Adjuvant radiation therapy in metastatic lymph nodes from melanoma

<p>Abstract</p> <p>Purpose</p> <p>To analyze the outcome after adjuvant radiation therapy with standard fractionation regimen in metastatic lymph nodes (LN) from cutaneous melanoma.</p> <p>Patients and methods</p> <p>86 successive patients (57 men) were treated for locally advanced melanoma in our institution. 60 patients (69%) underwent LN dissection followed by radiation therapy (RT), while 26 patients (31%) had no radiotherapy.</p> <p>Results</p> <p>The median number of resected LN was 12 (1 to 36) with 2 metastases (1 to 28). Median survival after the first relapse was 31.8 months. Extracapsular extension was a significant prognostic factor for regional control (p = 0.019). Median total dose was 50 Gy (30 to 70 Gy). A standard fractionation regimen was used (2 Gy/fraction). Median number of fractions was 25 (10 to 44 fractions). Patients were treated with five fractions/week. Patients with extracapsular extension treated with surgery followed by RT (total dose ≥50 Gy) had a better regional control than patients treated by surgery followed by RT with a total dose <50 Gy (80% vs. 35% at 5-year follow-up; p = 0.004).</p> <p>Conclusion</p> <p>Adjuvant radiotherapy was able to increase regional control in targeted sub-population (LN with extracapsular extension).</p

The dimension reduction power of ClustOfVar: application of the variable cluster analysis technique in a mixed data health database

ackground/Objective: Technological evolution is increasingly making real the elements necessary for the daily practice of personalized medicine, an improved vision of health care whose decisions regarding prognosis, diagnosis and therapeutic strategies depend on the patient's various characteristics. This approach leads to the collection and use of information that is broad in extension and complexity, for which dimensionality reduction techniques are imperative, in order to simplify and understand it. This paper aims to show the value of the ClustOfVar technique, a variable clustering technique capable of dealing with mixed data, resulting in data reduction. Through its hierarchical and non-hierarchical approaches, it replaces sample variables with representative synthetic variables. This dimensional reduction can be extended to individuals by applying Ward's method. Methods: The cleaning process of anthropometric, obstetric, vital signs and pubertal status data from 700 participants of the Generation XXI cohort and/or their mothers led to variables being removed (181 down to 105 variables, 82 quantitative and 23 qualitative). Then, the hierarchical technique of the ClustOfVar package was applied, which started by building a hierarchy of variables. The optimal number of clusters was then determined, considering the aggregation level plot and the bootstrap methodology, and each cluster was characterized. The partition into clusters was then tried with the non-hierarchical process. Once the partition was defined, Ward's method was applied, dividing the participants into clusters. We finished with their description according to the synthetic variables. Results: The partition in 8 clusters of variables suggested by the hierarchical technique was chosen, with the first and third cluster being filled mainly by maternal characteristics (relating mainly to menstruation and physical measurements, respectively). While cluster 2 mixes maternal and individual characteristics, cluster 4 contains only patient variables at birth. Cluster 5 is the most diverse, with anthropometric and related measurements of vital signs and blood macromolecules. Cluster 6 has total mass and fat measurements. Finally, cluster 7 is related to pubertal status variables, and cluster 8 includes cholesterol variables. The clustering of individuals results in the creation of specific profiles for each of the 8 clusters of individuals. Conclusions: The ClustOfVar technique accomplishes a data transformation relevant to the dispersion of personalized medicine. However, it lacks the ability to deal with high proportions of missing data and its bootstrap process is very time-consuming.publishe

Diagnostic ability of artificial intelligence using deep learning analysis of cyst fluid in differentiating malignant from benign pancreatic cystic lesions

横浜市立大学2020年

On the Potential, Feasibility, and Effectiveness of Chat Bots in Public Health Research Going Forward

This paper will discuss whether bots, particularly chat bots, can be useful in public health research and health or pharmacy systems operations. Bots have been discussed for many years; particularly when coupled with artificial intelligence, they offer the opportunity of automating mundane or error-ridden processes and tasks by replacing human involvement. This paper will discuss areas where there are greater advances in the use of bots, as well as areas that may benefit from the use of bots, and will offer practical ways to get started with bot technology. Several popular bot applications and bot development tools along with practical security considerations will be discussed, and a toolbox that one can begin to use to implement bots will be presented

Delta-radiomics Entropy Based on Tumor Heterogeneity Concept – Response Predictor to Irradiation for Unresectable/recurrent Glioblastoma

Although adjuvant radiotherapy in combination with Temozolomide administration has clearly demonstrated the benefit in improving the prognosis of patients with multiforme glioblastoma, radiotherapy as only treatment or in combination with systemic treatment is one of the best supportive in unresectable cases. For recurrent cases, the salvage radiotherapy option (re-irradiation) can be chosen in carefully selected cases so that the benefit is greater than the toxicities. Radiomics, a new subdomain of artificial intelligence (AI), relies on advanced analysis in high-resolution medical imaging to establish diagnostic, prognostic and predictive models for clinical medicine. The variation of the delta-radiomics parameters analyzed within a tumor volume may be via tumor heterogeneity indirectly correlated with the response to treatment. The aim of the study is to propose a delta-radiomic based on entropy algorithm to allow the non-invasive pre-therapeutic identification of patients with unresectable or recurrent multiform glioblastoma who will benefit from irradiation and/or salvage re-irradiation

Hepatocellular Carcinoma. Part 3: Surgical and Medical Treatment

Hepatocellular carcinoma (HCC) treatment is variable and depends on the size, location, and presence of extra hepatic metastasis and vascular invasion. HCC treatment options have advanced significantly over the past few decades and include surgical and non-surgical methods. In the past, systemic chemotherapy was the non-surgical treatment and there was no significant increase in overall survival rate. Nowadays sorafenib, a molecular targeted drug, is the treatment of choice and has shown proven benefits in increasing survival time; other systemic therapies did not show longer statistical superiority. However, surgical treatments, such as liver transplantation and surgical resection, are still the only methods offering a curative opportunity; however, these are not free of adverse effects and recurrence of the tumour. Non-surgical techniques including ablative treatment, radiotherapy, transarterial chemoembolisation, and percutaneous ethanol injection also show some benefit in the survival of patients with HCC. Future molecular targeted drugs are currently under investigation in different stages of clinical trials, and there are positive expectations regarding their benefit in treating HCC

South Africa : the early quest for liberty and democracy

The early quest for liberty and political freedom in South Africa had been influenced by various factors, inter alia political sentiments which originated in Reformed, Huguenot and Patriotten political theory. An analysis of early political ideas indicates that religious sentiments had a significant influence on the development of political ideas. These sentiments and ideas all contributed to a passionate search for freedom, justice and democracy. The different strata of religious and political ideas manifest in a continuous and discontinuous way, giving the impression of fragmented and contorted ideas, but still recognisable in terms of their origins. This contribution is an attempt to identify some of the fragmented and contorted strata of ideas which influenced the early quest for political freedom and the rejection of British colonial rule in South Africa.http://www.hts.org.zaam201

Modulational instability and critical regime in a highly birefringent fiber

info:eu-repo/semantics/publishe