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Radiotherapy is an essential postoperative treatment for grade II gliomas. However, comparative dosimetric studies of different radiotherapy plans for grade II gliomas are still lacking. Therefore, we conducted this case series analysis to compare the dosimetric differences among helical tomotherapy (TOMO), volumetric modulated arc therapy (VMAT), and intensity-modulated radiotherapy (IMRT) for grade II gliomas. To achieve that, seven diagnosed postoperative patients with grade II gliomas were analyzed by computed tomography and then planned with TOMO, VMAT, and IMRT. The plan target volume (PTV) prescribed dose was 50 Gy (daily fraction of 2.0 Gy, 5 days/week). The expected treatment efficiency was measured by monitor units (MUs) scoring. Treatment plans of the patients were compared in the quality of target volumes dosage coverage, the efficiency of dosage delivery, and the dosage exposure of normal adjacent organs at risk (OAR). Differences in each method were measured by utilizing the Nonparametric ANOVA. The study shows that TOMO achieved a significantly higher PTV-D98% (doses received by 98% of the PTV volume) than VMAT and IMRT (50.30 ± 0.13 vs 49.21 ± 0.19, p = 0.006; 50.30 ± 0.13 vs 49.78 ± 0.18, p = 0.014), while there was no difference in PTV-D2% (doses received by 2% of the PTV volume). IMRT achieved a conformity index (CI) preferably, and TOMO generated a favorable homogeneity index (HI) (p < 0.05 for both). The MUs were fewer for VMAT than IMRT and TOMO (294 ± 19, 572 ± 24, 317 ± 97, respectively). IMRT achieved better protection for the lens and brain stems. Our case series study indicated that TOMO, VMAT, and IMRT achieved a comparatively good target dosimetric coverage, and most OARs were protected well. IMRT is not inferior to TOMO and VMAT and is still very suitable for treating most grade II glioma patients.

Abstract Background This study is in regard to the comparison of whole brain radiation therapy for synchronous brain metastases with irradiation protecting the hippocampus versus whole brain radiotherapy for sequential brain metastases to boost irradiation in the treatment of brain metastases from small cell lung cancer (SCLC). Therapeutically, they have notably varying dose distributions. Based on theoretical and model studies, it has long been speculated that these modes may result in different prognostic outcomes. We aim to assess the efficacy of tomotherapy in the treatment of SCLC brain metastases while protecting the key functional area, the hippocampus, and minimizing any neurocognitive impairments incurred by radiation. Methods This is a randomized, controlled, prospective study including 102 SCLC patients with brain metastases randomized (1:1) to the experimental (whole brain radiation therapy for synchronous brain metastases with irradiation to protect the hippocampus) or control (whole brain radiotherapy for sequential brain metastases to boost irradiation) group. The sample size is calculated through a single-sided test; 102 participants will be required for the main results to have statistical and clinical significance. We aim to provide clinical trial data support for better prognostic treatment options in patients with SCLC and brain metastases. The clinical trial data include both the primary and secondary outcomes; the primary outcome is the intracranial progression-free survival time after the new technology application. The secondary study outcomes include the assessment of neurological function, the quality of life, and the overall survival rate. Follow-up consultations will be conducted every 2 months. After the final patient completes follow-up, the Statistical Product and Service Solutions software will be used for scientific and rigorous data analysis. Version 1.0 of the protocol was implemented on January 1, 2021; the recruitment process for this clinical trial commenced on April 1, 2021, and will end on March 31, 2024. Discussion The study will provide high-quality clinical evidence to support the efficacy and safety of whole brain radiation therapy for synchronous brain metastases with dose irradiation protecting the hippocampus versus whole brain radiotherapy for sequential brain metastases with push volume irradiation for the treatment of patients who have lung cancer as well as brain metastases. This has not been previously reported. Trial registration This trial is registered with the Chinese Clinical Trial Registry (ChiCTR1900027539; November 17, 2019) (URL: https://www.chictr.org.cn/hvshowproject.aspx?id=20515 ).

Background: This study is in regard to the comparison of whole brain radiation therapy for synchronous brain metastases with irradiation protecting the hippocampus versus whole brain radiotherapy for sequential brain metastases to boost irradiation in the treatment of brain metastases from small cell lung cancer (SCLC). Therapeutically, they have notably varying dose distributions. Based on theoretical and model studies, it has long been speculated that these modes may result in different prognostic outcomes. We aim to assess the efficacy of tomotherapy in the treatment of SCLC brain metastases while protecting the key functional area, the hippocampus, and minimizing any neurocognitive impairments incurred by radiation.Methods: This is a randomized, controlled, prospective study including 102 SCLC patients with brain metastases randomized (1:1) to the experimental (whole brain radiation therapy for synchronous brain metastases with irradiation to protect the hippocampus) or control (whole brain radiotherapy for sequential brain metastases to boost irradiation) group. The sample size is calculated through a single-sided test; 102 participants will be required for the main results to have statistical and clinical significance. We aim to provide clinical trial data support for better prognostic treatment options in patients with SCLC and brain metastases. The clinical trial data include both the primary and secondary outcomes; the primary outcome is the intracranial progression-free survival time after the new technology application. The secondary study outcomes include the assessment of neurological function, the quality of life, and the overall survival rate. Follow-up consultations will be conducted every 2 months. After the final patient completes follow-up, the Statistical Product and Service Solutions software will be used for scientific and rigorous data analysis. Version 1.0 of the protocol was implemented on January 1, 2021; the recruitment process for this clinical trial commenced on April 1, 2021, and will end on March 31, 2024.Discussion: The study will provide high-quality clinical evidence to support the efficacy and safety of whole brain radiation therapy for synchronous brain metastases with dose irradiation protecting the hippocampus versus whole brain radiotherapy for sequential brain metastases with push volume irradiation for the treatment of patients who have lung cancer as well as brain metastases. This has not been previously reported.Trial Registration: This trial is registered with the Chinese Clinical Trial Registry (ChiCTR1900027539; November 17, 2019) (URL: https://www.chictr.org.cn/hvshowproject.aspx?id=20515 ). [ABSTRACT FROM AUTHOR]

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Background: Radiotherapy (RT) provides a modern treatment to enhance the malignant glioma control rate. The purpose of our study was to determine the effect of tumor coverage on disease prognosis and to predict optimal RT plans to achieve a lower normal tissue complication probability (NTCP). Methods: Ten malignant-glioma patients with tumors adjacent to organs at risk (OARs) were collected. The patients were divided into two groups according to adequate coverage or not, and prognosis was analyzed. Then, using intensity-modulated radiation therapy (IMRT), volume-modulated arc therapy (VMAT), and helical tomotherapy (TOMO) to simulate new treatment plans for 10 patients, the advantages of these planning systems were revealed for subsequent prediction of NTCP. Results: The results of clinical analysis indicated that overall survival (p = 0.078) between the adequate and inadequate groups showed no differences, while the adequate group had better recurrence-free survival (p = 0.018) and progression-free survival (p = 0.009). TOMO had better CI (p < 0.001) and also predicted a lower total-irradiated dose to the normal brain (p = 0.001) and a lower NTCP (p = 0.027). Conclusions: The TOMO system provided optimal therapeutic planning, reducing NTCP and achieving better coverage. Combined with the clinical results, our findings suggest that TOMO can make malignant glioma patients close to OARs achieve better disease control. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the dosimetric impact of four different radiotherapy techniques for a case of left-sided breast cancer with Internal Mammary lymph Nodes (IMN) involvement. Materials and methods: To identify the best radiotherapy technique for this patient, four methods were compared: 3D Conformal Radiotherapy (3D-CRT), Volumetric Modulated Arc Therapy (VMAT), Tomotherapy (TOMO) and Intensity Modulated Proton Therapy (IMPT). Patient was treated using deep inspiration breath-hold (DIBH) technique. Prescribed dose was 40.05y in 15 fractions. Plan evaluation was performed on target coverage and dose to the organs-at-risk (OARs) using 3D-CRT as a baseline. Results: TOMO has the most ideal Conformity Index (CI) at 1.139, followed by IMPT at 1.158, VMAT at 0.765, and 3D-CRT at 0.685. Using 3D-CRT as a baseline, VMAT, TOMO and IMPT all showed improved dose coverage. IMPT has the best dose coverage. TOMO has the most ideal homogeneity index (HI) and Conformity Number (CN). Mean heart dose (MHD) is lowest for IMPT at 0.55 Gy and highest for VMAT at 4.79 Gy. V20Gy of left lung is the lowest for IMPT at 11.11%, compared to 17.53% for TOMO, 18.19% for VMAT and 33.33% for 3D-CRT. V5Gy for the contralateral breast ranges from 0.01% in IMPT to 72.32% in TOMO. Conclusion: 3D-CRT compromising target coverage but achieving good OAR sparing for the contralateral right breast, left lung and right lung. Overall, IMPT performed best in terms of target coverage and OAR-sparing. Protons delivered superior target dose coverage and sparing of normal structures for this patient. As dose value parameters are expected to correlate with acute and chronic toxicities, proton therapy should be given due consideration as the preferred technique for the treatment of left-sided breast cancers with IMN involvement. Further studies with more patients can be done to evaluate the effectiveness of proton therapy on acute and chronic toxicities.

Tomo indigenous conflict resolution approach is practiced by the Benč ethnic group and their neighboring communities within the southwestern fringe of Ethiopia. As an indigenous apparatus, the Tomo approach exhibits spirituality through blessing and cursing which are directed against the accused based on complying or contravening the very indigenous dispute management rules and regulations. The objective of this study was exploring the custom through which the studied community deals with conflict by using the indigenous Tomo approach. In pursuit of this objective, the researcher utilized a qualitative approach, particularly phenomenology. In terms of data collection tools, the researcher used key-informant interview with selected Benč ritual leaders, non-participant observation on Tomo adjudication sessions and critical document analysis. Built up on such data sources, the findings of the study discovered five inferences. First, regardless of the fact that Tomo is an indigenous approach owed by Benč communities, none of the Benč neighboring communities make use ofit. Secondly, the majority of cases seen by Tomo institution are issues that deify credible eyewitness and are cumbersome for verification and/or falsification within the mainstream court system. Thirdly, unlike the habitual Tomo practice within the Benč community, contemporary Tomo exhibits two conflicting formality and informality characteristics. Due to its semi-formal nature, contemporary Tomo ritual leaders notify charges against the presumed wrongdoer by sending an invitation letter for the accused to attend the charges against him/her, comparable with formal courts. Contrary to this formality, contemporary Tomo is also characterized by informality due to the fact that verdicts given against the perpetrator are passed through ritual cursing just like the habitual Tomo. Furthermore, identical with the habitual Tomo practice, cursing within contemporary Tomo goes the presumed wrongdoer including his/her family up to some future generations along with those who feast and bury the presumed wrongdoer. Overall, contemporary Tomo has terrifying delinquency deterring outcome along with the accustomed indigenous conflict resolution mechanism features. [ABSTRACT FROM AUTHOR]

The purpose of this study is to identify factors influenced by Organizational Culture within a company, and to find leads on how auditors could use these factors to assess an Organization's culture. The effects of Organizational culture on two factors, staff motivation and ethics, were confirmed. The Total motivation theory, used to evaluate a company's Organizational Culture, was confirmed during the study as matching auditing standards, and allowing the quantification of motivation-related processes, including staff motivation and ethics. Additional findings evidenced the lack of training of auditors over Organizational culture, questioning their ability to provide assurance on the matter. [ABSTRACT FROM AUTHOR]

Abstract: Evaluation of dose-volume histograms from three-dimensional conformal radiation therapy (3D CRT), intensity-modulated radiation therapy (IMRT), and Tomo therapy was conducted. These three modalities are among the diverse treatment systems available for tumor therapy. Three patients who received tumor therapy for a malignant oligodendroglioma in the cranium, nasopharyngeal carcinoma in the cervical neck, and prostate cancer in the pelvis were selected as study subjects. Therapy plans were made for the three patients before dose-volume histograms were obtained. The doses of the gross tumor volume (GTV) and the clinical target volume (CTV) were compared using the dose-volume histograms obtained from the LINAC-based 3D CRT, IMRT planning station (Varian Eclipse-Varian, version 8.1), and Tomo therapy planning station. In addition, the doses of critical organs in the cranium, cervix, and pelvis that should be protected were compared. The GTV was higher when Tomo therapy was used compared to 3D CRT and the LINAC-based IMRT, while the doses of critical organ tissues that required protection were low. These results demonstrated that Tomo therapy satisfied the ultimate goal of radiation therapy more than the other therapies. [Copyright &y& Elsevier]

The article presents the result of a taxonomic study of fishes found in the Tomo river within the Orinoco Basin in Colombia. Tables and details related to the diversity of families, species and the genera for the order of fishes present in the Orinoco Basin, and a taxonomic list including the complete scientific name for each taxon, general information about its distribution, reference to a voucher in a collection and a bibliographic reference are offered.

Wolbachia is an endosymbiont prevalent in arthropods. To maximize its transmission thorough the female germline, Wolbachia induces in infected hosts male-to-female transformation, male killing, parthenogenesis, and cytoplasmic incompatibility, depending on the host species and Wolbachia strain involved. However, the molecular mechanisms underlying these host manipulations by Wolbachia remain largely unknown. The Wolbachia strain wMel, an inhabitant of Drosophila melanogaster, impairs host oogenesis only when transplanted into a heterologous host, for example, Drosophila simulans. We found that egg polarity defects induced by wMel infection in D. simulans can be recapitulated in the natural host D. melanogaster by transgenic overexpression of a variant of the Wolbachia protein Toxic manipulator of oogenesis (TomO), TomO w , in the female germline. RNA immunoprecipitation assays demonstrated that TomO physically associates with orb mRNA, which, as a result, fails to interact with the translation repressor Cup. This leads to precocious translation of Orb, a posterior determinant, and thereby to the misspecification of oocytes and accompanying polarity defects. We propose that the ability of TomO to bind to orb mRNA might provide a means for Wolbachia to enter the oocyte located at the posterior end of the egg chamber, thereby accomplishing secure maternal transmission thorough the female germline.Mel ∆HS , in the female germline. RNA immunoprecipitation assays demonstrated that TomO physically associates with orb mRNA, which, as a result, fails to interact with the translation repressor Cup. This leads to precocious translation of Orb, a posterior determinant, and thereby to the misspecification of oocytes and accompanying polarity defects. We propose that the ability of TomO to bind to orb mRNA might provide a means for Wolbachia to enter the oocyte located at the posterior end of the egg chamber, thereby accomplishing secure maternal transmission thorough the female germline., (© 2018 Wiley Periodicals, Inc.)