Comparative Study of Eclipse and RayStation Multi-Criteria Optimization-Based Prostate Radiotherapy Treatment Planning Quality.

Multi-criteria optimization (MCO) function has been available on commercial radiotherapy (RT) treatment planning systems to improve plan quality; however, no study has compared Eclipse and RayStation MCO functions for prostate RT planning. The purpose of this study was to compare prostate RT MCO plan qualities in terms of discrepancies between Pareto optimal and final deliverable plans, and dosimetric impact of final deliverable plans. In total, 25 computed tomography datasets of prostate cancer patients were used for Eclipse (version 16.1) and RayStation (version 12A) MCO-based plannings with doses received by 98% of planning target volume having 76 Gy prescription (PTV76D98%) and 50% of rectum (rectum D50%) selected as trade-off criteria. Pareto optimal and final deliverable plan discrepancies were determined based on PTV76D98% and rectum D50% percentage differences. Their final deliverable plans were compared in terms of doses received by PTV76 and other structures including rectum, and PTV76 homogeneity index (HI) and conformity index (CI), using a t-test. Both systems showed discrepancies between Pareto optimal and final deliverable plans (Eclipse: -0.89% (PTV76D98%) and -2.49% (Rectum D50%); RayStation: 3.56% (PTV76D98%) and -1.96% (Rectum D50%)). Statistically significantly different average values of PTV76D98%,HI and CI, and mean dose received by rectum (Eclipse: 76.07 Gy, 0.06, 1.05 and 39.36 Gy; RayStation: 70.43 Gy, 0.11, 0.87 and 51.65 Gy) are noted, respectively (p < 0.001). Eclipse MCO-based prostate RT plan quality appears better than that of RayStation.

Local climate and vernalization sensitivity predict the latitudinal patterns of flowering onset in the crop wild relative Linum bienne Mill.

BACKGROUND AND AIMS: The timing of flowering onset is often correlated with latitude, indicative of climatic gradients. Flowering onset in temperate species commonly requires exposure to cold temperatures, known as vernalization. Hence, population differentiation of flowering onset with latitude might reflect adaptation to the local climatic conditions experienced by populations. METHODS: Within its western range, seeds from Linum bienne populations (the wild relative of cultivated Linum usitatissimum) were used to describe the latitudinal differentiation of flowering onset to determine its association with the local climate of the population. A vernalization experiment including different crop cultivars was used to determine how vernalization accelerates flowering onset, in addition to the vernalization sensitivity response among populations and cultivars. Additionally, genetic differentiation of L. bienne populations along the latitudinal range was scrutinized using microsatellite markers. KEY RESULTS: Flowering onset varied with latitude of origin, with southern populations flowering earlier than their northern counterparts. Vernalization reduced the number of days to flowering onset, but vernalization sensitivity was greater in northern populations compared with southern ones. Conversely, vernalization delayed flowering onset in the crop, exhibiting less variation in sensitivity. In L. bienne, both flowering onset and vernalization sensitivity were better predicted by the local climate of the population than by latitude itself. Microsatellite data unveiled genetic differentiation of populations, forming two groups geographically partitioned along latitude. CONCLUSIONS: The consistent finding of latitudinal variation across experiments suggests that both flowering onset and vernalization sensitivity in L. bienne populations are under genetic regulation and might depend on climatic cues at the place of origin. The association with climatic gradients along latitude suggests that the climate experienced locally drives population differentiation of the flowering onset and vernalization sensitivity patterns. The genetic population structure suggests that past population history could have influenced the flowering initiation patterns detected, which deserves further work.

Comparative Study of Plan Robustness for Breast Radiotherapy: Volumetric Modulated Arc Therapy Plans with Robust Optimization versus Manual Flash Approach.

A previous study investigated robustness of manual flash (MF) and robust optimized (RO) volumetric modulated arc therapy plans for breast radiotherapy based on five patients in 2020 and indicated that the RO was more robust than the MF, although the MF is still current standard practice. The purpose of this study was to compare their plan robustness in terms of dose variation to clinical target volume (CTV) and organs at risk (OARs) based on a larger sample size. This was a retrospective study involving 34 female patients. Their plan robustness was evaluated based on measured volume/dose difference between nominal and worst scenarios (ΔV/ΔD) for each CTV and OARs parameter, with a smaller difference representing greater robustness. Paired sample t-test was used to compare their robustness values. All parameters (except CTV ΔD98%) of the RO approach had smaller ΔV/ΔD values than those of the MF. Also, the RO approach had statistically significantly smaller ΔV/ΔD values (p < 0.001-0.012) for all CTV parameters except the CTV ΔV95% and ΔD98% and heart ΔDmean. This study's results confirm that the RO approach was more robust than the MF in general. Although both techniques were able to generate clinically acceptable plans for breast radiotherapy, the RO could potentially improve workflow efficiency due to its simpler planning process.

[Development of pre-hepatic portal hypertension of the rat]. / Tipos evolutivos de hipertensión portal prehepática en la rata.

OBJECTIVE: A long-term study of the prehepatic portal hypertension model by triple stenosing ligation of the portal vein in the rat. METHOD: A cluster analysis of the animals in the different evolutive stages of portal hypertension (1 1/2, 6, 12 and 14 months) has been carried out. This analysis has made it possible to identify three homogeneous groups (A, B and C) in relationship to the liver weight. RESULTS: The animals with liver atrophy (group C) show a decrease of body, splenic and testicular weights as well as a higher development of the portosystemic collateral circulation in relation to the A and B groups. CONCLUSION: The percentage of animals belonging to the group C decrease progressively during the evolution of portal hypertension and those animals corresponding to the group A, in which is superior the liver weight, increase, while the B group does not change.

Influence of boron supplementation on vertebral and femoral bone mass in rats on strenuous treadmill exercise. A morphometric, densitometric, and histomorphometric study.

We studied the effect of boron supplement on experimental osteopenia caused by strenuous exercise in 93- d-old female Wistar rats. A control group of 15 rats was not manipulated. The exercise group of 30 rats was divided into 2 groups of 15 rats each, one that was fed a diet supplemented with 50 mg/kg of boron in the form of Na(2)B(4)O(7), and other that, did not receive a boron supplement. The length and weight were determined in the femur and fifth lumbar vertebra and the bone mineral content and density were assessed through densitometry, and trabecular bone volume, trabecular number, trabecular thickness, and trabecular separation with histomorphometry. The femur length and weight, and vertebra weight, and femur and vertebra bone mineral content and density were significantly lower and the trabecular separation was higher in the exercise group than in the others (p < 0.005 in all). The femur weight, bone mineral content and density, trabecular bone volume and trabecular thickness, were significantly higher in the exercise plus boron group (p < 0.005 to 0.0001). It was concluded that boron preserves bone mass in rats that have been exposed to intense exercise.

Bone mass, bone metabolism, gonadal status and body mass index.

Weight and gonadal status are the main determinants of bone mass in women. Because of this it is important to study which influences it more. The effect of weight (expressed as body mass index, BMI) and gonadal status of women on total-body bone mineral content (TBBMC) and regional bone mineral content (BMC) was investigated. A total of 373 normal women (mean age 48.9 +/- 13.4 years) were studied: 171 postmenopausal women (mean age 59.3 +/- 9.5 years; years since menopause 11.3 +/- 6.7 years); 76 perimenopausal women (mean age 48.9 +/- 2.2 years); and 126 premenopausal women (mean age 34.7 +/- 7.4 years). In all the women, TBBMC and regional BMC were determined by dual-energy X-ray absorptiometry. Also biochemical markers of bone metabolism (total alkaline phosphatase and tartrate-resistant acid phosphatase) and serum estrone and estradiol were determined. When the women were stratified by gonadal status and BMI, thin women (BMI <20 kg/m2) had significantly lower TBBMC and regional BMC, lower gonadal steroid concentration and higher levels of biochemical markers than overweight (BMI 25-30 kg/m2) and obese (BMI >30 kg/m2) women, regardless of gonadal status. Overweight and obese women had findings suggestive of increased parathyroid activity, but greater bone mass. Weight rather than gonadal steroid concentration is the main determinant of bone mass in women regardless of gonadal status.

[Sepsis and septic shock: a turmoil of inflammatory mediators with difficult therapeutic management]. / Sepsis y shock séptico: un torbellino de mediadores inflamatorios de difícil manejo terapéutico.

Sepsis and septic shock continue being a topic of enormous interest for their high frequency, and for not existing a decrease in the figures of mortality in spite of the new acquired knowledges relation with their physiopathology and the advances arisen in the diverse applied treatments. The purpose of the present study is to update the present notions in the specialized literature, trying to summarize the complex existent interaction among different mediators of double character: exogenous and endogenous, and to enunciate the possible causes for those that the novel treatments applied in the sepsis continue not to be very promising.

Incidence of enterotoxigenic staphylococci and their toxins in foods.

Of 504 food samples collected from cafeterias, 19 (3.8%) yielded strains of enterotoxigenic staphylococci, and 10 (52.6%), 4 (21.1%), 3 (15.8%), and 2 (10.5%) of these strains produced enterotoxins C (SEC), D (SED), B (SEB), and A (SEA), respectively. Moreover, SEA, SEB, and SEC were isolated from three hamburger samples. Of 181 food samples collected from four restaurants before the implementation of the hazard analysis and critical control point (HACCP) system, 7 (3.9%) were found to contain enterotoxigenic strains, and SED, SEC, and SEA were produced by 4 (57.1%), 2 (28.6%), and 1 (14.3%) of these strains, respectively. One meatball sample with SEC was detected in a restaurant. After the implementation of the HACCP system in four restaurants, neither enterotoxigenic staphylococci nor enterotoxins were detected in 196 studied samples.

Can a determination of tartrate-resistant acid phosphatase predict postmenopausal loss of bone mass?

BACKGROUND: A study was carried out over a 24-month interval to determine if an initial measurement of serum tartrate-resistant acid phosphatase would be predictive of bone mass loss quantified by dual-energy X-ray absorptiometry, as total bone mineral content and total bone mineral content corrected for weight. DESIGN: Sixty-two women were studied (at onset: mean age 59.7 +/- 8.9 years, 10.8 +/- 8.8 years since menopause; at conclusion: mean age 61.9 +/- 8.8 and 13.0 +/- 8.7 since menopause). RESULTS: A paired Wilcoxon test showed a small, but significant, increase in weight (P < 0.05) and decrease in height (P < 0.05). Total bone mineral content and total bone mineral content corrected for weight decreased (P < 0.005 and 0.0001, respectively). Serum tartrate-resistant acid phosphatase increased (P < 0.005). Single-regression analysis showed that the per cent bone mass loss observed between the first and second body bone mineral content measurements correlated negatively with the first serum tartrate-resistant acid phosphatase determination (r = -0.62, P < 0.0001). Changes in tartrate-resistant acid phosphatase correlated negatively with changes in total bone mineral content (r = -0.79, P < 0.0001). In a multiple regression analysis of per cent change in bone mass against initially important variables such as age, years since menopause, weight, and tartrate-resistant acid phosphatase, only tartrate-resistant acid phosphatase was significant (P < 0.0001). The sensitivity and specifity of tartrate-resistant acid phosphatase for evaluating bone loss were 86% and 78%, respectively, and the area under the curve was of 0.83 (95% CI 0.71-0.95). CONCLUSION: These results show that a simple measurement of serum tartrate-resistant acid phosphatase can help to predict the potential rate of bone mass loss in women.

Ultrasound bone mass in paraplegic patients.

STUDY DESIGN: A cross-sectional study. OBJECTIVE: To clarify the existing controversy with regard to whether paraplegic patients suffer a loss of bone mass in the upper limbs. SETTING: Madrid, Spain. METHODS: We evaluated bone mass by phalangeal ultrasonography in 35 male patients with paraplegia (mean age 49+/-12 years), and 25(OH)D3 and PTH to exclude the presence of osteomalacia and secondary hyperparathyroidism. Spasticity was evaluated according to the Ashworth scale. Patients were compared with a control group of 35 healthy male subjects (mean age 48+/-13 years). RESULTS: The patients had lower 25(OH)D3 levels and amplitude-dependent speed of sound (Ad-SOS) than controls (both P<0.001), and higher PTH levels (P<0.05). There was a statistically significant negative association between PTH and 25(OH)D3 levels (r=-0.52, P<0.0001, CI -0.73 to -0.22) and between 25(OH)D3 and injury duration (r=0.34, P<0.05, CI -0.60 to -0.01). There was no correlation between Ad-SOS values, levels of PTH or 25(OH)D3, and the injury duration. No significant difference in Ad-SOS values was found in patients grouped according to low-to-normal 25(OH)D3 level or according to normal-to-high PTH level. There were no differences in relation to muscle tone. Only alkaline phosphatase and tartrate-resistant acid phosphatase levels were higher in patients than in controls (both P<0.001). CONCLUSION: Paraplegic patients had a loss of phalangeal bone mass that was unrelated to the levels of vitamin D or PTH, or to muscle tone, so it seems to be related to increased bone resorption rather than to deficient bone formation.

Effects of caffeine, vitamin D, and other nutrients on quantitative phalangeal bone ultrasound in postmenopausal women.

OBJECTIVE: We investigated the controversial effects of coffee and other nutrients on bone mass. METHODS: In a study of 93 healthy postmenopausal women (mean +/- standard deviation: 57.3 +/- 7.1 y old and 8.9 +/- 7.5 y since menopause) selected on the basis of not having changed their eating habits since premenopause, not smoking, not exercising, not receiving hormone-replacement therapy, and having a weight in the range of 70% to 130% of their ideal weights, amplitude-dependent speed of sound (Ad-SOS) was determined by quantitative bone ultrasound, and a prospective 7-d diet survey evaluated the intake of caffeine and nutrients involved in calcium metabolism. Women were stratified according to their caffeine, calcium, and vitamin D intakes and ratios of calcium to phosphorus and to protein. Ad-SOS differed only with vitamin D intake and was greater in the group taking at leasst 400 IU/d (P < 0.0001). RESULTS: In simple and multiple regression analyses, the only significant variable that affected Ad-SOS and nutrient intake was vitamin D (P < 0.0001). Phalangeal bone Ad-SOS was influenced only by the intake of vitamin D, not of caffeine or other nutrients. CONCLUSIONS: This lack of effect of caffeine and protein may be related to good nutritional intake or the low levels of caffeine consumed.

Sepsis y shock séptico: un torbellino de mediadores inflamatorios de difícil manejo terapéutico / Sepsis and septic shock: a turmoil of inflammatory mediators with a difficult therapeutic management

La sepsis y el shock séptico continúan siendo un capítulo de enorme interés por su elevada frecuencia, y por no existir una disminución en las cifras de mortalidad a pesar de los nuevos conocimientos adquiridos en su fisiopatología y los avances surgidos en los diversos tratamientos aplicados. El propósito de la presente revisión es actualizar los conceptos presentes en la literatura especializada, tratando de resumir la compleja interacción existente entre diferentes mediadores de doble carácter: exógenos y endógenos, y enunciar las posibles causas por las que los tratamientos novedosos aplicados en la sepsis siguen siendo poco prometedores (AU)

Quantitative phalangeal bone ultrasound is normal after long-term gluten-free diet in young coeliac patients.

BACKGROUND AND AIMS: To determine bone mass using quantitative phalangeal bone ultrasound in young coeliac patients after a long-term gluten-free diet. SUBJECTS: A total of 99 patients with coeliac disease (CD) (52 girls, mean age 15.5 +/- 9.7 years; 47 boys, mean age 14.4 +/- 8.4 years) and 44 healthy subjects matched for age, weight and height (26 girls, mean age 18.4 +/- 9.9 years; 18 boys, mean age 16.3 +/- 11.2 years) were included in the study. METHODS: Bone status was assessed using an ultrasound device that measures amplitude-dependent speed of sound (Ad-SoS) in metres per second. Measurements were made on the phalanges (II-V) of the non-dominant hand, and an average value was computed. Nutrient intake was assessed using a 7-day record. RESULTS: Analysis of variance (ANOVA) and the unpaired t-test showed that the intake of phosphates (P < 0.05), proteins, fat and carbohydrates (P < 0.005 in all) was higher in patients than in controls. No significant difference in Ad-SoS was found between patients and controls (95% CI -10.9 to 60.6) in the overall group, in girls or boys, or in patients following a gluten-free diet strictly or partially. In the patients, only age (beta 4.01, 95% CI 1.84-6.16, P < 0.0005) and weight (beta 2.62, 95% CI 1.53-3.70, P < 0.0001) showed a significant positive relation with Ad-SoS. CONCLUSIONS: In patients with CD, gluten-free diet and increased nutritional intake were accompanied by normal bone mass values as determined by ultrasound on phalanges.

Behavior of phalangeal bone ultrasound in normal women with relation to gonadal status and body mass index.

The behavior of phalangeal bone ultrasound was studied, measured by amplitude-dependent speed of sound (Ad-SOS) in meters per second, in 324 normal women (mean age 48.9 +/- 13.7 years) classified by gonadal status (premenopausal, perimenopausal and postmenopausal) and body mass index (BMI, thin, normal, overweight and obese). Ad-SOS differed significantly with gonadal status and BMI (p<0.0001 for all). In the overall group of women, Ad-SOS correlated negatively with age (r=-0.84, p<0.0001), weight (r=-0.16, p<0.005), BMI (r=-0.27, p<0.0001), and tartrate-resistant acid phosphatase concentration (TRAP) (r=-0.35, p<0.0001). The negative correlation remained significant in the groups separated by gonadal status, but to a lesser extent. After adjusting for confounding variables such as age and weight, Ad-SOS was dependent on age (but not on weight or BMI) in the overall group of women and in the gonadal status groups. In conclusion, Ad-SOS values differed significantly with gonadal status and BMI, and correlated negatively with TRAP. The plot of Ad-SOS against age differed significantly with gonadal status as well as BMI.

Do ultrasound measurements reflect bone microarchitecture rather than bone mass?: An in vitro study of the rat femur with the use of ultrasound, densitometry, and histomorphometry.

RATIONALE AND OBJECTIVES: In an experimental study in 40 rat femurs, the authors correlated the amplitude-dependent speed of bone ultrasound (Ad-SOS) with the bone mineral content and density and with the bone trabecular connectivity: trabecular bone volume, trabecular number, trabecular thickness, and trabecular separation to evaluate and compare the usefulness of the Ad-SOS to determine bone quantity and/or quality. METHODS: Bone mineral content and density were determined with dual-energy x-ray absorptiometry. Trabecular connectivity was determined with histomorphometric techniques. RESULTS: There was a strong correlation between the Ad-SOS and the other parameters studied, with a particularly high positive correlation with trabecular bone volume and trabecular thickness, and an inverse correlation with trabecular separation. The correlation was weaker with the bone mineral content and bone mineral density and with the trabecular number. For the trabecular separation, the correlation was significant in all cases, but it was negative. CONCLUSIONS: Bone ultrasound, in this case Ad-SOS, defines the quality of the bone in terms of trabecular architecture rather than bone density; however, this conclusion is valid only for the rat femur model that the authors used.

Phalangeal bone ultrasound and its possible correlation with nutrient in an area of high protein intake.

AIMS: The influence of eating habits on bone mass is a controversial topic. We have use ultrasound to search for the relationships between nutrients and bone density. METHODS: A total of 228 women (mean age 48.9 +/- 13.7 years) were studied, and divided according to their gonadal status (pre-, peri- and postmenopausal women). The dietary intake was recorded for 7 days, and their bone mass was measured by phalangeal amplitude-dependent speed of sound (Ad-SOS). ANOVA was made to examine the differences according to gonadal status. To determine the possible correlation between Ad-SOS and nutrient intake, partial correlations, adjusted for important confounding variables, were done. RESULTS: With partial correlations, there was no correlation of Ad-SOS with the nutrients studied here. CONCLUSION: We find no correlation of bone mass as measured by Ad-SOS with the most common nutrients and trace minerals, either for the participants as a whole or according to gonadal status.

Listeria species in raw and ready-to-eat foods from restaurants.

From September 1999 to March 2000, meat (pork, beef, and chicken), fish (salmon, hake, and sole), vegetable (lettuce and spinach), and Spanish potato omelette samples obtained at restaurants were collected and tested for the occurrence of Listeria spp. Listeria monocytogenes was isolated from 3 (2.9%) out of 103 studied samples. Other species isolated were Listeria grayi (13.6%), Listeria innocua (1.9%), Listeria ivanovii (5.8%), Listeria seeligeri (3.9%), and Listeria welshimeri (1.9%). Listeria was neither isolated from beef nor any type of fish.

Effects of sodium bicarbonate supplementation on axial and peripheral bone mass in rats on strenuous treadmill training exercise.

We observed the effects of sodium bicarbonate supplement on bone mass in rats on strenuous treadmill training. Sixty female Wistar rats (93-days-old; mean initial weight 261 +/- 16 g) were studied. One group of 15 rats was killed at the beginning of the experiments (basal control group), while another group of 15 rats was not manipulated (Exer-NaB-). Another group of 15 rats was exercised but did not receive sodium bicarbonate (Exer+NaB-), while the final group of 15 rats exercised and received sodium bicarbonate (Exer+NaB+) at a dose of 0.05 mg/kg/day, administered by esophageal catheter on exercise days. These rats were killed at the end of 11 weeks. Femoral and vertebral length, weight, and bone mineral content (BMC) and density (BMD) were measured. According to ANOVA with the Tukey-Kramer test, femur length and weight, vertebral weight, femur BMC and BMD, vertebral BMC and BMD and the ratio between femur and vertebral BMC and final body weight, and plasma bicarbonate were lower in the basal control and Exer+NaB- groups than in the two other groups (P < 0.005-0.0001). Overall, there was a positive correlation between femur and vertebral BMC and femur BMC and length (P < 0.0001 for all). Only in the Exer+NaB- group was there a positive association between plasma bicarbonate levels and femur length (r = 0.78; P < 0.0005). Our study demonstrates the adverse effects of strenuous exercise on bone, and the usefulness of sodium bicarbonate supplements in preventing and minimized these effects.

The effect of supplemental copper on osteopenia induced by ovariectomy in rats.

OBJECTIVE: The effect of a copper supplement on preventing bone mass loss induced by ovariectomy in rats was investigated. DESIGN: Three groups of fifteen 100-day-old female Wistar rats, each with a mean initial weight of approximately 260 g per animal, were selected for a 30-day experiment. One group of 15 ovariectomized rats was fed a diet supplemented with 15 mg of copper per kilogram of feed. The other two groups: 15 ovariectomized and 15 Sham- ovariectomized rats did not receive the supplement. Morphometric (weight and length) and densitometric studies with dual-energy x-ray absorptiometry were performed on the whole femur and the fifth lumbar vertebra of each animal at the end of the 30-day period. RESULTS: The ovariectomized rat group fed a diet supplemented with copper did not show the bone mass loss at the axial (fifth lumbar vertebra) or peripheral (femur) level that was evidenced in the ovariectomized group. CONCLUSIONS: The results of the measurement of axial and peripheral bones show that a supplement of copper may have a potential therapeutic application in the treatment and prevention of involutional osteoporosis.

Influence of vitamin D administration on bone ultrasound measurements in patients on anticonvulsant therapy.

BACKGROUND: The objective of the study was to evaluate bone mass status (as measured by bone ultrasound) in patients on anticonvulsant therapy, and the influence that Vitamin D administration exerts over it. MATERIALS AND METHODS: We measured and compared the basal serum levels of 25(OH)D3, parathyroid hormone (PTH), and phalangeal bone ultrasound (Ad-SOS), in 30 adult patients who were taking anticonvulsant drugs, with a control group of similar age and sex. We then gave the patients a large oral dose of 3 mg (120.000 UI) of 25(OH)D3, and repeated the measurements after one month. RESULTS: Basal 25(OH)D3 and Ad-SOS values were significantly lower, and PTH values significantly higher (P< 0.0001 in all), in the patient group. The low Ad-SOS values for the patients were independent of the treatment, but directly related to basal 25(OH)D3 levels (r = 0.45, P<0.01). There was a negative association between PTH and 25(OH)D3 (r = -0.64, P<0.0001), and no correlation between PTH y Ad-SOS (r = -0.20, p NS). After ingestion of the large dose of the vitamin D, the patient group registered a significant (P<0.0001) increase in 25(OH)D3 levels, their Ad-SOS values increased (P<0.0001) nearly to the mean basal value of the control group, and PTH decreased significantly (P<0.0001). CONCLUSIONS: These findings justify the need to assure adequate vitamin D intake in patients being treated with anticonvulsants, independently of the treatment, age, sex, and activity status, in order to prevent osteomalacia.