dataesr/scientific-paragraphs-categorization huggingface dataset:
We conducted a retrospective, nationwide, multicenter study to evaluate the clinical outcomes of PBT for BSs of the SB and spine in Japan. Materials and Methods: Eligibility criteria included histologically proven BS of the SB or spine, no metastasis, !20 years of age, and no previous radiotherapy. Of the 103 patients treated between January 2004 and January 2012, we retrospectively analyzed data from 96 patients who were followed-up for. 6 months or had died within 6 months. Results: Seventy-two patients had chordoma, 20 patients had chondrosarcoma, and 4 patients had osteosarcoma. The most frequent tumor locations included the SB in 68 patients and the sacral spine in 13 patients. Patients received a median total dose of 70 Gy (relative biological effectiveness [RBE]) (biologically effective dose, alpha/beta ¼ 10 Gy, 86 Gy [RBE]).
Clinical Trials PTC17-0300: Minimal Toxicity After Proton Beam Therapy for Prostate and Pelvic Nodal Irradiation: Results from the Proton Collaborative Group REG001-09 Trial Purpose: Proton therapy (PBT) reduces normal organ dose compared to intensity modulated radiation therapy (IMRT) for prostate cancer (PCa) patients who receive pelvic lymph node radiation (PLNR). It is not well described whether this dosimetric advantage results in less gastrointestinal (GI) and genitourinary (GU) toxicity than would be expected from IMRT. Materials and Methods: We evaluated treatment parameters and toxicity outcomes for non-metastatic PCa patients who received PLNR and enrolled on the Proton Collaborative Group REG001-09 trial (NCT01255748). Patients who received photon therapy and/or brachytherapy were excluded.
Above 19cc, all patients displayed radiation-induced imaging changes. The dependence on V105% PD was less prominent. Conclusion: There appears to be a relationship between BD hotspot volumes and post-RT changes. More data is required to confirm the observed trends. PTC17-0437: Esophagitis in the Multimodality Treatment of Thoracic Ewing Sarcoma: Incidence, Risk Factors, and Management V. Agarwal 1 , N. Logie 2 , J. Bradley 2 , R. Rotondo 2 , S. Bradfield 1 , C. Morris 2 , D. Indelicato 2 1 Nemours Children's Specialty Clinic, Pediatric Oncology, Jacksonville, USA 2 University of Florida, Radiation Oncology, Jacksonville, USA Purpose: To analyze the incidence, risk factors, and management of esophagitis in pediatric patients with Ewing sarcoma of the thoracic spine and chest wall treated with chemotherapy and proton therapy (PT).
A systematic approach for significant international patient referrals abroad to the US while maintaining excellent disease control and follow up is feasible. Gastrointestinal Organs and Breast PTC17-0515: Standardized Metric for Plan Evaluation in Breast Cancer Radiotherapy Creates Objective Measurement of Plan Quality, Enables Objective Comparison of Modalities J. Bradley 1 , M. Rutenberg 1 , M. W. Ho 1 , X. Liang 1 , D. Louis 1 , N. Getman 1 , Z. Li 1 , N. Mendenhall 1 , B. Nelms 2 1 University of Florida Health Proton Therapy Institute, Radiation Oncology, Jacksonville, USA 2 Canis Lupus, Not applicable, Merrimac-Wisconsin, USA Purpose: Plan assessment remains largely subjective. In this study, advanced plan-scoring methods for breast cancer are introduced to (1) study variability and achievable benchmarks in treatment planning and (2) compare a population of proton and photon plans designed for controlled patient datasets.
Materials and Methods: A breast cancer scoring method was developed, modeled on the NSABP-B51/RTOG-1304 protocol, including organ-at-risk (OAR) constraints and target coverage goals. Performance bins ranged from ideal (full target coverage; no OAR dose) to unacceptable (aligned with major deviation in the protocol). Deidentified datasets for 3 patients (intact breast, postmastectomy without reconstruction, postmastectomy with expander reconstruction) were available for download. Plan-scoring tools were implemented via a cloud-based web interface to allow participants to score plan iterations and submit a final plan. On a sliding scale, points were awarded according to performance versus objectives for 21 metrics. Results: This scoring method was confirmed with pilot data using treatment plans submitted by 4 planners (proton and photon) to establish proof of concept.
For the intact breast case, scores ranged from 84. 19-133. 94 points out of 150. Using this scoring method, an international study is being designed in which treatment plan data will be anonymously collected, with the goal of !50 proton and !50 photon plans for each of the three cases. Analysis of plan quality and variation will be done, and modalities compared objectively. Conclusion: Objective analysis of plan quality is a powerful and important way to determine and compare the capabilities of planners, planning systems, and modalities. Purpose: To evaluate the safety and efficacy of short-course carbon ion radiotherapy (CIRT) for hepatocellular carcinoma (HCC). Materials and Methods: Between April 2003 and July 2015, 196 patients with HCC underwent 2-fraction CIRT. The median age was 73 years old.
PTC17-0488: Efficient Interplay Effect Mitigation for Proton Pencil Beam Scanning by Spot-Adapted Layered Repainting Evenly Spread over the Full Breathing Cycle This work was performed to commission the clinical procedure for the treatment of moving targets with pencil-beam scanning at PSI and involved 4D-planning and patient-specific verifications in both water and a dynamic anthropomorphic phantom. 3-field SFUD plans were optimized on the mid-ventilation phase extracted from a 4DCT dataset of each patient, with primary anatomical motion below 8 mm in superior-inferior direction. In a 4D-dose calculation study, 4-8 rescans were found to provide full and homogeneous target coverage. For dosimetric verification, each 8-times-rescanned field was measured at proximal, mid-SOBP and distal depth using a stationary 2D-chamber array and moving under different motion scenarios: nominal (8mm motion), fluctuating or scaled to exceed the clinical inclusion criteria (.
10mm). Gamma score (GS) (3%/3mm) was 100% for all static measurements and. 98. 5% for all fields tested with nominal patient motion. Average GS reduced however to 97. 8% (1SD¼2. 9%) in the presence of moderate motion fluctuations, and was not clinically acceptable for amplitudes. 10mm (average GS¼76. 9%). The whole clinical treatment workflow, including 3-DOF patient positioning based on image registration of the averaged 4DCT with a slow, pre-treatment in-room CT, was verified using an anthropomorphic breathing phantom and radiochromic films positioned at 2 planes in the tumour. Spatial displacement of measured dose distributions were 1. 4mm (1SD¼0. 3mm) in the left-right direction and 1. 5mm (1SD¼0. 0mm) in the cranio-caudal direction. Dose inhomogeneity in the CTV was ,9%. Our data suggest that rescanning can be safely applied clinically to mitigate motion with irregularities in moving-target treatments for amplitudes 8mm.
Repeated measurements of the magnetic field strength were performed to assess its stability during irradiation experiments. Results: The modelled magnetic vector field data differed less than 2% from the measured data. Magnetic field-induced beam deflection was clearly observed from the planar dose distributions. Integrated depth-dose curves showed a similar form in comparison to measurements without magnetic field. Lateral displacement of the Bragg peak increased with energy from 1 to 10 mm for 80 and 180 MeV, respectively. Spot measurements of the magnetic field strength showed high reproducibility (r¼3 mT) and no effects of radiation-induced degradation. Conclusion: For the first time, a measurement setup to study magnetic field-induced proton beam dose effects in a film phantom has been realized.
The QA workflow can be operated from outside of the irradiation room. The analysis process is also automatized using validated in-house software for the spot and fields characterization and saved in a QA database including warnings and alarms. The implementation of this efficient QA workflow allows a quick and extensive follow-up of the PBS beam line without any hardware compromise. QA results are reproducible, user dependency is minimized and the whole procedure can be performed within 2 hours for the daily QA with 5 energies verified. PTC17-0096: Carbon-Ion Radiotherapy for Lung Cancer Patients with Interstitial Lung Disease M. Nakajima 1 , N. Yamamoto 1 , K. Hayashi 1 , D. Ebner 1 , H. Tsuji 1 , T. Kamada 1 1 National Institute of Radiological Sciences Hospital, Radiation Oncology Division, Chiba, Japan Purpose: Lung cancer is frequently complicated by interstitial lung disease (ILD).
Therefore, limited disease is the critical limit to cure. Recently, precision medicine and immunological therapy has gained dramatic survival over previous traditional chemotherapy to the subset of patients. Most effective targeted therapy, alectinib to patients with ALK gene translocation, can obtain survival for more than 3 years. Anti-PD-1 inhibitor are also dramatically effective, if only no more than 20% can enjoy the benefit and enriching those patients is still extremely difficult. There are some patients who are as if cured, that is in complete remission since the start of phase I study. We are now facing the time to thinking about how to evaluate efficacy of treatment if they can cure the patients. Is the treatment having a 1-year survival rate of 50% and 5year survival rate of 1% better than the treatment having a 1-year survival rate of 10% and 5-year survival rate of 10%? In this lecture, I will summarize the recent data of medical oncology, and discuss the evaluation method of treatment with potentially curability of cancer.
Using retrospective analyses of incident databases, referencing existing HRA methods, and prospective techniques like human performance models and Hierarchical Task Analysis (derived from talk-throughs and observations at CPT) we developed taxonomies of critical tasks and conditioning factors. Results: 6 generic tasks types (GTTs), supported by 40 example tasks, were formed representing critical tasks in the process. The GTT grouping of example tasks is based on similar task characteristics and cognitive functions. 18 Performance Influencing Factors (PIFs) could be determined and hierarchically structured. The quantification framework, consisting of 13 decision trees, was derived by identifying PIFs affecting GTTs; this included identification of 13 failure modes, 14 proximate causes and 15þ failure mechanisms.
Methods We experimentally assessed venereal transmission in two populations of Brazilian Ae. aegypti mosquitoes: Urca (URC; F2 generation), Rio de Janeiro, coastal Southeast region, and Goiânia (GOI; F1 generation), Goiás, inland Central-West region. Their F0 generation tested negative for ZIKV by qRT-PCR as described previously  [9]. Mosquitoes were reared at 26 ± 1 °C, 12 h:12 h light:dark cycle and 70 ± 10% humidity (standardized environmental condition, SEC) as previously described  [9, 10]. Mosquitoes were sexed at the pupal stage, and the emerged adults of each gender were maintained in distinct cages supplied with a 10% sucrose solution at SEC. Virgin Ae. aegypti females aged 5-7 days post-emergence were orally challenged with two ZIKV strains belonging to the Asian lineage, namely ZIKV-Rio-U1 (GenBank: KU926309) and ZIKV-PE243 (Gen-Bank: KX197192), respectively, isolated from humans in Southeast  [11]  and Northeast  [12]  Brazil.
CONCLUSIONS Coronary revascularization guided by iFR was noninferior to revascularization guided by FFR with respect to the risk of major adverse cardiac events at 1 year. The rate of adverse procedural signs and symptoms was lower and the procedural time was shorter with iFR than with FFR. (Funded by Philips Volcano; DEFINE-FLAIR ClinicalTrials. gov number, NCT02053038.
The trial is funded by an unrestricted educational grant from Philips Volcano, which had no role in the design of the trial, the collection or analysis of the data, the writing of the manuscript, or the decision to submit the manuscript for publication. Trial management and oversight were performed by personnel at the Imperial College Trials Unit, Imperial College London, who maintained the clinical database and conducted all the data analyses independent of the funder. A risk assessment established that the trial was of low risk to the patients; therefore, no data and safety monitoring board was established. The first draft of the manuscript was written by the first author, and all the authors participated in trial oversight, approved all subsequent drafts of the manuscript, and made the decision to submit the manuscript for publication.
Randomization Eligible patients were randomly assigned to undergo revascularization guided by either FFR or iFR. Randomization was performed with the use of an automated and validated online randomization tool (SRUB, Imperial College London). During the trial procedures, investigators were allowed to obtain FFR or iFR measurements only T h e ne w e ngl a nd jou r na l o f m e dicine in accordance with group assignment. Verification of the data was performed in each patient with the use of the electronic physiology record, which was uploaded directly from the physiological console for each patient into the electronic clinical record (Fig. S1  in the Supplementary Appendix). During the procedure, patients were not told which technique was used for physiological assessment, and they remained unaware of their group assignment throughout the entire course of the trial.
When the FFR or iFR was higher than the prespecified threshold, treatment was deferred. When multivessel revascularization was attempted, investigators could choose to prespecify a staged treatment plan, with the staged procedure performed within 60 days. Adverse procedural signs and symptoms were documented. Routine clinical follow-up assessments were performed at 30 days and at 1 year, and followup by telephone was conducted at 6 months. Complete monitoring of every electronic clinical record was performed, and the data were confirmed by on-site source-document verification in a randomly selected 30% of patients.
Introduction: REGAL (RSV Evidence-a Geographical Archive of the Literature) has provided a comprehensive review of the published evidence in the field of respiratory syncytial virus (RSV) in Western countries over the last 20 years. This review covers the risk and burden of RSV infection in children with underlying medical conditions or chronic diseases (excluding prematurity and congenital heart disease). Methods: A systematic review of publications between January 1, 1995 and December 31, 2015 across PubMed, Embase, The Cochrane Library, and Clinicaltrials. gov was supplemented by papers identified by the authors through March 2017. Studies reporting data for hospital visits/ admissions for RSV infection as well as studies reporting RSV-associated morbidity and mortality were included. Study quality and strength of evidence (SOE) were graded.
For both searches, age restrictions were not employed to enable capture of studies with mixed populations of children and adults. The inclusion criteria were studies reporting 'proven' or 'probable' RSV infection in specific populations of children (aged B18 years): Down syndrome with or without CHD, immunodeficiency, neuromuscular impairment, cystic fibrosis, congenital airway anomalies (CAA), and other rare congenital and metabolic disorders. For completeness, studies reporting on mixed populations of healthy children and children with underlying chronic conditions/comorbidities and those including RSV immunoprophylaxis were included and the relevant data extracted where possible. Studies with the specific purpose of assessing RSV immunoprophylaxis were excluded from this systematic review.
Articles Selected From the two literature searches, 2692 potentially relevant articles were identified, of which 607 were reviewed at abstract level following initial screening of titles (Fig. 1 ). Screening of abstracts resulted in a further 560 articles being rejected for not meeting the inclusion criteria, predominantly for not being focused on Western countries and/or RSV. The 47 relevant studies from the literature searches were supplemented by 11 studies identified from reference lists and other sources, resulting in a grand total of 58 studies included in the review. The online supplement includes data extraction tables for all 58 studies, including evidence grades and risk of bias assessments.
[31]  from the Netherlands reported an OR for RSVH of 10. 5 (95% CI 2. 2-49. 5) among term children (B2 years) with Down syndrome without any CHD in comparison to healthy controls (OR 12. 6, 95% CI 2. 9-54. 5, when including children with hemodynamically insignificant CHD). The study by Zachariah et al. [27]  also reported a significantly elevated rate of RSVH in children (B2 years) with Down syndrome but without risk factors for RSV (including CHD, CLD, prematurity, pulmonary hypertension, and neuromuscular disease; 42 vs. 12 per 1000 child-years in children without Down syndrome; OR 3. 5, 95% CI 3. 1-4. 1), though this rate was lower than that for children with Down syndrome and associated risk factors (67 per 1000 child-years). Another US study, using a medical claims database, found a significantly higher rate of RSVH in children (B2 years) with Down syndrome than matched control children (by birth, gender and State), when diagnoses of CHD and BPD and those born prematurely were excluded (36 vs.
Cystic Fibrosis Cystic fibrosis has been found to be a significant risk factor for severe RSV infection [7, 10, 60-63] (Table  3 ). In the population-based, cohort study by Murray et al. [7] , admission rates for RSV LRTI during the first year of life were found to be significantly higher among infants with cystic fibrosis (64 per 1000 infants, 95% CI 32. 1-115. 1) compared with otherwise healthy infants born at term (22 per 1000 infants, 95% CI 21. 8-22. 9; RR 2. 5, 95% CI 1. 4-4. 4). In contrast to the previous study, a considerably higher rate of RSVH of 181 per 1000 in children (\2 years) with cystic fibrosis was reported in the Danish national RSV cohort  [10]. Cystic fibrosis was a significant risk factor for RSVH in this study (IRR 4. 3, 95% CI 2. 4-7. 7; P\0. 001 [10]. In a subgroup analysis of the Canadian PIC-NIC RSV database, the morbidity of RSV infection in children (n = 68) with various causes of underlying lung disease (including cystic fibrosis, recurrent aspiration pneumonitis, pulmonary malformation, neurogenic disorders, and tracheoesophageal fistula) was found to be similar to those with BPD (n = 91)  [60].
Incidence of RSVH Over Time in Children Affected by Underlying Comorbidities A recently published study from the US has reported that RSVH rates have not declined in Down syndrome without CHD, CAA, and a number of other conditions (cystic fibrosis with pulmonary manifestations, neuromuscular disease, HIV, immunodeficiency, and other genetic metabolic musculoskeletal conditions)  [18]. This  15-year (1997-2012)  historical cohort study, using data from the nationwide Kids' Inpatient Database, found that RSVH rates increased by 7. 6% for Down syndrome without CHD (P = 0. 09), by 4. 3% for CAA (P = 0. 41), and by 9. 3% for other high risk conditions (P = 0. 62)  [18].
Predisposing risk factors for death were pre-existing disease (RR 2. 4, 95% CI 2. 0-2. 8), cardiac anomaly (RR 3. 0, 95% CI 2. 2-4. 1), and nosocomial/hospital-acquired RSV infection (RR 2. 9, 95% CI 1. 3-6. 6) [73]. A more recent analysis of RSV mortality rates in hospitalized infants and children aged \2 years was undertaken in the US using the Kids' Inpatient Database and the Pediatric Health Information System  [74]. Both datasets indicated that RSVH-associated mortality was uncommon, occurring in 3-4 per 10 000 admissions, and had decreased over the last 20 years. Of these deaths, 20-26% had neuromuscular conditions and 13-19% had congenital or genetic conditions. Nearly 40% of the deaths in both datasets occurred in medically fragile infants and children with C2 complex chronic conditions  [74].
subjects tested positive for a respiratory viral infection (including RSV, human rhinovirus, human metapneumovirus, parainfluenza 3, parainfluenza 4, and influenza B) was symptomatic at the time of testing (no information on virus identified in the symptomatic infant) Incidence rate ratios (IRR) for RSVH and geometric mean ratios for duration of RSVH in children with chronic conditions from the Danish RSV database [10] GI gastrointestinal, GMR geometric mean ratio, LOS length of stay for RSVH, IRR incidence rate ratio, NS not significant, RSV respiratory syncytial virus, RSVH respiratory syncytial virus hospitalization a Excludes the following conditions all of which were identified as significant risk factors for RSVH: CLD, CHD (both out with remit of review), Down syndrome, cancer and cystic fibrosis (data presented in relevant sections of this paper and.
ACKNOWLEDGEMENTS Sponsorship and article processing charges for this study were funded by  AbbVie. Dr. Joanne Smith ,  Julie Blake  (Reviewers 1 and 2) and  Dr. Barry Rodgers-Gray  (Reviewer 3), from  Strategen Limited , undertook the systematic review following the protocol approved by the authors. AbbVie provided funding to Strategen to undertake the systematic review. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published. Editorial assistance in the preparation of this manuscript was provided by  Julie Blake  and  Barry Rodgers-Gray. Julie Blake  and  Barry Rodgers-Gray  developed a first draft of the manuscript, based on the results of the systematic review and input/approval from all authors, which was initially edited by  Xavier Carbonell-Estrany  and  Paolo Manzoni  and then circulated among the other authors for input, further edits and subsequent approval.
subjects tested positive for a respiratory viral infection (including RSV, human rhinovirus, human metapneumovirus, parainfluenza 3, parainfluenza 4, and influenza B) was symptomatic at the time of testing (no information on virus identified in the symptomatic infant) Incidence rate ratios (IRR) for RSVH and geometric mean ratios for duration of RSVH in children with chronic conditions from the Danish RSV database [10] GI gastrointestinal, GMR geometric mean ratio, LOS length of stay for RSVH, IRR incidence rate ratio, NS not significant, RSV respiratory syncytial virus, RSVH respiratory syncytial virus hospitalization a Excludes the following conditions all of which were identified as significant risk factors for RSVH: CLD, CHD (both out with remit of review), Down syndrome, cancer and cystic fibrosis (data presented in relevant sections of this paper and symptoms of LRTI.
Background: Cases of higher-than-expected disease activity have been reported following fingolimod discontinuation. Objective: The objective of this paper is to assess the risk of substantially higher-than-expected disease activity post-study drug discontinuation (SDD) at the individual patient level using data from the Phase III, placebo-controlled FREEDOMS and FREEDOMS II trials. Methods: Baseline gadolinium-enhancing T1-lesion volumes were used to statistically model the expected level of MRI disease activity post-SDD. Patients exceeding this level were classed as ''MRI outliers. '' Patients with an unusually high increase in Expanded Disability Status Scale score, hospitalization for relapse, severe relapse, or relapse with incomplete recovery post-SDD were classed as ''clinical outliers.