LETd Optimization Verification With an SOI Microdosimeter.

PURPOSE: A first of its kind experimental verification of dose-averaged linear energy transfer (LETd) optimized treatment plans for proton therapy has been carried out using a silicon-on-insulator microdosimeter at the Massachusetts General Hospital (MGH), Boston, USA. METHODS AND MATERIALS: Three clinical treatment plans of a typical ependymoma structure set were designed using the standard clinical approach, the proposed protocol approach, and a one-field approach. The plans were then reoptimized to reduce the LETd-weighted dose in the brain stem. All six plans were delivered in a solid water phantom and the experimental yD‾ measured. RESULTS: After LETd optimization, a reduction in yD‾ was found within the brain stem by an average of 12%, 19%, and 4% for the clinical, protocol, and one-field plans, respectively, while maintaining adequate coverage of the tumor structure. The experimental LETd-weighted doses were in agreement with the treatment planning system calculations and Monte Carlo simulations and reinforced the improvement of the optimization. CONCLUSIONS: This work demonstrates the first experimental verification of the clinical implementation of LETd optimization for patient treatment with proton therapy.

Mucilage-bound sand reduces seed predation by ants but not by reducing apparency: a field test of 53 plant species.

Seed mucilage, a coating on seeds or fruit that becomes slimy and sticky when wet, has evolved convergently many times across plants. One common consequence of having seed mucilage is that sand and dirt particles stick to wet seeds and remain tightly bound to the seed surface after the mucilage dries. Here, we test the hypothesis that a mucilage-bound sand coating protects the seed from seed predators; either as a physical barrier or by reducing apparency of the seed (i.e., camouflage). We experimentally manipulated the sand coating on seeds of 53 plant species of 13 families and assayed the defensive benefit of the sand coating in feeding "depots" near harvester ant nests in California's Central Valley. Consistent with a defensive function, sand coating reduced ant predation on seeds in 48 of the 53 species examined. To test whether this striking benefit was due to reduced apparency, we conducted an addition experiment using flax seeds in which we factorially manipulated the color of both the background substrate and the sand coating, creating visually apparent and unapparent seeds. Our results did not support the reduced apparency hypothesis; seeds coated in background-matched sand were removed at the same rate as seeds coated in unmatched sand. The defensive benefit of a sand coating was not well-predicted by seed mass, entrapped sand mass, or sand mass scaled by seed mass. Together, our results demonstrate that seed mucilage is a phylogenetically widespread and effective seed defensive trait and point to the physical barrier, not reduced apparency, as a mechanism.

Genetic variation among 82 pharmacogenes: The PGRNseq data from the eMERGE network.

Genetic variation can affect drug response in multiple ways, although it remains unclear how rare genetic variants affect drug response. The electronic Medical Records and Genomics (eMERGE) Network, collaborating with the Pharmacogenomics Research Network, began eMERGE-PGx, a targeted sequencing study to assess genetic variation in 82 pharmacogenes critical for implementation of "precision medicine." The February 2015 eMERGE-PGx data release includes sequence-derived data from ∼5,000 clinical subjects. We present the variant frequency spectrum categorized by variant type, ancestry, and predicted function. We found 95.12% of genes have variants with a scaled Combined Annotation-Dependent Depletion score above 20, and 96.19% of all samples had one or more Clinical Pharmacogenetics Implementation Consortium Level A actionable variants. These data highlight the distribution and scope of genetic variation in relevant pharmacogenes, identifying challenges associated with implementing clinical sequencing for drug treatment at a broader level, underscoring the importance for multifaceted research in the execution of precision medicine.

Design and anticipated outcomes of the eMERGE-PGx project: a multicenter pilot for preemptive pharmacogenomics in electronic health record systems.

We describe here the design and initial implementation of the eMERGE-PGx project. eMERGE-PGx, a partnership of the Electronic Medical Records and Genomics Network and the Pharmacogenomics Research Network, has three objectives: (i) to deploy PGRNseq, a next-generation sequencing platform assessing sequence variation in 84 proposed pharmacogenes, in nearly 9,000 patients likely to be prescribed drugs of interest in a 1- to 3-year time frame across several clinical sites; (ii) to integrate well-established clinically validated pharmacogenetic genotypes into the electronic health record with associated clinical decision support and to assess process and clinical outcomes of implementation; and (iii) to develop a repository of pharmacogenetic variants of unknown significance linked to a repository of electronic health record-based clinical phenotype data for ongoing pharmacogenomics discovery. We describe site-specific project implementation and anticipated products, including genetic variant and phenotype data repositories, novel variant association studies, clinical decision support modules, clinical and process outcomes, approaches to managing incidental findings, and patient and clinician education methods.

13C NMR lineshapes of acetone adsorbed on silica.

13C NMR data, obtained as a function of temperature with magic-angle spinning (MAS) and either cross polarization or direct polarization, are reported on acetone and a sample of acetone (an approximately equal mixture with 13C labels at C-1 or C-2) adsorbed on dry silica gel. Various contributions to the observed linewidths and T2C values are considered in terms of a previously established model of the acetone/SiO2 system; in that model, acetone species are in equilibrium between a physisorbed-acetone (non-hydrogen-bonded) state and a state consisting of acetone units that are hydrogen bonded to silanol moieties on the silica surface. Spin dynamics simulations are useful in interpreting the effects of variations of experimental parameters. It is concluded that the main linewidth contributions, which increase at lower temperatures, are: (a) a dispersion of chemical shifts in the hydrogen-bonded state, associated with the inhomogeneous character of the silica surface; (b) the interference between MAS averaging of the chemical shift anisotropy (especially for the carbonyl carbon) and molecular motion and/or chemical exchange; and (c) chemical exchange broadening. Prominence of the last of these contributions is most consistent with data obtained as a function of magnetic field strength, MAS speed, and temperature.

Small town lead levels: a case study from the homes of pre-schoolers in Mt. Pleasant, Michigan.

This study evaluates the relationship between household Pb levels and four variables (home age, distance to road, traffic volume adjacent to the home, and the amount of exposed soil) for 42 homes in a small city. As a whole, Pb levels for the Mt. Pleasant sample were very low compared to large cities. Home age appeared to have the greatest impact on Pb levels as determined by atomic absorption soil = 65 microg g(-1), vacuum dust = 620 microg g(-1), window sill = 291 microg m(-1), indoor play area = 22 microg m(-1), and home entrance = 291 microg m(-1). The correlation coefficient for increasing home age and soil Pb level was r=0.63 (p<0.000). An inverse relationship (r=-0.45, p=0.003) occurred between soil Pb levels and distance from the road. Household Pb levels generally increased both with higher traffic volumes and greater amounts of exposed soil although both trends were not statistically significant. Study participants kept their home in a good to excellent state of repair and resided on lightly trafficked streets; as such, Pb deposition through the weathering of Pb-based paint and the former combustion of leaded gasoline was minimized.

Analysis of the heat-induced denaturation of proteins using temperature gradient gel electrophoresis.

A new technique, temperature gradient gel electrophoresis (TGGE), was applied to the study of heat-induced protein denaturation. The gels used contained 30 mM Borax + 75 mM boric acid, pH 8.4, and various concentrations of urea. When this technique was applied to bovine serum albumin, the protein showed discontinuous bands upon melting, indicating that the thermal transition is irreversible. The apparent melting temperature, calculated based on the relative intensity of two bands in the transition region, was 58 degrees C in 2 M urea. When the thermal denaturation of bovine serum albumin was analyzed spectroscopically, the transition was again irreversible, with an apparent transition temperature of 57 degrees C, consistent with the TGGE results. Recombinant stem cell factor, recombinant granulocyte macrophage-colony stimulating factor, and catalase were also analyzed by TGGE, indicating that the technique can be used to analyze denaturation of monomeric and multimeric proteins.

[Paracholecystic and intrahepatic abscesses as a complication of acute cholecystitis]. / Parapuzyrnye i vnutripechenochnye abstsessy kak oslozhnenie ostrogo kholetsistita.

The authors have studied 776 operations performed for acute cholecystitis. In 15 patients (1.9%) paravesicular and intrahepatic abscesses were found. Clinical symptoms are described which were observed in patients with such complications. The authors consider that these complications can be diagnozed in the preoperative period. The operation of choice is cholecystectomy (sometimes like the Pribram mucoclasias). In the paravesicular abscess it is necessary to resect the omentum involved in the inflammatory process. Great significance is attached to drainage of subdiaphragmatic and subhepatic space after Redon and to transumbilical infusion in the early postoperative period.