Greater anemia tolerance among hospitalized females compared to males.

Background: Although females have a lower baseline hemoglobin (Hb) compared to males, it is unknown whether females have a greater tolerance for anemia when hospitalized. We tested the hypothesis that females tolerate severe anemia better than males, with decreased inpatient mortality in this setting.

Study Design And Methods: We conducted a retrospective cohort study in 230,644 adult patients admitted to Johns Hopkins Hospital from January 2009 to June 2016.

One-unit compared to two-unit platelet transfusions for adult oncology outpatients.

Background And Objectives: Platelet dosing has been studied in adult oncology inpatients, but there is almost no published evidence to guide platelet dosing for adult outpatients. We evaluated transfusion indices after 1 unit and 2 unit apheresis platelet transfusions at our hospital to determine whether a benefit to 2-unit transfusions could be detected.

Materials And Methods: A retrospective chart review was conducted of all adult oncology patients who received an outpatient platelet transfusion over a 16-month period (July 2016-November 2017).

Optimizing laryngeal sparing with intensity modulated radiotherapy or volumetric modulated arc therapy for unilateral tonsil cancer.

Background And Purpose: Minimizing radiation dose exposure to nearby organs is key to limiting clinical toxicities associated with radiotherapy. Several treatment modalities such as split- or whole-field intensity-modulated radiotherapy (SF-IMRT, WF-IMRT) and volumetric modulated arc therapy (VMAT) are being used to treat tonsillar cancer patients with unilateral neck radiotherapy. Herein, we provide a modern dosimetric comparison of all three techniques.

Minocycline for symptom reduction during radiation therapy for head and neck cancer: a randomized clinical trial.

Purpose: Local/systemic symptoms during cancer therapy may be exacerbated by dysregulated inflammation and its downstream toxic effects. Minocycline can suppress proinflammatory cytokine release; therefore, we investigated its potential to reduce patient-reported symptom severity during radiotherapy (RT) for head and neck cancer (HNC).

Methods: Eligible patients for this blinded, placebo-controlled trial were adults with T0-3, N-any, and M0 HNC receiving single-modality RT.

How to Understand Behavioral Patterns in Big Data: The Case of Human Collective Memory.

Simple patterns often arise from complex systems. For example, human perception of similarity decays exponentially with perceptual distance. The ranking of word usage versus the frequency at which the words are used has a log-log slope of minus one.

Quantifying institutional resource utilization of adjuvant brachytherapy and intensity-modulated radiation therapy for endometrial cancer via time-driven activity-based costing.

Purpose: The purpose of this study was to quantify the cost of resources required to deliver adjuvant radiation therapy (RT) for high- to intermediate-risk endometrial cancer using time-driven activity-based costing (TDABC).

Methods And Materials: Comparisons were made for three and five fractions of vaginal cuff brachytherapy (VCB), 28 fractions of intensity-modulated radiation therapy (IMRT), and combined modality RT (25-fraction IMRT followed by 2-fraction VCB). Process maps were developed representing each phase of care.

Exotic urban trees conserve similar natural enemy communities to native congeners but have fewer pests.

Urban trees serve a critical conservation function by supporting arthropod and vertebrate communities but are often subject to arthropod pest infestations. Native trees are thought to support richer arthropod communities than exotic trees but may also be more susceptible to herbivorous pests. Exotic trees may be less susceptible to herbivores but provide less conservation value as a consequence.

Defining Usage and Clinical Outcomes Following Perioperative Fresh Frozen Plasma and Platelet Administration in Spine Surgery Patients.

Study Design: This was a retrospective study.

Objectives: The main objectives of this study were to characterize the utilization of fresh frozen plasma (FFP) and platelets in spine surgery and the clinical outcomes following their administration.

Summary Of Background Data: Blood component transfusion is often a crucial therapy during spine surgery.

Electronic remote blood issue supports efficient and timely supply of blood and cost reduction: evidence from five hospitals at different stages of implementation.

Background: This multicenter international study evaluated electronic remote blood issue (ERBI) for blood unit collection in hospitals.

Study Design And Methods: Retrospective data were collected from the ERBI software databases and blood bank information systems. Prospective "time-and-motion" data collection methods simulated the delivery of red blood cell units to determine the staff time for each step.

A Restrictive Hemoglobin Transfusion Threshold of Less Than 7 g/dL Decreases Blood Utilization Without Compromising Outcomes in Patients With Hip Fractures.

Introduction: In patients with hip fracture, a transfusion threshold of hemoglobin (Hb) <8 g/dL is associated with similar or better outcomes than more liberal thresholds. Whether a more restrictive threshold of <7 g/dL Hb produces equivalent outcomes in such patients is unknown. The aim of the study was to examine whether a restrictive threshold of <7 g/dL Hb is safe in this population.

Evolutionary design of regulatory control. II. Robust error-correcting feedback increases genetic and phenotypic variability.

As systems become more robust against perturbations, they can compensate for greater sloppiness in the performance of their components. That robust compensation reduces the force of natural selection on the system's components, leading to component decay. The paradoxical coupling of robustness and decay predicts that robust systems evolve cheaper, lower performing components, which accumulate greater mutational genetic variability and which have greater phenotypic stochasticity in trait expression.

Outcomes of carotid-sparing IMRT for T1 glottic cancer: Comparison with conventional radiation.

Objectives: We aim to report oncologic outcomes after conventional radiotherapy (ConRT) using opposed lateral beams and intensity-modulated radiation therapy (IMRT) for tumor (T)1 nodal (N)0 T1 N0 glottic squamous cell carcinoma.

Study Design: Retrospective case-control study.

Methods: We retrospectively reviewed demographic, disease, and treatment characteristics for patients treated at our institution during 2000 to 2013.

Usefulness of surveillance imaging in patients with head and neck cancer who are treated with definitive radiotherapy.

Background: The current study was performed to assess the efficacy of surveillance imaging in patients with head and neck cancer (HNC) who are treated definitively with radiotherapy.

Methods: Eligible patients included those with a demonstrable disease-free interval (≥1 follow-up imaging procedure without evidence of disease and a subsequent visit/imaging procedure) who underwent treatment of HNC from 2000 through 2010.

Results: A total of 1508 patients were included.

Hemostatic properties of cold-stored whole blood leukoreduced using a platelet-sparing versus a non-platelet-sparing filter.

Background: Whole blood (WB) is an appealing alternative to component-based transfusion in patients with significant bleeding. Historically, WB was transfused less than 48 hours after collection and was not leukoreduced (LR). However, LR components are now standard in many hospitals and LR WB is desirable.

Development and clinical implementation of SeedNet: A sliding-window convolutional neural network for radioactive seed identification in MRI-assisted radiosurgery (MARS).

Purpose: To develop and evaluate a sliding-window convolutional neural network (CNN) for radioactive seed identification in MRI of the prostate after permanent implant brachytherapy.

Methods: Sixty-eight patients underwent prostate cancer low-dose-rate (LDR) brachytherapy using radioactive seeds stranded with positive contrast MR-signal seed markers and were scanned using a balanced steady-state free precession pulse sequence with and without an endorectal coil (ERC). A sliding-window CNN algorithm (SeedNet) was developed to scan the prostate images using 3D sub-windows and to identify the implanted radioactive seeds.

Long-term quality of life after definitive treatment of sinonasal and nasopharyngeal malignancies.

Objective: To evaluate long-term global and site-specific health-related quality of life (HRQoL) in patients treated for sinonasal and nasopharyngeal malignancies.

Study Design: Cross-sectional.

Methods: One hundred fourteen patients with sinonasal and nasopharyngeal malignancies received surgery, radiation, systemic chemotherapy, or a combination thereof, with curative intent.

Fixed- versus Variable-RBE Computations for Intensity Modulated Proton Therapy.

Purpose: To evaluate how using models of proton therapy that incorporate variable relative biological effectiveness (RBE) versus the current practice of using a fixed RBE of 1.1 affects dosimetric indices on treatment plans for large cohorts of patients treated with intensity modulated proton therapy (IMPT).

Methods And Materials: Treatment plans for 4 groups of patients who received IMPT for brain, head-and-neck, thoracic, or prostate cancer were selected.

Urban forest fragments buffer trees from warming and pests.

Trees are important components of urban landscapes because of the ecosystem services they provide. However, the effects of urbanization, particularly high temperatures, can benefit chronic insect pests and threaten ecosystem services offered by urban trees. Urban forest fragments are an often-overlooked component of the greater urban forest which may help to mitigate the damaging effects of urbanization.

Risk factors for nonroutine discharge in adult spinal deformity surgery.

Background Context: Surgery for adult spinal deformity (ASD) is increasingly common. Although outcomes of ASD surgery have been studied extensively, to our knowledge, no data exist regarding factors predicting nonroutine discharge in this population. Nonroutine discharge is defined as discharge to a health care facility after surgery rather than to home.

Toxicity Evaluation of a Novel Magnetic Resonance Imaging Marker, CoCl2-N-Acetylcysteine, in Rats.

C4 (cobalt dichloride-N-acetylcysteine [1% CoCl:2% NAC]) is a novel magnetic resonance imaging contrast marker that facilitates visualization of implanted radioactive seeds in cancer brachytherapy. We evaluated the toxicity of C4. Rats were assigned to control (0% CoCl:NAC), low-dose (0.

Radiographic retropharyngeal lymph node involvement in HPV-associated oropharyngeal carcinoma: Patterns of involvement and impact on patient outcomes.

Background: The objective of the current study was to characterize the incidence, pattern, and impact on oncologic outcomes of retropharyngeal lymph node (RPLN) involvement in HPV-associated oropharyngeal cancer (OPC).

Methods: Data regarding patients with HPV-associated OPC who were treated at The University of Texas MD Anderson Cancer Center with intensity-modulated radiotherapy from 2004 through 2013 were analyzed retrospectively. RPLN status was determined by reviewing pretreatment imaging and/or reports.

Intensity modulated proton therapy (IMPT) - The future of IMRT for head and neck cancer.

Radiation therapy plays an integral role in the management of head and neck cancers (HNCs). While most HNC patients have historically been treated with photon-based radiation techniques such as intensity modulated radiation therapy (IMRT), there is a growing awareness of the potential clinical benefits of proton therapy over IMRT in the definitive, postoperative and reirradiation settings given the unique physical properties of protons. Intensity modulated proton therapy (IMPT), also known as "pencil beam proton therapy," is a sophisticated mode of proton therapy that is analogous to IMRT and an active area of investigation in cancer care.