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Image resolution Top features of Main Capital t Cellular Lymphoma throughout Bone fragments: An instance Statement as well as Review of Materials.
The quality of radiation therapy has been shown to significantly influence the outcomes for head and neck squamous cell carcinoma (HNSCC) patients. The results of dosimetric studies suggest that intensity-modulated proton therapy (IMPT) could be of added value for HNSCC by being more effective than intensity-modulated (photon) radiation therapy (IMRT) for reducing side effects of radiation therapy. However, the physical properties of protons make IMPT more sensitive than photons to planning uncertainties. This could potentially have a negative effect on the quality of IMPT planning and delivery. For this review, the three French proton therapy centers collaborated to evaluate the differences between IMRT and IMPT. The review explored the effects of these uncertainties and their management for developing a robust and optimized IMPT treatment delivery plan to achieve clinical outcomes that are superior to those for IMRT. We also provide practical suggestions for the management of HNSCC carcinoma with IMPT. Because metallic dental implants can increase range uncertainties (3-10%), patient preparation for IMPT may require more systematic removal of in-field alien material than is done for IMRT. Multi-energy CT may be an alternative to calculate more accurately the dose distribution. The practical aspects that we describe are essential to guarantee optimal quality in radiation therapy in both model-based and randomized clinical trials. PURPOSE/OBJECTIVE Radiation-induced mucositis is a severe acute side effect, which can jeopardize treatment compliance and cause weight loss during treatment. Bisindolylmaleimide I The study aimed to develop robust models to predict the risk of severe mucositis. MATERIALS/METHODS Mucosal toxicity scores were prospectively recorded for 802 consecutive Head and Neck (H&N) cancer patients and dichotomised into non-severe event (grade 0-2) and severe event (grade 3+) groups. Two different model approaches were utilised to evaluate the robustness of the models. These used LASSO and Best Subset selection combined with 10-fold cross-validation performed on two-thirds of the patient cohort using principal component analysis of DVHs. The remaining one-third of the patients were used for validation. Model performance was tested through calibration plot and model performance metrics. RESULTS The main predicted risk factors were treatment acceleration and the first two principal dose components, which reflect the mean dose and the balance between high and low doses to the oral cavity. For the LASSO model, gender and current smoker status were also included in the model. The AUC values of the two models on the validation cohort were 0.797 (95%CI 0.741-0.857) and 0.808 (95%CI 0.749-0.859), respectively. The two models predicted very similar risk values with an internal Pearson coefficient of 0.954, indicating their robustness. CONCLUSIONS Robust prediction models of the risk of severe mucositis have been developed based on information from the entire dose distribution for a large cohort of patients consisting of all patients treated H&N for within our institution over a five year period. BACKGROUND On Dec 31, 2019, China reported a cluster of cases of pneumonia in people at Wuhan, Hubei Province. The responsible pathogen is a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report the relevant features of the first cases in Europe of confirmed infection, named coronavirus disease 2019 (COVID-19), with the first patient diagnosed with the disease on Jan 24, 2020. METHODS In this case series, we followed five patients admitted to Bichat-Claude Bernard University Hospital (Paris, France) and Pellegrin University Hospital (Bordeaux, France) and diagnosed with COVID-19 by semi-quantitative RT-PCR on nasopharyngeal swabs. We assessed patterns of clinical disease and viral load from different samples (nasopharyngeal and blood, urine, and stool samples), which were obtained once daily for 3 days from hospital admission, and once every 2 or 3 days until patient discharge. All samples were refrigerated and shipped to laboratories in the National Reference Centerratory tract with systemic virus dissemination and virus detection in plasma. The 80-year-old patient died on day 14 of illness (Feb 14, 2020); all other patients had recovered and been discharged by Feb 19, 2020. INTERPRETATION We illustrated three different clinical and biological types of evolution in five patients infected with SARS-CoV-2 with detailed and comprehensive viral sampling strategy. We believe that these findings will contribute to a better understanding of the natural history of the disease and will contribute to advances in the implementation of more efficient infection control strategies. FUNDING REACTing (Research & Action Emerging Infectious Diseases). INTRODUCTION Adolescent-to-parent violence/aggression (APV/A) is an understudied yet increasingly common social problem for adolescents and families, particularly those involved in the juvenile justice system. The current study focused on improving interventions for this population by gathering qualitative data from stakeholders to inform treatment targets. METHODS Participants (N = 23) comprised of court professionals (n = 7), parents/guardians (n = 9), and their male adolescent children (n = 7) in the United States. Parent and adolescent participants were recruited through monthly court-mandated domestic violence education classes offered by the juvenile court. Parent/guardian participants were between the ages of 38 and 77 and consisted of four males and five females. Adolescents were between the ages of 14 and 17. Court professional participants consisted of judges, probation officers, and court psychologists. Semi-structured interviews were analyzed qualitatively using grounded theory. RESULTS Results indicated that, from the perspective of key stakeholders, an effective intervention to reduce APV/A likely involves a two-pronged approach (1) address specific and theoretically modifiable emotional, behavioral, and psychological factors at the adolescent-level; and (2) induce change in the family system by addressing environmental barriers to seeking treatment and by creating positive family relationships. CONCLUSIONS The present study aimed to gather the perspectives of court professionals, adolescents, and parents/guardians regarding the development of an effective intervention for APV/A-involved families. This study represents the first step toward the development of a feasible, acceptable, sustainable, and effective intervention for adolescents and their families who are involved in the juvenile justice system due to APV/A.
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