Comparison of CT and PET-CT based planning of radiation therapy in locally advanced pancreatic carcinoma

Abstract Background To compare computed tomography (CT) with co-registered positron emission tomography-computed tomography (PET-CT) as the basis for delineating gross tumor volume (GTV) in unresectable, locally advanced pancreatic carcinoma (LAPC). Methods Fourteen patients with unresectable LAPC had both CT and PET images acquired. For each patient, two three-dimensional conformal plans were made using the CT and PET-CT fusion data sets. We analyzed differences in treatment plans and doses of radiation to primary tumors and critical organs. Results Changes in GTV delineation were necessary in 5 patients based on PET-CT information. In these patients, the average increase in GTV was 29.7%, due to the incorporation of additional lymph node metastases and extension of the primary tumor beyond that defined by CT. For all patients, the GTVCT versus GTVPET-CT was 92.5 ± 32.3 cm3 versus 104.5 ± 32.6 cm3 (p = 0.009). Toxicity analysis revealed no clinically significant differences between two plans with regard to doses to critical organs. Conclusion Co-registration of PET and CT information in unresectable LAPC may improve the delineation of GTV and theoretically reduce the likelihood of geographic misses.</p

Le taux de fécondité totale dans le mariage et ses extensions

What we will call the age-based TMFR is computed conventionally by adding up age-specific marital fertility rates in the hope of estimating the number of children ever born to a woman who is married throughout her childbearing years. Demographers have long been strongly skeptical about this quantity because it normally indicates implausibly many children. Our analysis of data from the Romanian GGS confirms this finding, and we propose an alternative duration-based TMFR computed in the spirit of parity-progression ratios. At the same time, we extend the method to cover any type of living arrangement (cohabitation, marriage, non-partnered arrangement, and so on). Because each resulting total union-type fertility rate (TUFR) explicitly accounts for the living arrangement, it improves on the conventional total fertility rate (TFR), which does not. We embed the investigation in an event-history analysis with fixed and time-varying control covariates and find patterns of relative risks for such variables that reveal interesting features of childbearing behavior in the Romanian data, which we use to illustrate the method. In most cases, these patterns are quite robust against model re-specification, including the shift from the age-based to the duration-based approach. Since, the number of female respondents is “only” about 6,000 (minus records that cannot be used for the current purpose) in a normal single-round GGS, there is considerable inherent random variation in the data set, but we show that simple few-term moving average graduation suffices to overcome this problem.Le taux de fécondité totale en mariage (TFTM) selon l’âge est calculé par convention en sommant les taux de fécondité par âge dans le mariage en vue d’obtenir une estimation du nombre total d’enfants nés d’une femme qui aurait été mariée tout au long de sa vie reproductive. Depuis longtemps les démographes considèrent cette mesure avec scepticisme car elle aboutit souvent à un nombre total d’enfants beaucoup trop élevé. Notre analyse des données du EGG roumain confirme cette constatation et nous proposons dès lors, comme alternative, un TFTM selon la durée, dans l’esprit des probabilités d’agrandissement des familles. Par ailleurs, nous étendons la méthode à tous types de situation de couple (cohabitation, mariage, sans partenaire, etc.). Comme le taux de fécondité totale selon le type d’union (TFTU) tient compte explicitement de la situation de couple, il doit être préféré au TFTM qui ne tient pas compte de ce critère. Notre étude est conduite dans le cadre d’une analyse biographique tenant compte de covariables fixes ou dépendantes du temps. Les résultats de l’analyse nous permettent de découvrir des caractéristiques intéressantes de la fécondité roumaine, que nous utilisons pour illustrer la méthode. Dans la plupart des cas, ces caractéristiques sont robustes face à une re-spécification du modèle, notamment le passage de l’approche basée sur l’âge à l’approche tenant compte de la durée. Comme le nombre de répondants à l’enquête EGG à un passage n’est ‘que’ de l’ordre de 6000 (moins les cas qui n’ont pas pu être utilisés pour le présent travail), il existe une fluctuation aléatoire importante dans les données. Nous montrons toutefois qu’un lissage par moyenne mobile à quelques termes seulement nous permet de surmonter cette difficulté

An exploration of available methods and tools to improve the efficiency of systematic review production : a scoping review

Background: Systematic reviews (SRs) are time-consuming and labor-intensive to perform. With the growing number of scientific publications, the SR development process becomes even more laborious. This is problematic because timely SR evidence is essential for decision-making in evidence-based healthcare and policymaking. Numerous methods and tools that accelerate SR development have recently emerged. To date, no scoping review has been conducted to provide a comprehensive summary of methods and ready-to-use tools to improve efficiency in SR production.Objective: To present an overview of primary studies that evaluated the use of ready-to-use applications of tools or review methods to improve efficiency in the review process.Methods: We conducted a scoping review. An information specialist performed a systematic literature search in four databases, supplemented with citation-based and grey literature searching. We included studies reporting the performance of methods and ready-to-use tools for improving efficiency when producing or updating a SR in the health field. We performed dual, independent title and abstract screening, full-text selection, and data extraction. The results were analyzed descriptively and presented narratively.Results: We included 103 studies: 51 studies reported on methods, 54 studies on tools, and 2 studies reported on both methods and tools to make SR production more efficient. A total of 72 studies evaluated the validity (n = 69) or usability (n = 3) of one method (n = 33) or tool (n = 39), and 31 studies performed comparative analyses of different methods (n = 15) or tools (n = 16). 20 studies conducted prospective evaluations in real-time workflows. Most studies evaluated methods or tools that aimed at screening titles and abstracts (n = 42) and literature searching (n = 24), while for other steps of the SR process, only a few studies were found. Regarding the outcomes included, most studies reported on validity outcomes (n = 84), while outcomes such as impact on results (n = 23), time-saving (n = 24), usability (n = 13), and cost-saving (n = 3) were less often evaluated.Conclusion: For title and abstract screening and literature searching, various evaluated methods and tools are available that aim at improving the efficiency of SR production. However, only few studies have addressed the influence of these methods and tools in real-world workflows. Few studies exist that evaluate methods or tools supporting the remaining tasks. Additionally, while validity outcomes are frequently reported, there is a lack of evaluation regarding other outcomes.peer-reviewe

An exploration of available methods and tools to improve the efficiency of systematic review production: a scoping review

Background: Systematic reviews (SRs) are time-consuming and labor-intensive to perform. With the growing number of scientific publications, the SR development process becomes even more laborious. This is problematic because timely SR evidence is essential for decision-making in evidence-based healthcare and policymaking. Numerous methods and tools that accelerate SR development have recently emerged. To date, no scoping review has been conducted to provide a comprehensive summary of methods and ready-to-use tools to improve efficiency in SR production. Objective: To present an overview of primary studies that evaluated the use of ready-to-use applications of tools or review methods to improve efficiency in the review process. Methods: We conducted a scoping review. An information specialist performed a systematic literature search in four databases, supplemented with citation-based and grey literature searching. We included studies reporting the performance of methods and ready-to-use tools for improving efficiency when producing or updating a SR in the health field. We performed dual, independent title and abstract screening, full-text selection, and data extraction. The results were analyzed descriptively and presented narratively. Results: We included 103 studies: 51 studies reported on methods, 54 studies on tools, and 2 studies reported on both methods and tools to make SR production more efficient. A total of 72 studies evaluated the validity (n = 69) or usability (n = 3) of one method (n = 33) or tool (n = 39), and 31 studies performed comparative analyses of different methods (n = 15) or tools (n = 16). 20 studies conducted prospective evaluations in real-time workflows. Most studies evaluated methods or tools that aimed at screening titles and abstracts (n = 42) and literature searching (n = 24), while for other steps of the SR process, only a few studies were found. Regarding the outcomes included, most studies reported on validity outcomes (n = 84), while outcomes such as impact on results (n = 23), time-saving (n = 24), usability (n = 13), and cost-saving (n = 3) were less often evaluated. Conclusion: For title and abstract screening and literature searching, various evaluated methods and tools are available that aim at improving the efficiency of SR production. However, only few studies have addressed the influence of these methods and tools in real-world workflows. Few studies exist that evaluate methods or tools supporting the remaining tasks. Additionally, while validity outcomes are frequently reported, there is a lack of evaluation regarding other outcomes

ŠKOLSKA KLIMA – TEORIJSKA NAČELA I ISTRAŽIVANJE S MOTRIŠTA UČENIKA, NASTAVNIKA I RODITELJA

This paper analyses the quality of the school climate. One of its objectives is to defi ne such basic terms as environment, atmosphere, climate, and selected climate variants, above all the school climate. Attention is also paid to the following fi ve areas of school life, which are of signifi cance: 1) the overall attitude to school and the motivation to study; 2) teachers’ qualities and competence; 3) school rules and discipline in class; 4) the solidarity of the class as a social group; 5) the architectural, aesthetic and hygienic aspects of the school. The paper also seeks to present new practical methods supported by long experience of school climate gained abroad and even by similar experience lately picked up in the Czech Republic. Whereas in Europe and elsewhere school climate is part of basic educational disciplines, in the Czech Republic it is still waiting for recognition as a regular educational and psychological phenomenon. The primary overall aim was to devise a suitable method, i.e. a questionnaire, for the current research. This questionnaire was tested in a quantitative way. It has assisted in judging the quality of five areas of the school climate at a grammar school. One-factor analysis of dispersion revealed differences in pupils, teachers and parents’ judgement of the five areas. A comparison of the average answers given by the three groups of respondents shows that it is the teachers who are most satisfied with all areas of the school climate. Parents appeared to be less content. The biggest dissatisfaction is among pupils. In future, the gained results can become a basis for further research in this area. The long-term goal should be to propose a model for the creation of a positive school climate in the form of practical advice and recommendations for teachers and head teachers. The significance of the present work consists of setting up a survey method and carrying out the actual research.Ovaj rad proučava kvalitetu školske klime. Jedan od njegovih ciljeva jest defi nirati temeljne pojmove, poput okruženja, ozračja, klime, i odabranih inačica klime, posebno školsku klimu. Pozornost se usmjerava na sljedećih pet područja školskoga života koji su, prema mišljenju autorice, značajni: 1) sveukupan stav škole i motivacija za učenje; 2) kvalitete i kompetencije učitelja; 3) školska pravila i razredna disciplina; 4) solidarnost razreda kao društvene skupine; 5) arhitektonski, estetski i higijenski vidovi škole. Ovim se radom žele predstaviti i nove metode poduprte dugim iskustvom vezanim za školsku klimu, a prikupljenim u inozemstvu te sličnim nedavnim iskustvom iz zemlje. Dok je u Europi i drugdje školska klima dio temeljnih obrazovnih disciplina, u Češkoj ona još uvijek čeka na priznanje da se radi o redovnom obrazovnom i psihološkom fenomenu. Glavni cilj cijeloga rada jest pronaći odgovarajuću metodu, odnosno upitnik za provođenje istraživanja. Na ovom je upitniku provedena kvantitativna provjera, a pomogao mi je pri ocjeni kvalitete u pet područja školske klime u jednoj gimnaziji. Disperzivna analiza u jednom čimbeniku otkrila je razlike u ocjenama učenika, nastavnika i roditelja za pet područja. Usporedivši prosječne odgovore tih triju skupina ispitanika, možemo zaključiti da su najzadovoljniji sa svim područjima školske klime nastavnici. Proizašlo je da su roditelji nešto manje zadovoljni. Najveće nezadovoljstvo postoji među učenicima. Dobiveni rezultati mogu u budućnosti biti temelj za daljnje istraživanje u ovome području. Cilj bi trebao biti predložiti model stvaranja pozitivne školske klime u obliku savjeta i preporuka nastavnicima i ravnateljima. Važnost rada sastoji se u izradi metode upitnika i provođenja istraživanja u praksi