The effect of music therapy on cognitive function has been widely reported; however, its clinical implications remain controversial. Performing therapeutic musical activities in groups using individualized instruments can help overcome the issues of engagement and compliance. We aimed to evaluate the effect of a cognitive intervention with musical stimuli using digital devices on mild cognitive impairment (MCI). In this prospective study, 24 patients with MCI (intervention group, 12; and control group, 12) were enrolled. We developed an electronic device with musical instruments and the Song-based Cognitive Stimulation Therapy protocol (SongCST). Patients in the intervention group underwent a 10-week cognitive intervention involving musical stimuli generated by our device. Effect of the intervention on cognitive function was evaluated by the Mini-Mental State Examination-Dementia Screening (MMSE-DS), Montreal Cognitive Assessment-Korean (MOCA-K), and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB). In the intervention group, MMSE-DS and MOCA-K scores improved significantly after the 10-week intervention. The changes in MOCA-K and CDR-SB scores were significantly different between the intervention and control groups. Our study showed that music therapy with digital devices has a positive effect on the executive function and overall disease severity in patients with MCI. Our study can facilitate individualization of music therapy using digital devices in groups.

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Object The authors evaluated the accuracy of the automatic image coregistration function implemented in the Leksell GammaPlan treatment planning software (Version 4C with MultiView Extension and Version 8.0). Methods The authors used a phantom with 9 landmarks (tips of thin cylindrical acrylic rods) evenly distributed in the treatment space. Two sets of images of the phantom were taken with both CT and MR imaging systems. The first image was obtained with the phantom aligned with the scanner's axis and the second scan was made by intentionally shifting and rotating the phantom relative to the scanner's axis. The authors attempted image registration of 2 CT image sets, CT and MR image sets, and 2 MR image sets. The accuracy of image registration was evaluated by measuring the x, y, and z coordinate values of the landmarks on each image set after 2 image sets were coregistered. The authors calculated the differences of the x, y, and z values and the distance, d, between corresponding landmarks in 2 image sets. To minimize interobserver dependence of coordinate measurements, 2 physicists did measurements independently. Results The distances, d, averaged over the 9 landmarks, were 2.63 ± 1.64 and 0.95 ± 0.25 mm for CT–CT and MR–MR image registrations, respectively. When the CT images of the air-filled phantom and MR images were coregistered, however, the algorithm performed poorly: d = 13.8 ± 1.23 mm. To remedy this, the authors undertook a 2-step process by first performing landmark-based registration of the 2 image sets and subsequently applying the automatic registration. With this approach, the mean distance drastically improved: d = 0.74 ± 0.31 mm. When the water-filled phantom was used for CT scans, the registration accuracy of CT and MR image sets was acceptable without the 2-step registration process: d = 1.18 ± 0.36 mm. Conclusions The accuracy of automatic registration of image sets from the same modality was within the voxel size of the scanned images. The accuracy of CT–MR image registration strongly depended on whether the phantom for CT scans was filled with air or water. This indicates the significant effect of the amount of common data available for a mutual information-based algorithm on the accuracy.

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Purpose: The objective of this work is to investigate the impact of collimator jaw position on dose to organs at risk (OARs) during a 3-dimensional conformal radiotherapy (3DCRT) of pancreatic cancer and postulate a method to minimize OAR dose by proper positioning of the jaws. Methods: Clinically delivered 3DCRT treatment plans for 10 patients optimized with multiple static beams using multileaf collimator (MLC) leaves conformed to a block margin around target, and collimator jaws aligned with outer extent of the block margin were selected. Subsequent plans were generated by displacing the collimator jaws outward in lateral, superior-inferior or both directions by 1 and 2 cm without altering the MLC position. Computed dose to OARs and target with unaltered dose normalization were compared against the corresponding dose obtained from the original plans. Results: Outward displacement of the collimator jaws by 1 cm in lateral and/or superior-inferior direction resulted in a significant increase in mean dose to the studied OARs. The increase was found to be proportional to the outward displacement of the jaws. The increase in maximum dose to spinal cord was significant in a few patients while it was insignificant for all other OARs. Conclusion: Collimator jaws aligned with outer extent of a block margin minimize dose to OARs. Any gap between the block margin and the collimator jaws can lead to an inadvertent delivery of higher dose to the OARs. Hence, the use of an optimal jaw position during treatment planning becomes important to all patient plans.

The first aim of this study is to review and critique the empirical literature on dyadic problems of spousal caregivers. A total of 18 relevant studies published between 1990 and 2015 were identified via several databases in South Korea. Four major results were identified: (1) assuming caregiving roles easily caused various caregiving-related problems, such as stress and burden; (2) care recipients’ health conditions and problems were one of the crucial factors influencing caregiving-related problems in spousal caregivers; (3) caregiving easily caused marital problems in couples with frail spouses; and (4) spousal caregivers had negative communications with their care recipients.

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