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In cellular models, animal studies, and human feeding studies, glycomacropeptide (GMP) has a range of immunomodulatory bioactivities, including altering cytokine gene expression and production. Direct immunomodulation by GMP is primarily attributed to its interactions with key innate inflammatory pathways, specifically activated B cells (NF-κB) and mitogen-activated protein kinase (MAPK) signaling. Additionally, GMP indirectly modulates immune responses by inhibiting the adhesion of pathogenic bacteria and toxins. Some studies indicate that the sialic acid component of GMP is essential for GMP’s immunoregulatory activity and that GMP can function as a prebiotic. Though some studies incorporate digestion, many studies apply intact GMP directly to cell cultures, limiting the translational significance of these findings toward understanding GMP’s potential as an ingredient in functional foods. This review details GMP’s immunological effects as observed across cellular, animal and human studies, with a particular focus on the modulation of cytokine production and the various mechanisms underlying GMP's immunomodulatory actions.

Recent outbreaks of pertussis have highlighted the importance of surveillance of vaccine-preventable diseases. Here, the authors performed a cross-sectional seroprevalence study of pertussis, diphtheria, and tetanus in Europe and found evidence of circulation of pertussis in middle-aged adults.

β-Hydroxy-β-methylbutyrate (HMB), a leucine metabolite, can increase skeletal muscle size and function. However, HMB may be less effective at improving muscle function in people with insufficient Vitamin D3 (25-OH-D < 30 ng/mL) which is common in middle-aged and older adults. Therefore, we tested the hypothesis that combining HMB plus Vitamin D3 (HMB + D) supplementation would improve skeletal muscle size, composition, and function in middle-aged women. In a double-blinded fashion, women (53 ± 1 yrs, 26 ± 1 kg/m2, n = 43) were randomized to take placebo or HMB + D (3 g Calcium HMB + 2000 IU D per day) during 12 weeks of sedentary behavior (SED) or resistance exercise training (RET). On average, participants entered the study Vitamin D3 insufficient while HMB + D increased 25-OH-D to sufficient levels after 8 and 12 weeks. In SED, HMB + D prevented the loss of arm lean mass observed with placebo. HMB + D increased muscle volume and decreased intermuscular adipose tissue (IMAT) volume in the thigh compared to placebo but did not change muscle function. In RET, 12-weeks of HMB + D decreased IMAT compared to placebo but did not influence the increase in skeletal muscle volume or function. In summary, HMB + D decreased IMAT independent of exercise status and may prevent the loss or increase muscle size in a small cohort of sedentary middle-aged women. These results lend support to conduct a longer duration study with greater sample size to determine the validity of the observed positive effects of HMB + D on IMAT and skeletal muscle in a small cohort of middle-aged women.

Background: The optimal radiotherapy technique for cardiac sparing in left-sided early breast cancer (EBC) is not clear. In this context, the aim of our dosimetric study was to compare cardiac and lung doses according to the type of radiotherapy -- whole breast irradiation (WBI), external partial breast irradiation (PBI), and multicatheter interstitial brachytherapy-accelerated partial breast irradiation (MIB-APBI). The dosimetric results with the WBI and PBI were calculated with and without DIBH. Materials and methods: Dosimetric study of 23 patients treated with WBI, PBI, with and without DIBH, or MIB-APBI. The prescribed dose was 40 Gy in 15 fractions for WBI and PBI and 34 Gy in 10 fractions (bid) for MIB-APBI. Doses to the organs-at-risk (OAR) -- heart, left anterior descending coronary artery (LAD), left ventricle (LV), and left lung -- were recalculated to the equivalent dose in 2-Gy fractions (EQD2). Results: The addition of DIBH significantly reduced EQD2 doses to all OARs (except for the left lung maximal dose) in WBI and PBI. MHD values were 0.72 Gy for DIBH-WBI, 1.01 Gy for MIB-APBI and 0.24 Gy for DIBH-PBI. There were no significant differences in cardiac doses between WBI with DIBH and PBI without DIBH. DIBH-PBI resulted in significantly lower mean doses to all OARs (except for maximum lung dose) compared to MIB-APBI. Conclusions: These results show that the use of DIBH significantly reduces cardiac doses in patients with left EBC. Partial irradiation techniques (PBI, MIB-APBI) significantly reduced cardiac doses due to the smaller clinical target volume. The best results were obtained with DIBH-PBI. [ABSTRACT FROM AUTHOR]

Better understanding of combustion process in large scale pulverized coal boilers can help with increasing of coal combustion efficiency and decreasing of pollutant emissions, such as nitrogen oxides and arguable carbon dioxide. This improvement cannot be performed without testing in laboratory conditions. For this purpose, a new testing facility called the drop tube has been built in the Energy Research Center (ERC) of VSB-Technical University of Ostrava. This paper describes the methodology of pulverized coal thermo-kinetic properties determination with the use of the Drop Tube Test Facility and the first steps in improvement of this methodology. There is a new design of the sampling probe, an improved one, gas-tight double-wall design, implemented into the methodology lately. The intermediate space is vacuumed for the purpose of better isolating properties of the probe. Further, the probe is newly supplemented with a cryogenic control valve for smooth regulation of small flow rates of cooling media - liquid nitrogen. These innovations bring cooling media savings, especially thanks to increased efficiency of this media’s cooling potential. Furthermore, smoother regulation allows a sample cooling in an accurately defined point.

Purpose: This study aimed to evaluate prostate volume changes and prostate motions during radiotherapy. Methods: In 2010, twenty-five patients were treated for prostate cancer by external beam radiotherapy with implanted fiducial markers. Coordinates of three gold markers on kilovoltage images were calculated daily. Volume changes in target structure were observed through changes in intermarker distances. Differences in patient position between laser-tattoo alignment and gold marker localization were evaluated. Intrafraction motion was assessed by measuring marker displacement on kilovoltage images acquired before and after fraction delivery. Results: Prostate shrinkage was observed in 60% of patients. The average shrinkage was 7% of the prostate’s initial volume. Corrections after laser-tattoo alignment remained mostly below 1 cm. The difference between marker centroid position on the actual images and the planning images was 2 ± 1 mm on average. The extension of intrafraction movements was 7.6 ± 0.2 mm on average. Conclusions: In our retrospective study, the possibility for prostate volume changes during radiotherapy was revealed. Intrafraction movements turned out to be the limiting factor in safety margin reduction.

Acute toxicity has been evaluated in head and neck cancer patients treated with intensity-modulated radiotherapy using simultaneous integrated boost (SIB-IMRT). The basis of the treatment protocol is an irradiation in 30 fractions with a total dose: 66 Gy to the region of macroscopic tumor, 60 Gy to the region of high-risk subclinical disease and 54 Gy to the region of low-risk subclinical disease. Between December 2003 and September 2005, 38 patients with carcinoma of different locations in the head and neck region were irradiated. Five patients underwent concurrent chemotherapy (weekly cisplatin). Acute toxicity was evaluated according to Radiation Therapy Oncology Group toxicity scale for skin, mucous membrane, salivary glands, pharynx and esophagus and larynx. All 38 patients completed the therapy without urgency of interruption due to acute toxicity of radiotherapy. No patient experienced grade 4 toxicity. More severe toxicity was observed in patients with concurrent chemotherapy. The results confirm that the irradiation according to our SIB-IMRT protocol is a therapy with acceptable toxicity and there is a space for radiobiological enhancement of this regimen by concurrent chemotherapy, e.g. weekly cisplatin.

Background: The purpose of this work is to improve a sweeping beam technique for total body irradiation (TBI) on a low flat couch using a varying patient thickness model. We designed a flat couch for total body irradiation in supine and prone position. Three generic arcs with rectangular segments for a patient torso thickness of 16, 22 and 28 cm were generated with respect to varying patient thickness of four particular parts of the body: head, torso, thighs and calves. Materials and methods: Longitudinal and transversal dose profiles were measured using an ionization chamber and the EBT3 gafchromic film in a solid water slab phantom. The robustness of the method was examined in phantoms of different thicknesses. Results: Measured dose homogeneity stays within ±10% of prescribed dose for all of the three patient thickness models. The robustness of the method was evaluated as the increase in dose in the phantom center of 0.7% per 1 cm reduction in phantom thickness. Conclusion: The method is applicable for the broad range of patient sizes, comfortable for patients, robust and suitable for standard treatment rooms with a standard linear accelerator. It requires minimal investments into equipment. [ABSTRACT FROM AUTHOR]

[Display omitted] • Glycomacropeptide (GMP) has primarily been found to modulate innate inflammatory signaling. • Most inflammatory signaling is decreased by GMP. • The initial steps in several mechanisms by which GMP modulates inflammation are unknown. • Research on the effects of GMP consumption in human subjects has yielded little change. In cellular models, animal studies, and human feeding studies, glycomacropeptide (GMP) has a range of immunomodulatory bioactivities, including altering cytokine gene expression and production. Direct immunomodulation by GMP is primarily attributed to its interactions with key innate inflammatory pathways, specifically activated B cells (NF-κB) and mitogen-activated protein kinase (MAPK) signaling. Additionally, GMP indirectly modulates immune responses by inhibiting the adhesion of pathogenic bacteria and toxins. Some studies indicate that the sialic acid component of GMP is essential for GMP's immunoregulatory activity and that GMP can function as a prebiotic. Though some studies incorporate digestion, many studies apply intact GMP directly to cell cultures, limiting the translational significance of these findings toward understanding GMP's potential as an ingredient in functional foods. This review details GMP's immunological effects as observed across cellular, animal and human studies, with a particular focus on the modulation of cytokine production and the various mechanisms underlying GMP's immunomodulatory actions. [ABSTRACT FROM AUTHOR]

With a development of radiotherapeutic techniques, availability of radiotherapy data on cardiotoxicity, and slowly improving esophageal cancer outcomes, an increasing emphasis is placed on the heart protection in radiation treated esophageal cancer patients. Radiation induced heart complications encompass mainly pericardial disease, cardiomyopathy, coronary artery atherosclerosis, valvular heart disease, and arrhythmias. The most frequent toxicity is pericardial effusion which is usually asymptomatic in the majority of patients. The use of modern radiotherapy techniques is expected to reduce the risk of cardiotoxicity, although this expectation has to be confirmed by clinical data. [ABSTRACT FROM AUTHOR]

Abstract Aim To evaluate calculation of treatment plans based on synthetic-CT (sCT) images generated from MRI. Background Because of better soft tissue contrast, MR images are used in addition to CT images for radiotherapy planning. However, registration of CT and MR images or repositioning between scanning sessions introduce systematic errors, hence suggestions for MRI-only therapy. The lack of information on electron density necessary for dose calculation leads to sCT (synthetic CT) generation. This work presents a comparison of dose distribution calculated on standard CT and sCT. Materials and methods 10 prostate patients were included in this study. CT and MR images were collected for each patient and then water equivalent (WE) and MRCAT images were generated. The radiation plans were optimized on CT and then recalculated on MRCAT and WE data. 2D gamma analysis was also performed. Results The mean differences in the majority of investigated DVH points were in order of 1% up to 10%, including both MRCAT and WE dose distributions. Mean gamma pass for acceptance criteria 1%/1 mm were greater than 82.5%. Prescribed doses for target volumes and acceptable doses for organs at risk were met in almost all cases. Conclusions The dose calculation accuracy on MRCAT was not significantly compromised in the majority of clinical relevant DVH points. The introduction of MRCAT into practise would eliminate systematic errors, increase patients' comfort and reduce treatment expenses. Institutions interested in MRCAT commissioning must, however, consider changes to established workflow. [ABSTRACT FROM AUTHOR]

• MRI-based adaptive radiotherapy has the potential to reduce dysphagia. • Deformable image registration is a valuable tool for head and neck adaptive radiotherapy. • Quality of life of patients with head and neck cancer is associated with dysphagia. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To assess target volume coverage during prostate image-guided radiotherapy based on bony anatomy alignment and to assess possibility of safety margin reduction. Background: Implementation of IGRT should influence safety margins. Utilization of cone-beam CT provides current 3D anatomic information directly in irradiation position. Such information enables reconstruction of the actual dose distribution. Materials and methods: Seventeen prostate patients were treated with daily bony anatomy image-guidance. Cone-beam CT (CBCT) scans were acquired once a week immediately after bony anatomy alignment. After the prostate, seminal vesicles, rectum and bladder were contoured, the delivered dose distribution was reconstructed. Target dose coverage was evaluated by the proportion of the CTV encompassed by the 95% isodose. Original plans employed a 1cm safety margin. Alternative plans assuming a smaller 7mm margin between CTV and PTV were evaluated in the same way. Rectal and bladder volumes were compared with the initial ones. Rectal and bladder volumes irradiated with doses higher than 75Gy, 70Gy, 60Gy, 50Gy and 40Gy were analyzed. Results: In 12% of reconstructed plans the prostate coverage was not sufficient. The prostate underdosage was observed in 5 patients. Coverage of seminal vesicles was not satisfactory in 3% of plans. Most of the target underdosage corresponded to excessive rectal or bladder filling. Evaluation of alternative plans assuming a smaller 7mm margin revealed 22% and 11% of plans where prostate and seminal vesicles coverage, respectively, was compromised. These were distributed over 8 and 7 patients, respectively. Conclusion: Sufficient dose coverage of target volumes was not achieved for all patients. Reducing of safety margin is not acceptable. Initial rectal and bladder volumes cannot be considered representative for subsequent treatment. [Copyright &y& Elsevier]

Abstract: Background: Low-dose rate brachytherapy is a well established treatment modality of oral cancer. Data about high-dose rate (HDR) brachytherapy are still sparse with various fractionation schedules and heterogeneous results. Aim: The aim of our retrospective study was to evaluate the results of HDR brachytherapy with doses of 3Gy twice daily. Patients and methods: Twenty patients with squamous cell tongue cancer were treated in the years 2001–2009 by exclusive HDR BT 18×3Gy twice daily. The plastic tube technique was used. Median follow up was 47 months (7.8–118) since brachytherapy. Results: The local and locoregional control was 85% and 68%, respectively. Bone necrosis developed in one case treated without mandibular shielding and soft tissue necrosis in 2 cases. Conclusion: It can be concluded that HDR brachytherapy with 18×3Gy twice daily is safe with promising local control. The risk of nodal recurrences is substantial. [Copyright &y& Elsevier]

Abstract: We present ChunkStream, a system for efficient streaming and interactive editing of online video. Rather than using a specialized protocol and stream format, ChunkStream makes use of a generic mechanism employing chunks. Chunks are fixed-size arrays that contain a mixture of scalar data and references to other chunks. Chunks allow programmers to expose large, but fine-grained, data structures over the network. ChunkStream represents video clips using simple data types like linked lists and search trees, allowing a client to retrieve and work with only the portions of the clips that it needs. ChunkStream supports resource-adaptive playback and “live” streaming of real-time video as well as fast, frame-accurate seeking; bandwidth-efficient high-speed playback; and compilation of editing decisions from a set of clips. Benchmarks indicate that ChunkStream uses less bandwidth than HTTP Live Streaming while providing better support for editing primitives. [ABSTRACT FROM AUTHOR]

Abstract: We present a middleware platform for assembling pervasive applications that demand fault-tolerance and adaptivity in distributed, dynamic environments. Unlike typical adaptive middleware approaches, in which sophisticated component model semantics are embedded into an existing, underlying platform (e.g., CORBA, COM, EJB), we propose a platform that imposes minimal constraints for greater flexibility. Such a tradeoff is advantageous when the platform is targeted by automatic code generators that inherently enforce correctness by construction. Applications are written as simple, single-threaded programs that assemble and monitor a set of distributed components. The approach decomposes applications into two distinct layers: (1) a distributed network of interconnected modules performing computations, and (2) constructor logic that assembles that network via a simple block-diagram construction API. The constructor logic subsequently monitors the configured system via a stream of high-level events, such as notifications of resource availability or failures, and consequently provides a convenient, centralized location for reconfiguration and debugging. The component network is optimized for performance, while the construction API is optimized for ease of assembly. Microbenchmarks indicate that our runtime incurs minimal overhead. In addition to describing the programming model, platform implementation, and a variety of pervasive applications built using our system, this paper also extends our previous work with a thorough analysis of remote objects and tracking techniques, new contributions in distributed component liveness-monitoring approaches, and expanded microbenchmarks. [Copyright &y& Elsevier]

Abstract: We describe an approach to automate certain high-level implementation decisions in a pervasive application, allowing them to be postponed until runtime. Our system enables a model in which an application programmer can specify the behavior of an adaptive application as a set of open-ended decision points. We formalize decision points as Goals, each of which may be satisfied by a set of scripts called Techniques. The set of Techniques vying to satisfy any Goal is additive and may be extended at runtime without needing to modify or remove any existing Techniques. Our system provides a framework in which Techniques may compete and interoperate at runtime in order to maintain an adaptive application. Technique development may be distributed and incremental, providing a path for the decentralized evolution of applications. Benchmarks show that our system imposes reasonable overhead during application startup and adaptation. [Copyright &y& Elsevier]

Summary: Aim: To evaluate the toxicity of intensity-modulated radiotherapy with simultaneous integrated boost (SIB-IMRT) in head and neck cancer patients treated using a protocol comprising 66 Gy to the PTV1 (planning target volume; region of macroscopic tumour) and 60 Gy and 54 Gy to the regions with high risk (PTV2) and low risk (PTV3) of subclinical disease in 30 fractions in six weeks. Material and Methods: Between December 2003 and February 2006, 48 patients (median age 55; range 25–83, performance status 0–1) with evaluable non-metastatic head and neck cancer of various localizations and stages (stages: I–1; II–8; III–12; IV–27 patients, resp.) were irradiated according to the protocol and followed (median follow-up 20 months; range 4–42). Ten patients underwent concurrent chemotherapy (CT) and in 15 patients the regimen was indicated postoperatively because of close or positive margins. In all cases the regimen was used as an alternative to conventional radiotherapy (70 Gy in 7 weeks). The acute and late toxicities were evaluated according to RTOG and RTOG/EORTC toxicity scales, respectively. Results: All patients finished the treatment without the need for interruption due to acute toxicity. No patient experienced grade 4 toxicity. More severe acute toxicity was observed in patients with CT, but the most severe toxicity was grade 3. Grade 3 toxicity was observed in the skin, mucous membrane, salivary glands, pharynx/oesophagus and larynx in 8.4%, 35.4%, 39.6% and 2.1%, in the CT subgroup in 10%, 100%, 90%, 10%, respectively. The trend of impairment of acute toxicity by concurrent chemotherapy was statistically confirmed by Fisher''s exact test (for mucous membranes p=0.000002 and pharyngeal/oesophageal toxicity p=0.0004). The most severe late toxicity was grade 2 subcutaneous tissue (34.2%), mucous membrane (36.8%) and larynx (11.1%), grade 3 in salivary gland (2.6%) and grade 1 in skin (84.2%) and spinal cord (5.4%). The late toxicity was not increased by chemotherapy. Conclusion: In light of the toxicity profile we consider the presented regimen to be an alternative to conventional radiotherapy 70 Gy in 7 weeks. The addition of CT requires more intensive supportive care. [Copyright &y& Elsevier]

The larynx and surrounding soft tissues are vulnerable to injury during athletics despite protective equipment and rule modifications. Laryngeal injuries are uncommon but potentially fatal conditions that pose risks to the voice, airway, and esophagus of athletes who sustain blunt or penetrating neck trauma. Common symptoms and signs of laryngeal trauma include hoarseness, dyspnea, hemoptysis, dysphonia, respiratory distress, anterior neck tenderness, subcutaneous emphysema, and loss of normal laryngeal architecture. Diagnostic evaluation includes plain radiographs, computed tomography, and fibroscopic ertdoscopy. Most athletes with laryngeal injuries will require surgical treatment to restore normal regional anatomy and vocal quality. Less severe injuries may be treated with close observation, serial endoscopy, medications, and vocal rest. [ABSTRACT FROM AUTHOR]