The Development and Characteristics of Planetary Health in Medical Education: A Scoping Review.

Purpose: Climate change, biodiversity loss, and other ecological crises threaten human health globally. The interrelation between human health and ecosystems is addressed in the emerging field of planetary health. Ecological crises have created an urgency to integrate planetary health, including sustainable health care, into medical education.

How Small Can We Go? Partial Bladder Radiation Therapy and Brachytherapy.

Organ preservation for muscle-invasive bladder cancer (MIBC) may use trimodality therapy. This includes transurethral resection followed by radiation therapy. Radiosensitization has become one of the standard of care approaches for MIBC with high rates of local disease control and overall survival.

Perpetual role of brachytherapy in organ-sparing treatment for bladder cancer: a historical review.

Brachytherapy-based radiotherapy has been applied for decades in the curative treatment for solitary, ≤ 5 cm bladder tumors. This review provides a historical perspective of this organ sparing approach. A systematic search of the published literature between 1900 and 2019 was performed on the subject of bladder brachytherapy using PubMed, with digitally retrievable articles being supplemented with articles from the personal collection of the authors.

Ring Versus Ovoids and Intracavitary Versus Intracavitary-Interstitial Applicators in Cervical Cancer Brachytherapy: Results From the EMBRACE I Study.

Purpose: The aim of this study was to investigate the influence of brachytherapy technique and applicator type on target dose, isodose surface volumes, and organ-at-risk (OAR) dose.

Methods And Materials: Nine hundred two patients treated with tandem/ovoids (T&O) (n = 299) and tandem/ring (T&R) (n = 603) applicators from 16 EMBRACE centers were analyzed. Patients received external beam radiation therapy and magnetic resonance imaging guided brachytherapy with dose prescription according to departmental practice.

Isodose surface volumes in cervix cancer brachytherapy: Change of practice from standard (Point A) to individualized image guided adaptive (EMBRACE I) brachytherapy.

Purpose: To investigate the isodose surface volumes (ISVs) for 85, 75 and 60 Gy EQD2 for locally advanced cervix cancer patients.

Materials And Methods: 1201 patients accrued in the EMBRACE I study were analysed. External beam radiotherapy (EBRT) with concomitant chemotherapy was followed by MR based image-guided adaptive brachytherapy (MR-IGABT).

An evaluation of our experience in position verification of catheters used for interstitial high-dose-rate brachytherapy of solitary bladder tumors.

Purpose: The goal of this study was to verify the position of catheters used over 4 days for brachytherapy of solitary bladder tumors.

Methods And Materials: The study covered three phases. Shifting of catheters was studied using daily position verification CT scans of 20 patients.

The Curie-Da Vinci Connection: 5-Years' Experience With Laparoscopic (Robot-Assisted) Implantation for High-Dose-Rate Brachytherapy of Solitary T2 Bladder Tumors.

Purpose: To report experience and early results of laparoscopic implantation for interstitial brachytherapy (BT) of solitary bladder tumors and the feasibility of a high-dose-rate (HDR) schedule.

Methods And Materials: From December 2009 to April 2015, 57 patients with a T2 solitary bladder tumor were treated in Arnhem with transurethral bladder resection followed by external beam irradiation, applied to the bladder and regional iliac lymph nodes, 40 Gy in 20 fractions, 5 fractions per week, and within 1 week interstitial HDR BT, in selected cases combined with partial cystectomy and lymph node dissection. The BT catheters were placed via a transabdominal approach with robotic assistance from a Da Vinci robot after a successful initial experience with a nonrobotic laparoscopic approach.

Multicentre evaluation of a novel vaginal dose reporting method in 153 cervical cancer patients.

Background And Purpose: Recently, a vaginal dose reporting method for combined EBRT and BT in cervical cancer patients was proposed. The current study was to evaluate vaginal doses with this method in a multicentre setting, wherein different applicators, dose rates and protocols were used.

Material And Methods: In a subset of patients from the EMBRACE study, vaginal doses were evaluated.

Irradiation and responsiveness to pain stimuli in rats.

This study evaluates whether irradiation inhibits responses to pain in an animal model. We found that irradiation with doses of 10 Gy, 15 Gy and 17.5 Gy of the lumbar enlargement of the spinal cord inhibits the behavioural responses to the stimulus of the hot-plate.

Detection of diffuse liver disease by quantitative echography: dependence on a Priori choice of parameters.

Quantitative acoustic parameters and image texture parameters were used in a linear discriminant analysis. This analysis was applied to detect retrospectively the classes of diffuse liver disease against a population of normal livers. Three different sets of parameters were employed.

Correlations between acoustic and texture parameters from RF and B-mode liver echograms.

Radio frequency (RF) echograms were acquired from human subjects without liver pathology (n = 126), who were in the range of 20 to 84 years of age. After appropriate correction for the equipment settings and performance characteristics, acoustospectrographic parameters were estimated. The data were corrected for the frequency-dependent attenuation and then software demodulated.

Detection and differentiation of diffuse liver disease by quantitative echography. A retrospective assessment.

Rationale And Objectives: The detectability of diffuse liver diseases by quantitative echography was retrospectively investigated using scans of patients with known pathologic findings (n = 103) and of normal subjects (n = 129). The authors determined the best set of quantitative parameters for this task.

Methods: Quantitative echography was comprised of acoustospectrographic parameters (frequency dependence of attenuation and backscattering) and image texture parameters.

Ultrasound attenuation and texture analysis of diffuse liver disease: methods and preliminary results.

A study was performed to find and test quantitative methods of analysing echographic signals for the differentiation of diffuse liver diseases. An on-line data acquisition system was used to acquire radiofrequency (RF) echo signals from volunteers and patients. Several methods to estimate the frequency-dependent attenuation coefficient were evaluated, in which a correction for the frequency and depth-dependent diffraction and focusing effects caused by the sound beam was applied.

Ultrasonic differentiation of intraocular melanomas: parameters and estimation methods.

In this study, the estimation of ultrasound parameters is evaluated for in vivo differentiation of intraocular melanomas. For this purpose, both tissue and image parameters of the ultrasound signal are considered. These parameters comprised, respectively, the frequency dependent attenuation and backscattering coefficient of the melanoma tissue, and the first and second-order statistics of the amplitude-modulated and phase-derivative images of the melanomas.

Variability of quantitative echographic parameters of the liver: intra- and interindividual spread, temporal- and age-related effects.

The values of acoustic and image texture parameters were estimated from liver scans of healthy subjects. The values were obtained after appropriate preprocessing of the radio frequency echograms by an on-line computerized system. The preprocessing comprised a correction for the Time Gain Compensation (TGC), the beam diffraction and the frequency dependent attenuation in the Region of Interest (ROI).

Texture in tissue echograms. Speckle or information?

Models of biological tissues are described in terms of acoustic parameters and of structure. Beam formation is discussed for continuous wave and pulsed modes of transducer operation and the concept of the point spread function (PSF) is introduced. The PSF is equivalent to the resolution cell, or the sampling volume, of echographic equipment.

Phase-derivative imaging. III: Theoretical derivation of first and second order statistics.

The echo signal obtained from a homogenous and isotropically scattering medium can be described as a Poisson time series which is convolved with the transmission pulse of the transducer. The probability density function (pdf) of this signal approximates to a Gaussian pdf for narrowband pulse waveform. Methods to derive the phase-derivative (PD) signal from the complex envelope and the preenvelope of the echo signal are described.

Phase-derivative imaging. II: Effects of beam diffraction and scatterer density.

The potential of using the phase derivative (PD) of the radio-frequency echograms for producing 2-dimensional grey scale images was further investigated. The PD images were produced by five different algorithms, which according to the results described in the companion paper yield PD images dominated by the amplitude (envelope, ENV), mixed PD-AM images and pure PD images. These images are termed according to their algorithms: ZCS, zero crossing counter with squelch; ASS, analytic signal with squelch; ASW, analytic signal with Wiener kernel; UNP, unwrapped phase; and SAS, smoothed analytic signal.

Gray level transforms and lesion detectability in echographic images.

In search of the optimal display of echographic information for the detection of focal lesions, a systematic study was performed considering a wide range of gray level transforms (i.e., lookup tables).

Phase-derivative imaging. I: Methods and stabilization analysis.

The potential of using the phase derivative (PD) for echographic imaging was investigated. The PD data were calculated by four methods: zero crossing (ZCS) with squelch addition, analytic signal either with squelch addition (ASS) or with employment of a Wiener kernel (ASW), and unwrapped phase (UWP). The large peaks which occur in an unprocessed PD signal were "stabilized" by some kind of smoothing algorithm.

Texture of B-mode echograms: 3-D simulations and experiments of the effects of diffraction and scatterer density.

B-mode echograms were simulated by employing the impulse response method in transmission and reception using a discrete scatterer tissue model, with and without attenuation. The analytic signal approach was used for demodulation of the RF A-mode lines. The simulations were performed in 3-D space and compared to B-mode echograms obtained from experiments with scattering tissue phantoms.