ORCID Profile
0000-0002-3462-4546
Current Organisation
Mayo Clinic Minnesota
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Publisher: OMICS Publishing Group
Date: 2011
Publisher: Longwoods Publishing
Date: 20-02-2018
Publisher: Cambridge University Press (CUP)
Date: 20-05-2020
DOI: 10.1017/S1460396920000345
Abstract: The aim of this study was to evaluate whether RapidPlan (RP) could generate clinically acceptable prostate volumetric modulated arc therapy (VMAT) plans. The in-house RP model was used to generate VMAT plans for 50 previously treated prostate cancer patients, with no additional optimisation being performed. The VMAT plans that were generated using the RP model were compared with the patients’ previous, manually optimised clinical plans (MP), none of which had been used for the development of the in-house RP prostate model. Differences between RP and MP in planning target volume (PTV) doses, organs at risk (OAR) sparing, monitor units (MU) and planning time required to produce treatment plans were analysed. Assessment of PTV doses was based on the conformation number (CN), homogeneity index (HI), D 2% , D 99% and the mean dose of the PTV. The OAR doses evaluated were the rectal V 50 Gy , V 65 Gy , V 70 Gy and the mean dose, the bladder V 65 Gy , V 70 Gy and the mean dose, and the mean dose to both femurs. D 99% and mean dose of the PTV were lower for RP than for MP ( p = 0·006 and p = 0·040, respectively).V 50 Gy , V 65 Gy and the mean dose to rectum were lower in RP than in MP ( p 0·001). V 65 Gy , V 70 Gy and the mean dose to bladder were lower in RP than in MP ( p 0·001). RP had enhanced the sparing of both femurs ( p 0·001) and significantly reduced the planning time to less than 5% of the time taken with MP. MU in RP was significantly higher than MP by an average of 52·5 MU ( p 0·001) and 46 out of the 50 RP plans were approved by the radiation oncologist. This study has demonstrated that VMAT plans generated using an in-house RP prostate model in a single optimisation for prostate patients were clinically acceptable with comparable or better plan quality compared to MP. RP can add value and improve treatment planning efficiency in a high-throughput radiotherapy department through reduced plan optimisation time while maintaining consistency in the plan quality.
Publisher: Elsevier BV
Date: 10-1999
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.JOGC.2016.09.004
Abstract: Non-invasive prenatal testing (NIPT) is an exciting technology with the potential to provide a variety of clinical benefits, including a reduction in miscarriages, via a decline in invasive testing. However, there is also concern that the economic and near-future clinical benefits of NIPT have been overstated and the potential limitations and harms underplayed. NIPT, therefore, presents an opportunity to explore the ways in which a range of social pressures and policies can influence the translation, implementation, and use of a health care innovation. NIPT is often framed as a potential first tier screen that should be offered to all pregnant women, despite concerns over cost-effectiveness. Multiple forces have contributed to a problematic translational environment in Canada, creating pressure towards first tier implementation. Governments have contributed to commercialization pressure by framing the publicly funded research sector as a potential engine of economic growth. Members of industry have an incentive to frame clinical value as beneficial to the broadest possible cohort in order to maximize market size. Many studies of NIPT were directly funded and performed by private industry in laboratories lacking strong independent oversight. Physicians' fear of potential liability for failing to recommend NIPT may further drive widespread uptake. Broad social endorsement, when combined with these translation pressures, could result in the "routinization" of NIPT, thereby adversely affecting women's reproductive autonomy. Policymakers should demand robust independent evidence of clinical and public health utility relevant to their respective jurisdictions before making decisions regarding public funding for NIPT.
Publisher: Oxford University Press (OUP)
Date: 25-02-2014
DOI: 10.1093/JLB/LST004
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.MAYOCP.2021.06.026
Abstract: To explore the experiences, approaches, and challenges of physicians consulting patients about experimental stem cell and regenerative medicine interventions (SCRIs). From August 21, 2018, through July 30, 2019, semistructured interviews of 25 specialists in cardiology, ophthalmology, orthopedics, pulmonology, and neurology were conducted and qualitatively analyzed using modified grounded theory. All specialists used informational approaches to counsel patients, especially orthopedists. Informational approaches included explaining stem cell science, sharing risks, and providing principles. Several specialists also used relational counseling approaches including emphasizing that physicians want what is best for patients, acknowledging suffering, reassuring continued care, empathizing with patients and families, and underscoring that patients have the final decision. Many specialists reported being comfortable with the conversation, although some were less comfortable and several noted challenges in the consultation including wanting to support a patient's decision but worrying about harms from unproven SCRIs, navigating family pressure, and addressing stem cell hype and unrealistic expectations. Specialists also desired that additional resources be available for them and patients. Physicians relied more heavily on providing patients with information about SCRIs than using relational counseling approaches. Efforts should be directed at helping physicians address the informational and relational needs of patients, including providing tools and resources that inform physicians about the unproven SCRI industry, building skills in empathic communication, and the creation and dissemination of evidence-based resources to offer patients.
Publisher: Elsevier BV
Date: 09-2014
Publisher: EMBO
Date: 04-12-2014
Location: United States of America
No related grants have been discovered for Zubin Master.