EPA-0882 - Prediction of diagnosis of early-onset schizophrenia spectrum disorders using support vector machines

To develop a Support Vector Machine (SVM) algorithm as a predictive tool for diagnostic outcome in patients with FE-EOP, based on clinical and biomedical data at the emergence of the illness.

Feasibility assessment of the interactive use of a Monte Carlo algorithm in treatment planning for intraoperative electron radiation therapy

This work analysed the feasibility of using a fast, customized Monte Carlo (MC) method to perform accurate computation of dose distributions during pre- and intraplanning of intraoperative electron radiation therapy (IOERT) procedures. The MC method that was implemented, which has been integrated into a specific innovative simulation and planning tool, is able to simulate the fate of thousands of particles per second, and it was the aim of this work to determine the level of interactivity that could be achieved. The planning workflow enabled calibration of the imaging and treatment equipment, as well as manipulation of the surgical frame and insertion of the protection shields around the organs at risk and other beam modifiers. In this way, the multidisciplinary team involved in IOERT has all the tools necessary to perform complex MC dosage simulations adapted to their equipment in an efficient and transparent way. To assess the accuracy and reliability of this MC technique, dose distributions for a monoenergetic source were compared with those obtained using a general-purpose software package used widely in medical physics applications. Once accuracy of the underlying simulator was confirmed, a clinical accelerator was modelled and experimental measurements in water were conducted. A comparison was made with the output from the simulator to identify the conditions under which accurate dose estimations could be obtained in less than 3 min, which is the threshold imposed to allow for interactive use of the tool in treatment planning. Finally, a clinically relevant scenario, namely early-stage breast cancer treatment, was simulated with pre- and intraoperative volumes to verify that it was feasible to use the MC tool intraoperatively and to adjust dose delivery based on the simulation output, without compromising accuracy. The workflow provided a satisfactory model of the treatment head and the imaging system, enabling proper configuration of the treatment planning system and providing good accuracy in the dosage simulation.

Advanced morphometric techniques applied to the study of human brain anatomy

El desarrollo de las técnicas de imágenes por resonancia magnética han permitido el estudio y cuantificación, in vivo, de los cambios que ocurren en la morfología cerebral ligados a procesos tales como el neurodesarrollo, el envejecimiento, el aprendizaje o la enfermedad. Un gran número de métodos de morfometría han sido desarrollados con el fin de extraer la información contenida en estas imágenes y traducirla en indicadores de forma o tamaño, tales como el volumen o el grosor cortical; marcadores que son posteriormente empleados para encontrar diferencias estadísticas entre poblaciones de sujetos o realizar correlaciones entre la morfología cerebral y, por ejemplo, la edad o la severidad de determinada enfermedad. A pesar de la amplia variedad de biomarcadores y metodologías de morfometría, muchos estudios sesgan sus hipótesis, y con ello los resultados experimentales, al empleo de un número reducido de biomarcadores o a al uso de una única metodología de procesamiento. Con el presente trabajo se pretende demostrar la importancia del empleo de diversos métodos de morfometría para lograr una mejor caracterización del proceso que se desea estudiar. En el mismo se emplea el análisis de forma para detectar diferencias, tanto globales como locales, en la morfología del tálamo entre pacientes adolescentes con episodios tempranos de psicosis y adolescentes sanos. Los resultados obtenidos demuestran que la diferencia de volumen talámico entre ambas poblaciones de sujetos, previamente descrita en la literatura, se debe a una reducción del volumen de la región anterior-mediodorsal y del núcleo pulvinar del tálamo de los pacientes respecto a los sujetos sanos. Además, se describe el desarrollo de un estudio longitudinal, en sujetos sanos, que emplea simultáneamente distintos biomarcadores para la caracterización y cuantificación de los cambios que ocurren en la morfología de la corteza cerebral durante la adolescencia. A través de este estudio se revela que el proceso de “alisado” que experimenta la corteza cerebral durante la adolescencia es consecuencia de una disminución de la profundidad, ligada a un incremento en el ancho, de los surcos corticales. Finalmente, esta metodología es aplicada, en un diseño transversal, para el estudio de las causas que provocan el decrecimiento tanto del grosor cortical como del índice de girificación en adolescentes con episodios tempranos de psicosis. ABSTRACT The ever evolving sophistication of magnetic resonance image techniques continue to provide new tools to characterize and quantify, in vivo, brain morphologic changes related to neurodevelopment, senescence, learning or disease. The majority of morphometric methods extract shape or size descriptors such as volume, surface area, and cortical thickness from the MRI image. These morphological measurements are commonly entered in statistical analytic approaches for testing between-group differences or for correlations between the morphological measurement and other variables such as age, sex, or disease severity. A wide variety of morphological biomarkers are reported in the literature. Despite this wide range of potentially useful biomarkers and available morphometric methods, the hypotheses and findings of the grand majority of morphological studies are biased because reports assess only one morphometric feature and usually use only one image processing method. Throughout this dissertation biomarkers and image processing strategies are combined to provide innovative and useful morphometric tools for examining brain changes during neurodevelopment. Specifically, a shape analysis technique allowing for a fine-grained assessment of regional thalamic volume in early-onset psychosis patients and healthy comparison subjects is implemented. Results show that disease-related reductions in global thalamic volume, as previously described by other authors, could be particularly driven by a deficit in the anterior-mediodorsal and pulvinar thalamic regions in patients relative to healthy subjects. Furthermore, in healthy adolescents different cortical features are extracted and combined and their interdependency is assessed over time. This study attempts to extend current knowledge of normal brain development, specifically the largely unexplored relationship between changes of distinct cortical morphological measurements during adolescence. This study demonstrates that cortical flattening, present during adolescence, is produced by a combination of age-related increase in sulcal width and decrease in sulcal depth. Finally, this methodology is applied to a cross-sectional study, investigating the mechanisms underlying the decrease in cortical thickness and gyrification observed in psychotic patients with a disease onset during adolescence.

Infrared thermography to quantify the risk of breast cancer.

From the last decades, infrared thermography is quite often associated with things other than clinical medicine. For example, the chemical, automobile, aeronautic industries and civil engineering. However, thermography is where infrared images of the breast are analyzed by board certified thermographers and an abnormal thermogram is reported as the significant risk for the existence of breast tumor (Ng, 2009). Thermography is a painless, noninvasive, no radiation, as well as being cheaper and faster, easier access. The aim of this review was to identify the views of clinicians on the use of thermography for quantifying the risk of breast cancer. We used articles published recently in a reliable database. Thermography has been convicted over the years; it has been labeled by subjective interpretation. Most of the reviewed articles agree that mammography is currently the main examination chosen by doctors for the screening of breast cancer (Acharya et al., 2010; Kennedy et al., 2009). However, several studies have reported promising results for the technique (Wang et al., 2010). Additionally, some authors suggest that thermography is complementary to other diagnostic methods, and that the best strategy for the early detection of breast cancer would be to use them together (Kennedy et al., 2009; Hersh, 2004). The combination of thermal imaging with other tests would increase accuracy, sensitivity and specificity of the evaluation and allow a better quantification of the risk of breast cancer.

Influencia de un programa de ejercicio aeróbico en la calidad de vida de pacientes afectadas por cáncer de mama = Influence of an aerobic exercise program on breast cancer patients’ quality of life

INTRODUCCIÓN Actualmente las supervivientes de cáncer de mama viven durante más tiempo. Sin embargo, los tratamientos utilizados presentan importantes efectos secundarios que afectan y marcan su calidad de vida. Numerosos estudios han mostrado que el ejercicio es una herramienta apta, segura y efectiva reduciendo algunos de estos efectos secundarios y, en suma, mejorando la calidad de vida de estas pacientes, aspecto que presenta al ejercicio físico como una intervención integral para ellas. Por el contrario, se ha observado que las supervivientes de cáncer de mama reducen la cantidad de ejercicio que realizan después de dichos tratamientos. Por ello, el objetivo de este proyecto es examinar los efectos de un programa integral de ejercicio en la calidad de vida y la cantidad de ejercicio físico que realizan las pacientes con cáncer de mama en su tiempo, tras finalizar sus tratamientos. MATERIAL Y MÉTODOS Se diseñó un Ensayo Clínico Aleatorizado. Noventa pacientes diagnosticadas de cáncer de mama en estadios tempranos que habían terminado sus tratamientos de radioterapia y quimioterapia recientemente, fueron reclutadas por la Universidad Politécnica de Madrid, desde enero de 2013 hasta junio de 2014. Las pacientes fueron aleatorizadas tras las mediciones iniciales al grupo control (tratamientos habituales) o grupo intervención, durante tres meses. La intervención consistió en 24 clases de ejercicio combinando práctica aeróbica y de fuerza con el fin de reducir los efectos secundarios de dichos tratamientos. La calidad de vida, la cantidad de ejercicio físico realizado en tiempo de ocio, VO2max, la fuerza, la movilidad articular del hombro, la fatiga, la depresión y la ansiedad fueron medidos al inicio y después de los tres meses en todos los pacientes. RESULTADOS Un total de 89 pacientes con una media de 49.06±8.75 de edad fueron finalmente analizadas. El grupo intervención (n=44) mostraron significativamente mejores resultados en calidad de vida (p=0.0001; d=0.85), cantidad de ejercicio en tiempo de ocio (p=0.0001; d=2.77), en variables de la composición corporal, en variables físicas y en variables psicológicas comparado con el grupo control (n=45). Además, se observó una correlación significativa entre la calidad de vida y el ejercicio realizado en tiempo de ocio en el grupo intervención (r= 0.58; p=0.001), que no fue patente en el grupo control. Se observaron cambios significativos en el grupo de intervención relativos a la composición corporal, con aumento de la masa muscular (p=0.001) y reducción de la masa grasa (p=0.0001). Tanto las variables físicas como psicológicas también mostraron diferencias significativas a favor al grupo de intervención en las comparaciones entre grupos. CONCLUSIONES Según estos resultados, un programa de ejercicio físico específico es una intervención integral que mejora los hábitos y la calidad de vida de las supervivientes de cáncer de mama, lo que reduce determinados efectos secundarios de los tratamientos y aumenta la salud física y psicológica general de estas mujeres. Este tipo de intervenciones pude ser una herramienta barata y efectiva para ofrecer a los pacientes, integrada en los tratamientos habituales. ABSTRACT INTRODUCTION It is well known that breast cancer survivors are living longer. However, breast cancer treatments present serious side effects, which could affect breast cancer survivors’ (BCS) health and quality of life (QoL). Exercise has been presented as a feasible, safe and effective tool in reducing some of these side effects and to improve survivors’ QoL, acting as an integrative treatment for them, although it has been observed that BCS reduce their leisure time exercise (LTE) levels. Therefore, the aim of this study was to examine the effects of an integrative exercise program in QoL and LTE in BCS after the completion of their adjuvant treatment. MATERIAL AND METHODS A randomized controlled trial (RCT) was designed. Ninety patients diagnosed with an early stage of breast cancer and who recently finished chemotherapy and radiotherapy treatments were recruited by the Technical University of Madrid from January 2013 to June 2014. Patients were randomized after baseline assessments to the intervention group (IG) or to the control group (CG) (usual care) for three months. The Intervention consisted in 24 supervised exercise classes, combining aerobic and resistance exercises in order to reduce the most common side effects of the treatments. QoL, LTE, body composition, VO2max, strength, shoulder range of motion, fatigue, depression and self-esteem were measured in all the patients at baseline and after three months. RESULTS A total of 89 patients aged 49.06±8.75 years were finally assessed. IG (n=44) showed significant better results in QoL (p=0.0001; d=0.85), LTE (p=0.0001; d=2.77), in body composition, in the physical variable and in psychological outcomes, compared with the CG (n=45). In addition, a correlation between QoL and LTE (r= 0.58; p=0.001) was found in the IG, while CG did not show this correlation. Significant changes in body composition were observed in the group comparisons, especially in lean mass (p=0.001) and body fat mass (p= 0.0001). Positive changes were also observed in the physical and psychological variables in comparisons between groups. CONCLUSIONS These results suggest that this exercise program may be an integrative intervention, which is able to improve QoL and LTE levels in breast cancer survivors, reducing breast cancer side effects of treatments and improving their physical and psychological general health. Exercise may be an effective and inexpensive strategy to be included in patients integrative care.

Sensitive detection of major food allergens in breast milk: first gateway for allergenic contact during breastfeeding

Food allergy is recognized as a major public health issue, especially in early childhood. It has been hypothesized that early sensitization to food allergens maybe due to their ingestion as components dissolved in the milk during the breastfeeding, explaining reaction to a food, which has never been taken before. Thus, the aim of this work has been to detect the presence of the food allergens in breast milk by microarray technology. We produced a homemade microarray with antibodies produced against major food allergens. The antibody microarray was incubated with breast milk from 14 women collected from Fundación Jiménez Díaz Hospital. In this way, we demonstrated the presence of major foods allergens in breast milk. The analysis of allergens presented in breast milk could be a useful tool in allergy prevention and could provide us a key data on the role of this feeding in tolerance induction or sensitization in children.