Prospective Clinical Feasibility Study for MRI-Only Brain Radiotherapy

ObjectivesMRI-only radiotherapy (RT) provides a workflow to decrease the geometric uncertainty introduced by the image registration process between MRI and CT data and to streamline the RT planning. Despite the recent availability of validated synthetic CT (sCT) methods for the head region, there are no clinical implementations reported for brain tumors. Based on a preceding validation study of sCT, this study aims to investigate MRI-only brain RT through a prospective clinical feasibility study with endpoints for dosimetry and patient setup.Material and MethodsTwenty-one glioma patients were included. MRI Dixon images were used to generate sCT images using a CE-marked deep learning-based software. RT treatment plans were generated based on MRI delineated anatomical structures and sCT for absorbed dose calculations. CT scans were acquired but strictly used for sCT quality assurance (QA). Prospective QA was performed prior to MRI-only treatment approval, comparing sCT and CT image characteristics and calculated dose distributions. Additional retrospective analysis of patient positioning and dose distribution gamma evaluation was performed.ResultsTwenty out of 21 patients were treated using the MRI-only workflow. A single patient was excluded due to an MRI artifact caused by a hemostatic substance injected near the target during surgery preceding radiotherapy. All other patients fulfilled the acceptance criteria. Dose deviations in target were within ±1% for all patients in the prospective analysis. Retrospective analysis yielded gamma pass rates (2%, 2 mm) above 99%. Patient positioning using CBCT images was within ± 1 mm for registrations with sCT compared to CT.ConclusionWe report a successful clinical study of MRI-only brain radiotherapy, conducted using both prospective and retrospective analysis. Synthetic CT images generated using the CE-marked deep learning-based software were clinically robust based on endpoints for dosimetry and patient positioning.

A Case of Untreated Myeloid Sarcoma of the Pancreas Head Region: Diagnostic Process of AML Subtyping in an Autoptic Case

This study describes an autopsy case of pancreatic/peripancreatic myeloid sarcoma in a 70-year-old man, initially presenting with obstructive jaundice. Pathologically, diffuse infiltration of round cells containing atypical nuclei with marked cleavage was observed mainly in the pancreas head, peripancreatic lymph nodes, spleen, bilateral lung, and bone marrow. Immunohistochemically, the tumor cells were negative for CD20, CD79a, CD3, CD5, c-kit, CD34, and TdT and positive for myeloperoxidase, CD33, CD68, and CD163. Flow cytometry of the peripheral blood showed underexpression of CD11c and aberrant expression of CD56 in the monocyte subset. The peripheral blood smear showed an increase in monocytes and atypia in neutrophils and monocytes, as well as enlarged platelets and polychromatic erythroblasts. Hence, it was suggested that the myeloid sarcoma was derived from the acute transformation of chronic myelomonocytic leukemia. Myeloid sarcoma is an extramedullary-mass-forming hematologic malignancy that is difficult to diagnose, especially when the initial presentation is a pancreatic mass. However, early diagnosis is important for appropriate therapy. Although bone marrow examination could not be performed because of the patients’ severe condition, the pathological specimen obtained with autopsy helped subtype the patient’s leukemia. The immunohistochemical features of this case merit attention.

An explainable Artificial Intelligence approach to study MCI to AD conversion via HD-EEG processing

An explainable Artificial Intelligence (xAI) approach is proposed to longitudinally monitor subjects affected by Mild Cognitive Impairment (MCI) by using high-density electroencephalography (HD-EEG). To this end, a group of MCI patients was enrolled at IRCCS Centro Neurolesi Bonino Pulejo of Messina (Italy) within a follow-up protocol that included two evaluations steps: T0 (first evaluation) and T1 (three months later). At T1, four MCI patients resulted converted to Alzheimer’s Disease (AD) and were included in the analysis as the goal of this work was to use xAI to detect individual changes in EEGs possibly related to the degeneration from MCI to AD. The proposed methodology consists in mapping segments of HD-EEG into channel-frequency maps by means of the power spectral density. Such maps are used as input to a Convolutional Neural Network (CNN), trained to label the maps as “T0” (MCI state) or “T1” (AD state). Experimental results reported high intra-subject classification performance (accuracy rate up to 98.97% (95% confidence interval: 98.68–99.26)). Subsequently, the explainability of the proposed CNN is explored via a Grad-CAM approach. The procedure allowed to detect which EEG-channels (i.e., head region) and range of frequencies (i.e., sub-bands) resulted more active in the progression to AD. The xAI analysis showed that the main information is included in the delta sub-band and that, limited to the analyzed dataset, the highest relevant areas are: the left-temporal and central-frontal lobe for Sb01, the parietal lobe for Sb02, the left-frontal lobe for Sb03 and the left-frontotemporal region for Sb04.

Myofibre Hyper-Contractility in Horses Expressing the Myosin Heavy Chain Myopathy Mutation, MYH1E321G

Myosinopathies are defined as a group of muscle disorders characterized by mutations in genes encoding myosin heavy chains. Their exact molecular and cellular mechanisms remain unclear. In the present study, we have focused our attention on a MYH1-related E321G amino acid substitution within the head region of the type IIx skeletal myosin heavy chain, associated with clinical signs of atrophy, inflammation and/or profound rhabdomyolysis, known as equine myosin heavy chain myopathy. We performed Mant-ATP chase experiments together with force measurements on isolated IIx myofibres from control horses (MYH1E321G−/−) and Quarter Horses homozygous (MYH1E321G+/+) or heterozygous (MYH1E321G+/−) for the E321G mutation. The single residue replacement did not affect the relaxed conformations of myosin molecules. Nevertheless, it significantly increased its active behaviour as proven by the higher maximal force production and Ca2+ sensitivity for MYH1E321G+/+ in comparison with MYH1E321G+/− and MYH1E321G−/− horses. Altogether, these findings indicate that, in the presence of the E321G mutation, a molecular and cellular hyper-contractile phenotype occurs which could contribute to the development of the myosin heavy chain myopathy.

Detailed morphology of tentacular apparatus and central nervous system in Owenia borealis (Annelida, Oweniidae)

The Oweniidae are marine annelids with many unusual features of organ system, development, morphology, and ultrastructure. Together with magelonids, oweniids have been placed within the Palaeoannelida, a sister group to all remaining annelids. The study of this group may increase our understanding of the early evolution of annelids (including their radiation and diversification). In the current research, the morphology and ulta-anatomy of the head region of Owenia borealis is studied by scanning electron microscopy (SEM), 3D reconstructions, transmission electron microscopy (TEM), and whole-mount immunostaining with confocal laser scanning microscopy. According to SEM, the tentacle apparatus consists of 8–14 branched arms, which are covered by monociliary cells that form a ciliary groove extending along the oral side of the arm base. Each tentacle contains a coelomic cavity with a network of blood capillaries. Monociliary myoepithelial cells of the tentacle coelomic cavity form both the longitudinal and the transverse muscles. The structure of this myoepithelium is intermediate between a simple and pseudo-stratified myoepithelium. Overall, tentacles lack prominent zonality, i.e., co-localization of ciliary zones, neurite bundles, and muscles. This organization, which indicates a non-specialized tentacle crown in O. borealis and other oweniids with tentacles, may be ancestral for annelids. TEM, light, and confocal laser scanning microscopy revealed that the head region contains the anterior nerve center comprising of outer and inner (=circumoral) nerve rings. Both nerve rings are organized as concentrated nerve plexus, which contains perikarya and neurites extending between basal projections of epithelial cells (radial glia). The outer nerve ring gives rise to several thick neurite bundles, which branch and extend along aboral side of each tentacle. Accordingly to their immunoreactivity, both rings of the anterior nerve center could be homologized with the dorsal roots of circumesophageal connectives of the typical annelids. Accordingly to its ultrastructure, the outer nerve ring of O. borealis and so-called brain of other oweniids can not be regarded as a typical brain, i.e. the most anterior ganglion, because it lacks ganglionic structure.

Effect of Puffing Behavior on Particle Size Distributions and Respiratory Depositions From Pod-Style Electronic Cigarette, or Vaping, Products

The current fourth generation (“pod-style”) electronic cigarette, or vaping, products (EVPs) heat a liquid (“e-liquid”) contained in a reservoir (“pod”) using a battery-powered coil to deliver aerosol into the lungs. A portion of inhaled EVP aerosol is estimated as exhaled, which can present a potential secondhand exposure risk to bystanders. The effects of modifiable factors using either a prefilled disposable or refillable pod-style EVPs on aerosol particle size distribution (PSD) and its respiratory deposition are poorly understood. In this study, the influence of up to six puff profiles (55-, 65-, and 75-ml puff volumes per 6.5 and 7.5 W EVP power settings) on PSD was evaluated using a popular pod-style EVP (JUUL® brand) and a cascade impactor. JUUL® brand EVPs were used to aerosolize the manufacturers' e-liquids in their disposable pods and laboratory prepared “reference e-liquid” (without flavorings or nicotine) in refillable pods. The modeled dosimetry and calculated aerosol mass median aerodynamic diameters (MMADs) were used to estimate regional respiratory deposition. From these results, exhaled fraction of EVP aerosols was calculated as a surrogate of the secondhand exposure potential. Overall, MMADs did not differ among puff profiles, except for 55- and 75-ml volumes at 7.5 W (p < 0.05). For the reference e-liquid, MMADs ranged from 1.02 to 1.23 μm and dosimetry calculations predicted that particles would deposit in the head region (36–41%), in the trachea-bronchial (TB) region (19–21%), and in the pulmonary region (40–43%). For commercial JUUL® e-liquids, MMADs ranged from 0.92 to 1.67 μm and modeling predicted that more particles would deposit in the head region (35–52%) and in the pulmonary region (30–42%). Overall, 30–40% of the particles aerosolized by a pod-style EVP were estimated to deposit in the pulmonary region and 50–70% of the inhaled EVP aerosols could be exhaled; the latter could present an inhalational hazard to bystanders in indoor occupational settings. More research is needed to understand the influence of other modifiable factors on PSD and exposure potential.

Prevalence of Benign and Malignant Lesions in the Head Region: An Observational Study

Objective: The objective of this study was to evaluate the frequency of head benign and malignant lesions with regard to age group, sex, site and type of lesion and clinical variety in a tertiary care hospital in Lahore. Methodology: Basic research design: An observational cross-sectional study, included collection and analysis of histopathological data over the last 4 years i.e. 2016-2019. Test of significance chi-square was done for data analysis in IBM SPSS v17. Clinical setting: Pathology Departments of Sheikh Zayed Hospital (tertiary care hospital). Results: Sample included a total of 952 patient records in this study, with 587 (61.7%) males and 365 (38.3%) females. There were 514 cases of the head region and 438 cases of the neck region. Out of 514 total head region cases, 66 were malignant and 458 were benign. Participants were divided into age groups (1-18, 19-35, 36-50, 51-70, 70+) years respectively. The prevalence of benign cancers in head region was calculated in percentages according to which most patients were of nasal polyp at 26.3%, pleomorphic adenoma were 3.4%, with fibro-epithelial polyp were 9.5%. In the malignant category though Squamous cell carcinoma (SCC) was the most prevalent malignant lesion with highest frequency recorded in tongue region were 4.0%, rest with SCC nose were 0.6%, with SCC soft palate were 2.1%. The results of the chi-square revealed that there was a significant difference found with regards to the prevalence of various benign lesions in the head region between males (X2 = 1003.041, P>.001) and females (X2 = 593.937, P>.001). In addition, the difference among males and females was found statistically significant with regards to the prevalence of different types of malignant tumors in head region (for males, X2 = 238.447, P>.001, for females, X2 = 112.641, P>.001). With regards to the age groups the prevalence of different types of benign cancers was found to be statistically significant at head region (X2 = 140.500, P>.001), however there was a non-significant difference between the age-wise prevalence of different types of malignant cancers of head region (X2 = 44.702, P = .281). Conclusion: A reappraisal of neoplastic lesions of this important anatomical region in this study highlight the wide spectrum of tumors encountered along with its relative frequency. Squamous cell carcinoma constitutes the highest percentage of all the malignancies in the head region. Though head malignancies are a serious concern, good awareness, education, and early diagnosis can reduce their incidence.

Oncholaimus tripapillatus sp. nov., a New Free-Living Marine Nematode of the Genus Oncholaimus Dujardin, 1845 (Nematoda: Enoplida: Oncholaimidae) from the Subtidal Sediment of Dokdo Island, East Sea, Korea, with a New Record of O. qingdaoensis Zhang & Platt, 1983

During a survey of the free-living marine nematodes of Korea, two species belonging to the genus Oncholaimus Dujardin, 1845 were discovered. A new species, Oncholaimus tripapillatus sp. nov. and a newly recorded species, Oncholaimus qingdaoensis Zhang & Platt, 1983, are reported. Oncholaimus tripapillatus sp. nov. was collected from the washing of subtidal coarse sediments around Dokdo Island of the East Sea, Korea. Oncholaimus tripapillatus sp. nov. is characterized by a relatively long (4071–4435 µm in males and 4514–4661 µm in females) and slender body, a slightly constricted head region, relatively long cephalic setae (10–12 µm), males having a precloacal sexual protuberance bearing two small cone-shaped supplementary spines, five pairs of long cloacal setae (three pairs of precloacal and two pairs of postcloacal setae in subventral position), and three remarkable papillae near the end of the tail, with two pairs of subventral setae. The Korean specimens of Oncholaimus qingdaoensis Zhang & Platt, 1983 are almost identical to the Chinese specimens of the original description from the intertidal sand of Qingdao, China. However, the Korean specimens differ from the Chinese specimens in the longer body length in males (3379–3715 µm vs. 2380–2640 µm), the larger spicule length (47–52 µm vs. 34–36 µm), and the presence of ventral tail papillae situated around 14–16 µm from the tail tip. Detailed morphological features and illustrations of two Oncholaimus species from Korea were obtained by differential interference contrast microscopy and scanning electron microscopy. A pictorial key to the species group with distinct tail papillae among the genus Oncholaimus is also provided.

Morphology, morphometry and some aspects of clinical anatomy in the skull and mandible of Sharri sheep

The aim of this study was to investigate and record data on the morphometrical parameters of the skull and mandible in Sharri sheep. We have evaluated 34 skulls (24 females and 10 males) of Sharri sheep (Ovis aries), a local breed of sheep from Northern Macedonia. Fifty-one measurements were evaluated in total: 37 parameters on the skull and 14 parameters on the mandible. The results of the study show that, in general, the morphology and morphometric parameters of the skull and mandible, of Sharri sheep are similar to those of other sheep breeds with few differences. The mean skull length (SL), skull height (SH), distance between two supraorbital foramina (DBTSF), orbital length (OL), mandible length (ML) and Sharri sheep diastema (D) were 247.47 ± 13.12 mm, 104.71 ± 6.21 mm, 50.73 ± 3.44 mm, 41.21 ± 1.99 mm, 185.91 ± 13.33 mm and 45.81 ± 3.73 mm, respectively. The results also show that out of 51 parameters, only 13 show a statistically significant difference between females and males, particularly the distance of akrokranion to opisthion (AO), articular surface length of mandibular condyle (ASL) and anterior limit of the mandibular foramen to cranial border of ramus mandible (RBMFRMRM). The findings of this study are important in many aspects: morphologically, morphometrically and especially clinically, during surgical interventions in the head region. With a lack of information in current literature on the investigated parameters in this sheep breed, the present data are a solid basis for further studies in comparative anatomy with other ruminants and in other areas such as zooarchaeology and animal welfare.

CONTENT ANALYSIS OF SOME DOCTORAL THESIS STUDIES CARRIED OUT IN TURKEY ON THE BRANCH OF TAEKWONDO IN THE FIELD OF SPORTS SCIENCES

<p>Taekwondo is an old martial art with a Korean origin that is performed with hands and feet, where several combined techniques are used together, and nerve-muscle use levels are high (Mark, 1984; Kim et al., 2011). The history of taekwondo may be traced back to centuries ago. Initially, this branch used to be taught for the person to defend themselves. Afterwards, throughout the centuries, it has been spread around the world as an artistic form. In addition to having an artistic form, the branch of taekwondo also requires high competitive strength. Taekwondo is a competitive sport that requires the displacement of the body parts of the opponent. As words, ‘tae’ means foot strike, ‘kwon’ means hand strike, and ‘do’ means philosophy (Kazemi et al., 2006). Taekwondo competitions are divided into two categories as sparring and poomsae. Sparring is performed against an opponent, while poomsae (imaginary sparring) is a branch where a single person performs. Taekwondo that is known as a demonstration sport showed itself for the first time in the 1988 Seoul and 1992 Barcelona Olympics. Its inclusion in official competitions occurred in the 2000 Sydney Olympic Games (Kazemi et al., 2004; Gupta, 2011). Taekwondo as an Olympic sport is a branch performed by 75-120 million individuals in more than 140 countries (Razi, 2016). Innovations made in equipment in time, changes in rules, safety measures, organization of competitions, and its prominent media- and education-related aspects have increasingly raised the interest in this branch and helped it gain its popularity today. With the increase in the popularity of the branch and the prominence it has gained in the Olympics, World Taekwondo has recently made some changes in the rules. Some changes may be listed as changes in the scoring system (increase in the point score of techniques applied on the head region), smaller game dimensions, enaction of the 10-sec rule and changes in penalty points (Moenig, 2015). Competitions are held in the form of 3 rounds of 1.5 minutes each for the Juniors and Teens categories and 3 rounds of 2 minutes each for the Youths and Adults categories, with 1 minute of rest between the rounds (Birrer, 1996; Toskovic et al. 2004; Heller ve ark., 1998). Competitions consist of various techniques applied on the head and torso regions. These techniques may be applied in the form of attack, counterattack and combined techniques. Athletes are scored based on the region on which they apply the techniques and the degree of difficulty. For athletes to receive points, they need to have multiple physical qualities. For competitive performance, taekwondo requires various factors including physical (Heller ve ark., 1998; Gao, 2001; Melhim, 2001; Ball et al.,2011; Estevan et al., 2011), psychological (de Prado, 2012), technical (Bridge et al., 2011; Cular et al., 2011) and tactical (Falcó et al., 2009; González et al., 2011) factors. This is why taekwondo training has been structured in a way to target these specific performance mediators (Heller et al., 1998; Gao, 2001). From this perspective, the purpose of taekwondo training is to prepare athletes in terms of both their physical activities and meeting of the physiological demands of competition (Marković et al., 2005; Pieter, 1991; Casoline et al., 2012). As strikes are important in taekwondo, athletes need to have explosive leg strength, aerobic resilience, balance and flexibility (Heller et al., 1998; Marković et al., 2005). Taekwondo athletes must have the capacity to rapidly produce muscle strength through kicks, because 80% of taekwondo skills are related to kicking (Shirley, 1992). Although these characteristics are not the only determinants of performance, they are among helpful pieces of information for trainers. There are studies in the literature on the physical and physiological characteristics of athletes. Nevertheless, it is important to increase the number of these studies and select the suitable training method for this group of athletes.</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0985/a.php" alt="Hit counter" /></p>