In the earlier randomized controlled Physical Activity during Cancer Treatment (PACT) study, we found beneficial effects of an 18-week supervised exercise program on fatigue in patients with newly ...diagnosed breast or colon cancer undergoing adjuvant treatment. The present study assessed long-term effects of the exercise program on levels of fatigue and physical activity 4 years after participation in the PACT study.
The original study was a two-armed, multicenter randomized controlled trial comparing an 18-week supervised exercise program to usual care among 204 breast cancer patients and 33 colon cancer patients undergoing adjuvant treatment. Of the 237 PACT participants, 197 participants were eligible and approached to participate in the 4-year post-baseline measurements, and 128 patients responded. We assessed fatigue and physical activity levels at 4 years post-baseline and compared this to levels at baseline, post-intervention (18 weeks post-baseline), and at 36 weeks post-baseline.
Intention-to-treat mixed linear effects model analyses showed that cancer patients in the intervention group reported significantly higher moderate-to-vigorous total physical activity levels (141.46 min/week (95% confidence interval (CI) 1.31, 281.61, effect size (ES) = 0.22) after 4 years compared to the usual care group. Furthermore, cancer patients in the intervention group tended to experience less physical fatigue at 4 years post-baseline compared to the usual care group (- 1.13, 95% CI -2.45, 0.20, ES = 0.22), although the result was not statistically significant.
Patients with breast or colon cancer who participated in the 18-week exercise intervention showed significant higher levels of moderate-to-vigorous total physical activity levels and a tendency towards lower physical fatigue levels 4 years post-baseline. Our result indicate that exercising during chemotherapy is a promising strategy for minimizing treatment-related side effects, both short and long term.
Current Controlled Trials ISRCTN43801571 , Dutch Trial Register NTR2138 . Trial registered on 9 December 2009.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
A method was developed to determine the edge position of uranium blocks embedded in concrete, using Muon Scattering Tomography. This method is useful for nuclear waste management, as it provides a ...precise image of high-Z materials inside nuclear waste drums. Simulations were performed of uranium blocks with different sizes, encased in a concrete tube, and their lengths were reconstructed. The resolution obtained for the reconstructed lengths was 2.9±0.5 mm and the method works down to a smallest size of 5 mm. This result was obtained without including the muon momentum. The same method was then applied including the momentum information, resulting in a better resolution of 0.96±0.03 mm, and works down to a smallest size of 2 mm.
Influenza viruses have a segmented viral RNA (vRNA) genome, which is replicated by the viral RNA-dependent RNA polymerase (RNAP). Replication initiates on the vRNA 3' terminus, producing a ...complementary RNA (cRNA) intermediate, which serves as a template for the synthesis of new vRNA. RNAP structures show the 3' terminus of the vRNA template in a pre-initiation state, bound on the surface of the RNAP rather than in the active site; no information is available on 3' cRNA binding. Here, we have used single-molecule Förster resonance energy transfer (smFRET) to probe the viral RNA conformations that occur during RNAP binding and initial replication. We show that even in the absence of nucleotides, the RNAP-bound 3' termini of both vRNA and cRNA exist in two conformations, corresponding to the pre-initiation state and an initiation conformation in which the 3' terminus of the viral RNA is in the RNAP active site. Nucleotide addition stabilises the 3' vRNA in the active site and results in unwinding of the duplexed region of the promoter. Our data provide insights into the dynamic motions of RNA that occur during initial influenza replication and has implications for our understanding of the replication mechanisms of similar pathogenic viruses.
Having a physically active lifestyle after cancer diagnosis is beneficial for health, and this needs to be continued into survivorship to optimize long-term benefits. We found that patients, who ...participated in an 18-week exercise intervention, reported significant higher physical activity (PA) levels 4 years after participation in a randomized controlled trial of supervised exercise delivered during chemotherapy (PACT study). This study aimed to identify social-ecological correlates of PA levels in breast and colon cancer survivors 4 years after participation in the PACT study.
Self-reported PA levels and potential correlates (e.g. physical fitness, fatigue, exercise history, and built environment) were assessed in 127 breast and colon cancer survivors shortly after diagnosis (baseline), post-intervention and 4 years later. Multivariable linear regression analyses were performed to identify social-ecological correlates of PA 4 years post-baseline.
The final model revealed that lower baseline physical fatigue (β = -0.25, 95% CI -0.26; -0.24) and higher baseline total PA (0.06, 95% CI, 0.03; 0.10) were correlated with higher total PA levels 4 years post-baseline. Higher baseline leisure and sport PA (0.02, 95% CI 0.01; 0.03), more recreational facilities within a buffer of 1 km (4.05, 95% CI = 1.28; 6.83), lower physical fatigue at 4-year follow-up (-8.07, 95% CI -14.00; -2.13), and having a positive change in physical fatigue during the intervention period (0.04, 95% CI 0.001; 0.07) were correlates of sport and leisure PA levels 4 years post-baseline.
This study suggests that baseline and 4-year post-baseline physical fatigue, and past exercise behaviour, were significant correlates of PA 4 years after participation in an exercise trial. Additionally, this study suggests that the built environment should be taken into account when promoting PA. Understanding of socio-ecological correlates of PA can provide insights into how future exercise interventions should be designed to promote long-term exercise behaviour.
Current Controlled Trials ISRCTN43801571, Dutch Trial Register NTR2138. Trial registered on 9 December 2009, http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2138.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Higher energy and intensity X-ray radiotherapy treatments are coming into wider use, having the benefit of requiring fewer treatment fractions and fewer hospital visits per patient. However, ...small percentage errors in multileaf collimator positioning and dose become bigger problems with higher doses per fraction. Hence, real-time treatment verification becomes essential. Where devices downstream from the patient suffer from scattering in the patient, upstream devices can disturb the therapeutic beam. Here, a method is proposed for performing dosimetry upstream using monolithic active pixel sensors, which can be made thin enough to disturb the beam by <1%. In order to calculate the dose to the tumour, a verification device needs to make a measurement of the photon field. Some photons will Compton scatter an electron in the silicon and generate a signal. However, this signal is obscured by energy deposits from contamination electrons, originating from Compton scattering in the accelerator head and air. Often extensive build-up material is added to verification devices to reduce the electron contamination and enhance the photon signal. However, this leads to degradation of the beam intensity to the patient. Instead we propose using thin strips of 50 µm thick copper in a grating pattern and measuring the difference in the signal with and without it. The contamination electrons are relatively undisturbed by the presence of the thin copper strips and the photon signal generated via Compton scattering is enhanced under the strips. Hence the difference in the two signals mostly consists of energy deposits originating from the therapeutic photons. From this the dose to the patient can be derived. The 50 μm of copper is thin enough to keep the beam attenuation below 1%, but in itself would give a total signal response which consists of 38% contamination electrons. Using the grating technique, we show that the electron contamination can be reduced to 2.6% of the total signal. This allows the photon signal only to be extracted from the data and thus the dose to patient with a very thin upstream detector can be calculated using a Monte Carlo model to extrapolate the photon flux into the tumour.
Summary
Background
Hyaluronic acid fillers are known for a reliable safety profile, but complications do occur, even serious vascular adverse events.
Objective
To improve the safety of hyaluronic ...acid filler treatments.
Methods
Ultrasound is used to image hyaluronic acid fillers.
Results
Before a filler treatment is performed with ultrasound, previous filler treatments can be brought in to sight and vascular mapping can be performed. In case of adverse events, the filler and the surrounding tissues are visible. Dislocation, abscesses, and vascular adverse events can be seen. Under ultrasound guidance, hyaluronidase can be injected directly into the filler deposit.
Conclusion
Ultrasound examination can be an important tool to improve the safety of hyaluronic acid filler treatments.
With the advancement of high-precision radiotherapy and the increasing use of higher intensity beams, the risk to the patient increases should the radiotherapy machine malfunction. Hence more ...accurate treatment verification is required. In this paper we provide a solution for real-time monitoring of X-ray beams from radiotherapy linear accelerators using monolithic active pixel sensors. We show that leaf errors can be detected with high precision in static fields and IMRT step and shoot, and accurate leaf tracking is possible in Volumetric Modulated Arc Therapy. The prototype MAPS detector meets the criteria of 1% attenuation acceptable for clinical use.
•Achilles sensor can provide live treatment monitoring with <1% beam attenuation.•Multileaf collimators can be tracked in dynamic treatment deliveries.•Each multileaf collimator speed can be extracted from the images.•Leaf positioning errors as small as 0.5 mm can be detected.
PDF
