High dose bystander effects in spatially fractionated radiation therapy

Traditional radiotherapy of bulky tumors has certain limitations. Spatially fractionated radiation therapy (GRID) and intensity modulated radiotherapy (IMRT) are examples of advanced modulated beam therapies that help in significant reductions in normal tissue damage. GRID refers to the delivery of a single high dose of radiation to a large treatment area that is divided into several smaller fields, while IMRT allows improved dose conformity to the tumor target compared to conventional three-dimensional conformal radiotherapy. In this review, we consider spatially fractionated radiotherapy approaches focusing on GRID and IMRT, and present complementary evidence from different studies which support the role of radiation induced signaling effects in the overall radiobiological rationale for these treatments.

A population-based study of adverse physical effects following prostate cancer treatments: Results from the PiCTure (Prostate cancer treatment – your experience) study

Background:

Men and clinicians need reliable population based information when making decisions about investigation and treatment of prostate cancer. In the absence of clearly preferred treatments, differences in outcomes become more important.

Aim:

To investigate rates of adverse physical effects among prostate cancer survivors 2-15 years post diagnosis by treatment, and estimate population burden.

Methods:

A cross sectional, postal survey to 6,559 survivors (all ages) diagnosed with primary, invasive prostate cancer (ICD10-C61), identified in Northern Ireland and the Republic of Ireland via cancer registries. Questions included symptoms at diagnosis, treatments received and adverse physical effects (impotence, urinary incontinence, bowel problems, breast changes, libido loss, hot flashes, fatigue) experienced ‘ever’ and ‘current’ i.e. at questionnaire completion. Physical effect levels were weighted by age, country and time since diagnosis for all prostate cancer survivors. Bonferroni corrections were applied to account for multiple comparisons.

Results:

Adjusted response rate 54%, (n=3,348). 75% reported at least one current physical effect (90% ever), with 29% reporting at least three. These varied by treatment. Current impotence was reported by 76% post-prostatectomy, 64% post-external beam radiotherapy with hormone therapy, with average for all survivors of 57%. Urinary incontinence (overall current level: 16%) was highest post-prostatectomy (current 28%, ever 70%). 42% of brachytherapy patients reported no current adverse physical effects; however 43% reported current impotence and 8% current incontinence. Current hot flashes (41%), breast changes (18%) and fatigue (28%) were reported more commonly by patients on hormone therapy.

Conclusions:

This study provides evidence that adverse physical effects following prostate cancer represent a significant public health burden; an estimated 1.6% of men over 45 is a prostate cancer survivor with a current adverse physical effect. This information should facilitate investigation and treatment decision-making and follow-up care of patients.

Rapid Oscillations in the Solar Atmosphere: Spectra and Physical Effects

High-frequency fluctuations are observed with the Rapid Oscillations in the Solar Atmosphere (ROSA) instrument (Jess et al. 2010, Solar Phys, 261, 363) at the Dunn Solar Telescope. This can produce simultaneous observations in up to six channels, at different heights in the photosphere and chromosphere, at an unprecedentedly high cadence of 0.5 seconds, and at a spatial resolution of 100 km after photometrically correct speckle reconstruction. Here we concentrate on observations at two levels. The first is in the G-band of the CH radical at 4305.5Å, bandpass 9.2Å, with height of formation z <250 km at a cadence of 0.525 sec corresponding to Nyquist frequency 950 mHz. The second is in the Ca II K-line core at 3933.7Å, bandpass 1.0Å, with height of formation z <1300 km, and cadence 4.2 sec giving Nyquist frequency 120 mHz. The data span 53 min, and the maximum field of view is 45 Mm. The data were taken on 28 May 2009 in internetwork and network near disk center. Using both Fourier and Morlet wavelet methods we find evidence in the G-band spectra for intensity fluctuations above noise out to frequencies f >> 100 mHz. The K-line signal is noisier and is seen only for f <50 mHz. With wavelet techniques we find that G-band spectral power with 20 <f <100 mHz is clearly concentrated in the intergranular lanes and especially at the locations of magnetic elements indicated by G-band bright points. This wavelet power is highly intermittent in time. By cross-correlating the data we find that pulses of high-frequency G-band power in the photosphere tend to be followed by increases in K-line emission in the chromosphere with a time lag of about 2 min.

Radiation responses of stem cells: targeted and not-targeted effects

Stem cells are fundamental to the development of any tissue or organism via their ability to self-renew, which is aided by their unlimited proliferative capacity and their ability to produce fully differentiated offspring, often from multiple lineages. Stems cells are long lived and have the potential to accumulate mutations, including in response to radiation exposure. It is thought that stem cells have the potential to be induced into a cancer stem cell phenotype and that these may play an important role in resistance to radiotherapy. For radiation-induced carcinogenesis, the role of targeted and non-targeted effects is unclear with tissue or origin being important. Studies of genomic instability and bystander responses have shown consistent effects in haematopoietic models. Several models of radiation have predicted that stem cells play an important role in tumour initiation and that bystander responses could play a role in proliferation and self-renewal.

Cellular signalling effects in high precision radiotherapy

Radiotherapy is commonly planned on the basis of physical dose received by the tumour and surrounding normal tissue, with margins added to address the possibility of geometric miss. However, recent experimental evidence suggests that intercellular signalling results in a given cell's survival also depending on the dose received by neighbouring cells. A model of radiation-induced cell killing and signalling was used to analyse how this effect depends on dose and margin choices. Effective Uniform Doses were calculated for model tumours in both idealised cases with no delivery uncertainty and more realistic cases incorporating geometric uncertainty. In highly conformal irradiation, a lack of signalling from outside the target leads to reduced target cell killing, equivalent to under-dosing by up to 10% compared to large uniform fields. This effect is significantly reduced when higher doses per fraction are considered, both increasing the level of cell killing and reducing margin sensitivity. These effects may limit the achievable biological precision of techniques such as stereotactic radiotherapy even in the absence of geometric uncertainties, although it is predicted that larger fraction sizes reduce the relative contribution of cell signalling driven effects. These observations may contribute to understanding the efficacy of hypo-fractionated radiotherapy.

Using Process Algebra to Model Radiation Induced Bystander Effects

Radiation induced bystander effects are secondary effects caused by the production of chemical signals by cells in response to radiation. We present a Bio-PEPA model which builds on previous modelling work in this field to predict: the surviving fraction of cells in response to radiation, the relative proportion of cell death caused by bystander signalling, the risk of non-lethal damage and the probability of observing bystander signalling for a given dose. This work provides the foundation for modelling bystander effects caused by biologically realistic dose distributions, with implications for cancer therapies.

Protein disulphide isomerase as a target for nanoparticle-mediated sensitisation of cancer cells to radiation

Radiation resistance and toxicity in normal tissues are limiting factors in the efficacy of radiotherapy. Gold nanoparticles (GNPs) have been shown to be effective at enhancing radiation-induced cell death, and were initially proposed to physically enhance the radiation dose deposited. However, biological responses of GNP radiosensitization based on physical assumptions alone are not predictive of radiosensitisation and therefore there is a fundamental research need to determine biological mechanisms of response to GNPs alone and in combination with ionising radiation. This study aimed to identify novel mechanisms of cancer cell radiosensitisation through the use of GNPs, focusing on their ability to induce cellular oxidative stress and disrupt mitochondrial function. Using N-acetyl-cysteine, we found mitochondrial oxidation to be a key event prior to radiation for the radiosensitisation of cancer cells and suggests the overall cellular effects of GNP radiosensitisation are a result of their interaction with protein disulphide isomerase (PDI). This investigation identifies PDI and mitochondrial oxidation as novel targets for radiosensitisation.

Fuzzy modelling of prescribed burning effects on soil physical properties

This paper presents the preliminary work of an approach where Fuzzy Boolean Nets (FBN) are being used to extract qualitative knowledge regarding the effect of prescribed fire burning on soil chemical physical properties. FBN were chosen due to the scarcity on available quantitative data.

Potential Therapeutic Effects of Physical Exercise for Bipolar Disorder

Cognitive deficits are observed in a variety of domains in patients with bipolar disorder (BD). These deficits are attributed to neurobiological, functional and structural brain factors, particularly in prefrontal cortex. Furthermore, cortical alterations in each phase (mania/hypomania, euthymia and depression) are also present. A growing basis of evidence supports aerobic exercise as an alternative treatment method for BD symptoms. Its benefits for physical health in healthy subjects and some psychiatric disorders are fairly established; however evidence directly addressed to BD is scant. Lack of methodological consistency, mainly related to exercise, makes it difficult accuracy and extrapolation of the results. Nevertheless, mechanisms related to BD physiopathology, such as hormonal and neurotransmitters alterations and mainly related to brain-derived neurotrophic factors (BDNF) can be explored. BDNF, specially, have a large influence on brain ability and its gene expression is highly responsive to aerobic exercise. Moreover, aerobic exercise trough BDNF may induce chronic stress suppression, commonly observed in patients with BD, and reduce deleterious effects caused by allostatic loads. Therefore, it is prudent to propose that aerobic exercise plays an important role in BD physiopathological mechanisms and it is a new way for the treatment for this and others psychiatric disorders.

Effects of microcurrents and physical exercise on the abdominal fat in patients with coronary artery disease

Introduction Coronary artery disease is associated with decreased levels of physical activity, contributing to increases in abdominal fat and consequently increasing metabolic risk. The innovative use of microcurrents may be an effective method to increase the lipolytic rate of abdominal adipocytes. This study aimed to investigate the effects of utilizing microcurrents in a home-based exercise program in subjects with coronary artery disease to assess changes in total, subcutaneous and visceral abdominal adipose tissue. Methods This controlled trial included 44 subjects with myocardial infarction, randomly divided into Intervention Group 1 (IG1; n = 16), Intervention Group 2 (IG2; n = 12) and Control Group (CG; n = 16). IG1 performed a specific exercise program at home during 8 weeks, and IG2 additionally used microcurrents on the abdominal region before the exercise program. All groups were given health education sessions. Computed tomography was used to evaluate abdominal, subcutaneous and visceral fat, accelerometers to measure habitual physical activity and the semi-quantitative food frequency questionnaire for dietary intake. Results After 8 weeks, IG2 showed a significantly decrease in subcutaneous fat (p ≤ 0.05) when compared to CG. Concerning visceral fat, both intervention groups showed a significant decrease in comparison to the CG (p ≤ 0.05). No significant changes were found between groups on dietary intake and habitual physical activity, except for sedentary activity that decreased significantly for IG2 in comparison with CG (p ≤ 0.05). Conclusion This specific home-based exercise program using microcurrent therapy for individuals with coronary artery disease showed improvements in visceral and subcutaneous abdominal fat.

The Moderating Effects of Appearance Commentary on the Relationship Between Weight Status and Physical Activity Participation in Female College Students

When looked at individually, overweight status and a higher frequency of negative appearance commentary (AC) are associated with lower physical activity (PA) levels. However, the combined effect has yet to be examined. The purpose of this study was to examine if the frequency of AC moderated the relationship between weight status and PA in college-aged females. No significant differences in PA levels (F(1,99)=2.41, p=.12) were found between the Never Overweight and Previously/Presently Overweight groups. Significant correlations existed for both negative AC (r=-.30, p=.00) and positive AC (r=.20, p=.05) with PA participation. AC did not significantly moderate the relationship between weight status and PA (F(2,95)=.65, p=.52, R2 adjusted=.13) as the interaction term did not account for any additional increase in variance (ΔR2=.01). Overall, AC frequency does not moderate the relationship between weight status and PA; other predictor variables should be explored.

Can desert dust explain the outgoing longwave radiation anomaly over the Sahara during July 2003?

Measurements of the top‐of‐the‐atmosphere outgoing longwave radiation (OLR) for July 2003 from Meteosat‐7 are used to assess the performance of the numerical weather prediction version of the Met Office Unified Model. A significant difference is found over desert regions of northern Africa where the model emits too much OLR by up to 35 Wm−2 in the monthly mean. By cloud‐screening the data we find an error of up to 50 Wm−2 associated with cloud‐free areas, which suggests an error in the model surface temperature, surface emissivity, or atmospheric transmission. By building up a physical model of the radiative properties of mineral dust based on in situ, and surface‐based and satellite remote sensing observations we show that the most plausible explanation for the discrepancy in OLR is due to the neglect of mineral dust in the model. The calculations suggest that mineral dust can exert a longwave radiative forcing by as much as 50 Wm−2 in the monthly mean for 1200 UTC in cloud‐free regions, which accounts for the discrepancy between the model and the Meteosat‐7 observations. This suggests that inclusion of the radiative effects of mineral dust will lead to a significant improvement in the radiation balance of numerical weather prediction models with subsequent improvements in performance.