Simultaneous Focal Boost With Stereotactic Radiation Therapy for Localized Intermediate- to High-Risk Prostate Cancer: Primary Outcomes of the SPARC Phase 2 Trial.

Purpose: Dose-escalated radiation therapy is associated with better biochemical control at the expense of toxicity. Stereotactic body radiation therapy (SBRT) with dose escalation to the dominant intraprostatic lesion (DIL) provides a logical approach to improve outcomes in high-risk disease while limiting toxicity. This study evaluated the toxicity and quality of life (QoL) with CyberKnife-based SBRT and simultaneous integrated boost in localized prostate cancer.

Evaluation of PTV margins and plan robustness for single isocentre multiple target stereotactic radiosurgery.

Purpose: Robustness to residual setup errors and linac delivery errors of BrainLab Elements single-isocentre-multiple-target stereotactic radiosurgery was evaluated.

Methods: Residual setup errors of 13 patients were evaluated. Linac delivery error was quantified through multi-metastases-Winston-Lutz measurements.

Drinking water quality management progress in Ontario, two decades after Walkerton.

Following the waterborne disease outbreak in Walkerton, Ontario, the province made significant efforts to implement recommendations of the public inquiry that resulted. As Ontario reformed its drinking water sector, other jurisdictions were advancing risk-based quality management frameworks for drinking water, including the World Health Organization (WHO) through its water safety plan (WSP) framework. Two decades after the Walkerton tragedy, this paper seeks to: (i) evaluate alignment of Ontario's Drinking Water Quality Management Standard (DWQMS) with the WSP framework (ii) review readily available data for evidence that Ontario's DWQMS implementation has improved drinking water safety and promoted a preventive approach through risk-based quality management.

Congenital and Neoplastic Cranial Deformities in Wild Giraffe (Giraffa spp.).

Congenital deformities and neoplasia are poorly documented in wildlife, owing to the difficulty of detection in wild populations. Congenital deformities may lead to premature mortality, thus reducing the chances of thorough documentation. Importantly, neoplasia diagnoses depend on either sampling suspicious lesions from living individuals or access to fresh, undisturbed carcasses, which can prove challenging.

Inactivation of biofilm-bound bacterial cells using irradiation across UVC wavelengths.

Opportunistic pathogens (OPs), such as Pseudomonas spp., Legionella spp., and mycobacteria, have been detected in biofilms in drinking water distribution systems and water storage tanks and pose potential risks to finished drinking water quality and safety.

Skeletal dysplasia-like syndromes in wild giraffe.

Objective: Skeletal dysplasias, cartilaginous or skeletal disorders that sometimes result in abnormal bone development, are seldom reported in free-ranging wild animals. Here, we use photogrammetry and comparative morphometric analyses to describe cases of abnormal appendicular skeletal proportions of free-ranging giraffe in two geographically distinct taxa: a Nubian giraffe (Giraffa camelopardalis camelopardalis) in Murchison Falls National Park, Uganda and an Angolan giraffe (Giraffa giraffa angolensis) on a private farm in central Namibia.

Results: These giraffe exhibited extremely shortened radius and metacarpal bones relative to other similarly aged giraffe.

Reach, Recruitment, Dose, and Intervention Fidelity of the GoActive School-Based Physical Activity Intervention in the UK: A Mixed-Methods Process Evaluation.

School-based multi-component physical activity (PA) promotion is advocated; however, research has indicated that a multi-component approach may not always be effective at increasing adolescent PA. Evaluation of the GoActive 12-week multi-component school-based intervention showed no effect on adolescent PA. A mixed-methods process evaluation was embedded to facilitate greater understanding of the results, to elicit subgroup perceptions, and to provide insight into contextual factors influencing intervention implementation.

Effectiveness and cost-effectiveness of the GoActive intervention to increase physical activity among UK adolescents: A cluster randomised controlled trial.

Background: Less than 20% of adolescents globally meet recommended levels of physical activity, and not meeting these recommended levels is associated with social disadvantage and rising disease risk. The determinants of physical activity in adolescents are multilevel and poorly understood, but the school's social environment likely plays an important role. We conducted a cluster randomised controlled trial to assess the effectiveness of a school-based programme (GoActive) to increase moderate-to-vigorous physical activity (MVPA) among adolescents.

Clinical and cost-effectiveness of a diabetes education and behavioural weight management programme versus a diabetes education programme in adults with a recent diagnosis of type 2 diabetes: study protocol for the Glucose Lowering through Weight management (GLoW) randomised controlled trial.

Introduction: People with type 2 diabetes (T2D) can improve glycaemic control or even achieve remission through weight loss and reduce their use of medication and risk of cardiovascular disease. The Glucose Lowering through Weight management (GLoW) trial will evaluate whether a tailored diabetes education and behavioural weight management programme (DEW) is more effective and cost-effective than a diabetes education (DE) programme in helping people with overweight or obesity and a recent diagnosis of T2D to lower their blood glucose, lose weight and improve other markers of cardiovascular risk.

Methods And Analysis: This study is a pragmatic, randomised, single-blind, parallel group, two-arm, superiority trial.

Examining the factors that affect structural repetition in question answering.

We present two experiments that examine structural priming in the single-trial phone-call paradigm introduced by Levelt and Kelter (Cognitive psychology, 14 (1), 78-106, 1982). Experimenters called businesses and asked either What time do you close? or At what time do you close? Participants were more likely to produce a prepositional response (At 7 o'clock vs. 7 o'clock) following a prepositional question than following a non-prepositional question.

Adolescents' perspectives on a school-based physical activity intervention: A mixed method study.

Purpose: To examine adolescent experiences and perspectives of the GoActive intervention (ISRCTN31583496) using mixed methods process evaluation to determine satisfaction with intervention components and interpret adolescents' experiences of the intervention process in order to provide insights for future intervention design.

Methods: Participants ( = 1542; 13.2 ±  0.

Capturing the impact of adolescent inpatient admissions: The Social Connectedness Scale.

Background: Outcome measurement is central to health service provision. In child and adolescent mental health services (CAMHS), there are established tools used to assess symptoms and track progress. However, there is a relative dearth of assessments of subjective well-being or recovery.

Results of a multicentre randomised controlled trial of cochlear-sparing intensity-modulated radiotherapy versus conventional radiotherapy in patients with parotid cancer (COSTAR; CRUK/08/004).

Purpose: About 40-60% of patients treated with post-operative radiotherapy for parotid cancer experience ipsilateral sensorineural hearing loss. Intensity-modulated radiotherapy (IMRT) can reduce radiation dose to the cochlea. COSTAR, a phase III trial, investigated the role of cochlear-sparing IMRT (CS-IMRT) in reducing hearing loss.

An evaluation of systematic errors on marker-based registration of computed tomography and magnetic resonance images of the liver.

We demonstrated a general method to evaluate systematic errors related to Magnetic Resonance (MR) imaging sequences in marker-based co-registration of MR and Computed Tomography (CT) images, and investigated the effect of MR image quality in the co-registration process using clinical MR and CT protocols for stereotactic ablative body radiotherapy (SABR) planning of the liver. Small systematic errors (under 1.6 mm) were detected, unlikely to be a clinical risk to liver SABR.

Systems, supplies, and staff: a mixed-methods study of health care workers' experiences and health facility preparedness during a large national cholera outbreak, Kenya 2015.

Background: From December 2014 to September 2016, a cholera outbreak in Kenya, the largest since 2010, caused 16,840 reported cases and 256 deaths. The outbreak affected 30 of Kenya's 47 counties and occurred shortly after the decentralization of many healthcare services to the county level. This mixed-methods study, conducted June-July 2015, assessed cholera preparedness in Homa Bay, Nairobi, and Mombasa counties and explored clinic- and community-based health care workers' (HCW) experiences during outbreak response.

Physical Activity Duration but Not Energy Expenditure Differs between Daily and Intermittent Breakfast Consumption in Adolescent Girls: A Randomized Crossover Trial.

Background: It is not known whether breakfast frequency affects physical activity (PA) in children or adolescents.

Objective: This study examined the effect of daily compared with intermittent breakfast consumption on estimated PA energy expenditure (PAEE) in adolescent girls.

Methods: Under a randomized crossover design, 27 girls [mean ± SD age: 12.

An external dosimetry audit programme to credential static and rotational IMRT delivery for clinical trials quality assurance.

Purpose: External dosimetry audits give confidence in the safe and accurate delivery of radiotherapy. The RTTQA group have performed an on-site audit programme for trial recruiting centres, who have recently implemented static or rotational IMRT, and those with major changes to planning or delivery systems.

Methods: Measurements of reference beam output were performed by the host centre, and by the auditor using independent equipment.

Seeking Clearer Recommendations for Hand Hygiene in Communities Facing Ebola: A Randomized Trial Investigating the Impact of Six Handwashing Methods on Skin Irritation and Dermatitis.

Unlabelled: To prevent disease transmission, 0.05% chlorine solution is commonly recommended for handwashing in Ebola Treatment Units. In the 2014 West Africa outbreak this recommendation was widely extended to community settings, although many organizations recommend soap and hand sanitizer over chlorine.

Shelf-Life of Chlorine Solutions Recommended in Ebola Virus Disease Response.

In Ebola Virus Disease (EVD) outbreaks, it is widely recommended to wash living things (handwashing) with 0.05% (500 mg/L) chlorine solution and non-living things (surfaces, personal protective equipment, dead bodies) with 0.5% (5,000 mg/L) chlorine solution.

Accuracy, Precision, Ease-Of-Use, and Cost of Methods to Test Ebola-Relevant Chlorine Solutions.

To prevent transmission in Ebola Virus Disease (EVD) outbreaks, it is recommended to disinfect living things (hands and people) with 0.05% chlorine solution and non-living things (surfaces, personal protective equipment, dead bodies) with 0.5% chlorine solution.

Strategic flexibility in computational estimation for Chinese- and Canadian-educated adults.

The purpose of the present study was to examine factors that influence strategic flexibility in computational estimation for Chinese- and Canadian-educated adults. Strategic flexibility was operationalized as the percentage of trials on which participants chose the problem-based procedure that best balanced proximity to the correct answer with simplification of the required calculation. For example, on 42 × 57, the optimal problem-based solution is 40 × 60 because 2,400 is closer to the exact answer 2,394 than is 40 × 50 or 50 × 60.

The impacts of short break provision on families with a disabled child: an international literature review.

There are widespread assumptions about the potential impacts of short breaks on family carers and disabled children. This review aims to evaluate the existing international research evidence concerning the impacts of short breaks on families with a disabled child. Electronic literature searches were conducted using ASSIA, PsycInfo, CINAHL, and Web of Science, and requests for information were sent to selected email lists.

Using attached macroalgae to assess ecological status of British estuaries for the European Water Framework Directive.

The EC Water Framework Directive requires that ecological quality be assessed in transitional waters using the abundance and species composition of macroalgae. In estuaries, which form the majority of transitional waters, species composition is not a suitable measure. This arises from two features: (i) there is a continuous, natural change in species composition along the gradient of estuarine conditions which makes it difficult to know where within an estuary the species composition should be assessed, (ii) the inner estuarine macroalgal community of mat-forming species is very tolerant to both natural and anthropogenic stress and species poor which makes it insensitive to environmental variations in terms of species composition.

The use of macroalgal species richness and composition on intertidal rocky seashores in the assessment of ecological quality under the European Water Framework Directive.

The EC Water Framework Directive (WFD) suggests using abundance and species composition of intertidal seaweed communities for ecological quality classification of rocky seashores. There are two difficulties with this. According to WFD all sensitive species should be present on a shore.