Multi-centre real-world validation of automated treatment planning for breast radiotherapy.

PURPOSE: To present the results of the first multi-centre real-world validation of autoplanning for whole breast irradiation after breast-sparing surgery, encompassing high complexity cases (e.g. with a boost or regional lymph nodes) and a wide range of clinical practices. METHODS: The 24 participating centers each included 10 IMRT/VMAT/Tomotherapy patients, previously treated with a manually generated plan ('manplan'). There were no restrictions regarding case complexity, planning aims, plan evaluation parameters and criteria, fractionation, treatment planning system or treatment machine/technique. In addition to dosimetric comparisons of autoplans with manplans, blinded plan scoring/ranking was conducted by a clinician from the treating center. Autoplanning was performed using a single configuration for all patients in all centres. Deliverability was verified through measurements at delivery units. RESULTS: Target dosimetry showed comparability, while reductions in OAR dose parameters were 21.4 % for heart Dmean, 16.7 % for ipsilateral lung Dmean, and 101.9 %, 45.5 %, and 35.7 % for contralateral breast D0.03cc, D5% and Dmean, respectively (all p < 0.001). Among the 240 patients included, the clinicians preferred the autoplan for 119 patients, with manplans preferred for 96 cases (p = 0.01). Per centre there were on average 5.0 ± 2.9 (1SD) patients with a preferred autoplan (range [0-10]), compared to 4.0 ± 2.7 with a preferred manplan ([0,9]). No differences were observed regarding deliverability. CONCLUSION: The automation significantly reduced the hands-on planning workload compared to manual planning, while also achieving an overall superiority. However, fine-tuning of the autoplanning configuration prior to clinical implementation may be necessary in some centres to enhance clinicians' satisfaction with the generated autoplans.

The effect of transcranial direct current and magnetic stimulation on fear extinction and return of fear: A meta-analysis and systematic review.

BACKGROUND: We conducted a meta-analysis and qualitative review on the randomized controlled trials investigating the effects of transcranial direct current stimulation and transcranial magnetic stimulation on fear extinction and the return of fear in non-primate animals and humans. METHODS: The meta-analysis was conducted by searching PubMed, Web of science, PsycINFO, and Cochrane Library and extracting fear response in the active and sham groups in the randomized controlled trials. The pooled effect size was quantified by Hedges' g using a three-level meta-analytic model in R. RESULTS: We identified 18 articles on the tDCS effect and 5 articles on the TMS effect, with 466 animal subjects and 621 human subjects. Our findings show that tDCS of the prefrontal cortex significantly inhibit fear retrieval in animal models (Hedges' g = -0.50). In human studies, TMS targeting the dorsolateral/ventromedial prefrontal cortex has an inhibiting effect on the return of fear (Hedges' g = -0.24). LIMITATIONS: The limited number of studies and the heterogeneous designs of the selected studies made cross-study and cross-species comparison difficult. CONCLUSIONS: Our findings shed light on the optimal non-invasive brain stimulation protocols for targeting the neural circuitry of threat extinction in humans.

Increased H3K9me3 and F-Actin Reorganization in the Rapid Adaptive Response to Hypergravity in Human T Lymphocytes.

Our study explored the impact of hypergravity on human T cells, which experience additional acceleration forces beyond Earth's gravity due to various factors, such as pulsatile blood flow, and technology, such as high-performance aircraft flights or spaceflights. We investigated the histone modifications Histone 3 lysine 4 and 9 trimethylation (H3K4me3 and H3K9me3, respectively), as well as the structural and cytoskeletal organization of Jurkat T cells in response to hypergravity. Histone modifications play a crucial role in gene regulation, chromatin organization and DNA repair. In response to hypergravity, we found only minimal changes of H3K4me3 and a rapid increase in H3K9me3, which was sustained for up to 15 min and then returned to control levels after 1 h. Furthermore, rapid changes in F-actin fluorescence were observed within seconds of hypergravity exposure, indicating filament depolymerization and cytoskeletal restructuring, which subsequently recovered after 1 h of hypergravity. Our study demonstrated the rapid, dynamic and adaptive cellular response to hypergravity, particularly in terms of histone modifications and cytoskeletal changes. These responses are likely necessary for maintaining genome stability and structural integrity under hypergravity conditions as they are constantly occurring in the human body during blood cell circulation.

James Hillman e a fenomenologia: a base poética da psique / James Hillman and Phenomenology: the poetic basis of psyque / James Hillman y la Fenomenología: la base poética de la psique

O principal objetivo desse artigo é refletir e apontar para os possíveis horizontes epistemológicos e ontológicos da psicologia arquetípica de James Hillman ao aproximá-la de uma possível relação com a fenomenologia. Para cumprir com tal intento, torna-se necessário delimitar dois pontos de partida, sendo eles: (1) O lema central da psicologia arquetípica de "ficar com a imagem" (stick to the image) e sua possível relação com a noção fenomenológica de "voltar às coisas mesmas". (2) O postulado de uma base mito-poética para a psique humana e a possível aproximação com a noção de poiesis tal como apresentada na fenomenologia de Heidegger. A psicologia arquetípica surge em um novo contexto "pós-junguiano" que busca substituir uma atitude interpretativa, unívoca e metafísica, por uma atitude fenomenológica em relação as imagens da alma. A base mito-poética e o "ficar com a imagem", noções centrais em sua psicologia, constituem a base dessa possível atitude fenomenológica em seu pensamento.

The main objective of this article is to reflect and point to the possible epistemological and ontological horizons of James Hillman's archetypal psychology by approaching it to a possible relationship with phenomenology. In order to fulfill this intention, it is necessary to delimit two starting points, namely: (1) The central motto of archetypal psychology of "stick to the image" and its possible relationship with the phenomenological notion of "back to things themselves". (2) The postulate of a mytho-poetic basis for the human psyche and the possible approach to the notion of poiesis as presented in Heidegger's phenomenology. Archetypal psychology emerges in a new "post-Jungian" context that seeks to replace an interpretive, univocal and metaphysical attitude with a phenomenological attitude towards images of the soul. The mytho-poetic basis and "stick to the image", central notions in his psychology, constitute the basis of this possible phenomenological attitude in his thinking.

El objetivo principal de este artículo es reflexionar y señalar los posibles horizontes epistemológicos y ontológicos de la psicología arquetípica de James Hillman acercándola a una posible relación con la fenomenología. Para cumplir con esta intención, es necesario delimitar dos puntos de partida, a saber: (1) El lema central de la psicología arquetípica de "adherirse a la imagen" (stick to the image) y su posible relación con la noción fenomenológica de "volver a las mismas cosas". (2) El postulado de una base mitopoética para la psique humana y el posible acercamiento a la noción de poiesis tal como se presenta en la fenomenología de Heidegger. La psicología arquetípica surge en un nuevo contexto "pos junguiano" que busca reemplazar una actitud interpretativa, unívoca y metafísica por una actitud fenomenológica hacia las imágenes del alma. La base mitopoética y el "adherirse a la imagen", nociones centrales en su psicología, constituyen la base de esta posible actitud fenomenológica en su pensamiento.