34 research outputs found
Refining Treatment Planning in STereotactic Arrhythmia Radioablation (STAR): Benchmark Results and Consensus Statement from the STOPSTORM.eu Consortium.
BACKGROUND AND PURPOSE
STereotactic Arrhythmia Radioablation (STAR) showed promising results in patients with refractory ventricular tachycardia (VT). However, clinical data is scarce and heterogeneous. The STOPSTORM.eu consortium was established to investigate and harmonize STAR in Europe. The primary goal of this benchmark study was to investigate current treatment planning practice within the STOPSTORM project as a baseline for future harmonization.
METHODS
Planning target volumes (PTV) overlapping extra-cardiac organs-at-risk and/or cardiac substructures were generated for three STAR cases. Participating centers were asked to create single fraction treatment plans with 25 Gy dose prescription based on in-house clinical practice. All treatment plans were reviewed by an expert panel and quantitative crowd knowledge-based analysis was performed with independent software using descriptive statistics for ICRU report 91 relevant parameters and crowd dose-volume-histograms. Thereafter, treatment planning consensus statements were established using a dual-stage voting process.
RESULTS
Twenty centers submitted 67 treatment plans for this study. In most plans (75%) Intensity Modulated Arc Therapy (IMAT) with 6 MV flattening-filter-free beams was used. Dose prescription was mainly based on PTV D95% (49%) or D96-100% (19%). Many participants preferred to spare close extra-cardiac organs-at-risk (75%) and cardiac substructures (50%) by PTV coverage reduction. PTV D0.035cm3 ranged 25.5-34.6 Gy, demonstrating a large variety of dose inhomogeneity. Estimated treatment times without motion compensation or setup ranged 2-80 minutes. For the consensus statements, strong agreement was reached for beam technique planning, dose calculation, prescription methods and trade-offs between target and extra-cardiac critical structures. No agreement was reached on cardiac substructure dose limitations and on desired dose inhomogeneity in the target.
CONCLUSION
This STOPSTORM multi-center treatment planning benchmark study showed strong agreement on several aspects of STAR treatment planning, but also revealed disagreement on others. To standardize and harmonize STAR in the future, consensus statements were established, however clinical data is urgently needed for actionable guidelines for treatment planning
Developmental disruption of perineuronal nets in the medial prefrontal cortex after maternal immune activation
© The Author(s) 2016. Maternal infection during pregnancy increases the risk of offspring developing schizophrenia later in life. Similarly, animal models of maternal immune activation (MIA) induce behavioural and anatomical disturbances consistent with a schizophrenia-like phenotype in offspring. Notably, cognitive impairments in tasks dependent on the prefrontal cortex (PFC) are observed in humans with schizophrenia and in offspring after MIA during pregnancy. Recent studies of post-mortem tissue from individuals with schizophrenia revealed deficits in extracellular matrix structures called perineuronal nets (PNNs), particularly in PFC. Given these findings, we examined PNNs over the course of development in a well-characterized rat model of MIA using polyinosinic-polycytidylic acid (polyI:C). We found selective reductions of PNNs in the PFC of polyI:C offspring which did not manifest until early adulthood. These deficits were not associated with changes in parvalbumin cell density, but a decrease in the percentage of parvalbumin cells surrounded by a PNN. Developmental expression of PNNs was also significantly altered in the amygdala of polyI:C offspring. Our results indicate MIA causes region specific developmental abnormalities in PNNs in the PFC of offspring. These findings confirm the polyI:C model replicates neuropathological alterations associated with schizophrenia and may identify novel mechanisms for cognitive and emotional dysfunction in the disorder
Estudo das habilidades auditivas de resolução temporal e figura-fundo em dançarinos
Resumo:OBJETIVO:avaliar a habilidade auditiva de resolução temporal e de identificação de sentenças com mensagem competitiva em dançarinos.MÉTODOS:trata-se de um estudo prospectivo em que foram avaliados 40 indivÃduos distribuÃdos em dois grupos: grupo 1 (dançarinos) e grupo 2 (não-dançarinos). Os instrumentos de avaliação do processamento auditivo utilizados foram: teste Gaps-in-noise (GIN) e teste de reconhecimento de sentenças na presença de mensagem competitiva (SSI).RESULTADOS:os limiares de gap de ambos os grupos variaram de 3 a 6 ms e não demostraram diferença estatisticamente significante na comparação entre os grupos. Houve diferença estatisticamente significante ao comparar a porcentagem de identificação de gaps entre os dois grupos, sendo que o grupo de dançarinos apresentou média maior que o grupo de não dançarinos.O teste de reconhecimento de frases em escuta monótica (rel -10dB) mostrou resultados que variaram de 50% até 100% para o grupo de dançarinos e de 40% até 100% para o de não - dançarinos. A idade de inÃcio da dança (antes ou depois dos sete anos) não influenciou no desempenho dos testes estudados. Não houve correlação entre as variáveis dos achados obtidos nos testes estudados no grupo de dançarinos considerando o tempo de dança.CONCLUSÃO:a dança influenciou positivamente a habilidade auditiva de resolução temporal, pois o grupo de dançarinos apresentou desempenho melhor do que o grupo de não-dançarinos. A dança parece não ter influenciado a habilidade auditiva de figura-fundo
Art. 74 - Legittimazione all'azione civile
Il contributo ha ad oggetto lo specifico atteggiarsi dell’azione civile in ognuno dei procedimenti speciali previsti nel codice di procedura penale, soffermandosi in particolar modo su quelli più importanti (giudizio abbreviato, applicazione della pena su richiesta delle parti e procedimento per decreto). L'Autrice riflette sul fatto che nell'ambito dei procedimenti speciali previsti dal codice vigente il ruolo della parte civile presenta delle particolarita` e si atteggia a seconda della diversita` di concetto dei riti