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Find video protocols related to scientific articles indexed in Pubmed.
Examining the contextual and temporal stability of perceptions of emotional utility.
Cogn Emot
PUBLISHED: 11-08-2014
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The present research examined the degree to which perceptions of emotional utility are stable across contexts and over time. Self-reported perceptions of emotional utility and actual experience of emotion were measured in two samples of college students. In Study 1, participants were presented with two different types of goals (independent vs. interdependent) and were asked to rate the degree to which they found different types of emotions (e.g., appreciation, pride) useful in each context. In Study 2, participants completed daily online questionnaires in which they responded to questions assessing perceptions of emotional utility and actual affect in relation to personal goals. As predicted, across both samples, perceived utility of specific types of emotions was found to be associated with specific types of goals. Importantly, perceived utility of emotion was also found to be a relatively stable individual difference variable, even after taking into account the actual experience of emotion.
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Autoreactive T cells specific for insulin B:11-23 recognize a low-affinity peptide register in human subjects with autoimmune diabetes.
Proc. Natl. Acad. Sci. U.S.A.
PUBLISHED: 09-29-2014
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Previous studies in type 1 diabetes (T1D) in the nonobese diabetic mouse demonstrated that a crucial insulin epitope (B:9-23) is presented to diabetogenic CD4 T cells by IA(g7) in a weakly bound register. The importance of antigenic peptides with low-affinity HLA binding in human autoimmune disease remains less clear. The objective of this study was to investigate T-cell responses to a low-affinity self-epitope in subjects with T1D. HLA-DQ8 tetramers loaded with a modified insulin peptide designed to improve binding the low-affinity register were used to visualize T-cell responses following in vitro stimulation. Positive responses were only detectable in T1D patients. Because the immunogenic register of B:9-23 presented by DQ8 has not been conclusively demonstrated, T-cell assays using substituted peptides and DQ8 constructs engineered to express and present B:9-23 in fixed binding registers were used to determine the immunogenic register of this peptide. Tetramer-positive T-cell clones isolated from T1D subjects that responded to stimulation by B:11-23 peptide and denatured insulin protein were conclusively shown to recognize B:11-23 bound to HLA-DQ8 in the low-affinity register 3. These T cells also responded to homologous peptides derived from microbial antigens, suggesting that their initial priming could occur via molecular mimicry. These results are in accord with prior observations from the nonobese diabetic mouse model, suggesting a mechanism shared by mouse and man through which T cells that recognize a weakly bound peptide can circumvent tolerance mechanisms and play a role in the initiation of autoimmune diseases, such as T1D.
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ACR Appropriateness Criteria® Definitive External-Beam Irradiation in stage T1 and T2 prostate cancer.
Am. J. Clin. Oncol.
PUBLISHED: 09-03-2014
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To present the most updated American College of Radiology consensus guidelines formed from an expert panel on the appropriate use of external-beam radiation to manage stage T1 and T2 prostate cancer.
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Two phase I dose-escalation/pharmacokinetics studies of low temperature liposomal doxorubicin (LTLD) and mild local hyperthermia in heavily pretreated patients with local regionally recurrent breast cancer.
Int J Hyperthermia
PUBLISHED: 08-22-2014
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Unresectable chest wall recurrences of breast cancer (CWR) in heavily pretreated patients are especially difficult to treat. We hypothesised that thermally enhanced drug delivery using low temperature liposomal doxorubicin (LTLD), given with mild local hyperthermia (MLHT), will be safe and effective in this population.
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Recognition of posttranslationally modified GAD65 epitopes in subjects with type 1 diabetes.
Diabetes
PUBLISHED: 04-04-2014
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Posttranslational modification (PTM) of self-proteins has been shown to elicit clinically relevant immune responses in rheumatoid arthritis and celiac disease. Accumulating evidence suggests that recognition of modified self-proteins may also be important in type 1 diabetes. Our objective was to identify posttranslationally modified GAD65 peptides, which are recognized by subjects with type 1 diabetes, and to assess their disease relevance. We show that citrullination and transglutamination of peptides can enhance their binding to DRB1*04:01, a diabetes-susceptible HLA allele. These and corresponding modifications to amino acids at T-cell contact positions modulated the recognition of multiple GAD65 peptides by self-reactive T cells. Using class II tetramers, we verified that memory T cells specific for these modified epitopes were detectable directly ex vivo in the peripheral blood of subjects with type 1 diabetes at significantly higher frequencies than healthy controls. Furthermore, T cells that recognize these modified epitopes were either less responsive or nonresponsive to their unmodified counterparts. Our findings suggest that PTM contributes to the progression of autoimmune diabetes by eliciting T-cell responses to new epitope specificities that are present primarily in the periphery, thereby circumventing tolerance mechanisms.
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Dosimetric analysis of radiation therapy oncology group 0321: the importance of urethral dose.
Pract Radiat Oncol
PUBLISHED: 03-14-2014
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Radiation Therapy Oncology Group 0321 is the first multi-institutional cooperative group high-dose-rate (HDR) prostate brachytherapy trial with complete digital brachytherapy dosimetry data. This is a descriptive report of the data and an analysis of toxicity.
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Pre-plan parameters predict post-implant D90 ? 140 Gy for (125)I permanent prostate implants.
J Contemp Brachytherapy
PUBLISHED: 02-05-2014
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To find permanent prostate implant (PPI) pre-plan dosimetric parameters that predict post-implant D90 ? 140 Gy.
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A review of safety, quality management, and practice guidelines for high-dose-rate brachytherapy: executive summary.
Pract Radiat Oncol
PUBLISHED: 02-05-2014
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This white paper was commissioned by the American Society for Radiation Oncology (ASTRO) Board of Directors to evaluate the status of safety and practice guidance for high-dose-rate (HDR) brachytherapy. Given the maturity of HDR brachytherapy technology, this white paper considers, from a safety point of view, the adequacy of general physics and quality assurance guidance, as well as clinical guidance documents available for the most common treatment sites. The rate of medical events in HDR brachytherapy procedures in the United States in 2009 and 2010 was 0.02%, corresponding to 5-sigma performance. The events were not due to lack of guidance documents but failures to follow those recommendations or human failures in the performance of tasks. The white paper summarized by this Executive Summary reviews current guidance documents and offers recommendations regarding their application to delivery of HDR brachytherapy. It also suggests topics where additional research and guidance is needed.
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Long-term Outcomes Following Radiation Therapy For Prostate Cancer Patients With Lymph Node Metastases at Diagnosis Treated With and Without Surgery.
Am. J. Clin. Oncol.
PUBLISHED: 01-21-2014
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To evaluate the long-term outcomes for prostate cancer (PCa) patients with lymph node involvement (LNI) treated with radiotherapy at the University of California San Francisco.
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Hypofractionated SBRT versus conventionally fractionated EBRT for prostate cancer: comparison of PSA slope and nadir.
Radiat Oncol
PUBLISHED: 01-20-2014
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Patients with early stage prostate cancer have a variety of curative radiotherapy options, including conventionally-fractionated external beam radiotherapy (CF-EBRT) and hypofractionated stereotactic body radiotherapy (SBRT). Although results of CF-EBRT are well known, the use of SBRT for prostate cancer is a more recent development, and long-term follow-up is not yet available. However, rapid post-treatment PSA decline and low PSA nadir have been linked to improved clinical outcomes. The purpose of this study was to compare the PSA kinetics between CF-EBRT and SBRT in newly diagnosed localized prostate cancer.
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Self-conscious emotions in worry and generalized anxiety disorder.
Br J Clin Psychol
PUBLISHED: 01-17-2014
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Current theories regarding worry and generalized anxiety disorder (GAD) highlight the potential avoidance functions of worry, and it has been suggested that worry functions to avoid self-conscious emotions in particular. Therefore, the present study examined the roles of proneness and aversion to self-conscious emotions in worry and GAD.
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A training phantom for ultrasound-guided needle insertion and suturing.
Brachytherapy
PUBLISHED: 01-09-2014
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During gynecologic brachytherapy (BT), suturing and image-guided needle insertions are highly skill-dependent tasks. Medical residents often have to practice these techniques in the operating room; this is sub-optimal for many reasons. We present a fast and low-cost method of building realistic and disposable gynecologic phantoms, which can be used to train physicians new to gynecologic BT.
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Assessment of CD4+ T Cell Responses to Glutamic Acid Decarboxylase 65 Using DQ8 Tetramers Reveals a Pathogenic Role of GAD65 121-140 and GAD65 250-266 in T1D Development.
PLoS ONE
PUBLISHED: 01-01-2014
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Susceptibility to type 1 diabetes (T1D) is strongly associated with MHC class II molecules, particularly HLA-DQ8 (DQ8: DQA1*03:01/DQB1*03:02). Monitoring T1D-specific T cell responses to DQ8-restricted epitopes may be key to understanding the immunopathology of the disease. In this study, we examined DQ8-restricted T cell responses to glutamic acid decarboxylase 65 (GAD65) using DQ8 tetramers. We demonstrated that GAD65121-140 and GAD65250-266 elicited responses from DQ8+ subjects. Circulating CD4+ T cells specific for these epitopes were detected significantly more often in T1D patients than in healthy individuals after in vitro expansion. T cell clones specific for GAD65121-140 and GAD65250-266 carried a Th1-dominant phenotype, with some of the GAD65121-140-specific T cell clones producing IL-17. GAD65250-266-specific CD4+ T cells could also be detected by direct ex vivo staining. Analysis of unmanipulated peripheral blood mononuclear cells (PBMCs) revealed that GAD65250-266-specific T cells could be found in both healthy and diabetic individuals but the frequencies of specific T cells were higher in subjects with type 1 diabetes. Taken together, our results suggest a proinflammatory role for T cells specific for DQ8-restricted GAD65121-140 and GAD65250-266 epitopes and implicate their possible contribution to the progression of T1D.
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ACR Appropriateness Criteria high-dose-rate brachytherapy for prostate cancer.
Brachytherapy
PUBLISHED: 08-29-2013
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High-dose-rate (HDR) brachytherapy plays a potential curative role in the treatment of prostate cancer. An expert panel was convened to review the recent literature and reach a consensus on its appropriate clinical applications.
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Cold spot mapping inferred from MRI at time of failure predicts biopsy-proven local failure after permanent seed brachytherapy in prostate cancer patients: Implications for focal salvage brachytherapy.
Radiother Oncol
PUBLISHED: 05-31-2013
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(1) To establish a method to evaluate dosimetry at the time of primary prostate permanent implant (pPPI) using MRI of the shrunken prostate at the time of failure (tf). (2) To compare cold spot mapping with sextant-biopsy mapping at tf.
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Differential binding of pyruvate dehydrogenase complex-E2 epitopes by DRB1*08:01 and DRB1*11:01 Is predicted by their structural motifs and correlates with disease risk.
J. Immunol.
PUBLISHED: 03-29-2013
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DRB1*08:01 (DR0801) and DRB1*11:01 (DR1101) are highly homologous alleles that have opposing effects on susceptibility to primary biliary cirrhosis (PBC). DR0801 confers risk and shares a key feature with other HLA class II alleles that predispose to autoimmunity: a nonaspartic acid at beta57. DR1101 is associated with protection from PBC, and its sequence includes an aspartic acid at beta57. To elucidate a mechanism for the opposing effects of these HLA alleles on PBC susceptibility, we compared the features of epitopes presented by DR0801 and DR1101. First, we identified DR0801- and DR1101-restricted epitopes within multiple viral Ags, observing both shared and distinct epitopes. Because DR0801 is not well characterized, we deduced its motif by measuring binding affinities for a library of peptides, confirming its key features through structural modeling. DR0801 was distinct from DR1101 in its ability to accommodate charged residues within all but one of its binding pockets. In particular, DR0801 strongly preferred acidic residues in pocket 9. These findings were used to identify potentially antigenic sequences within PDC-E2 (an important hepatic autoantigen) that contain a DR0801 motif. Four peptides bound to DR0801 with reasonable affinity, but only one of these bound to DR1101. Three peptides, PDC-E2145-159, PDC-E2(249-263), and PDC-E2(629-643), elicited high-affinity T cell responses in DR0801 subjects, implicating these as likely autoreactive specificities. Therefore, the unique molecular features of DR0801 may lead to the selection of a distinct T cell repertoire that contributes to breakdown of self-tolerance in primary biliary cirrhosis, whereas those of DR1101 promote tolerance.
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Salvage HDR brachytherapy for recurrent prostate cancer after previous definitive radiation therapy: 5-year outcomes.
Int. J. Radiat. Oncol. Biol. Phys.
PUBLISHED: 01-22-2013
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Evaluate efficacy and toxicity of salvage high-dose-rate brachytherapy (HDRB) for locally recurrent prostate cancer after definitive radiation therapy (RT).
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A dosimetric evaluation of using a single treatment plan for multiple treatment fractions within a given applicator insertion in gynecologic brachytherapy.
Brachytherapy
PUBLISHED: 01-21-2013
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To evaluate the dosimetric impact of using one treatment plan for multiple fractions from a single tandem and ring applicator insertion of high-dose-rate brachytherapy for cervical cancer.
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Prostate-specific antigen response after short-term hormone therapy plus external-beam radiotherapy and outcome in patients treated on Radiation Therapy Oncology Group study 9413.
Cancer
PUBLISHED: 01-03-2013
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The objective of this study was to assess the impact of a prostate-specific antigen (PSA) complete response (PSA-CR), measured at the end of external-beam radiotherapy and short-term hormone therapy, on treatment outcomes.
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Temporal compartmental dosing effects for robotic prostate stereotactic body radiotherapy.
Phys Med Biol
PUBLISHED: 11-22-2011
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The rate of dose accumulation within a given area of a target volume tends to vary significantly for non-isocentric delivery systems such as Cyberknife stereotactic body radiotherapy. In this study, we investigated whether intra-target temporal dose distributions produce significant variations in the biological equivalent dose. For the study, time courses of ten patients were reconstructed and calculation of a biologically equivalent uniform dose (EUD) was performed using a formula derived from the linear quadratic model (?/? = 3 for prostate cancer cells). The calculated EUD values obtained for the actual patient treatments were then compared with theoretical EUD values for delivering the same physical dose distribution except that the whole target being irradiated continuously (e.g. large-field dose-bathing type of delivery). For all the case, the EUDs for the actual treatment delivery were found to correlate strongly with the EUDs for the large-field delivery: a linear correlation coefficient of R² = 0.98 was obtained and the average EUD for the actual Cyberknife delivery was somewhat higher (5.0 ± 4.7%) than that for the large-field delivery. However, no statistical significance was detected between the two types of delivery (p = 0.21). We concluded that non-isocentric small-field Cyberknife delivery produced consistent biological dosing that tracked well with the constant-dose-rate, large-field-type delivery for prostate stereotactic body radiotherapy.
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ACR Appropriateness Criteria® definitive external beam irradiation in stage T1 and T2 prostate cancer.
Am. J. Clin. Oncol.
PUBLISHED: 11-22-2011
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: External beam radiation therapy is a standard of care treatment for men who present with clinically localized (T1-T2) prostate cancer. The purpose of this review was to provide clarification on the appropriateness criteria and management considerations for the treatment of prostate cancer with external beam radiation therapy.
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DRB1*12:01 presents a unique subset of epitopes by preferring aromatics in pocket 9.
Mol. Immunol.
PUBLISHED: 09-15-2011
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This study characterized the unique peptide-binding characteristics of HLA-DRB1*12:01 (DR1201), an allele studied in the context of various autoimmune diseases, using a peptide competition assay and structural modeling. After defining Influenza A/Puerto Rico/8/34 Matrix Protein M1 (H1MP) 40-54 as a DR1201 restricted epitope, the critical anchor residues within this sequence were confirmed by measuring the relative binding of peptides with non-conservative substitutions in competition with biotin labeled H1MP(40-54) peptide. Based on this information, a set of peptides was designed with single amino acid substitutions at these anchor positions. The overall peptide binding preferences for the DR1201 allele were deduced by incubating these peptides in competition with the reference H1MP(40-54) to determine the relative binding affinities of each to recombinant DR1201 protein. As expected, pocket 1 preferred methionine and aliphatic residues, and tolerated phenylalanine. Pocket 4 was mostly composed of hydrophobic residues, thereby preferentially accommodating aliphatic residues, but could also weakly accommodate lysine due to its slightly acidic environment. Pocket 6 accepted a wide range of amino acids because of the diverse residues that comprise this pocket. Pocket 9 accepted aliphatic and negatively charged amino acids, but showed a remarkable preference for aromatic residues due to the conformation of the pocket, which lacks the typical salt bridge between ?57Asp and ?76Arg. These binding characteristics contrast with the closely related DR1104 allele, distinguishing DR1201 among the alleles of the HLA-DR5 group. These empirical results were used to develop an algorithm to predict peptide binding to DR1201. This algorithm was used to verify T cell epitopes within novel antigenic peptides identified by tetramer staining and within peptides from published reports that contain putative DR1201 epitopes.
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IPIP: A new approach to inverse planning for HDR brachytherapy by directly optimizing dosimetric indices.
Med Phys
PUBLISHED: 08-24-2011
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Many planning methods for high dose rate (HDR) brachytherapy require an iterative approach. A set of computational parameters are hypothesized that will give a dose plan that meets dosimetric criteria. A dose plan is computed using these parameters, and if any dosimetric criteria are not met, the process is iterated until a suitable dose plan is found. In this way, the dose distribution is controlled by abstract parameters. The purpose of this study is to develop a new approach for HDR brachytherapy by directly optimizing the dose distribution based on dosimetric criteria.
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Implant strategies for endocervical and interstitial ultrasound hyperthermia adjunct to HDR brachytherapy for the treatment of cervical cancer.
Phys Med Biol
PUBLISHED: 06-10-2011
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Catheter-based ultrasound devices provide a method to deliver 3D conformable heating integrated with HDR brachytherapy delivery. Theoretical characterization of heating patterns was performed to identify implant strategies for these devices which can best be used to apply hyperthermia to cervical cancer. A constrained optimization-based hyperthermia treatment planning platform was used for the analysis. The proportion of tissue ?41 °C in a hyperthermia treatment volume was maximized with constraints T(max) ? 47 °C, T(rectum) ? 41.5 °C, and T(bladder) ? 42.5 °C. Hyperthermia treatment was modeled for generalized implant configurations and complex configurations from a database of patients (n = 14) treated with HDR brachytherapy. Various combinations of endocervical (360° or 2 × 180° output; 6 mm OD) and interstitial (180°, 270°, or 360° output; 2.4 mm OD) applicators within catheter locations from brachytherapy implants were modeled, with perfusion constant (1 or 3 kg m(-3) s(-1)) or varying with location or temperature. Device positioning, sectoring, active length and aiming were empirically optimized to maximize thermal coverage. Conformable heating of appreciable volumes (>200 cm(3)) is possible using multiple sectored interstitial and endocervical ultrasound devices. The endocervical device can heat >41 °C to 4.6 cm diameter compared to 3.6 cm for the interstitial. Sectored applicators afford tight control of heating that is robust to perfusion changes in most regularly spaced configurations. T(90) in example patient cases was 40.5-42.7 °C (1.9-39.6 EM(43 °C)) at 1 kg m(-3) s(-1) with 10/14 patients ?41 °C. Guidelines are presented for positioning of implant catheters during the initial surgery, selection of ultrasound applicator configurations, and tailored power schemes for achieving T(90) ? 41 °C in clinically practical implant configurations. Catheter-based ultrasound devices, when adhering to the guidelines, show potential to generate conformal therapeutic heating ranging from a single endocervical device targeting small volumes local to the cervix (<2 cm radial) to a combination of a 2 × 180° endocervical and directional interstitial applicators in the lateral periphery to target much larger volumes (6 cm radial), while preferentially limiting heating of the bladder and rectum.
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Hard tissue structural changes in TMJ morphology prior to orthodontic therapy: a complex motion tomographic study.
Quintessence Int
PUBLISHED: 04-27-2011
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Temporomandibular joint (TMJ) disorders have been investigated for years due to their probable association with the neuromasticatory apparatus and the myoskeletal framework of the head and neck. In this study, we explored hard tissue structural changes within the TMJ (condyle, glenoid fossa, articular eminence, and joint space) using complex motion tomography. A correlation between these morphologic changes and clinical symptoms of disc-related TMJ disorders was attempted.
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Endocervical ultrasound applicator for integrated hyperthermia and HDR brachytherapy in the treatment of locally advanced cervical carcinoma.
Med Phys
PUBLISHED: 04-02-2011
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The clinical success of hyperthermia adjunct to radiotherapy depends on adequate temperature elevation in the tumor with minimal temperature rise in organs at risk. Existing technologies for thermal treatment of the cervix have limited spatial control or rapid energy falloff. The objective of this work is to develop an endocervical applicator using a linear array of multisectored tubular ultrasound transducers to provide 3-D conformal, locally targeted hyperthermia concomitant to radiotherapy in the uterine cervix. The catheter-based device is integrated within a HDR brachytherapy applicator to facilitate sequential and potentially simultaneous heat and radiation delivery.
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Interactive, multi-modality image registrations for combined MRI/MRSI-planned HDR prostate brachytherapy.
J Contemp Brachytherapy
PUBLISHED: 03-31-2011
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This study presents the steps and criteria involved in the series of image registrations used clinically during the planning and dose delivery of focal high dose-rate (HDR) brachytherapy of the prostate.
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Evaluation of an alcohol withdrawal protocol and a preprinted order set at a tertiary care hospital.
Can J Hosp Pharm
PUBLISHED: 02-07-2011
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Alcohol withdrawal protocols involving symptom-triggered administration of benzodiazepine have been established to reduce the duration of treatment and the cumulative benzodiazepine dose (relative to usual care). However, the effects of a protocol combining fixed-schedule and symptom-triggered benzodiazepine dosing are less clear.
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Urethra low-dose tunnels: validation of and class solution for generating urethra-sparing dose plans using inverse planning simulated annealing for prostate high-dose-rate brachytherapy.
Brachytherapy
PUBLISHED: 02-03-2011
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Urethral dose is related to severity of genitourinary toxicity in patients treated with brachytherapy for prostate cancer. This work describes a dose planning method that uses inverse planning to create a low-dose tunnel around the urethra and presents a class solution to achieve this additional dose sparing of the urethra.
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American College of Radiology Appropriateness Criteria permanent source brachytherapy for prostate cancer.
Brachytherapy
PUBLISHED: 01-31-2011
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Permanent prostate brachytherapy has emerged as a standard of care treatment for approximately 50,000 men annually who present with clinically localized prostate cancer. The purpose of this review was to provide clarification on the appropriateness criteria and management considerations for the treatment of prostate cancer with permanent prostate brachytherapy.
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ACR appropriateness criteria postradical prostatectomy irradiation in prostate cancer.
Am. J. Clin. Oncol.
PUBLISHED: 01-29-2011
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The role of postradical prostatectomy radiation therapy continues to evolve under the influence of new clinical data. In particular, 2 recently published or updated randomized trials have prompted a reevaluation of its utility in the adjuvant and salvage setting. The Southwest Oncology Group 8794 trial randomized 473 patients with stage T3a-T3b disease to adjuvant radiotherapy versus observation. With a median follow-up of 12.7 years, this trial demonstrates an improvement in metastasis-free (93/214 vs. 114/211, P = 0.016) and overall survival (88 vs. 110 deaths, P = 0.023) favoring adjuvant radiotherapy. The European Organization for Research and Treatment of Cancer 22911 study of 972 patients with at least 1 "high risk" feature at surgery (extracapsular extension, positive surgical margins, seminal vesicle involvement) randomized to immediate adjuvant radiotherapy (60 Gy) versus observation. The freedom from biochemical failure at 5 years was 53% in the observation alone group versus 74% in the adjuvant radiotherapy group (P < 0.0001). This review summarizes the current evidence-based literature supporting the use of postradical prostatectomy radiation therapy in various common clinical settings and will serve to illustrate the appropriateness of postoperative radiotherapy by reviewing its implementation in a variety of commonly occurring clinical scenarios. It is intended to serve both as a guideline for the practicing radiation oncologist and a resource for further learning.
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Comparison of high-dose rate prostate brachytherapy dose distributions with iridium-192, ytterbium-169, and thulium-170 sources.
Brachytherapy
PUBLISHED: 01-24-2011
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Recent studies have identified that among different available radionuclides, the dose characteristics and shielding properties of ytterbium-169 ((169)Yb) and thulium-170 ((170)Tm) may suit high-dose rate (HDR) brachytherapy needs. The purpose of this work was to compare clinically optimized dose distributions using proposed (169)Yb and (170)Tm HDR sources with the clinical dose distribution from a standard microSelectron V2 HDR iridium-192 ((192)Ir) brachytherapy source (Nucletron B.V., Veenendaal, The Netherlands).
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Cost-effectiveness analysis of human papillomavirus DNA testing and Pap smear for cervical cancer screening in a publicly financed health-care system.
Br. J. Cancer
PUBLISHED: 11-23-2010
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to evaluate the long-term cost-effectiveness of different strategies for human papillomavirus (HPV) DNA testing combined with Pap smear for cervical cancer screening in Taiwan.
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American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) practice guideline for the performance of high-dose-rate brachytherapy.
Int. J. Radiat. Oncol. Biol. Phys.
PUBLISHED: 08-19-2010
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High-Dose-Rate (HDR) brachytherapy is a safe and efficacious treatment option for patients with a variety of different malignancies. Careful adherence to established standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced a practice guideline for HDR brachytherapy. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrists. Review of the leading indications for HDR brachytherapy in the management of gynecologic, thoracic, gastrointestinal, breast, urologic, head and neck, and soft tissue tumors is presented. Logistics with respect to the brachytherapy implant procedures and attention to radiation safety procedures and documentation are presented. Adherence to these practice guidelines can be part of ensuring quality and safety in a successful HDR brachytherapy program.
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Toward adaptive stereotactic robotic brachytherapy for prostate cancer: demonstration of an adaptive workflow incorporating inverse planning and an MR stealth robot.
Minim Invasive Ther Allied Technol
PUBLISHED: 07-21-2010
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To translate any robot into a clinical environment, it is critical that the robot can seamlessly integrate with all the technology of a modern clinic. MRBot, an MR-stealth brachytherapy delivery device, was used in a closed-bore 3T MRI and a clinical brachytherapy cone beam CT suite. Targets included ceramic dummy seeds, MR-Spectroscopy-sensitive metabolite, and a prostate phantom. Acquired DICOM images were exported to planning software to register the robot coordinates in the imagers frame, contour and verify target locations, create dose plans, and export needle and seed positions to the robot. The coordination of each system element (imaging device, brachytherapy planning system, robot control, robot) was validated with a seed delivery accuracy of within 2 mm in both a phantom and soft tissue. An adaptive workflow was demonstrated by acquiring images after needle insertion and prior to seed deposition. This allows for adjustment if the needle is in the wrong position. Inverse planning (IPSA) was used to generate a seed placement plan and coordinates for ten needles and 29 seeds were transferred to the robot. After every two needles placed, an image was acquired. The placed seeds were identified and validated prior to placing the seeds in the next two needles. The ability to robotically deliver seeds to locations determined by IPSA and the ability of the system to incorporate novel needle patterns were demonstrated. Shown here is the ability to overcome this critical step. An adaptive brachytherapy workflow is demonstrated which integrates a clinical anatomy-based seed location optimization engine and a robotic brachytherapy device. Demonstration of this workflow is a key element of a successful translation to the clinic of the MRI stealth robotic delivery system, MRBot.
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Stereotactic body radiotherapy as monotherapy or post-external beam radiotherapy boost for prostate cancer: technique, early toxicity, and PSA response.
Int. J. Radiat. Oncol. Biol. Phys.
PUBLISHED: 06-11-2010
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High dose rate (HDR) brachytherapy has been established as an excellent monotherapy or after external-beam radiotherapy (EBRT) boost treatment for prostate cancer (PCa). Recently, dosimetric studies have demonstrated the potential for achieving similar dosimetry with stereotactic body radiotherapy (SBRT) compared with HDR brachytherapy. Here, we report our technique, PSA nadir, and acute and late toxicity with SBRT as monotherapy and post-EBRT boost for PCa using HDR brachytherapy fractionation.
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High-dose-rate brachytherapy boost for prostate cancer: comparison of two different fractionation schemes.
Int. J. Radiat. Oncol. Biol. Phys.
PUBLISHED: 06-02-2010
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This is a retrospective study comparing our experience with high-dose-rate (HDR) brachytherapy boost for prostate cancer, using two different fractionation schemes, 600 cGy × 3 fractions (patient group 1) and 950 cGy × 2 fractions (patient group 2).
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Phase II trial of combined high-dose-rate brachytherapy and external beam radiotherapy for adenocarcinoma of the prostate: preliminary results of RTOG 0321.
Int. J. Radiat. Oncol. Biol. Phys.
PUBLISHED: 03-06-2010
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To estimate the rate of late Grade 3 or greater genitourinary (GU) and gastrointestinal (GI) adverse events (AEs) after treatment with external beam radiotherapy and prostate high-dose-rate (HDR) brachytherapy.
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Investigation of geometric distortions on magnetic resonance and cone beam computed tomography images used for planning and verification of high-dose rate brachytherapy cervical cancer treatment.
Brachytherapy
PUBLISHED: 02-09-2010
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To measure the amount of geometric distortions present in the three-dimensional imaging modalities--cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI)--used at University of California, San Francisco, CA, for gynecologic high dose rate brachytherapy.
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Optimisation-based thermal treatment planning for catheter-based ultrasound hyperthermia.
Int J Hyperthermia
PUBLISHED: 01-27-2010
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A patient-specific optimisation-based hyperthermia treatment planning program for catheter-based ultrasound technology was developed for a priori evaluation of proposed applicator implant strategies and determination of initial applied power settings. The interstitial and endocavity heating applicators, designed for delivering 3-D controllable hyperthermia within High Dose Rate (HDR) brachytherapy implants, consist of linear and sectored arrays of ultrasound transducers with variable power control in both length and angle. A 3D biothermal model, which incorporates relevant anatomical structures and implant geometries based upon HDR treatment planning, has been developed to simulate the temperature distributions induced by these ultrasound applicators within the catheter implants. A temperature-based constrained optimisation algorithm was devised and integrated within the finite-element thermal solver to determine the optimal applied power levels. A temperature-expressed objective function and constraints were employed to limit maximum temperature (T(max)), maximise target coverage (T(target)), and minimise thermal exposure to normal tissue and surrounding organs. The optimisation-based treatment planning was applied on representative examples of clinical HDR implants for endocavity treatment of cervix (n = 3) and interstitial treatment of prostate (n = 3). Applicator positioning and orientation, T(max), and T(target), were varied, and temperature volume and thermal dose volume histograms calculated for each plan. The optimisation approach provided optimal applied power levels (4-24 independent transducer sections) leading to conforming or tailored temperature distributions for all cases, as indicated with improved temperature index T(90) in the target volume and negligible temperature and thermal dose (t(43,max) < 1 min) exposure in surrounding non-targeted tissues, such as bladder and rectum. The precision of the optimised power estimates was shown to be within <5% for a range of starting levels and were similarly convergent. The execution times of this optimisation (<16 min) and forward thermal treatment planning (<22 min) is sufficiently fast to be integrated into the clinical setting. This optimisation-based treatment planning platform for catheter-based ultrasound applicators is a useful tool to provide feedback for applicator selection (sector angle, number of transducer sections along length), positioning (angle or orientation), optimal initial power settings, and has potential to significantly improve the delivery of hyperthermia in conjunction with HDR brachytherapy.
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Dosimetric impact of interfraction catheter movement in high-dose rate prostate brachytherapy.
Int. J. Radiat. Oncol. Biol. Phys.
PUBLISHED: 01-08-2010
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To evaluate the impact of interfraction catheter movement on dosimetry in prostate high-dose-rate (HDR) brachytherapy.
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Valuation of the economic benefits of human papillomavirus vaccine in Taiwan.
Value Health
PUBLISHED: 05-30-2009
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The study aims to apply the contingent valuation method to elicit the willingness-to-pay (WTP), and measure the value of a statistic life (VSL), for human papillomavirus (HPV) vaccine in Taiwan.
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Adjuvant radiation therapy in stage III node-positive uterine cancer.
Gynecol. Oncol.
PUBLISHED: 05-08-2009
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To determine the association of adjuvant radiotherapy and outcomes of women with stage III node-positive uterine cancer.
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T2-Weighted endorectal magnetic resonance imaging of prostate cancer after external beam radiation therapy.
Int Braz J Urol
PUBLISHED: 05-05-2009
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To retrospectively determine the accuracy of T2-weighted endorectal MR imaging in the detection of prostate cancer after external beam radiation therapy and to investigate the relationship between imaging accuracy and time since therapy.
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Pretreatment endorectal magnetic resonance imaging and magnetic resonance spectroscopic imaging features of prostate cancer as predictors of response to external beam radiotherapy.
Int. J. Radiat. Oncol. Biol. Phys.
PUBLISHED: 03-04-2009
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To evaluate whether pretreatment combined endorectal magnetic resonance imaging (MRI) and magnetic resonance spectroscopic imaging (MRSI) findings are predictive of outcome in patients who undergo external beam radiotherapy for prostate cancer.
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Salvage permanent perineal radioactive-seed implantation for treating recurrence of localized prostate adenocarcinoma after external beam radiotherapy.
BJU Int.
PUBLISHED: 02-23-2009
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To assess our experience with salvage permanent perineal radioactive-seed implantation (SPPI) as a possible therapeutic option for recurrent prostate adenocarcinoma, as salvage therapies for recurrences after definitive external beam radiotherapy (EBRT) for localized adenocarcinoma of the prostate are associated with significant morbidity and biochemical failure.
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High-dose-rate brachytherapy for localized prostate adenocarcinoma post abdominoperineal resection of the rectum and pelvic irradiation: Technique and experience.
Brachytherapy
PUBLISHED: 02-11-2009
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Treatment options are limited for patients with localized prostate cancer and a prior history of abdominoperineal resection (APR) and pelvic irradiation. We have previously reported on the successful utility of high-dose-rate (HDR) brachytherapy salvage for prostate cancer failing definitive external beam radiation therapy (EBRT). In this report, we describe our technique and early experience with definitive HDR brachytherapy in patients post APR and pelvic EBRT.
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Sensorless motion planning for medical needle insertion in deformable tissues.
IEEE Trans Inf Technol Biomed
PUBLISHED: 01-08-2009
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Minimally invasive medical procedures such as biopsies, anesthesia drug injections, and brachytherapy cancer treatments require inserting a needle to a specific target inside soft tissues. This is difficult because needle insertion displaces and deforms the surrounding soft tissues causing the target to move during the procedure. To facilitate physician training and preoperative planning for these procedures, we develop a needle insertion motion planning system based on an interactive simulation of needle insertion in deformable tissues and numerical optimization to reduce placement error. We describe a 2-D physically based, dynamic simulation of needle insertion that uses a finite-element model of deformable soft tissues and models needle cutting and frictional forces along the needle shaft. The simulation offers guarantees on simulation stability for mesh modifications and achieves interactive, real-time performance on a standard PC. Using texture mapping, the simulation provides visualization comparable to ultrasound images that the physician would see during the procedure. We use the simulation as a component of a sensorless planning algorithm that uses numerical optimization to compute needle insertion offsets that compensate for tissue deformations. We apply the method to radioactive seed implantation during permanent seed prostate brachytherapy to minimize seed placement error.
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High-dose rate brachytherapy using inverse planning simulated annealing for locoregionally advanced cervical cancer: a clinical report with 2-year follow-up.
Int. J. Radiat. Oncol. Biol. Phys.
PUBLISHED: 01-02-2009
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We present clinical outcomes of image-guided brachytherapy using inverse planning simulated annealing (IPSA) planned high-dose rate (HDR) brachytherapy boost for locoregionally advanced cervical cancer.
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Computer-assisted, atlas-based segmentation for target volume delineation in whole pelvic IMRT for prostate cancer.
Technol. Cancer Res. Treat.
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The purpose of this study is to evaluate whether computer-assisted segmentation is clinically feasible in target volume delineation for prostate cancer patients treated with whole pelvic IMRT. An atlas was created, comprised of 44 clinically node-negative prostate cancer patients. Three regions of interest (ROIs) were chosen for analysis: prostate, pelvic lymph nodes, and rectum. For a separate tester set of 15 patients with previously contoured ROIs by three experienced physicians, atlas-assisted contours were compared to manual contours by calculating a volumetric overlap index. In the tester set patients, the average overlap between the manually drawn and atlas-based contours for the prostate, pelvic lymph nodes, and rectum was 60%, 51%, and 64%, respectively. The volume differences were significant in the rectum and pelvic lymph nodes (p =?0.049 and p =?0.016, respectively); this was not true for the prostate. A subset analysis based on physician-specific atlases showed that the average overlap index for the pelvic lymph nodal volume increased from 51% to 60%, while the other ROIs had no significant changes. Despite significant inter-physician differences, atlas-based segmentation for pelvic lymph node delineation serves as an initial guideline for physicians, potentially improving both consistency and efficiency in contouring.
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Embryotoxicity of Psoralea corylifolia L.: in vivo and in vitro studies.
Birth Defects Res. B Dev. Reprod. Toxicol.
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Psoralea corylifolia L. (PC) was commonly used to treat miscarriages clinically. The aim of this study was to examine its embryotoxicity in mice and embryonic stem cells (ESCs).
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NPIP: A skew line needle configuration optimization system for HDR brachytherapy.
Med Phys
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In this study, the authors introduce skew line needle configurations for high dose rate (HDR) brachytherapy and needle planning by integer program (NPIP), a computational method for generating these configurations. NPIP generates needle configurations that are specific to the anatomy of the patient, avoid critical structures near the penile bulb and other healthy structures, and avoid needle collisions inside the body.
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Feasibility of MR imaging/MR spectroscopy-planned focal partial salvage permanent prostate implant (PPI) for localized recurrence after initial PPI for prostate cancer.
Int. J. Radiat. Oncol. Biol. Phys.
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To assess the feasibility of magnetic resonance imaging (MRI)-planned partial salvage permanent prostate implant (psPPI) among patients with biopsy-proven local recurrence after initial PPI without evidence of distant disease.
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ACR Appropriateness Criteria® external-beam radiation therapy treatment planning for clinically localized prostate cancer.
J Am Coll Radiol
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Image-based radiation treatment planning and localization have contributed to better targeting of the prostate and sparing of normal tissues. Guidelines are needed to address radiation dose delivery, including patient setup and immobilization, target volume definition, treatment planning, treatment delivery methods, and target localization. Guidelines for external-beam radiation treatment planning have been updated and are presented here. The use of appropriate doses, simulation techniques, and verification of field setup are essential for the accurate delivery of radiation therapy. The ACR Appropriateness Criteria(®) are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
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Evaluating outcomes associated with alternative dosing strategies for piperacillin/tazobactam: a qualitative systematic review.
Ann Pharmacother
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To perform a qualitative systematic review of the evidence comparing traditional strategies against prolonged intermittent or continuous infusion strategies for piperacillin/tazobactam, based on clinical and pharmacodynamic outcomes.
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American Brachytherapy Society consensus guidelines for high-dose-rate prostate brachytherapy.
Brachytherapy
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A well-established body of literature supports the use of high-dose-rate (HDR) brachytherapy as definitive treatment for localized prostate cancer. Most of the articles describe HDR as a boost with adjuvant external beam radiation, but there is a growing experience with HDR monotherapy.
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Perceived utility of emotion: the structure and construct validity of the Perceived Affect Utility Scale in a cross-ethnic sample.
Cultur Divers Ethnic Minor Psychol
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This study introduces a new measure of the perceived utility of emotion, which is the degree to which emotions are perceived to be useful in achieving goals. In this study, we administered this new measure, the Perceived Affect Utility Scale (PAUSe), to a sample of 142 European American and 156 East Asian American college students. Confirmatory factor analyses provided support for a new, culturally informed parsing of emotion and for perceived utility of emotion to be distinguishable from ideal affect, a related but separate construct. Next, we explored the potential importance of perceived utility of emotion in cultural research. Through path analyses, we found that: (a) culturally relevant variables (e.g., independence) played a mediating role in the link between ethnic group and perceived utility of emotion; and (b) perceived utility of emotion played a mediating role in the link between culturally relevant variables and ideal affect. In particular, perceived utility of self-centered emotions (e.g., pride) was found to be associated with independence and ideal affect of those same emotions. In contrast, perceived utility of other-centered emotions (e.g., appreciation) was found to be associated with interdependence, dutifulness/self-discipline, and ideal affect of those same emotions. Implications for perceived utility of emotion in understanding cultural factors are discussed.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.