Dose-toxicity surface histogram-based prediction of radiation dermatitis severity and shapes.

OBJECTIVE: This study aimed to develop a new approach to predict radiation dermatitis (RD) by using the skin dose distribution in the actual area of RD occurrence to determine the predictive dose by grade. Approach: Twenty-three patients with head and neck cancer treated with volumetric modulated arc therapy were prospectively and retrospectively enrolled. A framework was developed to segment the RD occurrence area in skin photography by matching the skin surface image obtained using a 3D camera with the skin dose distribution. RD predictive doses were generated using the dose-toxicity surface histogram (DTH) calculated from the skin dose distribution within the segmented RD regions classified by severity. We then evaluated whether the developed DTH-based framework could visually predict RD grades and their occurrence areas and shapes according to severity. Main results: The developed framework successfully generated the DTH for three different RD severities: faint erythema (grade 1), dry desquamation (grade 2), and moist desquamation (grade 3); 48 DTHs were obtained from 23 patients: 23, 22, and 3 DTHs for grades 1, 2, and 3, respectively. The RD predictive doses determined using DTHs were 28.9 Gy, 38.1 Gy, and 54.3 Gy for grades 1, 2, and 3, respectively. The estimated RD occurrence area visualized by the DTH-based RD predictive dose showed acceptable agreement for all grades compared with the actual RD region in the patient. The predicted RD grade was accurate, except in two patients. Significance: The developed DTH-based framework can classify and determine RD predictive doses according to severity and visually predict the occurrence area and shape of different RD severities. The proposed approach can be used to predict the severity and shape of potential RD in patients and thus aid physicians in decision making.

Photosynthetic responses of Larix kaempferi and Pinus densiflora seedlings are affected by summer extreme heat rather than by extreme precipitation.

The frequency and intensity of summer extreme climate events are increasing over time, and have a substantial negative effect on plants, which may be evident in their impact on photosynthesis. Here, we examined the photosynthetic responses of Larix kaempferi and Pinus densiflora seedlings to extreme heat (+ 3 °C and + 6 °C), drought, and heavy rainfall by conducting an open-field multifactor experiment. Leaf gas exchange in L. kaempferi showed a decreasing trend under increasing temperature, showing a reduction in the stomatal conductance, transpiration rate, and net photosynthetic rate by 135.2%, 102.3%, and 24.8%, respectively, in the + 6 °C treatment compared to those in the control. In contrast, P. densiflora exhibited a peak function in the stomatal conductance and transpiration rate under + 3 °C treatment. Furthermore, both species exhibited increased total chlorophyll contents under extreme heat conditions. However, extreme precipitation had no marked effect on photosynthetic activities, given the overall favorable water availability for plants. These results indicate that while extreme heat generally reduces photosynthesis by triggering stomatal closure under high vapor pressure deficit, plants employ diverse stomatal strategies in response to increasing temperature, which vary among species. Our findings contribute to the understanding of mechanisms underlying the photosynthetic responses of conifer seedlings to summer extreme climate events.

Normal tissue complication probability models of hypothyroidism after radiotherapy for breast cancer.

Purpose: We aimed to develop Lyman-Kutcher-Burman (LKB) and multivariable normal tissue complication probability (NTCP) models to predict the risk of radiation-induced hypothyroidism (RIHT) in breast cancer patients. Materials and methods: A total of 1,063 breast cancer patients who underwent whole breast irradiation between 2009 and 2016 were analyzed. Individual dose-volume histograms were used to generate LKB and multivariable logistic regression models. LKB model was fit using the thyroid radiation dose-volume parameters. A multivariable model was constructed to identify potential dosimetric and clinical parameters associated with RIHT. Internal validation was conducted using bootstrapping techniques, and model performance was evaluated using the area under the curve (AUC) and Hosmer-Lemeshow (HL) goodness-of-fit test. Results: RIHT developed in 4 % of patients with a median follow-up of 77.7 months. LKB and multivariable NTCP models exhibited significant agreement between the predicted and observed results (HL P values > 0.05). The multivariable NTCP model outperformed the LKB model in predicting RIHT (AUC 0.62 vs. 0.54). In the multivariable model, systemic therapy, age, and percentage of thyroid volume receiving ≥ 10 Gy (V10) were significant prognostic factors for RIHT. The cumulative incidence of RIHT was significantly higher in patients who exceeded the cut-off values for all three risk predictors (systemic therapy, age ≥ 40 years, and thyroid V10 ≥ 26 %, P < 0.005). Conclusions: Systemic therapy, age, and V10 of the thyroid were identified as strong risk factors for the development of RIHT. Our NTCP models provide valuable insights to clinicians for predicting and preventing hypothyroidism by identifying high-risk patients.

Novel framework for determining TPS-calculated doses corresponding to detector locations using 3D camera inin vivosurface dosimetry.

Purpose. To address the shortcomings of current procedures for evaluating the measured-to-planned dose agreement inin vivodosimetry (IVD), this study aimed to develop an accurate and efficient novel framework to identify the detector location placed on a patient's skin surface using a 3D camera and determine the planned dose at the same anatomical position corresponding to the detector location.Methods. Breast cancer treatment was simulated using an anthropomorphic adult female phantom (ATOM 702D; CIRS, Norfolk, VA, USA). An optically stimulated luminescent dosimeter was used for surface dose measurements (MyOSLchip, RadPro International GmbH, Germany) at six IVD points. Three-dimensional surface imaging (3DSI) of the phantom with the detector was performed in the treatment position using a 3D camera. The developed framework, iSMART, was designed to import 3DSI and treatment planning data for determining the position of the IVD detectors in the 3D treatment planning DICOM image. The clinical usefulness of iSMART was evaluated in terms of accuracy and efficiency, for comparison with the results obtained using cone-beam computed tomography (CBCT) image guidance.Results. The relative dose difference between the planned doses determined using iSMART and CBCT images displayed similar accuracies (within approximately ±2.0%) at all detector locations. The relative dose differences between the planned and measured doses at the six detector locations ranged from -4.8% to 3.1% for the CBCT images and -3.5% to 2.1% for iSMART. The total time required to read the planned doses at six detector locations averaged at 8.1 and 0.8 min for the CBCT images and iSMART, respectively.Conclusions. The proposed framework can improve the robustness of IVD analyses and aid in accurate and efficient evaluations of the measured-to-planned dose agreement.

The influence of herbal medicine on serum motilin and its effect on human and animal model: a systematic review.

Introduction: Motilin (MLN) is a gastrointestinal (GI) hormone produced in the upper small intestine. Its most well understood function is to participate in Phase III of the migrating myoelectric complex component of GI motility. Changes in MLN availability are associated with GI diseases such as gastroesophageal reflux disease and functional dyspepsia. Furthermore, herbal medicines have been used for several years to treat various GI disorders. We systematically reviewed clinical and animal studies on how herbal medicine affects the modulation of MLN and subsequently brings the therapeutic effects mainly focused on GI function. Methods: We searched the PubMed, Embase, Cochrane, and Web of Science databases to collect all articles published until 30 July 2023, that reported the measurement of plasma MLN levels in human randomized controlled trials and in vivo herbal medicine studies. The collected characteristics of the articles included the name and ingredients of the herbal medicine, physiological and symptomatic changes after administering the herbal medicine, changes in plasma MLN levels, key findings, and mechanisms of action. The frequency patterns (FPs) of botanical drug use and their correlations were investigated using an FP growth algorithm. Results: Nine clinical studies with 1,308 participants and 20 animal studies were included in the final analyses. Herbal medicines in clinical studies have shown therapeutic effects in association with increased levels of MLN, including GI motility regulation and symptom improvement. Herbal medicines have also shown anti-stress, anti-tumor, and anti-inflammatory effects in vivo. Various biochemical markers may correlate with MLN levels. Markers may have a positive correlation with plasma MLN levels included ghrelin, acetylcholine, and secretin, whereas a negative correlation included triglycerides and prostaglandin E2. Markers, such as gastrin and somatostatin, did not show any correlation with plasma MLN levels. Based on the FP growth algorithm, Glycyrrhiza uralensis and Paeonia japonica were the most frequently used species. Conclusion: Herbal medicine may have therapeutic effects mainly on GI symptoms with involvement of MLN regulation and may be considered as an alternative option for the treatment of GI diseases. Further studies with more solid evidence are needed to confirm the efficacy and mechanisms of action of herbal medicines. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=443244, identifier CRD42023443244.

Development of a Real-Time Thermoplastic Mask Compression Force Monitoring System Using Capacitive Force Sensor.

Purpose: Thermoplastic masks keep patients in an appropriate position to ensure accurate radiation delivery. For a thermoplastic mask to maintain clinical efficacy, the mask should wrap the patient's surface properly and provide uniform pressure to all areas. However, to our best knowledge, no explicit method for achieving such a goal currently exists. Therefore, in this study, we intended to develop a real-time thermoplastic mask compression force (TMCF) monitoring system to measure compression force quantitatively. A prototype system was fabricated, and the feasibility of the proposed method was evaluated. Methods: The real-time TMCF monitoring system basically consists of four force sensor units, a microcontroller board (Arduino Bluno Mega 2560), a control PC, and an in-house software program. To evaluate the reproducibility of the TMCF monitoring system, both a reproducibility test using a micrometer and a setup reproducibility test using a head phantom were performed. Additionally, the reproducibility tests of mask setup and motion detection tests were carried out with a cohort of six volunteers. Results: The system provided stable pressure readings in all 10 trials during the sensor unit reproducibility test. The largest standard deviation (SD) among trials was about 36 gf/cm2 (∼2.4% of the full-scale range). For five repeated mask setups on the phantom, the compression force variation of the mask was less than 39 gf/cm2 (2.6% of the full-scale range). We were successful in making masks together with the monitoring system connected and demonstrated feasible utilization of the system. Compression force variations were observed among the volunteers and according to the location of the sensor (among forehead, both cheekbones, and chin). The TMCF monitoring system provided the information in real time on whether the mask was properly pressing the human subject as an immobilization tool. Conclusion: With the developed system, it is possible to monitor the effectiveness of the mask in real time by continuously measuring the compression force between the mask and patient during the treatment. The graphical user interface (GUI) of the monitoring system developed provides a warning signal when the compression force of the mask is insufficient. Although the number of volunteers participated in the study was small, the obtained preliminary results suggest that the system could ostensibly improve the setup accuracy of a thermoplastic mask.

A pilot study of a novel method to visualize three-dimensional dose distribution on skin surface images to evaluate radiation dermatitis.

Predicting the radiation dose‒toxicity relationship is important for local tumor control and patients' quality of life. We developed a first intuitive evaluation system that directly matches the three-dimensional (3D) dose distribution with the skin surface image of patients with radiation dermatitis (RD) to predict RD in patients undergoing radiotherapy. Using an RGB-D camera, 82 3D skin surface images (3DSSIs) were acquired from 19 patients who underwent radiotherapy. 3DSSI data acquired included 3D skin surface shape and optical imaging of the area where RD occurs. Surface registration between 3D skin dose (3DSD) and 3DSSI is performed using the iterative closest point algorithm, then reconstructed as a two-dimensional color image. The developed system successfully matched 3DSSI and 3DSD, and visualized the planned dose distribution onto the patient's RD image. The dose distribution pattern was consistent with the occurrence pattern of RD. This new approach facilitated the evaluation of the direct correlation between skin-dose distribution and RD and, therefore, provides a potential to predict the probability of RD and thereby decrease RD severity by enabling informed treatment decision making by physicians. However, the results need to be interpreted with caution due to the small sample size.

Effects of ID-HWS1000 on the Perception of Bowel Activity and Microbiome in Subjects with Functional Constipation: A Randomized, Double-Blind Placebo-Controlled Study.

During constipation, indigestible foods, such as probiotics, prebiotics, and dietary fiber, may improve the bowel environment and activity. In this randomized, double-blind, and placebo-controlled study, the effects of ID-HWS1000, composed of Lactobacillus and Bifidobacterium species, xylooligosaccharide, and dietary fiber, were evaluated to determine whether it improves the perception of bowel activity or cause changes in the gut microbiome. Thirty Korean adults with "functional constipation" according to the Rome III criteria were randomly assigned to the following groups: 20 in the ID-HWS1000 group and 10 in the placebo group. ID-HWS1000 or the placebo was consumed by the participants for 4 weeks. To assess the changes in the perception of bowel activity, clinical data and gut microbiome analyses were conducted before and after the experiment. There were significant differences between the groups in the response to 9 of the 12 survey questions (the number and duration of bowel movements, amount of feces, number of irritant bowel movements, number of times bowel movements felt incomplete, shape of the feces, amount of gas in the gut, discomfort after defecation, and discomfort owing to constipation) (P < .05). There was a decrease in the proportion of Firmicutes (Ruminococcaceae and Lachnospiraceae) and an increase in Bacteroidetes (Bacteroidaceae) (P < .05). Moreover, ID-HWS1000 directly improved the discomfort associated with bowel movements, decreased the proportion of Lachnospiraceae, and increased the proportion of Bacteroidaceae. These results confirmed that ID-HWS1000 improves the perception of bowel activity and exerts positive changes in individuals with functional constipation.

Characterization of Gut Microbiome in Korean Patients with Metabolic Associated Fatty Liver Disease.

Metabolic associated fatty liver disease (MAFLD) is a new concept where the presence of both fatty liver and metabolic abnormality are necessary for diagnosis. Several studies have reported that altered gut microbiome is closely associated with metabolic diseases and non-alcoholic fatty liver disease. However, the studies on MAFLD population are scarce. This prospective study aimed to identify differences in gut microbiome between patients with MAFLD and healthy controls in Korean population. In this study, patients with MAFLD and age, sex-matched healthy controls were included, and their stool samples were collected. Taxonomic composition of gut microbiota was analyzed using 16S ribosomal ribonucleic acid pyrosequencing. Twenty-two MAFLD patients and 44 healthy controls were included. Taxonomic diversity was lower in patients with MAFLD in the aspect of alpha and beta diversity. The differences were also found at phylum, class, family, and genus levels between the two groups. Phylum Proteobacteria, family Enterobactereriaceae, genus Citrobacter abundance was significantly increased and genus Faecalibacterium was significantly decreased in patients with MAFLD. In addition, butyrate-producing bacteria were decreased and ethanol-producing bacteria were increased in patients with MAFLD. The composition of gut microbiome was different between MAFLD and healthy controls in Korean population. This could offer potential targets for therapeutic intervention in MAFLD.

Statistical Analysis of Treatment Planning Parameters for Prediction of Delivery Quality Assurance Failure for Helical Tomotherapy.

PURPOSE: This study aimed to investigate the parameters with a significant impact on delivery quality assurance (DQA) failure and analyze the planning parameters as possible predictors of DQA failure for helical tomotherapy. METHODS: In total, 212 patients who passed or failed DQA measurements were retrospectively included in this study. Brain (n = 43), head and neck (n = 37), spinal (n = 12), prostate (n = 36), rectal (n = 36), pelvis (n = 13), cranial spinal irradiation and a treatment field including lymph nodes (n = 24), and other types of cancer (n = 11) were selected. The correlation between DQA results and treatment planning parameters were analyzed using logistic regression analysis. Receiver operating characteristic (ROC) curves, areas under the curves (AUCs), and the Classification and Regression Tree (CART) algorithm were used to analyze treatment planning parameters as possible predictors for DQA failure. RESULTS: The AUC for leaf open time (LOT) was 0.70, and its cut-off point was approximately 30%. The ROC curve for the predicted probability calculated when the multivariate variable model was applied showed an AUC of 0.815. We confirmed that total monitor units, total dose, and LOT were significant predictors for DQA failure using the CART. CONCLUSIONS: The probability of DQA failure was higher when the percentage of LOT below 100 ms was higher than 30%. The percentage of LOT below 100 ms should be considered in the treatment planning process. The findings from this study may assist in the prediction of DQA failure in the future.

Fecal Microbiota Transplantation for multidrug-resistant organism: Efficacy and Response prediction.

OBJECTIVES: The increasing prevalence of multidrug-resistant microorganisms (MDRO) is increasing the frequency of poor clinical outcomes, prolonging hospitalizations, and raising healthcare costs. This study evaluated the eradication efficacy of fecal microbiota transplantation (FMT) and identified microbial and functional biomarkers of MDRO decolonization. METHODS: Fecal solution obtained from healthy unrelated donors was infused in the participants' guts which had been colonized with carbapenemase-producing enterobacteriacea (CPE), vancomycin-resistant enterococci (VRE), or both CPE and VRE. Fecal samples from recipients were collected and microbiome changes before and after FMT were assessed. RESULTS: Twenty-four (68.6%) out of 35 patients were decolonized within one year of receiving FMT. Multivariate analysis showed that FMT (FMT: hazard ratio (HR) = 5.343, 95% confidence interval (CI) = 1.877-15.212, p = 0.002) and MDRO types (CPE: HR = 11.146, 95% CI = 2.420-51.340, p = 0.002; CPE/VRE: HR = 2.948, 95% CI = 1.200-7.246, p = 0.018; VRE served as the reference) were significant independent factors associated with time to decolonization. Microbiota analysis showed higher richness and biodiversity before FMT resulted in VRE decolonization. The species Clostridium ramosum and the genuses Anaerostipes and Eisenbergiella could serve as taxonomic biomarkers and K02017 could serve as a functional biomarker for VRE clearance. CONCLUSION: FMT is an effective way to decolonize MDRO and its effectiveness may be predicted by microbiome analysis.

Clinical implementation of a wide-field electron arc technique with a scatterer for widespread Kaposi's sarcoma in the distal extremities.

A novel wide-field electron arc technique with a scatterer is implemented for widespread Kaposi's sarcoma (KS) in the distal extremities. Monte Carlo beam modeling for electron arc beams was established to achieve <2% deviation from the measurements, and used for dose calculation. MC-based electron arc plan was performed using CT images of a foot and leg mimicking phantom and compared with in-vivo measurement data. We enrolled one patient with recurrent KS on the lower extremities who had been treated with photon radiation therapy. The 4- and 6-MeV electron arc plans were created, and then compared to two photon plans: two opposite photon beam and volumetric modulated arc with bolus. Compared to the two photon techniques, the electron arc plans resulted in superior dose saving to normal organs beneath the skin region, although it shows inferior coverage and homogeneity for PTV. The electron arc treatment technique with scatterer was successfully implemented for the treatment of widespread KS in the distal extremities with lower radiation exposure to the normal organs beyond the skin lesions, which could be a treatment option for recurrent skin cancer in the extremities.

Engulfment and cell motility 1 promotes tumor progression via the modulation of tumor cell survival in gastric cancer.

BACKGROUND/AIM: Engulfment and cell motility 1 (ELMO1) protein has been implicated in phagocytosis of apoptotic cells, cell migration, neurite outgrowth, cancer cell invasion and metastasis, and poor prognosis in various cancers. We investigated the role of ELMO1 in mediating the oncogenic behavior of gastric cancer (GC) cells. We also investigated the correlation between expression of ELMO1 in GC tissues and various clinicopathological parameters. METHODS: We studied the impact of ELMO1 on tumor cell behavior using the pcDNA-myc vector and small interfering RNA in AGS and SNU1750 GC cell lines. We performed western blotting and immunohistochemistry to investigate the expression of ELMO1 in GC cells and tissues. RESULTS: ELMO1 overexpression inhibited apoptosis via the modulation of PARP, caspase-3 and caspase-7 in GC cells. ELMO1 overexpression led to significant increase in the number of migrating and invading GC cells. The expression of E-cadherin decreased and that of Snail increased in GC cells upon ELMO1 overexpression. Phosphorylation of PI3K/Akt and GSK-3ß was increased and that of ß-catenin was decreased upon ELMO1 overexpression in GC cells. These results were reversed after ELMO1 knockdown. ELMO1 expression was significantly associated with tumor size, cancer stage, lymph node metastasis and survival. ELMO1-positive tumors had significantly higher mean of Ki-67 labeling index than ELMO1-negative tumors. There was no significant relationship between ELMO1 expression and the mean value of the apoptotic index. CONCLUSIONS: Our results indicate that ELMO1 promotes tumor progression by modulating tumor cell survival in human GC.

Differentiation of Bacillus thuringiensis From Bacillus cereus Group Using a Unique Marker Based on Real-Time PCR.

The efficiency of a novel biomarker (the transcriptional regulator, XRE) was tested and evaluated in differentiating Bacillus thuringiensis from Bacillus cereus group species in environmental and spiked samples based on PCR and real-time PCR. Totally 120 strains, representing two bacterial groups, B. cereus group and non-Bacillus sp., were used to evaluate the performance of XRE and crystal protein (cry2, an existing biomarker). Further, three diverse samples (kimbap, lettuce, and spinach) were inoculated with B. thuringiensis and prominent biomarkers XRE and cry2 were used as targets. Direct analysis of the detection results for the pure cultures of B. cereus group wild-types, references and type strains revealed an accuracy rate of 97.5% targeting XRE, and 83.3% targeting cry2. The real-time PCR was constructed with a R 2-value of 0.993. For the artificially contaminated samples, a concentration of 103 CFU/g of B. thuringiensis in spiked food samples could be detected using real-time PCR targeting XRE. A good performance was obtained with XRE in discriminating B. thuringiensis from B. cereus groups, as well as detecting B. thuringiensis in spiked food samples with PCR or real-time PCR. Therefore, this real-time PCR targeting XRE can be used as a dependable and promising tool to identify B. thuringiensis in foods.

Modulation of gut microbiome in nonalcoholic fatty liver disease: pro-, pre-, syn-, and antibiotics.

Nonalcoholic fatty liver disease (NAFLD) is one of the most common types of liver diseases worldwide and its incidence continues to increase. NAFLD occurs when the body can no longer effectively store excess energy in the adipose tissue. Despite the increasing prevalence of NAFLD, making lifestyle changes, including increased exercise, is often an elusive goal for patients with NAFLD. The liver directly connects to the gut-gastrointestinal milieu via the portal vein, which are all part of the gut-liver axis. Therefore, the gut-microbiome and microbial products have been actively studied as likely key factors in NAFLD pathophysiology. Hence, dysbiosis of the gut microbiome and therapeutic manipulation of the gut-liver axis are being investigated. Novel therapeutic approaches for modulating gut microbiota through the administration of probiotics, prebiotics, synbiotics, and antibiotics have been proposed with numerous promising initial reports on the effectiveness and clinical applications of these approaches. This review delves into the current evidence on novel therapies that modulate gut microbiota and discusses ongoing clinical trials targeting the gut-liver axis for the management and prevention of NAFLD.

To propose adding index of achievement (IOA) to IMRT QA process.

BACKGROUND: In intensity modulated radiation therapy (IMRT) quality assurance (QA), evaluation of QA result using a pass/non-pass strategy under an acceptance criterion often suffers from lack of information on how good the plan is in absolute manner. In this study, we suggested adding an index system, previously developed for dose painting technique, to current IMRT QA process for better understanding of QA result. METHODS: The index system consists of three indices, index of achievement (IOA), index of hotness (IOH) and index of coldness (IOC). As indicated by its name, IOA does measure the level of agreement. IOH and IOC, on the other hand, measure the magnitude of overdose and underdose, respectively. A systematic analysis was performed with three 1-dimensional hypothetical dose distributions to investigate the characteristics of the index system. The feasibility of the system was also assessed with clinical volumetric modulated arc therapy (VMAT) QA cases from 8 head & neck and 5 prostate patients. In both simulation studies, certain amount of errors was intentionally induced to each dose distribution. Furthermore, we applied the proposed system to compare calculated with actual measured data for a total of 60 patients (30 head & neck and 30 prostate cases). QA analysis was made using both the index system and gamma method, and results were compared. RESULTS: While the gamma evaluation showed limited sensitivity in evaluating QA result depending on the level of tolerance criteria used, the proposed indices tended to better distinguish plans in terms of the amount of errors. Hotness and coldness of prescribed dose in the plan could be evaluated quantitatively by the indices. CONCLUSIONS: The proposed index system provides information with which IMRT QA result would be better evaluated, especially when gamma pass rates are identical or similar among multiple plans. In addition, the independency of the index system on acceptance criteria would help making clear communications among readers of published articles and researchers in multi-institutional studies.

Understanding the ontogeny and succession of Bacillus velezensis and B. subtilis subsp. subtilis by focusing on kimchi fermentation.

Bacillus subtilis and B. velezensis are frequently isolated from various niches, including fermented foods, water, and soil. Within the Bacillus subtilis group, B. velezensis and B. subtilis subsp. subtilis have received significant attention as biological resources for biotechnology-associated industries. Nevertheless, radical solutions are urgently needed to identify microbes during their ecological succession to accurately confirm their action at the species or subspecies level in diverse environments, such as fermented materials. Thus, in this study, previously published genome data of the B. subtilis group were compared to exploit species- or subspecies-specific genes for use as improved qPCR targets to detect B. velezensis and B. subtilis subsp. subtilis in kimchi samples. In silico analyses of the selected genes and designed primer sequences, in conjunction with SYBR Green real-time PCR, confirmed the robustness of this newly developed assay. Consequently, this study will allow for new insights into the ontogeny and succession of B. velezensis and B. subtilis subsp. subtilis in various niches. Interestingly, in white kimchi without red pepper powder, neither B. subtilis subsp. subtilis nor B. velezensis was detected.

New insight and metrics to understand the ontogeny and succession of Lactobacillus plantarum subsp. plantarum and Lactobacillus plantarum subsp. argentoratensis.

Lactobacillus plantarum is one of the most extensively studied Lactobacillus species because of its presence in a variety of environmental niches, versatility, and metabolic capabilities, resulting in the use of this organism in many industrial applications. However, although extensive effort has been invested in screening this species from a variety of habitats, a reliable and accurate method for studying the succession and ontogeny of this organism in complex ecosystems is still required to confirm the activity of L. plantarum at the subspecies level. Therefore, in this study, novel subspecies-specific genes for the quantitative detection of two L. plantarum subspecies were identified by comparative genomic analysis. The specificity of primer sets for selected genes specific to each targeted microbe was confirmed in kimchi samples. Interestingly, in all the kimchi samples at 4 °C, the presence of L. plantarum subsp. argentoratensis was not observed. Hence, we found that low temperatures markedly affected the ontogeny of L. plantarum subsp. argentoratensis during kimchi fermentation. Subsequently, this touchstone method will offer new insight and metrics to understand the ontogeny and succession of L. plantarum subsp. plantarum and L. plantarum subsp. argentoratensis in various niches.

A method of respiratory phase optimization for better dose sparing of organs at risks: A validation study in patients with lung cancer.

BACKGROUND: To propose an effective and simple cost value function to determine an optimal respiratory phase for lung treatment using either respiratory gating or breath-hold technique. RESULTS: The optimized phase was obtained at a phase close to end inhalation in 11 out of 15 patients. For the rest of patients, the optimized phase was obtained at a phase close to end exhalation indicating that optimal phase can be patient specific. The mean doses of the Organs-at-risk (OARs) significantly decreased at the optimized phase without compromising the planning target volume (PTV) coverage (about 8% for all 3 OARs considered). MATERIALS AND METHODS: Fifteen lung patients were included for the feasibility test of the cost function. For all patients and all phases, delineation of the target volume and selected OARs such as esophagus, heart, and spinal cord was performed, and then cost values were calculated for all phases. After the breathing phases were ranked according to the cost values obtained, the relationship between score and dose distribution was evaluated by comparing dose volume histogram (DVH). CONCLUSIONS: The proposed cost value function can play an important role in choosing an optimal phase with minimal effort, that is, without actual plan optimization at all phases.

Development of real time abdominal compression force monitoring and visual biofeedback system.

In this study, we developed and evaluated a system that could monitor abdominal compression force (ACF) in real time and provide a surrogating signal, even under abdominal compression. The system could also provide visual-biofeedback (VBF). The real-time ACF monitoring system developed consists of an abdominal compression device, an ACF monitoring unit and a control system including an in-house ACF management program. We anticipated that ACF variation information caused by respiratory abdominal motion could be used as a respiratory surrogate signal. Four volunteers participated in this test to obtain correlation coefficients between ACF variation and tidal volumes. A simulation study with another group of six volunteers was performed to evaluate the feasibility of the proposed system. In the simulation, we investigated the reproducibility of the compression setup and proposed a further enhanced shallow breathing (ESB) technique using VBF by intentionally reducing the amplitude of the breathing range under abdominal compression. The correlation coefficient between the ACF variation caused by the respiratory abdominal motion and the tidal volume signal for each volunteer was evaluated and R 2 values ranged from 0.79 to 0.84. The ACF variation was similar to a respiratory pattern and slight variations of ACF ranges were observed among sessions. About 73-77% average ACF control rate (i.e. compliance) over five trials was observed in all volunteer subjects except one (64%) when there was no VBF. The targeted ACF range was intentionally reduced to achieve ESB for VBF simulation. With VBF, in spite of the reduced target range, overall ACF control rate improved by about 20% in all volunteers except one (4%), demonstrating the effectiveness of VBF. The developed monitoring system could help reduce the inter-fraction ACF set up error and the intra fraction ACF variation. With the capability of providing a real time surrogating signal and VBF under compression, it could improve the quality of respiratory tumor motion management in abdominal compression radiation therapy.