Statistical analysis of IMRT dosimetry quality assurance measurements for local delivery guideline

<p>Abstract</p> <p>Purpose</p> <p>To establish our institutional guideline for IMRT delivery, we statistically evaluated the results of dosimetry quality assurance (DQA) measurements and derived local confidence limits using the concept confidence limit of |mean|+1.96σ.</p> <p>Materials and methods</p> <p>From June 2006 to March 2009, 206 patients with head and neck cancer, prostate cancer, liver cancer, or brain tumor were treated using LINAC-based IMRT technique. In order to determine site specific DQA tolerances at a later stage, a hybrid plan with the same fluence maps as in the treatment plan was generated on CT images of a cylindrical phantom of acryl. Points of measurement using a 0.125 cm³ion-chamber were typically located in the region of high and uniform doses. The planar dose distributions perpendicular to the central axis were measured by using a diode array in solid water with all fields delivered, and assessed using gamma criteria of 3%/3 mm. The mean values and standard deviations were used to develop the local confidence and tolerance limits. The dose differences and gamma pass rates for the different treatment sites were also evaluated in terms of total monitor uints (MU), MU/cGy, and the number of PTV's pieces.</p> <p>Results</p> <p>The mean values and standard deviations of ion-chamber dosimetry differences between calculated and measured doses were -1.6 ± 1.2% for H&N cancer, -0.4 ± 1.2% for prostate and abdominal cancer, and -0.6 ± 1.5% for brain tumor. Most of measured doses (92.2%) agreed with the calculated doses within a tolerance limit of ±3% recommended in the literature. However, we found some systematic under-dosage for all treatment sites. The percentage of points passing the gamma criteria, averaged over all treatment sites was 97.3 ± 3.7%. The gamma pass rate and the agreement of ion-chamber dosimetry generally decreased with increasing the number of PTV's pieces, the degree of modulation (MU/cGy), and the total MU beyond 700. Our local confidence limits were comparable to those of AAPM TG 119 and ESTRO guidelines that were provided as a practical baseline for center-to-center commissioning comparison. Thus, our institutional confidence and action limits for IMRT delivery were set into the same levels of those guidelines.</p> <p>Discussion and Conclusions</p> <p>The systematic under-dosage were corrected by tuning up the MLC-related factors (dosimetric gap and transmission) in treatment planning system (TPS) and further by incorporating the tongue-and groove effect into TPS. Institutions that have performed IMRT DQA measurements over a certain period of time need to analyze their accrued DQA data. We confirmed the overall integrity of our IMRT system and established the IMRT delivery guideline during this procedure. Dosimetric corrections for the treatment plans outside of the action level can be suggested only with such rigorous DQA and statistical analysis.</p

Carpe Diem: On the Evaluation of World Knowledge in Lifelong Language Models

In an ever-evolving world, the dynamic nature of knowledge presents challenges for language models that are trained on static data, leading to outdated encoded information. However, real-world scenarios require models not only to acquire new knowledge but also to overwrite outdated information into updated ones. To address this under-explored issue, we introduce the temporally evolving question answering benchmark, EvolvingQA - a novel benchmark designed for training and evaluating LMs on an evolving Wikipedia database, where the construction of our benchmark is automated with our pipeline using large language models. Our benchmark incorporates question-answering as a downstream task to emulate real-world applications. Through EvolvingQA, we uncover that existing continual learning baselines have difficulty in updating and forgetting outdated knowledge. Our findings suggest that the models fail to learn updated knowledge due to the small weight gradient. Furthermore, we elucidate that the models struggle mostly on providing numerical or temporal answers to questions asking for updated knowledge. Our work aims to model the dynamic nature of real-world information, offering a robust measure for the evolution-adaptability of language models.Comment: 14 pages, 5 figures, 5 tables; accepted at NeurIPS Syntheticdata4ML workshop, 202

Ammonium Inhibits Chromomethylase 3-Mediated Methylation of the Arabidopsis Nitrate Reductase Gene NIA2

Gene methylation is an important mechanism regulating gene expression and genome stability. Our previous work showed that methylation of the nitrate reductase (NR) gene NIA2 was dependent on chromomethylase 3 (CMT3). Here, we show that CMT3-mediated NIA2 methylation is regulated by ammonium in Arabidopsis thaliana. CHG sequences (where H can be A, T, or C) were methylated in NIA2 but not in NIA1, and ammonium [(NH4)2SO4] treatment completely blocked CHG methylation in NIA2. By contrast, ammonium had no effect on CMT3 methylation, indicating that ammonium negatively regulates CMT3-mediated NIA2 methylation without affecting CMT3 methylation. Ammonium upregulated NIA2 mRNA expression, which was consistent with the repression of NIA2 methylation by ammonium. Ammonium treatment also reduced the overall genome methylation level of wild-type Arabidopsis. Moreover, CMT3 bound to specific promoter and intragenic regions of NIA2. These combined results indicate that ammonium inhibits CMT3-mediated methylation of NIA2 and that of other target genes, and CMT3 selectively binds to target DNA sequences for methylation

Synthetic chloride transporters with the binding mode observed in a ClC chloride channel

A series of synthetic molecules bearing the same hydrogen bonding mode observed in StClC were prepared and their transport ability of chloride ion across a lipid membrane was systematically optimized.close4

Effects of Rhythmic Auditory Stimulation During Hemiplegic Arm Reaching in Individuals with Stroke: An Exploratory Study

SummaryObjective/BackgroundThis study investigated the effects of rhythmic auditory stimulation (RAS) on muscle activity and elbow motion during arm reaching with hemiplegic arm in participants with stroke.MethodsSixteen adults with stroke who resided in a community were recruited in this study. The RAS consisted of sound emitted from a digital metronome. While sitting upright in a chair, participants reached their arms towards a target (a switch on a table) both with and without RAS. The three-dimensional motion analysis system and surface electromyography system were used for measurements during the reaching tasks.ResultsWe found that RAS elicited better performance in reaching movements than those movements performed without RAS. RAS shortened the movement time (p = .002), reduced the change in acceleration (p = .001), increased the elbow extension range of motion (p = .001), increased muscle activation of the triceps brachii (p = .024), and reduced the co-contraction ratio (p = .015) of the affected arm.ConclusionRAS might be a useful technique to facilitate improvements in motor function of the affected arm in patients with stroke

Arhgef16, a novel Elmo1 binding partner, promotes clearance of apoptotic cells via RhoG-dependent Rac1 activation

AbstractElmo is an evolutionarily conserved mammalian ortholog of Caenorhabditis elegans CED-12 with proposed roles during the removal of apoptotic cells, cell migration, neurite outgrowth, and myoblast fusion (Katoh and Negishi (2003) [1], Park and Tosello (2007) [2], Grimsley et al. (2004) [3], Hamoud et al. (2014) [4]). Elmo mediates these cellular processes by interacting with various proteins located in the plasma membrane, cytoplasm and nucleus, and by modulating their activities although it has no intrinsic catalytic activity (Park and Tosello (2007) [2], Hamoud et al. (2014) [4], Li et al. (2013) [5], Margaron, Fradet and Cote (2013) [6], and Mauldin et al. (2013)[7]). Because there are a limited number of proteins known to interact with Elmo, we performed a yeast two-hybrid screen using Elmo1 as bait to identify Elmo1-interacting proteins and to evaluate their mode of regulation. Arhgef16 was one of the proteins identified through the screen and subsequent analyses revealed that Arhgef16 interacted with Elmo1 in mammalian cells as well. Expression of Arhgef16 in phagocytes promoted engulfment of apoptotic cells, and engulfment mediated by Arhgef16 increased synergistically in the presence of Elmo1 but was abrogated in the absence of Elmo1. In addition, Arhgef16-mediated removal of apoptotic cells was dependent on RhoG, but independent of Dock1. Taken together, this study suggests that the newly identified Elmo1-interacting protein, Arhgef16, functions synergistically with Elmo1 to promote clearance of apoptotic cells in a RhoG-dependent and Dock1-independent manner

Effects of education on low-phosphate diet and phosphate binder intake to control serum phosphate among maintenance hemodialysis patients: A randomized controlled trial.

Background:For phosphate control, patient education is essential due to the limited clearance of phosphate by dialysis. However, well-designed randomized controlled trials about dietary and phosphate binder education have been scarce. Methods:We enrolled maintenance hemodialysis patients and randomized them into an education group (n = 48) or a control group (n = 22). We assessed the patients' drug compliance and their knowledge about the phosphate binder using a questionnaire. Results:The primary goal was to increase the number of patients who reached a calcium-phosphorus product of lower than 55. In the education group, 36 (75.0%) patients achieved the primary goal, as compared with 16 (72.7%) in the control group (P = 0.430). The education increased the proportion of patients who properly took the phosphate binder (22.9% vs. 3.5%, P = 0.087), but not to statistical significance. Education did not affect the amount of dietary phosphate intake per body weight (education vs. control: -1.18 ± 3.54 vs. -0.88 ± 2.04 mg/kg, P = 0.851). However, the dietary phosphate-to-protein ratio tended to be lower in the education group (-0.64 ± 2.04 vs. 0.65 ± 3.55, P = 0.193). The education on phosphate restriction affected neither the Patient-Generated Subjective Global Assessment score (0.17 ± 4.58 vs. -0.86 ± 3.86, P = 0.363) nor the level of dietary protein intake (-0.03 ± 0.33 vs. -0.09 ± 0.18, P = 0.569). Conclusion:Education did not affect the calcium-phosphate product. Education on the proper timing of phosphate binder intake and the dietary phosphate-to-protein ratio showed marginal efficacy

Influence of welding passes on grain orientation - The example of a multi-pass V-weld

International audienceThe accurate modelling of grain orientations in a weld is important, when accurate ultrasonic test predictions of a welded assembly are needed. To achieve this objective, Electricité de France (EDF) and the Laboratoire de Caractérisation Non Destructive (LCND) have developed a dedicated code, which makes use of information recorded in the welding procedure. Among the welding parameters recorded, although the order in which the welding passes are made is of primary importance in the welding process, this information is not always well known or accurately described. In the present paper we analyse in greater detail the influence of the order of welding passes, using data obtained from the Centre for Advanced Non Destructive Evaluation (CANDE), derived from a dissimilar metal weld (DMW) with buttering. Comparisons are made using grain orientation measurements on a macrograph

Spin-Orbital Locking, Emergent Pseudo-Spin, and Magnetic order in Honeycomb Lattice Iridates

The nature of the effective spin Hamiltonian and magnetic order in the honeycomb iridates is explored by considering a trigonal crystal field effect and spin-orbit coupling. Starting from a Hubbard model, an effective spin Hamiltonian is derived in terms of an emergent pseudo-spin-1/2 moment in the limit of large trigonal distortions and spin-orbit coupling. The present pseudo-spins arise from a spin-orbital locking and are different from the jeff = 1/2 moments that are obtained when the spin-orbit coupling dominates and trigonal distortions are neglected. The resulting spin Hamiltonian is anisotropic and frustrated by further neighbour interactions. Mean field theory suggests a ground state with 4-sublattice zig-zag magnetic order in a parameter regime that can be relevant to the honeycomb iridate compound Na2IrO3, where similar magnetic ground state has recently been observed. Various properties of the phase, the spin-wave spectrum and experimental consequences are discussed. The present approach contrasts with the recent proposals to understand iridate compounds starting from the strong spin-orbit coupling limit and neglecting non-cubic lattice distortions.Comment: 13 pages (Draft expanded; references updated; typos corrected and discussion on recent experiments added