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Knowledge based treatment planning

Jeanne S Mandelblatt, Aimee M Near, Diana L Miglioretti, Diego Munoz, Brian L Sprague, Amy Trentham-Dietz, Ronald Gangnon, Allison W Kurian, Harald Weedon-Fekjaer, Kathleen A Cronin, Sylvia K Plevritis
BACKGROUND: Since their inception in 2000, the Cancer Intervention and Surveillance Network (CISNET) breast cancer models have collaborated to use a nationally representative core of common input parameters to represent key components of breast cancer control in each model. Employment of common inputs permits greater ability to compare model output than when each model begins with different input parameters. The use of common inputs also enhances inferences about the results, and provides a range of reasonable results based on variations in model structure, assumptions, and methods of use of the input values...
April 2018: Medical Decision Making: An International Journal of the Society for Medical Decision Making
Yobelli A Jimenez, Steven Cumming, Wei Wang, Kirsty Stuart, David I Thwaites, Sarah J Lewis
PURPOSE: Improved access to technology in the radiation therapy (RT) workforce education has resulted in opportunities for innovative patient education methods. This study investigated the impact of a newly developed education tool using the Virtual Environment for Radiotherapy Training (VERT) system on patients' RT knowledge and anxiety. METHOD: Breast cancer patients were recruited into a control group (CG) (n = 18) who underwent the standard pre-RT education package at a targeted cancer therapy centre, followed by a VERT group (VG) (n = 19)...
March 13, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
I-Chan Huang, Conor M Jones, Tara M Brinkman, Melissa M Hudson, D Kumar Srivastava, Yuelin Li, Leslie L Robison, Kevin R Krull
BACKGROUND: To the authors' knowledge, social network status in adolescent and young adult (AYA) cancer survivors has not been adequately studied to date. The authors developed and validated a functional social network index (FSNI) for AYA survivors, and compared its performance with that of 2 traditional indices (density and betweenness centrality). METHODS: A total of 102 AYA survivors and 102 noncancer controls who were matched for age, sex, and race were recruited from an Internet panel...
March 8, 2018: Cancer
Taty Tshimangani, Jean Pongo, Joseph Bodi Mabiala, Marcel Yotebieng, Nicole F O'Brien
Empirical knowledge suggests that acute neurologic disorders are common in sub-Saharan Africa, but studies examining the true burden of these diseases in children are scarce. We performed this prospective, observational study to evaluate the prevalence, clinical characteristics, treatment approaches, and outcomes of children suffering acute neurologic illness or injury (ANI) in an urban and rural site in the Democratic Republic of the Congo. Over 12 months, 471 out of 6,563 children admitted met diagnostic criteria for ANI, giving a hospital-based prevalence of 72/1,000 admissions...
March 5, 2018: American Journal of Tropical Medicine and Hygiene
Robert D Ashford, Kevin Lynch, Brenda Curtis
BACKGROUND: Substance use disorder research and practice have not yet taken advantage of emerging changes in communication patterns. While internet and social media use is widespread in the general population, little is known about how these mediums are used in substance use disorder treatment. OBJECTIVE: The aims of this paper were to provide data on patients' with substance use disorders mobile phone ownership rates, usage patterns on multiple digital platforms (social media, internet, computer, and mobile apps), and their interest in the use of these platforms to monitor personal recovery...
March 6, 2018: Journal of Medical Internet Research
Ulrik Nikolaj Ascanius Felding
Isolated fractures of the orbital floor or medial wall are often referred to as blowout fractures (BOFs). Debilitating double vision and aesthetic deformity may affect the patients' quality of life and daily living skills, for instance, working or driving a car. The management of blowout fractures is, however, challenging, since not all fractures demand surgery. Some patients may have symptoms which subside, or may never develop symptoms. Due to a lack of evidence, there are still considerable differences in opinion on the criteria for surgery...
March 2018: Danish Medical Journal
Iris Reychav, Inam Najami, Daphne Ruth Raban, Roger McHaney, Joseph Azuri
PURPOSE: To examine the relationship between the media, through which medical information was made available (e.g. digital versus printed), and the patients' desire to play an active part in a medical decision in an SDM or an ISDM-based process. The goal of this research was to expand knowledge concerning social and personal factors that affect and explain patients' willingness to participate in the process. METHODS: A questionnaire was distributed in this empirical study of 103 third-age participants...
April 2018: International Journal of Medical Informatics
Mary E Northridge, Sara S Metcalf, Stella Yi, Qiuyi Zhang, Xiaoxi Gu, Chau Trinh-Shevrin
Introduction: While the US health care system has the capability to provide amazing treatment of a wide array of conditions, this care is not uniformly available to all population groups. Oral health care is one of the dimensions of the US health care delivery system in which striking disparities exist. More than half of the population does not visit a dentist each year. Improving access to oral health care is a critical and necessary first step to improving oral health outcomes and reducing disparities...
2018: Frontiers in Public Health
Bruna de Paula Fonseca E Fonseca, Priscila Costa Albuquerque, Ed Noyons, Fabio Zicker
BACKGROUND: South-south collaboration on health and development research is a critical mechanism for social and economic progress. It allows sharing and replicating experiences to find a "southern solution" to meet shared health challenges, such as access to adequate HIV/AIDS prevention and treatment. This study aimed to generate evidence on the dynamics of south-south collaboration in HIV/AIDS research, which could ultimately inform stakeholders on the progress and nature of collaboration towards increased research capacities in low- and middle-income countries (LMIC)...
March 1, 2018: Globalization and Health
Daniel L Faden, Marion A Hughes, Philippe Lavigne, Brian T Jankowitz, Eric W Wang, Juan C Fernandez-Miranda, Paul A Gardner, Carl H Snyderman
BACKGROUND: Nontraumatic pseudoaneurysms of the cranial base are rare and present unique diagnostic and treatment dilemmas compared with both true aneurysms and pseudoaneurysms outside of the cranial base. There is a dearth of knowledge regarding the management of these complicated lesions. METHODS: Nontraumatic pseudoaneurysms of the cranial base internal carotid artery (ICA) were retrospectively identified at the University of Pittsburgh Medical Center through a key word search of cranial base cases from 2010 to 2017...
February 27, 2018: International Forum of Allergy & Rhinology
Kelly C Younge, Robin B Marsh, Dawn Owen, Huaizhi Geng, Ying Xiao, Daniel E Spratt, Joseph Foy, Krithika Suresh, Q Jackie Wu, Fang-Fang Yin, Samuel Ryu, Martha M Matuszak
PURPOSE: To use knowledge-based planning (KBP) as a method of producing high-quality, consistent, protocol-compliant treatment plans in a complex setting of spine stereotactic body radiation therapy on NRG Oncology Radiation Therapy Oncology Group (RTOG) 0631. METHODS AND MATERIALS: An internally developed KBP model was applied to an external validation cohort of 22 anonymized cases submitted under NRG Oncology RTOG 0631. The original and KBP plans were compared via their protocol compliance, target conformity and gradient index, dose to critical structures, and dose to surrounding normal tissues...
March 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Maximilian Gertler, Sven Loik, Christian Kleine, Alexa Matuschek, Norbert Gresser, Mario di Gennaro, Andreas Fabricius, Thomas Kratz, August Stich, Joost Butenop
BACKGROUND: In September 2014, the German government mandated the German Red Cross (GRC) and the German Armed Forces to support the international efforts to stop the epidemic of Ebola virus disease (EVD) in West-Africa. The GRC requested specific training from the Medical Mission Institute Wuerzburg (MI). OBJECTIVES: We describe and discuss the development, strategy, results, and evaluation of the program to formulate conclusions and recommendations for similar emergencies...
February 26, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Janine Marie Traulsen, Louise C Druedahl
The future of the pharmacy profession and concerns about professional identity have been popular and recurring themes in professional journals and at international pharmacy conferences for more than 30 years. The aim of this paper is to contribute to realistic and viable visions for the future of the pharmacy profession via insights through labor market and work organization theories. These insights provide an understanding of contemporary work patterns and what they mean for the future role of community pharmacists...
February 17, 2018: Research in Social & Administrative Pharmacy: RSAP
Jing Lin, Zhen Cheng, Xiaoqiang Ding, Qi Qian
Acid-base and electrolyte alterations are common in patients with chronic kidney disease (CKD) and end-stage kidney failure (ESRD). The alterations become more complex as CKD advances to ESRD, leading to morbidity and mortality. Three cases are presented illustrating some key prototypic features in CKD and ESRD. Each is accompanied by discussion of pathophysiology, diagnosis, and treatment options. Newer investigational results are integrated into the existing body of knowledge. Although rigorous assessment of various dialysis prescriptions is scanty, in its current state, instituting a well thought-out, multi-pronged management plan to minimize CKD/ESRD and dialysis-related electrolyte and acid-base disruptions is appropriate...
January 26, 2018: Blood Purification
Valentina Lancellotta, Martina Iacco, Elisabetta Perrucci, Lorenzo Falcinelli, Claudio Zucchetti, Berardino de Bari, Simonetta Saldi, Cynthia Aristei
OBJECTIVE: To compare the dosimetric outcomes of four radiotherapy (RT) techniques for treating the chest wall plus draining nodes after mastectomy and breast reconstruction. METHODS: Three-dimensional conformal radiotherapy (3DCRT), linac-based intensity modulated radiotherapy, helical tomotherapy (HT) and direct tomotherapy (DT) treatments were planned for 40 breast cancer patients. Dose prescription was 50 Gy. Plans were compared in terms of doses to the planning target volume, organs at risk (OARs) and the homogeneity index (HI)...
February 23, 2018: British Journal of Radiology
Kit C B Roes, Indira S E van der Zande, Maarten van Smeden, Rieke van der Graaf
Evidence-based treatment for pregnant women will ultimately require research conducted in the population of pregnant women. Currently, few scholars have addressed the issue of responsible inclusion of pregnant women in drug research. Because of additional risks associated with including pregnant women in drug research and the altered ways in which drugs are processed by the pregnant body, pregnant women cannot be treated as an ordinary subgroup in the various phases of drug development. Instead, responsible inclusion of pregnant women requires careful design and planning of research for pregnant women specifically...
February 20, 2018: Trials
Dina H Griauzde, Jeffrey T Kullgren, Brad Liestenfeltz, Caroline Richardson, Michele Heisler
Background: Rates of participation in Diabetes Prevention Programs (DPPs) are low. This may be due, in part, to low levels of autonomous motivation (i.e., motivation that arises from internal sources and sustains healthy behaviors over time) to prevent type 2 diabetes (T2DM) among many individuals with prediabetes. Mobile health (mHealth) technologies that incorporate principles from the Self-Determination Theory offer an effective and scalable approach to increase autonomous motivation levels...
2018: Pilot and Feasibility Studies
Kihong Son, Jieun Chang, Hoyeon Lee, Changhwan Kim, Taewon Lee, Seungryong Cho, Sohyun Park, Jin Sung Kim
To reduce the radiation dose given to patients, a tube current modulation (TCM) method has been widely used in diagnostic CT systems. However, the TCM method has not yet been applied to a kV-CBCT system on a LINAC machine. The purpose of this study is to investigate if a TCM method would be desirable in a kV-CBCT system for image-guided radiation therapy (IGRT) or not. We have developed an attenuation-based TCM method using prior knowledge from planning CT images of patients. The TCM method can provide optimized dose reductions without degrading image quality for kV-CBCT imaging...
2018: PloS One
Shinnosuke Kuroda, Hiroki Ito, Kentaro Sakamaki, Tadashi Tabei, Takashi Kawahara, Atsushi Fujikawa, Kazuhide Makiyama, Masahiro Yao, Hiroji Uemura, Junichi Matsuzaki
This study aimed to develop a prediction model for the operative time of flexible ureteroscopy (fURS) for renal stones. We retrospectively evaluated patients with renal stones who had been treated successfully and had stone-free status determined by non-contrast computed tomography (NCCT) 3 months after fURS and holmium laser lithotripsy between December 2009 and September 2014 at a single institute. Correlations between possible factors and the operative time were analyzed using Spearman's correlation coefficients and a multivariate linear regression model...
2018: PloS One
Lee Goddard, Nils P Brodin, William R Bodner, Madhur Garg, Wolfgang A Tomé
OBJECTIVE: To investigate whether photon or proton based SBRT is the preferred modality for high dose hypofractionation prostate cancer treatment. Achievable dose distributions were compared when uncertainties in target positioning and range uncertainties were appropriately accounted for. METHODS: Ten patients with prostate cancer previously treated at our institution with photon SBRT using volumetric modulated arc therapy (VMAT) were identified. MRI images fused to the treatment planning CT allowed for accurate target and organ-at-risk (OAR) delineation...
February 13, 2018: British Journal of Radiology
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