Simulation of Focal Boosting in Online Adaptive MRI-Guided SBRT for Patients With Locally Advanced Prostate Cancer With Seminal Vesicle Involvement.

Purpose: To evaluate the feasibility and accuracy of focal boosting in online adaptive MRI-guided stereotactic body radiation therapy (SBRT) for patients with prostate cancer (PCa) with seminal vesicle invasion (T3b) by analyzing the impact of intrafraction motion on the dose planned for the gross tumor volume (GTV) and clinical target volume (CTV).

Methods And Materials: Data from 23 patients with T1-T3a PCa who received focal boosting SBRT on a 1.5T MR-Linac was used.

Art-based observational training for medical students and surgical residents in two Dutch museums.

Background: Art-based education is gaining interest in the medical field, particularly in specialties with a strong visual focus. Visual arts are increasingly used for the development of observational skills and social competencies. While content and objectives of art-based programs widely differ across medical faculties in the Netherlands, the diverse range of options underscore the interest in and the potential of this educational approach.

Corrigendum to "Exploring social movement concepts and actions in a knowledge uptake and sustainability context: A concept analysis" [Int J Nurs Sci 9/4 (2022) 411-421].

[This corrects the article DOI: 10.1016/j.ijnss.

Consensus Statement No. 434: Simulation in Obstetrics and Gynaecology.

Objective: To provide a comprehensive and current overview of the evidence for the value of simulation for education, team training, patient safety, and quality improvement in obstetrics and gynaecology, to familiarize readers with principles to consider in developing a simulation program, and to provide tools and references for simulation advocates.

Target Population: Providers working to improve health care for Canadian women and their families; patients and their families.

Outcomes: Simulation has been validated in the literature as contributing to positive outcomes in achieving learning objectives, maintaining individual and team competence, and enhancing patient safety.

Exploring social movement concepts and actions in a knowledge uptake and sustainability context: A concept analysis.

Objectives: To share a concept analysis of social movement aimed at advancing its application to evidence uptake and sustainability in health-care.

Methods: We applied Walker and Avant method to clarify the concept of social movement in the context of knowledge uptake and sustainability. Peer-reviewed and grey literature databases were systematically searched for relevant reports that described how social movement action led to evidence-based practice changes in health and community settings.

Benchmarking daily adaptation using fully automated radiotherapy treatment plan optimization for rectal cancer.

Background/purpose: In daily plan adaptation the radiotherapy treatment plan is adjusted just prior to delivery. A simple approach is taking the planning objectives of the reference plan and directly applying these in re-optimization. Here we present a tested method to verify whether daily adaptation without tweaking of the objectives can maintain the plan quality throughout treatment.

Hydrogels derived from decellularized liver tissue support the growth and differentiation of cholangiocyte organoids.

Human cholangiocyte organoids are promising for regenerative medicine applications, such as repair of damaged bile ducts. However, organoids are typically cultured in mouse tumor-derived basement membrane extracts (BME), which is poorly defined, highly variable and limits the direct clinical applications of organoids in patients. Extracellular matrix (ECM)-derived hydrogels prepared from decellularized human or porcine livers are attractive alternative culture substrates.

Precancerous liver diseases do not cause increased mutagenesis in liver stem cells.

Inflammatory liver disease increases the risk of developing primary liver cancer. The mechanism through which liver disease induces tumorigenesis remains unclear, but is thought to occur via increased mutagenesis. Here, we performed whole-genome sequencing on clonally expanded single liver stem cells cultured as intrahepatic cholangiocyte organoids (ICOs) from patients with alcoholic cirrhosis, non-alcoholic steatohepatitis (NASH), and primary sclerosing cholangitis (PSC).

Recapitulating Cholangiopathy-Associated Necroptotic Cell Death In Vitro Using Human Cholangiocyte Organoids.

Background & Aims: Liver and bile duct diseases often are associated with extensive cell death of cholangiocytes. Necroptosis represents a common mode of programmed cell death in cholangiopathy, however, detailed mechanistic knowledge is limited owing to the lack of appropriate in vitro models. To address this void, we investigated whether human intrahepatic cholangiocyte organoids (ICOs) can recapitulate cholangiopathy-associated necroptosis and whether this model can be used for drug screening.

MR-Linac Radiotherapy - The Beam Angle Selection Problem.

Background: With the large-scale introduction of volumetric modulated arc therapy (VMAT), selection of optimal beam angles for coplanar static-beam IMRT has increasingly become obsolete. Due to unavailability of VMAT in current MR-linacs, the problem has re-gained importance. An application for automated IMRT treatment planning with integrated, patient-specific computer-optimization of beam angles (BAO) was used to systematically investigate computer-aided generation of beam angle class solutions (CS) for replacement of computationally expensive patient-specific BAO.

Energetic constraints imposed on trophic interaction strengths enhance resilience in empirical and model food webs.

Food web stability and resilience are at the heart of understanding the structure and functioning of ecosystems. Previous studies show that models of empirical food webs are substantially more stable than random ones, due to a few strong interactions embedded in a majority of weak interactions. Analyses of trophic interaction loops show that in empirical food webs the patterns of the interaction strengths prevent the occurrence of destabilizing heavy loops and thereby enhances resilience.

Rotavirus Infection and Cytopathogenesis in Human Biliary Organoids Potentially Recapitulate Biliary Atresia Development.

Biliary atresia (BA) is a neonatal liver disease characterized by progressive fibroinflammatory obliteration of both intrahepatic and extrahepatic bile ducts. The etiologies of BA remain largely unknown, but rotavirus infection has been implicated at least for a subset of patients, and this causal relation has been well demonstrated in mouse models. In this study, we aim to further consolidate this evidence in human biliary organoids.

Knowledge-Based Assessment of Focal Dose Escalation Treatment Plans in Prostate Cancer.

Purpose: In a randomized focal dose escalation radiation therapy trial for prostate cancer (FLAME), up to 95 Gy was prescribed to the tumor in the dose-escalated arm, with 77 Gy to the entire prostate in both arms. As dose constraints to organs at risk had priority over dose escalation and suboptimal planning could occur, we investigated how well the dose to the tumor was boosted. We developed an anatomy-based prediction model to identify plans with suboptimal tumor dose and performed replanning to validate our model.

First system for fully-automated multi-criterial treatment planning for a high-magnetic field MR-Linac applied to rectal cancer.

In this study we developed a workflow for fully-automated generation of deliverable IMRT plans for a 1.5 T MR-Linac (MRL) based on contoured CT scans, and we evaluated automated MRL planning for rectal cancer. The Monte Carlo dose calculation engine used in the clinical MRL TPS (Monaco, Elekta AB, Stockholm, Sweden), suited for high accuracy dose calculations in a 1.

Investigating the impact of patient arm position in an MR-linac on liver SBRT treatment plans.

Purpose: The superior soft-tissue contrast offered by the integrated magnetic resonance imaging (MRI) of the Unity MR-linac compared to the x-ray-based image guidance on conventional linacs potentially allows for liver stereotactic body radiation therapy (SBRT) without the need for implanted markers or other surrogates. On conventional linacs, liver SBRT patients are typically positioned with their arms above their heads (arms-up) to minimize exposure to healthy tissue. However, the spatial confinement of the MRI-bore and increased treatment delivery times can make the arms-up position straining.

Tumor microRNA-126 controls cell viability and associates with poor survival in patients with esophageal adenocarcinoma.

Unlabelled: Esophageal adenocarcinoma displays a poor prognosis and current treatments are often not curative. Pathological TNM-stage is a prognostic parameter, but a better understanding of the pathophysiology of esophageal adenocarcinoma is needed to better predict survival. Recent work in other malignancies indicated an important role for the regulator microRNA-126 (miR-126) in tumors.

Implementing Patient Safety Initiatives.

Implementing change is difficult; few people want to wade into this area because of the challenge. However, it is highly rewarding and does not have to be complicated. Success requires a clear understanding of health care context, patient safety, and behavioral psychology.

Evaluation of plan quality in radiotherapy planning with an MR-linac.

Background & Purpose: Clinical introduction of magnetic resonance (MR)-guided radiotherapy involves treatment planning while taking into account machine-specific characteristics. Our aim was to investigate the feasibility of high-quality MR-linac treatment planning for an MR-linac and to benchmark MR-linac plan quality (IMRT) against current clinical practice (VMAT).

Materials & Methods: Data of eight rectal and eight prostate cancer patients, who received radiotherapy on a conventional CBCT-integrated linac, were selected.

Modulation of Litter Decomposition by the Soil Microbial Food Web Under Influence of Land Use Change.

Soil microbial communities modulate soil organic matter (SOM) dynamics by catalyzing litter decomposition. However, our understanding of how litter-derived carbon (C) flows through the microbial portion of the soil food web is far from comprehensive. This information is necessary to facilitate reliable predictions of soil C cycling and sequestration in response to a changing environment such as land use change in the form of agricultural abandonment.

Examining the effects of an obstetrics interprofessional programme on reductions to reportable events and their related costs.

There are many ways to account for the return on investment (ROI) in healthcare: improved communication, teamwork, culture, patient satisfaction, staff satisfaction, and clinical outcomes are but a few. Some of these are easier to quantify and associate to an intervention than others. What if the outcomes listed were not just independent results, but beget one another? In 2001, the Society of Obstetricians and Gynaecologists of Canada created the Managing Obstetrical Risk Efficiently (MORE) programme, to improve healthcare culture and patient outcomes in obstetrics by leveraging front-line ownership.

Interaction of immunosuppressants with HCV antivirals daclatasvir and asunaprevir: combined effects with mycophenolic acid.

Aim: To investigate the specific effects of immunosuppressants on the antiviral action of daclatasvir and asunaprevir.

Methods: The antiviral activity of daclatasvir (DCV) and asunaprevir (ASV) combined with immunosuppressants was tested using two models for hepatitis C virus (HCV) infection.

Results: Tacrolimus, rapamycin and cyclosporine did not negatively affect the antiviral action of DCV or ASV.

Energy Flux: The Link between Multitrophic Biodiversity and Ecosystem Functioning.

Relating biodiversity to ecosystem functioning in natural communities has become a paramount challenge as links between trophic complexity and multiple ecosystem functions become increasingly apparent. Yet, there is still no generalised approach to address such complexity in biodiversity-ecosystem functioning (BEF) studies. Energy flux dynamics in ecological networks provide the theoretical underpinning of multitrophic BEF relationships.