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Knowledge based treatment planning

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https://www.readbyqxmd.com/read/29790625/managing-paediatric-bleeding-disorder-patients-undergoing-surgical-procedures-leveraging-the-electronic-medical-record
#1
C Tarango, D Dahale, N Dodson, A Otte, P J Schoettker
INTRODUCTION: Individuals with bleeding disorders have a high risk of bleeding complications with surgical procedures. Careful planning and management of peri-operative treatment is vital for their safety. Yet, inter-provider communication and communication between patients/families and providers is not reliable. AIM: Our haemophilia treatment centre (HTC) created a care gap report that used the electronic medical record to inform our team when patients with bleeding disorders were scheduled for procedures...
May 23, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29787868/individualized-tractography-based-parcellation-of-the-globus-pallidus-pars-interna-using-7t-mri-in-movement-disorder-patients-prior-to-dbs-surgery
#2
Rémi Patriat, Scott E Cooper, Yuval Duchin, Jacob Niederer, Christophe Lenglet, Joshua Aman, Michael C Park, Jerrold Vitek, Noam Harel
The success of deep brain stimulation (DBS) surgeries for the treatment of movement disorders relies on the accurate placement of an electrode within the motor portion of subcortical brain targets. However, the high number of electrodes requiring relocation indicates that today's methods do not ensure sufficient accuracy for all patients. Here, with the goal of aiding DBS targeting, we use 7 T (T) MRI data to identify the functional territories and parcellate the globus pallidus interna (GPi) into motor, associative and limbic regions in individual subjects...
May 19, 2018: NeuroImage
https://www.readbyqxmd.com/read/29780363/microbial-community-analyses-of-the-deteriorated-storeroom-objects-in-the-tianjin-museum-using-culture-independent-and-culture-dependent-approaches
#3
Zijun Liu, Yanhong Zhang, Fengyu Zhang, Cuiting Hu, Genliang Liu, Jiao Pan
In the storeroom C7 of the Tianjin Museum, one wooden desk and two leather luggages dated back to Qing dynasty (1644-1912 AD) presented viable microbial contamination. The aim of the present study was to investigate microbial communities responsible for the biodeterioration of storeroom objects using a combination of culture-independent and culture-dependent methods as well microscopic techniques. Scanning electron microscopy (SEM) revealed that the microflora on three storeroom objects were characterized by a marked presence of Eurotium halophilicum ...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29779186/mastoid-foramen-mastoid-emissary-vein-and-clinical-implications-in-neurosurgery
#4
Martin Hampl, David Kachlik, Katerina Kikalova, Roxane Riemer, Matej Halaj, Vlastimil Novak, Premysl Stejskal, Miroslav Vaverka, Lumir Hrabalek, David Krahulik, Ondrej Nanka
BACKGROUND: Mastoid emissary vein is especially important from the neurosurgical point of view, because it is located in variable number in the area of the occipitomastoid suture and it can become a source of significant bleeding in surgical approaches through the mastoid process, especially in retrosigmoid craniotomy, which is used for approaches to pathologies localized in the cerebellopontine angle. Ideal imaging method for diagnosis of these neglected structures when planning a surgical approach is high-resolution computed tomography...
May 20, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29776399/simulation-based-power-calculations-for-planning-a-two-stage-individual-participant-data-meta-analysis
#5
Joie Ensor, Danielle L Burke, Kym I E Snell, Karla Hemming, Richard D Riley
BACKGROUND: Researchers and funders should consider the statistical power of planned Individual Participant Data (IPD) meta-analysis projects, as they are often time-consuming and costly. We propose simulation-based power calculations utilising a two-stage framework, and illustrate the approach for a planned IPD meta-analysis of randomised trials with continuous outcomes where the aim is to identify treatment-covariate interactions. METHODS: The simulation approach has four steps: (i) specify an underlying (data generating) statistical model for trials in the IPD meta-analysis; (ii) use readily available information (e...
May 18, 2018: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/29764450/evaluation-of-target-dose-inhomogeneity-in-breast-cancer-treatment-due-to-tissue-elemental-differences
#6
A Fogliata, F De Rose, A Stravato, G Reggiori, S Tomatis, M Scorsetti, L Cozzi
BACKGROUND: Monte Carlo simulations were run to estimate the dose variations generated by thedifference arising from the chemical composition of the tissues. METHODS: CT datasets of five breast cancer patients were selected. Mammary gland was delineated as clinical target volume CTV, as well as CTV_lob and CTV_fat, being the lobular and fat fractions of the entire mammary gland. Patients were planned for volumetric modulated arc therapy technique, optimized in the Varian Eclipse treatment planning system...
May 15, 2018: Radiation Oncology
https://www.readbyqxmd.com/read/29745754/modelling-the-influence-of-treatment-time-on-radiosurgery-single-treatment-biological-effectiveness-to-produce-protective-dose-modification-factors
#7
Bleddyn Jones, John W Hopewell
OBJECTIVE: To provide simpler models for adjusting total dose to compensate for significant variations in CNS radio-surgical treatment times, which vary and will influence treatment bio-effectiveness. At present, no allowance is made for time variations. A framework of simpler equations would allow radio-surgical outcomes to be analysed with respect to treatment time, and a system for dose adjustments between radio-isotope and linac-based techniques with different treatment durations...
May 10, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29735195/robust-proton-treatment-planning-physical-and-biological-optimization
#8
REVIEW
Jan Unkelbach, Harald Paganetti
Accurate prediction of tumor control and toxicities in radiation therapy faces many uncertainties. Besides interpatient variability in the response to radiation, there are also dosimetric uncertainties, that is, differences between the dose displayed in a treatment planning system and the dose actually delivered to the patient. These uncertainties originate from several sources including imperfect knowledge of the patient geometry, approximation in the physics of radiation interaction with tissues, and uncertainties in the biological effectiveness of radiation...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29730280/impact-of-database-quality-in-knowledge-based-treatment-planning-for-prostate-cancer
#9
Phillip D H Wall, Robert L Carver, Jonas D Fontenot
PURPOSE: This article investigates dose-volume prediction improvements in a common knowledge-based planning (KBP) method using a Pareto plan database compared with using a conventional, clinical plan database. METHODS AND MATERIALS: Two plan databases were created using retrospective, anonymized data of 124 volumetric modulated arc therapy (VMAT) prostate cancer patients. The clinical plan database (CPD) contained planning data from each patient's clinically treated VMAT plan, which were manually optimized by various planners...
March 13, 2018: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29729009/advanced-collapsed-cone-engine-dose-calculations-in-tissue-media-for-coms-eye-plaques-loaded-with-i-125-seeds
#10
Hali Morrison, Geetha Menon, Matthew P Larocque, Bob van Veelen, Yury Niatsetski, Ezekiel Weis, Ron S Sloboda
PURPOSE: To investigate the dose calculation accuracy of the Advanced Collapsed cone Engine (ACE) algorithm for ocular brachytherapy using a COMS plaque loaded with I-125 seeds for two heterogeneous patient tissue scenarios. METHODS: The Oncura model 6711 I-125 seed and 16 mm COMS plaque were added to a research version (v4.6) of the Oncentra® Brachy (OcB) treatment planning system (TPS) for dose calculations using ACE. Treatment plans were created for two heterogeneous cases: (i) a voxelized eye phantom comprising realistic eye materials and densities and (ii) a patient CT dataset with variable densities throughout the dataset...
May 4, 2018: Medical Physics
https://www.readbyqxmd.com/read/29714086/a-dosimetric-evaluation-on-applying-rtog-based-and-ct-mri-based-delineation-methods-to-brachial-plexus-in-radiotherapy-of-nasopharyngeal-carcinoma-treated-with-helical-tomotherapy
#11
Chi-Him Li, Vincent Wc Wu, George Chiu
OBJECTIVE: In radiotherapy of nasopharyngeal carcinoma (NPC) patients, the brachial plexus (BP) situating at both sides of the neck are often irradiated to high dose. This study was to evaluate different BP delineation methods and analyse the dosimetric consequences when applying BP dose constraints in radiotherapy planning of NPC. METHODS: 15 NPC cases treated radically with helical tomotherapy were recruited. Apart from the original treatment plan (Plan A), two new plans (Plan B & C) with additional BP dose constraints were computed using the same planning computed tomography (CT) images, structures and planning parameters...
May 1, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29703226/individualised-short-term-therapy-for-adolescents-impaired-by-attention-deficit-hyperactivity-disorder-despite-previous-routine-care-treatment-escaadol-study-protocol-of-a-randomised-controlled-trial-within-the-consortium-escalife
#12
Julia Geissler, Thomas Jans, Tobias Banaschewski, Katja Becker, Tobias Renner, Daniel Brandeis, Manfred Döpfner, Christina Dose, Christopher Hautmann, Martin Holtmann, Carolin Jenkner, Sabina Millenet, Marcel Romanos
BACKGROUND: Despite the high persistence rate of attention-deficit/hyperactivity disorder (ADHD) throughout the lifespan, there is a considerable gap in knowledge regarding effective treatment strategies for adolescents with ADHD. This group in particular often shows substantial psychosocial impairment, low compliance and insufficient response to psychopharmacological interventions. Effective and feasible treatments should further consider the developmental shift in ADHD symptoms, comorbidity and psychosocial adversity as well as family dysfunction...
April 27, 2018: Trials
https://www.readbyqxmd.com/read/29698362/combining-intraoral-scans-cone-beam-computed-tomography-and-face-scans-the-virtual-patient
#13
Carlo Mangano, Fabrizia Luongo, Mario Migliario, Carmen Mortellaro, Francesco Guido Mangano
PURPOSE: The aim of this literature review was to provide an update on the current scientific knowledge in the field of 3D virtual patient science and to identify a possible easy, smart, and affordable method to combine different file formats obtained from different digital devices. METHODS: Electronic searches of the Medline database was performed, up to May 2017, for articles dealing with the construction of a 3D virtual patient; the matching of data acquired with different digital devices (cone beam computed tomography, CBCT; face scanner, FS; intraoral scanner, IOS; and desktop scanner, DS) was considered...
April 25, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29697145/robust-quantitative-contrast-enhanced-dual-energy-ct-for-radiotherapy-applications
#14
Andréanne Lapointe, Arthur Lalonde, Houda Bahig, Jean-François Carrier, Stéphane Bedwani, Hugo Bouchard
PURPOSE: The purpose of this study is to develop and validate accurate methods for determining iodine content and virtual non contrast maps of physical parameters, such as electron density, in the context of radiotherapy. METHODS: A simulation environment is developed to compare three methods allowing extracting iodine content and virtual non-contrast composition: 1) two-material decomposition, 2) three-material decomposition with the conservation of volume constraint, and 3) eigentissue decomposition...
April 26, 2018: Medical Physics
https://www.readbyqxmd.com/read/29694941/knowledge-attitudes-and-practices-towards-epilepsy-among-general-practitioners-in-rural-bolivia-results-before-and-after-a-training-program-on-epilepsy
#15
Loretta Giuliano, Calogero Edoardo Cicero, Sandra Padilla, Mario Camargo, Vito Sofia, Mario Zappia, Alessandro Bartoloni, Elizabeth Blanca Crespo Gómez, Alessandra Nicoletti
INTRODUCTION: Epilepsy represents a major health problem in low- and middle-income countries where treatment gap (TG) levels are high. The reduction of epilepsy TG in the rural area of the Chaco region, Plurinational State of Bolivia, has been the aim of many projects based on the reinforcement of the primary care setting. To plan educational campaigns directed to the healthcare professionals, it is necessary to establish their baseline knowledge level. The objective of our study was to assess the baseline level of knowledge, attitudes, and practices (KAP) towards epilepsy among general practitioners (GPs) of the rural communities of the Chaco region...
April 22, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29691122/emr-based-medical-knowledge-representation-and-inference-via-markov-random-fields-and-distributed-representation-learning
#16
Chao Zhao, Jingchi Jiang, Yi Guan, Xitong Guo, Bin He
OBJECTIVE: Electronic medical records (EMRs) contain medical knowledge that can be used for clinical decision support (CDS). Our objective is to develop a general system that can extract and represent knowledge contained in EMRs to support three CDS tasks-test recommendation, initial diagnosis, and treatment plan recommendation-given the condition of a patient. METHODS: We extracted four kinds of medical entities from records and constructed an EMR-based medical knowledge network (EMKN), in which nodes are entities and edges reflect their co-occurrence in a record...
April 22, 2018: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/29688639/-children-with-attention-deficit-hyperactivity-disorder-adhd-clinical-activity-in-israel
#17
Yuval Bloch
This editorial relates to the study published in the current issue on how our current knowledge is practiced in screening, diagnosing and treating children suffering from ADHD in Israel. It seems that there is an awareness of the disorder by parents and teachers, thus there is no need for community screening. The roles of the different medical professions: pediatricians (after receiving training on ADHD), child neurologists and child psychiatrists are not clear enough and thus services are not utilized properly...
April 2018: Harefuah
https://www.readbyqxmd.com/read/29679492/knowledge-based-automated-planning-for-oropharyngeal-cancer
#18
Aaron Babier, Justin J Boutilier, Andrea L McNiven, Timothy C Y Chan
PURPOSE: To automatically generate radiation therapy plans for oropharynx patients by com-bining knowledge-based planning (KBP) predictions with an inverse optimization (IO) pipeline. METHODS: We developed two KBP approaches, the bagging query (BQ) method and the generalized principal component analysis-based (gPCA) method, to predict achievable dose volume histograms (DVHs). These approaches generalize existing methods by predicting physically feasible organ-at-risk (OAR) and target DVHs in sites with multiple targets...
April 21, 2018: Medical Physics
https://www.readbyqxmd.com/read/29674371/automation-of-ct-based-haemorrhagic-stroke-assessment-for-improved-clinical-outcomes-study-protocol-and-design
#19
Betty Chinda, George Medvedev, William Siu, Martin Ester, Ali Arab, Tao Gu, Sylvain Moreno, Ryan C N D'Arcy, Xiaowei Song
INTRODUCTION: Haemorrhagic stroke is of significant healthcare concern due to its association with high mortality and lasting impact on the survivors' quality of life. Treatment decisions and clinical outcomes depend strongly on the size, spread and location of the haematoma. Non-contrast CT (NCCT) is the primary neuroimaging modality for haematoma assessment in haemorrhagic stroke diagnosis. Current procedures do not allow convenient NCCT-based haemorrhage volume calculation in clinical settings, while research-based approaches are yet to be tested for clinical utility; there is a demonstrated need for developing effective solutions...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29674270/response-inhibition-and-emotional-cognition-improved-by-atomoxetine-in-children-and-adolescents-with-adhd-the-action-randomized-controlled-trial
#20
Kristi R Griffiths, John E Leikauf, Tracey W Tsang, Simon Clarke, Daniel F Hermens, Daryl Efron, Leanne M Williams, Michael R Kohn
Although the non-stimulant medication atomoxetine is effective for attention-deficit hyperactivity disorder (ADHD) in children and adolescents, there are still significant gaps in our knowledge about whether atomoxetine improves anxiety symptoms or cognition in children. Furthermore, while cognition has been proposed as an intermediate phenotype for ADHD dysfunction, the relationships between clinical and cognitive outcomes are not yet understood. We addressed these knowledge gaps in a controlled trial using objective assessments of both general and emotional cognitive functions implicated in ADHD and in anxiety, which commonly co-occurs with ADHD...
March 27, 2018: Journal of Psychiatric Research
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