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Objective To examine differences in parent feeding behaviors and general parenting of overweight children with and without loss of control (LOC) eating. Method One-hundred-and-eighteen overweight and obese children (10.40 ±-1.35 years; 53% female; 52% Caucasian; BMI-z: 2.06-±-0.39) and their parents (42.42-±-6.20 years; 91% female; 70% Caucasian; BMI: 31.74-±-6.96 kg/m2) were seen at a baseline assessment visit for a behavioral intervention that targeted overeating. The Eating Disorder Examination, adapted for children (ChEDE) was administered to assess for LOC eating. Parents completed the Parental Feeding Styles Questionnaire (PFSQ) and the Child Feeding Questionnaire (CFQ) to assess parent feeding styles and behaviors. Children also completed a self-report measure of general parenting (Child Report of Parent Behavior Inventory, CRPBI-30). Results Forty-three children (36.40%) reported at least one LOC eating episode in the month prior to assessment. Parents who reported greater restriction and higher levels of pressure to eat were more likely to have children that reported LOC eating (ps- 0.05). Discussion Parent feeding styles and behaviors appear to be differentially and uniquely related to LOC eating in treatment-seeking overweight and obese children. Future research is needed to determine if implementing interventions that target parent feeding behaviors may reduce LOC eating, prevent full-syndrome eating disorders, and reduce weight gain in youth.

Objective: This study sought to investigate differences in eating psychopathology between black and white treatment seekers at a specialty eating disorders (EDs) center. Method: Participants were drawn from 1680 individuals (n = 32 blacks; n = 1648 whites) who received treatment for an ED at a specialized center between 1979 and 1995, and had completed the EDs Questionnaire. The 32 black participants were matched to 153 white participants for ED diagnosis, year of presentation, and gender. Results: The majority of the participants were diagnosed with eating disorder not otherwise specified (EDNOS). No black participants met criteria for anorexia nervosa (AN). Black participants reported more body dissatisfaction and a higher percentage fulfilled the obesity criterion compared to white participants. There were few differences in reported history of previous treatment. Discussion: Black and white participants with EDs appeared similar in most respects, but AN was notably absent among black participants. In contrast to previous research, body dissatisfaction was surprisingly higher in black than in white participants. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2010 [ABSTRACT FROM AUTHOR]

Objective: The purpose of this investigation was to compare three types of treatment for binge eating disorder to determine the relative efficacy of self-help group treatment compared to therapist-led and therapist-assisted group cognitive-behavioral therapy.Method: A total of 259 adults diagnosed with binge eating disorder were randomly assigned to 20 weeks of therapist-led, therapist-assisted, or self-help group treatment or a waiting list condition. Binge eating as measured by the Eating Disorder Examination was assessed at baseline, at end of treatment, and at 6 and 12 months, and outcome was assessed using logistic regression and analysis of covariance (intent-to-treat).Results: At end of treatment, the therapist-led (51.7%) and the therapist-assisted (33.3%) conditions had higher binge eating abstinence rates than the self-help (17.9%) and waiting list (10.1%) conditions. However, no between-group differences in abstinence rates were observed at either of the follow-up assessments. The therapist-led condition also showed more reductions in binge eating at end of treatment and follow-up assessments compared to the self-help condition, and treatment or waiting period completion rates were higher in the therapist-led (88.3%) and waiting list (81.2%) conditions than in the therapist-assisted (68.3%) and self-help (59.7%) conditions.Conclusions: Therapist-led group cognitive-behavioral treatment for binge eating disorder led to higher binge eating abstinence rates, greater reductions in binge eating frequency, and lower attrition compared to group self-help treatment. Although these findings indicate that therapist delivery of group treatment is associated with better short-term outcome and less attrition than self-help treatment, the lack of group differences at follow-up suggests that self-help group treatment may be a viable alternative to therapist-led interventions. [ABSTRACT FROM AUTHOR]

BACKGROUND: There is empirical evidence suggesting that individuals with bulimia nervosa vary considerably in terms of psychiatric co-morbidity and personality functioning. In this study, latent profile analysis was used to attempt to identify clusters of bulimic subjects based on psychiatric co-morbidity and personality. METHOD: A total of 178 women with bulimia nervosa or a subclinical variant of bulimia nervosa completed a series of self-report inventories of co-morbid psychopathology and personality, and also provided a buccal smear sample for genetic analyses. RESULTS: Three clusters of bulimic women were identified: an affective-perfectionistic cluster, an impulsive cluster, and a low co-morbid psychopathology cluster. The clusters showed expected differences on external validation tests with both personality and eating-disorder measures. The impulsive cluster showed the highest elevations on dissocial behavior and the lowest scores on compulsivity, while the affective-perfectionistic cluster showed the highest levels of eating-disorder symptoms. The clusters did not differ on genetic variations of the serotonin transporter gene. CONCLUSIONS: This study corroborates previous findings suggesting that the bulimia nervosa diagnostic category is comprised of three classes of individuals based on co-morbid psychopathology and personality. These differences may have significant etiological and treatment implications. [ABSTRACT FROM AUTHOR]

Objective: To examine associations between puberty and disordered eating, body image, and other psychological variables. Method: Females were grouped into three categories of age at puberty onset (Study 1; N = 267) as well as three categories of self-perception of prepubertal weight (Study 2; N = 222). Participants in both studies were matched on current body mass index (BMI) across categories. Results: Females who perceived themselves to be overweight prior to puberty scored significantly higher on measures of disordered eating, body dissatisfaction, asceticism, drive for thinness, impulse regulation, interoceptive awareness, and perfectionism. They also perceived their current body figure to be larger when compared with those who believed they were average or underweight prior to puberty. Age at puberty onset was not significantly associated with disordered eating, body dissatisfaction, depression, or self-esteem. However, females who entered puberty at an earlier age scored higher on measures of asceticism, drive for thinness, impulse regulation, and social insecurity. They also chose a more slender ideal body figure than those who entered at an older age. Discussion: Females who believe they are overweight prior to puberty may be at risk for the development of disordered eating, body image dissatisfaction, and related problems. Age at puberty onset is not a consistent risk factor of pathological eating. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate the relationship between women's body image, self-image, and sexual behaviors; to determine the effect of body image on personal and sex variables; and to identify factors that contribute to more frequent and greater comfort with sex. METHOD: A magazine survey that included items about body image, self-image, and sexual behaviors was completed by 3,627 women. RESULTS: Women more satisfied with body image reported more sexual activity, orgasm, and initiating sex, greater comfort undressing in front of their partner, having sex with the lights on, trying new sexual behaviors, and pleasing their partner sexually than those dissatisfied. Positive body image was inversely related to self-consciousness and importance of physical attractiveness, and positively related to relationships with others and overall satisfaction. Body image was predictive only of one's comfort undressing in front of partner and having sex with lights on. Overall satisfaction was predictive of frequency of sex, orgasm, and initiating sex, trying new sexual behaviors, and confidence in giving partner sexual pleasure. DISCUSSION: Results indicate that overall self-image and body image are significant predictors of sexual activity. Directions for future research are discussed. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this investigation was to determine the test-retest reliability of the Eating Disorder Examination (EDE). METHOD: This study examined the test-retest and interrater reliability of the EDE in 20 adult women with a range of eating disorder symptoms. Trained assessors administered the EDE to participants on two separate occasions, ranging from 2 to 7 days apart. RESULTS: Test-retest correlations were .7 or greater for all subscales and measures of eating disorder behaviors except for subjective bulimic episodes and subjective bulimic days. Interrater reliability was uniformly high with correlations above.9. DISCUSSION: Results provide further support for the reliability of the EDE, but suggest that smaller binge episodes may not be reliable indicators of eating pathology. Copyright 2000 by John Wiley & Sons, Inc. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this study was to identify predictors of short-term treatment outcome for individuals with binge eating disorder (BED). METHOD: Fifty women who met DSM-IV criteria for BED were enrolled in a manual-based group cognitive-behavioral therapy that consisted of fourteen 1-hr sessions over an 8-week period. Baseline measures included the frequency of self-reported binge eating from the Eating Behaviors-IV (EB-IV), severity of binge eating and dietary restraint using the Binge Eating Scale (BES) and Three-Factor Eating Questionnaire (TFEQ), depressive symptoms as assessed by the Beck Depression Inventory (BDI) and the Hamilton Depression Rating Scale (HDRS), and self-esteem as measured by the Rosenberg Self-Esteem Questionnaire (RSEQ). RESULTS: Logistic regression analyses indicated that the baseline frequency of self-reported episodes of binge eating that were objectively large predicted the likelihood of such episodes at the end of treatment. No variables predicted the likelihood of binge eating episodes that were objectively and subjectively large at the conclusion of treatment. DISCUSSION: This study indicates that the frequency of binge eating episodes at baseline is predictive of outcome status at the end of treatment, suggesting that meaningful prognostic factors in BED are identifiable. Copyright 2000 by John Wiley & Sons, Inc. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this study was to assess the primary methods used by psychotherapists in treating individuals with eating disorders and to determine the extent to which certain empirically supported psychotherapies (i.e., cognitive behavioral therapy [CBT] and interpersonal psychotherapy [IPT]) are used in clinical settings. METHOD: Surveys developed for this study were sent to 500 psychologists randomly selected from a list of all licensed doctoral-level psychologists in an upper midwestern state. RESULTS: Despite the findings that CBT techniques were reported to be frequently used, most respondents identified something other than CBT or IPT as their primary theoretical approach. In addition, the majority of respondents indicated not having received training in the use of manual-based, empirically supported treatment approaches for working with individuals with eating disorders, although most reported a desire to obtain such training. CONCLUSIONS: Although commonly referred to as the 'treatments of choice' in research literature, manual-based, empirically supported approaches to working with individuals with eating disorders has not received adequate dissemination. Copyright 2000 by John Wiley Sons, Inc. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Potential differences in the hedonics of binge eating between female subjects with bulimia nervosa (BN) and female subjects with binge eating disorder (BED) were examined. METHOD: Women seeking treatment for BN (N = 29) and BED (N = 49) completed the Eating Hedonics Questionnaire. RESULTS: Subjects in both groups reported similar precipitants and levels of distress associated with binge eating. Of interest, BED subjects were more likely to report that they enjoyed the food, the taste of the food, the smell and the texture of the food while binge eating. In addition, the BED group reported more relaxation and less physical discomfort and anxiety as a consequence of binge eating compared to the BN group. DISCUSSION: There are interesting and potentially important differences between individuals with BN and BED in the cognitions and behaviors associated with binge eating. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this study was to evaluate whether a history of purging behaviors in individuals with binge eating disorder (BED) is associated with increased comorbid psychopathology, dietary restraint, severity of eating pathology, and attitudinal disturbance in self-esteem and body image. METHOD: Sixty-three women meeting DSM-IV criteria for BED who were participating in a psychotherapy treatment study were subclassified according to whether they reported a history of purging behavior using self-induced vomiting or laxatives (HP; N = 24) or no such history (NHP; N = 39). The two groups were compared on the following variables: DSM-IV Axis I Lifetime diagnoses, Hamilton Depression Rating Scale, Body Shape Questionnaire, Three Factor Eating Questionnaire, Binge Eating Scale, and the Rosenberg Self-Esteem Scale. RESULTS: Data analyses revealed no significant differences between the two BED subgroups on any of the measures. DISCUSSION: These findings indicate that a history of purging behavior in BED is not associated with increased rates of comorbid psychopathology, severity of eating problems, dietary restraint, or attitudinal disturbance. Purging history does not appear to be a clinically meaningful variable with which to subclassify individuals with BED. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this study was to compare three group cognitive-behavioral therapy (CBT) treatment models and a waiting list control condition (WL). METHOD: Sixty-one women who met DSM-IV criteria for binge eating disorder (BED) received treatment with the same cognitive-behavioral treatment manual in 14 one-hour sessions over an 8-week period. All sessions consisted of psychoeducation for the first 30 min and group discussion for the second half hour. In the therapist-led condition (TL; n = 16), a doctoral therapist led both the psychoeducational component and group discussion. In the partial self-help condition (PSH; n = 19), participants viewed a 30-min psychoeducational videotape, followed by participation in a therapist-led discussion. In the structured self-help condition (SH; n = 15), subjects viewed the 30-min psychoeducational videotape and subsequently led their own 30-min discussion. Eleven subjects were assigned to a wait-list control condition (WL). The primary outcome variables were frequency and duration of self-reported binge eating episodes. RESULTS: A mixed effects linear modeling (random regression) analysis indicated that subjects in all three active treatment conditions showed a decrease in binge eating symptoms over time. No group differences in rates of change over time were observed, although analysis of covariance indicated that all three treatment conditions showed significantly greater improvement in binge eating compared to the WL condition. DISCUSSION: The findings from this preliminary study suggest that CBT for BED can be delivered effectively in a structured group self-help format. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The present study examined agreement between survey and interview measures of weight control practices in a nonclinical sample of adolescents. METHOD: Surveys were administered in three school health classes. Clinical interviews were conducted in a student subsample (N = 43). RESULTS: Survey-based prevalences for eating behaviors in the past month were: trying to lose weight, 44%; binge eating, 41%; vomiting, 4.7%; laxative use, 0%; and fasting, 14%. Interview-based prevalences were 30%, 11.6%, 0%, 0% and 0%, respectively. Sensitivity was high for all behaviors assessed. However, positive predictive values were low. DISCUSSION: Surveys may be useful as preliminary screening tools for prevention programs, but may yield inflated estimates of unhealthy weight control practices in nonclinical adolescent populations. Research is needed to examine whether adolescents overreport weight control practices on surveys or whether they are less willing to disclose such practices in a private interview. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The current status of the research knowledge on the psychotherapy of bulimia nervosa is reviewed. METHODS: Published studies using randomization to treatment are discussed. RESULTS: The existing research data speak convincingly to the efficacy of cognitive behavioral treatment (CBT); however, certain important questions remain unanswered. DISCUSSION: The current deficiencies in the field are underscored. [ABSTRACT FROM AUTHOR]

Purpose: The Imaging Radiation Oncology Core (IROC) head and neck (H&N) phantom is used to credential institutions for intensity modulated radiation therapy delivery for all anatomic sites where delivery of modulated therapy is a primary challenge. This study evaluated how appropriate the use of this phantom is for varied clinical anatomy by evaluating how closely the IROC H&N phantom described clinical dose errors from beam modeling compared with various anatomic sites., Methods and Materials: The multileaf collimator (MLC) offset, transmission, percent depth dose, and 7 additional beam modeling parameters for a Varian accelerator were modified in RayStation to match community data at the 2.5th, 25th, 50th, 75th, and 97.5th percentile levels. Modifications were evaluated on 25 H&N phantom cases and 25 clinical cases (H&N, prostate, lung, mesothelioma, and brain), generating 2000 plan perturbations. Differences in mean dose delivered to clinical target volumes and maximum dose to organs at risk were compared between phantom and clinical plans to assess the relationship between dose deviations in phantom versus clinical target volumes and as a function of 18 different complexity metrics., Results: Perturbations to MLC offset and transmission parameters demonstrated the greatest impact on dose accuracy for phantom and clinical plans (for all anatomic sites). The phantom demonstrated equivalent or greater sensitivity to these parameter perturbations compared with clinical sites, largely aligning with treatment complexity. The mean MLC gap best described the impact of errors in treatment planning system beam modeling parameters in phantom plans and clinical plans from various anatomic sites., Conclusions: When compared across various anatomic sites, the IROC H&N credentialing phantom exhibited similar or greater sensitivity to errors in the treatment planning system. As such, it is a suitable surrogate device for assessing institutional performance across various anatomic sites. If an institution successfully irradiates the phantom, that result confers confidence that intensity modulated radiation therapy to a wide range of anatomic sites can be successfully delivered by the institution., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: We evaluated the impact of random and whole-bank multileaf collimator (MLC) delivery errors on dosimetric delivery accuracy in the Imaging and Radiation Oncology Core (IROC) phantom audits, as well as differences in delivery accuracy between the IROC phantom prescription and typical clinical fraction sizes., Methods and Materials: Plans were created for the IROC IMRT head and neck (H&N) and SBRT spine phantoms. MLC leaf errors were introduced into the plans: random shifts between -2 and 2 mm, and whole bank shifts of 0.5, 1, and 2 mm. Plans were recalculated and delivered on a Varian Truebeam, and the log files were analyzed using Mobius Fx software. A second study examined the impact of fraction size on MLC position accuracy and corresponding dose delivery accuracy. The standard IROC phantom prescriptions (∼6 Gy) were scaled to the extremes of 2 Gy for H&N and 27 Gy for spine. All plans (original and scaled) were delivered on a Varian Truebeam and 21EX machine., Results: Random MLC positioning errors produced small average dose deviations in the PTV of up to -2.8% for H&N and 0.7% for spine. Whole-bank MLC shifts resulted in larger average PTV dose deviations up to 8% for H&N and 7.1% for spine. The Varian 21EX irradiations had greater MLC root mean square (RMS) error than Truebeam plans. Plans with smaller prescriptions (and faster leaf motion) had greater MLC RMS errors, but plan accuracy was not affected dosimetrically - all results remained within 1% regardless of fraction size., Conclusions: Both random and whole bank MLC shifts caused dose deviations in the IROC phantoms that were comparable to clinical results previously found in the literature. Deviations measured with ion chambers were well matched with delivery log file analysis. Smaller dose-per-fraction prescriptions caused larger MLC RMS errors that were detected with log files, but were clinically insignificant compared to the dosimetric accuracy of the plan., (© 2025 The Author(s). Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine.)

Variable relative biological effectiveness (RBE) of carbon radiotherapy may be calculated using several models, including the microdosimetric kinetic model (MKM), stochastic MKM (SMKM), repair-misrepair-fixation (RMF) model, and local effect model I (LEM), which have not been thoroughly compared. In this work, we compared how these four models handle carbon beam fragmentation, providing insight into where model differences arise. Monoenergetic and spread-out Bragg peak carbon beams incident on a water phantom were simulated using Monte Carlo. Using these beams, input parameters for each model (microdosimetric spectra, DNA double-strand break yield, kinetic energy spectra, physical dose fragment contributions) were calculated for each contributing carbon beam fragment (hydrogen, helium, lithium, beryllium, boron, secondary carbon, primary carbon, electrons, and "other"). Scored input parameters for each fragment were used to calculate linear (α) and quadratic (β) parameters according to each model, which were combined with reference α and β values and absorbed physical dose to calculate RBE. Contributions from secondary fragments were found to exceed 30% of the total physical dose. Using identical beam parameters, the four models produced not only different RBE values but also different RBE trends. In all models, RBE was highest for secondary carbon ions. Beyond secondary carbons, the RBE magnitude typically increased with the atomic number of the fragment, but RBE trends differed dramatically by model and beamline region (entrance, spread-out Bragg peak, and tail). Variations in fragment RBE were large enough to be apparent in biological dose predictions. This study demonstrated that fragmentation is a nonnegligible consideration in carbon radiotherapy. Our findings identified differences in RBE among specific fragments and the four models, contributing to variability in the total biological dose across models. Because these findings emphasize differences in how various models handle carbon beam fragments, greater care should be taken in characterization of secondary fragments in particle therapy., (© 2025 by Radiation Research Society. All rights of reproduction in any form reserved.)

Malignant peripheral nerve sheath tumor (MPNST) development is characterized by an altered DNA methylation landscape, which presents a promising area for developing MPNST-specific biomarkers for screening patients with NF1. Genome-wide DNA methylation profiling of a cohort of 13 patients with MPNST (29 samples of tumor and adjacent neurofibroma tissues) and of NF1-MPNST cell lines was performed to identify and validate candidate MPNST-specific CpG sites (CpGs). A logistic regression prediction model was constructed to select MPNST-specific CpGs distinct from adjacent neurofibromas and normal tissues. To test if hypermethylation at selected CpGs can also be detected in plasma from patients with MPNST, cfMBD-seq was applied to profile the cfDNA methylome of blood from patients with MPNST and NF1. Based on stringent feature-selection criteria and predictive modeling, we identified 73 candidate MPNST-specific CpGs (67 with unique CpG island locations) that reliably discriminated MPNSTs from neurofibromas. Validation of five candidate biomarkers confirmed successful MPNST detection (sensitivity: > 88%, specificity: > 91%) in tissues. In plasma samples, 63 of 67 selected genomic regions had greater than 1.2-fold higher methylation in patients with MPNST than those with NF1. Further, we identified 15 CpG islands that consistently separated plasma from patients with confirmed MPNST diagnosis from plasma of individuals with NF1 without a diagnosis of malignant transformation (FDR < 0.1). Our findings confirmed a unique hypermethylation pattern present during malignant transformation. This study highlights the potential to be investigated further as biomarkers in clinical settings for early MPNST detection in patients with NF1., (© 2024 The Author(s). Molecular Carcinogenesis published by Wiley Periodicals LLC.)

Objective: The present study aimed to examine: (a) whether distinct momentary emotion dysregulation dimensions differentially mediated momentary associations between affect and disordered eating behaviours (DEBs) in the natural environment; (b) whether these associations differed based on affect, emotion dysregulation, and DEB type., Method: 150 women with eating disorder pathology (Mage = 20.95, SD = 4.14) completed 4 surveys targeting affect, emotion dysregulation, and DEBs each day for a 10-day ecological momentary assessment period. Multilevel structural equation models examined whether four momentary emotion dysregulation dimensions (difficulties with emotional and behavioural modulation, lack of emotional acceptance, awareness, and clarity) mediated momentary associations between negative and positive affect (PA), and loss of control eating, overeating, and dietary restriction., Results: Momentary difficulties with emotional and behavioural modulation mediated momentary associations between negative affect (NA) and women's loss of control eating and overeating. These findings did not extend to PA, the other emotion dysregulation dimensions, or dietary restriction., Conclusions: Collectively, these results support emotional and behavioural modulation deficits in the natural environment as potential transdiagnostic maintenance mechanisms of overeating and loss of control eating. These findings also support the potential benefits of targeting NA and this type of emotion dysregulation in existing and novel real-time eating disorders interventions., (© 2024 Eating Disorders Association and John Wiley & Sons Ltd.)

Objective: Binge eating appears to be associated with impulsivity, especially in response to negative affect (i.e., negative urgency). However, negative urgency is typically assessed via self-report, which captures only some aspects of urgency and may be subject to bias. Few studies have examined impulsivity following experimental manipulations of affect in binge-eating samples., Method: In the present study, individuals who engage in regular binge eating completed a behavioural impulsivity (go/no-go) task with high- and low-calorie food stimuli, once following negative affect induction and once following neutral affect induction., Results: Greater behavioural impulsivity to high-calorie food cues while in a negative (and not a neutral) affective state was associated with more frequent binge-eating behaviour. Further, this behavioural measure of negative urgency uniquely accounted for variance in binge-eating frequency when controlling for self-reported negative urgency, suggesting that behavioural measures may be a useful complement to self-report measures., Discussion: These findings provide novel and compelling evidence for the relationship between negative urgency and binge eating, highlighting negative urgency as a potentially important target for intervention., (© 2024 Eating Disorders Association and John Wiley & Sons Ltd.)

Background: A passive dosimeter framework for the measurement of dose in carbon ion beams has yet to be characterized or implemented for regular use., Purpose: This work determined the dose calculation correction factors for absorbed dose in thermoluminescent dosimeters (TLDs) in a therapeutic carbon ion beam. TLD could be a useful tool for remote audits, particularly in the context of clinical trials as new protocols are developed for carbon ion radiotherapy., Methods: TLD-100 were irradiated in a carbon ion beam at the Centro Nazionale di Adroterapia Oncologica (CNAO) in Pavia, Italy. The dose correction factors for linearity, fading, and beam quality were characterized. Fading was characterized from 5 to 100 days post-irradiation. For linearity, the TLDs were irradiated to absorbed doses ranging from 1 to 15 Gy in both the entrance of a high-energy pristine carbon ion peak and the center of a 2 cm spread-out Bragg peak. For beam quality, the TLD was irradiated to the same absorbed dose (3 Gy) in several pristine carbon ion Bragg peaks, as well as in several spread-out Bragg peaks. Each correction factor was calculated and compared to photon correction factors. The correction factors were also compared between high and low dose-averaged linear energy transfer (LET D ) in the carbon ion beams. The absorbed dose was compared between ion chamber and TLD-100 in the several tissue substitute phantom materials, applying the carbon ion TLD correction factors., Results: There was no statistically significant difference in the TLD fading correction factor between photons, low LET D carbon ion beams, or high LET D carbon ion beams. The TLD linearity correction factor did differ between photons, low LET D carbon ions, and high LET D carbon ions. The beam quality correction factor was large and changed linearly with LET D . The overall uncertainty of the carbon ion absorbed dose calculation was 3.9% at the one-sigma level, driven largely by a 3.5% uncertainty in the beam quality correction. TLD measurements were within 1.2% of ion chamber measurements in the phantom material for polyethylene, solid water (Gammex and Sun Nuclear), acrylic, blue water, and techtron HPV. TLD measurements in balsa wood were within 3.0% and cork was 6.6% low compared to ion chamber., Conclusion: TLD-100 can be used for passive dosimetry in a therapeutic carbon ion beam. Importantly, the linearity and beam quality correction factors are both different from photon therapy, and dependent on LET D of the carbon ion beam. This opens the possibility of TLD use for carbon ion output audits, phantom audits, and in vivo dose measurements, but may be subject to more complicated management and slightly larger uncertainties than are achieved in photon beams., (© 2024 American Association of Physicists in Medicine.)

Affect regulation models posit that aversive affective states drive binge-eating behavior, which then regulates negative emotions. However, recent findings among individuals with binge-eating disorder (BED) suggest that food-related anticipatory processes may precede and potentially explain the negative affect thought to drive binge eating. Specifically, studies using ecological momentary assessment (EMA) demonstrate that the negative affective state of "Guilt" (from the Positive and Negative Affect Schedule) most strongly predicts later binge eating in the natural environment, and it has been hypothesized that planning a binge or feeling that a binge-eating episode is inventible may account for the increases in Guilt observed prior to binge episodes. In the present study, we tested the hypothesis that binge planning or inevitability may contribute to feelings of shame (a key facet of the broader Guilt construct), which then predict binge-eating episodes, using EMA in 43 individuals with BED. Consistent with hypotheses, feelings of binge inevitability and planning prospectively predicted binge-eating episodes. Further, binge planning predicted subsequent increases in shame. However, shame did not predict subsequent increases in binge planning. Finally, a mediation model revealed that binge planning (Time 1) predicted future binge eating (Time 3) directly and indirectly through increases in shame (Time 2). The results provide novel evidence that individuals with BED anticipate and actively plan for binge-eating episodes, and that binge planning may explain the increased shame/guilt typically observed before binge eating. Overall, accruing evidence suggests that negative affect, although predictive of binge eating, may be better conceptualized as a consequence of the anticipatory processes that lead to binge eating, rather than the starting point, at least among some individuals with BED. Future experimental research is needed to more conclusively test this hypothesis., Competing Interests: Declaration of competing interest None. The lead author has full access to the data reported in the manuscript. These data are available upon reasonable request., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Repetitive transcranial magnetic stimulation (rTMS) therapy could be improved by more accurate and earlier prediction of response. Latent class mixture (LCMM) and non-linear mixed effects (NLME) modeling have been applied to model the trajectories of antidepressant response (or non-response) to TMS, but it is not known whether such models are useful in predicting clinically meaningful change in symptom severity, i.e. categorical (non)response as opposed to continuous scores., Methods: We compared LCMM and NLME approaches to model the antidepressant response to TMS in a naturalistic sample of 238 patients receiving rTMS for treatment resistant depression, across multiple coils and protocols. We then compared the predictive power of those models., Results: LCMM trajectories were influenced largely by baseline symptom severity, but baseline symptoms provided little predictive power for later antidepressant response. Rather, the optimal LCMM model was a nonlinear two-class model that accounted for baseline symptoms. This model accurately predicted patient response at 4 weeks of treatment (AUC = 0.70, 95% CI = [0.52 - 0.87]), but not before. NLME offered slightly improved predictive performance at 4 weeks of treatment (AUC = 0.76, 95% CI = [0.58 - 0.94], but likewise, not before., Conclusions: In showing the predictive validity of these approaches to model response trajectories to rTMS, we provided preliminary evidence that trajectory modeling could be used to guide future treatment decisions.

As next-generation sequencing technologies advance rapidly and the cost of metagenomic sequencing continues to decrease, researchers now face an unprecedented volume of microbiome data. This surge has stimulated the development of scalable microbiome data analysis methods and necessitated the incorporation of phylogenetic information into microbiome analysis for improved accuracy. Tools for constructing phylogenetic trees from 16S rRNA sequencing data are well-established, as the highly conserved regions of the 16S gene are limited, simplifying the identification of marker genes. In contrast, metagenomic and whole genome shotgun (WGS) sequencing involve sequencing from random fragments of the entire gene, making identification of consistent marker genes challenging owing to the vast diversity of genomic regions, resulting in a scarcity of robust tools for constructing phylogenetic trees. Although bacterial sequence tree construction tools exist for upstream bioinformatics, many downstream researchers-those integrating these trees into statistical models or machine learning-are either unaware of these tools or find them difficult to use due to the steep learning curve of processing raw sequences. This is compounded by the fact that public datasets often lack phylogenetic trees, providing only abundance tables and taxonomic classifications. To address this, we present a comprehensive review of phylogenetic tree construction techniques for microbiome data (16S rRNA or whole-genome shotgun sequencing). We outline the strengths and limitations of current methods, offering expert insights and step-by-step guidance to make these tools more accessible and widely applicable in quantitative microbiome data analysis., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

In this paper, we propose Varying Effects Regression with Graph Estimation (VERGE), a novel Bayesian method for feature selection in regression. Our model has key aspects that allow it to leverage the complex structure of data sets arising from genomics or imaging studies. We distinguish between the predictors, which are the features utilized in the outcome prediction model, and the subject-level covariates, which modulate the effects of the predictors on the outcome. We construct a varying coefficients modeling framework where we infer a network among the predictor variables and utilize this network information to encourage the selection of related predictors. We employ variable selection spike-and-slab priors that enable the selection of both network-linked predictor variables and covariates that modify the predictor effects. We demonstrate through simulation studies that our method outperforms existing alternative methods in terms of both feature selection and predictive accuracy. We illustrate VERGE with an application to characterizing the influence of gut microbiome features on obesity, where we identify a set of microbial taxa and their ecological dependence relations. We allow subject-level covariates, including sex and dietary intake variables to modify the coefficients of the microbiome predictors, providing additional insight into the interplay between these factors., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Biometric Society.)

Meta-analysis is a powerful tool for assessing drug safety by combining treatment-related toxicological findings across multiple studies, as clinical trials are typically underpowered for detecting adverse drug effects. However, incomplete reporting of adverse events (AEs) in published clinical studies is frequently encountered, especially if the observed number of AEs is below a pre-specified study-dependent threshold. Ignoring the censored AE information, often found in lower frequency, can significantly bias the estimated incidence rate of AEs. Despite its importance, this prevalent issue in meta-analysis has received little statistical or analytic attention in the literature. To address this challenge, we propose a Bayesian approach to accommodating the censored and possibly rare AEs for meta-analysis of safety data. Through simulation studies, we demonstrate that the proposed method can improve accuracy in point and interval estimation of incidence probabilities, particularly in the presence of censored data. Overall, the proposed method provides a practical solution that can facilitate better-informed decisions regarding drug safety.

Objective: Affect regulation theories of eating disorders (ED) posit that negative affect increases in the hours before and decreases following disordered eating behaviors (DEBs) in daily life, yet findings from studies assessing affective changes post-DEBs are mixed. This inconsistency may be due to the previously unassessed role of other transdiagnostic processes in these associations, such as interoception (the ability to sense and integrate information from bodily sensations). To address this research gap, the present study examined whether different interoception dimensions moderated negative affect trajectories surrounding DEBs in the natural environment., Method: 150 women with ED pathology (Mage = 21.0, SD = 4.1) completed 4 surveys targeting affect and DEBs each day for a 10-day ecological momentary assessment period. Polynomial multilevel models examined negative affect trajectories pre- and post-DEBs (dietary restriction, overeating, loss of control eating), and whether these trajectories varied based on daily interoception dimensions (not distracting, self-regulation, body listening and trust)., Results: Negative affect increased prior to loss of control eating-but not dietary restriction or overeating-and decreased following all DEBs. Further, the magnitude of the decrease in negative affect that emerged post-dietary restriction decreased in strength as daily "not distracting" interoception increased. The other interoception dimensions did not moderate negative affect trajectories surrounding DEBs., Conclusions: Allowing oneself to experience (vs. distract from) uncomfortable bodily sensations may weaken affect dysregulation processes that follow dietary restriction in daily life and are theorized to maintain DEBs. These results provide insight that may strengthen EDs theories, research, and inform interoception-focused interventions., Competing Interests: Declaration of competing interest The authors have no conflicts of interests to report., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Overweight and obesity affect >40% of adolescents. Family-based behavioral treatment (FBT) is the most efficacious behavioral treatment for weight management among youth and consists of nutrition and physical activity education, behavior change skills, and parent skills training. However, the efficacy of FBT decreases for youth as they get older. Increased emotional lability and limited emotion regulation skills may contribute to the reduced efficacy of FBT for adolescents. To date, there are no treatments for overweight or obesity specifically adapted for the needs of adolescents. We developed a treatment that integrates components from Dialectical Behavior Therapy and Emotion Focused Therapy with FBT (FBT+ER or FBT-ER) to address the specific needs of adolescents. The current study randomized 166 adolescents (BMI = 32.8; 14.3 years; 57% female; 32% Hispanic, 50% Non-Hispanic White, 18% Non-Hispanic and Non-White) and one of their parents (BMI = 32.9; 45.3 years; 85% female; 27% Hispanic, 57% Non-Hispanic White, 16% Non-Hispanic and Non-White) to 6 months of either standard FBT or FBT+ at 2 sites. Assessments were conducted at baseline, mid-treatment (month 3), post-treatment (month 6), 6-month follow-up (month 12) and 12-month follow-up (month 18). Primary outcomes are adolescent weight (BMIz/%BMIp95), emotion regulation skills, and emotional eating behaviors. Given the public health concern of adolescent obesity, FBT+ could prove extremely useful to provide more targeted and effective intervention for adolescents with overweight or obesity. CLINICAL TRIALS: # NCT03674944., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Miller receives royalties from Dialectical Behavior Therapy books and Dialectical Behavior Therapy Psychwire training videos. No other competing interests are declared by the other authors., (Copyright © 2024. Published by Elsevier Inc.)

Acute lower gastrointestinal GVHD (aLGI-GVHD) is a serious complication of allogeneic hematopoietic stem cell transplantation. Although the intestinal microbiota is associated with the incidence of aLGI-GVHD, how the intestinal microbiota impacts treatment responses in aLGI-GVHD has not been thoroughly studied. In a cohort of patients with aLGI-GVHD (n = 37), we found that non-response to standard therapy with corticosteroids was associated with prior treatment with carbapenem antibiotics and a disrupted fecal microbiome characterized by reduced abundances of Bacteroides ovatus. In a murine GVHD model aggravated by carbapenem antibiotics, introducing B. ovatus reduced GVHD severity and improved survival. These beneficial effects of Bacteroides ovatus were linked to its ability to metabolize dietary polysaccharides into monosaccharides, which suppressed the mucus-degrading capabilities of colonic mucus degraders such as Bacteroides thetaiotaomicron and Akkermansia muciniphila, thus reducing GVHD-related mortality. Collectively, these findings reveal the importance of microbiota in aLGI-GVHD and therapeutic potential of B. ovatus., Competing Interests: Declaration of interests R.R.J. has served as a consultant or advisory board member for Postbiotics Plus, Merck, Microbiome DX, Karius, MaaT Pharma, LISCure, Seres, Kaleido, and Prolacta and has received patent license fee or stock options from Seres, Kaleido, and Postbiotics Plus. E.J.S. has served as a consultant or advisory board member for Adaptimmune, Axio, Navan, Fibroblasts, and FibroBiologics, NY Blood Center, and Celaid Therapeutics and has received patent license fee from Takeda and Affimed. J.U.P. reports research funding, intellectual property fees, and travel reimbursement from Seres Therapeutics, and consulting fees from DaVolterra, CSL Behring, Crestone Inc, and from MaaT Pharma. J.U.P. serves on an advisory board of and holds equity in Postbiotics Plus Research. J.U.P. has filed intellectual property applications related to the microbiome (reference numbers #62/843,849, #62/977,908, and #15/756,845). Memorial Sloan Kettering Cancer Center (MSK) has financial interests relative to Seres Therapeutics. E.H., M.A.J., J.L.K., and R.R.J. are inventors on a patent application by The University of Texas MD Anderson Cancer Center supported by results of the current study entitled, “Methods and Compositions for Treating Cancer therapy-induced Neutropenic Fever and/or GVHD.”, (Copyright © 2024 Elsevier Inc. All rights reserved.)

Food cue reactivity (FCR) is an appetitive trait associated with overeating and weight gain. We developed a laboratory craving assessment to objectively evaluate cognitive aspects of FCR. This study examined the preliminary construct and criterion validity of this craving assessment and evaluated 4 different interventions, 2 of which incorporated cue-exposure treatment for food, on craving over treatment and follow-up. 271 treatment-seeking adults with overweight/obesity (body mass index = 34.6[5.2]; age = 46.5[11.8]; 81.2% female; 61.6% non-Latinx White) completed the Food Cue Responsivity Scale and the laboratory craving assessment, during which they alternated holding and smelling a highly craved food and provided craving ratings over 5 min. Participants were subsequently randomized to 26 treatment sessions over 12-months of ROC, Behavioral Weight Loss (BWL), a combined arm (ROC+) and an active comparator (AC), and repeated the craving assessment at post-treatment and 12-month follow-up. Linear mixed-effects models assessed associations between trial type (holding vs. smelling), trial number, pre-treatment FCR, treatment arm, assessment time point, and craving. Cravings were greater when smelling vs. holding food (b = 0.31, p < 0.001), and cravings decreased over time (b = -0.02, p < 0.001). Participants with higher pre-treatment FCR reported elevated cravings (b = 0.29, p < 0.001). Longitudinally, we observed a significant 3-way interaction in which treatment arm modified the relationship between pre-treatment FCR and craving over time (F(17,5122) = 6.88, p < 0.001). An attenuated FCR-craving relationship was observed in ROC+ and BWL from baseline to post-treatment but was only sustained in BWL at follow-up. This attenuation was also observed in ROC and AC from post-treatment to follow-up. The preliminary validity of this laboratory craving assessment was supported; however, greater craving reductions over time in ROC/ROC+ compared to BWL and AC were not consistently observed, and thus do not appear to fully account for the moderating effect of FCR on weight losses observed in the trial., Competing Interests: Declaration of competing interest All authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Establishing normative data for questionnaires is essential for the accurate interpretation of scores, given that these norms can vary according to different subpopulations and treatment contexts. The purpose of this study was to establish norms for the Eating Disorder Examination-Questionnaire (EDE-Q) among adults receiving higher levels of care (HLOCs) for the treatment of eating disorders. Participants were 2,283 people receiving treatment at the inpatient, residential, partial hospitalization, or intensive outpatient levels of care. The EDE-Q was completed at admission. Patients with anorexia nervosa-restricting subtype (AN-R) had the lowest EDE-Q Global scores when compared with all other eating disorder diagnoses. When compared with intensive outpatient care, only those in residential treatment had higher EDE-Q Global scores. This study is among the first to describe norms for the EDE-Q in a large sample of adults receiving various HLOCs. Programs utilizing the EDE-Q to assess treatment outcomes can use these findings to aid people in interpreting their scores., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Renee D. Rienecke receives consulting fees from the Training Institute for Child and Adolescent Eating Disorders, LLC, and royalties from Routledge. Daniel Le Grange receives royalties from Guilford Press and Routledge, is the Co-Director of the Training Institute for Child and Adolescent Eating Disorders, LLC, and is a member of the Clinical Advisory Board of Equip Health. Dan V. Blalock receives consulting fees from Eating Recovery Center. All other authors report no conflicts of interest.

Objective: Negative urgency (i.e., acting rashly when experiencing negative affect; NU), is a theorised maintenance factor in binge-eating type eating disorders. This study examined the association between trait NU and eating disorder severity, momentary changes in state NU surrounding episodes of binge eating, and the momentary mechanistic link between affect, rash action, and binge-eating risk., Methods: Participants were 112 individuals with binge-eating disorder (BED). Baseline measures included the UPPS-P Impulsive Behaviour Scale to assess trait NU and the Eating Disorders Examination to assess binge-eating frequency and global eating disorder severity. Ecological momentary assessment captured real-time data on binge eating, negative affect, and state NU., Results: Multiple regression analysis revealed a strong association between trait NU and eating disorder severity. Generalised estimating equations showed that state NU increased before and decreased after binge-eating episodes, and that this pattern was not moderated by trait-level NU. Finally, a multilevel structural equation model indicated that increases in rash action mediated the momentary relationship between states of high negative affect and episodes of binge eating., Conclusion: These findings underscore the importance of both trait and state NU in binge-eating type eating disorders, and suggest NU as a potential key target for intervention., (© 2024 Eating Disorders Association and John Wiley & Sons Ltd.)

Background: Adequate image enhancement of organs and blood vessels of interest is an important aspect of image quality in contrast-enhanced computed tomography (CT). There is a need for an objective method for evaluation of vessel contrast that can be automatically and systematically applied to large sets of CT exams., Purpose: The purpose of this work was to develop a method to automatically segment and measure attenuation Hounsfield Unit (HU) in the portal vein (PV) in contrast-enhanced abdomen CT examinations., Methods: Input CT images were processed by a vessel enhancing filter to determine candidate PV segmentations. Multiple machine learning (ML) classifiers were evaluated for classifying a segmentation as corresponding to the PV based on segmentation shape, location, and intensity features. A public data set of 82 contrast-enhanced abdomen CT examinations was used to train the method. An optimal ML classifier was selected by training and tuning on 66 out of the 82 exams (80% training split) in the public data set. The method was evaluated in terms of segmentation classification accuracy and PV attenuation measurement accuracy, compared to manually determined ground truth, on a test set of the remaining 16 exams (20% test split) held out from public data set. The method was further evaluated on a separate, independently collected test set of 21 examinations., Results: The best classifier was found to be a random forest, with a precision of 0.892 in the held-out test set to correctly identify the PV from among the input candidate segmentations. The mean absolute error of the measured PV attenuation relative to ground truth manual measurement was 13.4 HU. On the independent test set, the overall precision decreased to 0.684. However, the PV attenuation measurement remained relatively accurate with a mean absolute error of 15.2 HU., Conclusions: The method was shown to accurately measure PV attenuation over a large range of attenuation values, and was validated in an independently collected dataset. The method did not require time-consuming manual contouring to supervise training. The method may be applied to systematic quality control of contrast-enhanced CT examinations., (© 2024 American Association of Physicists in Medicine.)

This study aimed to determine the relationship between geometric and dosimetric agreement metrics in head and neck (H&N) cancer radiotherapy plans. A total 287 plans were retrospectively analyzed, comparing auto-contoured and clinically used contours using a Dice similarity coefficient (DSC), surface DSC (sDSC), and Hausdorff distance (HD). Organs-at-risk (OARs) with ≥200 cGy dose differences from the clinical contour in terms of D max (D0.01cc) and D mean were further examined against proximity to the planning target volume (PTV). A secondary set of 91 plans from multiple institutions validated these findings. For 4995 contour pairs across 19 OARs, 90% had a DSC, sDSC, and HD of at least 0.75, 0.86, and less than 7.65 mm, respectively. Dosimetrically, the absolute difference between the two contour sets was <200 cGy for 95% of OARs in terms of D max and 96% in terms of D mean . In total, 97% of OARs exhibiting significant dose differences between the clinically edited contour and auto-contour were within 2.5 cm PTV regardless of geometric agreement. There was an approximately linear trend between geometric agreement and identifying at least 200 cGy dose differences, with higher geometric agreement corresponding to a lower fraction of cases being identified. Analysis of the secondary dataset validated these findings. Geometric indices are approximate indicators of contour quality and identify contours exhibiting significant dosimetric discordance. For a small subset of OARs within 2.5 cm of the PTV, geometric agreement metrics can be misleading in terms of contour quality.

Summary: Advances in survival analysis have facilitated unprecedented flexibility in data modeling, yet there remains a lack of tools for illustrating the influence of continuous covariates on predicted survival outcomes. We propose the utilization of a colored contour plot to depict the predicted survival probabilities over time. Our approach is capable of supporting conventional models, including the Cox and Fine-Gray models. However, its capability shines when coupled with cutting-edge machine learning models such as random survival forests and deep neural networks., Availability and Implementation: We provide a Shiny app at https://biostatistics.mdanderson.org/shinyapps/survivalContour/ and an R package available at https://github.com/YushuShi/survivalContour as implementations of this tool., Competing Interests: None declared., (© The Author(s) 2024. Published by Oxford University Press.)

In this article, we develop an analytical approach for estimating brain connectivity networks that accounts for subject heterogeneity. More specifically, we consider a novel extension of a multi-subject Bayesian vector autoregressive model that estimates group-specific directed brain connectivity networks and accounts for the effects of covariates on the network edges. We adopt a flexible approach, allowing for (possibly) nonlinear effects of the covariates on edge strength via a novel Bayesian nonparametric prior that employs a weighted mixture of Gaussian processes. For posterior inference, we achieve computational scalability by implementing a variational Bayes scheme. Our approach enables simultaneous estimation of group-specific networks and selection of relevant covariate effects. We show improved performance over competing two-stage approaches on simulated data. We apply our method on resting-state functional magnetic resonance imaging data from children with a history of traumatic brain injury (TBI) and healthy controls to estimate the effects of age and sex on the group-level connectivities. Our results highlight differences in the distribution of parent nodes. They also suggest alteration in the relation of age, with peak edge strength in children with TBI, and differences in effective connectivity strength between males and females., (© 2024 The Author(s). Human Brain Mapping published by Wiley Periodicals LLC.)

Background: Loss of control eating is more likely to occur in the evening and is uniquely associated with distress. No studies have examined the effect of treatment on within-day timing of loss of control eating severity. We examined whether time of day differentially predicted loss of control eating severity at baseline (i.e. pretreatment), end-of-treatment, and 6-month follow-up for individuals with binge-eating disorder (BED), hypothesizing that loss of control eating severity would increase throughout the day pretreatment and that this pattern would be less pronounced following treatment. We explored differential treatment effects of cognitive-behavioral guided self-help (CBTgsh) and Integrative Cognitive-Affective Therapy (ICAT)., Methods: Individuals with BED ( N = 112) were randomized to receive CBTgsh or ICAT and completed a 1-week ecological momentary assessment protocol at baseline, end-of-treatment, and 6-month follow-up to assess loss of control eating severity. We used multilevel models to assess within-day slope trajectories of loss of control eating severity across assessment periods and treatment type., Results: Within-day increases in loss of control eating severity were reduced at end-of-treatment and 6-month follow-up relative to baseline. Evening acceleration of loss of control eating severity was greater at 6-month follow-up relative to end-of-treatment. Within-day increases in loss of control severity did not differ between treatments at end-of-treatment; however, evening loss of control severity intensified for individuals who received CBTgsh relative to those who received ICAT at 6-month follow-up., Conclusions: Findings suggest that treatment reduces evening-shifted loss of control eating severity, and that this effect may be more durable following ICAT relative to CBTgsh.

Purpose: As carbon ion radiotherapy increases in use, there are limited phantom materials for heterogeneous or anthropomorphic phantom measurements. This work characterized the radiological clinical equivalence of several phantom materials in a therapeutic carbon ion beam., Methods: Eight materials were tested for radiological material-equivalence in a carbon ion beam. The materials were computed tomography (CT)-scanned to obtain Hounsfield unit (HU) values, then irradiated in a monoenergetic carbon ion beam to determine relative linear stopping power (RLSP). The corresponding HU and RLSP for each phantom material were compared to clinical carbon ion calibration curves. For absorbed dose comparison, ion chamber measurements were made in the center of a carbon ion spread-out Bragg peak (SOBP) in water and in the phantom material, evaluating whether the material perturbed the absorbed dose measurement beyond what was predicted by the HU-RLSP relationship., Results: Polyethylene, solid water (Gammex and Sun Nuclear), Blue Water (Standard Imaging), and Techtron HPV had measured RLSP values that agreed within ±4.2% of RLSP values predicted by the clinical calibration curve. Measured RLSP for acrylic was 7.2% different from predicted. The agreement for balsa wood and cork varied between samples. Ion chamber measurements in the phantom materials were within 0.1% of ion chamber measurements in water for most materials (solid water, Blue Water, polyethylene, and acrylic), and within 1.9% for the rest of the materials (balsa wood, cork, and Techtron HPV)., Conclusions: Several phantom materials (Blue Water, polyethylene, solid water [Gammex and Sun Nuclear], and Techtron HPV) are suitable for heterogeneous phantom measurements for carbon ion therapy. Low density materials should be carefully characterized due to inconsistencies between samples., (© 2024 American Association of Physicists in Medicine.)

Gut-microbiota modulation shows promise in improving immune-checkpoint blockade (ICB) response; however, precision biomarker-driven, placebo-controlled trials are lacking. We performed a multicenter, randomized placebo-controlled, biomarker-stratified phase I trial in patients with ICB-naïve metastatic melanoma using SER-401, an orally delivered Firmicutesenriched spore formulation. Fecal microbiota signatures were characterized at baseline; patients were stratified by high versus low Ruminococcaceae abundance prior to randomization to the SER-401 arm (oral vancomycin-preconditioning/SER-401 alone/nivolumab + SER-401), versus the placebo arm [placebo antibiotic/placebo microbiome modulation (PMM)/nivolumab + PMM (NCT03817125)]. Analysis of 14 accrued patients demonstrated that treatment with SER-401 + nivolumab was safe, with an overall response rate of 25% in the SER-401 arm and 67% in the placebo arm (though the study was underpowered related to poor accrual during the COVID-19 pandemic). Translational analyses demonstrated that vancomycin preconditioning was associated with the disruption of the gut microbiota and impaired immunity, with incomplete recovery at ICB administration (particularly in patients with high baseline Ruminococcaceae). These results have important implications for future microbiome modulation trials. Significance: This first-of-its-kind, placebo-controlled, randomized biomarker-driven microbiome modulation trial demonstrated that vancomycin + SER-401 and anti-PD-1 are safe in melanoma patients. Although limited by poor accrual during the pandemic, important insights were gained via translational analyses, suggesting that antibiotic preconditioning and interventional drug dosing regimens should be carefully considered when designing such trials., (©2024 The Authors; Published by the American Association for Cancer Research.)

Motivation: Although the human microbiome plays a key role in health and disease, the biological mechanisms underlying the interaction between the microbiome and its host are incompletely understood. Integration with other molecular profiling data offers an opportunity to characterize the role of the microbiome and elucidate therapeutic targets. However, this remains challenging to the high dimensionality, compositionality, and rare features found in microbiome profiling data. These challenges necessitate the use of methods that can achieve structured sparsity in learning cross-platform association patterns., Results: We propose Tree-Aggregated factor RegressiOn (TARO) for the integration of microbiome and metabolomic data. We leverage information on the taxonomic tree structure to flexibly aggregate rare features. We demonstrate through simulation studies that TARO accurately recovers a low-rank coefficient matrix and identifies relevant features. We applied TARO to microbiome and metabolomic profiles gathered from subjects being screened for colorectal cancer to understand how gut microrganisms shape intestinal metabolite abundances., Availability and Implementation: The R package TARO implementing the proposed methods is available online at https://github.com/amishra-stats/taro-package., (© The Author(s) 2024. Published by Oxford University Press.)

Objective . This study characterized optically-stimulated luminescent dosimeter (OSLD) nanoDots for use in a therapeutic carbon beam using the Imaging and Radiation Oncology Core (IROC) framework for remote output verification. Approach . The absorbed dose correction factors for OSLD (fading, linearity, beam quality, angularity, and depletion), as defined by AAPM TG 191, were characterized for carbon beams. For the various correction factors, the effect of linear energy transfer (LET) was examined by characterizing in both a low and high LET setting. Main results . Fading was not statistically different between reference photons and carbon, nor between low and high LET beams; thus, the standard IROC-defined exponential function could be used to characterize fading. Dose linearity was characterized with a linear fit; while low and high LET carbon linearity was different, these differences were small and could be rolled into the uncertainty budget if using a single linearity correction. A linear fit between beam quality and dose-averaged LET was determined. The OSLD response at various angles of incidence was not statistically different, thus a correction factor need not be applied. There was a difference in depletion between low and high LET irradiations in a primary carbon beam, but this difference was small over the standard five readings. The largest uncertainty associated with the use of OSLDs in carbon was because of the k Q correction factor, with an uncertainty of 6.0%. The overall uncertainty budget was 6.3% for standard irradiation conditions. Significance . OSLD nanoDot response was characterized in a therapeutic carbon beam. The uncertainty was larger than for traditional photon applications. These findings enable the use of OSLDs for carbon absorbed dose measurements, but with less accuracy than conventional OSLD audit programs., (Creative Commons Attribution license.)

Background: Few measures have been validated to screen for eating disorders (ED) in youth with chronic pain. We conducted confirmatory (CFA) of two established factor structures of the Eating Attitudes Test-26 (EAT-26) in a sample of youth with chronic pain attending an intensive interdisciplinary pain treatment (IIPT) program and examined the validity of the best-fitting model in predicting ED diagnoses in this sample., Methods: Participants were 880 adolescents (M age = 16.1, SD = 2.1) consecutively admitted into an IIPT program who completed the EAT-26 upon admission. CFA was conducted and in the case of inadequate fit, EFA was planned to identify alternative models. Factors of the best-fitting model were included in a logistic regression analysis to predict ED diagnoses., Results: The TLIs (0.70; 0.90), RMSEAs (0.09; 0.07) and CFIs (0.73; 0.92) suggested poor fit of one model and adequate of the second model. Goodness of fit indices from EFA (TLI:0.85, RMSEA:0.06) did not outperform the fit of the second CFA. As such, the second model was retained with the exception of one factor. The items loaded onto a 16-item, five factor model: Fear of Getting Fat, Social Pressure to Gain Weight, Eating-Related Control, Eating-Related Guilt and Food Preoccupation. Based on chart review, 19.1% of the participants were diagnosed with an eating disorder. Logistic regression analyses indicated the new 16-item measure and Fear of Getting Fat, significantly predicted an ED diagnosis that did not include avoidant restrictive food intake disorder (ARFID) and Social Pressure to Gain Weight significantly predicted a diagnosis of ARFID., Conclusions: An alternative 16-item, 5-factor structure of the EAT-26 should be considered in screening for EDs with youth with chronic pain., (© 2024. The Author(s).)