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Article ; Online: Long-term survival in patients with brain-only metastatic non-small cell lung cancer undergoing upfront intracranial stereotactic radiosurgery and definitive treatment to the thoracic primary site.

Salari, K / Lee, J S / Ye, H / Seymour, Z A / Lee, K C / Chinnaiyan, P / Grills, I S

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

2024 Volume 196, Page(s) 110262

Abstract: Background and purpose: To evaluate modern clinical outcomes for patients with brain-only metastatic non-small cell lung cancer (NSCLC) treated with intracranial stereotactic radiosurgery (SRS) with or without definitive treatment of the primary site.!## ...

Abstract	Background and purpose: To evaluate modern clinical outcomes for patients with brain-only metastatic non-small cell lung cancer (NSCLC) treated with intracranial stereotactic radiosurgery (SRS) with or without definitive treatment of the primary site. Materials and methods: Patients with synchronously diagnosed NSCLC and brain-only metastatic disease treated with intracranial SRS at a single institution were retrospectively identified. Patients were stratified based on whether they did (A) or did not (B) receive definitive primary site treatment. Patient characteristics and clinical outcomes were compared. Results: From 2008 to 2022, 103 patients were identified, 53 of whom received definitive primary site treatment. Median follow-up was 2.1 y (A) and 0.8 y (B) (p < 0.001). 28 (53 %) patients in Group A received immune checkpoint inhibitor (ICI) therapy versus 19 (38 %) in Group B (p = 0.13) and there were no other statistically significant baseline or treatment characteristic differences between the groups. 5-year local-PFS was 34.5 % (A) versus 0 % (B) (p < 0.001). 5-year regional-PFS was 33.0 % (A) versus 0 % (B) (p < 0.001). 5-year distant body-PFS was 34.0 % (A) versus 0 % (B) (p < 0.001). 5-year CNS-PFS was 14.7 % (A) versus 0 % (B) (p = 0.12). 5-year OS was 40.2 % (A) versus 0 % (B) (p = 0.001). 5-year CSS was 67.6 % (A) versus 0 % (B) (p = 0.002). On multivariable analysis, lack of definitive treatment to the primary site (HR = 2.40), AJCC T3-4 disease (HR = 2.73), and lack of ICI therapy (HR = 2.86) were significant predictors of death. Conclusion: Definitive treatment to the thoracic primary site in patients with brain-only metastatic NSCLC after intracranial radiosurgery was associated with slower progression of disease and improved survival.
Language	English
Publishing date	2024-03-29
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	605646-5
ISSN	1879-0887 ; 0167-8140
ISSN (online)	1879-0887
ISSN	0167-8140
DOI	10.1016/j.radonc.2024.110262
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Book ; Online: Incremental Learning with Differentiable Architecture and Forgetting Search

Smith, James Seale / Seymour, Zachary / Chiu, Han-Pang

2022

Abstract: As progress is made on training machine learning models on incrementally expanding classification tasks (i.e., incremental learning), a next step is to translate this progress to industry expectations. One technique missing from incremental learning is ... ...

Abstract	As progress is made on training machine learning models on incrementally expanding classification tasks (i.e., incremental learning), a next step is to translate this progress to industry expectations. One technique missing from incremental learning is automatic architecture design via Neural Architecture Search (NAS). In this paper, we show that leveraging NAS for incremental learning results in strong performance gains for classification tasks. Specifically, we contribute the following: first, we create a strong baseline approach for incremental learning based on Differentiable Architecture Search (DARTS) and state-of-the-art incremental learning strategies, outperforming many existing strategies trained with similar-sized popular architectures; second, we extend the idea of architecture search to regularize architecture forgetting, boosting performance past our proposed baseline. We evaluate our method on both RF signal and image classification tasks, and demonstrate we can achieve up to a 10% performance increase over state-of-the-art methods. Most importantly, our contribution enables learning from continuous distributions on real-world application data for which the complexity of the data distribution is unknown, or the modality less explored (such as RF signal classification). Comment: Accepted by the 2022 International Joint Conference on Neural Networks (IJCNN 2022)
Keywords	Computer Science - Machine Learning ; Computer Science - Artificial Intelligence
Subject code	006
Publishing date	2022-05-19
Publishing country	us
Document type	Book ; Online
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Article ; Online: Quality of life is not compromised with intensification of androgen therapy in recurrent prostate cancer.

Seymour, Zachary / Hamstra, Daniel

The Lancet. Oncology

2018 Volume 19, Issue 10, Page(s) 1275–1276

MeSH term(s)	Androgen Antagonists ; Humans ; Male ; Neoplasm Recurrence, Local ; Prostatic Neoplasms ; Prostatic Neoplasms, Castration-Resistant ; Quality of Life ; Thiohydantoins
Chemical Substances	Androgen Antagonists ; Thiohydantoins ; apalutamide
Language	English
Publishing date	2018-09-10
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	2049730-1
ISSN	1474-5488 ; 1470-2045
ISSN (online)	1474-5488
ISSN	1470-2045
DOI	10.1016/S1470-2045(18)30567-9
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Article ; Online: Hallux Valgus Deformities: Preferred Surgical Repair Techniques and All-Cause Revision Rates.

Thier, Zachary T / Seymour, Zachary / Gonzalez, Tyler A / Jackson, J Benjamin

Foot & ankle specialist

2021 , Page(s) 19386400211040344

Abstract: Introduction: Hallux valgus is a commonly treated condition by foot and ankle surgeons with more than 200 different described correction techniques. Recurrence rates range from 5% to 50%, with increasing support of the theory that arthrodesis procedures ...

Abstract	Introduction: Hallux valgus is a commonly treated condition by foot and ankle surgeons with more than 200 different described correction techniques. Recurrence rates range from 5% to 50%, with increasing support of the theory that arthrodesis procedures may have a lower recurrence rate than osteotomies. Arthrodesis procedures to the first metatarsophalangeal (MTP) joint or tarsometatarsal (TMT) joint for correction of hallux valgus deformity are becoming more commonly utilized. The purpose of this study is to investigate the surgical incidence and revision rates of hallux valgus deformities corrected by arthrodesis compared to osteotomy in the state of South Carolina. Methods: The South Carolina Revenue and Fiscal Affairs Office was queried from 2000 to 2017 to identify all surgically treated hallux valgus deformities. Data extraction included patient demographics, ICD-9 diagnoses, CPT procedure codes, and dates of surgery. A logistic regression model was used for statistical inference. Results: A total of 22 199 feet had surgical treatment for hallux valgus during this time period, with 20 422 (92.0%), 592 (2.7%), and 1185(5.3%) receiving an osteotomy, arthrodesis, or other procedure at initial treatment, respectively. There was an all-cause revision rate of 5.6% in the osteotomy group and 6.4% in the arthrodesis group. Demographic factors such as female sex, white race, and surgery pre-2010 were associated with higher revision rates. Multiple comorbidities were correlated with higher revision rates such as tobacco use, hypothyroidism, osteoarthritis, recurrent dislocations, hallux rigidus, lesser toe deformities, metatarsus varus, and talipes cavus. Conclusion: Despite the recent increase in arthrodesis procedures for the treatment of hallux valgus deformity, our results suggest that osteotomy procedures are more commonly performed and there is no difference in all-cause revision surgery. However, there are multiple patient demographics and comorbidities that are associated with higher rates of revision surgery and should be considered and discussed during the preoperative planning period. Level of evidence: Level IV.
Language	English
Publishing date	2021-10-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2488579-4
ISSN	1938-7636 ; 1938-6400
ISSN (online)	1938-7636
ISSN	1938-6400
DOI	10.1177/19386400211040344
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Article ; Online: Commissioning cranial single-isocenter multi-target radiosurgery for the Versa HD.

Knill, Cory / Sandhu, Raminder / Halford, Robert / Snyder, Michael / Seymour, Zachary

Journal of applied clinical medical physics

2021 Volume 22, Issue 4, Page(s) 108–114

Abstract: Purpose: Brainlab's Elements Multiple Brain Mets SRS (MBMS) is a dedicated treatment planning system for single-isocenter multi-target (SIMT) cranial stereotactic radiosurgery (SRS) treatments. The purpose of this study is to present the commissioning ... ...

Abstract	Purpose: Brainlab's Elements Multiple Brain Mets SRS (MBMS) is a dedicated treatment planning system for single-isocenter multi-target (SIMT) cranial stereotactic radiosurgery (SRS) treatments. The purpose of this study is to present the commissioning experience of MBMS on an Elekta Versa HD. Methods: MBMS was commissioned for 6 X, 6 FFF, and 10 FFF. Beam data collected included: output factors, percent depth doses (PDDs), diagonal profiles, collimator transmission, and penumbra. Beam data were processed by Brainlab and resulting parameters were entered into the planning system to generate the beam model. Beam model accuracy was verified for simple fields. MBMS plans were created on previously treated cranial SRS patient data sets. Plans were evaluated using Paddick inverse conformity (ICI), gradient indices (GI), and cumulative volume of brain receiving 12 Gy. Dosimetric accuracy of the MBMS plans was verified using microDiamond, Gafchromic film, and SRS Mapcheck measurements of absolute dose and dose profiles for individual targets. Finally, an end-to-end (E2E) test was performed with a MR-CT compatible phantom to validate the accuracy of the simulation-to-delivery process. Results: For square fields, calculated scatter factors were within 1.0% of measured, PDDs were within 0.5% past dmax, and diagonal profiles were within 0.5% for clinically relevant off-axis distances (<10 cm). MBMS produced plans with ICIs < 1.5 and GIs < 5.0 for targets > 10 mm. Average point doses of the MBMS plans, measured by microDiamond, were within 0.31% of calculated (max 2.84%). Average per-field planar pass rates were 98.0% (95.5% minimum) using a 2%/1 mm/10% threshold relative gamma analysis. E2E point dose measurements were within 1.5% of calculated and Gafchromic film pass rates were 99.6% using a 5%/1 mm/10% threshold gamma analysis. Conclusion: The experience presented can be used to aid the commissioning of the Versa HD in the Brainlab MBMS treatment planning system, to produce safe and accurate SIMT cranial SRS treatments.
MeSH term(s)	Humans ; Phantoms, Imaging ; Radiometry ; Radiosurgery ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted
Language	English
Publishing date	2021-03-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2010347-5
ISSN	1526-9914 ; 1526-9914
ISSN (online)	1526-9914
ISSN	1526-9914
DOI	10.1002/acm2.13223
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Book ; Online: GraphMapper

Seymour, Zachary / Mithun, Niluthpol Chowdhury / Chiu, Han-Pang / Samarasekera, Supun / Kumar, Rakesh

Efficient Visual Navigation by Scene Graph Generation

2022

Abstract: Understanding the geometric relationships between objects in a scene is a core capability in enabling both humans and autonomous agents to navigate in new environments. A sparse, unified representation of the scene topology will allow agents to act ... ...

Abstract	Understanding the geometric relationships between objects in a scene is a core capability in enabling both humans and autonomous agents to navigate in new environments. A sparse, unified representation of the scene topology will allow agents to act efficiently to move through their environment, communicate the environment state with others, and utilize the representation for diverse downstream tasks. To this end, we propose a method to train an autonomous agent to learn to accumulate a 3D scene graph representation of its environment by simultaneously learning to navigate through said environment. We demonstrate that our approach, GraphMapper, enables the learning of effective navigation policies through fewer interactions with the environment than vision-based systems alone. Further, we show that GraphMapper can act as a modular scene encoder to operate alongside existing Learning-based solutions to not only increase navigational efficiency but also generate intermediate scene representations that are useful for other future tasks. Comment: ICPR 2022
Keywords	Computer Science - Computer Vision and Pattern Recognition
Subject code	004
Publishing date	2022-05-17
Publishing country	us
Document type	Book ; Online
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Article ; Online: Nation-wide assessment of the distribution and population size of the data-deficient nurse shark (Ginglymostoma cirratum).

Garzon, Francesco / Graham, Rachel T / Baremore, Ivy / Castellanos, Dan / Salazar, Hilmar / Xiu, Cynthia / Seymour, Zeddy / Witt, Matthew J / Hawkes, Lucy A

PloS one

2021 Volume 16, Issue 8, Page(s) e0256532

Abstract: The study presents the first national assessment of a nurse shark (Ginglymostoma cirratum) population, conducted using a combination of transect surveys and baited remote underwater videos (BRUVs). Density of nurse sharks in Belize was found to be higher ...

Abstract	The study presents the first national assessment of a nurse shark (Ginglymostoma cirratum) population, conducted using a combination of transect surveys and baited remote underwater videos (BRUVs). Density of nurse sharks in Belize was found to be higher in reefs than in lagoons, and in the atolls furthest away from the mainland and human settlements. Only large and old protected areas were found to have a positive impact on nurse shark abundance. Absolute abundance of nurse sharks was estimated using distance sampling analysis, giving a total nurse shark population in the range of 3,858 to 14,375 sharks. Thanks to a vast area of suitable habitat for nurse sharks in the country and legislation already in place for the safeguard of the species, Belize could represent an important hotspot for nurse sharks in the Western Atlantic. The data presented here hence offers a baseline for the long-term monitoring of the Belizean nurse shark population and improves our understanding of nurse shark abundance and distribution in the wider Caribbean basin.
MeSH term(s)	Animals ; Belize ; Conservation of Natural Resources ; Ecosystem ; Population Density ; Sharks/physiology
Language	English
Publishing date	2021-08-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0256532
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Article ; Online: Radionecrosis (RN) in patients with brain metastases treated with stereotactic radiosurgery (SRS) and immunotherapy.

Andring, Lauren / Squires, Bryan / Seymour, Zachary / Fahim, Daniel / Jacob, Jeffrey / Ye, Hong / Marvin, Kimberly / Grills, Inga

The International journal of neuroscience

2021 Volume 133, Issue 2, Page(s) 186–193

Abstract: Objectives: Limited data exist regarding radionecrosis (RN) rates when patients receive immunotherapy (IT) and SRS for brain metastases. This study assesses the influence of such treatments on the rate of RN.: Methods: We retrospectively reviewed 352 ...

Abstract	Objectives: Limited data exist regarding radionecrosis (RN) rates when patients receive immunotherapy (IT) and SRS for brain metastases. This study assesses the influence of such treatments on the rate of RN. Methods: We retrospectively reviewed 352 lesions from 105 patients with metastatic melanoma or NSCLC treated with SRS and IT from 2012 to 2018. Lesions were excluded from analysis if patients had received WBRT or prior GK to the same lesion, if RN occurred before IT, or if IT had been discontinued >6 months pre-SRS or initiated >1 year post-SRS. IT was delivered concurrently (±30 days of SRS) or sequentially. Overall survival and RN rates were assessed with Kaplan-Meier analysis. Univariate analysis and multivariate analysis were performed to identify characteristics predicting RN. Results: Of 195 lesions from 63 patients included in analysis, the median prescription dose, IDL, lesion volume, and maximum tumor dimension (MTD) were 19 Gy, 50%, 0.15 cc and 0.8 cm, respectively. RN rates at 1, 2, and 3 years were 7.3%, 10.4% and 10.4%. On UVA, RN risk increased with, isodose volume (IDV), MTD, and tumor volume (TV) whereas conformity index was associated with a trend toward decreased RN risk. Two-year RN rates increased with TV ≥ 0.3 cc (16% vs 1.1% Conclusions: Patients who received IT and SRS had acceptably low rates of RN. Timing of IT did not predict for RN. Further investigation is warranted to define RN risk with combined SRS and IT.
MeSH term(s)	Humans ; Radiosurgery/adverse effects ; Radiosurgery/methods ; Retrospective Studies ; Brain Neoplasms/radiotherapy ; Brain Neoplasms/secondary ; Immunotherapy ; Radiation Injuries/etiology ; Lung Neoplasms/radiotherapy
Language	English
Publishing date	2021-04-19
Publishing country	England
Document type	Journal Article
ZDB-ID	3061-2
ISSN	1563-5279 ; 1543-5245 ; 0020-7454
ISSN (online)	1563-5279 ; 1543-5245
ISSN	0020-7454
DOI	10.1080/00207454.2021.1900843
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Book ; Online: SASRA

Irshad, Muhammad Zubair / Mithun, Niluthpol Chowdhury / Seymour, Zachary / Chiu, Han-Pang / Samarasekera, Supun / Kumar, Rakesh

Semantically-aware Spatio-temporal Reasoning Agent for Vision-and-Language Navigation in Continuous Environments

2021

Abstract: This paper presents a novel approach for the Vision-and-Language Navigation (VLN) task in continuous 3D environments, which requires an autonomous agent to follow natural language instructions in unseen environments. Existing end-to-end learning-based ... ...

Abstract	This paper presents a novel approach for the Vision-and-Language Navigation (VLN) task in continuous 3D environments, which requires an autonomous agent to follow natural language instructions in unseen environments. Existing end-to-end learning-based VLN methods struggle at this task as they focus mostly on utilizing raw visual observations and lack the semantic spatio-temporal reasoning capabilities which is crucial in generalizing to new environments. In this regard, we present a hybrid transformer-recurrence model which focuses on combining classical semantic mapping techniques with a learning-based method. Our method creates a temporal semantic memory by building a top-down local ego-centric semantic map and performs cross-modal grounding to align map and language modalities to enable effective learning of VLN policy. Empirical results in a photo-realistic long-horizon simulation environment show that the proposed approach outperforms a variety of state-of-the-art methods and baselines with over 22% relative improvement in SPL in prior unseen environments. Comment: 10 pages, 4 figures
Keywords	Computer Science - Robotics ; Computer Science - Computation and Language ; Computer Science - Computer Vision and Pattern Recognition
Subject code	004
Publishing date	2021-08-26
Publishing country	us
Document type	Book ; Online
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Article ; Online: Outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer.

Anwar, Mekhail / Weinberg, Vivian / Seymour, Zachary / Hsu, I Joe / Roach, Mack / Gottschalk, Alex R

Radiation oncology (London, England)

2016 Volume 11, Page(s) 8

Abstract: Background and purpose: Treatment of intermediate and high-risk prostate cancer with a high BED has been shown to increase recurrence free survival (RFS). While high dose rate (HDR) brachytherapy, given as a boost is effective in delivering a high BED, ... ...

Abstract	Background and purpose: Treatment of intermediate and high-risk prostate cancer with a high BED has been shown to increase recurrence free survival (RFS). While high dose rate (HDR) brachytherapy, given as a boost is effective in delivering a high BED, many patients are not candidates for the procedure or wish to avoid an invasive procedure. We evaluated the use of stereotactic body radiotherapy (SBRT) as a boost, with dosimetry modeled after HDR-boost. Material and methods: Fifty patients were treated with two fractions of SBRT (9.5-10.5 Gy/fraction) after 45 Gy external-beam radiotherapy, with 48 eligible for analysis at a median follow-up of 42.7 months. Results: The Kaplan-Meier estimates of biochemical control post-radiation therapy (95 % Confidence Interval) at 3, 4 and 5 years were 95 % (81-99 %), 90 % (72-97 %) and 90 % (72-97 %), respectively (not counting 2 patients with a PSA bounce as failures). RFS (defined as disease recurrence or death) estimates at 3, 4 and 5 years were 92 % (77-97 %), 88 % (69-95 %) and 83 % (62-93 %) if patients with PSA bounces are not counted as failures, and were 90 % (75-96 %), 85 % (67-94 %) and 75 % (53-88 %) if they were. The median time to PSA nadir was 26.2 months (range 5.8-82.9 months), with a median PSA nadir of 0.05 ng/mL (range <0.01-1.99 ng/mL). 2 patients had a "benign PSA bounce", and 4 patients recurred with radiographic evidence of recurrence beyond the RT fields. Treatment was well tolerated with no acute G3 or higher GI or GU toxicity and only a single G3 late GU toxicity of urinary obstruction. Conclusions: SBRT boost is well-tolerated for intermediate and high-risk prostate cancer patients with good biochemical outcomes and low toxicity.
MeSH term(s)	Adenocarcinoma/radiotherapy ; Aged ; Aged, 80 and over ; Biopsy ; Brachytherapy/methods ; Disease-Free Survival ; Dose Fractionation ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Prospective Studies ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/radiotherapy ; Radiometry/methods ; Radiosurgery/methods ; Risk ; Treatment Outcome
Chemical Substances	Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2016-01-21
Publishing country	England
Document type	Journal Article
ISSN	1748-717X
ISSN (online)	1748-717X
DOI	10.1186/s13014-016-0585-y
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