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At least 19 records

Extracellular matrix and growth factor engineering for controlled angiogenesis in regenerative medicine.

Blood vessel growth plays a key role in regenerative medicine, both to restore blood supply to ischemic tissues and to ensure rapid vascularization of clinical-size tissue-engineered grafts. For example, vascular endothelial growth factor (VEGF) is the master regulator of physiological blood vessel growth and is one of the main molecular targets of therapeutic angiogenesis approaches. However, angiogenesis is a complex process and there is a need to develop rational therapeutic strategies based on a firm understanding of basic vascular biology principles, as evidenced by the disappointing results of initial clinical trials of angiogenic factor delivery. In particular, the spatial localization of angiogenic signals in the extracellular matrix (ECM) is crucial to ensure the proper assembly and maturation of new vascular structures. Here, we discuss the therapeutic implications of matrix interactions of angiogenic factors, with a special emphasis on VEGF, as well as provide an overview of current approaches, based on protein and biomaterial engineering that mimic the regulatory functions of ECM to optimize the signaling microenvironment of vascular growth factors.

Martino, Mikael M.↗

Printing of small molecular medicines from the vapor phase

There is growing need to develop efficient methods for early-stage drug discovery, continuous manufacturing of drug delivery vehicles, and ultra-precise dosing of high potency drugs. Here we demonstrate the use of solvent-free organic vapor jet printing to deposit nanostructured films of small molecular pharmaceutical ingredients, including caffeine, paracetamol, ibuprofen, tamoxifen, BAY 11-7082 and fluorescein, with accuracy on the scale of micrograms per square centimeter, onto glass, Tegaderm, Listerine tabs, and stainless steel microneedles. The printed films exhibit similar crystallographic order and chemistry as the original powders; controlled, order-of-magnitude enhancements of dissolution rate are observed relative to powder-form particles. In vitro treatment of breast and ovarian cancer cell cultures in aqueous media by tamoxifen and BAY 11-7082 films shows similar behavior to drugs pre-dissolved in dimethyl sulfoxide. In conclusion, the demonstrated precise printing of medicines as films, without the use of solvents, can accelerate drug screening and enable continuous manufacturing, while enhancing dosage accuracy.

60 APPLIED LIFE SCIENCES↗

Development of taste sensor system for differentiation of Indonesian herbal medicines

In Indonesia, herbal medicines are usually produced by small and medium enterprises which are relatively low in quality control. The purpose of this paper is to report that we have developed a taste sensor system with global selectivity, i.e., electronic tongue (e-tongue) for differentiation of Indonesian herbal medicines. The e-tongue was composed of five kinds of ion selective electrodes as working electrodes, data acquisition system, and pattern recognition system. Each ion selective electrode (ISE) was built by attaching lipid/polymer membrane. For this purpose, the five kinds of membranes were built by mixing lipid, plasticizer (nitrophenyl octyl ether/NPOE), polyvinyl chloride (PVC), and tetrahydrofuran (THF). In this study, we employed five kinds of lipid, namely oleic acid (OA), dioctyl phosphate (DOP), decyl alcohol (DA), dodecylamine (DDC), and trioctyl methyl ammonium chloride (TOMA). In this case, the membranes transform information of taste substances into electric signal. The five kinds of Indonesian herbal medicine were purchased from local supermarket in Yogyakarta, i.e., kunyit asam (made from turmeric and tamarind), beras kencur (made from rice and kencur), jahe wangi (made from ginger and fragrance), sirih wangi (made from betel leaf), and temulawak (made from Javanese ginger). Prior to detecting the taste from the Indonesian herbal medicine samples, each ion selective electrode was tested with five basic taste samples, i.e., for saltiness, sweetness, umami, bitterness, and sourness. All ISEs showed global selectivity to all samples. Furthermore, the array of ISEs showed specific response pattern to each Indonesian herbal medicine. For pattern recognition system, we employed principle component analysis (PCA). As a result, the e-tongue was able to differentiate five kinds of Indonesian herbal medicines, proven by the total variance of first and second principle components is about 93%. For the future, the e-tongue may be developed for quality control application in herbal medicine industries.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

The Michigan New Technology Training and Research (MNTR) Translational Program in Nuclear Medicine (Final Report)

The Michigan New Technology Training and Research (MNTR) Translational Program in Nuclear Medicine and Molecular Imaging This project established the Michigan New Technology Training and Research (MNTR) translational program, focused on the acceleration of new clinical molecular imaging methods. Molecular imaging approaches to imaging are a very flexible and powerful development, with many recent examples advancing the diagnosis and guiding the management of human disease. These methods depend on the design, synthesis and testing of new radiotracers (molecules designed to target specific cells or tissues in the body), labeled with short-lived radioactive atoms (positron emitters). The new radiotracers are imaged in the human body using positron emission tomography (PET) imaging. The University of Michigan PET Center has considerable experience in the discovery, development, refinement and initial human applications of new PET radiotracers. An emerging impediment to efficient availability of new PET radiotracers, however, involves the regulatory environment at multiple levels. Many potentially successful ideas are delayed or even prevented from entering human use by these barriers. In the current grant, we provided hands-on experience for the next generation of young scientists working in molecular imaging so that they are equipped to effectively move new ideas and radiotracers from the research laboratory to the nuclear medicine clinic (bench-to-bedside). For new radiotracer development, oversight by the Food and Drug Administration (FDA), the Nuclear Regulatory Commission (NRC), and local institutional committees and reviews are required. These aspects of translation from laboratory to clinic are often omitted from the formal training of new scientists, but were provided to three trainees via direct mentorship in the MNTR program. The MNTR training program built on the translational successes of the University of Michigan Division of Nuclear Medicine and capitalized on our strengths (facilities, faculty, a wide-ranging selection of projects, and the experience and commitment to bring new radiotracers into human studies) to systematically train three fellows in radiochemistry and nuclear medicine. Integrated training in development, validation and clinical translation of new PET radiotracers occurred through practical involvement in multiple research projects, each at a different stage along the pathway from bench-to-bedside. Each trainee obtained experience of the entire process over about 2 years. Projects involved development of new radiotracers for neurodegenerative disorders (e.g. Alzheimer disease), movement disorders (e.g. Parkinson disease, progressive supranuclear palsy) and neurodevelopmental syndromes (e.g. Tourette syndrome) as well as new radiochemistry methods for synthesizing radiotracers. Each project was pursued in a close collaboration between the fellow trainee and both the clinical and basic science faculty at the University of Michigan PET Center, and provided an unprecedented opportunity for the highest-level training in academic radiochemistry and nuclear medicine research. The project has resulted in 17 peer-reviewed publications to date, and at least 4 more are in preparation. Additionally, 1 book chapter and 26 conference presentations have resulted from this grant. Upon completion of the MNTR Program, the trainees have emerged as translational scientists wielding the necessary skill-set (practical research experience, multidisciplinary training, regulatory know-how) to embark on successful careers in translational molecular imaging, bringing continued advances in the field to bear on important human disorders. As a metric of the Program’s success, one fellow has already secured employment in the field, while the other two are finishing writing papers; they wish to also stay in the radiochemistry and nuclear medicine community, and are currently applying for jobs.

38 RADIATION CHEMISTRY, RADIOCHEMISTRY, AND NUCLEA↗

Global Issues of Radiopharmaceutical Access and Availability: a Nuclear Medicine Global Initiative Project

The Nuclear Medicine Global Initiative (NMGI) was formed in 2012 by 13 international organizations to promote human health by advancing the field of nuclear medicine and molecular imaging by supporting the practice and application of nuclear medicine. The first project focused on standardization of administered activities in pediatric nuclear medicine and resulted in two manuscripts. For its second project the NMGI chose to explore issues impacting on access and availability of radiopharmaceuticals around the world. Methods: Information was obtained by survey responses from 35 countries on available radioisotopes, radiopharmaceuticals and kits for diagnostic and therapeutic use. Issues impacting on access and availability of radiopharmaceuticals in individual countries were also identified. Results: Detailed information on radiopharmaceuticals utilized in each country, and sources of supply, was evaluated. Responses highlighted problems in access particularly due to the reliance on a sole provider, regulatory issues and reimbursement, as well as issues of facilities and workforce particularly in low- and middle-income countries. Conclusion: Finally, strategies to address access and availability of radiopharmaceuticals are outlined, to enable timely and equitable patient access to nuclear medicine procedures worldwide. In the face of disruptions to global supply chains by the COVID-19 outbreak, renewed focus on ensuring reliable supply of radiopharmaceuticals is a major priority for nuclear medicine practice globally.

43 PARTICLE ACCELERATORS↗

TH-E-9A-01: Medical Physics 1.0 to 2.0, Session 4: Computed Tomography, Ultrasound and Nuclear Medicine

Medical Physics 2.0 is a bold vision for an existential transition of clinical imaging physics in face of the new realities of value-based and evidencebased medicine, comparative effectiveness, and meaningful use. It speaks to how clinical imaging physics can expand beyond traditional insular models of inspection and acceptance testing, oriented toward compliance, towards team-based models of operational engagement, prospective definition and assurance of effective use, and retrospective evaluation of clinical performance. Organized into four sessions of the AAPM, this particular session focuses on three specific modalities as outlined below. CT 2.0: CT has been undergoing a dramatic transition in the last few decades. While the changes in the technology merits discussions of their own, an important question is how clinical medical physicists are expected to effectively engage with the new realities of CT technology and practice. Consistent with the upcoming paradigm of Medical Physics 2.0, this CT presentation aims to provide definitions and demonstration of the components of the new clinical medical physics practice pertaining CT. The topics covered include physics metrics and analytics that aim to provide higher order clinicallyrelevant quantification of system performance as pertains to new (and not so new) technologies. That will include the new radiation and dose metrics (SSDE, organ dose, risk indices), image quality metrology (MTF/NPS/d’), task-based phantoms, and the effect of patient size. That will follow with a discussion of the testing implication of new CT hardware (detectors, tubes), acquisition methods (innovative helical geometries, AEC, wide beam CT, dual energy, inverse geometry, application specialties), and image processing and analysis (iterative reconstructions, quantitative CT, advanced renditions). The presentation will conclude with a discussion of clinical and operational aspects of Medical Physics 2.0 including training and communication, use optimization (dose and technique factors), automated analysis and data management (automated QC methods, protocol tracking, dose monitoring, issue tracking), and meaningful QC considerations. US 2.0: Ultrasound imaging is evolving at a rapid pace, adding new imaging functions and modes that continue to enhance its clinical utility and benefits to patients. The ultrasound talk will look ahead 10–15 years and consider how medical physicists can bring maximal value to the clinical ultrasound practices of the future. The roles of physics in accreditation and regulatory compliance, image quality and exam optimization, clinical innovation, and education of staff and trainees will all be considered. A detailed examination of expected technology evolution and impact on image quality metrics will be presented. Clinical implementation of comprehensive physics services will also be discussed. Nuclear Medicine 2.0: Although the basic science of nuclear imaging has remained relatively unchanged since its inception, advances in instrumentation continue to advance the field into new territories. With a great number of these advances occurring over the past decade, the role and testing strategies of clinical nuclear medicine physicists must evolve in parallel. The Nuclear Medicine 2.0 presentation is designed to highlight some of the recent advances from a clinical medical physicist perspective and provide ideas and motivation for designing better evaluation strategies. Topics include improvement of traditional physics metrics and analytics, testing implications of hybrid imaging and advanced detector technologies, and strategies for effective implementation into the clinic. Learning Objectives: Become familiar with new physics metrics and analytics in nuclear medicine, CT, and ultrasound. To become familiar with the major new developments of clinical physics support. To understand the physics testing implications of new technologies, hardware, software, and applications. Identify approaches for implementing comprehensive medical physics services in future imaging practices.

60 APPLIED LIFE SCIENCES↗

MO-C-BRB-04: The role of the NIH in funding innovations in science and medicine

Diagnostic radiology and radiation oncology are arguably two of the most technologically advanced specialties in medicine. The imaging and radiation medicine technologies in clinical use today have been continuously improved through new advances made in the commercial and academic research arenas. This symposium explores the translational path from research through clinical implementation. Dr. Pettigrew will start this discussion by sharing his perspectives as director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB). The NIBIB has focused on promoting research that is technological in nature and has high clinical impact. We are in the age of precision medicine, and the technological innovations and quantitative tools developed by engineers and physicists working with physicians are providing innovative tools that increase precision and improve outcomes in health care. NIBIB funded grants lead to a very high patenting rate (per grant dollar), and these patents have higher citation rates by other patents, suggesting greater clinical impact, as well. Two examples of clinical translation resulting from NIH-funded research will be presented, in radiation therapy and diagnostic imaging. Dr. Yu will describe a stereotactic radiotherapy device developed in his laboratory that is designed for treating breast cancer with the patient in the prone position. It uses 36 rotating Cobalt-60 sources positioned in an annular geometry to focus the radiation beam at the system’s isocenter. The radiation dose is delivered throughout the target volume in the breast by constantly moving the patient in a planned trajectory relative to the fixed isocenter. With this technique, the focal spot dynamically paints the dose distribution throughout the target volume in three dimensions. Dr. Jackson will conclude this symposium by describing the RSNA Quantitative Imaging Biomarkers Alliance (QIBA), which is funded in part by NIBIB and is a synergistic collaboration between medical physicists, radiologists, oncologists, industry representatives, and other stakeholders. The mission of QIBA is to improve the accuracy and practicality of quantitative image-based biomarkers by increasing precision across devices, patients, and time, an essential step in incorporating quantitative imaging biomarkers into radiology practice. Validated quantitative imaging biomarkers are necessary to support precision medicine initiatives, multimodality / multiparametric applications in medicine, treatment planning and response assessment, and radiogenomics applications. Current applications in the QIBA portfolio extend to cancer diagnosis and treatment, pulmonary diseases, and neurological disorders. The overall goal of this symposium is to illustrate the bidirectional exchange between medical research and clinical practice. Revitalizing scientific excellence in clinical medical physics challenges practitioners to identify clinical limitations, which then drive research innovation; research funded by the NIH and other agencies develops technological solutions to these limitations, which are translated to the care environment to ultimately improve clinical practice in radiology and radiation oncology.

60 APPLIED LIFE SCIENCES↗

The role of general nuclear medicine in breast cancer

The rising incidence of breast cancer worldwide has prompted many improvements to current care. Routine nuclear medicine is a major contributor to a full gamut of clinical studies such as early lesion detection and stratification; guiding, monitoring, and predicting response to therapy; and monitoring progression, recurrence or metastases. Developments in instrumentation such as the high-resolution dedicated breast device coupled with the diagnostic versatility of conventional cameras have reinserted nuclear medicine as a valuable tool in the broader clinical setting. This review outlines the role of general nuclear medicine, concluding that targeted radiopharmaceuticals and versatile instrumentation position nuclear medicine as a powerful modality for patients with breast cancer.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Gaps in Radiation Therapy Awareness: Results From an Educational Multi-institutional Survey of US Internal Medicine Residents

Purpose: Internists and primary care providers play a growing role in cancer care. We therefore evaluated the awareness of radiation therapy in general and specifically the clinical utility of stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) among current US internal medicine residents. Methods and Materials: A web-based institutional review board–approved multi-institutional survey was distributed to US internal medicine residency programs. The survey evaluated trainee demographic characteristics, baseline radiation oncology awareness, knowledge of the role of SBRT for early-stage NSCLC, and whether the survey successfully improved awareness. Results: Thirty US internal medicine programs participated, with an overall participant response rate of 46% (1177 of 2551). Of the trainees, 93% (n=1076) reported no radiation oncology education in their residency, 39% (n=452) reported confidence in knowing when to consult radiation oncology in an oncologic emergency, and 26% (n=293) reported confidence in knowing when to consult radiation oncology in the setting of a newly diagnosed cancer. Of the participants, 76% (n=850) correctly identified that surgical resection is the standard treatment in operable early-stage NSCLC, but only 50% (n=559) of participants would recommend SBRT to a medically inoperable patient, followed by 31% of participants (n=347) who were unsure of the most appropriate treatment, and 10% (n=117) who recommended waiting to offer palliative therapy. Ninety percent of participants (n=1029) agreed that they would benefit from further training on when to consult radiation oncology. Overall, 96% (n=1072) indicated that the survey increased their knowledge and awareness of the role of SBRT. Conclusions: The majority of participating trainees received no education in radiation oncology in their residency, reported a lack of confidence regarding when to consult radiation oncology, and overwhelmingly agreed that they would benefit from further training. These findings should serve as a call to increase the educational collaboration between internal medicine and radiation oncology departments to ensure optimal cancer care.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Modelling kidney disease using ontology: insights from the Kidney Precision Medicine Project

An important need exists to better understand and stratify kidney disease according to its underlying pathophysiology in order to develop more precise and effective therapeutic agents. National collaborative efforts such as the Kidney Precision Medicine Project are working towards this goal through the collection and integration of large, disparate clinical, biological and imaging data from patients with kidney disease. Ontologies are powerful tools that facilitate these efforts by enabling researchers to organize and make sense of different data elements and the relationships between them. Ontologies are critical to support the types of big data analysis necessary for kidney precision medicine, where heterogeneous clinical, imaging and biopsy data from diverse sources must be combined to define a patient’s phenotype. Here, the development of two new ontologies — the Kidney Tissue Atlas Ontology and the Ontology of Precision Medicine and Investigation — will support the creation of the Kidney Tissue Atlas, which aims to provide a comprehensive molecular, cellular and anatomical map of the kidney. These ontologies will improve the annotation of kidney-relevant data, and eventually lead to new definitions of kidney disease in support of precision medicine.

60 APPLIED LIFE SCIENCES↗

Determination of elements in ayurvedic medicinal plants by AAS

India has a rich country for the uses of Ayurvedic medicinal plants for treatment and also the north- Karnataka boasts an unparallel diversity of medicinal plants. The present study attempts to estimate and compare the level of trace and heavy metals in some selected leaves and root samples of Ayurvedic medicinal plants such as Mg, Al, K, Cr, Mn, Fe, Cu, Zn, and Cd. The samples are collected from different places of North-Karnataka regions and sample solutions prepared as the ratio of 1:25:25+950ml=1000ppm.the trace and heavy elemental concentration was estimated using Atomic Absorption Spectrometric (AAS) Method. The average concentrations of Mg, Mn, Fe and Zn, are ranging from 2ppm to 5250.2ppm and potassium (K) has more concentration as compare to all other. The other elements likes Al, Cr, Cu, and Cd were also estimed and presented in the table. Therefore, these medicinal plants are rich in some essential minerals, especially K, Mg, Mn, Fe and Zn which are essential for human health.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Alignment of Short Reads: A Crucial Step for Application of Next-Generation Sequencing Data in Precision Medicine

Precision medicine or personalized medicine has been proposed as a modernized and promising medical strategy. Genetic variants of patients are the key information for implementation of precision medicine. Next-generation sequencing (NGS) is an emerging technology for deciphering genetic variants. Alignment of raw reads to a reference genome is one of the key steps in NGS data analysis. Many algorithms have been developed for alignment of short read sequences since 2008. Users have to make a decision on which alignment algorithm to use in their studies. Selection of the right alignment algorithm determines not only the alignment algorithm but also the set of suitable parameters to be used by the algorithm. Understanding these algorithms helps in selecting the appropriate alignment algorithm for different applications in precision medicine. Here, we review current available algorithms and their major strategies such as seed-and-extend and q-gram filter. We also discuss the challenges in current alignment algorithms, including alignment in multiple repeated regions, long reads alignment and alignment facilitated with known genetic variants.

59 BASIC BIOLOGICAL SCIENCES↗

Development of a series of Korean pediatric and adult head computational phantoms and application to nuclear medicine dosimetry - Paper 26

Over the past decades, advances in Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET) imaging techniques and an increasing number of new radiopharmaceuticals have resulted in a surge of neuroimaging applications in nuclear medicine on pediatric and adult patients. It is not feasible to directly measure the absorbed dose to the organs of the human body from nuclear medicine procedures. The formalism of the Medical Internal Radiation Dose (MIRD) committee of the Society of Nuclear Medicine has been adopted as the calculation method to estimate radiation dose to target organs from radionuclides distributed in source organs. The absorbed dose to a target organ from different types of radionuclides distributed within source organs can be estimated by the products of the time-integrated activity in each source region and organ dose conversion coefficients, called S values (Gy/MBq-s). S values are computed from a comprehensive set of Specific Absorbed Fraction (SAF), which are calculated from computational human phantoms with realistic anatomical structures coupled with Monte Carlo transport technique. The current SAF data for pediatric and adult head and brain dosimetry is based on a series of stylized computational phantoms. However, dosimetric errors caused by the unrealistic anatomy of stylized phantoms in internal dosimetry calculations have been reported by several studies. In the current study, we developed a series of realistic computational head phantoms representing 6, 9, 12, 15, and 22-year-old standard Korean males, and computed a comprehensive set of SAFs using the phantoms coupled with Monte Carlo transport technique. (authors)

61 RADIATION PROTECTION AND DOSIMETRY↗

An Emerging Role for Polystores in Precision Medicine

Medical data is organically heterogeneous, and it usually varies significantly in both size and composition. Yet, this data is also a key for the recent and promising field of precision medicine, which focuses on identifying and tailoring appropriate medical treatments for the needs of the individual patients, based on their specific conditions, their medical history, lifestyle, genetic, and other individual factors. As we, and a database community at large, recognize that a “one size does not fit all” solution is required to work with such data, we present in this paper our observations based on our experiences, and the applications in the field of precision medicine. Finally, we make the case for the use of polystore architecture; how it applies for precision medicine; we discuss the reference architecture; describe some of its critical components (array database); and discuss the specific types of analysis that directly benefit from this database architecture, and the ways it serves the data.

60 APPLIED LIFE SCIENCES↗

Comparison of 4-Dimensional Computed Tomography Ventilation With Nuclear Medicine Ventilation-Perfusion Imaging: A Clinical Validation Study

Purpose: Four-dimensional computed tomography (4DCT) ventilation imaging provides lung function information for lung cancer patients undergoing radiation therapy. Before 4DCT-ventilation can be implemented clinically it needs to be validated against an established imaging modality. The purpose of this work was to compare 4DCT-ventilation to nuclear medicine ventilation, using clinically relevant global metrics and radiologist observations. Methods and Materials: Fifteen lung cancer patients with 16 sets of 4DCT and nuclear medicine ventilation-perfusion (VQ) images were used for the study. The VQ-ventilation images were acquired in planar mode using Tc-99m-labeled diethylenetriamine-pentaacetic acid aerosol inhalation. 4DCT data, spatial registration, and a density-change-based model were used to compute a 4DCT-based ventilation map for each patient. The percent ventilation was calculated in each lung and each lung third for both the 4DCT and VQ-ventilation scans. A nuclear medicine radiologist assessed the VQ and 4DCT scans for the presence of ventilation defects. The VQ and 4DCT-based images were compared using regional percent ventilation and radiologist clinical observations. Results: Individual patient examples demonstrate good qualitative agreement between the 4DCT and VQ-ventilation scans. The correlation coefficients were 0.68 and 0.45, using the percent ventilation in each individual lung and lung third, respectively. Using radiologist-noted presence of ventilation defects and receiver operating characteristic analysis, the sensitivity, specificity, and accuracy of the 4DCT-ventilation were 90%, 64%, and 81%, respectively. Conclusions: The current work compared 4DCT with VQ-based ventilation using clinically relevant global metrics and radiologist observations. We found good agreement between the radiologist's assessment of the 4DCT and VQ-ventilation images as well as the percent ventilation in each lung. The agreement lessened when the data were analyzed on a regional level. Our study presents an important step for the integration of 4DCT-ventilation into thoracic clinical practice.

62 RADIOLOGY AND NUCLEAR MEDICINE↗