT the tomotherapy fan beam CT adds less extra dose fore the patient and has a better soft tissue contrast.
Toolkit for Determination of Dose-response Relations, Validation of Radiobiological Parameters and Treatment Plan Optimization Based on Radiobiological Measures
Authors: Mavroidis Panayiotis , Tzikas Athanasios , Papanikolaou Nikos , Lind Bengt K. 
Published: October 2014

Accurately determined dose-response relations of the different tumors and normal tissues should be estimated and used in the clinic. The aim of this study is to demonstrate developed tools that are necessary for determining the dose-response parameters of tumors and normal tissues, for clinically verifying already published parameter sets using local patient materials and for making use of all this information in the optimization and comparison of different treatment plans and radiation techniques. One of the software modules (the Parameter Determination Module) is designed to determine the dose-response parameters of tumors and normal tissues. This is accomplished by performing a maximum likelihood fitting to calculate the best estimates and confidence intervals of the parameters used by different radiobiological models. Another module of this software (the Parameter Validation Module) concerns the validation and compatibility of external or reported dose-response parameters describing tumor control and normal tissue complications. This is accomplished by associating the expected response rates, which are calculated using different models and published parameter sets, with the clinical follow-up records of the local patient population. Finally, the last module of the software (the Radiobiological Plan Evaluation Module) is used for estimating and optimizing the effectiveness a treatment plan in terms of complication-free tumor control, P+. The use of the Parameter Determination Module is demonstrated by deriving the dose-response relation of proximal esophagus from head & neck cancer radiotherapy. The application of the Parameter Validation Module is illustrated by verifying the clinical compatibility of those dose-response parameters with the examined treatment methodologies. The Radiobiological Plan Evaluation Module is demonstrated by evaluating and optimizing the effectiveness of head & neck cancer treatment plans. The results of the radiobiological evaluation are compared against dosimetric criteria. The presented toolkit appears to be very convenient and efficient for clinical implementation of radiobiological modeling. It can also be used for the development of a clinical data and health information database for assisting the performance of epidemiological studies and the collaboration between different institutions within research and clinical frameworks.
Characterization of Human Anterosuperior Acetabular Depression in Correlation With Labral Tears
Authors: Kopydlowski Nathan J. , Tannenbaum Eric P. , Smith Matthew V. , Sekiya Jon K. 
Published: October 2014

Background: Labral tears often occur in the same quadrant of the acetabulum at a small depression previously referred to as the psoas valley. Understanding the anatomic variations of this depression could help us understand the etiology of labral tears. Purpose: To describe the location and dimensions of the depression located in the anterosuperior acetabular rim. The hypothesis was that the location of this depression would be consistent with the common location of acetabular labral tears described in the literature. Study Design: Controlled laboratory study. Methods: A total of 240 pelvic specimens were divided into 2 groups (n = 120 for each) according to age (younger age group: 21.36 ± 3.12 years [range, 14-24 years]; older age group: 42.30 ± 10.27 years, [range, 25-60 years]).Specimens were also categorized based on sex (mean age: 31.93 ± 12.31 years [male]; 32.08 ± 13.66 years [female]) and race (mean age: 31.45 ± 13.16 years [black]; 32.57 ± 12.82 years [white]). The depth and width of the acetabular depression were measured using a digital caliper, and the location was measured using a goniometer. Results: The psoas valley was observed in every specimen and was located in the anterosuperior quadrant of the acetabulum. Its depth was significantly greater ( P < .001) in males (5.35 ± 1.60 mm) than in females (3.95 ± 1.31 mm). The width of the psoas valley was also greater ( P < .001) in males (29.39 ± 3.98 mm) than in females (24.49 ± 4.80 mm). There were no differences in size or location of the depression between races or age groups. The psoas valley was located between 3.92 ± 0.42 o’clock anteriorly and 2.12 ± 0.77 o’clock posteriorly. Conclusion: The differences observed in the study data are believed to be a result of the different anatomic morphologies of the pelvis in males and females. This loss of bony support, caused by the depression, could be the underlying cause of weakening of the acetabular labrum as people age. Clinical Relevance: The loss of bony support in the anterosuperior acetabular depression could contribute to the labral tears that commonly occur in this area. Understanding the normal anatomy of this area could be important in determining the risk of labral tears as well as treatment options.
Interaction of platelet-derived autotaxin with tumor integrin αVβ3 controls metastasis of breast cancer cells to bone
Authors: Leblanc Raphael , Lee Sue-Chin , David Marion , Bordet Jean-Claude , Norman Derek D. , Patil Renukadevi , Miller Duane , Sahay Debashish , Ribeiro Johnny , Clézardin Philippe , Tigyi Gabor J. , Peyruchaud Olivier 
Published: October 2014

Key PointsATX stored in α-granules of resting platelets is secreted upon tumor cell-induced aggregation leading to prometastatic LPA production. Nontumoral ATX promotes early bone colonization by breast cancer cells and contributes to the progression of skeletal metastases.
The Benefits and Harms of Systemic Dehydroepiandrosterone (DHEA) in Postmenopausal Women With Normal Adrenal Function: A Systematic Review and Meta-analysis
Authors: Elraiyah Tarig , Sonbol Mohamad Bassam , Wang Zhen , Khairalseed Tagwa , Asi Noor , Undavalli Chaitanya , Nabhan Mohammad , Altayar Osama , Prokop Larry , Montori Victor M. , Murad Mohammad Hassan 
Published: October 2014

AbstractContext:Exogenous dehydroepiandrosterone (DHEA) therapy has been proposed to replenish the depletion of endogenous DHEA and its sulfate form, which occurs with advancing age and is thought to be associated with loss of libido and menopausal symptoms.Objective:We conducted a systematic review and meta-analysis to summarize the evidence supporting the use of systemic DHEA in postmenopausal women with normal adrenal function.Methods:We searched MEDLINE, EMBASE, PsycInfo, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through January 2014. Pairs of reviewers, working independently, selected studies and extracted data from eligible randomized controlled trials (RCTs). We used the random-effects model to pool across studies and evaluated heterogeneity using the I2 statistic.Results:We included 23 RCTs with moderate to high risk of bias enrolling 1188 women. DHEA use was not associated with significant improvement in libido or sexual function (standardized mean difference, 0.35; 95% confidence interval, −0.02 to 0.73; P value = .06; I2 = 62%). There was also no significant effect of DHEA on serious adverse effects, serum lipids, serum glucose, weight, body mass index, or bone mineral density. This evidence warranted low confidence in the results, mostly due to imprecision, risk of bias, and inconsistency across RCTs.Conclusions:Evidence warranting low confidence suggests that DHEA administration does not significantly impact sexual symptoms or selected metabolic markers in postmenopausal women with normal adrenal function.
The utility of Apc-mutant rats in modeling human colon cancer
Authors: Irving Amy A. , Yoshimi Kazuto , Hart Marcia L. , Parker Taybor , Clipson Linda , Ford Madeline R. , Kuramoto Takashi , Dove William F. , Amos-Landgraf James M. 
Published: October 2014

Abstract
Prior to the advent of genetic engineering in the mouse, the rat was the model of choice for investigating the etiology of cancer. Now, recent advances in the manipulation of the rat genome, combined with a growing recognition of the physiological differences between mice and rats, have reignited interest in the rat as a model of human cancer. Two recently developed rat models, the polyposis in the rat colon (Pirc) and Kyoto Apc Delta (KAD) strains, each carry mutations in the intestinal-cancer-associated adenomatous polyposis coli (Apc) gene. In contrast to mouse models carrying Apc mutations, in which cancers develop mainly in the small intestine rather than in the colon and there is no gender bias, these rat models exhibit colonic predisposition and gender-specific susceptibility, as seen in human colon cancer. The rat also provides other experimental resources as a model organism that are not provided by the mouse: the structure of its chromosomes facilitates the analysis of genomic events, the size of its colon permits longitudinal analysis of tumor growth, and the size of biological samples from the animal facilitates multiplexed molecular analyses of the tumor and its host. Thus, the underlying biology and experimental resources of these rat models provide important avenues for investigation. We anticipate that advances in disease modeling in the rat will synergize with resources that are being developed in the mouse to provide a deeper understanding of human colon cancer.
Localization of K+, H+, Na+ and Ca2+ fluxes to the excretory pore in Caenorhabditis elegans: application of scanning ion-selective microelectrodes
Authors: Adlimoghaddam Aida , Weihrauch Dirk , O'Donnell Michael J. 
Published: October 2014

Abstract
Although C. elegans is commonly used as a model organism for studies of cell biology, development and physiology, the small size of the worm has impeded measurements of ion transport by the excretory cell and hypodermis. In this paper we have used the scanning ion-selective microelectrode technique to measure efflux and influx of K+, H+, Na+ and Ca2+ in intact worms. Transport of ion into, or out of, immobilized worms produces small gradients in ion concentration in the unstirred layer near the worm’s surface. These gradients are readily detectable with ion-selective microelectrodes and the corresponding ion fluxes can be estimated using the Fick equation. Our data show that effluxes of K+, H+, Na+ and Ca2+ are localized to the region of the excretory pore, consistent with release of these ions from the excretory cell, and that effluxes increase after experimental preloading with Na+, K+ or Ca2+. In addition, the hypodermis is a site of Na+ influx.
A Multivariate Analysis of Genetic Constraints to Life History Evolution in a Wild Population of Red Deer
Authors: Walling Craig A , Morrissey Michael B , Foerster Katharina , Clutton-Brock Tim H , Pemberton Josephine M , Kruuk Loeske E B 
Published: October 2014

Abstract
Evolutionary theory predicts that genetic constraints should be widespread, but empirical support for their existence is surprisingly rare. Commonly applied univariate and bivariate approaches to detecting genetic constraints can underestimate their prevalence, with important aspects potentially tractable only within a multivariate framework. However, multivariate genetic analyses of data from natural populations are challenging because of modest sample sizes, incomplete pedigrees, and missing data. Here we present results from a study of a comprehensive set of life history traits (juvenile survival, age at first breeding, annual fecundity, and longevity) for both males and females in a wild, pedigreed, population of red deer (Cervus elaphus). We use factor analytic modeling of the genetic variance–covariance matrix (G) to reduce the dimensionality of the problem and take a multivariate approach to estimating genetic constraints. We consider a range of metrics designed to assess the effect of G on the deflection of a predicted response to selection away from the direction of fastest adaptation and on the evolvability of the traits. We found limited support for genetic constraint through genetic covariances between traits, both within sex and between sexes. We discuss these results with respect to other recent findings and to the problems of estimating these parameters for natural populations.
Comparison of personality traits, attitude toward orthodontic treatment, and pain perception and experience before and after orthodontic treatment
Authors: Abu Alhaija Elham S. , Abu Nabaa Mona A. , Al Maaitah Emad F. , Al-Omairi Mahmoud K. 
Published: October 2014

ABSTRACT

Objective:
To compare personality traits, attitude toward orthodontic treatment, and pain perception and experience before and after orthodontic treatment.

Materials and Methods:
One hundred subjects (50 male and 50 female) were included in this study. The mean (SD) age was 17.5 (2.05) years at T1 and 19.15 (2.32) years at T2. The instruments for data collection were questionnaires that included assessment of patients' personality traits, attitudes toward orthodontic treatment, and pain perception/experience. Subjects completed the questionnaires at two different times: before orthodontic treatment (T1) and after fixed orthodontic treatment (T2). Subjects were treated by fixed orthodontic appliances for an average (SD) period of 18.64 (0.35) months. Paired sample t-test and chi-square test were used to detect any differences.

Results:
Significant changes in personality traits were detected after orthodontic treatment irrespective of gender. Neuroticism, openness, agreeableness, and conscientiousness scores were improved (P &lt; .001). A positive attitude toward orthodontic treatment was reported at T1 (4.31 [±1.26]) and improved at T2 (3.98 [±1.16]) irrespective of gender (P &lt; .05). The average (SD) expected pain score (T1) was 4.73 (1.88) and the average (SD) experienced pain score (T2) was 4.63 (1.58). Significant difference in the expected and experienced pain scores was not detected (P  =  .11).

Conclusions:
Personality traits and attitude toward orthodontic treatment improved after orthodontic treatment. Reported actual pain experience during orthodontic treatment was similar to that expected before treatment.
Habitual Physical Activity of Independently Ambulant Children and Adolescents With Cerebral Palsy: Are They Doing Enough?
Authors: Mitchell Louise E. , Ziviani Jenny , Boyd Roslyn N. 
Published: October 2014

Background
Despite the health benefits of regular physical activity, children with cerebral palsy (CP) are thought to participate in reduced levels of physical activity.

Objective
The study objective was to assess physical activity and determine the proportion adhering to the recommended 60 minutes of moderate-to-vigorous physical activity (MVPA) daily in independently ambulant children and adolescents with unilateral CP.

Design
This was a cross-sectional study.

Method
Children (N=102; 52 boys, 50 girls; mean age=11 years 3 months, SD=2 years 4 months) with spastic hemiplegia classified at Gross Motor Function Classification System (GMFCS) levels I (n=44) and II (n=58) recorded physical activity over 4 days using an accelerometer. Activity counts were converted to daily and hourly time spent inactive and in light physical activity or MVPA using uniaxial cutpoints (inactive: ≤100 vertical counts·min−1, light: 101 to 2,295 vertical counts·min−1, MVPA: ≥2,296 vertical counts·min−1) and recorded step counts. Differences between groups were examined using t tests.

Results
Of a potential 396 days, 341 days (86%) were recorded. The average wear time was 11:44 (SD=1:56) hours. On a typical day, participants recorded 438 (SD=234) counts·min−1, took 7,541 (SD=3,894) steps, spent 8:36 (SD=1:09) hours inactive, spent 2:38 (SD=0:51) hours in light activity, and spent 0:44 (SD=0:26) hours in MVPA. Only 25% of participants met the recommended level of MVPA on at least one day. Physical activity was highest in boys (versus girls), in children (versus adolescents), and on weekdays (versus weekends).

Limitations
Participants were limited to children with unilateral spasticity who were classified at GMFCS levels I and II.

Conclusions
The majority of independently ambulant children with unilateral CP did not perform sufficient physical activity to meet public health recommendations.
Use of sensory and motor action potentials to identify the position of trigeminal nerve divisions for radiofrequency thermocoagulation
Authors: Lin Bo , Lu Xuguang , Zhai Xinli , Cai Zhigang 
Published: October 2014

Object
The objective of this study was to develop an electrophysiological method for intraoperative localization of the trigeminal nerve branches during radiofrequency thermocoagulation (RFTC).

Methods
Twenty-three patients who were scheduled to undergo RFTC were included. The trigeminal nerve root was stimulated through the foramen ovale using the radiofrequency cannula. Antidromic responses were recorded from the target division through supraorbital, infraorbital, and mental foramina electrodes, and an additional electrode at the masseter muscle. Sensory and motor action responses, as well as verbal and masseter contraction responses, were recorded and correlated.

Results
The antidromic responses were easily recorded in the target division in all 23 patients, and they were invariably correlated with the patient's verbal responses. The potentials were recorded successively from V1 to V3. The amplitude in each division before and after RFTC showed little difference in response to electrical stimulation with the same current. The motor trigeminal nerve action potentials were recorded in 10 patients; 7 of these patients had postoperative masseter muscle weakness, while the remaining 3 had normal masseter muscle function. Potentials with low amplitudes were usually obtained from neighboring divisions, but no unexpected denervation of any branches was observed. All the patients experienced immediate pain relief after the procedure.

Conclusions
This technique is sensitive and easy to apply. The sensory and motor potentials matched the verbal responses and the complications. Although it cannot completely substitute for the patient's verbal response, this approach is helpful in uncooperative patients, and it predicts and reduces the incidence of masseter muscle weakness. The use of these complementary techniques could increase the chances of treatment success.