Accuracy of absorbed dose in external photon beam radiotherapy : what level is sufficient and how to approach it?

Radiation therapy (RT) plays currently significant role in curative treatments of several cancers. External beam RT is carried out mostly by using megavoltage beams of linear accelerators. Tumor eradication and normal tissue complications correlate to dose absorbed in tissues. Normally this dependence is steep and it is crucial that actual dose within patient accurately correspond to the planned dose. All factors in a RT procedure contain uncertainties requiring strict quality assurance. From hospital physicist´s point of a view, technical quality control (QC), dose calculations and methods for verification of correct treatment location are the most important subjects. Most important factor in technical QC is the verification that radiation production of an accelerator, called output, is within narrow acceptable limits. The output measurements are carried out according to a locally chosen dosimetric QC program defining measurement time interval and action levels. Dose calculation algorithms need to be configured for the accelerators by using measured beam data. The uncertainty of such data sets limits for best achievable calculation accuracy. All these dosimetric measurements require good experience, are workful, take up resources needed for treatments and are prone to several random and systematic sources of errors. Appropriate verification of treatment location is more important in intensity modulated radiation therapy (IMRT) than in conventional RT. This is due to steep dose gradients produced within or close to healthy tissues locating only a few millimetres from the targeted volume. The thesis was concentrated in investigation of the quality of dosimetric measurements, the efficacy of dosimetric QC programs, the verification of measured beam data and the effect of positional errors on the dose received by the major salivary glands in head and neck IMRT. A method was developed for the estimation of the effect of the use of different dosimetric QC programs on the overall uncertainty of dose. Data were provided to facilitate the choice of a sufficient QC program. The method takes into account local output stability and reproducibility of the dosimetric QC measurements. A method based on the model fitting of the results of the QC measurements was proposed for the estimation of both of these factors. The reduction of random measurement errors and optimization of QC procedure were also investigated. A method and suggestions were presented for these purposes. The accuracy of beam data was evaluated in Finnish RT centres. Sufficient accuracy level was estimated for the beam data. A method based on the use of reference beam data was developed for the QC of beam data. Dosimetric and geometric accuracy requirements were evaluated for head and neck IMRT when function of the major salivary glands is intended to be spared. These criteria are based on the dose response obtained for the glands. Random measurement errors could be reduced enabling lowering of action levels and prolongation of measurement time interval from 1 month to even 6 months simultaneously maintaining dose accuracy. The combined effect of the proposed methods, suggestions and criteria was found to facilitate the avoidance of maximal dose errors of up to even about 8 %. In addition, their use may make the strictest recommended overall dose accuracy level of 3 % (1SD) achievable.

Keho: Omaa sukupuolta koskevan tiedon ja ymmärryksen muotoutumisen perusta transsukupuolisilla

Body: The foundation for the formation of the knowledge and conception of gender identity among the transgendered The purpose of this study is to increase the understanding of the experiential formation of the knowledge and conception of one's gender and the foundation of that experience. This study is based on qualitative method and phenomenological approach. The research material consists: Herculine Barbin's Herculine Barbin, Christine Jorgensen's Christine Jorgensen. A Personal Autobiography Kate Bornstein's Gender Outlaw and Deirdre McCloskey's Crossing. A Memoir. The theoretical frame of reference for the study is Michel Henry's phenomenology of the body. The most important relations regarding the formation of the knowledge and conception of gender identity at which the sensing of the body is directed are human being's own subjective, organic and objective bodily form and other people and representatives of institutions. The concept of resistance reveals that gender division and the stereotypes and accountability related to it have dual character in culture. As a resistance they contain the potential for triggering the reflections about one's own gender. As an instrument they may function as means of exercising power and, as such, of monitoring gender normality. According to the research material the sources for the knowledge and conception of gender identity among the transgendered are literature, medical articles and books, internet, clerical and medical professionals, friends and relatives, and the peer group, that is, other transgendered. The transgendered are not only users of gender knowledge, but many of them are also active producers and contributors of gender knowledge and especially of knowledge about transgenderness. The problem is that this knowledge is unevenly distributed in society. The users of gender knowledge are mainly the transgendered, researchers of different disciplines specialized in gender issues, and medical and healthcare professionals specialized in gender adjustments. Therefore not everyone has the sufficient knowledge to support one's own or someone other's life as a gendered being in a society and ability to achieve gender autonomy. The quality of this knowledge is also rather narrow from the gender multiplicity point of view. The feeling of strangeness and the resulting experience of enstrangement have, like stereotypes, dual character in culture. They may be the reason for people's social disadvantage or exclusion, but the experiences may just as well be a resource for people's gender maturity and culture. As a cultural resource in gender issue this would mean innovativity in creating, upholding and changing cultural gender division, stereotypes and accounting customs. A transgendered may then become a liminal that aspires to change the limits related to resistances in society. Transgenderness is not only a medical issue but, first and foremost, an issue bearing upon human situation as a whole, or, in other words, related to the art of life. The subject of gender adjustment treatments is not only gender itself but the art of life as a gendered being. Transgenderness would then require multi-discipline co-operation.

Preterm birth and risk factors for chronic disease : Helsinki Study of Very Low Birth Weight Adults

Background: The improved prognosis of early preterm birth has created a generation of surviving very low birth weight (< 1500 g, VLBW) infants whose health risks in adulthood are poorly known. Of every 1000 live-born infants in Finland, about 8 are born at VLBW. Variation in birth weight, even within the normal range, relates to considerable variation in the risk for several common adult disorders, including cardiovascular disease and osteoporosis. Small preterm infants frequently exhibit severe postnatal or prenatal growth retardation, or both. Much reason for concern thus exists, regarding adverse health effects in surviving small preterm infants later lives. We studied young adults, aiming at exploring whether VLBW birth and postnatal events after such a birth are associated with higher levels of risk factors for cardiovascular disease or osteoporosis. Subjects and Methods: A follow-up study for VLBW infants began in 1978; by the end of 1985, 335 VLBW survivors at Helsinki University Central Hospital participated in the follow-up. Their gestational ages ranged from 24 to 35 weeks, mean 29.2 and standard deviation 2.2 weeks. In 2004, we invited for a clinic visit 255 subjects, aged 18 to 27, who still lived in the greater Helsinki area. From the same birth hospitals, we also invited 314 term-born controls of similar age and sex. These two study groups underwent measurements of body size and composition, function of brachial arterial endothelium (flow-mediated dilatation, FMD) and carotid artery intima-media thickness (cIMT) by ultrasound. In addition, we measured plasma lipid concentrations, ambulatory blood pressure, fasting insulin, glucose tolerance and, by dual-energy x-ray densitometry, bone-mineral density. Results: 172 control and 166 VLBW participants underwent lipid measurements and a glucose tolerance test. VLBW adults fasting insulin (adjusted for body mass index) was 12.6% (95% confidence interval, 0.8 to 25.8) higher than that of the controls. The glucose and insulin concentrations 120 minutes after 75 g glucose ingestion showed similar differences (N=332) (I). VLBW adults had 3.9 mmHg (1.3 to 6.4) higher office systolic blood pressure, 3.5 mmHg (1.7 to 5.2) higher office diastolic blood pressure (I), and, when adjusted for body mass index and height, 3.1 mmHg (0.5 to 5.5) higher 24-hour mean systolic blood pressure (N=238) (II). VLBW birth was associated neither with HDL- or total cholesterol nor triglyceride concentrations (N=332) (I), nor was it associated with a low FMD or a high cIMT (N=160) (III). VLBW adults had 0.51-unit (0.28 to 0.75) lower lumbar spine Z scores and 0.56-unit (0.34 to 0.78) lower femoral neck Z scores (N=283). Adjustments for size attenuated the differences, but only partially (IV). Conclusions: These results imply that those born at VLBW, although mostly healthy as young adults, already bear several risk factors for chronic adult disease. The significantly higher fasting insulin level in adults with VLBW suggests increased insulin resistance. The higher blood pressure in young adults born at VLBW may indicate they later are at risk for hypertension, although their unaffected endothelial function may be evidence for some form of protection from cardiovascular disease. Lower bone mineral density around the age of peak bone mass may suggest increased risk for later osteoporotic fractures. Because cardiovascular disease and osteoporosis are frequent, and their prevention is relatively cheap and safe, one should focus on prevention now. When initiated early, preventive measures are likely to have sufficient time to be effective in preventing or postponing the onset of chronic disease.

Preterm birth and risk factors for chronic disease : Helsinki Study of Very Low Birth Weight Adults

Background: The improved prognosis of early preterm birth has created a generation of surviving very low birth weight (PIENEMPI KUIN 1500 g, VLBW) infants whose health risks in adulthood are poorly known. Of every 1000 live-born infants in Finland, about 8 are born at VLBW. Variation in birth weight, even within the normal range, relates to considerable variation in the risk for several common adult disorders, including cardiovascular disease and osteoporosis. Small preterm infants frequently exhibit severe postnatal or prenatal growth retardation, or both. Much reason for concern thus exists, regarding adverse health effects in surviving small preterm infants later lives. We studied young adults, aiming at exploring whether VLBW birth and postnatal events after such a birth are associated with higher levels of risk factors for cardiovascular disease or osteoporosis. Subjects and Methods: A follow-up study for VLBW infants began in 1978; by the end of 1985, 335 VLBW survivors at Helsinki University Central Hospital participated in the follow-up. Their gestational ages ranged from 24 to 35 weeks, mean 29.2 and standard deviation 2.2 weeks. In 2004, we invited for a clinic visit 255 subjects, aged 18 to 27, who still lived in the greater Helsinki area. From the same birth hospitals, we also invited 314 term-born controls of similar age and sex. These two study groups underwent measurements of body size and composition, function of brachial arterial endothelium (flow-mediated dilatation, FMD) and carotid artery intima-media thickness (cIMT) by ultrasound. In addition, we measured plasma lipid concentrations, ambulatory blood pressure, fasting insulin, glucose tolerance and, by dual-energy x-ray densitometry, bone-mineral density. Results: 172 control and 166 VLBW participants underwent lipid measurements and a glucose tolerance test. VLBW adults fasting insulin (adjusted for body mass index) was 12.6% (95% confidence interval, 0.8 to 25.8) higher than that of the controls. The glucose and insulin concentrations 120 minutes after 75 g glucose ingestion showed similar differences (N=332) (I). VLBW adults had 3.9 mmHg (1.3 to 6.4) higher office systolic blood pressure, 3.5 mmHg (1.7 to 5.2) higher office diastolic blood pressure (I), and, when adjusted for body mass index and height, 3.1 mmHg (0.5 to 5.5) higher 24-hour mean systolic blood pressure (N=238) (II). VLBW birth was associated neither with HDL- or total cholesterol nor triglyceride concentrations (N=332) (I), nor was it associated with a low FMD or a high cIMT (N=160) (III). VLBW adults had 0.51-unit (0.28 to 0.75) lower lumbar spine Z scores and 0.56-unit (0.34 to 0.78) lower femoral neck Z scores (N=283). Adjustments for size attenuated the differences, but only partially (IV). Conclusions: These results imply that those born at VLBW, although mostly healthy as young adults, already bear several risk factors for chronic adult disease. The significantly higher fasting insulin level in adults with VLBW suggests increased insulin resistance. The higher blood pressure in young adults born at VLBW may indicate they later are at risk for hypertension, although their unaffected endothelial function may be evidence for some form of protection from cardiovascular disease. Lower bone mineral density around the age of peak bone mass may suggest increased risk for later osteoporotic fractures. Because cardiovascular disease and osteoporosis are frequent, and their prevention is relatively cheap and safe, one should focus on prevention now. When initiated early, preventive measures are likely to have sufficient time to be effective in preventing or postponing the onset of chronic disease.

A sufficient criterion for Rayleigh-Taylor instability of incompressible viscous three-layer flow

Using normal mode analysis Rayleigh-Taylor instability is investigated for three-layer viscous stratified incompressible steady flow, when the top 3rd and bottom 1st layers extend up to infinity, the middle layer has a small thickness δ. The wave Reynolds number in the middle layer is assumed to be sufficiently small. A dispersion relation (a seventh degree polynomial in wave frequency ω) valid up to the order of the maximal value of all possible Kj (j less-than-or-equals, slant 0, K is the wave number) in each coefficient of the polynomial is obtained. A sufficient condition for instability is found out for the first time, pursuing a medium wavelength analysis. It depends on ratios (α and β) of the coefficients of viscosity, the thickness of the middle layer δ, surface tension ratio T and wave number K. This is a new analytical criterion for Rayleigh-Taylor instability of three-layer fluids. It recovers the results of the corresponding problem for two-layer fluids. Among the results obtained, it is observed that taking the coefficients of viscosity of 2nd and 3rd layers same can inhibit the effect of surface tension completely. For large wave number K, the thickness of the middle layer should be correspondingly small to keep the domain of dependence of the threshold wave number Kc constant for fixed α, β and T.

A sufficient criterion for Kelvin–Helmholtz instability in the magnetopause boundary‐layer region

The Kelvin–Helmholtz instability has been investigated for the magnetopause boundary‐layer region by the linearized method. The plasma in magnetosheath and magnetopause is assumed to be semi‐infinitely extended homogeneous, nondissipative, and incompressible. It is observed that, if one relation of two plasma speeds on the two sides of the magnetopause, wave number, and boundary‐layer thickness exceeds a certain threshold, the instability sets in. This new analytically sufficient criterion for excitation of instability in the three‐layer plasma flow generalizes the corresponding Chandrasekhar’s instability criterion for two‐layer plasma flow. The known results have been recovered and modified, the new results have been discovered. It is proved that the velocity threshold for the onset of instability is low when the magnitude of the magnetosheath and boundary‐layer region magnetic field and the angle between them are small. Also the threshold depends on the direction of plasma flow. The following results are observed numerically. The growth of the instability is sensitive to the magnetic field direction in the magnetosheath. A slight variation in the magnetic field direction in the second region can substantially change the relative velocity threshold for instability. When the ratio of the density of the second and third layer (magnetosphere) increases or that of the first and third layer decreases, the threshold decreases. Apart from this a necessary criterion for instability is obtained for a particular case.

Is O-1(2) alone sufficient for DNA cleavage? Possible involvement of paramagnetic intermediates

It is proposed that singlet dioxygen reacting with guanosine or deoxyguanosine part of nucleotides does not, by itself, cause DNA cleavage. The strand break originates at the endoperoxide stage whenever this link evolves into a O-centered radical. The O-centered radical is then in a good spatial position to abstract an hydrogen intramolecularly from the ribose or desoxyribose part of the nucleotide. The carbon centered radical thus formed on the sugar part may lead to strand break either by a p-scission mechanism or by an homolytically induced solvolysis. High pH could also induce cleavage after the endoperoxide stage via a base catalyzed ring chain protomerism.

ZnO/Poly(3,4-ethylenedioxythiophene) Poly(styrenesulfonate) Based Ultraviolet and Visible Photodetectors: Role of Defects

Here, we report the ZnO/poly(3,4-ethylenedioxythiophene) poly(styrenesulfonate) (PEDOT:PSS) based photodetectors that can response to ultraviolet as well as visible light. The temporal response of the heterostructures for various excitations in the ultraviolet (UV) and visible range are performed. The time constants are found to be excitation-dependent, the response to visible light is better as compared to UV. The reason behind the better response to UV light is the high level of defects present in ZnO as confirmed by the photoluminescence (PL) measurements. This is corroborated by the time resolved fluorescence (TRF) measurements which provides sufficient information behind the slow response time under the UV excitations. The possible explanation being the non-radiative recombinations occurring due to the traps or impurities present in the film which slows down the photoresponse.

Sufficient conditions for formation of a network topology by self-interested agents

Networks such as organizational network of a global company play an important role in a variety of knowledge management and information diffusion tasks. The nodes in these networks correspond to individuals who are self-interested. The topology of these networks often plays a crucial role in deciding the ease and speed with which certain tasks can be accomplished using these networks. Consequently, growing a stable network having a certain topology is of interest. Motivated by this, we study the following important problem: given a certain desired network topology, under what conditions would best response (link addition/deletion) strategies played by self-interested agents lead to formation of a pairwise stable network with only that topology. We study this interesting reverse engineering problem by proposing a natural model of recursive network formation. In this model, nodes enter the network sequentially and the utility of a node captures principal determinants of network formation, namely (1) benefits from immediate neighbors, (2) costs of maintaining links with immediate neighbors, (3) benefits from indirect neighbors, (4) bridging benefits, and (5) network entry fee. Based on this model, we analyze relevant network topologies such as star graph, complete graph, bipartite Turan graph, and multiple stars with interconnected centers, and derive a set of sufficient conditions under which these topologies emerge as pairwise stable networks. We also study the social welfare properties of the above topologies.

Activation of InsP(3) receptors is sufficient for inducing graded intrinsic plasticity in rat hippocampal pyramidal neurons

The synaptic plasticity literature has focused on establishing necessity and sufficiency as two essential and distinct features in causally relating a signaling molecule to plasticity induction, an approach that has been surprisingly lacking in the intrinsic plasticity literature. In this study, we complemented the recently established necessity of inositol trisphosphate (InsP(3)) receptors (InsP(3)R) in a form of intrinsic plasticity by asking if InsP(3)R activation was sufficient to induce intrinsic plasticity in hippocampal neurons. Specifically, incorporation of D-myo-InsP(3) in the recording pipette reduced input resistance, maximal impedance amplitude, and temporal summation but increased resonance frequency, resonance strength, sag ratio, and impedance phase lead. Strikingly, the magnitude of plasticity in all these measurements was dependent on InsP 3 concentration, emphasizing the graded dependence of such plasticity on InsP(3)R activation. Mechanistically, we found that this InsP(3)-induced plasticity depended on hyperpolarization-activated cyclic nucleotide-gated channels. Moreover, this calcium-dependent form of plasticity was critically reliant on the release of calcium through InsP(3)Rs, the influx of calcium through N-methyl-D-aspartate receptors and voltage-gated calcium channels, and on the protein kinase A pathway. Our results delineate a causal role for InsP(3)Rs in graded adaptation of neuronal response dynamics, revealing novel regulatory roles for the endoplasmic reticulum in neural coding and homeostasis.

Necessary and sufficient conditions for optimality in constrained general sum stochastic games

In this paper we first derive a necessary and sufficient condition for a stationary strategy to be the Nash equilibrium of discounted constrained stochastic game under certain assumptions. In this process we also develop a nonlinear (non-convex) optimization problem for a discounted constrained stochastic game. We use the linear best response functions of every player and complementary slackness theorem for linear programs to derive both the optimization problem and the equivalent condition. We then extend this result to average reward constrained stochastic games. Finally, we present a heuristic algorithm motivated by our necessary and sufficient conditions for a discounted cost constrained stochastic game. We numerically observe the convergence of this algorithm to Nash equilibrium. (C) 2015 Elsevier B.V. All rights reserved.

Social Experience Is Sufficient to Modulate Sleep Need of Drosophila without Increasing Wakefulness

Organisms quickly learn about their surroundings and display synaptic plasticity which is thought to be critical for their survival. For example, fruit flies Drosophila melanogaster exposed to highly enriched social environment are found to show increased synaptic connections and a corresponding increase in sleep. Here we asked if social environment comprising a pair of same-sex individuals could enhance sleep in the participating individuals. To study this, we maintained individuals of D. melanogaster in same-sex pairs for a period of 1 to 4 days, and after separation, monitored sleep of the previously socialized and solitary individuals under similar conditions. Males maintained in pairs for 3 or more days were found to sleep significantly more during daytime and showed a tendency to fall asleep sooner as compared to solitary controls (both measures together are henceforth referred to as ``sleep-enhancement''). This sleep phenotype is not strain-specific as it is observed in males from three different ``wild type'' strains of D. melanogaster. Previous studies on social interaction mediated sleep-enhancement presumed `waking experience' during the interaction to be the primary underlying cause; however, we found sleep-enhancement to occur without any significant increase in wakefulness. Furthermore, while sleep-enhancement due to group-wise social interaction requires Pigment Dispersing Factor (PDF) positive neurons; PDF positive and CRYPTOCHROME (CRY) positive circadian clock neurons and the core circadian clock genes are not required for sleep-enhancement to occur when males interact in pairs. Pair-wise social interaction mediated sleep-enhancement requires dopamine and olfactory signaling, while visual and gustatory signaling systems seem to be dispensable. These results suggest that socialization alone (without any change in wakefulness) is sufficient to cause sleep-enhancement in fruit fly D. melanogaster males, and that its neuronal control is context-specific.

Role of G protein coupled inwardly rectifier K+ channels (GIRK) on the neurobiology depression

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