A systematic review of methods to immobilise breast tissue during adjuvant breast irradiation

Greater use of 3D conformal, Intensity Modulated Radiotherapy (IMRT) and external beam partial breast irradiation following local excision (LE) for breast cancer has necessitated a review of the effectiveness of immobilisation methods to stabilise breast tissue. To identify the suitability of currently available breast (rather than thorax) immobilisation techniques an appraisal of the literature was undertaken. The aim was to identify and evaluate the benefit of additional or novel immobilisation approaches (beyond the standard supine, single arm abducted and angled breast board technique adopted in most radiotherapy departments). A database search was supplemented with an individual search of key radiotherapy peer-reviewed journals, author searching, and searching of the grey literature. A total of 27 articles met the inclusion criteria. The review identified good reproducibility of the thorax using the standard supine arm-pole technique. Reproducibility with the prone technique appears inferior to supine methods (based on data from existing randomised controlled trials). Assessing the effectiveness of additional breast support devices (such as rings or thermoplastic material) is hampered by small sample sizes and a lack of randomised data for comparison. Attention to breast immobilisation is recommended, as well as agreement on how breast stability should be measured using volumetric imaging. Keywords: Breast, immobilisation, positioning, reproducibility, review.</p

Body composition and basal metabolic rate in pre-school children : no sex difference

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.Peer reviewedPublisher PD

Disease, activity and schoolchildren's health (DASH) in Port Elizabeth, South Africa: a study protocol

BACKGROUND: An in-depth epidemiological investigation on intestinal parasite infections in an impoverished area of Port Elizabeth, South Africa provides a unique opportunity for research on its impact on children's physical fitness, cognitive performance and psychosocial health. Additionally, we will screen risk factors for the development of diabetes and hypertension in adulthood. METHODS/DESIGN: A 2-year longitudinal cohort study will be conducted, consisting of three cross-sectional surveys (baseline and two follow-ups), in eight historically black and coloured (mixed race) primary schools located in different townships in Port Elizabeth, South Africa. Approximately 1000 Grade 4 primary schoolchildren, aged 8 to 12 years, will be enrolled and followed. At each survey, disease status, anthropometry and levels of physical fitness, cognitive performance and psychosocial health will be assessed. After each survey, individuals diagnosed with parasitic worm infections will be treated with anthelminthic drugs, while children with other infections will be referred to local clinics. Based on baseline results, interventions will be tailored to the local settings, embedded within the study and implemented in half of the schools, while the remaining schools will serve as controls. Implementation of the interventions will take place over two 8-week periods. The effect of interventions will be determined with predefined health parameters. DISCUSSION: This study will shed new light on the health burden incurred by children in deprived urban settings of South Africa and provide guidance for specific health interventions. Challenges foreseen in the conduct of this study include: (i) difficulty in obtaining written informed consent from parents/guardians; (ii) administration of questionnaires in schools where three languages are spoken (Afrikaans, Xhosa and English); (iii) challenges in grasping concepts of psychosocial health among schoolchildren using a questionnaire; and (iv) loss to follow-up due to the study setting where illiteracy, mobility and violence are common. Finally, designing the health interventions together with local principals and teachers will allow all concerned with the research to bolster a sense of community ownership and sustained use of the interventions after the study has ceased

PABO: Mitigating Congestion via Packet Bounce in Data Center Networks

In today's data center, a diverse mix of throughput-sensitive long flows and delay-sensitive short flows are commonly presented in shallow-buffered switches. Long flows could potentially block the transmission of delay-sensitive short flows, leading to degraded performance. Congestion can also be caused by the synchronization of multiple TCP connections for short flows, as typically seen in the partition/aggregate traffic pattern. While multiple end-to-end transport-layer solutions have been proposed, none of them have tackled the real challenge: reliable transmission in the network. In this paper, we fill this gap by presenting PABO -- a novel link-layer design that can mitigate congestion by temporarily bouncing packets to upstream switches. PABO's design fulfills the following goals: i) providing per-flow based flow control on the link layer, ii) handling transient congestion without the intervention of end devices, and iii) gradually back propagating the congestion signal to the source when the network is not capable to handle the congestion.Experiment results show that PABO can provide prominent advantage of mitigating transient congestions and can achieve significant gain on end-to-end delay

Using food intake records to estimate compliance with the Eatwell plate dietary guidelines

This work was supported by the Scottish Government's Rural and Environment Science and Analytical Services (RESAS) Division. The original studies, from which the current data were taken, were funded by the Food Standards Agency, UK, and the Biscuit, Cake, Chocolate and Confectionery Association, London, UK.Peer reviewedPostprin

The “Hypertension Approaches in the Elderly: a Lifestyle study” multicenter, randomized trial (HAEL Study): rationale and methodological protocol

Background: Hypertension is a clinical condition highly prevalent in the elderly, imposing great risks to cardiovascular diseases and loss of quality of life. Current guidelines emphasize the importance of nonpharmacological strategies as a first-line approach to lower blood pressure. Exercise is an efficient lifestyle tool that can benefit a myriad of health-related outcomes, including blood pressure control, in older adults. We herein report the protocol of the HAEL Study, which aims to evaluate the efficacy of a pragmatic combined exercise training compared with a health education program on ambulatory blood pressure and other health-related outcomes in older individuals. Methods: Randomized, single-blinded, multicenter, two-arm, parallel, superiority trial. A total of 184 subjects (92/center), ≥60 years of age, with no recent history of cardiovascular events, will be randomized on a 1:1 ratio to 12-week interventions consisting either of a combined exercise (aerobic and strength) training, three times per week, or an active-control group receiving health education intervention, once a week. Ambulatory (primary outcome) and office blood pressures, cardiorespiratory fitness and endothelial function, together with quality of life, functional fitness and autonomic control will be measured in before and after intervention. Discussion: Our conceptual hypothesis is that combined training intervention will reduce ambulatory blood pressure in comparison with health education group. Using a superiority framework, analysis plan prespecifies an intention-to-treat approach, per protocol criteria, subgroups analysis, and handling of missing data. The trial is recruiting since September 2017. Finally, this study was designed to adhere to data sharing practices. Trial registration: NCT03264443. Registered on 29 August, 2017

Scenario-based verification and validation of dynamic UML specifications

The Unified Modeling Language (UML) is the result of the unification process of earlier object oriented models and notations. Verification and validation (V&V) tasks, as applied to UML specifications, enable early detection of analysis and design flaws prior to implementation. In this work, we address four V&V analysis methods for UML dynamic specifications, namely: Timing analysis and automatic V&V of timing constraints, automated Architectural-level Risk assessment, Performance Modeling and Fault Injection analysis. For each we present: approaches, methods and/or automated techniques. We use two case studies: a Cardiac Pacemaker and a simplified Automatic Teller Machine (ATM) banking subsystem, for illustrating the developed techniques