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  1. Article ; Online: Radiation Therapy Technology Advances and Mitigation of Subsequent Neoplasms in Childhood Cancer Survivors.

    Stokkevåg, Camilla H / Journy, Neige / Vogelius, Ivan R / Howell, Rebecca M / Hodgson, David / Bentzen, Søren M

    International journal of radiation oncology, biology, physics

    2024  

    Abstract: Purpose: In this Pediatric Normal Tissue Effects in the Clinic (PENTEC) vision paper, challenges and opportunities in the assessment of subsequent neoplasms (SNs) from radiation therapy (RT) are presented and discussed in the context of technology ... ...

    Abstract Purpose: In this Pediatric Normal Tissue Effects in the Clinic (PENTEC) vision paper, challenges and opportunities in the assessment of subsequent neoplasms (SNs) from radiation therapy (RT) are presented and discussed in the context of technology advancement.
    Methods and materials: The paper discusses the current knowledge of SN risks associated with historic, contemporary, and future RT technologies. Opportunities for research and SN mitigation strategies in pediatric patients with cancer are reviewed.
    Results: Present experience with radiation carcinogenesis is from populations exposed during widely different scenarios. Knowledge gaps exist within clinical cohorts and follow-up; dose-response and volume effects; dose-rate and fractionation effects; radiation quality and proton/particle therapy; age considerations; susceptibility of specific tissues; and risks related to genetic predisposition. The biological mechanisms associated with local and patient-level risks are largely unknown.
    Conclusions: Future cancer care is expected to involve several available RT technologies, necessitating evidence and strategies to assess the performance of competing treatments. It is essential to maximize the utilization of existing follow-up while planning for prospective data collection, including standardized registration of individual treatment information with linkage across patient databases.
    Language English
    Publishing date 2024-03-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 197614-x
    ISSN 1879-355X ; 0360-3016
    ISSN (online) 1879-355X
    ISSN 0360-3016
    DOI 10.1016/j.ijrobp.2024.01.206
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Book ; Online: Chapter Review of the Central and South Atlantic Shelf and Deep-Sea Benthos: Science, Policy, and Management

    Bridges, Amelia E.H / Howell, Kerry L / Amaro, Teresa / Atkinson, Lara / Barnes, David K. A / Bax, Narissa / Bell, James B / Bernardino, Angelo F / Beuck, Lydia / Braga-Henriques, Andreia / Brandt, Angelika / Bravo, María E / Brix, Saskia / Butt, Stanley / Carranza, Alvar / Doti, Brenda L / Elegbede, Isa O / Esquete, Patricia / Freiwald, André /
    Gaudron, Sylvie M / Guilhon, Maila / Hebbeln, Dierk / Horton, Tammy / Kainge, Paulus / Kaiser, Stefanie / Lauretta, Daniel / Limongi, Pablo / McQuaid, Kirsty A / Milligan, Rosanna J / Miloslavich, Patricia / Narayanaswamy, Bhavani E / Orejas, Covadonga / Paulus, Sarah / Pearman, Tabitha R. R / Angel Perez, Jose A / Ross, Rebecca E / Saeedi, Hanieh / Shimabukuro, Mauricio / Sink, Kerry / Stevenson, Angela / Taylor, Michelle / Titschack, Jürgen / Vieira, Rui P / Vinha, Beatriz / Wienberg, Claudia

    2023  

    Keywords Ecological science, the Biosphere ; Evolution ; Biology, life sciences ; Atlantic deep sea ; Benthic ecology ; Marine spatial planning ; Biodiversity patterns ; Gap analysis
    Language English
    Size 1 electronic resource (91 pages)
    Publisher Taylor and Francis
    Publishing place Boca Raton, Abingdon
    Document type Book ; Online
    Note English
    HBZ-ID HT030613088
    ISBN 9781003363873 ; 1003363873
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  3. Article ; Online: PENTEC: Biodevelopmental Considerations in Pediatric Patients With Cancer and Childhood Cancer Survivors.

    Bates, James E / Marples, Brian / Hudson, Melissa M / Williams, AnnaLynn M / Marcus, Karen / Howell, Rebecca / Paulino, Arnold / Constine, Louis S

    International journal of radiation oncology, biology, physics

    2023  

    Language English
    Publishing date 2023-11-14
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 197614-x
    ISSN 1879-355X ; 0360-3016
    ISSN (online) 1879-355X
    ISSN 0360-3016
    DOI 10.1016/j.ijrobp.2023.09.054
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Spinal Muscular Atrophy: Huge Steps.

    Howell, Kelly / Gibbs, Rebecca M / Rubin, Lee L

    Cerebrum : the Dana forum on brain science

    2019  Volume 2019

    Abstract: Spinal muscular atrophy is the number one genetic cause of infant death. Until recently, half the babies born with it would die before their second birthdays, their hearts and lungs becoming too weak to continue. Medical care improved the odds somewhat, ... ...

    Abstract Spinal muscular atrophy is the number one genetic cause of infant death. Until recently, half the babies born with it would die before their second birthdays, their hearts and lungs becoming too weak to continue. Medical care improved the odds somewhat, but new discoveries and therapeutic developments have improved survival rates significantly-and more good news may be on the horizon
    Language English
    Publishing date 2019-03-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2251230-5
    ISSN 1524-6205
    ISSN 1524-6205
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: A Novel Instrument Holder to Improve Operative Efficiency in Endoscopic Laryngeal and Airway Surgery.

    Jain, Aseem / Adams, Sarah M / Hale, Isaac / Voskoboynik, Anna / Sissoko, Cheick / Bugada, Matthew / Dion, Gregory R / Howell, Rebecca J / Friedman, Aaron D

    The Laryngoscope

    2023  Volume 133, Issue 12, Page(s) 3492–3498

    Abstract: Objective: Receiving instruments from surgical technicians during endoscopic laryngeal and airway microsurgery (ELAM) has challenges including repeated, expeditious handling of delicate instruments and passing them to the surgeon's hand opposite of ... ...

    Abstract Objective: Receiving instruments from surgical technicians during endoscopic laryngeal and airway microsurgery (ELAM) has challenges including repeated, expeditious handling of delicate instruments and passing them to the surgeon's hand opposite of where the surgical assistant is standing. Optimizing this interaction may reduce surgical errors and improve operative efficiency.
    Methods: A proprietary ELAM instrument holder was attached to both sides of the operating room bed. The device consisted of an articulating arm with custom silicone inserts mounted on a tray (storing up to three endoscopic instruments). ELAM cases were randomized to be performed either with (device) or without the holder (control). Using custom software, instrument pass time (IPT), instrument drop rate (IDR), and communication errors (eg handing incorrect instruments) were manually recorded. Qualitative use metrics relating to overall device satisfaction were also obtained.
    Results: Data were collected from 25 device and 23 control cases among three different laryngologists. Average IPT was nearly three times quicker for the device (0.80 s, n = 1175 passes) compared with controls (2.09 s, n = 1208 passes) [p < 0.001]. IPT interquartile range was five times higher for control (1.65 s) versus device cases (0.42 s). IDR was not significantly different [p = 0.48]; however, device cases had significantly lower communication errors compared to control cases [p = 0.01]. Surgeons and surgical assistants were similarly satisfied with the device on a 5-point Likert scale (mean: 4.2/5, standard deviation: 0.92).
    Conclusion: The proposed endoscopic instrument holder can improve ELAM operative workflow by reducing instrument passing time and variability without increasing IDR.
    Level of evidence: 2 Laryngoscope, 133:3492-3498, 2023.
    MeSH term(s) Humans ; Surgical Instruments ; Endoscopy ; Larynx/surgery ; Laryngoscopes ; Operating Rooms
    Language English
    Publishing date 2023-06-19
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1002/lary.30835
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Physics Considerations for Evaluation of Dose for Dose-Response Models of Pediatric Late Effects From Radiation Therapy.

    Olch, Arthur J / van Luijk, Peter / Hua, Chia-Ho / Avanzo, Michele / Howell, Rebecca M / Yorke, Ellen / Aznar, Marianne C / Kry, Stephen F

    International journal of radiation oncology, biology, physics

    2023  

    Abstract: Purpose: We describe the methods used to estimate the accuracy of dosimetric data found in literature sources used to construct the Pediatric Normal Tissue Effects in the Clinic (PENTEC) dose-response models, summarize these findings of each organ- ... ...

    Abstract Purpose: We describe the methods used to estimate the accuracy of dosimetric data found in literature sources used to construct the Pediatric Normal Tissue Effects in the Clinic (PENTEC) dose-response models, summarize these findings of each organ-specific task force, describe some of the dosimetric challenges and the extent to which these efforts affected the final modeling results, and provide guidance on the interpretation of the dose-response results given the various dosimetric uncertainties.
    Methods and materials: Each of the PENTEC task force medical physicists reviewed all the journal articles used for dose-response modeling to identify, categorize, and quantify dosimetric uncertainties. These uncertainties fell into 6 broad categories. A uniform nomenclature was developed for describing the "dosimetric quality" of the articles used in the PENTEC reviews. Among the multidisciplinary experts in the PENTEC effort, the medical physicists were charged with the dosimetric evaluation, as they are most expert in this subject.
    Results: The percentage dosimetric uncertainty was estimated for each late effect endpoint for all PENTEC organ reports. Twelve specific sources of dose uncertainty were identified related to the 6 broad categories. The most common reason for organ dose uncertainty was that prescribed dose rather than organ dose was reported. Percentage dose uncertainties ranged from 5% to 200%. Systematic uncertainties were used to correct the dose component of the models. Random uncertainties were also described in each report and in some cases used to modify dose axis error bars. In addition, the potential effects of dose binning were described.
    Conclusions: PENTEC reports are designed to provide guidance to radiation oncologists and treatment planners for organ dose constraints. It is critical that these dose constraint recommendations are as accurate as possible, acknowledging the large error bars for many. Achieving this accuracy is important as it enables clinicians to better balance target dose coverage with risk of late effects. Evidence-based dose constraints for pediatric patients have been lacking and, in this regard, PENTEC fills an important unmet need. One must be aware of the limitations of our recommendations, and that for some organ systems, large uncertainties exist in the dose-response model because of clinical endpoint uncertainty, dosimetric uncertainty, or both.
    Language English
    Publishing date 2023-03-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 197614-x
    ISSN 1879-355X ; 0360-3016
    ISSN (online) 1879-355X
    ISSN 0360-3016
    DOI 10.1016/j.ijrobp.2023.02.060
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Technical note: Radiological clinical equivalence for phantom materials in carbon ion therapy.

    Taylor, Paige A / Mirandola, Alfredo / Ciocca, Mario / Hartzell, Shannon / Vai, Alessandro / Alvarez, Paola / Howell, Rebecca M / Koay, Eugene J / Peeler, Christopher R / Peterson, Christine B / Kry, Stephen F

    Medical physics

    2024  

    Abstract: Purpose: As carbon ion radiotherapy increases in use, there are limited phantom materials for heterogeneous or anthropomorphic phantom measurements. This work characterized the radiological clinical equivalence of several phantom materials in a ... ...

    Abstract Purpose: As carbon ion radiotherapy increases in use, there are limited phantom materials for heterogeneous or anthropomorphic phantom measurements. This work characterized the radiological clinical equivalence of several phantom materials in a therapeutic carbon ion beam.
    Methods: Eight materials were tested for radiological material-equivalence in a carbon ion beam. The materials were computed tomography (CT)-scanned to obtain Hounsfield unit (HU) values, then irradiated in a monoenergetic carbon ion beam to determine relative linear stopping power (RLSP). The corresponding HU and RLSP for each phantom material were compared to clinical carbon ion calibration curves. For absorbed dose comparison, ion chamber measurements were made in the center of a carbon ion spread-out Bragg peak (SOBP) in water and in the phantom material, evaluating whether the material perturbed the absorbed dose measurement beyond what was predicted by the HU-RLSP relationship.
    Results: Polyethylene, solid water (Gammex and Sun Nuclear), Blue Water (Standard Imaging), and Techtron HPV had measured RLSP values that agreed within ±4.2% of RLSP values predicted by the clinical calibration curve. Measured RLSP for acrylic was 7.2% different from predicted. The agreement for balsa wood and cork varied between samples. Ion chamber measurements in the phantom materials were within 0.1% of ion chamber measurements in water for most materials (solid water, Blue Water, polyethylene, and acrylic), and within 1.9% for the rest of the materials (balsa wood, cork, and Techtron HPV).
    Conclusions: Several phantom materials (Blue Water, polyethylene, solid water [Gammex and Sun Nuclear], and Techtron HPV) are suitable for heterogeneous phantom measurements for carbon ion therapy. Low density materials should be carefully characterized due to inconsistencies between samples.
    Language English
    Publishing date 2024-04-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 188780-4
    ISSN 2473-4209 ; 0094-2405
    ISSN (online) 2473-4209
    ISSN 0094-2405
    DOI 10.1002/mp.17056
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: OSLD nanoDot characterization for carbon radiotherapy dosimetry.

    Taylor, Paige / Hartzell, Shannon / Mirandola, Alfredo / Ciocca, Mario / Magro, Giuseppe / Alvarez, Paola / Peterson, Christine B / Peeler, Christopher R / Koay, Eugene J / Howell, Rebecca M / Kry, Stephen F

    Physics in medicine and biology

    2024  

    Abstract: Objective: This study characterized OSLD nanoDots for use in a therapeutic carbon beam using the IROC framework for remote output verification. Approach: The absorbed dose correction factors for OSLD (fading, linearity, beam quality, angularity, and ... ...

    Abstract Objective: This study characterized OSLD nanoDots for use in a therapeutic carbon beam using the IROC framework for remote output verification. Approach: The absorbed dose correction factors for OSLD (fading, linearity, beam quality, angularity, and depletion), as defined by AAPM TG 191, were characterized for carbon beams. For the various correction factors, the effect of carbon LET was examined by characterizing in both a low and high LET setting. Main Results: Fading was not statistically different between reference photons and carbon, nor between low and high LET carbon; thus, the standard IROC-defined exponential function could be used to characterize fading. Dose linearity was characterized with a linear fit; while low and high LET carbon linearity was different, these differences were small and could be rolled into the uncertainty budget if using a single linearity correction. A linear fit between beam quality and dose-averaged LET was determined. The OSLD response at various angles of incidence was not statistically different, thus a correction factor need not be applied. There was a difference in depletion between low and high LET carbon irradiations, but this difference was small over the standard five readings. The largest uncertainty associated with the use of OSLDs in carbon was because of the kQ, with an uncertainty of 6.0%. The overall uncertainty budget was 6.3% for standard irradiation conditions. Significance: OSLD nanoDot response was characterized in a therapeutic carbon beam. The uncertainty was larger than for traditional photon applications. These findings enable the use of OSLDs for carbon absorbed dose measurements, but with less accuracy than conventional OSLD audit programs. .
    Language English
    Publishing date 2024-04-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 208857-5
    ISSN 1361-6560 ; 0031-9155
    ISSN (online) 1361-6560
    ISSN 0031-9155
    DOI 10.1088/1361-6560/ad43ac
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Understanding the impact of COVID-19 on women's access to and experiences of contraceptive services in England: a qualitative study.

    McMillan, Lauren / Gadsby, Erica / Howell, Rebecca / Ussher, Michael / Hunt, Kate / Ford, Allison

    BMJ sexual & reproductive health

    2024  

    Abstract: Background: The COVID-19 pandemic response prompted rapid changes to how contraceptive services were delivered in England. Our aim was to examine women's experiences of accessing contraceptive services since March 2020 and to understand any inequalities ...

    Abstract Background: The COVID-19 pandemic response prompted rapid changes to how contraceptive services were delivered in England. Our aim was to examine women's experiences of accessing contraceptive services since March 2020 and to understand any inequalities of access.
    Methods: We conducted telephone interviews with 31 women aged 17-54 years who had accessed contraceptive services in England since March 2020. The sample was skewed to include participants with lower educational attainment and higher deprivation. Interview transcripts were thematically analysed using inductive and deductive approaches.
    Results: Few differences were found regarding educational attainment. Participants using contraceptive injections (all living in areas in the most deprived quintile) reported the greatest access challenges. Some switched method or stopped using contraception as a result. More general barriers reported by participants included service closures, unclear booking processes, and lack of appointment availability. Many participants welcomed the flexibility and convenience of remote contraceptive services. However, telephone appointments posed challenges for those at school or living with parents, and some described them as rushed and inconducive to asking questions or raising concerns. Those accessing contraception for the first time or nearing menopause felt they were unable to access sufficient support and guidance during the pandemic. Some participants voiced concerns around the lasting effects of COVID-19 on appointment availability and inadequate service delivery.
    Conclusions: Women's experiences of accessing contraceptive services in England since March 2020 are diverse. While remote services were suitable for some, COVID-19 restrictions unequally impacted women depending on their method of contraception and life stage.
    Language English
    Publishing date 2024-03-19
    Publishing country England
    Document type Journal Article
    ISSN 2515-2009
    ISSN (online) 2515-2009
    DOI 10.1136/bmjsrh-2023-202206
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: An Urgent Need for School-Based Diversion Programs for Adolescent Substance Use: A Statewide Survey of School Personnel.

    Liu, Jessica / Butler, Rebecca / Turncliff, Amy / Gray, Caroline / Lynch, Stacey / Whittaker, Jennie / Iroegbulem, Vanessa / Howell, Dan / Schuster, Randi M

    The Journal of adolescent health : official publication of the Society for Adolescent Medicine

    2023  Volume 73, Issue 3, Page(s) 428–436

    Abstract: Purpose: There has been growing interest in reserving punishment as a last resort to address substance use in schools. However, there is significant variability in adoption of alternative approaches. This study reported school personnel's perceptions of ...

    Abstract Purpose: There has been growing interest in reserving punishment as a last resort to address substance use in schools. However, there is significant variability in adoption of alternative approaches. This study reported school personnel's perceptions of diversion programs, identified characteristics of schools/districts that currently have diversion programs, and defined barriers of implementation of diversion programs.
    Methods: One hundred fifty six school stakeholders from Massachusetts' K-12 schools, including district administrators, principals and vice principals, school resource officers, guidance counselors, and nurses, completed a web-based survey in May-June 2020. Participants were recruited through e-mail distributed via professional listservs, direct school outreach, and community coalitions. The web survey queried beliefs, attitudes, and actions that schools take regarding substance use infractions as well as perceived barriers to implementing diversion programs.
    Results: Participants endorsed strong beliefs that punishment was an appropriate school response for student substance use, particularly for nontobacco-related infractions. Despite these personal beliefs, diversion programs were rated as more effective but less commonly used than punitive approaches (37% of respondents reported having diversion programs in their schools/districts vs. 85% used punitive approaches) (p < .03). Punishment was more likely to be used to respond to cannabis, alcohol, and other substances compared to tobacco (p < .02). Primary barriers of implementing diversion programs included funding, staff training, and parental support.
    Discussion: Based on school personnel perceptions, these findings lend further support for a transition away from punishment and toward more restorative alternatives. However, barriers to sustainability and equity were identified that warrant consideration when implementing diversion programs.
    MeSH term(s) Humans ; Adolescent ; Schools ; Substance-Related Disorders ; Surveys and Questionnaires ; Attitude ; Massachusetts
    Language English
    Publishing date 2023-06-15
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 1063374-1
    ISSN 1879-1972 ; 1054-139X
    ISSN (online) 1879-1972
    ISSN 1054-139X
    DOI 10.1016/j.jadohealth.2023.04.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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