Exposure of non‐target tissues in medical diathermy

With different prevalence in different regions, radio frequency (RF) electromagnetic fields (EMF) are widely used for therapeutic tissue heating. Although short‐wave diathermy (27.12 MHz) is the most popular treatment modality, quantitative data on patient's exposure have been lacking. By numerical simulation with the numerical anatomical model NORMAN, intracorporal distributions of specific absorption rates (SAR) were investigated for different treatment scenarios and applicators. Quantitative data are provided for exposures of target treatment areas as well as for vulnerable regions such as the eye lenses, central nervous system, and testes. Different applicators and distances were investigated. Capacitive and inductive applicators exhibit quite a different heating efficiency. It could be shown that for the same output power therapeutic heat deposition can vary by almost one order of magnitude. By mimicking therapist's practice to use patient's heat perception as an indicator for output power setting, numerical data were elaborated demonstrating that muscle tissue exposures may be several times higher for inductive than for capacitive applicators. Presented quantitative data serve as a guide for power adjustment preventing relevant overexposures without compromising therapy; they also provide a basis for estimating target tissue heat load and developing therapeutic guidelines. Bioelectromagnetics 31:12–19, 2010. © 2009 Wiley‐Liss, Inc.     

Comparison between beta radiation dose distribution due to LDR and HDR ocular brachytherapy applicators using GATE Monte Carlo platform

Eye applicators with 90Sr/90Y and 106Ru/106Rh beta-ray sources are generally used in brachytherapy for the treatment of eye diseases as uveal melanoma. Whenever, radiation is used in treatment, dosimetry is essential. However, knowledge of the exact dose distribution is a critical decision-making to the outcome of the treatment. The Monte Carlo technique provides a powerful tool for calculation of the dose and dose distributions which helps to predict and determine the doses from different shapes of various types of eye applicators more accurately. The aim of this work consisted in using the Monte Carlo GATE platform to calculate the 3D dose distribution on a mathematical model of the human eye according to international recommendations. Mathematical models were developed for four ophthalmic applicators, two HDR 90Sr applicators SIA.20 and SIA.6, and two LDR 106Ru applicators, a concave CCB model and a flat CCB model. In present work, considering a heterogeneous eye phantom and the chosen tumor, obtained results with the use of GATE for mean doses distributions in a phantom and according to international recommendations show a discrepancy with respect to those specified by the manufacturers. The QC of dosimetric parameters shows that contrarily to the other applicators, the SIA.20 applicator is consistent with recommendations. The GATE platform show that the SIA.20 applicator present better results, namely the dose delivered to critical structures were lower compared to those obtained for the other applicators, and the SIA.6 applicator, simulated with MCNPX generates higher lens doses than those generated by GATE.     

Vibration of DNA polymer in viscous solvent

The problem of viscous damping of vibrating DNA polymer in solution is solved in the low-amplitude limit for all acoustic branches of the spectrum. The acoustic spectrum covers the microwave region of frequencies. Analytic solutions are obtained for a model describing the DNA polymer as a smooth circular cylinder. Numerical solutions are presented for a model describing the DNA polymer as a twisted cylinder of elliptical cross section. The amount of mass loading is determined for both models and the damped spectrum for the mass-loaded oscillator is calculated. The viscous damping is found to be a strong function of frequency, singular at very low frequencies for all modes except the torsional mode of the circular cylinder. All acoustic modes are overdamped, implying that the observation of well-defined resonances in DNA requires either highly structured water on the molecular level or very dry material.     

Radiation leakage study for the Valencia applicators

Introduction and purposeThe Valencia applicators which are accessories of the microSelectron-HDR afterloader (Nucletron, Veenendaal, The Netherlands) are designed to treat skin lesions. These cup-shaped applicators are an alternative to superficial/orthovoltage x-ray treatment units. They limit the irradiation to the required area using tungsten-alloy shielding, and are equipped with a tungsten-alloy flattering filter allowing the treatment of skin tumors, the oral cavity, vaginal cuff, etc. The tungsten-alloy thickness to shield radiation is not the same in all parts of the applicators. This fact led us to question whether the leakage radiation differs depending on where it is measured, and whether this may be relevant in some clinical cases. The purpose of this work is to study from the radiation protection point of view the radiation leakage of the Valencia applicators, and provide a solution for current users and for the manufacturer.Methods and materialsSimulations based on the Monte Carlo (MC) method using the Geant4 code have been realized studying the dose rate distribution in air around the cup of the Valencia applicators. An experimental study with radiochromic film has also been done to measure the dose distribution in the back side of the applicators and to compare it with MC results.Results and conclusionsRadiation leakage of up to 170% of the prescribed dose has been found at the back surface of these applicators. Although this side is not usually directed to the patient, in some applications such as the treatment of a lesion on the nose, special care must be taken to avoid unexpected and unnecessary irradiation of the eyes. A possible solution could be to add additional shielding to the applicator in order to reduce this leakage or to put some shielding to protect the eyes. Additionally, a new concept design of the Valencia applicators using more shielding material in the applicator backside is proposed.     

Coding of odor intensity in a steady-state deterministic model of an olfactory receptor neuron

The coding of odor intensity by an olfactory receptor neuron model was studied under steady-state stimulation. Our model neuron is an elongated cylinder consisting of the following three components: a sensory dendritic region bearing odorant receptors, a passive region consisting of proximal dendrite and cell body, and an axon. First, analytical solutions are given for the three main physiological responses: (1) odorant-dependent conductance change at the sensory dendrite based on the Michaelis-Menten model, (2) generation and spreading of the receptor potential based on a new solution of the cable equation, and (3) firing frequency based on a Lapicque model. Second, the magnitudes of these responses are analyzed as a function of odorant concentration. Their dependence on chemical, electrical, and geometrical parameters is examined. The only evident gain in magnitude results from the activation-to-conductance conversion. An optimal encoder neuron is presented that suggests that increasing the length of the sensory dendrite beyond about 0.3 space constant does not increase the magnitude of the receptor potential. Third, the sensivities of the responses are examined as functions of (1) the concentration at half-maximum response, (2) the lower and upper concentrations actually discriminated, and (3) the width of the dynamic range. The overall gain in sensitivity results entirely from the conductance-to-voltage conversion. The maximum conductance at the sensory dendrite appears to be the main tuning constant of the neuron because it determines the shift toward low concentrations and the increase in dynamic range. The dynamic range of the model cannot exceed 5.7 log units, for a sensitivity increase at low odor concentration is compensated by a sensitivity decrease at high odor concentration.     

Development of a Composite Measure of Product Adherence,Protocol Compliance,and Semen Exposure Using DNA and Protein Biomarkers for Topical HIV Prevention Studies

Background

Poor and inconsistent use of study products has hindered clinical HIV prevention studies. It is important to be able to monitor product adherence and protocol compliance in order to determine microbicide efficacy and safety more accurately. Current methods for monitoring adherence are subjective, non-specific, or invasive. Herein, we present a composite, objective measure of product adherence and protocol compliance to assess vaginal insertion, semen exposure and drug expulsion utilizing DNA, protein, and drug isolated directly from returned, vaginally used gel applicators.

Methods

DNA, vaginal cells, and residual tenofovir were isolated from vaginally inserted applicators. Vaginal and semen biomarkers were amplified using a multiplex PCR to determine vaginal insertion. Vaginal cells were fixed followed by cytokeratin 4 immunocytochemistry to confirm DNA assessment of vaginal insertion. Tenofovir was extracted and quantitated through LC-MS/MS.

Results

DNA isolated from vaginally inserted applicators were positive for vaginal bacteria DNA and the control eukaryotic gene, amelogenin, while manually handled, “sham”, applicators were negative for both. Semen exposure was independently determined by simultaneous amplification of one or both Y-chromosomal genes, SRY and TSPY4. Vaginal insertion determination by DNA analysis was further confirmed by positive cytokeratin 4 (CK4) immunocytochemistry of vaginal cells remaining on the gel applicators. On the contrary, sham applicators provided very few cells when swabbed, and they were all negative for CK4. CK4 was not found in epidermal cells from the hand. Drug expulsion was detected through quantitation of residual gel present on the surface of returned applicators. Sham applicators had no detectable tenofovir.

Conclusion

Utilizing a composite, triple marker based panel of DNA, protein, and drug present on the surface of returned vaginal gel applicators, it is possible to determine, objectively and non-invasively, product adherence, protocol compliance, and semen exposure in microbicide trials.     

Size and shape of the repetitive domain of high molecular weight wheat gluten proteins. I. Small-angle neutron scattering

The solution structure of the central repetitive domain of high molecular weight (HMW) wheat gluten proteins has been investigated for a range of concentrations and temperatures using mainly small-angle neutron scattering. A representative part of the repetitive domain (dB1) was studied as well as an "oligomer" basically consisting of four dB1 units, which has a length similar to the complete central domain. The scattering data over the entire angular range of both proteins are in quantitative agreement with a structural model based on a worm-like chain, a model frequently used in polymer theory. This model describes the "supersecondary structure" of dB1 and dB4 as a semiflexible cylinder with a length of about 235 and 900 A, respectively, and a cross-sectional diameter of about 15 A. The flexibility of both proteins is characterized by a persistence length of about 13 A. Their structures are thus quantitatively identical, which implies that the central HMW domain can be elongated while retaining its structural characteristics. It seems conceivable that the flexible cylinder results from a helical structure, which resembles the beta-spiral observed in earlier studies on gluten proteins and elastin. However, compared to the previously proposed structure of a (stiff) rod, our experiments clearly indicate flexibility of the cylinder.     

Coding of stimulus intensity in an olfactory receptor neuron: Role of neuron spatial extent and passive dendritic backpropagation of action potentials

The olfactory receptor neuron provides a good opportunity to analyze a biophysical model of a single neuron because its dendritic structure is simple and even close to a cylinder in the case of the moth sex-pheromone receptor cell. We have considered this cylindrical case and studied two main problems. First, we were concerned with the effect of the neuron's length on the receptor potential for a constant stimulus-induced conductance change. An analytical solution for the receptor potential was determined by using input, resistances. It was shown that the longer the neuron, the greater its ability to code over a wide range of values of the intensity of the stimulus. Second, we studied numerically the passive backpropagation of action potentials into the dendrite and its influence on the firing frequency. While propagating along the dendrite the action potential decreases in amplitude and its shape becomes rounded. The firing frequency in the model with backpropagation was found to be greater than that obtained analytically in the absence of backpropagation. However, for any given conductance change, when normalized with respect to their maxima, both firing frequencies were found to be very similar over a wide range of parameter values. Therefore, the actual firing rate (with backpropagation) may be approximated by the analytical solution without backpropagation if the actual firing rate for a large conductance change is known.     

Dosimetric characterization of INTRABEAM® miniature accelerator flat and surface applicators for dermatologic applications

PurposeThis study aims at characterizing the dosimetric behavior of an INTRABEAM^® miniature accelerator equipped with flat and surface applicators, converting the spherical dose distribution into a flat one.MethodsDosimetric characterization was carried out in two steps. Firstly characterization was made in standard conditions for dermatologic applications, which is with the applicator directly on contact with the skin. Secondly, characterization was made in more clinical conditions, such as obliquities and heterogeneities.ResultsBehaviors of flat and surface applicators are different. Dose distribution for surface applicators is uniform at surface, whereas for flat applicator the maximum homogeneity is shown at a particular depth in water. Some results are different from previously published studies due to differences in the X-ray source design. The study showed that in the absence of a perfect contact between the applicator and the skin of the patient, there is a dose distribution spread on the edge of the irradiation field where the contact is not made. Dose loss due to lack of backscatter radiations is significant. By contrast, influence of a denser material behind the measurement point has no significant influence on the dose at this point. Thickness of tissue treated with flat and surface applicators is only a few millimeters, depending on the applicator's size, making these applicators ideal for superficial lesions, compared to high energy electrons and iridium brachytherapy.ConclusionsThe INTRABEAM^® miniature accelerator equipped with surface applicators is a reliable way of treating superficial cutaneous malignancies.     

Dynamics of left ventricular wall and mitral valve mechanics--a model study

The relation between global left ventricular pumping characteristics and local cardiac muscle fiber mechanics is represented by a mathematical model of left ventricular mechanics in which the mitral valve papillary muscle system is incorporated. The wall of the left ventricle is simulated by a thick-walled cylinder. Transmural differences in fiber orientation are incorporated by changing the direction of material anisotropy across the wall. The cylinder is free to twist. The upper end of the cylinder is covered by a thin, flexible sheet, representing the base of the left ventricle. The mitral valve is incorporated in this sheet. The tips of the mitral leaflets are connected by chordae tendineae to the papillary muscles which are attached to the bottom of the cylinder. Canine cardiac cycles were simulated for various end-diastolic values of left ventricular volume (25-120 ml, control 60 ml), left atrial pressure (0-2.7 kPa, control 0.22 kPa) and aortic pressure (5-11 kPa, control 11 kPa). In this wide range of preload and afterload mechanical loading of the muscle fibers appeared to be distributed quite evenly (SD: +/- 5% of control value) over all muscular structures of the left ventricle, including the papillary muscles.     

Magnetic field measurements near RF induction heaters

We discuss initial magnetic field strength measurements made around radiofrequency (RF) induction heaters. These measurements were made with a monitor developed for the National Institute for Occupational Safety and Health (NIOSH) by the National Bureau of Standards (NBS). The monitor has a dynamic range of .01 to 10,000 A2/m2, a frequency range of 300 kHz to 100 MHz, an isotropic response (+/- .3 dB) with three mutally orthogonal loop antennas that have the ability to measure and display each of three orthogonal magnetic field components, a high probe burnout protection level of 20,000 A2/m2, and an accuracy of +/- 1.0 dB at 13 calibration frequencies. The portable survey monitor was used to measure the magnetic field strengths in the vicinity of 16 RF induction heaters. Typically these induction heaters are operated continuously for several hours. The maximum field strengths (without duty factor correction) ranged from 15 to 4,500 A2/m2 and were measured 5 to 51 cm from the loop applicators of the induction heaters. At locations commonly occupied by workers (ie, approximately 30 to 76 cm from heaters), the fields ranged from .01 to 300 A2/m2 (without duty factor correction).     

Lipid-mediated interactions between intrinsic membrane proteins: a theoretical study based on integral equations

This study of lipid-mediated interactions between proteins is based on a theory recently developed by the authors for describing the structure of the hydrocarbon chains in the neighborhood of a protein inclusion embedded in a lipid membrane [Lagüe et al., Farad. Discuss. 111:165-172, 1998]. The theory involves the hypernetted chain integral equation formalism for liquids. The exact lateral density-density response function of the hydrocarbon core, extracted from molecular dynamics simulations of a pure dipalmitoylphosphatidylcholine bilayer based on an atomic model, is used as input. For the sake of simplicity, protein inclusions are modeled as hard repulsive cylinders. Numerical calculations were performed with three cylinder sizes: a small cylinder of 2.5-A radius, corresponding roughly to an aliphatic chain; a medium cylinder of 5-A radius, corresponding to a alpha-helical polyalanine protein; and a large cylinder of 9-A radius, representing a small protein, such as the gramicidin channel. The calculations show that the average hydrocarbon density is perturbed over a distance of 20-25 A from the edge of the cylinder for every cylinder size. The lipid-mediated protein-protein effective interaction is calculated and is shown to be nonmonotonic. In the case of the small and the medium cylinders, the lipid-mediated effective interaction of two identical cylinders is repulsive at an intermediate range but attractive at short range. At contact, there is a free energy of -2k(B)T for the 2.5-A-radius cylinder and -9k(B)T for the 5-A-radius cylinder, indicating that the association of two alpha-helices of both sizes is favored by the lipid matrix. In contrast, the effective interaction is repulsive at all distances in the case of the large cylinder. Results were obtained with two integral equations theories: hypernetted chain and Percus-Yevick. For the two theories, all results are qualitatively identical.     

Integration of rotatable tandem applicator to conventional ovoid applicator toward complete framework of intensity modulated brachytherapy (IMBT) for cervical cancer

A new tandem applicator with tungsten shield for Ir-192 radiation source used in intra-cavitary brachytherapy (ICBT) enabled intensity modulated brachytherapy (IMBT) in cervical cancer treatment through fluence-modulation by rotating shield. Our previous work employed group-wise and element-wise sparsity constraints for plan optimization of tandem applicator to minimizes the number of activated angles and source dwell points for delivery efficiency. It, however, did not incorporate the ovoid applicators into the optimizing process, which is generally used to prevent cancer recurrence. To integrate ovoid applicators to the new tandem applicator, this work proposed a comprehensive framework that modifies 1) dose deposition matrix for inverse planning, and 2) plan optimizing algorithm. The dose deposition matrix was newly formulated by the Monte-Carlo simulated dose distribution for 10 positions of ovoid applicators, followed by combining those with tandem-associated dose deposition matrix. The plan optimizing algorithm decomposed entire elements into tandem and ovoid applicators, which were governed by different constraints adaptive to specified plan objectives. The integrated framework was compared against conventional ICBT, and IMBT with tandem only for three patients with asymmetric dose distributions. Integrated IMBT framework resulted in the most optimal plans. Including fluence-modulation by rotating-shield outperformed conventional ICBT in dose sparing to critical organs. Adopting ovoid applicators to the optimization yielded more conformal dose distribution around inferior, laterally expanded region of target volume. The resulting plans reduced D_5cc and D_2cc by 30.9% and 27.8% for critical organs over conventional ICBT, and by 20.6% and 21.5% for target volume over IMBT with tandem only.     

Impact of spherical applicator diameter on relative biologic effectiveness of low energy IORT X-rays: A hybrid Monte Carlo study

IntroductionLow-kV IORT (Low kilovoltage intraoperative radiotherapy) using INTRABEAM machine and dedicated spherical applicators is a candidate modality for breast cancer treatment. The current study aims to quantify the RBE (relative biologic effectiveness) variations of emitted X-rays from the surface of different spherical applicators and bare probe through a hybrid Monte Carlo (MC) simulation approach.Materials and methodsA validated MC model of INTRABEAM machine and different applicator diameters, based on GEANT4 Toolkit, was employed for RBE evaluation. To doing so, scored X-ray energy spectra at the surface of each applicator diameter/bare probe were used to calculate the corresponding secondary electron energy spectra at various distances inside the water and breast tissue. Then, MCDS (Monte Carlo damage simulation) code was used to calculate the RBE values according to the calculated electron spectra.ResultsPresence of spherical applicators can increase the RBE of emitted X-rays from the bare probe by about 22.3%. In return, changing the applicator diameter has a minimal impact (about 3.2%) on RBE variation of emitted X-rays from each applicator surface. By increasing the distance from applicator surface, the RBE increments too, so that its value enhances by about 10% with moving from 2 to 10 mm distance. Calculated RBE values within the breast tissue were higher than those of water by about 4% maximum value.ConclusionBall section of spherical IORT applicators can affect the RBE value of the emitted X-rays from INTRABEAM machine. Increased RBE of breast tissue can reduce the prescribed dose for breast irradiation if INTRABEAM machine has been calibrated inside the water.     

Monte Carlo calculations of order parameter profiles in models of lipid-protein interactions in bilayers

The Monte Carlo method has been utilized to calculate lipid chain order parameters in model monomolecular layers (half-bilayers) containing several different model polypeptides. The systems all consist of a periodic array of identical cells, each containing 35 hydrocarbon chains and 1 "perturbant" (a small model polypeptide or protein). The lipid chains are each 10 CH2 subunits long, have one end constrained to lie in the bilayer plane, and interact via van der Waals forces between all subunits. The chains also interact with the perturbant via van der Waals forces. With standard Monte Carlo procedures order parameter profiles are calculated for chains that are close to the perturbant and for the nonneighboring chains. In order to examine a wide range of possibilities, several different model polypeptides are considered: (i) a rigid smooth cylinder, (ii) a cylinder with identical side chains at alpha-helical positions, (iii) a cylinder with nonidentical side chains at alpha-helical positions, and (iv) a cylinder identical with (ii) but which only extends about halfway through the monolayer. Although results differ for the different systems studied, in all cases only slight conformational differences between the bulk chains and the chains that are nearest the perturbants are found, and it is not possible to characterize the boundary chains as "more ordered" or "less ordered" than the nonboundary chains.     

Lipid-mediated interactions between intrinsic membrane proteins: dependence on protein size and lipid composition.

The present study is an application of an approach recently developed by the authors for describing the structure of the hydrocarbon chains of lipid-bilayer membranes (LBMs) around embedded protein inclusions ( Biophys. J. 79:2867-2879). The approach is based on statistical mechanical integral equation theories developed for the study of dense liquids. First, the configurations extracted from molecular dynamics simulations of pure LBMs are used to extract the lateral density-density response function. Different pure LBMs composed of different lipid molecules were considered: dioleoyl phosphatidylcholine (DOPC), palmitoyl-oleoyl phosphatidylcholine (POPC), dipalmitoyl phosphatidylcholine (DPPC), and dimyristoyl phosphatidylcholine (DMPC). The results for the lateral density-density response function was then used as input in the integral equation theory. Numerical calculations were performed for protein inclusions of three different sizes. For the sake of simplicity, protein inclusions are represented as hard smooth cylinders excluding the lipid hydrocarbon core from a small cylinder of 2.5 A radius, corresponding roughly to one aliphatic chain, a medium cylinder of 5 A radius, corresponding to one alpha-helix, and a larger cylinder of 9 A radius, representing a small protein such as the gramicidin channel. The lipid-mediated interaction between protein inclusions was calculated using a closed-form expression for the configuration-dependent free energy. This interaction was found to be repulsive at intermediate range and attractive at short range for two small cylinders in POPC, DPPC, and DMPC bilayers, whereas it oscillates between attractive and repulsive values in DOPC bilayers. For medium size cylinders, it is again repulsive at intermediate range and attractive at short range, but for every model LBM considered here. In the case of a large cylinder, the lipid-mediated interaction was shown to be repulsive for both short and long ranges for the DOPC, POPC, and DPPC bilayers, whereas it is again repulsive and attractive for DMPC bilayers. The results indicate that the packing of the hydrocarbon chains around protein inclusions in LBMs gives rise to a generic (i.e., nonspecific) lipid-mediated interaction which favors the association of two alpha-helices and depends on the lipid composition of the membrane.     

Evaluation of microwave hyperthermia applicators.

Hyperthermia has been used in conjunction with radiation and chemotherapy for cancer treatment. When using electromagnetic heating, applicators are critical components in contact with or in proximity to patients and can be the determining factor for effective and safe treatment. Tissue absorption of electromagnetic energy is determined by many factors. Three cases are shown to illustrate the complexity of microwave heating: 1) The BSD MA-151 applicator has good center heating on a muscle-only phantom as shown in the operation manual. When fat slabs of 0.25, 0.5, 1, and 2 cm thick were added, two hot spots near the periphery of the applicator were evident on all fat surfaces, exposed at 631 MHz. At 915 MHz, the heating was elongated on the surface of the models with 0.25- and 2-cm fat, and two hot spots were observed on the 0.5- and 1-cm fat surfaces. 2) Heating patterns of the Clini-Therm applicators on a muscle-only phantom, as indicated in the operations guide, are elliptical with their major axes perpendicular to the electric field. However, when a bolus is used, the elliptical pattern is parallel to the E field. 3) Heating patterns in cylindrical structures were studied with inhomogeneous models of limbs. Arm and thigh models consisting of fat, bone, and muscle material were heated with Clini-Therm L, M, and MS applicators at 915 MHz. In addition to the geometric effect, the results indicated that placing the applicators with E field parallel to the long axis of cylindrical structures can minimize required power, produce less heating of fats and reduce stray radiation. In conclusion, to apply penetrating microwave or other RF fields for tissue heating, one must simulate the clinical exposure conditions as closely as possible to obtain useful heating patterns.     

3D-printed applicators for high dose rate brachytherapy: Dosimetric assessment at different infill percentage

PurposeDosimetric assessment of high dose rate (HDR) brachytherapy applicators, printed in 3D with acrylonitrile butadiene styrene (ABS) at different infill percentage.Materials and methodsA low-cost, desktop, 3D printer (Hamlet 3DX100, Hamlet, Dublin, IE) was used for manufacturing simple HDR applicators, reproducing typical geometries in brachytherapy: cylindrical (common in vaginal treatment) and flat configurations (generally used to treat superficial lesions). Printer accuracy was investigated through physical measurements. The dosimetric consequences of varying the applicator’s density by tuning the printing infill percentage were analysed experimentally by measuring depth dose profiles and superficial dose distribution with Gafchromic EBT3 films (International Specialty Products, Wayne, NJ). Dose distributions were compared to those obtained with a commercial superficial applicator.ResultsMeasured printing accuracy was within 0.5 mm. Dose attenuation was not sensitive to the density of the material. Surface dose distribution comparison of the 3D printed flat applicators with respect to the commercial superficial applicator showed an overall passing rate greater than 94% for gamma analysis with 3% dose difference criteria, 3 mm distance-to-agreement criteria and 10% dose threshold.ConclusionLow-cost 3D printers are a promising solution for the customization of the HDR brachytherapy applicators. However, further assessment of 3D printing techniques and regulatory materials approval are required for clinical application.     

Does the cylinder model of gastric evacuation predict observed evacuation of mixed meals of prey of contrasting geometries in a piscivorous fish?

The simple surface abstraction of the cylinder model (each prey as well as the total stomach contents is considered a cylinder that is gradually reduced by successive peeling off its curved side) was challenged by data on evacuation of a meal composed of three sandeels Ammodytes tobianus and a dab Limanda limanda fed to Atlantic cod Gadus morhua. While the body shape of A. tobianus comes close to that of a cylinder, the flatfish L. limanda takes a discoid form. As opposed to a modified form of the cylinder model, where the contrasting geometries of the fish prey were implemented, the simple, original cylinder model held the potential to predict evacuation of the individual prey types as well as the total stomach contents. Thus, the present study adds significantly to the increasing evidence that points to the generic nature of the model and its implicit square root function. Also, the present study corroborated a basic assumption that the variability of evacuation data not accounted for by the cylinder model primarily can be ascribed to the intraspecific variation in gastric performance of the predator.