Advantages and limitations of navigation-based multicriteria optimization (MCO) for localized prostate cancer IMRT planning

Efficacy of inverse planning is becoming increasingly important for advanced radiotherapy techniques. This study's aims were to validate multicriteria optimization (MCO) in RayStation (v2.4, RaySearch Laboratories, Sweden) against standard intensity-modulated radiation therapy (IMRT) optimization in Oncentra (v4.1, Nucletron BV, the Netherlands) and characterize dose differences due to conversion of navigated MCO plans into deliverable multileaf collimator apertures. Step-and-shoot IMRT plans were created for 10 patients with localized prostate cancer using both standard optimization and MCO. Acceptable standard IMRT plans with minimal average rectal dose were chosen for comparison with deliverable MCO plans. The trade-off was, for the MCO plans, managed through a user interface that permits continuous navigation between fluence-based plans. Navigated MCO plans were made deliverable at incremental steps along a trajectory between maximal target homogeneity and maximal rectal sparing. Dosimetric differences between navigated and deliverable MCO plans were also quantified. MCO plans, chosen as acceptable under navigated and deliverable conditions resulted in similar rectal sparing compared with standard optimization (33.7 ± 1.8Gy vs 35.5 ± 4.2Gy, p = 0.117). The dose differences between navigated and deliverable MCO plans increased as higher priority was placed on rectal avoidance. If the best possible deliverable MCO was chosen, a significant reduction in rectal dose was observed in comparison with standard optimization (30.6 ± 1.4Gy vs 35.5 ± 4.2Gy, p = 0.047). Improvements were, however, to some extent, at the expense of less conformal dose distributions, which resulted in significantly higher doses to the bladder for 2 of the 3 tolerance levels. In conclusion, similar IMRT plans can be created for patients with prostate cancer using MCO compared with standard optimization. Limitations exist within MCO regarding conversion of navigated plans to deliverable apertures, particularly for plans that emphasize avoidance of critical structures. Minimizing these differences would result in better quality treatments for patients with prostate cancer who were treated with radiotherapy using MCO plans.

Construct validity of the Experiences of Therapy Questionnaire (ETQ)

ObjectiveThe Experiences of Therapy Questionnaire (ETQ) is a reliable measure of adverse effects associated with psychotherapy. The measure has not been subject to validity analyses. This study sought to examine the validity of the ETQ by comparison against a measure of therapist satisfaction.MethodsParticipants were recruited from the Black Dog Institute¿s website and completed all measures online, at two time points (two weeks apart). Correlational analyses compared scale scores on the ETQ with related constructs of the Therapist Satisfaction Scale (TSS). To exclude any impact of current depression on ratings, we examined correlations between salient ETQ and TSS scales after controlling for depression severity.ResultsForty-six participants completed all the measures at both time points. Hypothesised associations between the ETQ and TSS scales were supported, irrespective of current depression severity.ConclusionsThe validity of the ETQ is supported; however limitations of the study are noted, including generalizability due to sample characteristics.

Improving chondrogenesis: potential and limitations of SOX9 gene transfer and mechanical stimulation for cartilage tissue engineering

Articular cartilage injuries and degeneration affect a large proportion of the population in developed countries world wide. Stem cells can be differentiated into chondrocytes by adding transforming growth factor-beta1 and dexamethasone to a pellet culture, which are unfeasible for tissue engineering purposes. We attempted to achieve stable chondrogenesis without any requirement for exogenous growth factors. Human mesenchymal stem cells were transduced with an adenoviral vector containing the SRY-related HMG-box gene 9 (SOX9), and were cultured in a three-dimensional (3D) hydrogel scaffold composite. As an additional treatment, mechanical stimulation was applied in a custom-made bioreactor. SOX9 increased the expression level of its known target genes, as well as its cofactors: the long form of SOX5 and SOX6. However, it was unable to increase the synthesis of sulfated glycosaminoglycans (GAGs). Mechanical stimulation slightly enhanced collagen type X and increased lubricin expression. The combination of SOX9 and mechanical load boosted GAG synthesis as shown by (35)S incorporation. GAG production rate corresponded well with the amount of (endogenous) transforming growth factor-beta1. Finally, cartilage oligomeric matrix protein expression was increased by both treatments. These findings provide insight into the mechanotransduction of mesenchymal stem cells and demonstrate the potential of a transcription factor in stem cell therapy.

Cautionary tales in the interpretation of systematic reviews of therapy trials

This is the second in a series of articles emphasizing the cautions in the interpretation of health-care studies. Systematic reviews are presented as comprehensive, unbiased summaries of evidence and are often referred to by clinicians, guideline developers and health policy-makers. Their strengths and limitations, and how their results can be subject to bias and misinterpretation, are discussed.

Whither culture? Australian horror films and the limitations of cultural policy

Cultural policy that attempts to foster the Australian film industry’s growth and development in an era of globalisation is coming under increasing pressure. Throughout the 2000s, there has been a substantial boom in Australian horror films led by ‘runaway’ horror film Saw (2004), Wolf Creek (2005), and Undead (2003), achieving varying levels of popularity and commercial success worldwide. However, emerging within a national cinema driven by public subsidy and valuing ‘quality’ and ‘cultural content’ over ‘entertainment’ and ‘commercialism’, horror films have generally been antithetical to these objectives. Consequently, the recent boom in horror films has occurred largely outside the purview and subvention of cultural policy. This paper argues that global forces and emerging production and distribution models are challenging the ‘narrowness’ of cultural policy – a narrowness that mandates a particular film culture, circumscribes certain notions of value and limits the variety of films produced domestically. Despite their low-culture status, horror films have been well suited to the Australian film industry’s financial limitations, they are a growth strategy for producers, and a training ground for emerging filmmakers.

Towards an understanding of Australian genre cinema and entertainment : beyond the limitations of ‘Ozploitation’ discourse

While Australian cinema has produced popular movie genres since the 1970s, including action/adventure, road movies, crime, and horror movies, genre cinema has occupied a precarious position within a subsidised national cinema and has been largely written out of film history. In recent years the documentary Not Quite Hollywood (2008) has brought Australia’s genre movie heritage from the 1970s and 1980s back to the attention of cinephiles, critics and cult audiences worldwide. Since its release, the term ‘Ozploitation’ has become synonymous with Australian genre movies. In the absence of discussion about genre cinema within film studies, Ozploitation (and ‘paracinema’ as a theoretical lens) has emerged as a critical framework to fill this void as a de facto approach to genre and a conceptual framework for understanding Australian genres movies. However, although the Ozploitation brand has been extremely successful in raising the awareness of local genre flicks, Ozploitation discourse poses problems for film studies, and its utility is limited for the study of Australian genre movies. This paper argues that Ozploitation limits analysis of genre movies to the narrow confines of exploitation or trash cinema and obscures more important discussion of how Australian cinema engages with popular movies genres, the idea of Australian filmmaking as entertainment, and the dynamics of commercial filmmaking practises more generally.

Trading spaces : on the lore and limitations of latent semantic analysis

Two decades after its inception, Latent Semantic Analysis(LSA) has become part and parcel of every modern introduction to Information Retrieval. For any tool that matures so quickly, it is important to check its lore and limitations, or else stagnation will set in. We focus here on the three main aspects of LSA that are well accepted, and the gist of which can be summarized as follows: (1) that LSA recovers latent semantic factors underlying the document space, (2) that such can be accomplished through lossy compression of the document space by eliminating lexical noise, and (3) that the latter can best be achieved by Singular Value Decomposition. For each aspect we performed experiments analogous to those reported in the LSA literature and compared the evidence brought to bear in each case. On the negative side, we show that the above claims about LSA are much more limited than commonly believed. Even a simple example may show that LSA does not recover the optimal semantic factors as intended in the pedagogical example used in many LSA publications. Additionally, and remarkably deviating from LSA lore, LSA does not scale up well: the larger the document space, the more unlikely that LSA recovers an optimal set of semantic factors. On the positive side, we describe new algorithms to replace LSA (and more recent alternatives as pLSA, LDA, and kernel methods) by trading its l2 space for an l1 space, thereby guaranteeing an optimal set of semantic factors. These algorithms seem to salvage the spirit of LSA as we think it was initially conceived.

Valuation of family firms : the limitations of accounting information

This conceptual paper explores the extent to which reported accounting information captures unique family firm decision-making and intangible asset factors that impact financial value. We review the family firm valuation-relevant literature and identify that this body of research is predicated on the assumption that accounting information reflects the underlying reality of family firms. This research, however, fails to recognise that current accounting technology does not fully recognise the family firm factors in the book value of the firm or the implications for long run persistence of earnings. Thus, valuation models underpinning the extant empirical research, which are predicated on reported accounting information, may not fully reflect the intrinsic value of family firms. We present propositions on the interaction between accounting information, family factors and valuation as a road map for future empirical research with a discussion of appropriate methodologies.

Towards an understanding of Australian genre cinema and entertainment : beyond the limitations of ‘Ozploitation’ discourse

While Australian cinema has produced popular movie genres since the 1970s, including action/adventure, road movies, crime, and horror movies, genre cinema has occupied a precarious position within a subsidised national cinema and has been largely written out of film history. In recent years the documentary Not Quite Hollywood (2008) has brought Australia’s genre movie heritage from the 1970s and 1980s back to the attention of cinephiles, critics and cult audiences worldwide. Since its release, the term ‘Ozploitation’ has become synonymous with Australian genre movies. In the absence of discussion about genre cinema within film studies, Ozploitation (and ‘paracinema’ as a theoretical lens) has emerged as a critical framework to fill this void as a de facto approach to genre and a conceptual framework for understanding Australian genres movies. However, although the Ozploitation brand has been extremely successful in raising the awareness of local genre flicks, Ozploitation discourse poses problems for film studies, and its utility is limited for the study of Australian genre movies. This paper argues that Ozploitation limits analysis of genre movies to the narrow confines of exploitation or trash cinema and obscures more important discussion of how Australian cinema engages with popular movies genres, the idea of Australian filmmaking as entertainment, and the dynamics of commercial filmmaking practises more generally.

Is there an app for that? A case study of the potentials and limitations of the participator turn and networked publics for classical music audience engagement

The participatory turn, fuelled by discourses and rhetoric regarding social media, and in the aftermath of the dot.com crash of the early 2000s, enrols to some extent an idea of being able to deploy networks to achieve institutional aims. The arts and cultural sector in the UK, in the face of funding cuts, has been keen to engage with such ideas in order to demonstrate value for money; by improving the efficiency of their operations, improving their respective audience experience and ultimately increasing audience size and engagement. Drawing on a case study compiled via a collaborative research project with a UK-based symphony orchestra (UKSO) we interrogate the potentials of social media engagement for audience development work through participatory media and networked publics. We argue that the literature related to mobile phones and applications (‘apps’) has focused primarily on marketing for engagement where institutional contexts are concerned. In contrast, our analysis elucidates the broader potentials and limitations of social-media-enabled apps for audience development and engagement beyond a marketing paradigm. In the case of UKSO, it appears that the technologically deterministic discourses often associated with institutional enrolment of participatory media and networked publics may not necessarily apply due to classical music culture. More generally, this work raises the contradictory nature of networked publics and argues for increased critical engagement with the concept.

Measuring Online user engagement : the limitations of Web analytics

The ability to identify and assess user engagement with transmedia productions is vital to the success of individual projects and the sustainability of this mode of media production as a whole. It is essential that industry players have access to tools and methodologies that offer the most complete and accurate picture of how audiences/users engage with their productions and which assets generate the most valuable returns of investment. Drawing upon research conducted with Hoodlum Entertainment, a Brisbane-based transmedia producer, this chapter outlines an initial assessment of the way engagement tends to be understood, why standard web analytics tools are ill-suited to measuring it, how a customised tool could offer solutions, and why this question of measuring engagement is so vital to the future of transmedia as a sustainable industry.