ABSTRACT
Purpose: Of the 260,000 women diagnosed with breast cancer annually in the United States, more than 60% are treated with breast-conserving surgery or lumpectomy, followed by radiation to decrease the chance of local recurrence. More than 70% of breast cancer recurrences are localized to the original tumor cavity. Hence, targeted radiation therapy after lumpectomy is critical for recurrence prevention. With 30,000 patients annually opting for oncoplastic reconstruction of the breast after lumpectomy to improve cosmesis, the resulting tissue rearrangement increases the difficulty for radiation oncologists to accurately delineate the cavity when planning radiation therapy. Owing to the absence of a standardized protocol, it is important to assess the efficacy of various methods used to mark the tumor cavity for improved delineation. Methods and Materials: A keyword search and analysis was used to compile relevant articles on PubMed (National Center for Biotechnology Information). Results: Currently, a common practice for tumor cavity localization is applying titanium surgical clips to the borders of lumpectomy cavity. Tissue movement and seroma formation both impact the positioning of surgical clips within the tumor cavity and lead to significant interobserver variability. Furthermore, the main application of surgical clips is to control the small vessels during surgery, and that can create confusion when the same clips are used for tumor bed localization. All alternative solutions present more precise tumor bed delineation but possess individual concerns with workflow integration, patient comfort, and accuracy. Though liquid-based fiducials were found to be the most effective for delineating tumor cavities, there are still drawbacks for clinical use. Conclusions: These findings should encourage medical innovators to develop novel techniques for tumor cavity marking to increase delineation accuracy and effectively target at-risk tissue. Future solutions in this space should consider the properties of liquid-based fiducial markers to improve radiation oncologists' ability to precisely delineate the tumor cavity.
ABSTRACT
Older adults tend to suffer from multi-morbidity, requiring complex treatment methodologies demanding poly-pharmacy. The increasing medication usage can tend towards the mismanagement of prescriptions and irregular or faulty administration. Thus, there arises an urgent need for a proper pill management system for these prescribed medicines. To tackle this grave concern, we propose a mobile, cost-effective, robust, and easy to use solution involving the extension to the human body-smartphones and conductive stickers. The technology utilizes a unique combination of touch-points on the smartphone screen to recognize the medication and give information regarding the proper usage and dosage and gives a reminder of the intake of the medicine. Our tool is comprised of two components-(1) the conductive ink stickers containing a unique combination of conductive inks to be applied to the pill container and (2) the mobile application utilizing touch-points generated by the conductive ink sticker to give information of the corresponding medicine. The following functionalities could be performed by the application-detection of pill container: providing essential information about pill container and dosage; keeping a count of pills already taken, to be taken and remaining pills; reordering the medication and reminding about the medicine intake at the correct designated time.
