BACKGROUND Postirradiation fibrosis is one of the most common late effects of radiation therapy for patients with head and neck carcinoma. An objective and quantitative method for its measurement is much desired, but the criteria currently used to score fibrosis are mostly semiquantitative and partially subjective. METHODS The Young Modulus (YM) is a physical parameter that characterizes the deformability of material to stress. The authors measured the YM in soft tissues of the neck, at defined reference points, using an ultrasound probe and computer algorithm that quantified the indentation (deformation) on tissue due to a measured, applied force. One hundred five patients who had received previous radiation therapy to the entire neck were assessed, and the results were compared with the hand palpation scores and with a functional parameter represented by the range of neck rotation, and all results were correlated with symptoms. RESULTS The YM was obtained successfully in all patients examined. It had a significant positive correlation with the palpation score and a significant negative correlation with the range of neck rotation. The YM was significantly higher on the side of the neck that received a boost dose of radiation, although the corresponding palpation scores were similar. The results of all three measurement methods were correlated with symptoms. CONCLUSIONS Postirradiation neck fibrosis can be measured in absolute units based on the YM. The results showed a significant correlation with hand palpation scores, with restriction of neck rotation, and with symptoms. Compared with the palpation method, the YM is more quantitative, objective, focused on small subregions, and better discriminates regions subject to differential radiation dose levels. Its inclusion in the Analytic category of the Late Effects of Normal Tissues‐SOMA system should be considered to facilitate comparative studies. Cancer 2002;95:656–62. © 2002 American Cancer Society. DOI 10.1002/cncr.10700
The aim of the study was to compare the effect of a gentian violet topical application with that of a moist dressing (hydrocolloid) on the rate and efficacy of radiotherapy-induced moist desquamation wound healing and the patients' satisfaction level with each method. This prospective randomized clinical trial used a stratified sampling design. A sample of 39 patients with 60 wounds had their wounds assessed on alternate days in terms of several wound-healing parameters including wound size, wound pain, incidence of infection, and time required for healing. Patient satisfaction with each treatment was evaluated at the completion of the study. Gentian violet significantly decreased wound size and reduced wound pain. However, this treatment received significantly lower ratings for dressing comfort and dressing aesthetic acceptance. Nevertheless, the time required for healing was not statistically different in the two groups. These findings suggest that the lower score of dressing satisfaction level in the gentian violet group may result from the skin discoloration and drying effects of the treatment, which renders patients unable to move or stretch their skin. Although the aim is to have complete wound healing, this may not be realistic for many lesions such as radiotherapy-induced moist desquamation wounds. The best evidence on which to make decisions about individual care can now be based on patients' own perception of quality.
The Collaboratory for the Study of Earthquake Predictability (CSEP) is a global cyberinfrastructure for prospective evaluations of earthquake forecast models and prediction algorithms. CSEP's goals are to improve our understanding of earthquake predictability, advance forecasting model development, test key scientific hypotheses and their predictive power, and to improve seismic hazard assessments. Since its inception in California in 2007, the global CSEP collaboration has been conducting forecast experiments in a variety of tectonic settings and at the global scale, and now operates four testing centers on four continents to automatically and objectively evaluate models against prospective data. These experiments have provided a multitude of results that are informing operational earthquake forecasting systems and seismic hazard models, and they have provided new, and sometimes surprising, insights into the predictability of earthquakes and spurned model improvements. CSEP has also conducted pilot studies to evaluate ground-motion and hazard models. Here, we report on selected achievements from a decade of CSEP, and we present our priorities for future activities.
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