| 1. |
- Adam, A, et al.
(författare)
-
Abstracts from Hydrocephalus 2016.
- 2017
-
Ingår i: Fluids and Barriers of the CNS. - : Springer Science and Business Media LLC. - 2045-8118. ; 14:Suppl 1
-
Tidskriftsartikel (refereegranskat)
|
|
| 2. |
- Craven, C. L., et al.
(författare)
-
The predictive value of T-tau and AB1-42 levels in idiopathic normal pressure hydrocephalus
- 2017
-
Ingår i: Acta Neurochirurgica. - : Springer Science and Business Media LLC. - 0001-6268 .- 0942-0940. ; 159:12, s. 2293-2300
-
Tidskriftsartikel (refereegranskat)abstract
- Idiopathic normal pressure hydrocephalus (INPH) has no reliable biomarker to assist in the selection of patients who could benefit from ventriculo-peritoneal (VP) shunt insertion. The neurodegenerative markers T-tau and A beta 1-42 have been found to successfully differentiate between Alzheimer's disease (AD) and INPH and therefore are candidate biomarkers for prognosis and shunt response in INPH. The aim of this study was to test the predictive value of cerebrospinal fluid (CSF) T-tau and A beta 1-42 for shunt responsiveness. In particular, we pay attention to the subset of INPH patients with raised T-tau, who are often expected to be poor surgical candidates. Single-centre retrospective analysis of probable INPH patients with CSF samples collected from 2006 to 2016. Index test: CSF levels of T-tau and A beta 1-42. Reference standard: postoperative outcome. ROC analysis assessed the predictive value. A total of 144 CSF samples from INPH patients were analysed. Lumbar T-tau was a good predictor of post-operative mobility (AUROC 0.80). The majority of patients with a co-existing neurodegenerative disease responded well, including those with high T-tau levels. INPH patients tended to exhibit low levels of CSF T-tau, and this can be a good predictor outcome. However levels are highly variable between individuals. Raised T-tau and being shunt-responsive are not mutually exclusive, and such patients ought not necessarily be excluded from having a VP shunt. A combined panel of markers may be a more specific method for aiding selection of patients for VP shunt insertion. This is the most comprehensive presentation of CSF samples from INPH patients to date, thus providing further reference values to the current literature.
|
|
| 3. |
- Flejmer, Anna M., 1971-, et al.
(författare)
-
Impact of physiological breathing motion for breast cancer radiotherapy with proton beam scanning - An in silico study
- 2017
-
Ingår i: Physica medica (Testo stampato). - : Elsevier BV. - 1120-1797 .- 1724-191X. ; 39, s. 88-94
-
Tidskriftsartikel (refereegranskat)abstract
- This study investigates the impact of breathing motion on proton breast treatment plans. Twelve patients with CT datasets acquired during breath-hold-at-inhalation (BHI), breath-hold-at-exhalation (BHE) and in free-breathing (FB) were included in the study. Proton plans were designed for the left breast for BHI and subsequently recalculated for BHE or designed for FB and recalculated for the extreme breath-hold phases. The plans were compared from the point of view of their target coverage and doses to organs-at-risk. The median amplitude of breathing motion determined from the positions of the sternum was 4.7 mm (range 0.5-14.6 mm). Breathing motion led to a degradation of the dose coverage of the target (heterogeneity index increased from 4-7% to 8-11%), but the degraded values of the dosimetric parameters of interest fulfilled the clinical criteria for plan acceptance. Exhalation decreased the lung burden [average dose 3.1-4.5 Gy (RBE)], while inhalation increased it [average dose 5.8-6.8 Gy (RBE)]. The individual values depended on the field arrangement. Smaller differences were seen for the heart [average dose 0.1-0.2 Gy (RBE)] and the LAD [1.9-4.6 Gy (RBE)]. Weak correlations were generally found between changes in dosimetric parameters and respiratory motion. The differences between dosimetric parameters for various breathing phases were small and their expected clinical impact is consequently quite small. The results indicated that the dosimetric parameters of the plans corresponding to the extreme breathing phases are little affected by breathing motion, thus suggesting that this motion might have little impact for the chosen beam orientations with scanned proton beams.
|
|
| 4. |
- Kupfer, T., et al.
(författare)
-
The OmegaWhite Survey for Short-period Variable Stars. V. Discovery of an Ultracompact Hot Subdwarf Binary with a Compact Companion in a 44-minute Orbit
- 2017
-
Ingår i: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 851:1
-
Tidskriftsartikel (refereegranskat)abstract
- We report the discovery of the ultracompact hot subdwarf (sdOB) binary OW J074106.0-294811.0 with an orbital period of P-orb = 44.66279 +/- 1.16 x 10(-4) minutes, making it the most compact hot subdwarf binary known. Spectroscopic observations using the VLT, Gemini and Keck telescopes revealed a He-sdOB primary with an intermediate helium abundance, T-eff = 39 400 +/- 500 K and log g = 5.74 +/- 0.09. High signal-to-noise ratio light curves show strong ellipsoidal modulation resulting in a derived sdOB mass M-sdOB= 0.23 +/- 0.12 M-circle dot with a WD companion (M-WD = 0.72 +/- 0.17 M-circle dot). The mass ratio was found to be q = M-sdOB/M-WD = 0.32 +/- 0.10. The derived mass for the He-sdOB is inconsistent with the canonical mass for hot subdwarfs of approximate to 0.47 M-circle dot. To put constraints on the structure and evolutionary history of the sdOB star we compared the derived T-eff, log g, and sdOB mass to evolutionary tracks of helium stars and helium white dwarfs calculated with Modules for Experiments in Stellar Astrophysics (MESA). We find that the best-fitting model is a helium white dwarf with a mass of 0.320 M-circle dot, which left the common envelope approximate to 1.1 Myr ago, which is consistent with the observations. As a helium white dwarf with a massive white dwarf companion, the object will reach contact in 17.6 Myr at an orbital period of 5 minutes. Depending on the spin-orbit synchronization timescale the object will either merge to form an R CrB star or end up as a stably accreting AM CVn-type system with a helium white dwarf donor.
|
|
| 5. |
|
|
| 6. |
- Ödén, Jakob, et al.
(författare)
-
The influence of breathing motion and a variable relative biological effectiveness in proton therapy of left-sided breast cancer
- 2017
-
Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 56:11, s. 1428-1436
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Proton breast radiotherapy has been suggested to improve target coverage as well as reduce cardiopulmonary and integral dose compared with photon therapy. This study aims to assess this potential when accounting for breathing motion and a variable relative biological effectiveness (RBE).Methods: Photon and robustly optimized proton plans were generated to deliver 50 Gy (RBE) in 25 fractions (RBE=1.1) to the CTV (whole left breast) for 12 patients. The plan evaluation was performed using the constant RBE and a variable RBE model. Robustness against breathing motion, setup, range and RBE uncertainties was analyzed using CT data obtained at free-breathing, breath-hold-at-inhalation and breath-hold-at-exhalation.Results: All photon and proton plans (RBE=1.1) met the clinical goals. The variable RBE model predicted an average RBE of 1.18 for the CTVs (range 1.14–1.21) and even higher RBEs in organs at risk (OARs). However, the dosimetric impact of this latter aspect was minor due to low OAR doses. The normal tissue complication probability (NTCP) for the lungs was low for all patients (<1%), and similar for photons and protons. The proton plans were generally considered robust for all patients. However, in the most extreme scenarios, the lowest dose received by 98% of the CTV dropped from 96 to 99% of the prescribed dose to around 92–94% for both protons and photons. Including RBE uncertainties in the robustness analysis resulted in substantially higher worst-case OAR doses.Conclusions: Breathing motion seems to have a minor effect on the plan quality for breast cancer. The variable RBE might impact the potential benefit of protons, but could probably be neglected in most cases where the physical OAR doses are low. However, to be able to identify outlier cases at risk for high OAR doses, the biological evaluation of proton plans taking into account the variable RBE is recommended.
|
|
