IMRT QA using machine learning: A multi-institutional validation.

PurposeTo validate a machine learning approach to Virtual intensity-modulated radiation therapy (IMRT) quality assurance (QA) for accurately predicting gamma passing rates using different measurement approaches at different institutions.MethodsA Virtual IMRT QA framework was previously developed using a machine learning algorithm based on 498 IMRT plans, in which QA measurements were performed using diode-array detectors and a 3%local/3 mm with 10% threshold at Institution 1. An independent set of 139 IMRT measurements from a different institution, Institution 2, with QA data based on portal dosimetry using the same gamma index, was used to test the mathematical framework. Only pixels with ≥10% of the maximum calibrated units (CU) or dose were included in the comparison. Plans were characterized by 90 different complexity metrics. A weighted poison regression with Lasso regularization was trained to predict passing rates using the complexity metrics as input.ResultsThe methodology predicted passing rates within 3% accuracy for all composite plans measured using diode-array detectors at Institution 1, and within 3.5% for 120 of 139 plans using portal dosimetry measurements performed on a per-beam basis at Institution 2. The remaining measurements (19) had large areas of low CU, where portal dosimetry has a larger disagreement with the calculated dose and as such, the failure was expected. These beams need further modeling in the treatment planning system to correct the under-response in low-dose regions. Important features selected by Lasso to predict gamma passing rates were as follows: complete irradiated area outline (CIAO), jaw position, fraction of MLC leafs with gaps smaller than 20 or 5 mm, fraction of area receiving less than 50% of the total CU, fraction of the area receiving dose from penumbra, weighted average irregularity factor, and duty cycle.ConclusionsWe have demonstrated that Virtual IMRT QA can predict passing rates using different measurement techniques and across multiple institutions. Prediction of QA passing rates can have profound implications on the current IMRT process

Segmentaci?n psicogr?fica de la peque?a y microempresa

La peque?a y microempresa se ha convertido en foco de atenci?n porque genera oportunidades de empleo e ingresos y dinamiza la econom?a. Las mypes representan m?s del 98% del total de las empresas del Per?, absorben el 88% de la PEA nacional y generan el 42% del PBI. No obstante, solo un porcentaje peque?o de ellas tiene acceso al cr?dito, lo que representa un mercado no atendido por investigar. En nuestro sistema financiero las entidades financieras no bancarias fueron las primeras en iniciar la "aventura del microcr?dito", lo que result? una pr?ctica positiva porque los microempresarios demostraron ser buenos pagadores. Pero ?qu? tipos de mypes existen en la ciudad de Lima y cu?les son sus necesidades? La presente investigaci?n busca identificar los tipos de mypes existentes en Lima Metropolitana a partir de una metodolog?a innovadora de segmentaci?n de mercado que considera no solo las variables socioecon?micas, sino tambi?n las psicogr?ficas, como los estilos de vida, con el fin de definir los lineamientos que sirvan de base para el desarrollo de productos financieros y de cr?dito de acuerdo con las necesidades de los microempresarios y seg?n la etapa del ciclo de vida en que se encuentren sus organizaciones. Igualmente, se estudia las caracter?sticas del cr?dito ofrecido a las mypes, las principales fuentes de financiamiento y los atributos del cr?dito que m?s valoran los microempresarios

A characteristics framework for Semantic Information Systems Standards

Semantic Information Systems (IS) Standards play a critical role in the development of the networked economy. While their importance is undoubted by all stakeholders—such as businesses, policy makers, researchers, developers—the current state of research leaves a number of questions unaddressed. Terminological confusion exists around the notions of “business semantics”, “business-to-business interoperability”, and “interoperability standards” amongst others. And, moreover, a comprehensive understanding about the characteristics of Semantic IS Standards is missing. The paper addresses this gap in literature by developing a characteristics framework for Semantic IS Standards. Two case studies are used to check the applicability of the framework in a “real-life” context. The framework lays the foundation for future research in an important field of the IS discipline and supports practitioners in their efforts to analyze, compare, and evaluate Semantic IS Standard

Efficacy and safety of the anti-IL-12/23 p40 monoclonal antibody, ustekinumab, in patients with active psoriatic arthritis despite conventional non-biological and biological anti-tumour necrosis factor therapy: 6-month and 1-year results of the phase 3, multicentre, double-blind, placebo-controlled, randomised PSUMMIT 2 trial

Objective: Assess ustekinumab efficacy (week 24/week 52) and safety (week 16/week 24/week 60) in patients with active psoriatic arthritis (PsA) despite treatment with conventional and/or biological anti-tumour necrosis factor (TNF) agents. Methods: In this phase 3, multicentre, placebo-controlled trial, 312 adults with active PsA were randomised (stratified by site, weight (≤100 kg/>100 kg), methotrexate use) to ustekinumab 45 mg or 90 mg at week 0, week 4, q12 weeks or placebo at week 0, week 4, week 16 and crossover to ustekinumab 45 mg at week 24, week 28 and week 40. At week 16, patients with <5% improvement in tender/swollen joint counts entered blinded early escape (placebo→45 mg, 45 mg→90 mg, 90 mg→90 mg). The primary endpoint was ≥20% improvement in American College of Rheumatology (ACR20) criteria at week 24. Secondary endpoints included week 24 Health Assessment Questionnaire-Disability Index (HAQ-DI) improvement, ACR50, ACR70 and ≥75% improvement in Psoriasis Area and Severity Index (PASI75). Efficacy was assessed in all patients, anti-TNF-naïve (n=132) patients and anti-TNF-experienced (n=180) patients. Results: More ustekinumab-treated (43.8% combined) than placebo-treated (20.2%) patients achieved ACR20 at week 24 (p<0.001). Significant treatment differences were observed for week 24 HAQ-DI improvement (p<0.001), ACR50 (p≤0.05) and PASI75 (p<0.001); all benefits were sustained through week 52. Among patients previously treated with ≥1 TNF inhibitor, sustained ustekinumab efficacy was also observed (week 24 combined vs placebo: ACR20 35.6% vs 14.5%, PASI75 47.1% vs 2.0%, median HAQ-DI change −0.13 vs 0.0; week 52 ustekinumab-treated: ACR20 38.9%, PASI75 43.4%, median HAQ-DI change −0.13). No unexpected adverse events were observed through week 60. Conclusions: The interleukin-12/23 inhibitor ustekinumab (45/90 mg q12 weeks) yielded significant and sustained improvements in PsA signs/symptoms in a diverse population of patients with active PsA, including anti-TNF-experienced PsA patients

El mapa conceptual, herramienta did?ctica que contribuye al desarrollo de procesos de comprensi?n lectora a trav?s de la metacognici?n en los estudiantes del grado sexto del gimnasio nuevo Suba de localidad 11

100 p. Recurso Electr?nicoEl proyecto de intervenci?n pedag?gica "el mapa conceptual, herramienta did?ctica que contribuye al desarrollo de procesos de comprensi?n lectora a trav?s de la metacognici?n en los estudiantes de grado sexto del Gimnasio Nuevo Suba de la localidad 11?, se basa en las dificultades encontradas en el ?rea de lengua castellana; realizando un enfoque en estudiantes con dificultades en comprensi?n lectora, efectuando entrevistas a educandos y educadores, grupos focales y talleres cuyo prop?sito es estudiar y determinar las variables que les dificultan la comprensi?n de diferentes textos, as? se evidenci? el bajo desarrollo de habilidades b?sicas, impidiendo la interiorizaci?n de informaci?n para crear un mundo de posibilidades y con ello la construcci?n del conocimiento. De ah?, la elaboraci?n, el dise?o y aplicaci?n del proyecto de intervenci?n pedag?gica, empleando para ello 20 sesiones, enfocadas en el uso de organizadores gr?ficos como el mapa conceptual, para implementarlos como herramienta did?ctica en el desarrollo del conocimiento consciente de ciertos procesos cognitivos (metacognici?n); en la medida en que se lleve a cabo cada una de las actividades propuestas. Finalmente, se espera que con la incorporaci?n de los Mapas Conceptuales como estrategia pedag?gica en las actividades de aula, se garantice la eficiencia en el proceso de ense?anza, mejorando las competencias investigativas, comunicativas, de an?lisis, interpretaci?n y s?ntesis, mediante las destrezas de la metacognici?n, en los estudiantes de grado sexto del Gimnasio nuevo Suba. Palabras Clave: Metacognici?n, autorregulaci?n, organizadores gr?ficos, mapa conceptual, proceso cognitivo, aprendizaje significativo.The pedagogical intervention project "THE CONCEPT MAP, TEACHING TOOL THAT CONTRIBUTES TO THE DEVELOPMENT OF PROCESSES OF READING COMPREHENSION PROCESSESTHROUGH METACOGNICI?N IN SIXTH GRADE STUDENTS RAISE NEW GYM SUBA IN THE TOWN 11", It is based on the difficulties encountered in the along the Participatory Action (IAP), Research such as the diary, based on direct observation of classes, especially in the area of Spanish language; case studies, focusing on students with difficulties in reading, interviewing students and teachers; and focus groups, developed through workshops whose purpose is to study and determine the variables that make it difficult for them to understand different texts, and low development of basic skills such as observation and therefore the perception is evidenced by preventing internalization of information create a world of possibilities and thus the construction of knowledge. Hence, the development, design and implementation of pegadogical intervention project, employing 20 sessions, focused on the use of graphic organizers such as concept mapping, to implement them as a teaching tool in the development of conscious awareness of certain cognitive processes (metacognition); insofar as it takes place each of proposed activities. Finally, it is expected that the incorporation of Concept Maps as a teaching strategy in the classroom activities, the efficiency of the teaching is guaranteed, improving investigative, communication skills, analysis, interpretation and synthesis, using the skills of metacognition, students sixth graders of the New Gym Suba. Keywords: metacognition, self, graphic organizers, concept maps, cognitive process, meaningful learning

Application of Chinese Jun-Cao technique for the production of Brazilian Ganoderma lucidum strains

Ganoderma lucidum is a medicinal mushroom traditionally used in China against a wide range of diseases such as cancer and also for its prevention. In this work, commercial Chinese strains G. lucidum were compared to wild Brazilian strains aiming to determine the cultivation potential through the use of Jun-Cao. Six formulations were tested and the strains presented good response to the applied method. In general, the mixture between the grass and wood was well suited for the basidiomycetes, contributing to the preparation of substrates that generated better results in Jun Cao

Tenure, gender and household structure

Starting with a review of recent literature on gender and housing, this paper goes on to develop a new theory of household structure, in which concepts of gender and generation play a key role. The utility of this theory is then demonstrated in the analysis of data from a survey of households in the City of Salford

Real world study of sacituzumab govitecan in metastatic triple-negative breast cancer in the United Kingdom

Background: Treatment options for pre-treated patients with metastatic triple-negative breast cancer (mTNBC) remain limited. This is the first study to assess the real-world safety and efficacy of sacituzumab govitecan (SG) in the UK. Methods: Data was retrospectively collected from 16 tertiary UK cancer centres. Pts had a diagnosis of mTNBC, received at least two prior lines of treatment (with at least one being in the metastatic setting) and received at least one dose of SG. Results: 132 pts were included. Median age was 56 years (28–91). All patients were ECOG performance status (PS) 0-3 (PS0; 39, PS1; 76, PS2; 16, PS3;1). 75% (99/132) of pts had visceral metastases including 18% (24/132) of pts with CNS disease. Median PFS (mPFS) was 5.2 months (95% CI 4.5–6.6) with a median OS (mOS) of 8.7 months (95% CI 6.8-NA). The most common adverse events (AEs) were fatigue (all grade; 82%, G3/4; 14%), neutropenia (all grade; 55%, G3/4; 29%), diarrhoea (all grade; 58%, G3/4, 15%), and nausea (all grade; 38%, G3/4; 3%). SG dose reduction was required in 54% of pts. Conclusion: This study supports significant anti-tumour activity in heavily pre-treated pts with mTNBC. Toxicity data aligns with clinical trial experience