IMRT national audit in Portugal.

PURPOSE: The IAEA newly developed "end-to-end" audit methodology for on-site verification of IMRT dose delivery has been carried out in Portugal in 2018. The main goal was to evaluate the physical aspects of the head and neck (H&N) cancer IMRT treatments. This paper presents the national results. METHODS: All institutions performing IMRT treatments in Portugal, 20 out of 24, have voluntarily participated in this audit. Following the adopted methodology, a Shoulder, Head and Neck End-to-End phantom (SHANE) - that mimics an H&N region, underwent all steps of an IMRT treatment, according to the local practices. The measurements using an ionization chamber placed inside the SHANE phantom at four reference locations (three in PTVs and one in the spinal cord) and an EBT3 film positioned in a coronal plane were compared with calculated doses. FilmQA Pro software was used for film analysis. RESULTS: For ionization chamber measurements, the percent difference was within the specified tolerances of ±5% for PTVs and ±7% for the spinal cord in all participating institutions. Considering film analysis, gamma passing rates were on average 96.9%±2.9% for a criterion of 3%/3 mm, 20% threshold, all above the acceptance limit of 90%. CONCLUSIONS: The national results of the H&N IMRT audit showed a compliance between the planned and the delivered doses within the specified tolerances, confirming no major reasons for concern. At the same time the audit identified factors that contributed to increased uncertainties in the IMRT dose delivery in some institutions resulting in recommendations for quality improvement.

Lifestyle in patients with chronic kidney disease is associated with less arterial stiffness.

UNLABELLED: Cardiovascular disease is the major cause of mortality in chronic kidney disease (CKD). Arterial stiffening is recognised as a critical precursor of cardiovascular disease. Available evidence indicates that lifestyle modifications are therapeutic interventions for preventing and treating arterial stiffening. OBJECTIVE: To evaluate the influence of lifestyle modifications on the arterial vessel compliance in CKD patients not receiving renal replacement therapy (RRT). We measured the arterial vessel compliance in 50 CKD patients not receiving RRT (30 post-transplant, 20 pre-RRT). Noninvasive pulse wave analysis of radial artery was used to estimate large artery (C1) and small artery elasticity (C2) and was corrected for patients age. Renal transplant (RT) patients were younger than CKD patients. RT patients C1 normal in 13%. C2 lower than normal in 77% of cases and not associated with evaluated variables, but worse large artery compliance was observed. In CKD patients, C1 was normal in 55%. C1 was strongly associated with aerobic exercise. For CKD patients, exercise normalises large artery compliance. C2 was lower than normal in 90%. Small artery compliance was affected in majority of patients.

Automatic detection of large dense-core vesicles in secretory cells and statistical analysis of their intracellular distribution.

Analyzing the morphological appearance and the spatial distribution of large dense-core vesicles (granules) in the cell cytoplasm is central to the understanding of regulated exocytosis. This paper is concerned with the automatic detection of granules and the statistical analysis of their spatial locations in different cell groups. We model the locations of granules of a given cell as a realization of a finite spatial point process and the point patterns associated with the cell groups as replicated point patterns of different spatial point processes. First, an algorithm to segment the granules using electron microscopy images is proposed. Second, the relative locations of the granules with respect to the plasma membrane are characterized by two functional descriptors: the empirical cumulative distribution function of the distances from the granules to the plasma membrane and the density of granules within a given distance to the plasma membrane. The descriptors of the different cells for each group are compared using bootstrap procedures. Our results show that these descriptors and the testing procedure allow discriminating between control and treated cells. The application of these novel tools to studies of secretion should help in the analysis of diseases associated with dysfunctional secretion, such as diabetes.

Measuring spatiotemporal dependencies in bivariate temporal random sets with applications to cell biology.

Analyzing spatio-temporal dependencies between different types of events is highly relevant to numerous biological phenomena (e.g. signalling and trafficking) especially as advances in probes and microscopy have facilitated imaging of dynamic processes in living cells. For many types of events, the segmented areas can overlap spatially and temporally forming random clumps. In this paper, we model binary image sequences of two different event types as a realization of a bivariate temporal random set and propose a non-parametric approach to quantify spatial and spatio-temporal interrelations using the pair-correlation, cross-covariance and the Ripley IK functions. Based on these summary statistics we propose a randomization procedure to test independence between event types by applying random toroidal shifts and Monte Carlo tests. A simulation study assessed the performance of the proposed estimators and showed that these statistics capture the spatio-temporal dependencies accurately. The estimation of the spatio-temporal interval of interactions was also obtained. The method was successfully applied to analyze the interdependencies of several endocytic proteins using image sequences of living cells and validated the procedure as a new way to automatically quantify dependencies between proteins in a formal and robust manner.

Ocular dominance diagnosis and its influence in monovision.

PURPOSE: To analyze the response of normal emmetropic subjects to different ocular dominance tests and to analyze the influence of this response in surgically induced monovision. DESIGN: A prospective study of diagnostic accuracy was carried out to analyze the different tests to determine ocular dominance, without a gold standard test. METHODS: Nine different tests were carried out in a group of 51 emmetropic subjects to determine both motor and sensory ocular dominance. For analysis, patients were divided into two groups according to age. Normal ophthalmologic examination results were the inclusion requirement, with normal binocular vision and good stereoacuity. RESULTS: A significant percentage of uncertain or ambiguous results in all tests performed was found, except in the hole-in-card and kaleidoscope tests. When the tests were compared, two by two, the correlation or equivalence found was low and was much lower if tests were compared three by three. CONCLUSIONS: No clear ocular dominance was found in most studied subjects; instead, there must be a constant alternating balance between both eyes in most emmetropic persons, but not in those with pathologic features. This fact would explain the great variability both between and within different kinds of tests. Also, it would establish that the monovision technique is well tolerated in most patients, with unsuccessful results only in those patients with strong or clear dominance. Consequently, it seems appropriate to evaluate patient's dominance before monovision surgery to exclude those individuals with clear dominance.

Overlapping events with application to image sequences.

Counting spatially and temporally overlapping events in image sequences and estimating their shape-size and duration features are important issues in some applications. We propose a stochastic model, a particular case of the nonisotropic 3D Boolean model, for performing this analysis: the temporal Boolean model. Some probabilistic properties are derived and a methodology for parameter estimation from time-lapse image sequences is proposed using an explicit treatment of the temporal dimension. We estimate the mean number of germs per unit area and time, the mean grain size and the duration distribution. A wide simulation study in order to assess the proposed estimators showed promising results. The model was applied on biological image sequences of in-vivo cells in order to estimate new parameters such as the mean number and duration distribution of endocytic events. Our results show that the proposed temporal Boolean model is effective for obtaining information about dynamic processes which exhibit short-lived, but spatially and temporally overlapping events.

Phosphatidylinositol phosphate kinase type I gamma regulates dynamics of large dense-core vesicle fusion.

Phosphatidylinositol-4,5-bisphosphate was proposed to be an important regulator of large dense-core vesicle exocytosis from neuroendocrine tissues. Here, we have examined the kinetics of secretion in chromaffin cells from mice lacking phosphatidylinositol phosphate kinase type I gamma, the major neuronal phosphatidylinositol-4-phosphate 5-kinase. Absence of this enzyme caused a reduction of the readily releasable vesicle pool and its refilling rate, with a small increase in morphologically docked vesicles, indicating a defect in vesicle priming. Furthermore, amperometry revealed a delay in fusion pore expansion. These results provide direct genetic evidence for a key role of phosphatidylinositol-4,5-bisphosphate synthesis in the regulation of large dense-core vesicle fusion dynamics.