Thoracoabdominal chordoma in a pediatric patient. A rare entity.

Introduction: Chordoma is a rare, slow-growing notochordal neoplasm typical of adults. Less than 5% of the cases occur in children, where they are located at the skull base. Treatment involves surgical resection with or without radiotherapy.

Benchmarking and performance evaluation of a novel deformable image registration software for radiotherapy CT images.

Purpose: We evaluated and benchmarked a novel deformable image registration (DIR) software functionality (DirOne, Cosylab d.d., Ljubljana, Slovenia) by comparing it to two commercial systems, MIM and VelocityAI, following AAPM task group 132 (TG-132) guidelines.

Comparing new tools of artificial intelligence to the authentic intelligence of our global health students.

Introduction: The transformative feature of Artificial Intelligence (AI) is the massive capacity for interpreting and transforming unstructured data into a coherent and meaningful context. In general, the potential that AI will alter traditional approaches to student research and its evaluation appears to be significant. With regard to research in global health, it is important for students and research experts to assess strengths and limitations of GenAI within this space.

Heavy Ion Particle Therapy in Modern Day Radiation Oncology.

Heavy ion radiotherapy is an emerging technology for treating radioresistant solid tumors. Unlike current low-linear energy transfer techniques, heavy ion radiotherapy, such as carbon ion radiotherapy, enhances the biologic effects related to cancer therapy. Prospective clinical evidence has demonstrated feasibility and efficacy in several disease sites, including head and neck, thoracic, central nervous system, gastrointestinal, pelvic tumors, and sarcomas.

Dosimetric study of synchrotron rapid beam off control and skip spot function for high beam intensity proton therapy.

Background: All Hitachi proton pencil beam scanning facilities currently use discrete spot scanning (DSS). Mayo Clinic Florida (MCF) is installing a Hitachi particle therapy system with advanced technologies, including fast scan speeds, high beam intensity, rapid beam off control (RBOC), a skip spot function, and proton pencil beam scanning using dose driven continuous scanning (DDCS). A potential concern of RBOC is the generation of a shoulder at the end of the normal spot delivery due to a flap spot (FS) with a flap dose (FD), which has been investigated for carbon synchrotron but not for proton delivery.

Bovine brucellosis in dual-purpose cattle herds and its potential economic impact in the Colombian Caribbean region.

Bovine brucellosis (BB) is a cosmopolitan zoonotic disease caused by certain bacteria of the genus Brucella. It has negative health implications for the cattle, economic implications for the owners and is present in numerous cattle and wildlife populations worldwide. To determine the seroprevalence of BB in dual-purpose herds and assess its impact in the southern part of the Department of Atlántico, northern Colombia.

Global change, climate change, and asthma in children: Direct and indirect effects - A WAO Pediatric Asthma Committee Report.

The twenty-first century has seen a fundamental shift in disease epidemiology with anthropogenic environmental change emerging as the likely dominant factor affecting the distribution and severity of current and future human disease. This is especially true of allergic diseases and asthma with their intimate relationship with the natural environment. Climate change-related variables including increased ambient temperature, heat waves, extreme weather events, air pollution, and rainfall distribution, all can affect asthma in children, but each of these variables also affects asthma via alterations in pollen production and release, outdoor allergen exposure or the microbiome.

Convalescent Plasma Therapy in Severe COVID-19: A Pilot Study at the Beginning of the Pandemic Outbreak in Southern Chile.

Unlabelled: Convalescent Plasma (CP) from patients who recovered from COVID-19 may present neutralizing antibodies against viral protein S of SARS-CoV-2 and emerged as a potential therapeutic alternative for patients with severe infection at the beginning of the COVID-19 pandemic breakout. Thus, this study aimed to evaluate the effect and safety of CP treatment in patients with severe COVID-19.

Methods: We designed a quasi-experimental study that included 156 patients with SARS-CoV-2 infection confirmed by RT-qPCR and severe symptoms who received CP.

Temporal variability of spatial patterns of correlations between summer rainfall and the Oceanic Niño Index in the Pampean region.

The Argentinean Pampean region is essential for global food security, known for its extensive production of soybeans, corn, and wheat. The November to January (NDJ) trimester is critical for rainfed summer crops, as precipitation during this period directly affects soil moisture and crop yields. The El Niño-Southern Oscillation (ENSO), particularly its Oceanic Niño Index (ONI), plays a crucial role in influencing precipitation patterns in this region.

Requested a Different Doctor: Developing and Evaluating an OSCE Assessing Core Skills in Supporting Trainees Facing Patient Discrimination.

Background: Suboptimal support for colleagues experiencing discrimination can adversely impact clinician well-being and patient care.

Aim: To describe resident performance and experience during an Objective Structured Clinical Examination (OSCE) case centered on supporting a trainee facing discrimination to inform enhanced, supportive learning environments.

Setting: Formative, internal medicine OSCE at a simulation center.

The InterVision Framework: An Enhanced Fine-Tuning Deep Learning Strategy for Auto-Segmentation in Head and Neck.

Adaptive radiotherapy (ART) workflows are increasingly adopted to achieve dose escalation and tissue sparing under dynamic anatomical conditions. However, recontouring and time constraints hinder the implementation of real-time ART workflows. Various auto-segmentation methods, including deformable image registration, atlas-based segmentation, and deep learning-based segmentation (DLS), have been developed to address these challenges.

Exploring the LET dependence of DNA DSB repair kinetics using the DR DNA database.

The repair of DNA double-strand breaks is a crucial yet delicate process which is affected by a multitude of factors. In this study, our goal is to analyse the influence of the linear energy transfer (LET) on the DNA repair kinetics. By utilizing the database of repair of DNA and aggregating the results of 84 experiments, we conduct various model fits to evaluate and compare different hypothesis regarding the effect of LET on the rejoining of DNA ends.

Hyperglycemia adversely affects critical physiological events related to rat sperm capacitation.

Hyperglycemia, the hallmark of diabetes mellitus (DM), is the main cause of DM-related systemic complications, including reproductive issues. Furthermore, the incidence of DM in males of reproductive ages is becoming an increasing concern, as the complexity of sperm capacitation (an essential process for fertilizing the egg) extends beyond conventional sperm parameters such as count, viability, and motility. Capacitation defects cause male infertility, and DM-related hyperglycemia may affect this process.

Pulmonary Foreign Body Granulomatosis Following Intravenous Injection of Oral Medication: A Rare Case Report.

Intravenous injection of pulverized tablet formulations intended for oral use may lead to pulmonary foreign body granulomatosis, a rare and serious condition. This case report details an unusual case of pulmonary micronodular disease resulting from the injection of crushed hydrocodone bitartrate and acetaminophen tablets via a peripherally inserted central catheter (PICC). A 62-year-old female on total parenteral nutrition presented with progressive dyspnea on exertion.

Enhanced IDOL segmentation framework using personalized hyperspace learning IDOL.

Background: Adaptive radiotherapy (ART) workflows have been increasingly adopted to achieve dose escalation and tissue sparing under shifting anatomic conditions, but the necessity of recontouring and the associated time burden hinders a real-time or online ART workflow. In response to this challenge, approaches to auto-segmentation involving deformable image registration, atlas-based segmentation, and deep learning-based segmentation (DLS) have been developed. Despite the particular promise shown by DLS methods, implementing these approaches in a clinical setting remains a challenge, namely due to the difficulty of curating a data set of sufficient size and quality so as to achieve generalizability in a trained model.

Association of coinfections with differences in outcomes across COVID-19 variants.

Background: In previous studies, there was an increase in mortality with secondary coinfections in all COVID-19 variants. However, no prior study has explored the association of coinfection with outcomes of hospitalized patients among the COVID-19 variants (Alpha, Delta, and Omicron).

Methods: This observational cohort study involved 21,186 patients hospitalized with COVID-19 in 25 hospitals in Texas.

LET-based approximation of the microdosimetric kinetic model for proton radiotherapy.

Background: Phenomenological relative biological effectiveness (RBE) models for proton therapy, based on the dose-averaged linear energy transfer (LET), have been developed to address the apparent RBE increase towards the end of the proton range. The results of these phenomenological models substantially differ due to varying empirical assumptions and fitting functions. In contrast, more theory-based approaches are used in carbon ion radiotherapy, such as the microdosimetric kinetic model (MKM).

An age-friendly chart review tool: integrating geriatrics education and quality improvement in a resident primary care clinic.

Resident primary care clinics have no standardized approach for assessing geriatric-specific quality of care measures. This results in wide variability in the quality of care offered to older adults in these clinics and the quality of geriatrics education residents receive in the primary care setting. To address this need, we developed a structured resident self-assessment chart review tool designed to be integrated into a required Geriatrics rotation within an Internal Medicine residency program.

Innovative 3D printing and molding process for secondary-skin-collimator fabrication.

. Secondary skin collimation (SSC) is essential for shielding normal tissues near tumors during electron and orthovoltage radiation treatments. Traditional SSC fabrication methods, such as crafting in-house lead sheets, are labor-intensive and produce SSCs with low geometric accuracy.

An automation of Monte Carlo workflow for dosimetry study of an Elekta LINAC delivery system in radiotherapy.

Purpose: This study aims to automate the Monte Carlo (MC) workflow utilized for radiotherapy dosimetry, focusing on an Elekta LINAC delivery system. It addresses the challenge of integrating MC simulations into routine clinical practice, making this accurate yet complex method more accessible and efficient for radiotherapy dosimetry.

Methods And Materials: We developed a user-friendly software featuring a graphical user interface (GUI) that integrates EGSnrc for MC simulations.

Practice Makes Perfect: Objective Structured Clinical Examinations Across the UME-to-GME Continuum Improve Care of Transgender Simulated Patients.

Residents lack confidence in caring for transgender individuals. More exposure and practice throughout training is needed. To explore whether and how prior exposure to transgender health skills during medical school impacted competency with these skills during residency.

Experiential Learning with Ketamine: A Mixed-Methods Exploratory Study on Prescription and Perception.

Background: Incorporating unfamiliar therapies into practice requires effective longitudinal learning and the optimal way to achieve this is debated. Though not a novel therapy, ketamine in critical care has a paucity of data and variable acceptance, with limited research describing intensivist perceptions and utilization. The Coronavirus-19 pandemic presented a particular crisis where providers rapidly adapted analgosedation strategies to achieve prolonged, deep sedation due to a surge of severe acute respiratory distress syndrome (ARDS).