In-vivo EPID dosimetry for IMRT and VMAT based on through-air predicted portal dose algorithm.

We have adapted the methodology of Berry et al. (2012) for Intensity Modulated Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) treatments at a fixed source to imager distance (SID) based on the manufacturer's through-air portal dose image prediction algorithm. In order to fix the SID a correction factor was introduced to account for the change in air gap between patient and imager. Commissioning data, collected with multiple field sizes, solid water thicknesses and air gaps, were acquired at 150 cm SID on the Varian aS1200 EPID. The method was verified using six IMRT and seven VMAT plans on up to three different phantoms. The method's sensitivity and accuracy were investigated by introducing errors. A global 3%/3 mm gamma was used to assess the differences between the predicted and measured portal dose images. The effect of a varying air gap on EPID signal was found to be significant - varying by up to 30% with field size, phantom thickness, and air gap. All IMRT plans passed the 3%/3 mm gamma criteria by more than 95% on the three phantoms. 23 of 24 arcs from the VMAT plans passed the 3%/3 mm gamma criteria by more than 95%. This method was found to be sensitive to a range of potential errors. The presented approach provides fast and accurate in-vivo EPID dosimetry for IMRT and VMAT treatments and can potentially replace many pre-treatment verifications

Chemical simulation of greywater

Sustainable water resources management attracts considerable attention in today’s world. Recycling and reuse of both wastewater and greywater are becoming more attractive. The strategy is to protect ecosystem services by balancing the withdrawal of water and the disposal of wastewater. In the present study, a timely and novel synthetic greywater composition has been proposed with respect of the composition of heavy metals, nutrients and organic matter. The change in water quality of the synthetic greywater due to increasing storage time was monitored to evaluate the stability of the proposed chemical formula. The new greywater is prepared artificially using analytical grade chemicals to simulate either low (LC) or high (HC) pollutant concentrations. The characteristics of the synthetic greywater were tested (just before starting the experiment, after two days and a week of storage under real weather conditions) and compared to those reported for real greywater. Test results for both synthetic greywater types showed great similarities with the physiochemical properties of published findings concerning real greywater. Furthermore, the synthetic greywater is relatively stable in terms of its characteristics for different storage periods. However, there was a significant (p<0.05) reduction in 5-day biochemical oxygen demand (BOD5) for both low (LC) and high (HC) concentrations of greywater after two days of storage with reductions of 62% and 55%, respectively. A significant (p<0.05) change was also noted for the reduction (70%) of nitrate‒nitrogen (NO3‒N) concerning HC greywater after seven days of storage

Central nervous system immune interactome is a function of cancer lineage, tumor microenvironment, and STAT3 expression.

BACKGROUNDImmune cell profiling of primary and metastatic CNS tumors has been focused on the tumor, not the tumor microenvironment (TME), or has been analyzed via biopsies.METHODSEn bloc resections of gliomas (n = 10) and lung metastases (n = 10) were analyzed via tissue segmentation and high-dimension Opal 7-color multiplex imaging. Single-cell RNA analyses were used to infer immune cell functionality.RESULTSWithin gliomas, T cells were localized in the infiltrating edge and perivascular space of tumors, while residing mostly in the stroma of metastatic tumors. CD163+ macrophages were evident throughout the TME of metastatic tumors, whereas in gliomas, CD68+, CD11c+CD68+, and CD11c+CD68+CD163+ cell subtypes were commonly observed. In lung metastases, T cells interacted with CD163+ macrophages as dyads and clusters at the brain-tumor interface and within the tumor itself and as clusters within the necrotic core. In contrast, gliomas typically lacked dyad and cluster interactions, except for T cell CD68+ cell dyads within the tumor. Analysis of transcriptomic data in glioblastomas revealed that innate immune cells expressed both proinflammatory and immunosuppressive gene signatures.CONCLUSIONOur results show that immunosuppressive macrophages are abundant within the TME and that the immune cell interactome between cancer lineages is distinct. Further, these data provide information for evaluating the role of different immune cell populations in brain tumor growth and therapeutic responses.FUNDINGThis study was supported by the NIH (NS120547), a Developmental research project award (P50CA221747), ReMission Alliance, institutional funding from Northwestern University and the Lurie Comprehensive Cancer Center, and gifts from the Mosky family and Perry McKay. Performed in the Flow Cytometry & Cellular Imaging Core Facility at MD Anderson Cancer Center, this study received support in part from the NIH (CA016672) and the National Cancer Institute (NCI) Research Specialist award 1 (R50 CA243707). Additional support was provided by CCSG Bioinformatics Shared Resource 5 (P30 CA046592), a gift from Agilent Technologies, a Research Scholar Grant from the American Cancer Society (RSG-16-005-01), a Precision Health Investigator Award from University of Michigan (U-M) Precision Health, the NCI (R37-CA214955), startup institutional research funds from U-M, and a Biomedical Informatics & Data Science Training Grant (T32GM141746)

Overweight and obesity in relation to cardiovascular disease risk factors among medical students in Crete, Greece

BACKGROUND: Recent data indicate increasing rates of adult obesity and mortality from cardiovascular disease (CVD) in Greece. No data, however, are available on prevalence of overweight and obesity in relation to CVD risk factors among young adults in Greece. METHODS: A total of 989 third-year medical students (527 men, 462 women), aged 22 ± 2 years, were recruited from the University of Crete during the period 1989–2001. Anthropometric measures and blood chemistries were obtained. The relationships between obesity indices (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHpR], waist-to-height ratio [WHtR]) and CVD risk factor variables (blood pressure, glucose, serum lipoproteins) were investigated. RESULTS: Approximately 40% of men and 23% of women had BMI ≥ 25.0 kg/m(2). Central obesity was found in 33.4% (average percentage corresponding to WC ≥ 90 cm, WHpR ≥ 0.9 and WHtR ≥ 50.0) of male and 21.7% (using WC ≥ 80 cm, WHpR ≥ 0.8, WHtR ≥ 50.0) of female students. Subjects above the obesity indices cut-offs had significantly higher values of CVD risk factor variables. BMI was the strongest predictor of hypertension. WHtR in men and WC in women were the most important indicators of dyslipidaemia. CONCLUSION: A substantial proportion of Greek medical students were overweight or obese, obesity status being related to the presence of hypertension and dyslipidaemia. Simple anthropometric indices can be used to identify these CVD risk factors. Our results underscore the need to implement health promotion programmes and perform large-scale epidemiological studies within the general Greek young adult population

Application of lactate testing and pulsogramms in the rehabilitation of patients with obesity

The optimization of mental and physical performance at all stages of training is the main task for untrained athletes. Performing overly in intensity or duration of stress leads to the development of fatigue and reduce the potential in adaptation. Narrowing the boundaries of adaptation leads to reduced performance. The purpose of the study was to assess the level of lactate in untrained patients with overweight and obesity, as well as, to create for these patients the optimal training patterns using the pulsogram method. Determining the concentration of lactate (lactic acid) in the blood is an important indicator of assessing the intensity of the load, one of the main methods of operational control over the effectiveness of the training process, provides valuable information about changes in the blood, muscles and other tissues. Knowing of the concentration of lactate in the blood we can determine the level of the anaerobic threshold, equal to 4-5 mmol/l (fixed threshold) and, depending on the physiological characteristics of the athlete, reaches 6 mmol/l.Основной задачей для нетренированных спортсменов является оптимизация умственной и физической работоспособности на всех этапах подготовки. Выполнение неадекватных по интенсивности или длительности нагрузок способствует развитию переутомления и снижению потенциала адаптации. Сужение границ адаптации приводит к снижению работоспособности. Цель исследования состояла в оценке уровня лактата у нетренированных пациентов с избыточным весом и ожирением, а также, составления для данных пациентов оптимальных шаблонов тренировок по методу пульсограмм. Определение концентрации лактата (молочной кислоты) в крови является важным показателем оценки интенсивности нагрузки, одним из основных методов оперативного контроля за эффективностью тренировочного процесса, дает ценную информацию об изменениях, происходящих в крови, в мышцах, других тканях. По концентрации лактата в крови прямым способом определяется уровень анаэробного порога, равный 4-5 ммоль/л (фиксированный порог) и в зависимости от физиологических особенностей спортсмена достигающий 6 ммоль/л

May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension

Aims Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk

Stimulation of insulin signaling and inhibition of JNK-AP1 activation protect cells from amyloid-\u3b2-induced signaling dysregulation and inflammatory response

One of the hallmarks of Alzheimer's disease (AD) is the accumulation and deposition of amyloid-\u3b2 (A\u3b2) peptides in the brain and cerebral vasculature. A\u3b2 evokes neuroinflammation and has been implicated in insulin signaling disruption and JNK-AP1 activation, contributing to AD neuropathologies including oxidative injury and vascular insufficiencies. In this study we aim to better understand the protective mechanisms of insulin signaling and JNK-AP1 inhibition on the adverse effects of A\u3b2. Four-hour treatment of hCMEC/D3, the immortalized human brain endothelial cells (iHBEC), with A\u3b21-42 resulted in significant c-Jun phosphorylation, oxidative stress, and cell toxicity. Concurrent treatment with A\u3b21-42 and insulin or A\u3b21-42 and JNK inhibitor SP600125 significantly improved cell viability. Cytokine array on conditioned media showed that insulin and SP600125 strongly reduced all A\u3b2 1-42-induced cytokines. ELISA confirmed the protective effect of insulin and SP600125 on A\u3b2-induced expression of interleukin (IL)-8 and Growth related oncogene-\u3b1 (Gro-\u3b1). qRT-PCR revealed that insulin and SP600125 protected iHBEC from A\u3b21-42-induced inflammatory gene expression. Transcription factor profiling showed that treatment of iHBEC with A\u3b21-42, insulin, or SP600125 alone or in combination resulted in profound changes in modulating the activities of multiple transcription factors and relevant pathways, some of which were validated by western blot. Insulin treatment and JNK inhibition in vitro synergistically reduced c-Jun phosphorylation and thus JNK-AP1 signaling activation. The study suggests that activation of insulin and blocking of JNK-AP1 signaling inhibits A\u3b2-induced dysregulation of insulin signaling and inflammatory response.Peer reviewed: YesNRC publication: Ye