Extraction of User Navigation Pattern Based on Particle Swarm Optimization

With current projections regarding the growth of Internet sales, online retailing raises many questions about how to market on the Net. A Recommender System (RS) is a composition of software tools that provides valuable piece of advice for items or services chosen by a user. Recommender systems are currently useful in both the research and in the commercial areas. Recommender systems are a means of personalizing a site and a solution to the customer?s information overload problem. Recommender Systems (RS) are software tools and techniques providing suggestions for items and/or services to be of use to a user. These systems are achieving widespread success in e-commerce applications nowadays, with the advent of internet. This paper presents a categorical review of the field of recommender systems and describes the state-of-the-art of the recommendation methods that are usually classified into four categories: Content based Collaborative, Demographic and Hybrid systems. To build our recommender system we will use fuzzy logic and Markov chain algorithm

A Prospective Phase II Study of Induction Carboplatin and Vinorelbine followed by Concomitant Topotecan and Accelerated Radiotherapy (ART) in Locally Advanced Non-small Cell Lung Cancer (NSCLC)

BackgroundSurvival of locally advanced/unresectable non-small cell lung cancer (NSCLC) has improved with the use of concurrent radiation and chemotherapy over the past decades, but local and distant failure remain high. In addition, a key limiting factor in combining chemotherapy with accelerated radiotherapy (ART) is severe esophagitis. We investigated the toxicity, response rate, and overall survival (OS) with induction carboplatin and vinorelbine followed by concomitant topotecan and ART in patients with locally advanced/unresectable NSCLC.MethodsIn this phase II trial, stage IIIA or IIIB NSCLC patients with a Karnofsky performance score >60 were eligible. Patients received induction carboplatin (area under the curve = 5.5) on days 1 and 22, and vinorelbine (25 mg/m2) on days 1, 8, 22, and 29. During the concurrent chemoradiation, patients received intravenous topotecan (0.5 mg/m2) on days 43 to 47, days 57 to 61, and days 71 to 75 before the morning radiotherapy (RT) fraction. RT was administered in an accelerated fashion at 2 Gy per fraction, twice daily for five consecutive days, every other week, to a cumulative dose of 60 Gy during a 5-week period.ResultsThirty-seven patients were accrued; of these, 35 were evaluable. Overall response rate was 71% (14% complete response, 57% partial response). Six of 35 (17%) patients had stable disease. Four (11%) patients progressed during treatment. At a median follow-up of 45 months for surviving patients, the median survival based on Kaplan–Meier estimates is 17.9 months. OS at 1, 2, and 3 years is 62%, 41%, and 33%, respectively. Actuarial 5-year OS is 21%. The median time to first relapse is 12.2 months (9.1–24.7 months). There were no cases of grade 3 or 4 esophagitis.ConclusionsThis combined-modality regimen yielded encouraging OS rates, with no severe esophagitis. Using four-dimensional RT treatment planning, we plan to further evaluate altered fractionation RT and chemotherapy for this group of patients

Ultrasound-guided out-of-plane (OOP) adductor canal continuous catheter placement compared to in-plane (IP) placement in total knee arthroplasty: a randomized, single blinded, pilot clinical trial

Background: Adductor canal continuous catheters (ACCCs) have largely replaced femoral nerve continuous catheters for providing analgesia after total knee arthroplasty. Both have similar analgesic efficacy, but ACCCs preserve quadricep strength and facilitate patient mobility more quickly. We hypothesized that placing the ACCC using an out of-plane (OOP) technique would decrease pain scores and opioid use due to parallel alignment with the saphenous nerve when compared to the in-plane (IP) technique. Methods: Sixty-nine patients undergoing total knee arthroplasty were randomized to either the IP or OOP technique for ultrasound-guided ACCC. The primary outcomes of the investigation were hospital length of stay, total opioid consumption, and average post-operative pain score. Secondary outcomes included total ondansetron consumption, total acetaminophen consumption, and the incidence of anti-emetic drug use. Results: There were no significant differences between the IP and the OOP groups for any of the measured variables: hospital length of stay, pre-operative pain score, average post-operative pain score, total opioid consumption, total ondansetron consumption, total acetaminophen consumption, and the incidence of anti-emetic drug administration. Conclusion: The OOP ACCC technique did not provide superior analgesia or decrease opioid consumption when compared to the IP ACCC technique. Both techniques can be used interchangeably for analgesia status-post TKA

Pioglitazone Treatment Following Spinal Cord Injury Maintains Acute Mitochondrial Integrity and Increases Chronic Tissue Sparing and Functional Recovery

Pioglitazone is an FDA-approved PPAR-γ agonist drug used to for treat diabetes, and it has demonstrated neuroprotective effects in multiple models of central nervous system (CNS) injury. Acute treatment after spinal cord injury (SCI) in rats is reported to suppress neuroinflammation, rescue injured tissues, and improve locomotor recovery. In the current study, we additionally assessed the protective efficacy of pioglitazone treatment on acute mitochondrial respiration, as well as functional and anatomical recovery after contusion SCI in adult male C57BL/6 mice. Mice received either vehicle or pioglitazone (10 mg/kg) at either 15 min or 3 hr after injury (75 kDyn at T9) followed by a booster at 24 hr post-injury. At 25 hr, mitochondria were isolated from spinal cord segments centered on the injury epicenters and assessed for their respiratory capacity. Results showed significantly compromised mitochondrial respiration 25 hr following SCI, but pioglitazone treatment that was initiated either at 15 min or 3 hr post-injury significantly maintained mitochondrial respiration rates near sham levels. A second cohort of injured mice received pioglitazone at 15 min post injury, then once a day for 5 days post-injury to assess locomotor recovery and tissue sparing over 4 weeks. Compared to vehicle, pioglitazone treatment resulted in significantly greater recovery of hind-limb function over time, as determined by serial locomotor BMS assessments and both terminal BMS subscores and gridwalk performance. Such improvements correlated with significantly increased grey and white matter tissue sparing, although pioglitazone treatment did not abrogate long-term injury-induced inflammatory microglia/macrophage responses. In sum, pioglitazone significantly increased functional neuroprotection that was associated with remarkable maintenance of acute mitochondrial bioenergetics after traumatic SCI. This sets the stage for dose-response and delayed administration studies to maximize pioglitazone’s efficacy for SCI while elucidating the precise role that mitochondria play in governing its neuroprotection; the ultimate goal to develop novel therapeutics that specifically target mitochondrial dysfunction

PTCOG Head and Neck Subcommittee Consensus Guidelines on Particle Therapy for the Management of Head and Neck Tumors

Purpose: Radiation therapy is a standard modality in the treatment for cancers of the head and neck, but is associated with significant short- and long-term side effects. Proton therapy, with its unique physical characteristics, can deliver less dose to normal tissues, resulting in fewer side effects. Proton therapy is currently being used for the treatment of head and neck cancer, with increasing clinical evidence supporting its use. However, barriers to wider adoption include access, cost, and the need for higher-level evidence.Methods: The clinical evidence for the use of proton therapy in the treatment of head and neck cancer are reviewed here, including indications, advantages, and challenges.Results: The Particle Therapy Cooperative Group Head and Neck Subcommittee task group provides consensus guidelines for the use of proton therapy for head and neck cancer.Conclusion: This report can be used as a guide for clinical use, to understand clinical trials, and to inform future research efforts.</p

Effects of gabapentin on muscle spasticity and both induced as well as spontaneous autonomic dysreflexia after complete spinal cord injury

We recently reported that the neuropathic pain medication, gabapentin (GBP; Neurontin), significantly attenuated both noxious colorectal distension (CRD)-induced autonomic dysreflexia (AD) and tail pinch-induced spasticity compared to saline-treated cohorts 2–3 weeks after complete high thoracic (T4) spinal cord injury (SCI). Here we employed long-term blood pressure telemetry to test, firstly, the efficacy of daily versus acute GBP treatment in modulating AD and tail spasticity in response to noxious stimuli at 2 and 3 weeks post-injury. Secondly, we determined whether daily GBP alters baseline cardiovascular parameters, as well as spontaneous AD events detected using a novel algorithm based on blood pressure telemetry data. At both 14 and 21 days after SCI, irrespective of daily treatment, acute GBP given 1 h prior to stimulus significantly attenuated CRD-induced AD and pinch-evoked tail spasticity; conversely, acute saline had no such effects. Moreover, daily GBP did not alter 24 h mean arterial pressure (MAP) or heart rate (HR) values compared to saline treatment, nor did it reduce the incidence of spontaneous AD events compared to saline over the three week assessment period. Power spectral density (PSD) analysis of the MAP signals demonstrated relative power losses in mid frequency ranges (0.2–0.8 Hz) for all injured animals relative to low frequency MAP power (0.02–0.08 Hz). However, there was no significant difference between groups over time post-injury; hence, GBP had no effect on the persistent loss of MAP fluctuations in the mid frequency range after injury. In summary, the mechanism(s) by which acute GBP treatment mitigate aberrant somatosensory and cardiophysiological responses to noxious stimuli after SCI remain unclear. Nevertheless, with further refinements in defining the dynamics associated with AD events, such as eliminating requisite concomitant bradycardia, the objective repeatability of automatic detection of hypertensive crises provides a potentially useful tool for assessing autonomic function pre- and post-SCI, in conjunction with experimental pharmacotherapeutics for neuropathic pain, such as GBP

Modelling small block aperture in an in-house developed GPU-accelerated Monte Carlo-based dose engine for pencil beam scanning proton therapy

Purpose: To enhance an in-house graphic-processing-unit (GPU) accelerated virtual particle (VP)-based Monte Carlo (MC) proton dose engine (VPMC) to model aperture blocks in both dose calculation and optimization for pencil beam scanning proton therapy (PBSPT)-based stereotactic radiosurgery (SRS). Methods and Materials: A block aperture module was integrated into VPMC. VPMC was validated by an opensource code, MCsquare, in eight water phantom simulations with 3cm thick brass apertures: four were with aperture openings of 1, 2, 3, and 4cm without a range shifter, while the other four were with same aperture opening configurations with a range shifter of 45mm water equivalent thickness. VPMC was benchmarked with MCsquare and RayStation MC for 10 patients with small targets (average volume 8.4 cc). Finally, 3 patients were selected for robust optimization with aperture blocks using VPMC. Results: In the water phantoms, 3D gamma passing rate (2%/2mm/10%) between VPMC and MCsquare were 99.71$\pm$0.23%. In the patient geometries, 3D gamma passing rates (3%/2mm/10%) between VPMC/MCsquare and RayStation MC were 97.79$\pm$2.21%/97.78$\pm$1.97%, respectively. The calculation time was greatly decreased from 112.45$\pm$114.08 seconds (MCsquare) to 8.20$\pm$6.42 seconds (VPMC), both having statistical uncertainties of about 0.5%. The robustly optimized plans met all the dose-volume-constraints (DVCs) for the targets and OARs per our institutional protocols. The mean calculation time for 13 influence matrices in robust optimization by VPMC was 41.6 seconds. Conclusion: VPMC has been successfully enhanced to model aperture blocks in dose calculation and optimization for the PBSPT-based SRS.Comment: 3 tables, 3 figure

RadOnc-GPT: A Large Language Model for Radiation Oncology

This paper presents RadOnc-GPT, a large language model specialized for radiation oncology through advanced tuning methods. RadOnc-GPT was finetuned on a large dataset of radiation oncology patient records and clinical notes from the Mayo Clinic in Arizona. The model employs instruction tuning on three key tasks - generating radiotherapy treatment regimens, determining optimal radiation modalities, and providing diagnostic descriptions/ICD codes based on patient diagnostic details. Evaluations conducted by comparing RadOnc-GPT outputs to general large language model outputs showed that RadOnc-GPT generated outputs with significantly improved clarity, specificity, and clinical relevance. The study demonstrated the potential of using large language models fine-tuned using domain-specific knowledge like RadOnc-GPT to achieve transformational capabilities in highly specialized healthcare fields such as radiation oncology