Validation of an in vivo transit dosimetry algorithm using Monte Carlo simulations and ionization chamber measurements.

PURPOSE: Transit dosimetry is a safety tool based on the transit images acquired during treatment. Forward-projection transit dosimetry software, as PerFRACTION, compares the transit images acquired with an expected image calculated from the DICOM plan, the CT, and the structure set. This work aims to validate PerFRACTION expected transit dose using PRIMO Monte Carlo simulations and ionization chamber measurements, and propose a methodology based on MPPG5a report. METHODS: The validation process was divided into three groups of tests according to MPPG5a: basic dose validation, IMRT dose validation, and heterogeneity correction validation. For the basic dose validation, the fields used were the nine fields needed to calibrate PerFRACTION and three jaws-defined. For the IMRT dose validation, seven sweeping gaps fields, the MLC transmission and 29 IMRT fields from 10 breast treatment plans were measured. For the heterogeneity validation, the transit dose of these fields was studied using three phantoms: 10 , 30 , and a 3 cm cork slab placed between 10 cm of solid water. The PerFRACTION expected doses were compared with PRIMO Monte Carlo simulation results and ionization chamber measurements. RESULTS: Using the 10 cm solid water phantom, for the basic validation fields, the root mean square (RMS) of the difference between PerFRACTION and PRIMO simulations was 0.6%. In the IMRT fields, the RMS of the difference was 1.2%. When comparing respect ionization chamber measurements, the RMS of the difference was 1.0% both for the basic and the IMRT validation. The average passing rate with a γ(2%/2 mm, TH = 20%) criterion between PRIMO dose distribution and PerFRACTION expected dose was 96.0% ± 5.8%. CONCLUSION: We validated PerFRACTION calculated transit dose with PRIMO Monte Carlo and ionization chamber measurements adapting the methodology of the MMPG5a report. The methodology presented can be applied to validate other forward-projection transit dosimetry software.

Severe acute herpes virus type 2 primo-infection and its association with anti-type 1 interferon autoantibodies.

Herpes simplex virus type 2 (HSV-2) is a common cause of infection, which is usually self-limited and asymptomatic. A 71-year-old patient with HSV-2 primo-infection developed acute hepatitis and secondary hemophagocytic lymphohistiocytosis. The patient had high levels of autoantibodies against type I interferon (IFN) (> 1000 ng/mL), neutralizing high concentration (10 ng/mL) of both IFN-α and IFN-ω but not IFN-ß. Anti-IFN-I auto-antibodies are rarely observed in healthy individuals; however, their prevalence increases in individuals over 70 years of age and have been identified as a cause of some severe viral diseases, including critical COVID-19. Considering the function of IFN-I in innate immunity, the pathological role of these autoantibodies in severe viral diseases following primo-infections in elderly patient appears crucial.

Tissue Concentration Analysis of Sulfur, Calcium and Oxygen in Novel Skin Primo Nodes After Acupuncture.

Over the past 5000 years, acupuncture has been practiced in Korea, China, and Japan to relieve various diseases, and it is now widely used and accepted worldwide. Although the anatomical substance and function of meridians has been actively studied, it is still not clearly defined. One of the keys to acupuncture is determining the specific anatomical location exactly on or under the skin. We discovered that the skin primo node is a new anatomical structure in the skin of rats. The present study aimed to analyze the relationship between skin primo nodes and acupoints through changes in the expression of tissue concentrations of skin primo nodes. Analysis of this skin primo node confirmed that the skin primo node after acupuncture had a significantly higher concentration of sulfur and calcium than found in normal skin. And the significant pO2 in the skin primo node was confirmed by measuring pO2 using a needle oxygen sensor. Through sulfur, calcium, and pO2 concentration values of skin primo nodes, we confirmed whether these nodes could be related to acupoint. To understand the clear structure and function of this node, it is necessary to further study through the known properties of acupoints and the function of Primo Vascular System (PVS).

Primo Vessels Inside Lymphatic Vessels Are Absent in an ALS Mouse Model.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the selective death of motor neurons in the central nervous system. It is also a representative rare disease among degenerative diseases of the nervous system. Although many drugs for the treatment of degenerative brain diseases are being developed, they are not delivered correctly to the target due to the blood-brain barrier. The present study aimed to analyze changes in the primo vascular system (PVS) in ALS mice with symptoms and the partial oxygen pressure (pO2) in normal mice. In normal mice, we consistently observed primo vessels in lymphatic vessels (L-PVS). However, in ALS mice with symptoms, L-PVS were mostly lost, rendering them difficult to observe. The pO2 of the L-PVS in normal mice was significantly higher than that of normal dermis and lymph nodes.In conclusion, the relatively higher oxygen levels measured in the L-PVS than in normal dermis and lymph nodes suggest a role for the PVS in oxygen transport and enable a hypothesis that the L-PVS can function as a drug delivery pathway.

Remote usability testing carried out during the COVID-19 pandemic on the example of Primo VE implementation in an Academic Library.

The article presents usability tests of Primo VE carried out as part of the implementation of the Alma library services platform at the Nicolaus Copernicus University Library. Remote usability tests were carried out during the COVID-19 pandemic. The aim of the tests was to assess the ease of use of selected system functionalities and the ease of learning how to use them by users. The method of remote usability testing using the Office365 application package, including MS Teams, was used. The tests allowed for the preparation of a report that took into account the identified problems and became the basis for introducing modifications to the configuration of the system's functionality and some elements of its interface, as well as for the preparation of instructional materials. The results indicate a fairly high level of intuitiveness of the interface and the analyzed functionalities. Test participants had no major problems with using Primo, apart from handling facets and full record services.

PRIMO Monte Carlo software as a tool for commissioning of an external beam radiotherapy treatment planning system.

Background: The purpose was to validate the PRIMO Monte Carlo software to be used during the commissioning of a treatment planning system (TPS). Materials and methods: The Acuros XB v. 16.1 algorithm of the Eclipse was configured for 6 MV and 6 MV flattening-filter-free (FFF) photon beams, from a TrueBeam linac equipped with a high-definition 120-leaf multileaf collimator (MLC). PRIMO v. 0.3.64.1814 software was used with the phase space files provided by Varian and benchmarked against the reference dosimetry dataset published by the Imaging and Radiation Oncology Core-Houston (IROC-H). Thirty Eclipse clinical intensity-modulated radiation therapy (IMRT)/volumetric modulated arc therapy (VMAT) plans were verified in three ways: 1) using the PTW Octavius 4D (O4D) system; 2) the Varian Portal Dosimetry system and 3) the PRIMO software. Clinical validation of PRIMO was completed by comparing the simulated dose distributions on the O4D phantom against dose measurements for these 30 clinical plans. Agreement evaluations were performed using a 3% global/2 mm gamma index analysis. Results: PRIMO simulations agreed with the benchmark IROC-H data within 2.0% for both energies. Gamma passing rates (GPRs) from the 30 clinical plan verifications were (6 MV/6MV FFF): 99.4% ± 0.5%/99.9% ± 0.1%, 99.8% ± 0.4%/98.9% ± 1.4%, 99.7% ± 0.4%/99.7% ± 0.4%, for the 1), 2) and 3) verification methods, respectively. Agreement between PRIMO simulations on the O4D phantom and 3D dose measurements resulted in GPRs of 97.9% ± 2.4%/99.7% ± 0.4%. Conclusion: The PRIMO software is a valuable tool for dosimetric verification of clinical plans during the commissioning of the primary TPS.

Using PRIMO to determine the initial beam parameters of Elekta Synergy linac for electron beam energies of 6, 9, 12, and 15 MeV.

Background: The purpose of this research was to establish the primary electron beam characteristics for an Elekta Synergy linear accelerator. In this task, we take advantage of the PRIMO Monte Carlo software, where the model developed contains the majority of the component materials of the Linac. Materials and methods: For all energies, the Elekta Linac electron mode and 14 × 14 cm2 applicator were chosen. To obtain percentage depth dose (PDD) curves, a homogeneous water phantom was voxelized in a 1 × 1 × 0.1 cm3 grid along the central axis. At the reference depth, the dose profile was recorded in 0.1 × 1 × 1 cm3 voxels. Iterative changes were made to the initial beams mean energy and full width at half maximum (FWHM) of energy in order to keep the conformity of the simulated and measured dose curves within. To confirm simulation results, the Gamma analysis was performed with acceptance criteria of 2 mm - 2%. From the validated calculation, the parameters of the PDD and profile curve (R100, R50, Rp, and field size) were collected. Results: Initial mean energies of 7.3, 9.85, 12.9, and 15.7 MeV were obtained for nominal energies of 6, 9, 12, and 15, respectively. The PRIMO Monte Carlo model for Elekta Synergy was precisely validated. Conclusions: PRIMO is an easy-to-use software program that can calculate dose distribution in water phantoms.

Comparison of PRIMO Monte Carlo code and Eclipse treatment planning system in calculation of dosimetric parameters in brain cancer radiotherapy.

Background: It is important to evaluate the dose calculated by treatment planning systems (TPSs) and dose distribution in tumor and organs at risk (OARs). The aim of this study is to compare dose calculated by the PRIMO Monte Carlo code and Eclipse TPS in radiotherapy of brain cancer patients. Materials and methods: PRIMO simulation code was used to simulate a Varian Clinac 600C linac. The simulations were validated for the linac by comparison of the simulation and measured results. In the case of brain cancer patients, the dosimetric parameters obtained by the PRIMO code were compared with those calculated by Eclipse TPS. Gamma function analysis with 3%, 3 mm criteria was utilized to compare the dose distributions. The evaluations were based on the dosimetric parameters for the planning target volume (PTV) and OAR including D min, D mean, and D max, homogeneity index (HI), and conformity index (CI). Results: The gamma function analysis showed a 98% agreement between the results obtained by the PRIMO code and measurement for the percent depth dose (PDD) and dose profiles. The corresponding value in comparing the dosimetric parameters from PRIMO code and Eclipse TPS for the brain patients was 94%, on average. The results of the PRIMO simulation were in good agreement with the measured data and Eclipse TPS calculations. Conclusions: Based on the results of this study, the PRIMO code can be utilized to simulate a medical linac with good accuracy and to evaluate the accuracy of treatment plans for patients with brain cancer.

Primo Levi: A frustrated stereochemist?-Insight in hindsight.

Primo Levi (1919-1987) has become an iconic figure at the intersection of chemistry and culture. Levi has long been praised for his autobiographical account as survivor in Auschwitz and by his literary masterpiece "The Periodic Table." Little is however known beyond such facts, especially his academic period and early research on stereochemistry at the University of Turin, which were abruptly truncated by the racial laws and WWII. Even if, later on, Primo Levi succeeded as industrial chemist, he had a vivid interest in molecular asymmetry that lasted through his entire life. This concise paper highlights a little known academic period in the midst of social and political upheaval. Levi left us his humanity in an otherwise tortuous life, and his literature took inspiration from chemistry; perhaps as a metaphor connecting the physical world and people's life.

Gene Expression of Prox-1 and Hif-1a in Primo Vessels Inside Lymph Vessels of the Rabbit.

The gene expression of Prox-1 and Hif-1a for the isolated primo vessels (PVs) and composite lymphatic vessels (LVs) containing PVs (LVs + PVs) was investigated by RNA-sequencing (Seq) and quantitative polymerase chain reaction (qRT-PCR) analysis. RNA-Seq on the passed 10 samples on RNA-QC for two experimental groups with PVs and PVs + LVs proceeded to the library construction stage automatically and analyzed differentially expressed genes (DEGs). From the real-time qRT-PCR analysis data, we found the marker genes of Prox-1 and Hif-1a were enriched and decreased in an isolated PVs compared to LVs, respectively. Based on mRNA transcriptional data, Prox-1 and Hif-1a were increased and decreased in PVs compared to LVs + PVs under lipopolysaccharide (LPS) treatment and relieved by acupuncture electric stimulation (AES), respectively. This finding indicates that high and low levels of Prox-1 and Hif-1a may be involved in the function of PVs and that pathophysiological and physiological condition could progress into inflamed lymphatic endothelial cells expanding the PV within the LV.

[Dealing with the bleeding patient, being effective with (almost) nothing]. / Face au patient hémorragique, être efficace avec (quasiment) rien.

The practice of pre-hospital care, whether you are a professional rescuer, a nurse, a doctor or a simple citizen, sometimes exposes you to the management of a patient who presents an acute hemorrhage. The prognosis is quickly life-threatening if the safety, assessment, life-saving gestures and activation of the rescue chain are not carried out. A basic, inexpensive first aid kit can further reduce morbidity and mortality. Training first responders in life-saving techniques is a public health issue.

Acute Anemia Induces Erythropoiesis in Rat Organ Surface Primo-Vascular Tissue.

The primo-vascular system (PVS) is a newly identified vascular tissue composed of primo-nodes (PNs) and primo-vessels (PVs). Previously, we reported erythropoietic activity in the organ-surface PVS (osPVS) tissue of rats with heart failure. In this study, we further investigated whether acute anemia could induce erythropoiesis in the PVS of rats, based on the hypothesis that erythropoiesis in osPVS tissue is due to anemia accompanying heart failure. Acute anemia was induced by an intraperitoneal injection of phenylhydrazine (PHZ). Circulating red blood cells (RBCs) and hematocrit decreased by 31.6%, whereas reticulocytes and white blood cells increased at day 3 and day 6 after PHZ treatment. All these parameters recovered to control levels at day 10. At days 3 and 6, we observed an increase in the size of the PNs (P < 0.05), the number of the osPVS tissue samples per rat (P < 0.01), and the proportion of osPVS tissue samples with red chromophore (P < 0.001), which was from the RBCs in the PVS tissue. The number of RBCs, estimated from the PN sections stained with hematoxylin and eosin, increased at day 6 in the rats with anemia (P < 0.01). All these anemia-induced changes in the osPVS tissue recovered to the control levels by day 10. Taken together, the results showed that the morphological and cytological changes in the osPVS tissue appear to be related to the erythropoietic activity induced by acute anemia in rats. This study confirmed the previous findings that the osPVS can exert erythropoietic activity in disease states accompanied by anemia, such as heart failure.

Analysis and Differential Expression of Primo Genes Using RNA-Seq and qRT-PCR Experiments.

Although the existence of the primo vasculature system has been shown in many species, including mice, rats, rabbits and humans, the biological role of this system, including expression of genes and proteins, has not yet been investigated. Especially the transcriptional action by mRNA, which is required for biological action, needs to be studied in primo vasculature biology. Differentially expressed genes in both isolated primo vessels and lymphatic vessels of rabbits were analyzed by RNA sequencing experiments. Primer efficiency and RNA purity of the primo vessels under lipopolysaccharides were confirmed prior to performing real-time qRT-PCR analysis following RNA extraction. We demonstrated that FLT4 was enriched in primo vessels and that several genes, including HSPH1 and EPHB2, were highly expressed in primo vessels compared with lymphatic vessels. Our data show that almost all genes, except HSPA4, were increased or sustained in isolated primo vessels compared with lymphatic vessels (FLT4 2.58 fold, HSPH1 1.83 fold, EPHB2 1.52 fold; whereas HSPA4 decreased 0.50 fold), suggesting primo vessels as a central regulator in diverse physiology. This implies that FLT4, HSPH1, and EPHB2 in high amounts may be involved in the functional activity of primo vessels. Our experimental data show that several genes are highly enriched in primo vessels in the lymphatic vessels of the rabbit.

Effects of three different diets on the fatty acid profile and sensory properties of fresh Pecorino cheese "Primo Sale".

OBJECTIVE: This study aimed to evaluate and compare the effects of three different diets on the fatty acids (FA) profile and sensory properties of a characteristic Italian fresh cheese: Pecorino "Primo Sale" (PS). METHODS: Fifty-four sheep were divided into three feeding groups: total mixed ration (TMR) enriched with extruded linseed (TL), control diet with TMR without any integration (TC), and pasture (P). During cheese production, six cheeses per experimental group were produced each week, stored for 10 days at 4°C, and then analyzed for chemical composition, FA profile, and sensory properties. RESULTS: Saturated fatty acids (SFA) were significantly higher in PS from group TC (82.11%) than in cheese from other two groups (P 75.48% and TL 66.83%). TL and P groups presented higher values of polyunsaturated fatty acids, 4.35 and 3.65%, respectively, than that of TC group (2.31%). The lowest SFA/unsaturated fatty acid ratio was found in TL and P groups, while the highest was found in the TC group. Vaccenic acid and conjugated linoleic acid (CLA) were higher in group P (p<0.05) than in groups L and TC. Sensory properties of cheese from group P received the highest scores for odor intensity and friability, while control group had a greater chewing consistency. Overall, all cheeses received good scores for acceptability. CONCLUSION: In conclusion, this study showed how the integration of extruded linseed improved the FA profile of fresh pecorino cheese PS preserving its sensory properties. Levels of CLA in the PS group achieved using this approach was not higher than that in a grazing diet. Cheeses from groups P and L contained a higher value of FA, with nutritional implications for humans, when compared with un-supplemented diet. Linseed may be a good feeding strategy when pasture is not available.

Monte Carlo simulation using PRIMO code as a tool for checking the credibility of commissioning and quality assurance of 6 MV TrueBeam STx varian LINAC.

AIM: To validate and implement Monte Carlo simulation using PRIMO code as a tool for checking the credibility of measurements in LINAC initial commissioning and routine Quality Assurance (QA). Relative and absolute doses of 6 MV photon beam from TrueBeam STx Varian Linear Accelerator (LINAC) were simulated and validated with experimental measurement, Analytical Anisotropic Algorithm (AAA) calculation, and golden beam. METHODS AND MATERIALS: Varian phase-space files were imported to the PRIMO code and four blocks of jaws were simulated to determine the field size of the photon beam. Water phantom was modeled in the PRIMO code with water equivalent density. Golden beam data, experimental measurement, and AAA calculation results were imported to PRIMO code for gamma comparison. RESULTS: PRIMO simulations of Percentage Depth Dose (PDD) and in-plane beam profiles had good agreement with experimental measurements, AAA calculations and golden beam. However, PRIMO simulations of cross-plane beam profiles have a better agreement with AAA calculation and golden beam than the experimental measurement. Furthermore, PRIMO simulations of absolute dose agreed well with experimental results with ±0.8% uncertainty. CONCLUSION: The PRIMO code has good accuracy and is appropriate for use as a tool to check the credibility of beam scanning and output measurement in initial commissioning and routine QA.

The hyaluronic acid-rich node and duct system is a structure organized for innate immunity and mediates the local inflammation.

The Hyaluronic Acid-rich Node and Duct System (HAR-NDS or NDS), Primo Vascular System (PVS) or Bonghan System (BHS), is thought to be a third circulatory system independent of the blood and lymphatic systems and a structure of connected nodes and ducts. Although it seems to be part of the immune system as it is enriched with cells of innate immunity, little is known about its immunological roles. We performed cellular profiling and secretome analysis of NDS in a steady state and under TLR2- or TLR4-mediated local inflammation, and found that the NDS is pre-dominantly enriched with the myeloid cells, selectively attracts the inflammatory macrophages and neutrophils, has a flexible structure just like the lymph node, and is structured with the fibroblastic reticular cells and reticular network. NDS dominantly harbored the myeloid cells in both steady and activated status, and secreted various types of inflammatory cytokines by proinflammatory stimuli. These results suggest that NDS is the lymphoid structure for the innate immunity and plays an intermediary role in the innate immune cell-mediated local inflammation.

Evaluation of the human bioelectromagnetic field in medicine: the development of methodology and prospects are at the present scientific stage.

OBJECTIVE: Introduction: The authors focus on the unresolved problem of NCDs and on the relevance of further scientific research in accordance with the current physics-biological level of knowledge about the structure and functioning of the human body. In the course, emphasis is placed on the need for further study of methods for assessing the bioelectromagnetic field of the human body as a potential "tool" for a possible solution of the NCD problem in the framework of system medicine. The aim is to assess the level of development of the methodology and substantiate the scientific feasibility of further exploring the possibilities of the clinical application of these methods for assessing the bioelectromagnetic field of the human body in the algorithms for examining and managing patients with NCDs to study valeological status and objective monitoring of physical phenomena in the clinic of internal diseases. PATIENTS AND METHODS: Materials and methods: The analysis of the literature data was carried out in the course of a search study of methods for the rapid assessment of valeological status as a fragment of the initiative research project "Development of algorithms and technology for introducing a healthy lifestyle in patients with non-communicable diseases based on the study of psycho-emotional status" (State registration No. 0116U007798, UDC 613:616-052:159.942:616-03). RESULTS: Review: The gnoseological aspect of the development of the methodology for assessing the bioelectric and biomagnetic fields of the human body is described in the article. The conditional time stages of the methodology are highlighted and characterized in it. It was proposed to distinguish between periods: 1) cumulative (XIII-XVIII centuries), 2) cumulative-dynamic (XII-XX centuries), 3) modern (XXI century) 4) modern (prospective). Questions of the feasibility of further research assessing the bioelectromagnetic field of the human body are discussed. CONCLUSION: Conclusions: 1. The above gnoseological aspect of the 700-year-old methodology for studying the bioelectromagnetic field of a human body demonstrates a staged evolution of its development, the presence of a significant amount of cumulated scientific information, which requires rethinking as part of system medicine. This convinces us of the existence of a tendency of inevitable approaching the final stage of knowledge of the human bioelectromagnetic field with the widespread introduction of these techniques into the practical public health of the world. 2. The accumulated layer of scientific knowledge about the bioelectromagnetic component of the human body requires integration into fundamental medicine, transformation of the modern paradigm by creating a bioelectromagnetic-chemical concept of the exchange of matter and energy in the human body. 3. Further research on the assessment of the bioelectromagnetic field is relevant and can contribute to solving the NCD problem both at a fundamental level within the framework of system medicine and by optimizing the diagnostic assessment in patient management algorithms during diagnosis, treatment, primary and secondary prevention.

The Periodic-Table-A Universal Icon: Its Birth 150†Years Ago, and Its Popularization Through Literature Art and Music.

This Essay projects the spark of genius of Mendeleev, whose efforts led to the effective formulation of the periodic table, which has placed the entire world of chemical matter on a palm. The periodic table gave rise to a central paradigm, which did for chemistry what Newton had done for physics and Darwin for biology. Subsequently the Essay recounts the popularization of the Periodic Table through literature by Primo Levi, Oliver Sacks and others, and through music and art by composers and artists, such as Jerry Feldman, the King Crimson band, Tom Lehrer, and George Brecht, Blair Bradshaw, Eugènia Balcells, etc.

La santé des migrants en France.

THE HEALTH OF MIGRANTS IN FRANCE: France has 6 million immigrants of which 1.8 million are French, and there are 200 000 legal new arrivals in France each year. Migrants, immigrants, foreigners, new arrivals, asylum seekers, exiles, 'undocumented' migrants are some of the terms used to refer to them and which imply different realities, people and statuses. What is the situation with regard to their health status, vulnerability factors and their access to rights? Significant prevention work must be undertaken, notably by carrying out a coordinated and unique health assessment after their arrival.

Potential Erythropoiesis in the Primo-Vascular System in Heart Failure.

The primo-vascular system (PVS), composed of primo-nodes (PNs) and primo-vessels (PVs), has been identified in various animal models. However, little is known about its function. Here, we investigated the changes in gross morphology and cellular composition of the organ-surface PVS (osPVS) in rats with heart failure (HF) induced by myocardial infarction. The size of the PNs in rats with HF was larger than in sham rats (1.87 vs. 0.80 mm2; P < 0.01) and the density of osPVS per rat was greater for the HF rats (28 of 6 rats vs. 19 of 9 rats; P < 0.01). In addition, the osPVS number containing red chromophore was greater in HF rats (P < 0.001). The chromophore was identified as hemoglobin. Transmission electron microscopy and H&E staining revealed that the osPVS of HF rats (P < 0.001) possessed more red blood cells (RBCs) than that of the sham rats. In particular, immature RBC number increased in the HF rats (90.7 vs. 42.3%; P < 0.001). Altogether, the results showed that the osPVS in HF rats increased in its size, density, and the proportion of immature RBCs in the PNs, which may indicate that the PVS has erythropoietic activity. Our study will help to elucidate the physiological roles of PVS in normal and disease states associated with HF.