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Sample records for actual delivered dose

  1. Experimental evaluation of actual delivered dose using mega-voltage cone-beam CT and direct point dose measurement

    SciTech Connect

    Matsubara, Kana; Kohno, Ryosuke; Nishioka, Shie; Shibuya, Toshiyuki; Ariji, Takaki; Akimoto, Tetsuo; Saitoh, Hidetoshi

    2013-07-01

    Radiation therapy in patients is planned by using computed tomography (CT) images acquired before start of the treatment course. Here, tumor shrinkage or weight loss or both, which are common during the treatment course for patients with head-and-neck (H and N) cancer, causes unexpected differences from the plan, as well as dose uncertainty with the daily positional error of patients. For accurate clinical evaluation, it is essential to identify these anatomical changes and daily positional errors, as well as consequent dosimetric changes. To evaluate the actual delivered dose, the authors proposed direct dose measurement and dose calculation with mega-voltage cone-beam CT (MVCBCT). The purpose of the present study was to experimentally evaluate dose calculation by MVCBCT. Furthermore, actual delivered dose was evaluated directly with accurate phantom setup. Because MVCBCT has CT-number variation, even when the analyzed object has a uniform density, a specific and simple CT-number correction method was developed and applied for the H and N site of a RANDO phantom. Dose distributions were calculated with the corrected MVCBCT images of a cylindrical polymethyl methacrylate phantom. Treatment processes from planning to beam delivery were performed for the H and N site of the RANDO phantom. The image-guided radiation therapy procedure was utilized for the phantom setup to improve measurement reliability. The calculated dose in the RANDO phantom was compared to the measured dose obtained by metal-oxide-semiconductor field-effect transistor detectors. In the polymethyl methacrylate phantom, the calculated and measured doses agreed within about +3%. In the RANDO phantom, the dose difference was less than +5%. The calculated dose based on simulation-CT agreed with the measured dose within±3%, even in the region with a high dose gradient. The actual delivered dose was successfully determined by dose calculation with MVCBCT, and the point dose measurement with the image

  2. Estimating the actual dose delivered by intravascular coronary brachytherapy using geometrically correct 3D modeling

    NASA Astrophysics Data System (ADS)

    Wahle, Andreas; Lopez, John J.; Pennington, Edward C.; Meeks, Sanford L.; Braddy, Kathleen C.; Fox, James M.; Brennan, Theresa M. H.; Buatti, John M.; Rossen, James D.; Sonka, Milan

    2003-05-01

    Intravascular brachytherapy has shown to reduce re-occurrence of in-stent restenosis in coronary arteries. For beta radiation, application time is determined from source activity and the angiographically estimated vessel diameter. Conventionally used dosing models assume a straight vessel with the catheter centered and a constant-diameter circular cross section. Aim of this study was to compare the actual dose delivered during in-vivo intravascular brachytherapy with the target range determined from the patient's prescribed dose. Furthermore, differences in dose distribution between a simplified tubular model (STM) and a geometrically correct 3-D model (GCM) obtained from fusion between biplane angiography and intravascular ultrasound were quantified. The tissue enclosed by the segmented lumen/plaque and media/adventitia borders was simulated using a structured finite-element mesh. The beta-radiation sources were modeled as 3-D objects in their angiographically determined locations. The accumulated dose was estimated using a fixed distance function based on the patient-specific radiation parameters. For visualization, the data was converted to VRML with the accumulated doses represented by color encoding. The statistical comparison between STM and GCM models in 8 patients showed that the STM significantly underestimates the dose delivered and its variability. The analysis revealed substantial deviations from the target dose range in curved vessels.

  3. Parotid Glands Dose-Effect Relationships Based on Their Actually Delivered Doses: Implications for Adaptive Re-Planning in Radiotherapy of Head and Neck Cancer

    PubMed Central

    Hunter, Klaudia U.; Fernandes, Laura; Vineberg, Karen A.; McShan, Daniel; Antonuk, Alan E.; Cornwall, Craig; Feng, Mary; Schipper, Mathew; Balter, James; Eisbruch, Avraham

    2013-01-01

    Purpose Doses actually delivered to the parotid glands during radiotherapy often exceed planned doses. We hypothesized that the delivered doses correlate better with parotid salivary output than the planned doses, used in all previous studies, and that determining these correlations will help decisions regarding adaptive re-planning (ART) aimed at reducing the delivered doses. Methods and Materials Prospective study: oropharyngeal cancer patients treated definitively with chemo-irradiation underwent daily cone beam CT (CBCT) with clinical set-up alignment based on C2 posterior edge. Parotid glands in the CBCTs were aligned by deformable registration to calculate cumulative delivered doses. Stimulated salivary flow rates were measured separately from each parotid gland pretherapy and periodically posttherapy. Results 36 parotid glands of 18 patients were analyzed. Average mean planned doses was 32 Gy and differences from planned to delivered mean gland doses were −4.9 to +8.4 Gy, median difference +2.2 Gy in glands whose delivered doses increased relative to planned. Both planned and delivered mean doses were significantly correlated with post-treatment salivary outputs at almost all post-therapy time points, without statistically significant differences in the correlations. Large dispersions [on average, standard deviation (SD) 3.6 Gy] characterized the dose/effect relationships for both. The differences between the cumulative delivered doses and planned doses were evident already at first fraction (r=0.92, p<0.0001) due to complex set-up deviations, e.g. rotations and neck articulations, uncorrected by the translational clinical alignments. Conclusions After daily translational set-up corrections, differences between planned and delivered doses in most glands were small relative to the SDs of the dose/saliva data, suggesting that ART is not likely to gain measurable salivary output improvement in most cases. These differences were observed already at first

  4. Parotid Glands Dose–Effect Relationships Based on Their Actually Delivered Doses: Implications for Adaptive Replanning in Radiation Therapy of Head-and-Neck Cancer

    SciTech Connect

    Hunter, Klaudia U.; Fernandes, Laura L.; Vineberg, Karen A.; McShan, Daniel; Antonuk, Alan E.; Cornwall, Craig; Feng, Mary; Schipper, Mathew J.; Balter, James M.; Eisbruch, Avraham

    2013-11-15

    Purpose: Doses actually delivered to the parotid glands during radiation therapy often exceed planned doses. We hypothesized that the delivered doses correlate better with parotid salivary output than the planned doses, used in all previous studies, and that determining these correlations will help make decisions regarding adaptive radiation therapy (ART) aimed at reducing the delivered doses. Methods and Materials: In this prospective study, oropharyngeal cancer patients treated definitively with chemoirradiation underwent daily cone-beam computed tomography (CBCT) with clinical setup alignment based on the C2 posterior edge. Parotid glands in the CBCTs were aligned by deformable registration to calculate cumulative delivered doses. Stimulated salivary flow rates were measured separately from each parotid gland pretherapy and periodically posttherapy. Results: Thirty-six parotid glands of 18 patients were analyzed. Average mean planned doses was 32 Gy, and differences from planned to delivered mean gland doses were −4.9 to +8.4 Gy, median difference +2.2 Gy in glands in which delivered doses increased relative to planned. Both planned and delivered mean doses were significantly correlated with posttreatment salivary outputs at almost all posttherapy time points, without statistically significant differences in the correlations. Large dispersions (on average, SD 3.6 Gy) characterized the dose–effect relationships for both. The differences between the cumulative delivered doses and planned doses were evident at first fraction (r=.92, P<.0001) because of complex setup deviations (eg, rotations and neck articulations), uncorrected by the translational clinical alignments. Conclusions: After daily translational setup corrections, differences between planned and delivered doses in most glands were small relative to the SDs of the dose–saliva data, suggesting that ART is not likely to gain measurable salivary output improvement in most cases. These differences were

  5. Do We Need Daily Image-Guided Radiotherapy by Megavoltage Computed Tomography in Head and Neck Helical Tomotherapy? The Actual Delivered Dose to the Spinal Cord

    SciTech Connect

    Duma, Marciana Nona; Kampfer, Severin; Schuster, Tibor; Aswathanarayana, Nandana; Fromm, Laura-Sophie; Molls, Michael; Andratschke, Nicolaus; Geinitz, Hans

    2012-09-01

    Purpose: To quantify the actual delivered dose to the cervical spinal cord with different image-guided radiotherapy (IGRT) approaches during head and neck (HN) cancer helical tomotherapy. Methods and Materials: Twenty HN patients (HNpts) treated with bilateral nodal irradiation were analyzed. Daily megavoltage computed tomography MVCT) scans were performed for setup purposes. The maximum dose on the planning CT scan (plan-Dmax) and the magnitude and localization of the actual delivered Dmax (a-Dmax) were analyzed for four scenarios: daily image-guided radiotherapy (dIGRT), twice weekly IGRT (2 Multiplication-Sign WkIGRT), once weekly IGRT (1 Multiplication-Sign WkIGRT), and no IGRT at all (non-IGRT). The spinal cord was recontoured on 236 MVCTs for each scenario (total, 944 fractions), and the delivered dose was recalculated for each fraction (fx) separately. Results: Fifty-one percent of the analyzed fx for dIGRT, 56% of the analyzed fx for the 2 Multiplication-Sign WkIGRT, 62% of the analyzed fx for the 1 Multiplication-Sign WkIGRT, and 63% of the analyzed fx for the non-IGRT scenarios received a higher a-Dmax than the plan-Dmax. The median increase of dose in these fx was 3.3% more for dIGRT, 5.8% more for 2 Multiplication-Sign WkIGRT, 10.0% more for 1 Multiplication-Sign WkIGRT, and 9.5% more for non-IGRT than the plan-Dmax. The median spinal cord volumes receiving a higher dose than the plan-Dmax were 0.02 cm{sup 3} for dIGRT, 0.11 cm{sup 3} for 2 Multiplication-Sign WkIGRT, 0.31 cm{sup 3} for 1 Multiplication-Sign WkIGRT, and 0.22 cm{sup 3} for non-IGRT. Differences between the dIGRT and all other scenarios were statistically significant (p < 0.05). Conclusions: Compared to the Dmax of the initial plan, daily IGRT had the smallest increase in dose. Furthermore, daily IGRT had the lowest proportion of fractions and the smallest volumes affected by a dose that was higher than the planned dose. For patients treated with doses close to the tolerance dose of the

  6. Comparison of Planned Versus Actual Dose Delivered for External Beam Accelerated Partial Breast Irradiation Using Cone-Beam CT and Deformable Registration

    SciTech Connect

    Hasan, Yasmin; Kim, Leonard; Wloch, Jennifer; Chi, Y.; Liang, J.; Martinez, Alvaro; Yan Di; Vicini, Frank

    2011-08-01

    Purpose: To assess the adequacy of dose delivery to the clinical target volume (CTV) using external beam (EB) accelerated partial breast irradiation (APBI). Methods and Materials: Sixteen patients treated with EB APBI underwent cone beam CT (CBCT) before each fraction and daily helical CT (HCT) scans to determine setup errors and calculate the dose per fraction. For 12 patients, an in-house image-intensity-based deformable registration program was used to register the HCTs to the planning CT and generate the cumulative dose. Treatment was 38.5 Gy in 10 fractions. EB APBI constraints from the National Surgical Adjuvant Breast and Bowel Project B39/Radiation Therapy Oncology Group 0413 Phase III protocol were used. Results: The mean setup error per CBCT registration was 9 {+-} 5 mm. Dose-volume histogram analysis showed only one patient (8%) with a decrease in the CTV V90 (8% underdosage). All other patients demonstrated adequate target coverage. PTV{sub E}VAL V90 was on average 3% (range, 0%-16%) less than planned. For the ipsilateral breast, four patients had an increase in V50 ({<=}1% increase) and three patients had an increase in V100 ({<=}9% increase). Only one patient showed an increase >5%. Four patients had an increase in ipsilateral lung V30 (maximum 3%), and one had an increase in heart V5 (1%). Four patients had an increase in MaxDose (maximum 89 cGy). Conclusions: The current CTV-to-PTV margin of 10 mm appears sufficient for {approx}92% of patients treated with EB APBI. Although expansion of the population PTV margin to 14 mm would provide {approx}97% confidence level for CTV coverage, online image guidance should be considered.

  7. Radioactive Doses - Predicted and Actual - and Likely Health Effects.

    PubMed

    Nagataki, S; Takamura, N

    2016-04-01

    Five years have passed since the nuclear accident at Fukushima Daiichi Nuclear Power Stations on 11 March 2011. Here we refer to reports from international organisations as sources of predicted values obtained from environmental monitoring and dose estimation models, and reports from various institutes in Japan are used as sources of individual actual values. The World Health Organization, based on information available up to 11 September 2011 (and published in 2012), reported that characteristic effective doses in the first year after the accident, to all age groups, were estimated to be in the 10-50 mSv dose band in example locations in evacuation areas. Estimated characteristic thyroid doses to infants in Namie Town were within the 100-200 mSv dose band. A report from the United Nations Scientific Committee on the Effects of Atomic Radiation published in 2014 shows that the effective dose received by adults in evacuation areas during the first year after the accident was 1.1-13 mSv. The absorbed dose to the thyroid in evacuated settlements was 7.2-35 mSv in adults and 15-83 mSv in 1-year-old infants. Individual external radiation exposure in the initial 4 months after the accident, estimated by superimposing individual behaviour data on to a daily dose rate map, was less than 3 mSv in 93.9% of residents (maximum 15 mSv) in evacuation areas. Actual individual thyroid equivalent doses were less than 15 mSv in 98.8% of children (maximum 25 mSv) in evacuation areas. When uncertainty exists in dose estimation models, it may be sensible to err on the side of caution, and final estimated doses are often much greater than actual radiation doses. However, overestimation of the dose at the time of an accident has a great influence on the psychology of residents. More than 100 000 residents have not returned to the evacuation areas 5 years after the Fukushima accident because of the social and mental effects during the initial period of the disaster. Estimates of

  8. Radioactive Doses - Predicted and Actual - and Likely Health Effects.

    PubMed

    Nagataki, S; Takamura, N

    2016-04-01

    Five years have passed since the nuclear accident at Fukushima Daiichi Nuclear Power Stations on 11 March 2011. Here we refer to reports from international organisations as sources of predicted values obtained from environmental monitoring and dose estimation models, and reports from various institutes in Japan are used as sources of individual actual values. The World Health Organization, based on information available up to 11 September 2011 (and published in 2012), reported that characteristic effective doses in the first year after the accident, to all age groups, were estimated to be in the 10-50 mSv dose band in example locations in evacuation areas. Estimated characteristic thyroid doses to infants in Namie Town were within the 100-200 mSv dose band. A report from the United Nations Scientific Committee on the Effects of Atomic Radiation published in 2014 shows that the effective dose received by adults in evacuation areas during the first year after the accident was 1.1-13 mSv. The absorbed dose to the thyroid in evacuated settlements was 7.2-35 mSv in adults and 15-83 mSv in 1-year-old infants. Individual external radiation exposure in the initial 4 months after the accident, estimated by superimposing individual behaviour data on to a daily dose rate map, was less than 3 mSv in 93.9% of residents (maximum 15 mSv) in evacuation areas. Actual individual thyroid equivalent doses were less than 15 mSv in 98.8% of children (maximum 25 mSv) in evacuation areas. When uncertainty exists in dose estimation models, it may be sensible to err on the side of caution, and final estimated doses are often much greater than actual radiation doses. However, overestimation of the dose at the time of an accident has a great influence on the psychology of residents. More than 100 000 residents have not returned to the evacuation areas 5 years after the Fukushima accident because of the social and mental effects during the initial period of the disaster. Estimates of

  9. Electronic compensation technique to deliver a total body dose

    NASA Astrophysics Data System (ADS)

    Lakeman, Tara E.

    Purpose: Total body irradiation (TBI) uses large parallel-opposed radiation fields to suppress the patient's immune system and eradicate the residual cancer cells in preparation of recipient for bone marrow transplant. The manual placement of lead compensators has been conventionally used to compensate for the varying thickness throughout the body in large-field TBI. The goal of this study is to pursue utilizing the modern electronic compensation technique to more accurately and efficiently deliver dose to patients in need of TBI. Method: Treatment plans utilizing the electronic compensation to deliver a total body dose were created retrospectively for patients for whom CT data had been previously acquired. Each treatment plan includes two pair of parallel opposed fields. One pair of large fields is used to encompass the majority of the patient's anatomy. The other pair are very small open fields focused only on the thin bottom portion of the patient's anatomy, which requires much less radiation than the rest of the body to reach 100% of the prescribed dose. A desirable fluence pattern was manually painted within each of the larger fields for each patient to provide a more uniform distribution. Results: Dose-volume histograms (DVH) were calculated for evaluating the electronic compensation technique. In the electronically compensated plans, the maximum body doses calculated from the DVH were reduced from the conventionally-compensated plans by an average of 15%, indicating a more uniform dose. The mean body doses calculated from the electronically compensated DVH remained comparable to that of the conventionally-compensated plans, indicating an accurate delivery of the prescription dose using electronic compensation. All calculated monitor units were within clinically acceptable limits. Conclusion: Electronic compensation technique for TBI will not increase the beam on time beyond clinically acceptable limits while it can substantially reduce the compensator setup

  10. Delivered dose estimate to standardize airway hyperresponsiveness assessment in mice.

    PubMed

    Robichaud, Annette; Fereydoonzad, Liah; Schuessler, Thomas F

    2015-04-15

    Airway hyperresponsiveness often constitutes a primary outcome in respiratory studies in mice. The procedure commonly employs aerosolized challenges, and results are typically reported in terms of bronchoconstrictor concentrations loaded into the nebulizer. Yet, because protocols frequently differ across studies, especially in terms of aerosol generation and delivery, direct study comparisons are difficult. We hypothesized that protocol variations could lead to differences in aerosol delivery efficiency and, consequently, in the dose delivered to the subject, as well as in the response. Thirteen nebulization patterns containing common protocol variations (nebulization time, duty cycle, particle size spectrum, air humidity, and/or ventilation profile) and using increasing concentrations of methacholine and broadband forced oscillations (flexiVent, SCIREQ, Montreal, Qc, Canada) were created, characterized, and studied in anesthetized naïve A/J mice. A delivered dose estimate calculated from nebulizer-, ventilator-, and subject-specific characteristics was introduced and used to account for protocol variations. Results showed that nebulization protocol variations significantly affected the fraction of aerosol reaching the subject site and the delivered dose, as well as methacholine reactivity and sensitivity in mice. From the protocol variants studied, addition of a slow deep ventilation profile during nebulization was identified as a key factor for optimization of the technique. The study also highlighted sensitivity differences within the lung, as well as the possibility that airway responses could be selectively enhanced by adequate control of nebulizer and ventilator settings. Reporting results in terms of delivered doses represents an important standardizing element for assessment of airway hyperresponsiveness in mice. PMID:25637610

  11. 3D delivered dose assessment using a 4DCT-based motion model

    SciTech Connect

    Cai, Weixing; Hurwitz, Martina H.; Williams, Christopher L.; Dhou, Salam; Berbeco, Ross I.; Mishra, Pankaj E-mail: jhlewis@lroc.harvard.edu; Lewis, John H. E-mail: jhlewis@lroc.harvard.edu; Seco, Joao

    2015-06-15

    Purpose: The purpose of this work is to develop a clinically feasible method of calculating actual delivered dose distributions for patients who have significant respiratory motion during the course of stereotactic body radiation therapy (SBRT). Methods: A novel approach was proposed to calculate the actual delivered dose distribution for SBRT lung treatment. This approach can be specified in three steps. (1) At the treatment planning stage, a patient-specific motion model is created from planning 4DCT data. This model assumes that the displacement vector field (DVF) of any respiratory motion deformation can be described as a linear combination of some basis DVFs. (2) During the treatment procedure, 2D time-varying projection images (either kV or MV projections) are acquired, from which time-varying “fluoroscopic” 3D images of the patient are reconstructed using the motion model. The DVF of each timepoint in the time-varying reconstruction is an optimized linear combination of basis DVFs such that the 2D projection of the 3D volume at this timepoint matches the projection image. (3) 3D dose distribution is computed for each timepoint in the set of 3D reconstructed fluoroscopic images, from which the total effective 3D delivered dose is calculated by accumulating deformed dose distributions. This approach was first validated using two modified digital extended cardio-torso (XCAT) phantoms with lung tumors and different respiratory motions. The estimated doses were compared to the dose that would be calculated for routine 4DCT-based planning and to the actual delivered dose that was calculated using “ground truth” XCAT phantoms at all timepoints. The approach was also tested using one set of patient data, which demonstrated the application of our method in a clinical scenario. Results: For the first XCAT phantom that has a mostly regular breathing pattern, the errors in 95% volume dose (D95) are 0.11% and 0.83%, respectively for 3D fluoroscopic images

  12. 3D delivered dose assessment using a 4DCT-based motion model

    PubMed Central

    Cai, Weixing; Hurwitz, Martina H.; Williams, Christopher L.; Dhou, Salam; Berbeco, Ross I.; Seco, Joao; Mishra, Pankaj; Lewis, John H.

    2015-01-01

    Purpose: The purpose of this work is to develop a clinically feasible method of calculating actual delivered dose distributions for patients who have significant respiratory motion during the course of stereotactic body radiation therapy (SBRT). Methods: A novel approach was proposed to calculate the actual delivered dose distribution for SBRT lung treatment. This approach can be specified in three steps. (1) At the treatment planning stage, a patient-specific motion model is created from planning 4DCT data. This model assumes that the displacement vector field (DVF) of any respiratory motion deformation can be described as a linear combination of some basis DVFs. (2) During the treatment procedure, 2D time-varying projection images (either kV or MV projections) are acquired, from which time-varying “fluoroscopic” 3D images of the patient are reconstructed using the motion model. The DVF of each timepoint in the time-varying reconstruction is an optimized linear combination of basis DVFs such that the 2D projection of the 3D volume at this timepoint matches the projection image. (3) 3D dose distribution is computed for each timepoint in the set of 3D reconstructed fluoroscopic images, from which the total effective 3D delivered dose is calculated by accumulating deformed dose distributions. This approach was first validated using two modified digital extended cardio-torso (XCAT) phantoms with lung tumors and different respiratory motions. The estimated doses were compared to the dose that would be calculated for routine 4DCT-based planning and to the actual delivered dose that was calculated using “ground truth” XCAT phantoms at all timepoints. The approach was also tested using one set of patient data, which demonstrated the application of our method in a clinical scenario. Results: For the first XCAT phantom that has a mostly regular breathing pattern, the errors in 95% volume dose (D95) are 0.11% and 0.83%, respectively for 3D fluoroscopic images

  13. Actual Dose Variation of Parotid Glands and Spinal Cord for Nasopharyngeal Cancer Patients During Radiotherapy

    SciTech Connect

    Han Chunhui Chen Yijen; Liu An; Schultheiss, Timothy E.; Wong, Jeffrey Y.C.

    2008-03-15

    Purpose: For intensity-modulated radiotherapy of nasopharyngeal cancer, accurate dose delivery is crucial to the success of treatment. This study aimed to evaluate the significance of daily image-guided patient setup corrections and to quantify the parotid gland volume and dose variations for nasopharyngeal cancer patients using helical tomotherapy megavoltage computed tomography (CT). Methods and Materials: Five nasopharyngeal cancer patients who underwent helical tomotherapy were selected retrospectively. Each patient had received 70 Gy in 35 fractions. Daily megavoltage CT scans were registered with the planning CT images to correct the patient setup errors. Contours of the spinal cord and parotid glands were drawn on the megavoltage CT images at fixed treatment intervals. The actual doses delivered to the critical structures were calculated using the helical tomotherapy Planned Adaptive application. Results: The maximal dose to the spinal cord showed a significant increase and greater variation without daily setup corrections. The significant decrease in the parotid gland volume led to a greater median dose in the later phase of treatment. The average parotid gland volume had decreased from 20.5 to 13.2 cm{sup 3} by the end of treatment. On average, the median dose to the parotid glands was 83 cGy and 145 cGy for the first and the last treatment fractions, respectively. Conclusions: Daily image-guided setup corrections can eliminate significant dose variations to critical structures. Constant monitoring of patient anatomic changes and selective replanning should be used during radiotherapy to avoid critical structure complications.

  14. SU-E-T-517: Analytic Formalism to Compute in Real Time Dose Distributions Delivered by HDR Units

    SciTech Connect

    Pokhrel, S; Loyalka, S; Palaniswaamy, G; Rangaraj, D; Izaguirre, E

    2014-06-01

    Purpose: Develop an analytical algorithm to compute the dose delivered by Ir-192 dwell positions with high accuracy using the 3-dimensional (3D) dose distribution of an HDR source. Using our analytical function, the dose delivered by an HDR unit as treatment progresses can be determined using the actual delivered temporal and positional data of each individual dwell. Consequently, true delivered dose can be computed when each catheter becomes active. We hypothesize that the knowledge of such analytical formulation will allow developing HDR systems with a real time treatment evaluation tool to avoid mistreatments. Methods: In our analytic formulation, the dose is computed by using the full anisotropic function data of the TG 43 formalism with 3D ellipsoidal function. The discrepancy between the planned dose and the delivered dose is computed using an analytic perturbation method over the initial dose distribution. This methodology speeds up the computation because only changes in dose discrepancies originated by spatial and temporal deviations are computed. A dose difference map at the point of interest is obtained from these functions and this difference can be shown during treatment in real time to examine the treatment accuracy. Results: We determine the analytical solution and a perturbation function for the 3 translational 3 rotational, and 1D temporal errors in source distributions. The analytic formulation is a sequence of simple equations that can be processed in any modern computer in few seconds. Because computations are based in an analytical solution, small deviations of the dose when sub-millimeter positional changes occur can be detected. Conclusions: We formulated an analytical method to compute 4D dose distributions and dose differences based on an analytical solution and perturbations to the original dose. This method is highly accurate and can be.

  15. Delivered dialysis dose is suboptimal in hospitalized patients.

    PubMed

    Obialo, C I; Hernandez, B; Carter, D

    1998-01-01

    Underdialyzed patients have high hospitalization and mortality rates. It is unclear if such patients receive adequate dialysis during hospitalization. In this cross-sectional study, we evaluated single treatment delivered dialysis dose during hospitalization and compared this to the dosage received at the free-standing outpatient clinics in the same patients. Eighty-four patients (54% male) aged 23-63 years (means +/- SD 55.5 +/- 14.6) who have been on dialysis for at least 3 months were evaluated. Hypertension and diabetes were the most common diagnoses, while thrombosed graft or fistula accounted for 40% of admissions. The mean dialysis treatment time (Td) was 30 min longer in the outpatient (OP) setting than the hospital (H): 3.6 +/- 0.3 vs. 3.1 +/- 0.2 h (p < 0.0001). Attained blood flow (QB) was 15% greater in the OP than H: 394 +/- 40 vs. 331 +/- 54 ml/min (p < 0.0001). The Kt/V was analyzed in 49 of 84 patients; the OP Kt/V was 20% greater than the H Kt/V: 1.38 +/- 0.2 vs. 1.11 +/- 0.1 (p < 0.0001). A further breakdown of H Kt/V according to access and membrane types showed that patients with functional grafts/fistula had a higher Kt/V than those with temporary accesses 1.14 +/- 0.1 vs. 1.07 +/- 0.1 (p = 0.01). We conclude that hospitalized patients receive suboptimal dialysis dose, this could have a negative impact on survival if hospitalization is recurrent and prolonged. Kinetic modeling should be routinely performed in such patients and Td should be increased in patients with temporary accesses. PMID:9845829

  16. Daily variations in delivered doses in patients treated with radiotherapy for localized prostate cancer

    SciTech Connect

    Kupelian, Patrick A. . E-mail: patrick.kupelian@orhs.org; Langen, Katja M.; Zeidan, Omar A.; Meeks, Sanford L.; Willoughby, Twyla R.; Wagner, Thomas H.; Jeswani, Sam; Ruchala, Kenneth J.; Haimerl, Jason; Olivera, Gustavo H.

    2006-11-01

    Purpose: The aim of this work was to study the variations in delivered doses to the prostate, rectum, and bladder during a full course of image-guided external beam radiotherapy. Methods and Materials: Ten patients with localized prostate cancer were treated with helical tomotherapy to 78 Gy at 2 Gy per fraction in 39 fractions. Daily target localization was performed using intraprostatic fiducials and daily megavoltage pelvic computed tomography (CT) scans, resulting in a total of 390 CT scans. The prostate, rectum, and bladder were manually contoured on each CT by a single physician. Daily dosimetric analysis was performed with dose recalculation. The study endpoints were D95 (dose to 95% of the prostate), rV2 (absolute rectal volume receiving 2 Gy), and bV2 (absolute bladder volume receiving 2 Gy). Results: For the entire cohort, the average D95 ({+-}SD) was 2.02 {+-} 0.04 Gy (range, 1.79-2.20 Gy). The average rV2 ({+-}SD) was 7.0 {+-} 8.1 cc (range, 0.1-67.3 cc). The average bV2 ({+-}SD) was 8.7 {+-} 6.8 cc (range, 0.3-36.8 cc). Unlike doses for the prostate, there was significant daily variation in rectal and bladder doses, mostly because of variations in volume and shape of these organs. Conclusion: Large variations in delivered doses to the rectum and bladder can be documented with daily megavoltage CT scans. Image guidance for the targeting of the prostate, even with intraprostatic fiducials, does not take into account the variation in actual rectal and bladder doses. The clinical impact of techniques that take into account such dosimetric parameters in daily patient set-ups should be investigated.

  17. Maximizing the biological effect of proton dose delivered with scanned beams via inhomogeneous daily dose distributions

    SciTech Connect

    Zeng Chuan; Giantsoudi, Drosoula; Grassberger, Clemens; Goldberg, Saveli; Niemierko, Andrzej; Paganetti, Harald; Efstathiou, Jason A.; Trofimov, Alexei

    2013-05-15

    Purpose: Biological effect of radiation can be enhanced with hypofractionation, localized dose escalation, and, in particle therapy, with optimized distribution of linear energy transfer (LET). The authors describe a method to construct inhomogeneous fractional dose (IFD) distributions, and evaluate the potential gain in the therapeutic effect from their delivery in proton therapy delivered by pencil beam scanning. Methods: For 13 cases of prostate cancer, the authors considered hypofractionated courses of 60 Gy delivered in 20 fractions. (All doses denoted in Gy include the proton's mean relative biological effectiveness (RBE) of 1.1.) Two types of plans were optimized using two opposed lateral beams to deliver a uniform dose of 3 Gy per fraction to the target by scanning: (1) in conventional full-target plans (FTP), each beam irradiated the entire gland, (2) in split-target plans (STP), beams irradiated only the respective proximal hemispheres (prostate split sagittally). Inverse planning yielded intensity maps, in which discrete position control points of the scanned beam (spots) were assigned optimized intensity values. FTP plans preferentially required a higher intensity of spots in the distal part of the target, while STP, by design, employed proximal spots. To evaluate the utility of IFD delivery, IFD plans were generated by rearranging the spot intensities from FTP or STP intensity maps, separately as well as combined using a variety of mixing weights. IFD courses were designed so that, in alternating fractions, one of the hemispheres of the prostate would receive a dose boost and the other receive a lower dose, while the total physical dose from the IFD course was roughly uniform across the prostate. IFD plans were normalized so that the equivalent uniform dose (EUD) of rectum and bladder did not increase, compared to the baseline FTP plan, which irradiated the prostate uniformly in every fraction. An EUD-based model was then applied to estimate tumor

  18. Nanoparticle-based cancer treatment: can delivered dose and biological dose be reliably modeled and quantified?

    NASA Astrophysics Data System (ADS)

    Hoopes, P. Jack; Petryk, Alicia A.; Giustini, Andrew J.; Stigliano, Robert V.; D'Angelo, Robert N.; Tate, Jennifer A.; Cassim, Shiraz M.; Foreman, Allan; Bischof, John C.; Pearce, John A.; Ryan, Thomas

    2011-03-01

    Essential developments in the reliable and effective use of heat in medicine include: 1) the ability to model energy deposition and the resulting thermal distribution and tissue damage (Arrhenius models) over time in 3D, 2) the development of non-invasive thermometry and imaging for tissue damage monitoring, and 3) the development of clinically relevant algorithms for accurate prediction of the biological effect resulting from a delivered thermal dose in mammalian cells, tissues, and organs. The accuracy and usefulness of this information varies with the type of thermal treatment, sensitivity and accuracy of tissue assessment, and volume, shape, and heterogeneity of the tumor target and normal tissue. That said, without the development of an algorithm that has allowed the comparison and prediction of the effects of hyperthermia in a wide variety of tumor and normal tissues and settings (cumulative equivalent minutes/ CEM), hyperthermia would never have achieved clinical relevance. A new hyperthermia technology, magnetic nanoparticle-based hyperthermia (mNPH), has distinct advantages over the previous techniques: the ability to target the heat to individual cancer cells (with a nontoxic nanoparticle), and to excite the nanoparticles noninvasively with a noninjurious magnetic field, thus sparing associated normal cells and greatly improving the therapeutic ratio. As such, this modality has great potential as a primary and adjuvant cancer therapy. Although the targeted and safe nature of the noninvasive external activation (hysteretic heating) are a tremendous asset, the large number of therapy based variables and the lack of an accurate and useful method for predicting, assessing and quantifying mNP dose and treatment effect is a major obstacle to moving the technology into routine clinical practice. Among other parameters, mNPH will require the accurate determination of specific nanoparticle heating capability, the total nanoparticle content and biodistribution in

  19. Accuracy of one algorithm used to modify a planned DVH with data from actual dose delivery.

    PubMed

    Ma, Tianjun; Podgorsak, Matthew B; Kumaraswamy, Lalith K

    2016-01-01

    Detection and accurate quantification of treatment delivery errors is important in radiation therapy. This study aims to evaluate the accuracy of DVH based QA in quantifying delivery errors. Eighteen previously treated VMAT plans (prostate, H&N, and brain) were randomly chosen for this study. Conventional IMRT delivery QA was done with the ArcCHECK diode detector for error-free plans and plans with the following modifications: 1) induced monitor unit differences up to ± 3.0%, 2) control point deletion (3, 5, and 8 control points were deleted for each arc), and 3) gantry angle shift (2° uniform shift clockwise and counterclockwise). 2D and 3D distance-to-agreement (DTA) analyses were performed for all plans with SNC Patient software and 3DVH software, respectively. Subsequently, accuracy of the reconstructed DVH curves and DVH parameters in 3DVH software were analyzed for all selected cases using the plans in the Eclipse treatment planning system as standard. 3D DTA analysis for error-induced plans generally gave high pass rates, whereas the 2D evaluation seemed to be more sensitive to detecting delivery errors. The average differences for DVH parameters between each pair of Eclipse recalculation and 3DVH prediction were within 2% for all three types of error-induced treatment plans. This illustrates that 3DVH accurately quantifies delivery errors in terms of actual dose delivered to the patients. 2D DTA analysis should be routinely used for clinical evaluation. Any concerns or dose discrepancies should be further analyzed through DVH-based QA for clinically relevant results and confirmation of a conventional passing-rate-based QA. PMID:27685140

  20. SU-E-J-21: Advantages of Ultra Fast Radiation Dose Delivering

    SciTech Connect

    Feng, Y

    2014-06-01

    Purpose: For delivering conformed dose to a moving tumor and sparing normal tissue, we presented an innovation that was combined a linear accelerator and a storage ring to generate ultra high dose rate. This innovation allows delivering prescribed dose to a moving target in such a short time period, for an example 0.1 second, during which the displacement of the target could be ignored. Methods: The advantages of this approach were evaluated based on normal tissue sparing, feasibility, accuracy, and time saving in clinical treatment. The target volume reduction with this innovation approach was demonstrated by analyzing the values of GTVs, ITVs, and PTVs obtained from 15 patients who had been diagnosed with malignant neoplasm of lung and treated with SBRT. The processes of SBRT treatment were investigated and advantages of this innovation in improving SBRT lung treatment were evaluated. Results: With the ultra-high dose rate, the target volumes could be reduced by ∼30% to 50%. The innovation combining with IGRT technique could deliver prescribed dose to moving target accurately with simpler procedures than that of adaptive approach. This new approach could reduce the time of guiding treatment by many times. The new technique make a new strategy became feasible that was to deliver the dose to a target when it moved to a desirable location, such as away from critical organs. Conclusion: Combining with IGRT technique, this innovation could significantly improve the accuracy to deliver dose to moving targets with a shorter time than conventional techniques. The innovation opens a door for new strategies to deliver dose to moving targets.

  1. Involved field radiation for Hodgkin's lymphoma: The actual dose to breasts in close proximity

    SciTech Connect

    Dabaja, Bouthaina; Wang Zhonglo; Stovall, Marilyn; Baker, Jamie S.; Smith, Susan A.; Khan, Meena; Ballas, Leslie; Salehpour, Mohammad R.

    2012-01-01

    To decrease the risk of late toxicities in Hodgkin's lymphoma (HL) patients treated with radiation therapy (RT) (HL), involved field radiation therapy (IFRT) has largely replaced the extended fields. To determine the out-of-field dose delivered from a typical IFRT to surrounding critical structures, we measured the dose at various points in an anthropomorphic phantom. The phantom is divided into 1-inch-thick slices with the ability to insert TLDs at 3-cm intervals grid spacing. Two treatment fields were designed, and a total of 45 TLDs were placed (equally spaced) at the margin of the each of the 2 radiation fields. After performing a computed tomography simulation, 2 treatment plans targeting the mediastinum, a typical treatment field in patients with early stage HL, were generated. A total dose of 3060 cGy was delivered to the gross tumor volume for each field consecutively. The highest measured dose detected at 1 cm from the field edge in the planning target volume was 496 cGy, equivalent to 16% of the isocentric dose. The dose dropped significantly with increasing distance from the field edge. It ranged from 1.1-3.9% of the isocentric dose at a distance of 3.2-4 cm to <1.6% at a distance of >6 cm. Although the computer treatment planning system (CTPS) frequently underestimated the dose delivered, the difference in dose between measured and generated by CTPS was <2.5% in 90 positions measured. The collateral dose of radiation to breasts from IFRT is minimal. The out-of-field dose, although mildly underestimated by CTPS, becomes insignificant at >3 cm from the field edge of the radiation field.

  2. SU-E-T-371: Validation of Organ Doses Delivered During Craniospinal Irradiation with Helical Tomotherapy

    SciTech Connect

    Perez-Andujar, A; Chen, J; Garcia, A; Haas-Kogan, D

    2014-06-01

    Purpose: New techniques have been developed to deliver more conformal treatments to the craniospinal axis. One concern, however, is the widespread low dose delivered and implications for possible late effects. The purpose of this work is for the first time to validate the organ doses calculated by the treatment planning system (TPS), including out-of-field doses for a pediatric craniospinal treatment (CSI). Methods: A CSI plan prescribed to 23.4 Gy and a posterior fossa boost plan to 30.6 Gy (total dose 54.0 Gy) was developed for a pediatric anthropomorphic phantom representing a 13 yearold- child. For the CSI plan, the planning target volumes (PTV) consisted of the brain and spinal cord with 2 mm and 5 mm expansions, respectively. Organs at risk (OAR) were contoured and included in the plan optimization. The plans were delivered on a helical tomotherapy unit. Thermoluminescent dosimeters (TLDs) were used to measure the dose at 54 positions within the PTV and OARs. Results: For the CSI treatment, the mean percent difference between TPS dose calculations and measurements was 5% for the PTV and 10% for the OARs. For the boost, the average was 3% for the PTV. The percent difference for the OARs, which lie outside the field and received a small fraction of the prescription dose, varied from 15% to 200%. However in terms of absolute dose, the average difference between measurement and TPS per treatment Gy was 2 cGy/Gy and 3 mGy/Gy for the CSI and boost plans, respectively. Conclusion: There was good agreement between doses calculated by the TPS and measurements for the CSI treatment. Higher percent differences were observed for out-of-field doses in the boost plan, but absolute dose differences were very small compared to the prescription dose. These findings can help in the estimation of late effects after radiotherapy for pediatric patients.

  3. Morphological transformation of Syrian hamster embryo cells by low doses of fission neutrons delivered at different dose rates

    SciTech Connect

    Jones, C.A.; Sedita, B.A. ); Hill, C.K. . Cancer Research Lab.); Elkind, M.M. . Dept. of Radiology and Radiation Biology)

    1991-01-01

    Both induction of cell transformation and killing were examined with Syrian hamster embryo (SHE) fibroblasts exposed to low doses of JANUS fission-spectrum neutrons delivered at high (10.3 cGy/min) and low (0.43 and 0.086 cGy/min) dose rates. Second-passage cells were irradiated in mass cultures, then cloned over feeder cells. Morphologically transformed colonies were identified 8-10 days later. Cell killing was independent of dose rate, but the yield of transformation was greater after low-dose-rate irradiations. Decreasing the neutron dose-rate from 10.3 to 0.086 cGy/min resulted in a two- to threefold increase in the yield of transformation for neutron exposures below 50 cGy, and enhancement which was consistently observed in repetitive experiments in different radiosensitive SHE cell preparations. 43 refs., 5 figs., 1 tab.

  4. Dose Rate Analysis Capability for Actual Spent Fuel Transportation Cask Contents

    SciTech Connect

    Radulescu, Georgeta; Lefebvre, Robert A; Peplow, Douglas E.; Williams, Mark L; Scaglione, John M

    2014-01-01

    The approved contents for a U.S. Nuclear Regulatory Commission (NRC) licensed spent nuclear fuel casks are typically based on bounding used nuclear fuel (UNF) characteristics. However, the contents of the UNF canisters currently in storage at independent spent fuel storage installations are considerably heterogeneous in terms of fuel assembly burnup, initial enrichment, decay time, cladding integrity, etc. Used Nuclear Fuel Storage, Transportation & Disposal Analysis Resource and Data System (UNF ST&DARDS) is an integrated data and analysis system that facilitates automated cask-specific safety analyses based on actual characteristics of the as-loaded UNF. The UNF-ST&DARDS analysis capabilities have been recently expanded to include dose rate analysis of as-loaded transportation packages. Realistic dose rate values based on actual canister contents may be used in place of bounding dose rate values to support development of repackaging operations procedures, evaluation of radiation-related transportation risks, and communication with stakeholders. This paper describes the UNF-ST&DARDS dose rate analysis methodology based on actual UNF canister contents and presents sample dose rate calculation results.

  5. Nominal effective radiation doses delivered during clinical trials of boron neutron capture therapy

    SciTech Connect

    Capala, J.; Diaz, A.Z.; Chanana, A.D.

    1997-12-31

    Boron neutron capture therapy (BNCT) is a binary system that, in theory, should selectively deliver lethal, high linear energy transfer (LET) radiation to tumor cells dispersed within normal tissues. It is based on the nuclear reaction 10-B(n, {alpha})7-Li, which occurs when the stable nucleus of boron-10 captures a thermal neutron. Due to the relatively high cross-section of the 10-B nucleus for thermal neutron capture and short ranges of the products of this reaction, tumor cells in the volume exposed to thermal neutrons and containing sufficiently high concentration of 10-B would receive a much higher radiation dose than the normal cells contained within the exposed volume. Nevertheless, radiation dose deposited in normal tissue by gamma and fast neutron contamination of the neutron beam, as well as neutron capture in nitrogen, 14-N(n,p)14-C, hydrogen, 1-H(n,{gamma})2-H, and in boron present in blood and normal cells, limits the dose that can be delivered to tumor cells. It is, therefore, imperative for the success of the BNCT the dosed delivered to normal tissues be accurately determined in order to optimize the irradiation geometry and to limit the volume of normal tissue exposed to thermal neutrons. These are the major objectives of BNCT treatment planning.

  6. Outcomes for newly diagnosed patients with acute myeloid leukemia dosed on actual or adjusted body weight

    PubMed Central

    Bivona, Cory; Rockey, Michelle; Henry, Dave; Grauer, Dennis; Abhyankar, Sunil; Aljitawi, Omar; Ganguly, Siddhartha; McGuirk, Joseph; Singh, Anurag; Lin, Tara L.

    2015-01-01

    Purpose Data from solid tumor malignancies suggest that actual body weight (ABW) dosing improves overall outcomes. There is the potential to compromise efficacy when chemotherapy dosages are reduced, but the impact of dose adjustment on clinical response and toxicity in hematologic malignancies is unknown. The purpose of this study was to evaluate the outcomes of utilizing a percent of ABW for acute myeloid leukemia (AML) induction chemotherapy dosing. Methods This retrospective, single-center study included 146 patients who received 7 + 3 induction (cytarabine and anthracycline) for treatment of AML. Study design evaluated the relationship between percentage of ABW dosing and complete response (CR) rates in patients newly diagnosed with AML. Results Percentage of ABW dosing did not influence CR rates in patients undergoing induction chemotherapy for AML (p = 0.83); nor did it influence rate of death at 30 days or relapse at 6 months (p = 0.94). When comparing patients dosed at 90–100 % of ABW compared to <90 % ABW, CR rates were not significantly different in patients classified as poor risk (p = 0.907). All favorable risk category patients obtained CR. Conclusions Preemptive dose reductions for obesity did not influence CR rates for patients with AML undergoing induction chemotherapy and did not influence the composite endpoint of death at 30 days or disease relapse at 6 months. PMID:26231954

  7. Reduction of Dose Delivered to Organs at Risk in Prostate Cancer Patients via Image-Guided Radiation Therapy

    SciTech Connect

    Pawlowski, Jason M.; Yang, Eddy S.; Malcolm, Arnold W.; Coffey, Charles W.; Ding, George X.

    2010-03-01

    Purpose: To determine whether image guidance can improve the dose delivered to target organs and organs at risk (OARs) for prostate cancer patients treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Eight prostate cancer patients were treated with IMRT to 76 Gy at 2 Gy per fraction. Daily target localization was performed via alignment of three intraprostatic fiducials and weekly kV-cone beam computed tomography (CBCT) scans. The prostate and OARs were manually contoured on each CBCT by a single physician. Daily patient setup shifts were obtained by comparing alignment of skin tattoos with the treatment position based on fiducials. Treatment fields were retrospectively applied to CBCT scans. The dose distributions were calculated using actual treatment plans (an 8-mm PTV margin everywhere except for 6-mm posteriorly) with and without image guidance shifts. Furthermore, the feasibility of margin reduction was evaluated by reducing planning margins to 4 mm everywhere except for 3 mm posteriorly. Results: For the eight treatment plans on the 56 CBCT scans, the average doses to 98% of the prostate (D98) were 102% (range, 99-104%) and 99% (range, 45-104%) with and without image guidance, respectively. Using margin reduction, the average D98s were 100% (range, 84-104%) and 92% (range, 40-104%) with and without image guidance, respectively. Conclusions: Currently, margins used in IMRT plans are adequate to deliver a dose to the prostate with conventional patient positioning using skin tattoos or bony anatomy. The use of image guidance may facilitate significant reduction of planning margins. Future studies to assess the efficacy of decreasing margins and improvement of treatment-related toxicities are warranted.

  8. Dose delivered from Varian's CBCT to patients receiving IMRT for prostate cancer

    NASA Astrophysics Data System (ADS)

    Wen, Ning; Guan, Huaiqun; Hammoud, Rabih; Pradhan, Deepak; Nurushev, T.; Li, Shidong; Movsas, Benjamin

    2007-04-01

    With the increased use of cone beam CT (CBCT) for daily patient setup, the accumulated dose from CBCT may be significantly higher than that from simulation CT or portal imaging. The objective of this work is to measure the dose from daily pelvic scans with fixed technical settings and collimations. CBCT scans were acquired in half-fan mode using a half bowtie and x-rays were delivered in pulsed-fluoro mode. The skin doses for seven prostate patients were measured on an IRB-approved protocol. TLD capsules were placed on the patient's skin at the central axis of three beams: AP, left lateral (Lt Lat) and right lateral (Rt Lat). To avoid the ring artefacts centred in the prostate, the treatment couch was dropped 3 cm from the patient's tattoo (central axis). The measured AP skin doses ranged 3-6 cGy for 20-33 cm separation. The larger the patient size the less the AP skin dose. Lateral doses did not change much with patient size. The Lt Lat dose was ~4.0 cGy, which was ~40% higher than the Rt Lat dose of ~2.6 cGy. To verify this dose asymmetry, surface doses on an IMRT QA phantom (oval shaped, 30 cm × 20 cm) were measured at the same three sites using TLD capsules with 3 cm table-drop. The dose asymmetry was due to: (1) kV source rotation which always starts from the patient's Lt Lat and ends at Lt Lat. Gantry rotation gets much slower near the end of rotation but dose rate stays constant and (2) 370° scan rotation (10° scan overlap on the Lt Lat side). In vivo doses were measured inside a Rando pelvic heterogeneous phantom using TLDs. The left hip (femoral head and neck) received the highest doses of ~10-11 cGy while the right hip received ~6-7 cGy. The surface and in vivo doses were also measured for phantoms at the central-axis setup. The difference was less than ~12% to the table-drop setup.

  9. An assessment of PTV margin based on actual accumulated dose for prostate cancer radiotherapy

    NASA Astrophysics Data System (ADS)

    Wen, Ning; Kumarasiri, Akila; Nurushev, Teamour; Burmeister, Jay; Xing, Lei; Liu, Dezhi; Glide-Hurst, Carri; Kim, Jinkoo; Zhong, Hualiang; Movsas, Benjamin; Chetty, Indrin J.

    2013-11-01

    The purpose of this work is to present the results of a margin reduction study involving dosimetric and radiobiologic assessment of cumulative dose distributions, computed using an image guided adaptive radiotherapy based framework. Eight prostate cancer patients, treated with 7-9, 6 MV, intensity modulated radiation therapy (IMRT) fields, were included in this study. The workflow consists of cone beam CT (CBCT) based localization, deformable image registration of the CBCT to simulation CT image datasets (SIM-CT), dose reconstruction and dose accumulation on the SIM-CT, and plan evaluation using radiobiological models. For each patient, three IMRT plans were generated with different margins applied to the CTV. The PTV margin for the original plan was 10 mm and 6 mm at the prostate/anterior rectal wall interface (10/6 mm) and was reduced to: (a) 5/3 mm, and (b) 3 mm uniformly. The average percent reductions in predicted tumor control probability (TCP) in the accumulated (actual) plans in comparison to the original plans over eight patients were 0.4%, 0.7% and 11.0% with 10/6 mm, 5/3 mm and 3 mm uniform margin respectively. The mean increase in predicted normal tissue complication probability (NTCP) for grades 2/3 rectal bleeding for the actual plans in comparison to the static plans with margins of 10/6, 5/3 and 3 mm uniformly was 3.5%, 2.8% and 2.4% respectively. For the actual dose distributions, predicted NTCP for late rectal bleeding was reduced by 3.6% on average when the margin was reduced from 10/6 mm to 5/3 mm, and further reduced by 1.0% on average when the margin was reduced to 3 mm. The average reduction in complication free tumor control probability (P+) in the actual plans in comparison to the original plans with margins of 10/6, 5/3 and 3 mm was 3.7%, 2.4% and 13.6% correspondingly. The significant reduction of TCP and P+ in the actual plan with 3 mm margin came from one outlier, where individualizing patient treatment plans through margin adaptation

  10. Initial beam size study for passive scatter proton therapy. II. Changes in delivered depth dose profiles

    SciTech Connect

    Polf, Jerimy C.; Harvey, Mark C.; Smith, Alfred R.

    2007-11-15

    In passively scattered proton radiotherapy, a clinically useful treatment beam is produced by spreading a small proton 'pencil beam' extracted from the accelerator to create both a uniform dose profile laterally and a uniform spread-out Bragg peak (SOBP) in depth. Lateral spreading and range modulation of the beam are accomplished using specially designed components within the treatment delivery nozzle. The purpose of this study was to determine how changes in the size of the initial proton pencil beam affect the delivery of dose with a passive scatter treatment nozzle. Monte Carlo calculations were used to study changes of the beam's in-air energy distribution at the exit of the nozzle and the central axis depth dose profiles in water resulting from changes in the incident beam size. Our results indicate that the width of the delivered SOBP decreases as the size of the initial beam increases.

  11. Variable dose rate single-arc IMAT delivered with a constant dose rate and variable angular spacing

    NASA Astrophysics Data System (ADS)

    Tang, Grace; Earl, Matthew A.; Yu, Cedric X.

    2009-11-01

    Single-arc intensity-modulated arc therapy (IMAT) has gained worldwide interest in both research and clinical implementation due to its superior plan quality and delivery efficiency. Single-arc IMAT techniques such as the Varian RapidArc™ deliver conformal dose distributions to the target in one single gantry rotation, resulting in a delivery time in the order of 2 min. The segments in these techniques are evenly distributed within an arc and are allowed to have different monitor unit (MU) weightings. Therefore, a variable dose-rate (VDR) is required for delivery. Because the VDR requirement complicates the control hardware and software of the linear accelerators (linacs) and prevents most existing linacs from delivering IMAT, we propose an alternative planning approach for IMAT using constant dose-rate (CDR) delivery with variable angular spacing. We prove the equivalence by converting VDR-optimized RapidArc plans to CDR plans, where the evenly spaced beams in the VDR plan are redistributed to uneven spacing such that the segments with larger MU weighting occupy a greater angular interval. To minimize perturbation in the optimized dose distribution, the angular deviation of the segments was restricted to <=± 5°. This restriction requires the treatment arc to be broken into multiple sectors such that the local MU fluctuation within each sector is reduced, thereby lowering the angular deviation of the segments during redistribution. The converted CDR plans were delivered with a single gantry sweep as in the VDR plans but each sector was delivered with a different value of CDR. For four patient cases, including two head-and-neck, one brain and one prostate, all CDR plans developed with the variable spacing scheme produced similar dose distributions to the original VDR plans. For plans with complex angular MU distributions, the number of sectors increased up to four in the CDR plans in order to maintain the original plan quality. Since each sector was delivered

  12. The impact of modeling nuclear fragmentation on delivered dose and radiobiology in ion therapy.

    PubMed

    Lühr, Armin; Hansen, David C; Teiwes, Ricky; Sobolevsky, Nikolai; Jäkel, Oliver; Bassler, Niels

    2012-08-21

    The importance of nuclear interactions for ion therapy arises from the influence of the particle spectrum on, first, radiobiology and therefore also on treatment planning, second, the accuracy of measuring dose and, third, the delivered dose distribution. This study tries to determine the qualitative as well as the quantitative influence of the modeling of inelastic nuclear interactions on ion therapy. Thereby, three key disciplines are investigated, namely dose delivery, dose assessment and radiobiology. In order to perform a quantitative analysis, a relative comparison between six different descriptions of nuclear interactions is carried out for carbon ions. The particle transport is simulated with the Monte Carlo code SHIELD-HIT10A while dose planning and radiobiology are covered by the analytic treatment planning program for particles TRiP, which determines the relative biological effectiveness (RBE) with the local effect model. The obtained results show that the physical dose distribution can in principle be significantly influenced by the modeling of fragmentation (about 10% for a 20% change in all inelastic nuclear cross sections for a target volume ranging from 15 to 25 cm). While the impact of nuclear fragmentation on stopping power ratios can be neglected, the fluence correction factor may be influenced by the applied nuclear models. In contrast to the results for the physical dose, the variation of the RBE is only small (about 1% for a 20% change in all inelastic nuclear cross sections) suggesting a relatively weak dependence of radiobiology on the detailed composition of the particle energy spectrum of the mixed radiation field. Also, no significant change (about 0.2 mm) of the lateral penumbra of the RBE-weighted dose is observed.

  13. High-Dose 131I-Tositumomab (Anti-CD20) Radioimmunotherapy for Non-Hodgkin's Lymphoma: Adjusting Radiation Absorbed Dose to Actual Organ Volumes

    SciTech Connect

    Rajendran, Joseph G.; Fisher, Darrell R.; Gopal, A K.; Durack, L. D.; Press, O. W.; Eary, Janet F.

    2004-06-01

    Radioimmunotherapy (RIT) using 131I-tositumomab has been used successfully to treat relapsed or refractory B-cell non-Hodgin's lymphoma (NHL). Our approach to treatment planning has been to determine limits on radiation absorbed close to critical nonhematopoietic organs. This study demonstrates the feasibility of using CT to adjust for actual organ volumes in calculating organ-specific absorbed dose estimates. Methods: Records of 84 patients who underwent biodistribution studies after a trace-labeled infusion of 131I-tositumomab for RIT (January 1990 and April 2003) were reviewed. Serial planar -camera images and whole-body Nal probe counts were obtained to estimate 131I-antibody source-organ residence times as recommended by the MIRD Committee. The source-organ residence times for standard man or woman were adjusted by the ratio of the MIRD phantom organ mass to the CT-derived organ mass. Results: The mean radiation absorbed doses (in mGy/MBq) for our data using the MIRD model were lungs= 1.67; liver= 1.03; kidneys= 1.08; spleen= 2.67; and whole body= 0.3; and for CT volume-adjusted organ volumes (in mGy/MBq) were lungs= 1.30; liver= 0.92; kidneys= 0.76; spleen= 1.40; and whole body= 0.22. We determined the following correlation coefficients between the 2 methods for the various organs; lungs, 0.49; (P= 0.0001); liver, 0.64 (P= 0.004); kidneys, 0.45 (P= 0.0001), for the residence times. For therapy, patients received mean 131I administered activities of 19.2 GBq (520 mCi) after adjustment for CT-derived organ mass compared with 16.0 GBq (433 mCi) that would otherwise have been given had therapy been based only using standard MIRD organ volumes--a statistically significant difference (P= 0.0001). Conclusion: We observed large variations in organ masses among our patients. Our treatments were planned to deliver the maximally tolerated radiation dose to the dose-limiting normal organ. This work provides a simplified method for calculating patient-specific radiation

  14. The lateral plane delivers higher dose than the frontal plane in biplane cardiac catheterization systems.

    PubMed

    Aldoss, Osamah; Patel, Sonali; Harris, Kyle; Divekar, Abhay

    2015-06-01

    The objective of the study is to compare radiation dose between the frontal and lateral planes in a biplane cardiac catheterization laboratory. Tube angulation progressively increases patient and operator radiation dose in single-plane cardiac catheterization laboratories. This retrospective study captured biplane radiation dose in a pediatric cardiac catheterization laboratory between April 2010 and January 2014. Raw and time-indexed fluoroscopic, cineangiographic and total (fluoroscopic + cineangiographic) air kerma (AK, mGy) and kerma area product (PKA, µGym(2)/Kg) for each plane were compared. Data for 716 patients were analyzed: 408 (56.98 %) were male, the median age was 4.86 years, and the median weight was 17.35 kg. Although median beam-on time (minutes) was 4.2 times greater in the frontal plane, there was no difference in raw median total PKA between the two planes. However, when indexed to beam-on time, the lateral plane had a higher median-indexed fluoroscopic (0.75 vs. 1.70), cineangiographic (16.03 vs. 24.92), and total (1.43 vs. 5.15) PKA (p < 0.0001). The median time-indexed total PKA in the lateral plane is 3.6 times the frontal plane. This is the first report showing that the lateral plane delivers a higher dose than the frontal plane per unit time. Operators should consciously reduce the lateral plane beam-on time and incorporate this practice in radiation reduction protocols.

  15. Doses delivered to normal brain under different treatment protocols at Brookhaven National Laboratory

    SciTech Connect

    Capala, J.; Coderre, J.A.; Liu, H.B.

    1996-12-31

    As of October 31, 1996, 23 glioblastoma multiforme patients underwent BNCT under several treatment protocols at the Brookhaven Medical Research Reactor. For treatment planning and dosimetry purposes, these protocols may be divided into four groups. The first group comprises protocols that used an 8-cm collimator and allowed a peak normal brain dose of 10.5 Gy-Eq to avolume of 1 cm{sup 3} were the thermal neutron flux was maximal (even if it happened to be in the tumor volume). The second group differs from the first in that it allowed a peak normal brain dose of 12.6 Gy-Eq. The protocols of the third and fourth groups allowed the prescribed peak normal brain dose of 12.6 Gy-Eq to be outside of the tumor volume, used a 12-cm collimator and, respectively, uni- or bilateral irradiations. We describe the treatment planning procedures and report the doses delivered to various structures of the brain.

  16. Impact of Gastric Filling on Radiation Dose Delivered to Gastroesophageal Junction Tumors

    SciTech Connect

    Bouchard, Myriam; McAleer, Mary Frances; Starkschall, George

    2010-05-01

    Purpose: This study examined the impact of gastric filling variation on target coverage of gastroesophageal junction (GEJ) tumors in three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), or IMRT with simultaneous integrated boost (IMRT-SIB) plans. Materials and Methods: Eight patients previously receiving radiation therapy for esophageal cancer had computed tomography (CT) datasets acquired with full stomach (FS) and empty stomach (ES). We generated treatment plans for 3DCRT, IMRT, or IMRT-SIB for each patient on the ES-CT and on the FS-CT datasets. The 3DCRT and IMRT plans were planned to 50.4 Gy to the clinical target volume (CTV), and the same for IMRT-SIB plus 63.0 Gy to the gross tumor volume (GTV). Target coverage was evaluated using dose-volume histogram data for patient treatments simulated with ES-CT sets, assuming treatment on an FS for the entire course, and vice versa. Results: FS volumes were a mean of 3.3 (range, 1.7-7.5) times greater than ES volumes. The volume of the GTV receiving >=50.4 Gy (V{sub 50.4Gy}) was 100% in all situations. The planning GTV V{sub 63Gy} became suboptimal when gastric filling varied, regardless of whether simulation was done on the ES-CT or the FS-CT set. Conclusions: Stomach filling has a negligible impact on prescribed dose delivered to the GEJ GTV, using either 3DCRT or IMRT planning. Thus, local relapses are not likely to be related to variations in gastric filling. Dose escalation for GEJ tumors with IMRT-SIB may require gastric filling monitoring.

  17. Absolute calibration of the Gamma Knife{sup ®} Perfexion™ and delivered dose verification using EPR/alanine dosimetry

    SciTech Connect

    Hornbeck, Amaury E-mail: tristan.garcia@cea.fr; Garcia, Tristan E-mail: tristan.garcia@cea.fr; Cuttat, Marguerite; Jenny, Catherine

    2014-06-15

    Purpose: Elekta Leksell Gamma Knife{sup ®} (LGK) is a radiotherapy beam machine whose features are not compliant with the international calibration protocols for radiotherapy. In this scope, the Laboratoire National Henri Becquerel and the Pitié-Salpêtrière Hospital decided to conceive a new LKG dose calibration method and to compare it with the currently used one. Furthermore, the accuracy of the dose delivered by the LGK machine was checked using an “end-to-end” test. This study also aims to compare doses delivered by the two latest software versions of the Gammaplan treatment planning system (TPS). Methods: The dosimetric method chosen is the electron paramagnetic resonance (EPR) of alanine. Dose rate (calibration) verification was done without TPS using a spherical phantom. Absolute calibration was done with factors calculated by Monte Carlo simulation (MCNP-X). For “end-to-end” test, irradiations in an anthropomorphic head phantom, close to real treatment conditions, are done using the TPS in order to verify the delivered dose. Results: The comparison of the currently used calibration method with the new one revealed a deviation of +0.8% between the dose rates measured by ion chamber and EPR/alanine. For simple fields configuration (less than 16 mm diameter), the “end-to-end” tests showed out average deviations of −1.7% and −0.9% between the measured dose and the calculated dose by Gammaplan v9 and v10, respectively. Conclusions: This paper shows there is a good agreement between the new calibration method and the currently used one. There is also a good agreement between the calculated and delivered doses especially for Gammaplan v10.

  18. Late Effects After Radiotherapy for Locally Advanced Cervical Cancer: Comparison of Two Brachytherapy Schedules and Effect of Dose Delivered Weekly

    SciTech Connect

    Paulsen Hellebust, Taran; Kristensen, Gunnar B.; Olsen, Dag Rune

    2010-03-01

    Purpose: To compare the severe late effects (Grade 3 or greater) for two groups of cervical cancer patients treated with the same external beam radiotherapy and two high-dose-rate intracavitary brachytherapy regimens and to investigate the influence of the dose delivered each week. Methods and Materials: For 120 patients, intracavitary brachytherapy was delivered with 33.6 Gy in eight fractions to Point A (HD group), and for 119, intracavitary brachytherapy was delivered with 29.4 Gy in seven fractions to Point A (LD group). The cumulative incidence of severe gastrointestinal and genitourinary late effects were calculated for both dose groups using Kaplan-Meier survival analysis. This method was also used to explore whether the number of weeks with different dose levels could predict the cumulative incidence of late effects. Results: The actuarial rate of developing severe gastrointestinal morbidity at 7 years was 10.7% and 8.3% for HD and LD groups, respectively. The rate for genitourinary morbidity was 6.6% for the HD group and 5.0% for the LD group, respectively. No significant difference was found between the two groups. The analyses showed that a marginally significant increase occurred in severe gastrointestinal complications as the number of weeks with a physical dose >20 Gy increased in the HD group (p = .047). Conclusion: To establish dose-response relationships for late complications, three-dimensional imaging and dose-volume histogram parameters are needed. We found some indications that 20 Gy/wk is an upper tolerance level when the dose to the International Commission on Radiation Units and Measurements rectum point is 81 Gy{sub {alpha}/{beta}=3} (isoeffective [equivalent] dose of 2-Gy fractions). However, additional investigations using three-dimensional data are needed.

  19. Clinical examples of 3D dose distribution reconstruction, based on the actual MLC leaves movement, for dynamic treatment techniques

    PubMed Central

    Osewski, Wojciech; Dolla, Łukasz; Radwan, Michał; Szlag, Marta; Rutkowski, Roman; Smolińska, Barbara; Ślosarek, Krzysztof

    2014-01-01

    Aim To present practical examples of our new algorithm for reconstruction of 3D dose distribution, based on the actual MLC leaf movement. Background DynaLog and RTplan files were used by DDcon software to prepare a new RTplan file for dose distribution reconstruction. Materials and methods Four different clinically relevant scenarios were used to assess the feasibility of the proposed new approach: (1) Reconstruction of whole treatment sessions for prostate cancer; (2) Reconstruction of IMRT verification treatment plan; (3) Dose reconstruction in breast cancer; (4) Reconstruction of interrupted arc and complementary plan for an interrupted VMAT treatment session of prostate cancer. The applied reconstruction method was validated by comparing reconstructed and measured fluence maps. For all statistical analysis, the U Mann–Whitney test was used. Results In the first two and the fourth cases, there were no statistically significant differences between the planned and reconstructed dose distribution (p = 0.910, p = 0.975, p = 0.893, respectively). In the third case the differences were statistically significant (p = 0.015). Treatment plan had to be reconstructed. Conclusion Developed dose distribution reconstruction algorithm presents a very useful QA tool. It provides means for 3D dose distribution verification in patient volume and allows to evaluate the influence of actual MLC leaf motion on the dose distribution. PMID:25337416

  20. SU-C-BRF-04: Delivered 4D Dose Calculation for Lung-VMAT Patients Using In- Treatment CBCT and LINAC Log Data

    SciTech Connect

    Saotome, N; Haga, A; Imae, T; Kida, S; Nakano, M; Yamashita, H; Nakagawa, K; Ohtomo, K

    2014-06-15

    Purpose: To verify the delivered four-dimensional (4D) dose distribution for the lung VMAT using in-treatment 4D cone-beam CT (CBCT) and LINAC log data. Methods: Three patients for lung stereotactic radiotherapy (SRT) were treated by single-arc volumetric modulated arc therapy (VMAT) created by SmartArc in Pinnacle v9.2 (Philips, USA).Kilovoltage (kV) projection images were acquired during VMAT delivery using the x-ray volumetric imager, XVI (Elekta, UK). LINAC log data were also recorded via iCom interface (Elekta, UK). Subsequently, the iCom data format was converted to Pinnacle data format, thereby allowing Pinnacle to read actual MLC positions, jaw positions, gantry angles and MUs. These parameters were categorized into four groups according to patient's respiratory phase. The patient respiratory phase was determined from kV-projection images by in-house phase recognizing software. By exporting these data back to Pinnacle, in-treatment dose distributions for each respiratory phase were obtained by combining calculated dose having a particular phase. The 4D CBCT were reconstructed by in-house program. The density in the structures on the CBCT was overridden by the average density in the corresponding structures on the planning CT for the dose calculation. The dose indexes, such as maximum, minimum, mean dose in the target were compared among the plan, in-treatment 3D calculation, and in-treatment 4D calculation. Results: The day-to-day variation of the delivered dose was observed for all three patients. The maximum difference was 5.9% for the minimum dose in the target. Difference for the mean dose was found to be small (1.1% at maximum). Conclusion: We have obtained in-treatment dose distribution for each of the different respiratory phases using in-treatment 4D CBCT and LINAC log data during lung VMAT delivery. Our result indicate a small but significant dose difference between the 3D and 4D calculations for the case of large target traveling.

  1. Measurement of effects of nasal and facial shields on delivered radiation dose for superficial x-ray treatments

    NASA Astrophysics Data System (ADS)

    Yu, Peter K. N.; Butson, Martin J.

    2013-03-01

    Kilovoltage x-ray beams are used for the treatment of facial cancers when located on the patient's skin or subcutaneous tissue. This is of course due to the sharp depth dose characteristics of these beams delivering much lower doses at depth, than high energy x-ray beams. When treatment is performed, lead shields are often used within the nasal passage, or behind the lips and ears. These shields affect the backscattering patterns of the x-ray beams producing perturbations to upstream dose thus reducing delivered dose to the tumour. Experimental results using radiochromic films have shown that up to 10.5% ± 1.9% reduction in tumour dose can occur for field sizes less than 5 cm circle diameter for x-ray beams of 50 to 150 kVp. These results were confirmed using EGSnrc Monte Carlo techniques. Clinically more than 70% of treatments used fields of diameters less than 3 cm where the reductions were up to 6% ± 1.3%. Using a 1 cm diameter field, which can be used for skin cancer treatment on the nose, reductions up to 2.5% ± 1.3% were seen. Thus corrections need to be applied for dose calculations when underlying lead shields are used clinically in kilovoltage x-rays. The size of the reduction was also found to be dependent on the depth of the shield which will normally clinically vary from approximately 0.5 cm for nasal shields or behind eye lobes and up to approximately 1 cm for lips or cheek areas. We recommend that clinics utilize data for corrections to delivered dose in kilovoltage x-ray beams when lead shields are used in nasal passages, behind lips or behind ears for dose reduction. This can be easily and accurately measured with EBT2 Gafchromic film.

  2. A simplified technique for delivering total body irradiation (TBI) with improved dose homogeneity

    SciTech Connect

    Yao Rui; Bernard, Damian; Turian, Julius; Abrams, Ross A.; Sensakovic, William; Fung, Henry C.; Chu, James C. H.

    2012-04-15

    Purpose: Total body irradiation (TBI) with megavoltage photon beams has been accepted as an important component of management for a number of hematologic malignancies, generally as part of bone marrow conditioning regimens. The purpose of this paper is to present and discuss the authors' TBI technique, which both simplifies the treatment process and improves the treatment quality. Methods: An AP/PA TBI treatment technique to produce uniform dose distributions using sequential collimator reductions during each fraction was implemented, and a sample calculation worksheet is presented. Using this methodology, the dosimetric characteristics of both 6 and 18 MV photon beams, including lung dose under cerrobend blocks was investigated. A method of estimating midplane lung doses based on measured entrance and exit doses was proposed, and the estimated results were compared with measurements. Results: Whole body midplane dose uniformity of {+-}10% was achieved with no more than two collimator-based beam modulations. The proposed model predicted midplane lung doses 5% to 10% higher than the measured doses for 6 and 18 MV beams. The estimated total midplane doses were within {+-}5% of the prescribed midplane dose on average except for the lungs where the doses were 6% to 10% lower than the prescribed dose on average. Conclusions: The proposed TBI technique can achieve dose uniformity within {+-}10%. This technique is easy to implement and does not require complicated dosimetry and/or compensators.

  3. [Cooperation with the electronic medical record and accounting system of an actual dose of drug given by a radiology information system].

    PubMed

    Yamamoto, Hideo; Yoneda, Tarou; Satou, Shuji; Ishikawa, Toru; Hara, Misako

    2009-12-20

    By input of the actual dose of a drug given into a radiology information system, the system converting with an accounting system into a cost of the drug from the actual dose in the electronic medical record was built. In the drug master, the first unit was set as the cost of the drug, and we set the second unit as the actual dose. The second unit in the radiology information system was received by the accounting system through electronic medical record. In the accounting system, the actual dose was changed into the cost of the drug using the dose of conversion to the first unit. The actual dose was recorded on a radiology information system and electronic medical record. The actual dose was indicated on the accounting system, and the cost for the drug was calculated. About the actual dose of drug, cooperation of the information in a radiology information system and electronic medical record were completed. It was possible to decide the volume of drug from the correct dose of drug at the previous inspection. If it is necessary for the patient to have another treatment of medicine, it is important to know the actual dose of drug given. Moreover, authenticity of electronic medical record based on a statute has also improved.

  4. In vivo verification of radiation dose delivered to healthy tissue during radiotherapy for breast cancer

    NASA Astrophysics Data System (ADS)

    Lonski, P.; Taylor, M. L.; Hackworth, W.; Phipps, A.; Franich, R. D.; Kron, T.

    2014-03-01

    Different treatment planning system (TPS) algorithms calculate radiation dose in different ways. This work compares measurements made in vivo to the dose calculated at out-of-field locations using three different commercially available algorithms in the Eclipse treatment planning system. LiF: Mg, Cu, P thermoluminescent dosimeter (TLD) chips were placed with 1 cm build-up at six locations on the contralateral side of 5 patients undergoing radiotherapy for breast cancer. TLD readings were compared to calculations of Pencil Beam Convolution (PBC), Anisotropic Analytical Algorithm (AAA) and Acuros XB (XB). AAA predicted zero dose at points beyond 16 cm from the field edge. In the same region PBC returned an unrealistically constant result independent of distance and XB showed good agreement to measured data although consistently underestimated by ~0.1 % of the prescription dose. At points closer to the field edge XB was the superior algorithm, exhibiting agreement with TLD results to within 15 % of measured dose. Both AAA and PBC showed mixed agreement, with overall discrepancies considerably greater than XB. While XB is certainly the preferable algorithm, it should be noted that TPS algorithms in general are not designed to calculate dose at peripheral locations and calculation results in such regions should be treated with caution.

  5. SU-E-J-176: Characterization of Inter-Fraction Breast Variability and the Implications On Delivered Dose

    SciTech Connect

    Sudhoff, M; Lamba, M; Kumar, N; Ward, A; Elson, H

    2015-06-15

    Purpose: To systematically characterize inter-fraction breast variability and determine implications on delivered dose. Methods: Weekly port films were used to characterize breast setup variability. Five evenly spaced representative positions across the contour of each breast were chosen on the electronic port film in reference to graticule, and window and level was set such that the skin surface of the breast was visible. Measurements from the skin surface to treatment field edge were taken on each port film at each position and compared to the planning DRR, quantifying the variability. The systematic measurement technique was repeated for all port films for 20 recently treated breast cancer patients. Measured setup variability for each patient was modeled as a normal distribution. The distribution was randomly sampled from the model and applied as isocentric shifts in the treatment planning computer, representing setup variability for each fraction. Dose was calculated for each shifted fraction and summed to obtain DVHs and BEDs that modeled the dose with daily setup variability. Patients were categorized in to relevant groupings that were chosen to investigate the rigorousness of immobilization types, treatment techniques, and inherent anatomical difficulties. Mean position differences and dosimetric differences were evaluated between planned and delivered doses. Results: The setup variability was found to follow a normal distribution with mean position differences between the DRR and port film between − 8.6–3.5 mm with sigma range of 5.3–9.8 mm. Setup position was not found to be significantly different than zero. The mean seroma or whole breast PTV dosimetric difference, calculated as BED, ranged from a −0.23 to +1.13Gy. Conclusion: A systematic technique to quantify and model setup variability was used to calculate the dose in 20 breast cancer patients including variable setup. No statistically significant PTV or OAR BED differences were found between

  6. Design and implementation of a film dosimetry audit tool for comparison of planned and delivered dose distributions in high dose rate (HDR) brachytherapy.

    PubMed

    Palmer, Antony L; Lee, Chris; Ratcliffe, Ailsa J; Bradley, David; Nisbet, Andrew

    2013-10-01

    A novel phantom is presented for 'full system' dosimetric audit comparing planned and delivered dose distributions in HDR gynaecological brachytherapy, using clinical treatment applicators. The brachytherapy applicator dosimetry test object consists of a near full-scatter water tank with applicator and film supports constructed of Solid Water, accommodating any typical cervix applicator. Film dosimeters are precisely held in four orthogonal planes bisecting the intrauterine tube, sampling dose distributions in the high risk clinical target volume, points A and B, bladder, rectum and sigmoid. The applicator position is fixed prior to CT scanning and through treatment planning and irradiation. The CT data is acquired with the applicator in a near clinical orientation to include applicator reconstruction in the system test. Gamma analysis is used to compare treatment planning system exported RTDose grid with measured multi-channel film dose maps. Results from two pilot audits are presented, using Ir-192 and Co-60 HDR sources, with a mean gamma passing rate of 98.6% using criteria of 3% local normalization and 3 mm distance to agreement (DTA). The mean DTA between prescribed dose and measured film dose at point A was 1.2 mm. The phantom was funded by IPEM and will be used for a UK national brachytherapy dosimetry audit.

  7. Out-of-Field Dose Equivalents Delivered by Passively Scattered Therapeutic Proton Beams for Clinically Relevant Field Configurations

    SciTech Connect

    Wroe, Andrew Clasie, Ben; Kooy, Hanne; Flanz, Jay; Schulte, Reinhard; Rosenfeld, Anatoly

    2009-01-01

    Purpose: Microdosimetric measurements were performed at Massachusetts General Hospital, Boston, MA, to assess the dose equivalent external to passively delivered proton fields for various clinical treatment scenarios. Methods and Materials: Treatment fields evaluated included a prostate cancer field, cranial and spinal medulloblastoma fields, ocular melanoma field, and a field for an intracranial stereotactic treatment. Measurements were completed with patient-specific configurations of clinically relevant treatment settings using a silicon-on-insulator microdosimeter placed on the surface of and at various depths within a homogeneous Lucite phantom. The dose equivalent and average quality factor were assessed as a function of both lateral displacement from the treatment field edge and distance downstream of the beam's distal edge. Results: Dose-equivalent value range was 8.3-0.3 mSv/Gy (2.5-60-cm lateral displacement) for a typical prostate cancer field, 10.8-0.58 mSv/Gy (2.5-40-cm lateral displacement) for the cranial medulloblastoma field, 2.5-0.58 mSv/Gy (5-20-cm lateral displacement) for the spinal medulloblastoma field, and 0.5-0.08 mSv/Gy (2.5-10-cm lateral displacement) for the ocular melanoma field. Measurements of external field dose equivalent for the stereotactic field case showed differences as high as 50% depending on the modality of beam collimation. Average quality factors derived from this work ranged from 2-7, with the value dependent on the position within the phantom in relation to the primary beam. Conclusions: This work provides a valuable and clinically relevant comparison of the external field dose equivalents for various passively scattered proton treatment fields.

  8. Duration of salbutamol-induced bronchodilation delivered by metered-dose inhaler in mechanically ventilated COPD patients.

    PubMed

    Mouloudi, E; Maliotakis, C; Kondili, E; Kafetzakis, A; Georgopoulos, D

    2001-06-01

    The delivery of bronchodilators with metered-dose inhaler (MDI) and a spacer in mechanically ventilated patients has become a widespread practice. However, the duration of action of bronchodilators delivered with this technique is not well established. The purpose of the study was to examine the duration of bronchodilation induced by short-term beta 2-agonists administered with an MDI and a spacer in a group of mechanically ventilated patients with exacerbation of chronic obstructive pulmonary disease (COPD). Ten patients with COPD, mechanically ventilated on volume-controlled mode, received 6 puffs of salbutamol (S, 100 micrograms/puff). S was administered with an MDI adapted to the inspiratory limb of the ventilator circuit using an aerosol cloud enhance spacer. Static and dynamic airway pressures, minimum (Rint) and maximum (Rrs) inspiratory resistance, the difference between Rrs and Rint (delta R), static end-inspiratory system compliance (Cst, rs), intrinsic positive end-expiratory pressure (PEEPi) and heart rate (HR) were measured before and at 15, 30, 60, 120, 180, 240, 300, 360 min after S. S caused a significant decrease in dynamic and static airway pressures, PEEPi, Rint and Rrs. These changes were evident at 15 minutes and remained significant for 2 hours after S. The duration of bronchodilation was highly variable and unpredictable among patients, lasting in some patients more than 4 hours while in others wearing off in less than 2 hours. We conclude that 6 puffs of S delivered with an MDI and a spacer device induces significant bronchodilation in mechanically ventilated patients with COPD, the duration of which is highly variable precluding guidelines regarding the time scheduled for dosing.

  9. Verification of Entrance Dose Measurements with Thermoluminescent Dosimeters in Conventional Radiotherapy Procedures Delivered with Co-60 Teletherapy Machine

    PubMed Central

    Evwierhurhoma, OB; Ibitoye, ZA; Ojieh, CA; Duncan, JTK

    2015-01-01

    Background: The use of in vivo dosimetry with thermolumiscent dosimeters (TLDs) as a veritable means of quality control in conventional radiotherapy procedures was determined in this work. Aim: The objective of this study was to determine the role of in vivo dosimetry with thermoluminescent dosimeters (TLDs) as part of quality control and audit in conventional radiotherapy procedures delivered with Co-60 teletherapy machine. Subjects and Methods: Fifty-seven patients with cancers of the breast, pelvis, head and neck were admitted for this study. TLD system at the Radiation Monitoring and Protection Centre, Lagos State University, Ojo, Lagos-Nigeria was used for the in vivo entrance dose readings. All patients were treated with Co-60 (T780c) teletherapy machine at 80 cm source to surface distance located at Eko Hospitals, Lagos. Two TLDs were placed on the patient surface within 1 cm from the center of the field of treatment. Build-up material made of paraffin wax with a density of 0.939 g/cm3 and a thickness 0.5 cm was placed on top of the TLDs. A RADOS RE 200 TLD reader was used to read out the TLDs over 12 s and at a temperature of 300°C. Results: The results showed that there was no significant difference between the expected dose and measured dose of breast (P = 0.11), H and N (P = 0.52), and pelvis (P = 0.31) patients. Furthermore, percentage difference between expected dose and measured dose of the three treatment sites were not significantly different (P = 0.11). More so, 88.9% (16/18) treated breast, 91.3% (21/23) pelvis, and 86.7% (13/15) H and N patients had percentage deviation difference less than 5%. In general, 89.3% (50/56) patients admitted for this study had their percentage deviation difference below 5% recommended standard limit. Conclusion: The values obtained establish that there are no major differences from similar studies reported in literature. This study was also part of quality control and audit of the radiotherapy procedures in the

  10. SU-E-T-29: A Web Application for GPU-Based Monte Carlo IMRT/VMAT QA with Delivered Dose Verification

    SciTech Connect

    Folkerts, M; Graves, Y; Tian, Z; Gu, X; Jia, X; Jiang, S

    2014-06-01

    Purpose: To enable an existing web application for GPU-based Monte Carlo (MC) 3D dosimetry quality assurance (QA) to compute “delivered dose” from linac logfile data. Methods: We added significant features to an IMRT/VMAT QA web application which is based on existing technologies (HTML5, Python, and Django). This tool interfaces with python, c-code libraries, and command line-based GPU applications to perform a MC-based IMRT/VMAT QA. The web app automates many complicated aspects of interfacing clinical DICOM and logfile data with cutting-edge GPU software to run a MC dose calculation. The resultant web app is powerful, easy to use, and is able to re-compute both plan dose (from DICOM data) and delivered dose (from logfile data). Both dynalog and trajectorylog file formats are supported. Users upload zipped DICOM RP, CT, and RD data and set the expected statistic uncertainty for the MC dose calculation. A 3D gamma index map, 3D dose distribution, gamma histogram, dosimetric statistics, and DVH curves are displayed to the user. Additional the user may upload the delivery logfile data from the linac to compute a 'delivered dose' calculation and corresponding gamma tests. A comprehensive PDF QA report summarizing the results can also be downloaded. Results: We successfully improved a web app for a GPU-based QA tool that consists of logfile parcing, fluence map generation, CT image processing, GPU based MC dose calculation, gamma index calculation, and DVH calculation. The result is an IMRT and VMAT QA tool that conducts an independent dose calculation for a given treatment plan and delivery log file. The system takes both DICOM data and logfile data to compute plan dose and delivered dose respectively. Conclusion: We sucessfully improved a GPU-based MC QA tool to allow for logfile dose calculation. The high efficiency and accessibility will greatly facilitate IMRT and VMAT QA.

  11. Modeling of Dose Distribution for a Proton Beam Delivering System with the use of the Multi-Particle Transport Code 'Fluka'

    SciTech Connect

    Mumot, Marta; Agapov, Alexey

    2007-11-26

    We have developed a new delivering system for hadron therapy which uses a multileaf collimator and a range shifter. We simulate our delivering beam system with the multi-particle transport code 'Fluka'. From these simulations we obtained information about the dose distributions, about stars generated in the delivering system elements and also information about the neutron flux. All the informations obtained were analyzed from the point of view of radiation protection, homogeneity of beam delivery to patient body, and also in order to improve some modifiers used.

  12. Estimation of the delivered patient dose in lung IMRT treatment based on deformable registration of 4D-CT data and Monte Carlo simulations

    NASA Astrophysics Data System (ADS)

    Flampouri, Stella; Jiang, Steve B.; Sharp, Greg C.; Wolfgang, John; Patel, Abhijit A.; Choi, Noah C.

    2006-06-01

    The purpose of this study is to accurately estimate the difference between the planned and the delivered dose due to respiratory motion and free breathing helical CT artefacts for lung IMRT treatments, and to estimate the impact of this difference on clinical outcome. Six patients with representative tumour motion, size and position were selected for this retrospective study. For each patient, we had acquired both a free breathing helical CT and a ten-phase 4D-CT scan. A commercial treatment planning system was used to create four IMRT plans for each patient. The first two plans were based on the GTV as contoured on the free breathing helical CT set, with a GTV to PTV expansion of 1.5 cm and 2.0 cm, respectively. The third plan was based on the ITV, a composite volume formed by the union of the CTV volumes contoured on free breathing helical CT, end-of-inhale (EOI) and end-of-exhale (EOE) 4D-CT. The fourth plan was based on GTV contoured on the EOE 4D-CT. The prescribed dose was 60 Gy for all four plans. Fluence maps and beam setup parameters of the IMRT plans were used by the Monte Carlo dose calculation engine MCSIM for absolute dose calculation on both the free breathing CT and 4D-CT data. CT deformable registration between the breathing phases was performed to estimate the motion trajectory for both the tumour and healthy tissue. Then, a composite dose distribution over the whole breathing cycle was calculated as a final estimate of the delivered dose. EUD values were computed on the basis of the composite dose for all four plans. For the patient with the largest motion effect, the difference in the EUD of CTV between the planed and the delivered doses was 33, 11, 1 and 0 Gy for the first, second, third and fourth plan, respectively. The number of breathing phases required for accurate dose prediction was also investigated. With the advent of 4D-CT, deformable registration and Monte Carlo simulations, it is feasible to perform an accurate calculation of the

  13. Estimation of the delivered patient dose in lung IMRT treatment based on deformable registration of 4D-CT data and Monte Carlo simulations.

    PubMed

    Flampouri, Stella; Jiang, Steve B; Sharp, Greg C; Wolfgang, John; Patel, Abhijit A; Choi, Noah C

    2006-06-01

    The purpose of this study is to accurately estimate the difference between the planned and the delivered dose due to respiratory motion and free breathing helical CT artefacts for lung IMRT treatments, and to estimate the impact of this difference on clinical outcome. Six patients with representative tumour motion, size and position were selected for this retrospective study. For each patient, we had acquired both a free breathing helical CT and a ten-phase 4D-CT scan. A commercial treatment planning system was used to create four IMRT plans for each patient. The first two plans were based on the GTV as contoured on the free breathing helical CT set, with a GTV to PTV expansion of 1.5 cm and 2.0 cm, respectively. The third plan was based on the ITV, a composite volume formed by the union of the CTV volumes contoured on free breathing helical CT, end-of-inhale (EOI) and end-of-exhale (EOE) 4D-CT. The fourth plan was based on GTV contoured on the EOE 4D-CT. The prescribed dose was 60 Gy for all four plans. Fluence maps and beam setup parameters of the IMRT plans were used by the Monte Carlo dose calculation engine MCSIM for absolute dose calculation on both the free breathing CT and 4D-CT data. CT deformable registration between the breathing phases was performed to estimate the motion trajectory for both the tumour and healthy tissue. Then, a composite dose distribution over the whole breathing cycle was calculated as a final estimate of the delivered dose. EUD values were computed on the basis of the composite dose for all four plans. For the patient with the largest motion effect, the difference in the EUD of CTV between the planed and the delivered doses was 33, 11, 1 and 0 Gy for the first, second, third and fourth plan, respectively. The number of breathing phases required for accurate dose prediction was also investigated. With the advent of 4D-CT, deformable registration and Monte Carlo simulations, it is feasible to perform an accurate calculation of the

  14. SU-E-CAMPUS-T-01: Analysis of the Precision of Patient Set-Up, and Fidelity of the Delivered Dose Distribution in Proton Therapy of Ocular Tumors

    SciTech Connect

    Trofimov, A; Carpenter, K; Shih, HA

    2014-06-15

    Purpose: To quantify daily set-up variations in fractionated proton therapy of ocular melanomas, and to assess the effect on the fidelity of delivered distribution to the plan. Methods: In a typical five-fraction course, daily set-up is achieved by matching the position of fiducial markers in orthogonal radiographs to the images generated by treatment planning program. A patient maintains the required gaze direction voluntarily, without the aid of fixation devices. Confirmation radiographs are acquired to assess intrafractional changes. For this study, daily radiographs were analyzed to determine the daily iso-center position and apparent gaze direction, which were then transferred to the planning system to calculate the dose delivered in individual fractions, and accumulated dose for the entire course. Dose-volume metrics were compared between the planned and accumulated distributions for the tumor and organs at risk, for representative cases that varied by location within the ocular globe. Results: The analysis of the first set of cases (3 posterior, 3 transequatorial and 4 anterior tumors) revealed varying dose deviation patterns, depending on the tumor location. For anterior and posterior tumors, the largest dose increases were observed in the lens and ciliary body, while for the equatorial tumors, macula, optic nerve and disk, were most often affected. The iso-center position error was below 1.3 mm (95%-confidence interval), and the standard deviation of daily polar and azimuthal gaze set-up were 1.5 and 3 degrees, respectively. Conclusion: We quantified interfractional and intrafractional set-up variation, and estimated their effect on the delivered dose for representative cases. Current safety margins are sufficient to maintain the target coverage, however, the dose delivered to critical structures often deviates from the plan. The ongoing analysis will further explore the patterns of dose deviation, and may help to identify particular treatment scenarios

  15. SU-E-T-86: Comparison of Two Commercially Available Programs for the Evaluation of Delivered Daily Dose Using Cone Beam CT (CBCT)

    SciTech Connect

    Tuohy, R; Bosse, C; Mavroidis, P; Shi, Z; Crownover, R; Papanikolaou, N; Stathakis, S

    2014-06-01

    Purpose: In this study, two commercially available programs were compared for the evaluation of delivered daily dose using cone beam CT (CBCT). Methods: Thirty (n=30) patients previously treated in our clinic (10 prostate, 10 SBRT lung and 10 abdomen) were used in this study. The patients' plans were optimized and calculated using the Pinnacle treatment planning system. The daily CBCT scans were imported into Velocity and RayStation along with the corresponding planning CTs, structure sets and 3D dose distributions for each patient. The organs at risk (OAR) were contoured on each CBCT by the prescribing physician and were included in the evaluation of the daily delivered dose. Each CBCT was registered to the planning CT, once with rigid registration and then again, separately, with deformable registration. After registering each CBCT, the dose distribution from the planning CT was overlaid and the dose volume histograms (DVH) for the OAR and the planning target volumes (PTV) were calculated. Results: For prostate patients, we observed daily volume changes for the OARs. The DVH analysis for those patients showed variation in the sparing of the OARs while PTV coverage remained virtually unchanged using both Velocity and RayStation systems. Similar results were observed for abdominal patients. In contrast, for SBRT lung patients, the DVH for the OARs and target were comparable to those from the initial treatment plan. Differences in organ volume and organ doses were also observed when comparing the daily fractions using deformable and rigid registrations. Conclusion: By using daily CBCT dose reconstruction, we proved PTV coverage for prostate and abdominal targets is adequate. However, there is significant dosimetric change for the OARs. For lung SBRT patients, the delivered daily dose for both PTV and OAR is comparable to the planned dose with no significant differences.

  16. Comparison of testicular dose delivered by intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in patients with prostate cancer.

    PubMed

    Martin, Jeffrey M; Handorf, Elizabeth A; Price, Robert A; Cherian, George; Buyyounouski, Mark K; Chen, David Y; Kutikov, Alexander; Johnson, Matthew E; Ma, Chung-Ming Charlie; Horwitz, Eric M

    2015-01-01

    A small decrease in testosterone level has been documented after prostate irradiation, possibly owing to the incidental dose to the testes. Testicular doses from prostate external beam radiation plans with either intensity-modulated radiation therapy (IMRT) or volumetric-modulated arc therapy (VMAT) were calculated to investigate any difference. Testicles were contoured for 16 patients being treated for localized prostate cancer. For each patient, 2 plans were created: 1 with IMRT and 1 with VMAT. No specific attempt was made to reduce testicular dose. Minimum, maximum, and mean doses to the testicles were recorded for each plan. Of the 16 patients, 4 received a total dose of 7800 cGy to the prostate alone, 7 received 8000 cGy to the prostate alone, and 5 received 8000 cGy to the prostate and pelvic lymph nodes. The mean (range) of testicular dose with an IMRT plan was 54.7 cGy (21.1 to 91.9) and 59.0 cGy (25.1 to 93.4) with a VMAT plan. In 12 cases, the mean VMAT dose was higher than the mean IMRT dose, with a mean difference of 4.3 cGy (p = 0.019). There was a small but statistically significant increase in mean testicular dose delivered by VMAT compared with IMRT. Despite this, it unlikely that there is a clinically meaningful difference in testicular doses from either modality.

  17. Comparison of testicular dose delivered by intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in patients with prostate cancer

    SciTech Connect

    Martin, Jeffrey M.; Handorf, Elizabeth A.; Price, Robert A.; Cherian, George; Buyyounouski, Mark K.; Chen, David Y.; Kutikov, Alexander; Johnson, Matthew E.; Ma, Chung-Ming Charlie; Horwitz, Eric M.

    2015-10-01

    A small decrease in testosterone level has been documented after prostate irradiation, possibly owing to the incidental dose to the testes. Testicular doses from prostate external beam radiation plans with either intensity-modulated radiation therapy (IMRT) or volumetric-modulated arc therapy (VMAT) were calculated to investigate any difference. Testicles were contoured for 16 patients being treated for localized prostate cancer. For each patient, 2 plans were created: 1 with IMRT and 1 with VMAT. No specific attempt was made to reduce testicular dose. Minimum, maximum, and mean doses to the testicles were recorded for each plan. Of the 16 patients, 4 received a total dose of 7800 cGy to the prostate alone, 7 received 8000 cGy to the prostate alone, and 5 received 8000 cGy to the prostate and pelvic lymph nodes. The mean (range) of testicular dose with an IMRT plan was 54.7 cGy (21.1 to 91.9) and 59.0 cGy (25.1 to 93.4) with a VMAT plan. In 12 cases, the mean VMAT dose was higher than the mean IMRT dose, with a mean difference of 4.3 cGy (p = 0.019). There was a small but statistically significant increase in mean testicular dose delivered by VMAT compared with IMRT. Despite this, it unlikely that there is a clinically meaningful difference in testicular doses from either modality.

  18. SU-E-T-205: Improving Quality Assurance of HDR Brachytherapy: Verifying Agreement Between Planned and Delivered Dose Distributions Using DICOM RTDose and Advanced Film Dosimetry

    SciTech Connect

    Palmer, A L; Bradley, D A; Nisbet, A

    2014-06-01

    Purpose: HDR brachytherapy is undergoing significant development, and quality assurance (QA) checks must keep pace. Current recommendations do not adequately verify delivered against planned dose distributions: This is particularly relevant for new treatment planning system (TPS) calculation algorithms (non TG-43 based), and an era of significant patient-specific plan optimisation. Full system checks are desirable in modern QA recommendations, complementary to device-centric individual tests. We present a QA system incorporating TPS calculation, dose distribution export, HDR unit performance, and dose distribution measurement. Such an approach, more common in external beam radiotherapy, has not previously been reported in the literature for brachytherapy. Methods: Our QA method was tested at 24 UK brachytherapy centres. As a novel approach, we used the TPS DICOM RTDose file export to compare planned dose distribution with that measured using Gafchromic EBT3 films placed around clinical brachytherapy treatment applicators. Gamma analysis was used to compare the dose distributions. Dose difference and distance to agreement were determined at prescription Point A. Accurate film dosimetry was achieved using a glass compression plate at scanning to ensure physically-flat films, simultaneous scanning of known dose films with measurement films, and triple-channel dosimetric analysis. Results: The mean gamma pass rate of RTDose compared to film-measured dose distributions was 98.1% at 3%(local), 2 mm criteria. The mean dose difference, measured to planned, at Point A was -0.5% for plastic treatment applicators and -2.4% for metal applicators, due to shielding not accounted for in TPS. The mean distance to agreement was 0.6 mm. Conclusion: It is recommended to develop brachytherapy QA to include full-system verification of agreement between planned and delivered dose distributions. This is a novel approach for HDR brachytherapy QA. A methodology using advanced film

  19. Multimodality image guided total marrow irradiation and verification of the dose delivered to the lung, PTV, and thoracic bone in a patient: a case study.

    PubMed

    Hui, Susanta K; Verneris, M R; Froelich, Jerry; Dusenbery, K; Welsh, James S

    2009-02-01

    This work reports our initial experience using multimodality image guidance to improve total marrow irradiation (TMI) using helical tomotherapy. We also monitored the details of the treatment delivery to glean information necessary for the implementation of future adaptive processes. A patient with metastatic Ewing's sarcoma underwent MRI, and bone scan imaging prior to TMI. A whole body kilovoltage CT (kVCT) scan was obtained for intensity modulated TMI treatment planning, including a boost treatment to areas of bony involvement. The delivered dose was estimated by using MVCT images from the helical tomotherapy treatment unit, compared to the expected dose distributions mapped onto the kVCT images. Clinical concerns regarding patient treatment and dosimetric uncertainties were also evaluated. A small fraction of thoracic bone volume received lower radiation dose than the prescribed dose. Reconstructed planned treatment volume (PTV) and the dose delivered to the lung were identical to planned dose. Bone scan imaging had a higher sensitivity for detecting skeletal metastasis compared to MR imaging. However the bone scan lacked sufficient specificity in three dimensions to be useful for planning conformal radiation boost treatments. Inclusion of appropriate imaging modalities improves detection of metastases, which allows the possibility of a radiation dose boost to metastases during TMI. Conformal intensity modulated radiation therapy via helical tomotherapy permitted radiation delivery to metastases in the skull with reduced dose to brain in conjunction with TMI. While TMI reduces irradiation to the lungs, onboard megavoltage computed tomography (MVCT) to verify accurate volumetric dose coverage to marrow-containing thoracic bones may be essential for successful conformal TMI treatment.

  20. Characterization of differences in calculated and actual measured skin doses to canine limbs during stereotactic radiosurgery using Gafchromic film

    SciTech Connect

    Walters, Jerri; Ryan, Stewart; Harmon, Joseph F.

    2012-07-01

    Accurate calculation of absorbed dose to the skin, especially the superficial and radiosensitive basal cell layer, is difficult for many reasons including, but not limited to, the build-up effect of megavoltage photons, tangential beam effects, mixed energy scatter from support devices, and dose interpolation caused by a finite resolution calculation matrix. Stereotactic body radiotherapy (SBRT) has been developed as an alternative limb salvage treatment option at Colorado State University Veterinary Teaching Hospital for dogs with extremity bone tumors. Optimal dose delivery to the tumor during SBRT treatment can be limited by uncertainty in skin dose calculation. The aim of this study was to characterize the difference between measured and calculated radiation dose by the Varian Eclipse (Varian Medical Systems, Palo Alto, CA) AAA treatment planning algorithm (for 1-mm, 2-mm, and 5-mm calculation voxel dimensions) as a function of distance from the skin surface. The study used Gafchromic EBT film (International Specialty Products, Wayne, NJ), FilmQA analysis software, a limb phantom constructed from plastic water Trade-Mark-Sign (fluke Biomedical, Everett, WA) and a canine cadaver forelimb. The limb phantom was exposed to 6-MV treatments consisting of a single-beam, a pair of parallel opposed beams, and a 7-beam coplanar treatment plan. The canine forelimb was exposed to the 7-beam coplanar plan. Radiation dose to the forelimb skin at the surface and at depths of 1.65 mm and 1.35 mm below the skin surface were also measured with the Gafchromic film. The calculation algorithm estimated the dose well at depths beyond buildup for all calculation voxel sizes. The calculation algorithm underestimated the dose in portions of the buildup region of tissue for all comparisons, with the most significant differences observed in the 5-mm calculation voxel and the least difference in the 1-mm voxel. Results indicate a significant difference between measured and calculated data

  1. Evaluation of radiation dose delivered by cone beam CT and tomosynthesis employed for setup of external breast irradiation

    SciTech Connect

    Winey, Brian; Zygmanski, Piotr; Lyatskaya, Yulia

    2009-01-15

    A systematic set of measurements is reported for evaluation of doses to critical organs resulting from cone-beam CT (CB-CT) and cone-beam tomosynthesis (CB-TS) as applied to breast setup for external beam irradiation. The specific focus of this study was on evaluation of doses from these modalities in a setting of volumetric breast imaging for target localization in radiotherapy treatments with the goal of minimizing radiation to healthy organs. Ion chamber measurements were performed in an anthropomorphic female thorax phantom at the center of each breast and lung and on the phantom surface at one anterior and two lateral locations (seven points total). The measurements were performed for three different isocenters located at the center of the phantom and at offset locations of the right and left breast. The dependence of the dose on angle selection for the CB-TS arc was also studied. For the most typical situation of centrally located CB-CT isocenter the measured doses ranged between 3 and 7 cGy, in good agreement with previous reports. Dose measurements were performed for a range of start/stop angles commonly used for CB-TS and the impact of direct and scatter dose on organs at risk was analyzed. All measured CB-TS doses were considerably lower than CB-CT doses, with greater decrease in dose for the organs outside of the beam (up to 98% decrease in dose). Remarkably, offsetting the isocenter towards the ipsilateral breast resulted on average to additional 46% dose reduction to organs at risk. The lowest doses to the contralateral breast and lung were less than 0.1 cGy when they were measured for the offset isocenter. The biggest reduction in dose was obtained by using CB-TS beams that completely avoid the critical organ. For points inside the CB-TS beam, the dose was reduced in a linear relation with distance from the center of the imaging arc. The data indicate that it is possible to reduce substantially radiation doses to the contralateral organs by proper

  2. Efficiency of Ipratropium Bromide and Albuterol Deposition in the Lung Delivered via a Soft Mist Inhaler or Chlorofluorocarbon Metered-Dose Inhaler.

    PubMed

    MacGregor, T R; ZuWallack, R; Rubano, V; Castles, M A; Dewberry, H; Ghafouri, M; Wood, C C

    2016-04-01

    The propellant-free Combivent Respimat Soft Mist Inhaler (CVT-R) was developed to replace the chlorofluorocarbon-propelled Combivent metered-dose inhaler (CVT-MDI). This steady-state pharmacokinetic (PK) substudy evaluated drug lung-delivery efficiency, using data from two phase III safety and efficacy trials. PK parameters were obtained from well-controlled population PK analyses. Area under the plasma concentration-time curve (AUC), maximum observed plasma concentration (C(max)), and minimum observed plasma concentration (C(min)) showed systemic exposure to ipratropium bromide and albuterol delivered via the CVT-R was proportional to ex-mouthpiece delivered dose. Although the labeled dose of ipratropium bromide in the CVT-R was half that in the CVT-MDI, the systemic exposure was comparable. No PK interaction for the ipratropium bromide and albuterol Respimat drug components was demonstrated. Ipratropium bromide alone resulted in similar exposure to the combination of ipratropium bromide and albuterol. These results show that CVT-R delivers drug more efficiently to the lung than CVT-MDI. PMID:26945929

  3. Efficiency of Ipratropium Bromide and Albuterol Deposition in the Lung Delivered via a Soft Mist Inhaler or Chlorofluorocarbon Metered-Dose Inhaler.

    PubMed

    MacGregor, T R; ZuWallack, R; Rubano, V; Castles, M A; Dewberry, H; Ghafouri, M; Wood, C C

    2016-04-01

    The propellant-free Combivent Respimat Soft Mist Inhaler (CVT-R) was developed to replace the chlorofluorocarbon-propelled Combivent metered-dose inhaler (CVT-MDI). This steady-state pharmacokinetic (PK) substudy evaluated drug lung-delivery efficiency, using data from two phase III safety and efficacy trials. PK parameters were obtained from well-controlled population PK analyses. Area under the plasma concentration-time curve (AUC), maximum observed plasma concentration (C(max)), and minimum observed plasma concentration (C(min)) showed systemic exposure to ipratropium bromide and albuterol delivered via the CVT-R was proportional to ex-mouthpiece delivered dose. Although the labeled dose of ipratropium bromide in the CVT-R was half that in the CVT-MDI, the systemic exposure was comparable. No PK interaction for the ipratropium bromide and albuterol Respimat drug components was demonstrated. Ipratropium bromide alone resulted in similar exposure to the combination of ipratropium bromide and albuterol. These results show that CVT-R delivers drug more efficiently to the lung than CVT-MDI.

  4. SU-D-201-02: Prediction of Delivered Dose Based On a Joint Histogram of CT and FDG PET Images

    SciTech Connect

    Park, M; Choi, Y; Cho, A; Hwang, S; Cha, J; Lee, N; Yun, M

    2015-06-15

    Purpose: To investigate whether pre-treatment images can be used in predicting microsphere distribution in tumors. When intra-arterial radioembolization using Y90 microspheres was performed, the microspheres were often delivered non-uniformly within the tumor, which could lead to an inefficient therapy. Therefore, it is important to estimate the distribution of microspheres. Methods: Early arterial phase CT and FDG PET images were acquired for patients with primary liver cancer prior to radioembolization (RE) using Y90 microspheres. Tumor volume was delineated on CT images and fused with FDG PET images. From each voxel (3.9×3.9×3.3 mm3) in the tumor, the Hounsfield unit (HU) from the CT and SUV values from the FDG PET were harvested. We binned both HU and SUV into 11 bins and then calculated a normalized joint-histogram in an 11×11 array.Patients also underwent a post-treatment Y90 PET imaging. Radiation dose for the tumor was estimated using convolution of the Y90 distribution with a dose-point kernel. We also calculated a fraction of the tumor volume that received a radiation dose great than 100Gy. Results: Averaged over 40 patients, 55% of tumor volume received a dose greater than 100Gy (range : 1.1 – 100%). The width of the joint histogram was narrower for patients with a high dose. For patients with a low dose, the width was wider and a larger fraction of tumor volume had low HU. Conclusion: We have shown the pattern of joint histogram of the HU and SUV depends on delivered dose. The patterns can predict the efficacy of uniform intra-arterial delivery of Y90 microspheres.

  5. Postprandial metabolic responses of serum calcium, parathyroid hormone and C-telopeptide of type I collagen to three doses of calcium delivered in milk.

    PubMed

    Kruger, Marlena C; von Hurst, Pamela R; Booth, Christine L; Kuhn-Sherlock, Barbara; Todd, Joanne M; Schollum, Linda M

    2014-01-01

    Acute doses of Ca rapidly increase serum Ca and reduce bone resorption concomitant with a reduction in serum parathyroid hormone (PTH) levels. The physiological response to a dose of Ca in milk and to a Ca salt may be different. The present study investigated Ca absorption patterns with increasing levels of fortification in milk, and the response to one dose of a Ca salt. A group of twenty-eight Asian women aged 20-45 years volunteered to attend the laboratory over several weeks. The fasted volunteers were randomised to one of three experimental drinks: 200 ml skimmed milk containing 250, 500 or 1000 mg Ca. A subgroup of seven volunteers also received a calcium gluconate/carbonate salt containing 1000 mg Ca in 200 ml water. Serial blood samples and urine were collected for 5 h from baseline. Different doses of Ca in milk resulted in a graded response in serum corrected Ca, PTH and C-telopeptide of type I collagen (CTx) but not ionised Ca. Serum Ca increased in response to all milk drinks and from 2 to 5 h the blood Ca levels were significantly different for the 250 and 1000 mg doses, as was the integrated response between the loads. The PTH response to the two higher doses was significantly more than following the 250 mg dose. The integrated response for CTx and urinary Ca between all three doses of Ca in milk was significantly different. A dose of Ca salt elicited a more immediate response reaching a plateau faster, and declining faster to baseline. Fortified milk is a safe matrix for delivering larger doses of Ca. PMID:25191614

  6. TH-A-19A-03: Impact of Proton Dose Calculation Method On Delivered Dose to Lung Tumors: Experiments in Thorax Phantom and Planning Study in Patient Cohort

    SciTech Connect

    Grassberger, C; Daartz, J; Dowdell, S; Ruggieri, T; Sharp, G; Paganetti, H

    2014-06-15

    Purpose: Evaluate Monte Carlo (MC) dose calculation and the prediction of the treatment planning system (TPS) in a lung phantom and compare them in a cohort of 20 lung patients treated with protons. Methods: A 2-dimensional array of ionization chambers was used to evaluate the dose across the target in a lung phantom. 20 lung cancer patients on clinical trials were re-simulated using a validated Monte Carlo toolkit (TOPAS) and compared to the TPS. Results: MC increases dose calculation accuracy in lung compared to the clinical TPS significantly and predicts the dose to the target in the phantom within ±2%: the average difference between measured and predicted dose in a plane through the center of the target is 5.6% for the TPS and 1.6% for MC. MC recalculations in patients show a mean dose to the clinical target volume on average 3.4% lower than the TPS, exceeding 5% for small fields. The lower dose correlates significantly with aperture size and the distance of the tumor to the chest wall (Spearman's p=0.0002/0.004). For large tumors MC also predicts consistently higher V{sub 5} and V{sub 10} to the normal lung, due to a wider lateral penumbra, which was also observed experimentally. Critical structures located distal to the target can show large deviations, though this effect is very patient-specific. Conclusion: Advanced dose calculation techniques, such as MC, would improve treatment quality in proton therapy for lung cancer by avoiding systematic overestimation of target dose and underestimation of dose to normal lung. This would increase the accuracy of the relationships between dose and effect, concerning tumor control as well as normal tissue toxicity. As the role of proton therapy in the treatment of lung cancer continues to be evaluated in clinical trials, this is of ever-increasing importance. This work was supported by National Cancer Institute Grant R01CA111590.

  7. A Monte Carlo study on the effect of the orbital bone to the radiation dose delivered to the eye lens

    NASA Astrophysics Data System (ADS)

    Stratis, Andreas; Zhang, Guozhi; Jacobs, Reinhilde; Bogaerts, Ria; Bosmans, Hilde

    2015-03-01

    The aim of this work was to investigate the influence of backscatter radiation from the orbital bone and the intraorbital fat on the eye lens dose in the dental CBCT energy range. To this end we conducted three different yet interrelated studies; A preliminary simulation study was conducted to examine the impact of a bony layer situated underneath a soft tissue layer on the amount of backscatter radiation. We compared the Percentage Depth Dose (PDD) curves in soft tissue with and without the bone layer and we estimated the depth in tissue where the decrease in backscatter caused by the presence of the bone is noticeable. In a supplementary study, an eye voxel phantom was designed with the DOSxyznrc code. Simulations were performed exposing the phantom at different x-ray energies sequentially in air, in fat tissue and in realistic anatomy with the incident beam perpendicular to the phantom. Finally, a virtual head phantom was implemented into a validated hybrid Monte Carlo (MC) framework to simulate a large Field of View protocol of a real CBCT scanner and examine the influence of scattered dose to the eye lens during the whole rotation of the paired tube-detector system. The results indicated an increase in the dose to the lens due to the fatty tissue in the surrounding anatomy. There is a noticeable dose reduction close to the bone-tissue interface which weakens with increasing distance from the interface, such that the impact of the orbital bone in the eye lens dose becomes small.

  8. Intraoperative Full-Dose of Partial Breast Irradiation with Electrons Delivered by Standard Linear Accelerators for Early Breast Cancer

    PubMed Central

    Barros, Alfredo Carlos S. D.; Hanna, Samir A.; Carvalho, Heloísa A.; Martella, Eduardo; Andrade, Felipe Eduardo M.; Piato, José Roberto M.; Bevilacqua, José Luiz B.

    2014-01-01

    Purpose. To assess feasibility, efficacy, toxicity, and cosmetic results of intraoperative radiotherapy (IORT) with electrons delivered by standard linear accelerators (Linacs) during breast conserving surgeries for early infiltrating breast cancer (BC) treatment. Materials and Methods. A total of 152 patients with invasive ductal carcinoma (T ≤ 3.0 cm) at low risk for local relapses were treated. All had unicentric lesions by imaging methods and negative sentinel node. After a wide local excision, 21 Gy were delivered on the parenchyma target volume with electron beams. Local recurrences (LR), survival, toxicity, and cosmetic outcomes were analyzed. Results. The median age was 58.3 years (range 40–85); median follow-up was 50.7 months (range 12–101.5). There were 5 cases with LR, 2 cases with distant metastases, and 2 cases with deaths related to BC. The cumulative incidence rates of LR, distant metastases, and BC death were 3.2%, 1.5%, and 1.5%, respectively. Complications were rare, and the cosmetic results were excellent or good in most of the patients. Conclusions. IORT with electrons delivered by standard Linacs is feasible, efficient, and well tolerated and seems to be beneficial for selected patients with early infiltrating BC. PMID:25587452

  9. SU-E-T-515: Field-In-Field Compensation Technique Using Multi-Leaf Collimator to Deliver Total Body Irradiation (TBI) Dose

    SciTech Connect

    Lakeman, T; Wang, IZ

    2014-06-01

    Purpose: Total body irradiation (TBI) uses large parallel-opposed radiation fields to suppress the patient's immune system and eradicate the residual cancer cells in preparation of recipient for bone marrow transplant. The manual placement of lead compensators has been used conventionally to compensate for the varying thickness through the entire body in large-field TBI. The goal of this study is to pursue utilizing the modern field-in-field (FIF) technique with the multi-leaf collimator (MLC) to more accurately and efficiently deliver dose to patients in need of TBI. Method: Treatment plans utilizing the FIF technique to deliver a total body dose were created retrospectively for patients for whom CT data had been previously acquired. Treatment fields include one pair of opposed open large fields (collimator=45°) with a specific weighting and a succession of smaller fields (collimator=90°) each with their own weighting. The smaller fields are shaped by moving MLC to block the sections of the patient which have already received close to 100% of the prescribed dose. The weighting factors for each of these fields were calculated using the attenuation coefficient of the initial lead compensators and the separation of the patient in different positions in the axial plane. Results: Dose-volume histograms (DVH) were calculated for evaluating the FIF compensation technique. The maximum body doses calculated from the DVH were reduced from the non-compensated 179.3% to 148.2% in the FIF plans, indicating a more uniform dose with the FIF compensation. All calculated monitor units were well within clinically acceptable limits and exceeded those of the original lead compensation plan by less than 50 MU (only ~1.1% increase). Conclusion: MLC FIF technique for TBI will not significantly increase the beam on time while it can substantially reduce the compensator setup time and the potential risk of errors in manually placing lead compensators.

  10. SU-E-J-154: Deformable Image Registration Based Delivered Dose Estimation for Head and Neck Radiotherapy

    SciTech Connect

    Kumarasiri, A; Liu, C; Chetvertkov, M; Gordon, J; Siddiqui, F; Chetty, I; Kim, J

    2014-06-01

    Purpose: To estimate the accumulated dose to targets and organs at risk (OAR) for head and neck (H'N) radiotherapy using 3 deformable image registration (DIR) algorithms. Methods: Five H'N patients, who had daily CBCTs taken during the course of treatment, were retrospectively studied. All plans had 5 mm CTV-to-PTV expansions. To overcome the small field of view (FOV) limitations and HU uncertainties of CBCTs, CT images were deformably registered using a parameter-optimized B-spline DIR algorithm (Elastix, elastix.isi.uu.nl) and resampled onto each CBCT with a 4 cm uniform FOV expansion. The dose of the day was calculated on these resampled CT images. Calculated daily dose matrices were warped and accumulated to the planning CT using 3 DIR algorithms; SmartAdapt (Eclipse/Varian), Velocity (Velocity Medical Solutions), and Elastix. Dosimetric indices for targets and OARs were determined from the DVHs and compared with corresponding planned quantities. Results: The cumulative dose deviation was less than 2%, on average, for PTVs from the corresponding plan dose, for all algorithms/patients. However, the parotids show as much as a 37% deviation from the intended dose, possibly due to significant patient weight loss during the first 3 weeks of treatment (15.3 lbs in this case). The mean(±SD) cumulative dose deviations of the 5 patients estimated using the 3 algorithms (SmartAdapt, Velocity, and Elastix) were (0.8±0.9%, 0.5±0.9%, 0.6±1.3%) for PTVs, (1.6±1.9%, 1.4±2.0%, 1.7±1.9%) for GTVs, (10.4±12.1%, 10.7±10.6%, 6.5±10.1%) for parotid glands, and (4.5±4.6%, 3.4±5.7%, 3.9±5.7%) for mucosa, respectively. The differences among the three DIR algorithms in the estimated cumulative mean doses (1SD (in Gy)) were: 0.1 for PTVs, 0.1 for GTVs, 1.9 for parotid glands, and 0.4 for mucosa. Conclusion: Results of this study are suggestive that more frequent plan adaptation for organs, such as the parotid glands, might be beneficial during the course of H'N RT. This

  11. High-dose-rate brachytherapy delivered in two fractions as monotherapy for low-risk prostate cancer

    PubMed Central

    Alwers, Elizabeth; Cifuentes, Javier; Bobadilla, Ivan; Torres, Felipe; Arbelaez, Juan; Gaitan, Armando; Cortes, Helber; Acevedo, Yenny; Quintero, Paulo; Vasquez, Jaider

    2015-01-01

    Purpose High-dose-rate (HDR) brachytherapy has been accepted as an effective and safe method to treat prostate cancer. The aim of this study was to describe acute toxicity following HDR brachytherapy to the prostate, and to examine the association between dosimetric parameters and urinary toxicity in low-risk prostate cancer patients. Material and methods Patients with low-risk prostate cancer were given HDR brachytherapy as monotherapy in two 12.5 Gy fractions. Planning objectives for the planning target volume (PTV) were V100% ≥ 90% and V150% ≤ 35%. Planning objectives for organs at risk were V75% ≤ 1 cc for the bladder, rectum and perineum, and V125% ≤ 1 cc for the urethra. Toxicity was assessed three months after treatment using the Common Terminology Criteria for Adverse Events. Results Seventy-three patients were included in the analysis. Thirty-three patients (45%) reported having any type of toxicity in the three months following HDR brachytherapy. Most toxicity cases (26%) were grade 1 urinary toxicity. Mean coverage index was 0.89 and mean V100 was 88.85. Doses administered to the urethra were associated with urinary toxicity. Patients who received more than 111.3% of the prescribed dose in 1 cc of the urethra were four times more likely to have urinary toxicity compared to patients receiving less than 111.3% (OR = 4.71, 95% CI: 1.43-15.6; p = 0.011). Conclusions High-dose-rate brachytherapy administered as monotherapy for prostate cancer proved to be a safe alternative treatment for patients with low-risk prostate cancer. Urinary toxicity was associated with the dose administered to 1 cc and 0.1 cc of the urethra and was remarkably inferior to the reported toxicity in similar studies. PMID:25829931

  12. Low-dose oxytocin delivered intranasally with Breath Powered device affects social-cognitive behavior: a randomized four-way crossover trial with nasal cavity dimension assessment

    PubMed Central

    Quintana, D S; Westlye, L T; Rustan, Ø G; Tesli, N; Poppy, C L; Smevik, H; Tesli, M; Røine, M; Mahmoud, R A; Smerud, K T; Djupesland, P G; Andreassen, O A

    2015-01-01

    Despite the promise of intranasal oxytocin (OT) for modulating social behavior, recent work has provided mixed results. This may relate to suboptimal drug deposition achieved with conventional nasal sprays, inter-individual differences in nasal physiology and a poor understanding of how intranasal OT is delivered to the brain in humans. Delivering OT using a novel ‘Breath Powered' nasal device previously shown to enhance deposition in intranasal sites targeted for nose-to-brain transport, we evaluated dose-dependent effects on social cognition, compared response with intravenous (IV) administration of OT, and assessed nasal cavity dimensions using acoustic rhinometry. We adopted a randomized, double-blind, double-dummy, crossover design, with 16 healthy male adults completing four single-dose treatments (intranasal 8 IU (international units) or 24 IU OT, 1 IU OT IV and placebo). The primary outcome was social cognition measured by emotional ratings of facial images. Secondary outcomes included the pharmacokinetics of OT, vasopressin and cortisol in blood and the association between nasal cavity dimensions and emotional ratings. Despite the fact that all the treatments produced similar plasma OT increases compared with placebo, there was a main effect of treatment on anger ratings of emotionally ambiguous faces. Pairwise comparisons revealed decreased ratings after 8 IU OT in comparison to both placebo and 24 IU OT. In addition, there was an inverse relationship between nasal valve dimensions and anger ratings of ambiguous faces after 8-IU OT treatment. These findings provide support for a direct nose-to-brain effect, independent of blood absorption, of low-dose OT delivered from a Breath Powered device. PMID:26171983

  13. Low-dose oxytocin delivered intranasally with Breath Powered device affects social-cognitive behavior: a randomized four-way crossover trial with nasal cavity dimension assessment.

    PubMed

    Quintana, D S; Westlye, L T; Rustan, Ø G; Tesli, N; Poppy, C L; Smevik, H; Tesli, M; Røine, M; Mahmoud, R A; Smerud, K T; Djupesland, P G; Andreassen, O A

    2015-01-01

    Despite the promise of intranasal oxytocin (OT) for modulating social behavior, recent work has provided mixed results. This may relate to suboptimal drug deposition achieved with conventional nasal sprays, inter-individual differences in nasal physiology and a poor understanding of how intranasal OT is delivered to the brain in humans. Delivering OT using a novel 'Breath Powered' nasal device previously shown to enhance deposition in intranasal sites targeted for nose-to-brain transport, we evaluated dose-dependent effects on social cognition, compared response with intravenous (IV) administration of OT, and assessed nasal cavity dimensions using acoustic rhinometry. We adopted a randomized, double-blind, double-dummy, crossover design, with 16 healthy male adults completing four single-dose treatments (intranasal 8 IU (international units) or 24 IU OT, 1 IU OT IV and placebo). The primary outcome was social cognition measured by emotional ratings of facial images. Secondary outcomes included the pharmacokinetics of OT, vasopressin and cortisol in blood and the association between nasal cavity dimensions and emotional ratings. Despite the fact that all the treatments produced similar plasma OT increases compared with placebo, there was a main effect of treatment on anger ratings of emotionally ambiguous faces. Pairwise comparisons revealed decreased ratings after 8 IU OT in comparison to both placebo and 24 IU OT. In addition, there was an inverse relationship between nasal valve dimensions and anger ratings of ambiguous faces after 8-IU OT treatment. These findings provide support for a direct nose-to-brain effect, independent of blood absorption, of low-dose OT delivered from a Breath Powered device. PMID:26171983

  14. Comparison between Three Promising ß-emitting Radionuclides, 67Cu, 47Sc and 161Tb, with Emphasis on Doses Delivered to Minimal Residual Disease

    PubMed Central

    Champion, Christophe; Quinto, Michele A.; Morgat, Clément; Zanotti-Fregonara, Paolo; Hindié, Elif

    2016-01-01

    PURPOSE: Radionuclide therapy is increasingly seen as a promising option to target minimal residual disease. Copper-67, scandium-47 and terbium-161 have a medium-energy β- emission which is similar to that of lutetium-177, but offer the advantage of having diagnostic partner isotopes suitable for pretreatment imaging. The aim of this study was to compare the efficacy of 67Cu, 47Sc and 161Tb to irradiate small tumors. METHODS: The absorbed dose deriving from a homogeneous distribution of 67Cu, 47Sc or 161Tb in water-density spheres was calculated with the Monte Carlo code CELLDOSE. The diameters of the spheres ranged from 5 mm to 10 µm, thus simulating micrometastases or single tumor cells. All electron emissions, including β- spectra, Auger and conversion electrons were taken into account. Because these radionuclides differ in electron energy per decay, the simulations were run assuming that 1 MeV was released per µm3, which would result in a dose of 160 Gy if totally absorbed. RESULTS: The absorbed dose was similar for the three radionuclides in the 5-mm sphere (146-149 Gy), but decreased differently in smaller spheres. In particular, 161Tb delivered higher doses compared to the other radionuclides. For instance, in the 100-µm sphere, the absorbed dose was 24.1 Gy with 67Cu, 14.8 Gy with 47Sc and 44.5 Gy with 161Tb. Auger and conversion electrons accounted for 71% of 161Tb dose. The largest dose differences were found in cell-sized spheres. In the 10-µm sphere, the dose delivered by 161Tb was 4.1 times higher than that from 67Cu and 8.1 times that from 47Sc. CONCLUSION: 161Tb can effectively irradiate small tumors thanks to its decay spectrum that combines medium-energy β- emission and low-energy conversion and Auger electrons. Therefore 161Tb might be a better candidate than 67Cu and 47Sc for treating minimal residual disease in a clinical setting. PMID:27446495

  15. Cone Beam CT vs. Fan Beam CT: A Comparison of Image Quality and Dose Delivered Between Two Differing CT Imaging Modalities

    PubMed Central

    Weidlich, Georg A.

    2016-01-01

    A comparison of image quality and dose delivered between two differing computed tomography (CT) imaging modalities—fan beam and cone beam—was performed. A literature review of quantitative analyses for various image quality aspects such as uniformity, signal-to-noise ratio, artifact presence, spatial resolution, modulation transfer function (MTF), and low contrast resolution was generated. With these aspects quantified, cone beam computed tomography (CBCT) shows a superior spatial resolution to that of fan beam, while fan beam shows a greater ability to produce clear and anatomically correct images with better soft tissue differentiation. The results indicate that fan beam CT produces superior images to that of on-board imaging (OBI) cone beam CT systems, while providing a considerably less dose to the patient. PMID:27752404

  16. Treatment of acute severe asthma with inhaled albuterol delivered via jet nebulizer, metered dose inhaler with spacer, or dry powder.

    PubMed

    Raimondi, A C; Schottlender, J; Lombardi, D; Molfino, N A

    1997-07-01

    Despite the increasing use of dry powder formulations in the ambulatory setting, there is a paucity of information on the efficacy of this therapeutic modality to treat acute severe asthma. In addition, studies that compared wet nebulization vs metered dose inhalers formulated with chlorofluorocarbon (CFCMDI) attached to holding chambers have yielded discrepant results. Thus, it is unclear which of the three delivery systems would elicit a superior bronchodilator response, particularly in patients with life-threatening asthma. In a prospective, randomized open design, we studied the response to inhaled albuterol (salbutamol) in 27 adult asthmatics presenting to the emergency department (ED) with an FEV1 <30% predicted. Subjects were treated with one of the following regimens (nine subjects in each group): group A, mean (SD) baseline FEV1 of 0.7 (0.2) L, received albuterol solution, 5 mg, via a nebulizer (Puritan-Bennett Raindrop; Lawrenceville, Ga) impelled with oxygen (O2) at 8 L/min; group B, baseline FEV1 of 0.6 (0.15) L, received albuterol, 400 microg, via a CFCMDI attached to a 145-mL valved aerosol holding chamber (Aerochamber; Trudell Medical; London, ON); and group C, baseline FEV1 of 0.6 (0.17) L, received albuterol powder, 400 microg, by another means (Rotahaler; Glaxo; Research Triangle Park, NC). All groups received the respective treatments on arrival in the ED, every 30 min during the first 2 h, and then hourly until the sixth hour. Clinical parameters and FEV1 were recorded on ED admission and 15 min after each dose of albuterol. At the time of ED admission, all patients also received continuous O2 and one dose of I.V. steroids (dexamethasone, 8 mg). The total dose of inhaled albuterol administered during the 6-h treatment was 45 mg of nebulized solution in group A and 3,600 microg of albuterol aerosol and dry powder in groups B and C, respectively. No significant differences were found in the population demographics, baseline FEV1, and arterial

  17. Comparison of film measurements and Monte Carlo simulations of dose delivered with very high-energy electron beams in a polystyrene phantom

    SciTech Connect

    Bazalova-Carter, Magdalena; Liu, Michael; Palma, Bianey; Koong, Albert C.; Maxim, Peter G. E-mail: BWLoo@Stanford.edu; Loo, Billy W. E-mail: BWLoo@Stanford.edu; Dunning, Michael; McCormick, Doug; Hemsing, Erik; Nelson, Janice; Jobe, Keith; Colby, Eric; Tantawi, Sami; Dolgashev, Valery

    2015-04-15

    Purpose: To measure radiation dose in a water-equivalent medium from very high-energy electron (VHEE) beams and make comparisons to Monte Carlo (MC) simulation results. Methods: Dose in a polystyrene phantom delivered by an experimental VHEE beam line was measured with Gafchromic films for three 50 MeV and two 70 MeV Gaussian beams of 4.0–6.9 mm FWHM and compared to corresponding MC-simulated dose distributions. MC dose in the polystyrene phantom was calculated with the EGSnrc/BEAMnrc and DOSXYZnrc codes based on the experimental setup. Additionally, the effect of 2% beam energy measurement uncertainty and possible non-zero beam angular spread on MC dose distributions was evaluated. Results: MC simulated percentage depth dose (PDD) curves agreed with measurements within 4% for all beam sizes at both 50 and 70 MeV VHEE beams. Central axis PDD at 8 cm depth ranged from 14% to 19% for the 5.4–6.9 mm 50 MeV beams and it ranged from 14% to 18% for the 4.0–4.5 mm 70 MeV beams. MC simulated relative beam profiles of regularly shaped Gaussian beams evaluated at depths of 0.64 to 7.46 cm agreed with measurements to within 5%. A 2% beam energy uncertainty and 0.286° beam angular spread corresponded to a maximum 3.0% and 3.8% difference in depth dose curves of the 50 and 70 MeV electron beams, respectively. Absolute dose differences between MC simulations and film measurements of regularly shaped Gaussian beams were between 10% and 42%. Conclusions: The authors demonstrate that relative dose distributions for VHEE beams of 50–70 MeV can be measured with Gafchromic films and modeled with Monte Carlo simulations to an accuracy of 5%. The reported absolute dose differences likely caused by imperfect beam steering and subsequent charge loss revealed the importance of accurate VHEE beam control and diagnostics.

  18. Two doses of bovine viral diarrhea virus DNA vaccine delivered by electroporation induce long-term protective immune responses.

    PubMed

    van Drunen Littel-van den Hurk, Sylvia; Lawman, Zoe; Snider, Marlene; Wilson, Don; van den Hurk, Jan V; Ellefsen, Barry; Hannaman, Drew

    2013-02-01

    Bovine viral diarrhea virus (BVDV) is a pathogen of major importance in cattle, so there is a need for new effective vaccines. DNA vaccines induce balanced immune responses and are relatively inexpensive and thus promising for both human and veterinary applications. In this study, newborn calves with maternal antibodies were vaccinated intramuscularly (i.m.) with a BVDV E2 DNA vaccine with the TriGrid Delivery System for i.m. delivery (TDS-IM). Two doses of this vaccine spaced 6 or 12 weeks apart were sufficient to induce significant virus-neutralizing antibody titers, numbers of activated T cells, and reduction in viral shedding and clinical presentations after BVDV-2 challenge. In contrast to the placebo-treated animals, the vaccinated calves did not lose any weight, which is an excellent indicator of the well-being of an animal and has a significant economic impact. Furthermore, the interval between the two vaccinations did not influence the magnitude of the immune responses or degree of clinical protection, and a third immunization was not necessary or beneficial. Since electroporation may enhance not only the magnitude but also the duration of immunity after DNA immunization, the interval between vaccination and challenge was extended in a second trial, which showed that two doses of this E2 DNA vaccine again significantly reduced clinical disease against BVDV for several months. These results are promising and support this technology for use against infectious diseases in cattle and large species, including humans, in general.

  19. Early effects comparison of X-rays delivered at high-dose-rate pulses by a plasma focus device and at low dose rate on human tumour cells.

    PubMed

    Virelli, A; Zironi, I; Pasi, F; Ceccolini, E; Nano, R; Facoetti, A; Gavoçi, E; Fiore, M R; Rocchi, F; Mostacci, D; Cucchi, G; Castellani, G; Sumini, M; Orecchia, R

    2015-09-01

    A comparative study has been performed on the effects of high-dose-rate (DR) X-ray beams produced by a plasma focus device (PFMA-3), to exploit its potential medical applications (e.g. radiotherapy), and low-DR X-ray beams produced by a conventional source (XRT). Experiments have been performed at 0.5 and 2 Gy doses on a human glioblastoma cell line (T98G). Cell proliferation rate and potassium outward currents (IK) have been investigated by time lapse imaging and patch clamp recordings. The results showed that PFMA-3 irradiation has a greater capability to reduce the proliferation rate activity with respect to XRT, while it does not affect IK of T98G cells at any of the dose levels tested. XRT irradiation significantly reduces the mean IK amplitude of T98G cells only at 0.5 Gy. This work confirms that the DR, and therefore the source of radiation, is crucial for the planning and optimisation of radiotherapy applications. PMID:25883300

  20. Early effects comparison of X-rays delivered at high-dose-rate pulses by a plasma focus device and at low dose rate on human tumour cells.

    PubMed

    Virelli, A; Zironi, I; Pasi, F; Ceccolini, E; Nano, R; Facoetti, A; Gavoçi, E; Fiore, M R; Rocchi, F; Mostacci, D; Cucchi, G; Castellani, G; Sumini, M; Orecchia, R

    2015-09-01

    A comparative study has been performed on the effects of high-dose-rate (DR) X-ray beams produced by a plasma focus device (PFMA-3), to exploit its potential medical applications (e.g. radiotherapy), and low-DR X-ray beams produced by a conventional source (XRT). Experiments have been performed at 0.5 and 2 Gy doses on a human glioblastoma cell line (T98G). Cell proliferation rate and potassium outward currents (IK) have been investigated by time lapse imaging and patch clamp recordings. The results showed that PFMA-3 irradiation has a greater capability to reduce the proliferation rate activity with respect to XRT, while it does not affect IK of T98G cells at any of the dose levels tested. XRT irradiation significantly reduces the mean IK amplitude of T98G cells only at 0.5 Gy. This work confirms that the DR, and therefore the source of radiation, is crucial for the planning and optimisation of radiotherapy applications.

  1. High-Dose-Rate Brachytherapy as Monotherapy Delivered in Two Fractions Within One Day for Favorable/Intermediate-Risk Prostate Cancer: Preliminary Toxicity Data

    SciTech Connect

    Ghilezan, Michel; Martinez, Alvaro; Gustason, Gary; Krauss, Daniel; Antonucci, J. Vito; Chen, Peter; Fontanesi, James; Wallace, Michelle; Ye Hong; Casey, Alyse; Sebastian, Evelyn; Kim, Leonard; Limbacher, Amy

    2012-07-01

    Purpose: To report the toxicity profile of high-dose-rate (HDR)-brachytherapy (BT) as monotherapy in a Human Investigation Committee-approved study consisting of a single implant and two fractions (12 Gy Multiplication-Sign 2) for a total dose of 24 Gy, delivered within 1 day. The dose was subsequently increased to 27 Gy (13.5 Gy Multiplication-Sign 2) delivered in 1 day. We report the acute and early chronic genitourinary and gastrointestinal toxicity. Methods and Materials: A total of 173 patients were treated between December 2005 and July 2010. However, only the first 100 were part of the IRB-approved study and out of these, only 94 had a minimal follow-up of 6 months, representing the study population for this preliminary report. All patients had clinical Stage T2b or less (American Joint Committee on Cancer, 5th edition), Gleason score 6-7 (3+4), and prostate-specific antigen level of {<=}12 ng/mL. Ultrasound-guided HDR-BT with real-time dosimetry was used. The prescription dose was 24 Gy for the first 50 patients and 27 Gy thereafter. The dosimetric goals and constraints were the same for the two dose groups. Toxicity was scored using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. The highest toxicity scores encountered at any point during follow-up are reported. Results: The median follow-up was 17 months (range, 6-40.5). Most patients had Grade 0-1 acute toxicity. The Grade 2 acute genitourinary toxicity was mainly frequency/urgency (13%), dysuria (5%), hematuria, and dribbling/hesitancy (2%). None of the patients required a Foley catheter at any time; however, 8% of the patients experienced transient Grade 1 diarrhea. No other acute gastrointestinal toxicities were found. The most common chronic toxicity was Grade 2 urinary frequency/urgency in 16% of patients followed by dysuria in 4% of patients; 2 patients had Grade 2 rectal bleeding and 1 had Grade 4, requiring laser treatment. Conclusions: Favorable

  2. A two one-sided parametric tolerance interval test for control of delivered dose uniformity. Part 1--characterization of FDA proposed test.

    PubMed

    Novick, Steven; Christopher, David; Dey, Monisha; Lyapustina, Svetlana; Golden, Michael; Leiner, Stefan; Wyka, Bruce; Delzeit, Hans-Joachim; Novak, Chris; Larner, Gregory

    2009-01-01

    The FDA proposed a parametric tolerance interval (PTI) test at the October 2005 Advisory Committee meeting as a replacement of the attribute (counting) test for delivered dose uniformity (DDU), published in the 1998 draft guidance for metered dose inhalers (MDIs) and dry powder inhalers (DPIs) and the 2002 final guidance for inhalation sprays and intranasal products. This article (first in a series of three) focuses on the test named by the FDA "87.5% coverage." Unlike a typical two-sided PTI test, which controls the proportion of the DDU distribution within a target interval (coverage), this test is comprised of two one-sided tests (TOST) designed to control the maximum amount of DDU values in either tail of the distribution above and below the target interval. Through simulations, this article characterizes the properties and performance of the proposed PTI-TOST under different scenarios. The results show that coverages of 99% or greater are needed for a batch to have acceptance probability 98% or greater with the test named by the FDA "87.5% coverage" (95% confidence level), while batches with 87.5% coverage have less than 1% probability of being accepted. The results also illustrate that with this PTI-TOST, the coverage requirement for a given acceptance probability increases as the batch mean deviates from target. The accompanying articles study the effects of changing test parameters and the test robustness to deviations from normality.

  3. A two one-sided parametric tolerance interval test for control of delivered dose uniformity--part 3--investigation of robustness to deviations from normality.

    PubMed

    Novick, Steven; Christopher, David; Dey, Monisha; Lyapustina, Svetlana; Golden, Michael; Leiner, Stefan; Wyka, Bruce; Delzeit, Hans-Joachim; Novak, Chris; Larner, Gregory

    2009-01-01

    The robustness of the parametric tolerance interval test, which was proposed by the Food and Drug Administration for control of delivered dose uniformity in orally inhaled and nasal drug products, is investigated in this article using different scenarios for deviations from a univariate normal distribution. The studied scenarios span a wide range of conditions, the purpose of which is to provide an understanding of how the test performs depending on the nature and degree of the deviation from normality. Operating characteristic curves were generated to compare the performance of the test for different types of distributions (normal and non-normal) having the same proportion of doses in the tails (on one or both sides) outside the target interval. The results show that, in most cases, non-normality does not increase the probability of accepting a batch of unacceptable quality (i.e., the test is robust) except in extreme situations, which do not necessarily represent commercially viable products. The results also demonstrate that, in the case of bimodal distributions where the life-stage means differ from each other by up to 24% label claim, the test's criterion on life-stage means does not affect pass rates because the tolerance interval portion of the test reacts to shifting means as well.

  4. A single dose of oral DNA immunization delivered by attenuated Salmonella typhimurium down-regulates transgene expression in HBsAg transgenic mice.

    PubMed

    Zheng, Bo Jian; Ng, Mun Hon; Chan, Kwok Wah; Tam, Sidney; Woo, Patrick C Y; Ng, Sze Park; Yuen, Kwok Yung

    2002-11-01

    The efficacy of immunization with Salmonella typhimurium aroA to deliver the plasmid pRc/CMV-HBsAg (i.e. an oral DNA vaccine) was compared with that of intramuscular immunization with the same plasmid DNA, and with recombinant HBsAg protein, in a HBsAg transgenic mouse model. A single dose of oral DNA vaccine evoked vigorous Th1 cell and CTL responses and production of IgG2 subclass of anti-HBs after 2 weeks, and this was accompanied by a transient hepatitic flare with elevated alanine aminotransferase in the first 3 weeks. Concomitantly, the level of HBsAg-mRNA in liver tissues decreased by more than fourfold and viral-antigen expression was curtailed markedly in hepatocytes compared with controls. Hepatitic flare subsided after 3 weeks, but suppression of the transgene expression was continued in the absence of overt liver pathology for the remaining duration of the experiment (i.e. 12 weeks), and possibly beyond. The other vaccines could also break immune tolerance, but this was achieved only after repeated booster doses of the respective vaccines, and they did not affect transgene expression, or induce hepatic flare. We previously showed in non-transgenic mice that immunization by the oral DNA vaccine is achieved by an active intestinal infection with a bacterial carrier that is an adept intracellular parasite, and the immune response to the vaccination is orchestrated by phagocytic APC. Our present findings further implicated that the combined effects of an innate and a specific immune response induced by oral DNA vaccination are crucial in down-regulating HBsAg-transgene expression in hepatocytes.

  5. Assessing the safety of cosmetic chemicals: Consideration of a flux decision tree to predict dermally delivered systemic dose for comparison with oral TTC (Threshold of Toxicological Concern).

    PubMed

    Williams, Faith M; Rothe, Helga; Barrett, Gordon; Chiodini, Alessandro; Whyte, Jacqueline; Cronin, Mark T D; Monteiro-Riviere, Nancy A; Plautz, James; Roper, Clive; Westerhout, Joost; Yang, Chihae; Guy, Richard H

    2016-04-01

    Threshold of Toxicological Concern (TTC) aids assessment of human health risks from exposure to low levels of chemicals when toxicity data are limited. The objective here was to explore the potential refinement of exposure for applying the oral TTC to chemicals found in cosmetic products, for which there are limited dermal absorption data. A decision tree was constructed to estimate the dermally absorbed amount of chemical, based on typical skin exposure scenarios. Dermal absorption was calculated using an established predictive algorithm to derive the maximum skin flux adjusted to the actual 'dose' applied. The predicted systemic availability (assuming no local metabolism), can then be ranked against the oral TTC for the relevant structural class. The predictive approach has been evaluated by deriving the experimental/prediction ratio for systemic availability for 22 cosmetic chemical exposure scenarios. These emphasise that estimation of skin penetration may be challenging for penetration enhancing formulations, short application times with incomplete rinse-off, or significant metabolism. While there were a few exceptions, the experiment-to-prediction ratios mostly fell within a factor of 10 of the ideal value of 1. It can be concluded therefore, that the approach is fit-for-purpose when used as a screening and prioritisation tool.

  6. Synchronized dynamic dose reconstruction

    SciTech Connect

    Litzenberg, Dale W.; Hadley, Scott W.; Tyagi, Neelam; Balter, James M.; Ten Haken, Randall K.; Chetty, Indrin J.

    2007-01-15

    Variations in target volume position between and during treatment fractions can lead to measurable differences in the dose distribution delivered to each patient. Current methods to estimate the ongoing cumulative delivered dose distribution make idealized assumptions about individual patient motion based on average motions observed in a population of patients. In the delivery of intensity modulated radiation therapy (IMRT) with a multi-leaf collimator (MLC), errors are introduced in both the implementation and delivery processes. In addition, target motion and MLC motion can lead to dosimetric errors from interplay effects. All of these effects may be of clinical importance. Here we present a method to compute delivered dose distributions for each treatment beam and fraction, which explicitly incorporates synchronized real-time patient motion data and real-time fluence and machine configuration data. This synchronized dynamic dose reconstruction method properly accounts for the two primary classes of errors that arise from delivering IMRT with an MLC: (a) Interplay errors between target volume motion and MLC motion, and (b) Implementation errors, such as dropped segments, dose over/under shoot, faulty leaf motors, tongue-and-groove effect, rounded leaf ends, and communications delays. These reconstructed dose fractions can then be combined to produce high-quality determinations of the dose distribution actually received to date, from which individualized adaptive treatment strategies can be determined.

  7. Quantifying the Reproducibility of Heart Position During Treatment and Corresponding Delivered Heart Dose in Voluntary Deep Inhalation Breath Hold for Left Breast Cancer Patients Treated With External Beam Radiotherapy

    SciTech Connect

    McIntosh, Alyson; Shoushtari, Asal N.; Benedict, Stanley H.; Read, Paul W.; Wijesooriya, Krishni

    2011-11-15

    Purpose: Voluntary deep inhalation breath hold (VDIBH) reduces heart dose during left breast irradiation. We present results of the first study performed to quantify reproducibility of breath hold using bony anatomy, heart position, and heart dose for VDIBH patients at treatment table. Methods and Materials: Data from 10 left breast cancer patients undergoing VDIBH whole-breast irradiation were analyzed. Two computed tomography (CT) scans, free breathing (FB) and VDIBH, were acquired to compare dose to critical structures. Pretreatment weekly kV orthogonal images and tangential ports were acquired. The displacement difference from spinal cord to sternum across the isocenter between coregistered planning Digitally Reconstructed Radiographs (DRRs) and kV imaging of bony thorax is a measure of breath hold reproducibility. The difference between bony coregistration and heart coregistration was the measured heart shift if the patient is aligned to bony anatomy. Results: Percentage of dose reductions from FB to VDIBH: mean heart dose (48%, SD 19%, p = 0.002), mean LAD dose (43%, SD 19%, p = 0.008), and maximum left anterior descending (LAD) dose (60%, SD 22%, p = 0.008). Average breath hold reproducibility using bony anatomy across the isocenter along the anteroposterior (AP) plane from planning to treatment is 1 (range, 0-3; SD, 1) mm. Average heart shifts with respect to bony anatomy between different breath holds are 2 {+-} 3 mm inferior, 1 {+-} 2 mm right, and 1 {+-} 3 mm posterior. Percentage dose changes from planning to delivery: mean heart dose (7%, SD 6%); mean LAD dose, ((9%, SD 7%)S, and maximum LAD dose, (11%, SD 11%) SD 11%, p = 0.008). Conclusion: We observed excellent three-dimensional bony registration between planning and pretreatment imaging. Reduced delivered dose to heart and LAD is maintained throughout VDIBH treatment.

  8. Radiation dose delivered to the proximal penis as a predictor of the risk of erectile dysfunction after three-dimensional conformal radiotherapy for localized prostate cancer

    SciTech Connect

    Wernicke, A. Gabriella; Valicenti, Richard . E-mail: richard.valicenti@mail.tju.edu; DiEva, Kelly; Houser, Christopher; Pequignot, Ed

    2004-12-01

    Purpose/objective: In this study, we evaluated in a serial manner whether radiation dose to the bulb of the penis is predictive of erectile dysfunction, ejaculatory difficulty (EJ), and overall satisfaction with sex life (quality of life) by using serial validated self-administered questionnaires. Methods and materials: Twenty-nine potent men with AJCC Stage II prostate cancer treated with three-dimensional conformal radiation therapy alone to a median dose 72.0 Gy (range: 66.6-79.2 Gy) were evaluated by determining the doses received by the penile bulb. The penile bulb was delineated volumetrically, and the dose-volume histogram was obtained on each patient. Results: The median follow-up time was 35 months (range, 16-43 months). We found that for D{sub 30}, D{sub 45}, D{sub 60}, and D{sub 75} (doses to a percent volume of PB: 30%, 45%, 60%, and 75%), higher than the corresponding median dose (defined as high-dose group) correlated with an increased risk of impotence (erectile dysfunction firmness score = 0) (odds ratio [OR] = 7.5, p = 0.02; OR = 7.5, p = 0.02; OR = 8.6, p = 0.008; and OR = 6.9, p = 0.015, respectively). Similarly, for EJD D{sub 30}, D{sub 45}, D{sub 60}, and D{sub 75}, doses higher than the corresponding median ones correlated with worsening ejaculatory function score (EJ = 0 or 1) (OR = 8, p = 0.013; OR = 8, p 0.013; OR = 9.2, p = 0.015; and OR = 8, p = 0.026, respectively). For quality of life, low ({<=}median dose) dose groups of patients improve over time, whereas high-dose groups of patients worsen. Conclusions: This study supports the existence of a penile bulb dose-volume relationship underlying the development of radiation-induced erectile dysfunction. Our data may guide the use of inverse treatment planning to maximize the probability of maintaining sexual potency after radiation therapy.

  9. Measuring uncertainty in dose delivered to the cochlea due to setup error during external beam treatment of patients with cancer of the head and neck

    SciTech Connect

    Yan, M.; Lovelock, D.; Hunt, M.; Mechalakos, J.; Hu, Y.; Pham, H.; Jackson, A.

    2013-12-15

    Purpose: To use Cone Beam CT scans obtained just prior to treatments of head and neck cancer patients to measure the setup error and cumulative dose uncertainty of the cochlea. Methods: Data from 10 head and neck patients with 10 planning CTs and 52 Cone Beam CTs taken at time of treatment were used in this study. Patients were treated with conventional fractionation using an IMRT dose painting technique, most with 33 fractions. Weekly radiographic imaging was used to correct the patient setup. The authors used rigid registration of the planning CT and Cone Beam CT scans to find the translational and rotational setup errors, and the spatial setup errors of the cochlea. The planning CT was rotated and translated such that the cochlea positions match those seen in the cone beam scans, cochlea doses were recalculated and fractional doses accumulated. Uncertainties in the positions and cumulative doses of the cochlea were calculated with and without setup adjustments from radiographic imaging. Results: The mean setup error of the cochlea was 0.04 ± 0.33 or 0.06 ± 0.43 cm for RL, 0.09 ± 0.27 or 0.07 ± 0.48 cm for AP, and 0.00 ± 0.21 or −0.24 ± 0.45 cm for SI with and without radiographic imaging, respectively. Setup with radiographic imaging reduced the standard deviation of the setup error by roughly 1–2 mm. The uncertainty of the cochlea dose depends on the treatment plan and the relative positions of the cochlea and target volumes. Combining results for the left and right cochlea, the authors found the accumulated uncertainty of the cochlea dose per fraction was 4.82 (0.39–16.8) cGy, or 10.1 (0.8–32.4) cGy, with and without radiographic imaging, respectively; the percentage uncertainties relative to the planned doses were 4.32% (0.28%–9.06%) and 10.2% (0.7%–63.6%), respectively. Conclusions: Patient setup error introduces uncertainty in the position of the cochlea during radiation treatment. With the assistance of radiographic imaging during setup

  10. Total body irradiation must be delivered at high dose for efficient engraftment and tolerance in a rhesus stem cell gene therapy model

    PubMed Central

    Uchida, Naoya; Weitzel, R Patrick; Shvygin, Anna; Skala, Luke P; Raines, Lydia; Bonifacino, Aylin C; Krouse, Allen E; Metzger, Mark E; Donahue, Robert E; Tisdale, John F

    2016-01-01

    Reduced intensity conditioning (RIC) is desirable for hematopoietic stem cell (HSC) gene therapy applications. However, low gene marking was previously observed in gene therapy trials, suggesting that RIC might be insufficient for (i) opening niches for efficient engraftment and/or (ii) inducing immunological tolerance for transgene-encoded proteins. Therefore, we evaluated both engraftment and tolerance for gene-modified cells using our rhesus HSC gene therapy model following RIC. We investigated a dose de-escalation of total body irradiation (TBI) from our standard dose of 10Gy (10, 8, 6, and 4Gy), in which rhesus CD34+ cells were transduced with a VSVG-pseudotyped chimeric HIV-1 vector encoding enhanced green fluorescent protein (GFP) (or enhanced yellow fluorescent protein (YFP)). At ~6 months after transplantation, higher-dose TBI resulted in higher gene marking with logarithmic regression in peripheral blood cells. We then evaluated immunological tolerance for gene-modified cells, and found that lower-dose TBI allowed vigorous anti-GFP antibody production with logarithmic regression, while no significant anti-VSVG antibody formation was observed among all TBI groups. These data suggest that higher-dose TBI improves both engraftment and immunological tolerance for gene-modified cells. Additional immunosuppression might be required in RIC to induce tolerance for transgene products. Our findings should be valuable for developing conditioning regimens for HSC gene therapy applications.

  11. Total body irradiation must be delivered at high dose for efficient engraftment and tolerance in a rhesus stem cell gene therapy model.

    PubMed

    Uchida, Naoya; Weitzel, R Patrick; Shvygin, Anna; Skala, Luke P; Raines, Lydia; Bonifacino, Aylin C; Krouse, Allen E; Metzger, Mark E; Donahue, Robert E; Tisdale, John F

    2016-01-01

    Reduced intensity conditioning (RIC) is desirable for hematopoietic stem cell (HSC) gene therapy applications. However, low gene marking was previously observed in gene therapy trials, suggesting that RIC might be insufficient for (i) opening niches for efficient engraftment and/or (ii) inducing immunological tolerance for transgene-encoded proteins. Therefore, we evaluated both engraftment and tolerance for gene-modified cells using our rhesus HSC gene therapy model following RIC. We investigated a dose de-escalation of total body irradiation (TBI) from our standard dose of 10Gy (10, 8, 6, and 4Gy), in which rhesus CD34(+) cells were transduced with a VSVG-pseudotyped chimeric HIV-1 vector encoding enhanced green fluorescent protein (GFP) (or enhanced yellow fluorescent protein (YFP)). At ~6 months after transplantation, higher-dose TBI resulted in higher gene marking with logarithmic regression in peripheral blood cells. We then evaluated immunological tolerance for gene-modified cells, and found that lower-dose TBI allowed vigorous anti-GFP antibody production with logarithmic regression, while no significant anti-VSVG antibody formation was observed among all TBI groups. These data suggest that higher-dose TBI improves both engraftment and immunological tolerance for gene-modified cells. Additional immunosuppression might be required in RIC to induce tolerance for transgene products. Our findings should be valuable for developing conditioning regimens for HSC gene therapy applications. PMID:27652288

  12. Total body irradiation must be delivered at high dose for efficient engraftment and tolerance in a rhesus stem cell gene therapy model

    PubMed Central

    Uchida, Naoya; Weitzel, R Patrick; Shvygin, Anna; Skala, Luke P; Raines, Lydia; Bonifacino, Aylin C; Krouse, Allen E; Metzger, Mark E; Donahue, Robert E; Tisdale, John F

    2016-01-01

    Reduced intensity conditioning (RIC) is desirable for hematopoietic stem cell (HSC) gene therapy applications. However, low gene marking was previously observed in gene therapy trials, suggesting that RIC might be insufficient for (i) opening niches for efficient engraftment and/or (ii) inducing immunological tolerance for transgene-encoded proteins. Therefore, we evaluated both engraftment and tolerance for gene-modified cells using our rhesus HSC gene therapy model following RIC. We investigated a dose de-escalation of total body irradiation (TBI) from our standard dose of 10Gy (10, 8, 6, and 4Gy), in which rhesus CD34+ cells were transduced with a VSVG-pseudotyped chimeric HIV-1 vector encoding enhanced green fluorescent protein (GFP) (or enhanced yellow fluorescent protein (YFP)). At ~6 months after transplantation, higher-dose TBI resulted in higher gene marking with logarithmic regression in peripheral blood cells. We then evaluated immunological tolerance for gene-modified cells, and found that lower-dose TBI allowed vigorous anti-GFP antibody production with logarithmic regression, while no significant anti-VSVG antibody formation was observed among all TBI groups. These data suggest that higher-dose TBI improves both engraftment and immunological tolerance for gene-modified cells. Additional immunosuppression might be required in RIC to induce tolerance for transgene products. Our findings should be valuable for developing conditioning regimens for HSC gene therapy applications. PMID:27652288

  13. Potent response of QS-21 as a vaccine adjuvant in the skin when delivered with the Nanopatch, resulted in adjuvant dose sparing

    PubMed Central

    Ng, Hwee-Ing; Fernando, Germain J. P.; Depelsenaire, Alexandra C. I.; Kendall, Mark A. F.

    2016-01-01

    Adjuvants play a key role in boosting immunogenicity of vaccines, particularly for subunit protein vaccines. In this study we investigated the induction of antibody response against trivalent influenza subunit protein antigen and a saponin adjuvant, QS-21. Clinical trials of QS-21 have demonstrated the safety but, also a need of high dose for optimal immunity, which could possibly reduce patient acceptability. Here, we proposed the use of a skin delivery technology – the Nanopatch – to reduce both adjuvant and antigen dose but also retain its immune stimulating effects when compared to the conventional needle and syringe intramuscular (IM) delivery. We have demonstrated that Nanopatch delivery to skin requires only 1/100th of the IM antigen dose to induce equivalent humoral response. QS-21 enhanced humoral response in both skin and muscle route. Additionally, Nanopatch has demonstrated 30-fold adjuvant QS-21 dose sparing while retaining immune stimulating effects compared to IM. QS-21 induced localised, controlled cell death in the skin, suggesting that the danger signals released from dead cells contributed to the enhanced immunogenicity. Taken together, these findings demonstrated the suitability of reduced dose of QS-21 and the antigen using the Nanopatch to enhance humoral responses, and the potential to increase patient acceptability of QS-21 adjuvant. PMID:27404789

  14. [Dose loads on and radiation risk values for cosmonauts on a mission to Mars estimated from actual Martian vehicle engineering development].

    PubMed

    Shafirkin, A V; Kolomenskiĭ, A V; Mitrikas, V G; Petrov, V M

    2010-01-01

    The current design philosophy of a Mars orbiting vehicle, takeoff and landing systems and the transport return vehicle was taken into consideration for calculating the equivalent doses imparted to cosmonaut's organs and tissues by galactic cosmic rays, solar rays and the Earth's radiation belts, values of the total radiation risk over the lifespan following the mission and over the whole career period, and possible shortening of life expectancy. There are a number of uncertainties that should be evaluated, and radiation limits specified before setting off to Mars.

  15. [Dose loads on and radiation risk values for cosmonauts on a mission to Mars estimated from actual Martian vehicle engineering development].

    PubMed

    Shafirkin, A V; Kolomenskiĭ, A V; Mitrikas, V G; Petrov, V M

    2010-01-01

    The current design philosophy of a Mars orbiting vehicle, takeoff and landing systems and the transport return vehicle was taken into consideration for calculating the equivalent doses imparted to cosmonaut's organs and tissues by galactic cosmic rays, solar rays and the Earth's radiation belts, values of the total radiation risk over the lifespan following the mission and over the whole career period, and possible shortening of life expectancy. There are a number of uncertainties that should be evaluated, and radiation limits specified before setting off to Mars. PMID:20803991

  16. LESM: a laser-driven sub-MeV electron source delivering ultra-high dose rate on thin biological samples

    NASA Astrophysics Data System (ADS)

    Labate, L.; Andreassi, M. G.; Baffigi, F.; Bizzarri, R.; Borghini, A.; Bussolino, G. C.; Fulgentini, L.; Ghetti, F.; Giulietti, A.; Köster, P.; Lamia, D.; Levato, T.; Oishi, Y.; Pulignani, S.; Russo, G.; Sgarbossa, A.; Gizzi, L. A.

    2016-07-01

    We present a laser-driven source of electron bunches with average energy 260~\\text{keV} and picosecond duration, which has been setup for radiobiological tests covering the previously untested sub-MeV energy range. Each bunch combines high charge with short duration and sub-millimeter range into a record instantaneous dose rate, as high as {{10}9}~\\text{Gy}~{{\\text{s}}-1} . The source can be operated at 10~\\text{Hz} and its average dose rate is 35~\\text{mGy}~{{\\text{s}}-1} . Both the high instantaneous dose rate and high level of relative biological effectiveness, attached to sub-MeV electrons, make this source very attractive for studies of ultrafast radiobiology on thin cell samples. The source reliability, in terms of shot-to-shot stability of features such as mean energy, bunch charge and transverse beam profile, is discussed, along with a dosimetric characterization. Finally, a few preliminary biological tests performed with this source are presented.

  17. SU-E-P-55: The Reaserch of Cervical Cancer Delivered with Constant Dose Rate and Gantry Speed Arc Therapy(CDR-CAS-IMAT) On Conventional Linac

    SciTech Connect

    Zhang, R; Bai, W; Chi, Z; Gao, C; Xiaomei, F; Gao, Y

    2015-06-15

    Purpose: Postoperative cervical cancer patients with large target volume and the target shape is concave, treatmented with static intensity-modulated radiotherapy (IMRT) is time consuming. The purpose of this study is to investigate using constant dose rate and gantry speed arc therapy(CDR-CAS-IMAT) on conventional linear accelrator, by comparing with the IMRT technology to evaluate the performance of CDR-CAS-IMAT on postoperative cervical cancer patients. Methods: 18 cervical cancer patients treated with IMRT on Varian 23IX were replanted using CDR-CAS-IMAT. The plans were generated on Oncentra v4.1 planning system, PTV was prescribed to 50.4 Gy in 28 fractions. Plans were evaluated based on the ability to meet the dose volume histogram. The homogeneity index (HI), conformity index (CI) of target volume, the dose of organs at risk, radiation delivery time and monitor units were also compared. SPSS 19.0 software paired T-test analysis was carried out on the two sets of data. Results: Compared with the IMRT plans PTV’s CI (t= 3.85, P =0.001), CTV’s CI, HI, D90, D95, D98, V95, V98, V100 (t=4.21, −3.18, 2.13, 4.65, 7.79, 2.29, 6.00, 2.13, p=0.001, 0.005, 0.049, 0.000, 0.000, 0.035, 0.000, 0.049), and cord D2 and rectum V40 (t=−2.65, −2.47, p= P =0.017, 0.025), and treatment time and MU (t=−36.0, −6.26, P =0.000, 0.000) were better than that of IMRT group. But the IMRT plans in terms of decreasing bladder V50, bowel V30 (t=2.14, 3.00, P =0.048, 0.008) and low dose irradiation volume were superior to that of CDR-CAS-IMAT plans. There were no significant differences in other statistical index. Conclusion: Cervical cancer patients with CDR-CAS-IMAT on Varian Clinical 23IX can get equivalent or superior dose distribution compared with the IMRT technology. IMAT have much less treatment time and MU can reduce the uncertainty factor and patient discomfort in treatment. This work was supported by the Medical Science Foundation of the health department of Hebei

  18. Impact of High-Dose Chemotherapy on The Ability to Deliver Subsequent Local–Regional Radiotherapy for Breast Cancer: Analysis of Cancer and Leukemia Group B Protocol 9082

    PubMed Central

    Marks, Lawrence B.; Cirrincione, Constance; Fitzgerald, Thomas J.; Laurie, Frances; Glicksman, Arvin S.; Vredenburgh, James; Prosnitz, Leonard R.; Shpall, Elizabeth J.; Crump, Michael; Richardson, Paul G.; Schuster, Michael W.; Ma, Jinli; Peterson, Bercedis L.; Norton, Larry; Seagren, Steven; Henderson, I. Craig; Hurd, David D.; Peters, William P.

    2009-01-01

    Purpose To report, from Cancer and Leukemia Group B Protocol 9082, the impact of high-dose cyclophosphamide, cisplatin, and BCNU (HD-CPB) vs. intermediate-dose CPB (ID-CPB) on the ability to start and complete the planned course of local–regional radiotherapy (RT) for women with breast cancer involving ≥10 axillary nodes. Methods and Materials From 1991 to 1998, 785 patients were randomized. The HD-CPB and ID-CPB arms were balanced regarding patient characteristics. The HD-CPB and ID-CPB arms were compared on the probability of RT initiation, interruption, modification, or incompleteness. The impact of clinical variables and interactions between variables were also assessed. Results Radiotherapy was initiated in 82% (325 of 394) of HD-CPB vs. 92% (360 of 391) of ID-CPB patients (p = 0.001). On multivariate analyses, RT was less likely given to patients who were randomized to HD treatment (odds ratio [OR] = 0 .38, p < 0.001), older (p = 0.005), African American (p = 0.003), postmastectomy (p = 0.02), or estrogen receptor positive (p = 0.03). High-dose treatment had a higher rate of RT interruption (21% vs. 12%, p = 0.001, OR = 2.05), modification (29% vs. 14%, p = 0.001, OR = 2.46), and early termination of RT (9% vs. 2%, p = 0.0001, OR = 5.35), compared with ID. Conclusion Treatment arm significantly related to initiation, interruption, modification, and early termination of RT. Patients randomized to HD-CPB were less likely to initiate RT, and of those who did, they were more likely to have RT interrupted, modified, and terminated earlier than those randomized to ID-CPB. The observed lower incidence of RT usage in African Americans vs. non–African Americans warrants further study. PMID:19747781

  19. Impact of High-Dose Chemotherapy on the Ability to Deliver Subsequent Local-Regional Radiotherapy for Breast Cancer: Analysis of Cancer and Leukemia Group B Protocol 9082

    SciTech Connect

    Marks, Lawrence B.; Cirrincione, Constance M.S.; Fitzgerald, Thomas J.; Laurie, Frances; Glicksman, Arvin S.; Vredenburgh, James; Prosnitz, Leonard R.; Shpall, Elizabeth J.; Crump, Michael; Richardson, Paul G.; Schuster, Michael W.; Ma Jinli; Peterson, Bercedis L.; Norton, Larry; Seagren, Steven

    2010-04-15

    Purpose: To report, from Cancer and Leukemia Group B Protocol 9082, the impact of high-dose cyclophosphamide, cisplatin, and BCNU (HD-CPB) vs. intermediate-dose CPB (ID-CPB) on the ability to start and complete the planned course of local-regional radiotherapy (RT) for women with breast cancer involving >=10 axillary nodes. Methods and Materials: From 1991 to 1998, 785 patients were randomized. The HD-CPB and ID-CPB arms were balanced regarding patient characteristics. The HD-CPB and ID-CPB arms were compared on the probability of RT initiation, interruption, modification, or incompleteness. The impact of clinical variables and interactions between variables were also assessed. Results: Radiotherapy was initiated in 82% (325 of 394) of HD-CPB vs. 92% (360 of 391) of ID-CPB patients (p = 0.001). On multivariate analyses, RT was less likely given to patients who were randomized to HD treatment (odds ratio [OR] = 0 .38, p < 0.001), older (p = 0.005), African American (p = 0.003), postmastectomy (p = 0.02), or estrogen receptor positive (p = 0.03). High-dose treatment had a higher rate of RT interruption (21% vs. 12%, p = 0.001, OR = 2.05), modification (29% vs. 14%, p = 0.001, OR = 2.46), and early termination of RT (9% vs. 2%, p = 0.0001, OR = 5.35), compared with ID. Conclusion: Treatment arm significantly related to initiation, interruption, modification, and early termination of RT. Patients randomized to HD-CPB were less likely to initiate RT, and of those who did, they were more likely to have RT interrupted, modified, and terminated earlier than those randomized to ID-CPB. The observed lower incidence of RT usage in African Americans vs. non-African Americans warrants further study.

  20. Study of radiation effects on the cell structure and evaluation of the dose delivered by x-ray and {alpha}-particles microscopy

    SciTech Connect

    Kosior, Ewelina; Cloetens, Peter; Deves, Guillaume; Ortega, Richard; Bohic, Sylvain

    2012-12-24

    Hard X-ray fluorescence microscopy and magnified phase contrast imaging are combined to study radiation effects on cells. Experiments were performed on freeze-dried cells at the nano-imaging station ID22NI of the European synchrotron radiation facility. Quantitative phase contrast imaging provides maps of the projected mass and is used to evaluate the structural changes due to irradiation during X-ray fluorescence experiments. Complementary to phase contrast imaging, scanning transmission ion microscopy is performed and doses of all the experiments are compared. We demonstrate the sensitivity of the proposed approach to study radiation-induced damage at the sub-cellular level.

  1. Radionuclide characterization and associated dose from long-lived radionuclides in close-in fallout delivered to the marine environment at Bikini and Enewetak Atolls.

    PubMed

    Robison, W L; Noshkin, V E

    1999-09-30

    Between June 1946 and October 1958, Enewetak and Bikini Atolls were used by the US as testing grounds for 66 nuclear devices. The combined explosive yield from these tests was 107 million t (million t TNT equivalents). This testing produced close-in fallout debris that was contaminated with quantities of radioactive fission and particle activated products, and unspent radioactive nuclear fuel that entered the aquatic environment of the atolls. Today, the sediments in the lagoons are reservoirs for tens of TBq of the transuranics and some long-lived fission and activation products. The larger amounts of contamination are associated with fine and coarse sediment material adjacent to the locations of the high yield explosions. Radionuclides are also distributed vertically in the sediment column to various depths in all regions of the lagoons. Concentrations greater than fallout background levels are found in filtered water sampled over several decades from all locations and depths in the lagoons. This is a direct indication that the radionuclides are continuously mobilized to solution from the solid phases. Of particular importance is the fact that the long-lived radionuclides are accumulated to different levels by indigenous aquatic plants and organisms that are used as food by resident people. One might anticipate finding continuous high contamination levels in many of the edible marine organisms from the lagoons, since the radionuclides associated with the sediments are not contained and are available to the different organisms in a relatively shallow water environment. This is not the case. We estimate that the radiological dose from consumption of the edible parts of marine foods at Enewetak and Bikini is presently approximately 0.05% of the total 50-year integral effective dose from all other exposure pathways that include ingestion of terrestrial foods and drinking water, external exposure and inhalation. The total radiological dose from the marine pathway is

  2. Radionuclide characterization and associated dose from long-lived radionuclides in close-in fallout delivered to the marine environment at Bikini and Enewetak Atoll

    SciTech Connect

    Noshkin, V. E.; Robison, W. L.

    1998-09-01

    Between June 1946 and October 1958, Enewetak and Bikini Atolls were used by the United States as testing grounds for 66 nuclear devices. The combined explosive yield from these tests was 107 Mt (Mt TNT equivalents). This testing produced close-in fallout debris that was contaminated with quantities of radioactive fission and particle activated products, and unspent radioactive nuclear fuel that entered the aquatic environment of the atolls. Today, the sediments in the lagoons are reservoirs for 10's of TBq of the transuranics and some long-lived fission and activation products. The larger amounts of contamination are associated with fine and coarse sediment material adjacent to the locations of the high yield explosions. Radionuclides are also distributed vertically in the sediment column to various depths in all regions of the lagoons. Concentrations greater than fallout background levels are found in filtered water sampled over several decades from all locations and depths in the lagoons. This is a direct indication that the radionuclides are continuously mobilized to solution from the solid phases. Of particular importance is the fact that the long-lived radionuclides are accumulated to different levels by indigenous aquatic plants and organisms that are used as food by resident people. One might anticipate finding continuous high contamination levels in many of the edible marine organisms from the lagoons, since the radionuclides associated with the sediments are not contained and are available to the different organisms in a relatively shallow water environment. This is not the case. We estimate that the radiological dose from consumption of the edible parts of marine foods at Enewetak and Bikini is presently about 0.05% of the total 50-year integral effective dose from all other exposure pathways that include ingestion of terrestrial foods and drinking water, external exposure and inhalation. The total radiological dose from the marine pathway is dominated by

  3. TH-C-BRD-08: Reducing the Effect of Respiratory Motion On the Delivered Dose in Proton Therapy Through Proper Field Angle Selection

    SciTech Connect

    Matney, J; Park, P; Court, L; Zhu, X; Li, H; Mohan, R; Liu, W; Dong, L

    2014-06-15

    Purpose: This work investigated a novel planning strategy of selecting radiotherapy beam angles that minimizes the change in water equivalent thickness (dWET) during respiration in order to reduce the effects of respiratory motion in passively scattered proton therapy (PSPT). Methods: In a clinical trial treating locally-advanced lung cancer with proton therapy, 2–4 co-planar beams were previously selected by dosimetrists in the design of physician-approved PSPT treatment plans. The authors identified a cohort of patients in which respiratory motion affected the planned PSPT dose delivery. For this cohort, this work analyzed dWET during respiration over a 360 degree arc of potential treatment angles around the patient: the dWET was defined as the difference in WET between the full-exhale (T50) and full-inhale (T0) phases of the simulation 4DCT. New PSPT plans were redesigned by selecting new beam angles that demonstrated significant reduction in the value of dWET. Between the T50 and T0 phases, the root-mean-square deviation of dose and the change in dose-volume histogram curves (dAUC) for anatomical structures were calculated to compare the original to dWET reduction plans. Results: To date, three plans were retrospectively redesigned based on dWET analysis. In the dWET reduction plan, the root mean square dose (T50-T0) was reduced by 15–35% and the DVH dAUC values were reduced by more than 60%.The PSPT plans redesigned by selecting appropriate field angles to minimize dWET demonstrated less dosimetric variation due to respiration. Conclusion: We have introduced the use of a new metric to quantify respiratory motion in proton therapy: dWET. The use of dWET allows us to minimize the impact of respiratory motion of the entire anatomy in the beam path. This work is a proof of principle that dWET could suggest field angles in proton therapy that are more robust to the effects of respiratory motion.

  4. Effect of Infant Formula Containing a Low Dose of the Probiotic Bifidobacterium lactis CNCM I-3446 on Immune and Gut Functions in C-Section Delivered Babies: A Pilot Study

    PubMed Central

    Baglatzi, L.; Gavrili, S.; Stamouli, K.; Zachaki, S.; Favre, L.; Pecquet, S.; Benyacoub, J.; Costalos, C.

    2016-01-01

    BACKGROUND In the absence of breast-feeding and its immunomodulatory factors, supplementation of starter infant formula (IF) with probiotics is currently used to support immune functions and gut development. AIM To assess whether immune-related beneficial effects of regular dose (107 CFU/g of powder) of the probiotic Bifidobacterium lactis CNCM I-3446 (hereafter named B. lactis) in starter IF supplementation can be maintained with starter IF containing a low dose (104 CFU/g of powder) of B. lactis. METHOD This trial was designed as a pilot, prospective, double-blind, randomized, single-center clinical trial of two parallel groups (n = 77 infants/group) of C-section delivered infants receiving a starter IF containing either low dose or regular dose of the probiotic B. lactis from birth to six months of age. In addition, a reference group of infants breast-fed for a minimum of four months (n = 44 infants), also born by C-section, were included. All groups were then provided follow-up formula without B. lactis up to 12 months of age. Occurrence of diarrhea, immune and gut maturation, responses to vaccinations, and growth were assessed from birth to 12 months. The effect of low-dose B. lactis formula was compared to regular-dose B. lactis formula, considered as reference for IF with probiotics, and both were further compared to breast-feeding as a physiological reference. RESULTS Data showed that feeding low-dose B. lactis IF provides similar effects as feeding regular-dose B. lactis IF or breast milk. No consistent statistical differences regarding early life protection against gastrointestinal infections, immune and gut maturation, microbiota establishment, and growth were observed between randomized formula-fed groups as well as with the breast-fed reference group. CONCLUSION This pilot study suggests that supplementing C-section born neonates with low-dose B. lactis-containing starter formula may impact immune as well as gut maturation similarly to regular-dose B

  5. Peripheral dose measurements with diode and thermoluminescence dosimeters for intensity modulated radiotherapy delivered with conventional and un-conventional linear accelerator.

    PubMed

    Kinhikar, Rajesh; Gamre, Poonam; Tambe, Chandrashekhar; Kadam, Sudarshan; Biju, George; Suryaprakash; Magai, C S; Dhote, Dipak; Shrivastava, Shyam; Deshpande, Deepak

    2013-01-01

    The objective of this paper was to measure the peripheral dose (PD) with diode and thermoluminescence dosimeter (TLD) for intensity modulated radiotherapy (IMRT) with linear accelerator (conventional LINAC), and tomotherapy (novel LINAC). Ten patients each were selected from Trilogy dual-energy and from Hi-Art II tomotherapy. Two diodes were kept at 20 and 25 cm from treatment field edge. TLDs (LiF:MgTi) were also kept at same distance. TLDs were also kept at 5, 10, and 15 cm from field edge. The TLDs were read with REXON reader. The readings at the respective distance were recorded for both diode and TLD. The PD was estimated by taking the ratio of measured dose at the particular distance to the prescription dose. PD was then compared with diode and TLD for LINAC and tomotherapy. Mean PD for LINAC with TLD and diode was 2.52 cGy (SD 0.69), 2.07 cGy (SD 0.88) at 20 cm, respectively, while at 25 cm, it was 1.94 cGy (SD 0.58) and 1.5 cGy (SD 0.75), respectively. Mean PD for tomotherapy with TLD and diode was 1.681 cGy SD 0.53) and 1.58 (SD 0.44) at 20 cm, respectively. The PD was 1.24 cGy (SD 0.42) and 1.088 cGy (SD 0.35) at 25 cm, respectively, for tomotherapy. Overall, PD from tomotherapy was found lower than LINAC by the factor of 1.2-1.5. PD measurement is essential to find out the potential of secondary cancer. PD for both (conventional LINAC) and novel LINACs (tomotherapy) were measured and compared with each other. The comparison of the values for PD presented in this work and those published in the literature is difficult because of the different experimental conditions. The diode and TLD readings were reproducible and both the detector readings were comparable.

  6. Immune response elicited by an intranasally delivered HBsAg low-dose adsorbed to poly-ε-caprolactone based nanoparticles.

    PubMed

    Jesus, Sandra; Soares, Edna; Costa, João; Borchard, Gerrit; Borges, Olga

    2016-05-17

    Among new strategies to increase hepatitis B virus (HBV) vaccination, especially in developing countries, the development of self-administered vaccines is considered one of the most valuable. Nasal vaccination using polymeric nanoparticles (NPs) constitutes a valid approach to this issue. In detail, poly-ε-caprolactone (PCL)/chitosan NPs present advantages as a mucosal vaccine delivery system: the high resistance of PCL against degradation in biological fluids and the mucoadhesive and immunostimulatory properties of chitosan. In vitro studies revealed these NPs were retained in a mucus-secreting pulmonary epithelial cell line and were capable of entering into differentiated epithelial cells. The intranasal (IN) administration of 3 different doses of HBsAg (1.5 μg, 5 μg and 10 μg) adsorbed on a fixed amount of PCL/chitosan NPs (1614 μg) generated identical titers of serum anti-HBsAg IgG and anti-HBsAg sIgA in mice nasal secretions. Besides other factors, the NP surface characteristics, particularly, zeta potential differences among the administered formulations are believed to be implicated in the outcome of the immune response generated.

  7. Influence of carrier cells on the clinical outcome of children with neuroblastoma treated with high dose of oncolytic adenovirus delivered in mesenchymal stem cells.

    PubMed

    Melen, Gustavo J; Franco-Luzón, Lidia; Ruano, David; González-Murillo, África; Alfranca, Arantzazu; Casco, Fernando; Lassaletta, Álvaro; Alonso, Mercedes; Madero, Luís; Alemany, Ramón; García-Castro, Javier; Ramírez, Manuel

    2016-02-28

    We report here our clinical experience of a program of compassionate use of Celyvir--autologous marrow-derived mesenchymal stem cells (MSCs) carrying an oncolytic adenovirus--for treating children with advanced metastatic neuroblastoma. Children received weekly doses of Celyvir with no concomitant treatments. The tolerance was excellent, with very mild and self-limited viral-related symptoms. Patients could be distinguished based on their response to therapy: those who had a clinical response (either complete, partial or stabilization) and those who did not respond. We found differences between patients who responded versus those who did not when analyzing their respective MSCs, at the expression levels of adhesion molecules (CCR1, CXCR1 and CXCR4) and in migration capacities in transwell assays, and in immune-related molecules (IFNγ, HLA-DR). These results suggest interpatient differences in the homing and immune modulation capacities of the therapy administered. In addition, the pretherapy immune T cell status and the T effector response were markedly different between responders and non-responders. We conclude that multidoses of Celyvir have an excellent safety profile in children with metastatic neuroblastoma. Intrinsic patients' and MSCs' factors appear to be related to clinical outcome.

  8. Comparison of gamma scintigraphy and a pharmacokinetic technique for assessing pulmonary deposition of terbutaline sulphate delivered by pressurized metered dose inhaler.

    PubMed

    Newman, S; Steed, K; Hooper, G; Källén, A; Borgström, L

    1995-02-01

    A comparison has been made of pulmonary deposition of terbutaline sulphate from a pressurized metered dose inhaler (pMDI), measured in 8 healthy male subjects by gamma scintigraphy and by a pharmacokinetic (charcoal-block) method, involving drug recovery in urine. Measurements were carried out with a pMDI at slow (27 l/min) and fast (151 l/min) inhaled flows and with Nebuhaler large volume spacer device (average inhaled flow 17 l/min). Overall, the two methods did not differ significantly in their estimates of whole lung deposition, although values obtained by gamma scintigraphy exceeded those from the charcoal-block method for the pMDI with fast inhalation. The regional distribution of drug within the lungs and deposition in the oropharynx could be assessed by gamma scintigraphy, but not by the charcoal-block method. It is concluded that either method may be used to assess whole lung deposition of terbutaline sulphate from pMDIs, both with and without a spacer, although each method has its own inherent advantages and disadvantages. PMID:7784338

  9. Delivering a “Dose of Hope”: A Faith-Based Program to Increase Older African Americans’ Participation in Clinical Trials

    PubMed Central

    Omer, Saad B; Parker, Kimberly; Bolton, Marcus; Schamel, Jay; Shapiro, Eve; Owens, Lauren; Saint-Victor, Diane; Boggavarapu, Sahithi; Braxton, Nikia; Archibald, Matthew; Kalokhe, Ameeta S; Horton, Takeia; Root, Christin M; Fenimore, Vincent L; Anderson, Aaron M

    2015-01-01

    Background Underrepresentation of older-age racial and ethnic minorities in clinical research is a significant barrier to health in the United States, as it impedes medical research advancement of effective preventive and therapeutic strategies. Objective The objective of the study was to develop and test the feasibility of a community-developed faith-based intervention and evaluate its potential to increase the number of older African Americans in clinical research. Methods Using a cluster-randomized design, we worked with six matched churches to enroll at least 210 persons. We provided those in the intervention group churches with three educational sessions on the role of clinical trials in addressing health disparity topics, and those in the comparison group completed surveys at the same timepoints. All persons enrolled in the study received ongoing information via newsletters and direct outreach on an array of clinical studies seeking participants. We evaluated the short-, mid-, and longer-term effects of the interventional program on clinical trial-related outcomes (ie, screening and enrollment). Results From 2012 to 2013, we enrolled a balanced cohort of 221 persons in the program. At a 3-month follow-up, mean intention to seek information about clinical trials was higher than baseline in both treatment (mu=7.5/10; sigma=3.1) and control arms (mu=6.6/10; sigma=3.3), with the difference more pronounced in the treatment arm. The program demonstrated strong retention at 3-month (95.4%, 211/221) and 6-month timepoints (94.1%, 208/221). Conclusions The “Dose of Hope” program addressed an unmet need to reach an often overlooked audience of older African Americans who are members of churches and stimulate their interest in clinical trial participation. The program demonstrated its appeal in the delivery of effective messages and information about health disparities, and the role of clinical research in addressing these challenges. PMID:26036841

  10. Safety and Efficacy of High Dose AAV9 Encoding SERCA2a Delivered by Molecular Cardiac Surgery with Recirculating Delivery (MCARD) in Ovine Ischemic Cardiomyopathy

    PubMed Central

    Katz, Michael G.; Fargnoli, Anthony S.; Williams, Richard D.; Steuerwald, Nury M.; Isidro, Alice; Ivanina, Anna V.; Sokolova, Inna M.; Bridges, Charles R.

    2014-01-01

    Objective Therapeutic safety and efficacy are the basic prerequisites for clinical gene therapy. Herein we investigate the effect of high dose MCARD-mediated AAV9/SERCA2a gene delivery on clinical parameters, oxidative stress, humoral and cellular immune response, and cardiac remodeling. Methods Ischemic cardiomyopathy was generated in a sheep model. Then animals were assigned to one of two groups: control (n=10), and study (MCARD, n=6). The control had no intervention while the study group received 1014 gc of AAV9.SERCA2a 4 weeks post-infarction. Results Our ischemic model produced reliable infarcts leading to heart failure. The baseline ejection fraction (EF) in the MCARD group was 57.6±1.6 vs. 61.2±1.9 in the control group, (p>0.05). Twelve weeks post-infarction, the MCARD group had superior LV function compared to control: stroke volume index (46.6±1.8 vs. 35.8±2.5 mL/m2, p<0.05), EF (46.2±1.9 vs. 38.7±2.5%, p<0.05); and LV end systolic and end diastolic dimensions [41.3±1.7 vs. 48.2±1.4 mm; 51.2±1.5 vs. 57.6±1.7 mm], p<0.05. Markers of oxidative stress were significantly reduced in the infarct zone in the MCARD group. There was no positive T cell mediated immune response in the MCARD group at any time point. Myocyte hypertrophy was also significantly attenuated in the MCARD group compared to control. Conclusions Cardiac overexpression of the SERCA2a gene via MCARD is a safe therapeutic intervention. It significantly improves LV function, decreases markers of oxidative stress, abrogates myocyte hypertrophy, arrests remodeling and does not induce a T cell mediated immune response. PMID:25037619

  11. SU-E-J-181: Effect of Prostate Motion On Combined Brachytherapy and External Beam Dose Based On Daily Motion of the Prostate

    SciTech Connect

    Narayana, V; McLaughlin, P; Ealbaj, J

    2015-06-15

    Purpose: In this study, the adequacy of target expansions on the combined external beam and implant dose was examined based on the measured daily motion of the prostate. Methods: Thirty patients received an I–125 prostate implant prescribed to dose of 90Gy. This was followed by external beam to deliver a dose of 90Gyeq (external beam equivalent) to the prostate over 25 to 30 fractions. An ideal IMRT plan was developed by optimizing the external beam dose based on the delivered implant dose. The implant dose was converted to an equivalent external beam dose using the linear quadratic model. Patients were set up on the treatment table by daily orthogonal imaging and aligning the marker seeds in the prostate. Orthogonal images were obtained at the end of treatment to assess prostate intrafraction motion. Based on the observed motion of the markers between the initial and final images, 5 individual plans showing the actual dose delivered to the patient were calculated. A final true dose distribution was established based on summing the implant dose and the 5 external beam plans. Dose to the prostate, seminal vesicles, lymphnodes and normal tissues, rectal wall, urethra and lower sphincter were calculated and compared to ideal. On 18 patients who were sexually active, dose to the corpus cavernosum and internal pudendal artery was also calculated. Results: The average prostate motion in 3 orthogonal directions was less than 1 mm with a standard deviation of less than +2 mm. Dose and volume parameters showed that there was no decrease in dose to the targets and a marginal decrease in dose to in normal tissues. Conclusion: Dose delivered by seed implant moves with the prostate, decreasing the impact of intrafractions dose movement on actual dose delivered. Combined brachytherapy and external beam dose delivered to the prostate was not sensitive to prostate motion.

  12. Assessment of MLC tracking performance during hypofractionated prostate radiotherapy using real-time dose reconstruction.

    PubMed

    Fast, M F; Kamerling, C P; Ziegenhein, P; Menten, M J; Bedford, J L; Nill, S; Oelfke, U

    2016-02-21

    By adapting to the actual patient anatomy during treatment, tracked multi-leaf collimator (MLC) treatment deliveries offer an opportunity for margin reduction and healthy tissue sparing. This is assumed to be especially relevant for hypofractionated protocols in which intrafractional motion does not easily average out. In order to confidently deliver tracked treatments with potentially reduced margins, it is necessary to monitor not only the patient anatomy but also the actually delivered dose during irradiation. In this study, we present a novel real-time online dose reconstruction tool which calculates actually delivered dose based on pre-calculated dose influence data in less than 10 ms at a rate of 25 Hz. Using this tool we investigate the impact of clinical target volume (CTV) to planning target volume (PTV) margins on CTV coverage and organ-at-risk dose. On our research linear accelerator, a set of four different CTV-to-PTV margins were tested for three patient cases subject to four different motion conditions. Based on this data, we can conclude that tracking eliminates dose cold spots which can occur in the CTV during conventional deliveries even for the smallest CTV-to-PTV margin of 1 mm. Changes of organ-at-risk dose do occur frequently during MLC tracking and are not negligible in some cases. Intrafractional dose reconstruction is expected to become an important element in any attempt of re-planning the treatment plan during the delivery based on the observed anatomy of the day.

  13. Assessment of MLC tracking performance during hypofractionated prostate radiotherapy using real-time dose reconstruction

    NASA Astrophysics Data System (ADS)

    Fast, M. F.; Kamerling, C. P.; Ziegenhein, P.; Menten, M. J.; Bedford, J. L.; Nill, S.; Oelfke, U.

    2016-02-01

    By adapting to the actual patient anatomy during treatment, tracked multi-leaf collimator (MLC) treatment deliveries offer an opportunity for margin reduction and healthy tissue sparing. This is assumed to be especially relevant for hypofractionated protocols in which intrafractional motion does not easily average out. In order to confidently deliver tracked treatments with potentially reduced margins, it is necessary to monitor not only the patient anatomy but also the actually delivered dose during irradiation. In this study, we present a novel real-time online dose reconstruction tool which calculates actually delivered dose based on pre-calculated dose influence data in less than 10 ms at a rate of 25 Hz. Using this tool we investigate the impact of clinical target volume (CTV) to planning target volume (PTV) margins on CTV coverage and organ-at-risk dose. On our research linear accelerator, a set of four different CTV-to-PTV margins were tested for three patient cases subject to four different motion conditions. Based on this data, we can conclude that tracking eliminates dose cold spots which can occur in the CTV during conventional deliveries even for the smallest CTV-to-PTV margin of 1 mm. Changes of organ-at-risk dose do occur frequently during MLC tracking and are not negligible in some cases. Intrafractional dose reconstruction is expected to become an important element in any attempt of re-planning the treatment plan during the delivery based on the observed anatomy of the day.

  14. Metallochaperones: bind and deliver

    SciTech Connect

    Rosenzweig, A.C.

    2010-03-08

    Metallochaperones deliver metal ions directly to target proteins via specific protein-protein interactions. Recent research has led to a molecular picture of how some metallochaperones bind metal ions, recognize their partner proteins, and accomplish metal ion transfer.

  15. Form and Actuality

    NASA Astrophysics Data System (ADS)

    Bitbol, Michel

    A basic choice underlies physics. It consists of banishing actual situations from theoretical descriptions, in order to reach a universal formal construct. Actualities are then thought of as mere local appearances of a transcendent reality supposedly described by the formal construct. Despite its impressive success, this method has left major loopholes in the foundations of science. In this paper, I document two of these loopholes. One is the problem of time asymmetry in statistical thermodynamics, and the other is the measurement problem of quantum mechanics. Then, adopting a broader philosophical standpoint, I try to turn the whole picture upside down. Here, full priority is given to actuality (construed as a mode of the immanent reality self-reflectively being itself) over formal constructs. The characteristic aporias of this variety of "Copernican revolution" are discussed.

  16. Can solar power deliver?

    PubMed

    Nelson, Jenny; Emmott, Christopher J M

    2013-08-13

    Solar power represents a vast resource which could, in principle, meet the world's needs for clean power generation. Recent growth in the use of photovoltaic (PV) technology has demonstrated the potential of solar power to deliver on a large scale. Whilst the dominant PV technology is based on crystalline silicon, a wide variety of alternative PV materials and device concepts have been explored in an attempt to decrease the cost of the photovoltaic electricity. This article explores the potential for such emerging technologies to deliver cost reductions, scalability of manufacture, rapid carbon mitigation and new science in order to accelerate the uptake of solar power technologies.

  17. Temporal compartmental dosing effects for robotic prostate stereotactic body radiotherapy

    NASA Astrophysics Data System (ADS)

    Shiao, Stephen L.; Sahgal, Arjun; Hu, Weigang; Jabbari, Siavash; Chuang, Cynthia; Descovich, Martina; Hsu, I.-Chow; Gottschalk, Alexander R.; Roach, Mack, III; Ma, Lijun

    2011-12-01

    The rate of dose accumulation within a given area of a target volume tends to vary significantly for non-isocentric delivery systems such as Cyberknife stereotactic body radiotherapy. In this study, we investigated whether intra-target temporal dose distributions produce significant variations in the biological equivalent dose. For the study, time courses of ten patients were reconstructed and calculation of a biologically equivalent uniform dose (EUD) was performed using a formula derived from the linear quadratic model (α/β = 3 for prostate cancer cells). The calculated EUD values obtained for the actual patient treatments were then compared with theoretical EUD values for delivering the same physical dose distribution except that the whole target being irradiated continuously (e.g. large-field ‘dose-bathing’ type of delivery). For all the case, the EUDs for the actual treatment delivery were found to correlate strongly with the EUDs for the large-field delivery: a linear correlation coefficient of R2 = 0.98 was obtained and the average EUD for the actual Cyberknife delivery was somewhat higher (5.0 ± 4.7%) than that for the large-field delivery. However, no statistical significance was detected between the two types of delivery (p = 0.21). We concluded that non-isocentric small-field Cyberknife delivery produced consistent biological dosing that tracked well with the constant-dose-rate, large-field-type delivery for prostate stereotactic body radiotherapy.

  18. Remotion of organic compounds of actual industrial effluents by electron beam irradiation

    NASA Astrophysics Data System (ADS)

    Sampa, M. H. O.; Duarte, C. L.; Rela, P. R.; Somessari, E. S. R.; Silveira, C. G.; Azevedo, A. L.

    1998-06-01

    Organic compounds has been a great problem of environmental pollution, the traditional methods are not effecient on removing these compounds and most of them are deposited to ambient and stay there for long time causing problems to the environment. Ionizing radiation has been used with success to destroy organic molecules. Actual industrial effluents were irradiated using IPEN's electron beam wastewater pilot plant to study organic compounds degradation. The samples were irradiated with and without air mixture by different doses. Irradiation treatment efficiency was evaluated by the Cromatography Gas Analyses of the samples before and after irradiation. The studied organic compounds were: phenol, chloroform, tetrachloroethylene (PCE), carbon tetrachloride, trichloroethylene (TCE), 1,1-dichloroethane, dichloromethane, benzene, toluene and xilene. A degradation superior to 80% was achieved for the majority of the compounds with air addition and 2kGy delivered dose condition. For the samples that were irradiated without air addition the degradation was higher.

  19. Gamma-H2AX-Based Dose Estimation for Whole and Partial Body Radiation Exposure

    PubMed Central

    Horn, Simon; Barnard, Stephen; Rothkamm, Kai

    2011-01-01

    Most human exposures to ionising radiation are partial body exposures. However, to date only limited tools are available for rapid and accurate estimation of the dose distribution and the extent of the body spared from the exposure. These parameters are of great importance for emergency triage and clinical management of exposed individuals. Here, measurements of γ-H2AX immunofluorescence by microscopy and flow cytometry were compared as rapid biodosimetric tools for whole and partial body exposures. Ex vivo uniformly X-irradiated blood lymphocytes from one donor were used to generate a universal biexponential calibration function for γ-H2AX foci/intensity yields per unit dose for time points up to 96 hours post exposure. Foci – but not intensity – levels remained significantly above background for 96 hours for doses of 0.5 Gy or more. Foci-based dose estimates for ex vivo X-irradiated blood samples from 13 volunteers were in excellent agreement with the actual dose delivered to the targeted samples. Flow cytometric dose estimates for X-irradiated blood samples from 8 volunteers were in excellent agreement with the actual dose delivered at 1 hour post exposure but less so at 24 hours post exposure. In partial body exposures, simulated by mixing ex vivo irradiated and unirradiated lymphocytes, foci/intensity distributions were significantly over-dispersed compared to uniformly irradiated lymphocytes. For both methods and in all cases the estimated fraction of irradiated lymphocytes and dose to that fraction, calculated using the zero contaminated Poisson test and γ-H2AX calibration function, were in good agreement with the actual mixing ratios and doses delivered to the samples. In conclusion, γ-H2AX analysis of irradiated lymphocytes enables rapid and accurate assessment of whole body doses while dispersion analysis of foci or intensity distributions helps determine partial body doses and the irradiated fraction size in cases of partial body exposures. PMID

  20. Defining the “Hostile Pelvis” for Intensity Modulated Radiation Therapy: The Impact of Anatomic Variations in Pelvic Dimensions on Dose Delivered to Target Volumes and Organs at Risk in Patients With High-Risk Prostate Cancer Treated With Whole Pelvic Radiation Therapy

    SciTech Connect

    Yirmibeşoğlu Erkal, Eda; Karabey, Sinan; Karabey, Ayşegül; Hayran, Mutlu; Erkal, Haldun Şükrü

    2015-07-15

    Purpose: The aim of this study was to evaluate the impact of variations in pelvic dimensions on the dose delivered to the target volumes and the organs at risk (OARs) in patients with high-risk prostate cancer (PCa) to be treated with whole pelvic radiation therapy (WPRT) in an attempt to define the hostile pelvis in terms of intensity modulated radiation therapy (IMRT). Methods and Materials: In 45 men with high-risk PCa to be treated with WPRT, the target volumes and the OARs were delineated, the dose constraints for the OARs were defined, and treatment plans were generated according to the Radiation Therapy Oncology Group 0924 protocol. Six dimensions to reflect the depth, width, and height of the bony pelvis were measured, and 2 indexes were calculated from the planning computed tomographic scans. The minimum dose (D{sub min}), maximum dose (D{sub max}), and mean dose (D{sub mean}) for the target volumes and OARs and the partial volumes of each of these structures receiving a specified dose (V{sub D}) were calculated from the dose-volume histograms (DVHs). The data from the DVHs were correlated with the pelvic dimensions and indexes. Results: According to an overall hostility score (OHS) calculation, 25 patients were grouped as having a hospitable pelvis and 20 as having a hostile pelvis. Regarding the OHS grouping, the DVHs for the bladder, bowel bag, left femoral head, and right femoral head differed in favor of the hospitable pelvis group, and the DVHs for the rectum differed for a range of lower doses in favor of the hospitable pelvis group. Conclusions: Pelvimetry might be used as a guide to define the challenging anatomy or the hostile pelvis in terms of treatment planning for IMRT in patients with high-risk PCa to be treated with WPRT.

  1. Accuracy and reproducibility of low dose insulin administration using pen-injectors and syringes

    PubMed Central

    Gnanalingham, M; Newland, P; Smith, C

    1998-01-01

    Many children with diabetes require small doses of insulin administered with syringes or pen-injector devices (at the Booth Hall Paediatric Diabetic Clinic, 20% of children aged 0-5 years receive 1-2 U insulin doses). To determine how accurately and reproducibly small doses are delivered, 1, 2, 5, and 10 U doses of soluble insulin (100 U/ml) were dispensed in random order 15times from five new NovoPens (1.5 ml), five BD-Pens (1.5 ml), and by five nurses using 30 U syringes. Each dose was weighed, and intended and actual doses compared. The two pen-injectors delivered less insulin than syringes, differences being inversely proportional to dose. For 1 U (mean (SD)): 0.89 (0.04) U (NovoPen), 0.92 (0.03) U (BD-Pen), 1.23 (0.09) U (syringe); and for 10 U: 9.8 (0.1) U (NovoPen), 9.9 (0.1) U (BD-Pen), 10.1 (0.1) U (syringe). The accuracy (percentage errors) of the pen-injectors was similar and more accurate than syringes delivering 1, 2, and 5 U of insulin. Errors for 1 U: 11(4)% (NovoPen), 8(3)% (BD-Pen), 23(9)% (syringe). The reproducibility (coefficient of variation) of actual doses was similar (< 7%) for all three devices, which were equally consistent at underdosing (pen-injectors) or overdosing (syringes) insulin. All three devices, especially syringes, are unacceptably inaccurate when delivering 1 U doses of insulin. Patients on low doses need to be educated that their dose may alter when they transfer from one device to another.

 PMID:9771255

  2. 4D cone beam CT-based dose assessment for SBRT lung cancer treatment.

    PubMed

    Cai, Weixing; Dhou, Salam; Cifter, Fulya; Myronakis, Marios; Hurwitz, Martina H; Williams, Christopher L; Berbeco, Ross I; Seco, Joao; Lewis, John H

    2016-01-21

    The purpose of this research is to develop a 4DCBCT-based dose assessment method for calculating actual delivered dose for patients with significant respiratory motion or anatomical changes during the course of SBRT. To address the limitation of 4DCT-based dose assessment, we propose to calculate the delivered dose using time-varying ('fluoroscopic') 3D patient images generated from a 4DCBCT-based motion model. The method includes four steps: (1) before each treatment, 4DCBCT data is acquired with the patient in treatment position, based on which a patient-specific motion model is created using a principal components analysis algorithm. (2) During treatment, 2D time-varying kV projection images are continuously acquired, from which time-varying 'fluoroscopic' 3D images of the patient are reconstructed using the motion model. (3) Lateral truncation artifacts are corrected using planning 4DCT images. (4) The 3D dose distribution is computed for each timepoint in the set of 3D fluoroscopic images, from which the total effective 3D delivered dose is calculated by accumulating deformed dose distributions. This approach is validated using six modified XCAT phantoms with lung tumors and different respiratory motions derived from patient data. The estimated doses are compared to that calculated using ground-truth XCAT phantoms. For each XCAT phantom, the calculated delivered tumor dose values generally follow the same trend as that of the ground truth and at most timepoints the difference is less than 5%. For the overall delivered dose, the normalized error of calculated 3D dose distribution is generally less than 3% and the tumor D95 error is less than 1.5%. XCAT phantom studies indicate the potential of the proposed method to accurately estimate 3D tumor dose distributions for SBRT lung treatment based on 4DCBCT imaging and motion modeling. Further research is necessary to investigate its performance for clinical patient data.

  3. 4D cone beam CT-based dose assessment for SBRT lung cancer treatment

    NASA Astrophysics Data System (ADS)

    Cai, Weixing; Dhou, Salam; Cifter, Fulya; Myronakis, Marios; Hurwitz, Martina H.; Williams, Christopher L.; Berbeco, Ross I.; Seco, Joao; Lewis, John H.

    2016-01-01

    The purpose of this research is to develop a 4DCBCT-based dose assessment method for calculating actual delivered dose for patients with significant respiratory motion or anatomical changes during the course of SBRT. To address the limitation of 4DCT-based dose assessment, we propose to calculate the delivered dose using time-varying (‘fluoroscopic’) 3D patient images generated from a 4DCBCT-based motion model. The method includes four steps: (1) before each treatment, 4DCBCT data is acquired with the patient in treatment position, based on which a patient-specific motion model is created using a principal components analysis algorithm. (2) During treatment, 2D time-varying kV projection images are continuously acquired, from which time-varying ‘fluoroscopic’ 3D images of the patient are reconstructed using the motion model. (3) Lateral truncation artifacts are corrected using planning 4DCT images. (4) The 3D dose distribution is computed for each timepoint in the set of 3D fluoroscopic images, from which the total effective 3D delivered dose is calculated by accumulating deformed dose distributions. This approach is validated using six modified XCAT phantoms with lung tumors and different respiratory motions derived from patient data. The estimated doses are compared to that calculated using ground-truth XCAT phantoms. For each XCAT phantom, the calculated delivered tumor dose values generally follow the same trend as that of the ground truth and at most timepoints the difference is less than 5%. For the overall delivered dose, the normalized error of calculated 3D dose distribution is generally less than 3% and the tumor D95 error is less than 1.5%. XCAT phantom studies indicate the potential of the proposed method to accurately estimate 3D tumor dose distributions for SBRT lung treatment based on 4DCBCT imaging and motion modeling. Further research is necessary to investigate its performance for clinical patient data.

  4. Actualizing Concepts in Home Management: Proceedings of a National Conference.

    ERIC Educational Resources Information Center

    American Home Economics Association, Washington, DC.

    The booklet prints the following papers delivered at a national conference: Actualizing Concepts in Home Management: Decision Making, Dorothy Z. Price; Innovations in Teaching: Ergonomics, Fern E. Hunt; Relevant Concepts of Home Management: Innovations in Teaching, Kay P. Edwards; Standards in a Managerial Context, Florence S. Walker; Organizing:…

  5. Assessment of MLC tracking performance during hypofractionated prostate radiotherapy using real-time dose reconstruction.

    PubMed

    Fast, M F; Kamerling, C P; Ziegenhein, P; Menten, M J; Bedford, J L; Nill, S; Oelfke, U

    2016-02-21

    By adapting to the actual patient anatomy during treatment, tracked multi-leaf collimator (MLC) treatment deliveries offer an opportunity for margin reduction and healthy tissue sparing. This is assumed to be especially relevant for hypofractionated protocols in which intrafractional motion does not easily average out. In order to confidently deliver tracked treatments with potentially reduced margins, it is necessary to monitor not only the patient anatomy but also the actually delivered dose during irradiation. In this study, we present a novel real-time online dose reconstruction tool which calculates actually delivered dose based on pre-calculated dose influence data in less than 10 ms at a rate of 25 Hz. Using this tool we investigate the impact of clinical target volume (CTV) to planning target volume (PTV) margins on CTV coverage and organ-at-risk dose. On our research linear accelerator, a set of four different CTV-to-PTV margins were tested for three patient cases subject to four different motion conditions. Based on this data, we can conclude that tracking eliminates dose cold spots which can occur in the CTV during conventional deliveries even for the smallest CTV-to-PTV margin of 1 mm. Changes of organ-at-risk dose do occur frequently during MLC tracking and are not negligible in some cases. Intrafractional dose reconstruction is expected to become an important element in any attempt of re-planning the treatment plan during the delivery based on the observed anatomy of the day. PMID:26816273

  6. SU-E-J-89: Motion Effects On Organ Dose in Respiratory Gated Stereotactic Body Radiation Therapy

    SciTech Connect

    Wang, T; Zhu, L; Khan, M; Landry, J; Rajpara, R; Hawk, N

    2014-06-01

    Purpose: Existing reports on gated radiation therapy focus mainly on optimizing dose delivery to the target structure. This work investigates the motion effects on radiation dose delivered to organs at risk (OAR) in respiratory gated stereotactic body radiation therapy (SBRT). A new algorithmic tool of dose analysis is developed to evaluate the optimality of gating phase for dose sparing on OARs while ensuring adequate target coverage. Methods: Eight patients with pancreatic cancer were treated on a phase I prospective study employing 4DCT-based SBRT. For each patient, 4DCT scans are acquired and sorted into 10 respiratory phases (inhale-exhale- inhale). Treatment planning is performed on the average CT image. The average CT is spatially registered to other phases. The resultant displacement field is then applied on the plan dose map to estimate the actual dose map for each phase. Dose values of each voxel are fitted to a sinusoidal function. Fitting parameters of dose variation, mean delivered dose and optimal gating phase for each voxel over respiration cycle are mapped on the dose volume. Results: The sinusoidal function accurately models the dose change during respiratory motion (mean fitting error 4.6%). In the eight patients, mean dose variation is 3.3 Gy on OARs with maximum of 13.7 Gy. Two patients have about 100cm{sup 3} volumes covered by more than 5 Gy deviation. The mean delivered dose maps are similar to plan dose with slight deformation. The optimal gating phase highly varies across the patient, with phase 5 or 6 on about 60% of the volume, and phase 0 on most of the rest. Conclusion: A new algorithmic tool is developed to conveniently quantify dose deviation on OARs from plan dose during the respiratory cycle. The proposed software facilitates the treatment planning process by providing the optimal respiratory gating phase for dose sparing on each OAR.

  7. Delivering bad news to patients.

    PubMed

    Monden, Kimberley R; Gentry, Lonnie; Cox, Thomas R

    2016-01-01

    When physicians lack proper training, breaking bad news can lead to negative consequences for patients, families, and physicians. A questionnaire was used to determine whether a didactic program on delivering bad news was needed at our institution. Results revealed that 91% of respondents perceived delivering bad news as a very important skill, but only 40% felt they had the training to effectively deliver such news. We provide a brief review of different approaches to delivering bad news and advocate for training physicians in a comprehensive, structured model.

  8. SU-E-J-141: Activity-Equivalent Path Length Approach for the 3D PET-Based Dose Reconstruction in Proton Therapy

    SciTech Connect

    Attili, A; Vignati, A; Giordanengo, S; Kraan, A; Dalmasso, F; Battistoni, G

    2015-06-15

    Purpose: Ion beam therapy is sensitive to uncertainties from treatment planning and dose delivery. PET imaging of induced positron emitter distributions is a practical approach for in vivo, in situ verification of ion beam treatments. Treatment verification is usually done by comparing measured activity distributions with reference distributions, evaluated in nominal conditions. Although such comparisons give valuable information on treatment quality, a proper clinical evaluation of the treatment ultimately relies on the knowledge of the actual delivered dose. Analytical deconvolution methods relating activity and dose have been studied in this context, but were not clinically applied. In this work we present a feasibility study of an alternative approach for dose reconstruction from activity data, which is based on relating variations in accumulated activity to tissue density variations. Methods: First, reference distributions of dose and activity were calculated from the treatment plan and CT data. Then, the actual measured activity data were cumulatively matched with the reference activity distributions to obtain a set of activity-equivalent path lengths (AEPLs) along the rays of the pencil beams. Finally, these AEPLs were used to deform the original dose distribution, yielding the actual delivered dose. The method was tested by simulating a proton therapy treatment plan delivering 2 Gy on a homogeneous water phantom (the reference), which was compared with the same plan delivered on a phantom containing inhomogeneities. Activity and dose distributions were were calculated by means of the FLUKA Monte Carlo toolkit. Results: The main features of the observed dose distribution in the inhomogeneous situation were reproduced using the AEPL approach. Variations in particle range were reproduced and the positions, where these deviations originated, were properly identified. Conclusions: For a simple inhomogeneous phantom the 3D dose reconstruction from PET

  9. Tracking the dose distribution in radiation therapy by accounting for variable anatomy

    NASA Astrophysics Data System (ADS)

    Schaly, B.; Kempe, J. A.; Bauman, G. S.; Battista, J. J.; Van Dyk, J.

    2004-03-01

    The goal of this research is to calculate the daily and cumulative dose distribution received by the radiotherapy patient while accounting for variable anatomy, by tracking the dose distribution delivered to tissue elements (voxels) that move within the patient. Non-linear image registration techniques (i.e., thin-plate splines) are used along with a conventional treatment planning system to combine the dose distributions computed for each 3D computed tomography (CT) study taken during treatment. For a clinical prostate case, we demonstrate that there are significant localized dose differences due to systematic voxel motion in a single fraction as well as in 15 cumulative fractions. The largest positive dose differences in rectum, bladder and seminal vesicles were 29%, 2% and 24%, respectively, after the first fraction of radiation treatment compared to the planned dose. After 15 cumulative fractions, the largest positive dose differences in rectum, bladder and seminal vesicles were 23%, 32% and 18%, respectively, compared to the planned dose. A sensitivity analysis of control point placement is also presented. This method provides an important understanding of actual delivered doses and has the potential to provide quantitative information to use as a guide for adaptive radiation treatments.

  10. TU-PIS-Exhibit Hall-01: CT Dose Optimization Technologies II

    SciTech Connect

    Driesser, I; Angel, E

    2014-06-15

    Partners in Solutions is an exciting new program in which AAPM partners with our vendors to present practical “hands-on” information about the equipment and software systems that we use in our clinics. The imaging topic this year is CT scanner dose optimization capabilities. Note that the sessions are being held in a special purpose room built on the Exhibit Hall Floor, to encourage further interaction with the vendors. Siemens‘ Commitment to the Right Dose in Computed Tomography Presentation Time: 11:15 - 11:45 AM Providing sustainable clinical results at highest patient safety: This is the challenge in medical imaging. Especially for Computed Tomography this means applying not simply the lowest, but the right dose for sound diagnostic imaging. Consequently, Siemens is committed to deliver the right dose in CT. In order to reduce radiation to the right dose, the first step is to provide the right dose technology. Through decades of research and development in CT imaging, Siemens CT has constantly introduced new ideas leading to a comprehensive portfolio of unique CARE technologies to deliver the right dose. For example automated kV adjustment based on patient size and the clinical question with CARE kV and three generations of iterative reconstruction. Based on the right dose technology, the next step is to actually scan at the right dose. For this, it is key to know the right dose targets for every examination. Siemens continuously involves CT experts to push developments further and outline how users can best adapt their procedures to the right dose. For users to know whether they met the right dose targets, it is therefore important to understand and monitor the actual absolute dose values. All scanners are delivered with defined default protocols which automatically use the available right dose technologies. Finally, to deliver the right dose not just in singular cases, but ideally to patients everywhere, organizations need then to manage dose across

  11. A real time dose monitoring and dose reconstruction tool for patient specific VMAT QA and delivery

    SciTech Connect

    Tyagi, Neelam; Yang Kai; Gersten, David; Yan Di

    2012-12-15

    Purpose: To develop a real time dose monitoring and dose reconstruction tool to identify and quantify sources of errors during patient specific volumetric modulated arc therapy (VMAT) delivery and quality assurance. Methods: The authors develop a VMAT delivery monitor tool called linac data monitor that connects to the linac in clinical mode and records, displays, and compares real time machine parameters with the planned parameters. A new measure, called integral error, keeps a running total of leaf overshoot and undershoot errors in each leaf pair, multiplied by leaf width, and the amount of time during which the error exists in monitor unit delivery. Another tool reconstructs Pinnacle{sup 3} Trade-Mark-Sign format delivered plan based on the saved machine logfile and recalculates actual delivered dose in patient anatomy. Delivery characteristics of various standard fractionation and stereotactic body radiation therapy (SBRT) VMAT plans delivered on Elekta Axesse and Synergy linacs were quantified. Results: The MLC and gantry errors for all the treatment sites were 0.00 {+-} 0.59 mm and 0.05 {+-} 0.31 Degree-Sign , indicating a good MLC gain calibration. Standard fractionation plans had a larger gantry error than SBRT plans due to frequent dose rate changes. On average, the MLC errors were negligible but larger errors of up to 6 mm and 2.5 Degree-Sign were seen when dose rate varied frequently. Large gantry errors occurred during the acceleration and deceleration process, and correlated well with MLC errors (r= 0.858, p= 0.0004). PTV mean, minimum, and maximum dose discrepancies were 0.87 {+-} 0.21%, 0.99 {+-} 0.59%, and 1.18 {+-} 0.52%, respectively. The organs at risk (OAR) doses were within 2.5%, except some OARs that showed up to 5.6% discrepancy in maximum dose. Real time displayed normalized total positive integral error (normalized to the total monitor units) correlated linearly with MLC (r= 0.9279, p < 0.001) and gantry errors (r= 0.742, p= 0.005). There

  12. Linguistic Theory and Actual Language.

    ERIC Educational Resources Information Center

    Segerdahl, Par

    1995-01-01

    Examines Noam Chomsky's (1957) discussion of "grammaticalness" and the role of linguistics in the "correct" way of speaking and writing. It is argued that the concern of linguistics with the tools of grammar has resulted in confusion, with the tools becoming mixed up with the actual language, thereby becoming the central element in a metaphysical…

  13. El Observatorio Gemini - Status actual

    NASA Astrophysics Data System (ADS)

    Levato, H.

    Se hace una breve descripción de la situación actual del Observatorio Gemini y de las últimas decisiones del Board para incrementar la eficiencia operativa. Se hace también una breve referencia al uso argentino del observatorio.

  14. A stochastic approach to estimate the uncertainty of dose mapping caused by uncertainties in b-spline registration

    SciTech Connect

    Hub, Martina; Thieke, Christian; Kessler, Marc L.; Karger, Christian P.

    2012-04-15

    Purpose: In fractionated radiation therapy, image guidance with daily tomographic imaging becomes more and more clinical routine. In principle, this allows for daily computation of the delivered dose and for accumulation of these daily dose distributions to determine the actually delivered total dose to the patient. However, uncertainties in the mapping of the images can translate into errors of the accumulated total dose, depending on the dose gradient. In this work, an approach to estimate the uncertainty of mapping between medical images is proposed that identifies areas bearing a significant risk of inaccurate dose accumulation. Methods: This method accounts for the geometric uncertainty of image registration and the heterogeneity of the dose distribution, which is to be mapped. Its performance is demonstrated in context of dose mapping based on b-spline registration. It is based on evaluation of the sensitivity of dose mapping to variations of the b-spline coefficients combined with evaluation of the sensitivity of the registration metric with respect to the variations of the coefficients. It was evaluated based on patient data that was deformed based on a breathing model, where the ground truth of the deformation, and hence the actual true dose mapping error, is known. Results: The proposed approach has the potential to distinguish areas of the image where dose mapping is likely to be accurate from other areas of the same image, where a larger uncertainty must be expected. Conclusions: An approach to identify areas where dose mapping is likely to be inaccurate was developed and implemented. This method was tested for dose mapping, but it may be applied in context of other mapping tasks as well.

  15. A real-time in vivo dosimetric verification method for high-dose rate intracavitary brachytherapy of nasopharyngeal carcinoma

    SciTech Connect

    Qi Zhenyu; Deng Xiaowu; Cao Xinping; Huang Shaomin; Lerch, Michael; Rosenfeld, Anatoly

    2012-11-15

    Purpose: A real-time in vivo dosimetric verification method using metal-oxide-semiconductor field effect transistor (MOSFET) dosimeters has been developed for patient dosimetry in high-dose rate (HDR) intracavitary brachytherapy of nasopharyngeal carcinoma (NPC). Methods: The necessary calibration and correction factors for MOSFET measurements in {sup 192}Iridium source were determined in a water phantom. With the detector placed inside a custom-made nasopharyngeal applicator, the actual dose delivered to the tumor was measured in vivo and compared to the calculated values using a commercial brachytherapy planning system. Results: Five MOSFETs were independently calibrated with the HDR source, yielding calibration factors of 0.48 {+-} 0.007 cGy/mV. The maximum sensitivity variation was no more than 7% in the clinically relevant distance range of 1-5 cm from the source. A total of 70 in vivo measurements in 11 NPC patients demonstrated good agreement with the treatment planning. The mean differences between the planned and the actually delivered dose within a single treatment fraction were -0.1%{+-} 3.8% and -0.1%{+-} 3.7%, respectively, for right and left side assessments. The maximum dose deviation was less than 8.5%. Conclusions: In vivo measurement using the real-time MOSFET dosimetry system is possible to evaluate the actual dose to the tumor received by the patient during a treatment fraction and thus can offer another line of security to detect and prevent large errors.

  16. Dose Recalculation and the Dose-Guided Radiation Therapy (DGRT) Process Using Megavoltage Cone-Beam CT

    SciTech Connect

    Cheung, Joey Aubry, Jean-Francois; Yom, Sue S.; Gottschalk, Alexander R.; Celi, Juan Carlos; Pouliot, Jean

    2009-06-01

    Purpose: At University of California San Francisco, daily or weekly three-dimensional images of patients in treatment position are acquired for image-guided radiation therapy. These images can be used for calculating the actual dose delivered to the patient during treatment. In this article, we present the process of performing dose recalculation on megavoltage cone-beam computed tomography images and discuss possible strategies for dose-guided radiation therapy (DGRT). Materials and Methods: A dedicated workstation has been developed to incorporate the necessary elements of DGRT. Patient image correction (cupping, missing data artifacts), calibration, completion, recontouring, and dose recalculation are all implemented in the workstation. Tools for dose comparison are also included. Examples of image correction and dose analysis using 6 head-and-neck and 2 prostate patient datasets are presented to show possible tracking of interfraction dosimetric endpoint variation over the course of treatment. Results: Analysis of the head-and-neck datasets shows that interfraction treatment doses vary compared with the planning dose for the organs at risk, with the mean parotid dose and spinal cord D{sub 1} increasing by as much as 52% and 10%, respectively. Variation of the coverage to the target volumes was small, with an average D{sub 5} dose difference of 1%. The prostate patient datasets revealed accurate dose coverage to the targeted prostate and varying interfraction dose distributions to the organs at risk. Conclusions: An effective workflow for the clinical implementation of DGRT has been established. With these techniques in place, future clinical developments in adaptive radiation therapy through daily or weekly dosimetric measurements of treatment day images are possible.

  17. Investigation of pulsed low dose rate radiotherapy using dynamic arc delivery techniques

    NASA Astrophysics Data System (ADS)

    Ma, C.-M.; Lin, M. H.; Dai, X. F.; Koren, Sion; Klayton, T.; Wang, L.; Li, J. S.; Chen, L.; Price, R. A.

    2012-07-01

    There has been no consensus standard of care to treat recurrent cancer patients who have previously been irradiated. Pulsed low dose rate (PLDR) external beam radiotherapy has the potential to reduce normal tissue toxicities while still providing significant tumor control for recurrent cancers. This work investigates the dosimetry feasibility of PLDR treatment using dynamic arc delivery techniques. Five treatment sites were investigated in this study including breast, pancreas, prostate, head and neck, and lung. Dynamic arc plans were generated using the Varian Eclipse system and the RapidArc delivery technique with 6 and 10 MV photon beams. Each RapidArc plan consisted of two full arcs and the plan was delivered five times to achieve a daily dose of 200 cGy. The dosimetry requirement was to deliver approximately 20 cGy/arc with a 3 min interval to achieve an effective dose rate of 6.7 cGy min-1. Monte Carlo simulations were performed to calculate the actual dose delivered to the planning target volume (PTV) per arc taking into account beam attenuation/scattering and intensity modulation. The maximum, minimum and mean doses to the PTV were analyzed together with the dose volume histograms and isodose distributions. The dose delivery for the five plans was validated using solid water phantoms inserted with an ionization chamber and film, and a cylindrical detector array. Two intensity-modulated arcs were used to efficiently deliver the PLDR plans that provided conformal dose distributions for treating complex recurrent cancers. For the five treatment sites, the mean PTV dose ranged from 18.9 to 22.6 cGy/arc. For breast, the minimum and maximum PTV dose was 8.3 and 35.2 cGy/arc, respectively. The PTV dose varied between 12.9 and 27.5 cGy/arc for pancreas, 12.6 and 28.3 cGy/arc for prostate, 12.1 and 30.4 cGy/arc for H&N, and 16.2 and 27.6 cGy/arc for lung. Advanced radiation therapy can provide superior target coverage and normal tissue sparing for PLDR

  18. How People Actually Use Thermostats

    SciTech Connect

    Meier, Alan; Aragon, Cecilia; Hurwitz, Becky; Mujumdar, Dhawal; Peffer, Therese; Perry, Daniel; Pritoni, Marco

    2010-08-15

    Residential thermostats have been a key element in controlling heating and cooling systems for over sixty years. However, today's modern programmable thermostats (PTs) are complicated and difficult for users to understand, leading to errors in operation and wasted energy. Four separate tests of usability were conducted in preparation for a larger study. These tests included personal interviews, an on-line survey, photographing actual thermostat settings, and measurements of ability to accomplish four tasks related to effective use of a PT. The interviews revealed that many occupants used the PT as an on-off switch and most demonstrated little knowledge of how to operate it. The on-line survey found that 89% of the respondents rarely or never used the PT to set a weekday or weekend program. The photographic survey (in low income homes) found that only 30% of the PTs were actually programmed. In the usability test, we found that we could quantify the difference in usability of two PTs as measured in time to accomplish tasks. Users accomplished the tasks in consistently shorter times with the touchscreen unit than with buttons. None of these studies are representative of the entire population of users but, together, they illustrate the importance of improving user interfaces in PTs.

  19. Four-Dimensional Patient Dose Reconstruction for Scanned Ion Beam Therapy of Moving Liver Tumors

    SciTech Connect

    Richter, Daniel; Saito, Nami; Chaudhri, Naved; Härtig, Martin; Ellerbrock, Malte; Jäkel, Oliver; Combs, Stephanie E.; Habermehl, Daniel; Herfarth, Klaus; Durante, Marco; Bert, Christoph

    2014-05-01

    Purpose: Estimation of the actual delivered 4-dimensional (4D) dose in treatments of patients with mobile hepatocellular cancer with scanned carbon ion beam therapy. Methods and Materials: Six patients were treated with 4 fractions to a total relative biological effectiveness (RBE)–weighted dose of 40 Gy (RBE) using a single field. Respiratory motion was addressed by dedicated margins and abdominal compression (5 patients) or gating (1 patient). 4D treatment dose reconstructions based on the treatment records and the measured motion monitoring data were performed for the single-fraction dose and a total of 17 fractions. To assess the impact of uncertainties in the temporal correlation between motion trajectory and beam delivery sequence, 3 dose distributions for varying temporal correlation were calculated per fraction. For 3 patients, the total treatment dose was formed from the fractional distributions using all possible combinations. Clinical target volume (CTV) coverage was analyzed using the volumes receiving at least 95% (V{sub 95}) and 107% (V{sub 107}) of the planned doses. Results: 4D dose reconstruction based on daily measured data is possible in a clinical setting. V{sub 95} and V{sub 107} values for the single fractions ranged between 72% and 100%, and 0% and 32%, respectively. The estimated total treatment dose to the CTV exhibited improved and more robust dose coverage (mean V{sub 95} > 87%, SD < 3%) and overdose (mean V{sub 107} < 4%, SD < 3%) with respect to the single-fraction dose for all analyzed patients. Conclusions: A considerable impact of interplay effects on the single-fraction CTV dose was found for most of the analyzed patients. However, due to the fractionated treatment, dose heterogeneities were substantially reduced for the total treatment dose. 4D treatment dose reconstruction for scanned ion beam therapy is technically feasible and may evolve into a valuable tool for dose assessment.

  20. On-line MR imaging for dose validation of abdominal radiotherapy.

    PubMed

    Glitzner, M; Crijns, S P M; de Senneville, B Denis; Kontaxis, C; Prins, F M; Lagendijk, J J W; Raaymakers, B W

    2015-11-21

    For quality assurance and adaptive radiotherapy, validation of the actual delivered dose is crucial.Intrafractional anatomy changes cannot be captured satisfactorily during treatment with hitherto available imaging modalitites. Consequently, dose calculations are based on the assumption of static anatomy throughout the treatment. However, intra- and interfraction anatomy is dynamic and changes can be significant.In this paper, we investigate the use of an MR-linac as a dose tracking modality for the validation of treatments in abdominal targets where both respiratory and long-term peristaltic and drift motion occur.The on-line MR imaging capability of the modality provides the means to perform respiratory gating of both delivery and acquisition yielding a model-free respiratory motion management under free breathing conditions.In parallel to the treatment, the volumetric patient anatomy was captured and used to calculate the applied dose. Subsequently, the individual doses were warped back to the planning grid to obtain the actual dose accumulated over the entire treatment duration. Ultimately, the planned dose was validated by comparison with the accumulated dose.Representative for a site subject to breathing modulation, two kidney cases (25 Gy target dose) demonstrated the working principle on volunteer data and simulated delivery. The proposed workflow successfully showed its ability to track local dosimetric changes. Integration of the on-line anatomy information could reveal local dose variations  -2.3-1.5 Gy in the target volume of a volunteer dataset. In the adjacent organs at risk, high local dose errors ranging from  -2.5 to 1.9 Gy could be traced back. PMID:26531846

  1. The actual goals of geoethics

    NASA Astrophysics Data System (ADS)

    Nemec, Vaclav

    2014-05-01

    The most actual goals of geoethics have been formulated as results of the International Conference on Geoethics (October 2013) held at the geoethics birth-place Pribram (Czech Republic): In the sphere of education and public enlightenment an appropriate needed minimum know how of Earth sciences should be intensively promoted together with cultivating ethical way of thinking and acting for the sustainable well-being of the society. The actual activities of the Intergovernmental Panel of Climate Changes are not sustainable with the existing knowledge of the Earth sciences (as presented in the results of the 33rd and 34th International Geological Congresses). This knowledge should be incorporated into any further work of the IPCC. In the sphere of legislation in a large international co-operation following steps are needed: - to re-formulate the term of a "false alarm" and its legal consequences, - to demand very consequently the needed evaluation of existing risks, - to solve problems of rights of individuals and minorities in cases of the optimum use of mineral resources and of the optimum protection of the local population against emergency dangers and disasters; common good (well-being) must be considered as the priority when solving ethical dilemmas. The precaution principle should be applied in any decision making process. Earth scientists presenting their expert opinions are not exempted from civil, administrative or even criminal liabilities. Details must be established by national law and jurisprudence. The well known case of the L'Aquila earthquake (2009) should serve as a serious warning because of the proven misuse of geoethics for protecting top Italian seismologists responsible and sentenced for their inadequate superficial behaviour causing lot of human victims. Another recent scandal with the Himalayan fossil fraud will be also documented. A support is needed for any effort to analyze and to disclose the problems of the deformation of the contemporary

  2. Effects of Proton Radiation Dose, Dose Rate and Dose Fractionation on Hematopoietic Cells in Mice

    PubMed Central

    Ware, J. H.; Sanzari, J.; Avery, S.; Sayers, C.; Krigsfeld, G.; Nuth, M.; Wan, X. S.; Rusek, A.; Kennedy, A. R.

    2012-01-01

    The present study evaluated the acute effects of radiation dose, dose rate and fractionation as well as the energy of protons in hematopoietic cells of irradiated mice. The mice were irradiated with a single dose of 51.24 MeV protons at a dose of 2 Gy and a dose rate of 0.05–0.07 Gy/min or 1 GeV protons at doses of 0.1, 0.2, 0.5, 1, 1.5 and 2 Gy delivered in a single dose at dose rates of 0.05 or 0.5 Gy/min or in five daily dose fractions at a dose rate of 0.05 Gy/min. Sham-irradiated animals were used as controls. The results demonstrate a dose-dependent loss of white blood cells (WBCs) and lymphocytes by up to 61% and 72%, respectively, in mice irradiated with protons at doses up to 2 Gy. The results also demonstrate that the dose rate, fractionation pattern and energy of the proton radiation did not have significant effects on WBC and lymphocyte counts in the irradiated animals. These results suggest that the acute effects of proton radiation on WBC and lymphocyte counts are determined mainly by the radiation dose, with very little contribution from the dose rate (over the range of dose rates evaluated), fractionation and energy of the protons. PMID:20726731

  3. Effects of proton radiation dose, dose rate and dose fractionation on hematopoietic cells in mice

    SciTech Connect

    Ware, J.H.; Rusek, A.; Sanzari, J.; Avery, S.; Sayers, C.; Krigsfeld, G.; Nuth, M.; Wan, X.S.; Kennedy, A.R.

    2010-09-01

    The present study evaluated the acute effects of radiation dose, dose rate and fractionation as well as the energy of protons in hematopoietic cells of irradiated mice. The mice were irradiated with a single dose of 51.24 MeV protons at a dose of 2 Gy and a dose rate of 0.05-0.07 Gy/min or 1 GeV protons at doses of 0.1, 0.2, 0.5, 1, 1.5 and 2 Gy delivered in a single dose at dose rates of 0.05 or 0.5 Gy/min or in five daily dose fractions at a dose rate of 0.05 Gy/min. Sham-irradiated animals were used as controls. The results demonstrate a dose-dependent loss of white blood cells (WBCs) and lymphocytes by up to 61% and 72%, respectively, in mice irradiated with protons at doses up to 2 Gy. The results also demonstrate that the dose rate, fractionation pattern and energy of the proton radiation did not have significant effects on WBC and lymphocyte counts in the irradiated animals. These results suggest that the acute effects of proton radiation on WBC and lymphocyte counts are determined mainly by the radiation dose, with very little contribution from the dose rate (over the range of dose rates evaluated), fractionation and energy of the protons.

  4. Evaluation of Drug Concentrations Delivered by Microiontophoresis.

    PubMed

    Kirkpatrick, Douglas C; Wightman, R Mark

    2016-06-21

    Microiontophoresis uses an electric current to eject a drug solution from a glass capillary and is often utilized for targeted delivery in neurochemical investigations. The amount of drug ejected, and its effective concentration at the tip, has historically been difficult to determine, which has precluded its use in quantitative studies. To address this, a method called controlled iontophoresis was developed which employs a carbon-fiber microelectrode incorporated into a multibarreled iontophoretic probe to detect the ejection of electroactive species. Here, we evaluate the accuracy of this method. To do this, we eject different concentrations of quinpirole, a D2 receptor agonist, into a brain slice containing the dorsal striatum, a brain region with a high density of dopamine terminals. Local electrical stimulation was used to evoke dopamine release, and inhibitory actions of quinpirole on this release were examined. The amount of drug ejected was estimated by detection of a coejected electrochemical marker. Dose response curves generated in this manner were compared to curves generated by conventional perfusion of quinpirole through the slice. We find several experimental conditions must be optimized for accurate results. First, selection of a marker with an identical charge was necessary to mimic the ejection of the cationic agonist. Next, evoked responses were more precise following longer periods between the end of the ejection and stimulation. Lastly, the accuracy of concentration evaluations was improved by longer ejections. Incorporation of these factors into existing protocols allows for greater certainty of concentrations delivered by controlled iontophoresis. PMID:27212615

  5. Delivering Science from Big Data

    NASA Astrophysics Data System (ADS)

    Quinn, Peter Joseph

    2015-08-01

    The SKA will be capable of producing a stream of science data products that are Exa-scale in terms of their storage and processing requirements. This Google-scale enterprise is attracting considerable international interest and excitement from within the industrial and academic communities. In this paper we examine the data flow, storage and processing requirements of a number of key SKA survey science projects to be executed on the baseline SKA1 configuration. Based on a set of conservative assumptions about trends for HPC and storage costs, and the data flow process within the SKA Observatory, it is apparent that survey projects of the scale proposed will potentially drive construction and operations costs beyond the current anticipated SKA1 budget. This implies a sharing of the resources and costs to deliver SKA science between the community and what is contained within the SKA Observatory. A similar situation was apparent to the designers of the LHC more than 10 years ago. We propose that it is time for the SKA project and broader community to consider the effort and process needed to design and implement a distributed science data system that leans on the lessons of other projects and looks to recent developments in Cloud technologies to ensure an affordable, effective and global achievement of science goals.

  6. Evaluation of Rectal Dose During High-Dose-Rate Intracavitary Brachytherapy for Cervical Carcinoma

    SciTech Connect

    Sha, Rajib Lochan; Reddy, Palreddy Yadagiri; Rao, Ramakrishna; Muralidhar, Kanaparthy R.; Kudchadker, Rajat J.

    2011-01-01

    High-dose-rate intracavitary brachytherapy (HDR-ICBT) for carcinoma of the uterine cervix often results in high doses being delivered to surrounding organs at risk (OARs) such as the rectum and bladder. Therefore, it is important to accurately determine and closely monitor the dose delivered to these OARs. In this study, we measured the dose delivered to the rectum by intracavitary applications and compared this measured dose to the International Commission on Radiation Units and Measurements rectal reference point dose calculated by the treatment planning system (TPS). To measure the dose, we inserted a miniature (0.1 cm{sup 3}) ionization chamber into the rectum of 86 patients undergoing radiation therapy for cervical carcinoma. The response of the miniature chamber modified by 3 thin lead marker rings for identification purposes during imaging was also characterized. The difference between the TPS-calculated maximum dose and the measured dose was <5% in 52 patients, 5-10% in 26 patients, and 10-14% in 8 patients. The TPS-calculated maximum dose was typically higher than the measured dose. Our study indicates that it is possible to measure the rectal dose for cervical carcinoma patients undergoing HDR-ICBT. We also conclude that the dose delivered to the rectum can be reasonably predicted by the TPS-calculated dose.

  7. Dose rate mapping of VMAT treatments

    NASA Astrophysics Data System (ADS)

    Podesta, Mark; Antoniu Popescu, I.; Verhaegen, Frank

    2016-06-01

    Human tissues exhibit a varying response to radiation dose depending on the dose rate and fractionation scheme used. Dose rate effects have been reported for different radiations, and tissue types. The literature indicates that there is not a significant difference in response for low-LET radiation when using dose rates between 1 Gy min‑1 and 12 Gy min‑1 but lower dose rates have an observable sparing effect on tissues and a differential effect between tissues. In intensity-modulated radiotherapy such as volumetric modulated arc therapy (VMAT) the dose can be delivered with a wide range of dose rates. In this work we developed a method based on time-resolved Monte Carlo simulations to quantify the dose rate frequency distribution for clinical VMAT treatments for three cancer sites, head and neck, lung, and pelvis within both planning target volumes (PTV) and normal tissues. The results show a wide range of dose rates are used to deliver dose in VMAT and up to 75% of the PTV can have its dose delivered with dose rates  <1 Gy min‑1. Pelvic plans on average have a lower mean dose rate within the PTV than lung or head and neck plans but a comparable mean dose rate within the organs at risk. Two VMAT plans that fulfil the same dose objectives and constraints may be delivered with different dose rate distributions, particularly when comparing single arcs to multiple arc plans. It is concluded that for dynamic plans, the dose rate range used varies to a larger degree than previously assumed. The effect of the dose rate range in VMAT on clinical outcome is unknown.

  8. Dose rate mapping of VMAT treatments

    NASA Astrophysics Data System (ADS)

    Podesta, Mark; Antoniu Popescu, I.; Verhaegen, Frank

    2016-06-01

    Human tissues exhibit a varying response to radiation dose depending on the dose rate and fractionation scheme used. Dose rate effects have been reported for different radiations, and tissue types. The literature indicates that there is not a significant difference in response for low-LET radiation when using dose rates between 1 Gy min-1 and 12 Gy min-1 but lower dose rates have an observable sparing effect on tissues and a differential effect between tissues. In intensity-modulated radiotherapy such as volumetric modulated arc therapy (VMAT) the dose can be delivered with a wide range of dose rates. In this work we developed a method based on time-resolved Monte Carlo simulations to quantify the dose rate frequency distribution for clinical VMAT treatments for three cancer sites, head and neck, lung, and pelvis within both planning target volumes (PTV) and normal tissues. The results show a wide range of dose rates are used to deliver dose in VMAT and up to 75% of the PTV can have its dose delivered with dose rates  <1 Gy min-1. Pelvic plans on average have a lower mean dose rate within the PTV than lung or head and neck plans but a comparable mean dose rate within the organs at risk. Two VMAT plans that fulfil the same dose objectives and constraints may be delivered with different dose rate distributions, particularly when comparing single arcs to multiple arc plans. It is concluded that for dynamic plans, the dose rate range used varies to a larger degree than previously assumed. The effect of the dose rate range in VMAT on clinical outcome is unknown.

  9. Dose rate mapping of VMAT treatments.

    PubMed

    Podesta, Mark; Popescu, I Antoniu; Verhaegen, Frank

    2016-06-01

    Human tissues exhibit a varying response to radiation dose depending on the dose rate and fractionation scheme used. Dose rate effects have been reported for different radiations, and tissue types. The literature indicates that there is not a significant difference in response for low-LET radiation when using dose rates between 1 Gy min(-1) and 12 Gy min(-1) but lower dose rates have an observable sparing effect on tissues and a differential effect between tissues. In intensity-modulated radiotherapy such as volumetric modulated arc therapy (VMAT) the dose can be delivered with a wide range of dose rates. In this work we developed a method based on time-resolved Monte Carlo simulations to quantify the dose rate frequency distribution for clinical VMAT treatments for three cancer sites, head and neck, lung, and pelvis within both planning target volumes (PTV) and normal tissues. The results show a wide range of dose rates are used to deliver dose in VMAT and up to 75% of the PTV can have its dose delivered with dose rates  <1 Gy min(-1). Pelvic plans on average have a lower mean dose rate within the PTV than lung or head and neck plans but a comparable mean dose rate within the organs at risk. Two VMAT plans that fulfil the same dose objectives and constraints may be delivered with different dose rate distributions, particularly when comparing single arcs to multiple arc plans. It is concluded that for dynamic plans, the dose rate range used varies to a larger degree than previously assumed. The effect of the dose rate range in VMAT on clinical outcome is unknown.

  10. Helping oxytocin deliver: considerations in the development of oxytocin-based therapeutics for brain disorders.

    PubMed

    Macdonald, K; Feifel, D

    2013-01-01

    Concerns regarding a drought in psychopharmacology have risen from many quarters. From one perspective, the wellspring of bedrock medications for anxiety disorders, depression, and schizophrenia was serendipitously discovered over 30 year ago, the swell of pharmaceutical investment in drug discovery has receded, and the pipeline's flow of medications with unique mechanisms of action (i.e., glutamatergic agents, CRF antagonists) has slowed to a trickle. Might oxytocin (OT)-based therapeutics be an oasis? Though a large basic science literature and a slowly increasing number of studies in human diseases support this hope, the bulk of extant OT studies in humans are single-dose studies on normals, and do not directly relate to improvements in human brain-based diseases. Instead, these studies have left us with a field pregnant with therapeutic possibilities, but barren of definitive treatments. In this clinically oriented review, we discuss the extant OT literature with an eye toward helping OT deliver on its promise as a therapeutic agent. To this end, we identify 10 key questions that we believe future OT research should address. From this overview, several conclusions are clear: (1) the OT system represents an extremely promising target for novel CNS drug development; (2) there is a pressing need for rigorous, randomized controlled clinical trials targeting actual patients; and (3) in order to inform the design and execution of these vital trials, we need further translational studies addressing the questions posed in this review. Looking forward, we extend a cautious hope that the next decade of OT research will birth OT-targeted treatments that can truly deliver on this system's therapeutic potential.

  11. Helping oxytocin deliver: considerations in the development of oxytocin-based therapeutics for brain disorders

    PubMed Central

    MacDonald, K.; Feifel, D.

    2013-01-01

    Concerns regarding a drought in psychopharmacology have risen from many quarters. From one perspective, the wellspring of bedrock medications for anxiety disorders, depression, and schizophrenia was serendipitously discovered over 30 year ago, the swell of pharmaceutical investment in drug discovery has receded, and the pipeline's flow of medications with unique mechanisms of action (i.e., glutamatergic agents, CRF antagonists) has slowed to a trickle. Might oxytocin (OT)-based therapeutics be an oasis? Though a large basic science literature and a slowly increasing number of studies in human diseases support this hope, the bulk of extant OT studies in humans are single-dose studies on normals, and do not directly relate to improvements in human brain-based diseases. Instead, these studies have left us with a field pregnant with therapeutic possibilities, but barren of definitive treatments. In this clinically oriented review, we discuss the extant OT literature with an eye toward helping OT deliver on its promise as a therapeutic agent. To this end, we identify 10 key questions that we believe future OT research should address. From this overview, several conclusions are clear: (1) the OT system represents an extremely promising target for novel CNS drug development; (2) there is a pressing need for rigorous, randomized controlled clinical trials targeting actual patients; and (3) in order to inform the design and execution of these vital trials, we need further translational studies addressing the questions posed in this review. Looking forward, we extend a cautious hope that the next decade of OT research will birth OT-targeted treatments that can truly deliver on this system's therapeutic potential. PMID:23508240

  12. Implementation examined in a health center-delivered, educational intervention that improved infant growth in Trujillo, Peru: successes and challenges.

    PubMed

    Robert, Rebecca C; Gittelsohn, Joel; Creed-Kanashiro, Hilary M; Penny, Mary E; Caulfield, Laura E; Narro, M Rocio; Steckler, Allan; Black, Robert E

    2007-06-01

    Process evaluation was used to examine the implementation of a randomized, controlled trial of an education intervention that improved infant growth in Trujillo, Peru. Health personnel delivered the multi-component intervention as part of usual care in the government health centers. Quantitative and qualitative methods were used to examine process indicators, which included the extent of delivery (dose), fidelity to intervention protocol, barriers to implementation and context. Results demonstrated that most intervention components were delivered at a level of 50-90% of expectations. Fidelity to intervention protocol, where measured, was lower (28-70% of expectations). However, when compared with existing nutrition education, as represented by the control centers, significant improvements were demonstrated. This included both improved delivery of existing educational activities as well as delivery of new intervention components to strengthen overall nutrition education. Barriers to, and facilitators of, implementation were explored with health personnel and helped to explain results. This study demonstrates the importance of examining actual versus planned implementation in order to improve our understanding of how interventions succeed. The information gained from this study will inform future evaluation designs, and lead to the development and implementation of more effective intervention programs for child health.

  13. Actual and Prescribed Energy and Protein Intakes for Very Low Birth Weight Infants: An Observational Study

    ERIC Educational Resources Information Center

    Abel, Deborah Marie

    2012-01-01

    Objectives: To determine (1) whether prescribed and delivered energy and protein intakes during the first two weeks of life met Ziegler's estimated requirements for Very Low Birth Weight (VLBW) infants, (2) if actual energy during the first week of life correlated with time to regain birth weight and reach full enteral nutrition (EN) defined as…

  14. Delineating intracellular pharmacokinetics of paclitaxel delivered by PLGA nanoparticles.

    PubMed

    Li, Mingguang; Czyszczon, Emilia Anna; Reineke, Joshua James

    2013-12-01

    Although many studies have shown that drug delivery and efficacy can be improved by nano-sized drug carriers, we understand little regarding their pharmacokinetics (PK). PK calculations for drugs delivered by carriers are more complex than those for drug-only solutions. The overall PK depends on many factors, including drug-release rate and the PK of both the drug itself and the carrier. We built a mathematical model to describe the intracellular PK of paclitaxel delivered by nanoparticles. Paclitaxel was incorporated into poly (lactic-co-glycolic acid) nanoparticles, which were chemically labeled with a fluorescence probe for quantification. PK profiles of drug alone, nanoparticles alone, and drug delivered by nanoparticles were studied in human breast cancer MCF7 cells. Simulated results from the model were similar to observed data, indicating that the model was properly developed. The model clearly and quantitatively represented the effects of relative factors, such as drug dose, drug-release kinetics, and nanoparticle PK, on the PK of paclitaxel delivered by nanoparticles. We also used this model to estimate the intracellular drug-release rate, which was found to be slightly slower than the in vitro release rate in this study. This mathematical model could be used to provide guidelines to design, evaluate, and optimize nano-sized drug carriers. PMID:25786375

  15. Parotid Gland Dose in Intensity-Modulated Radiotherapy for Head and Neck Cancer: Is What You Plan What You Get?

    SciTech Connect

    O'Daniel, Jennifer C.; Garden, Adam S.; Schwartz, David L.; Wang He; Ang, Kian K.; Ahamad, Anesa; Rosenthal, David I.; Morrison, William H.; Asper, Joshua A.; Zhang Lifei; Tung Shihming; Mohan, Radhe; Dong Lei

    2007-11-15

    Purpose: To quantify the differences between planned and delivered parotid gland and target doses, and to assess the benefits of daily bone alignment for head and neck cancer patients treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Eleven head and neck cancer patients received two CT scans per week with an in-room CT scanner over the course of their radiotherapy. The clinical IMRT plans, designed with 3-mm to 4-mm planning margins, were recalculated on the repeat CT images. The plans were aligned using the actual treatment isocenter marked with radiopaque markers (BB) and bone alignment to the cervical vertebrae to simulate image-guided setup. In-house deformable image registration software was used to map daily dose distributions to the original treatment plan and to calculate a cumulative delivered dose distribution for each patient. Results: Using conventional BB alignment led to increases in the parotid gland mean dose above the planned dose by 5 to 7 Gy in 45% of the patients (median, 3.0 Gy ipsilateral, p = 0.026; median, 1.0 Gy contralateral, p = 0.016). Use of bone alignment led to reductions relative to BB alignment in 91% of patients (median, 2 Gy; range, 0.3-8.3 Gy; 15 of 22 parotids improved). However, the parotid dose from bone alignment was still greater than planned (median, 1.0 Gy, p = 0.007). Neither approach affected tumor dose coverage. Conclusions: With conventional BB alignment, the parotid gland mean dose was significantly increased above the planned mean dose. Using daily bone alignment reduced the parotid dose compared with BB alignment in almost all patients. A 3- to 4-mm planning margin was adequate for tumor dose coverage.

  16. SU-E-J-269: Assessing the Precision of Dose Delivery in CBCT-Guided Stereotactic Body Radiation Therapy for Lung and Soft Tissue Metastatic Lesions

    SciTech Connect

    Parsai, S; Dalhart, A; Chen, C; Parsai, E; Pearson, D; Sperling, N; Reddy, K

    2014-06-01

    Purpose: Ensuring reproducibility of target localization is critical to accurate stereotactic body radiation treatment (SBRT) for lung and soft tissue metastatic lesions. To characterize interfraction variability in set-up and evaluate PTV margins utilized for SBRT, daily CBCTs were used to calculate delivered target and OAR doses compared to those expected from planning. Methods: CBCT images obtained prior to each fraction of SBRT for a lung and thyroid metastatic lesion were evaluated. The target CTV/ITV and OARs on each of 8 CBCT data sets were contoured. Using MIM fusion software and Pinnacle{sup 3} RTP system, delivered dose distribution was reconstructed on each CBCT, utilizing translational shifts performed prior to treatment. Actual delivered vs. expected doses received by target CTV/ITV and adjacent critical structures were compared to characterize accuracy of pre-treatment translational shifts and PTV margins. Results: The planned CTV/ITV D95% and V100% were 4595cGy and 91.47% for the lung lesion, and 3010cGy and 96.34% for the thyroid lesion. Based on CBCT analysis, actual mean D95% and V100% for lung ITV were 4542±344.4cGy and 91.54±3.45%; actual mean D95% and V100% for thyroid metastasis CTV were 3005±25.98cGy and 95.20±2.522%. For the lung lesion, ipsilateral lung V20, heart V32 (cc) and spinal cord (.03 cc) max were 110.15cc, 3.33cc, and 1680cGy vs. 110.27±14.79cc, 6.74±3.76cc, and 1711±46.56cGy for planned vs. delivered doses, respectively. For the thyroid metastatic lesion, esophagus V18, trachea (.03 cc) max, and spinal cord (.03 cc) max were 0.35cc, 2555cGy, and 850cGy vs. 0.16±0.13cc, 2147±367cGy, and 838±45cGy for planned vs. delivered treatments, respectively. Conclusion: Minimal variability in SBRT target lesion dose delivered based on pre-treatment CBCT-based translational shifts suggests tighter PTV margins may be considered to further decrease dose to surrounding critical structures. Guidelines for optimal target alignment during

  17. Non-uniform dose distributions in cranial radiation therapy

    NASA Astrophysics Data System (ADS)

    Bender, Edward T.

    Radiation treatments are often delivered to patients with brain metastases. For those patients who receive radiation to the entire brain, there is a risk of long-term neuro-cognitive side effects, which may be due to damage to the hippocampus. In clinical MRI and CT scans it can be difficult to identify the hippocampus, but once identified it can be partially spared from radiation dose. Using deformable image registration we demonstrate a semi-automatic technique for obtaining an estimated location of this structure in a clinical MRI or CT scan. Deformable image registration is a useful tool in other areas such as adaptive radiotherapy, where the radiation oncology team monitors patients during the course of treatment and adjusts the radiation treatments if necessary when the patient anatomy changes. Deformable image registration is used in this setting, but there is a considerable level of uncertainty. This work represents one of many possible approaches at investigating the nature of these uncertainties utilizing consistency metrics. We will show that metrics such as the inverse consistency error correlate with actual registration uncertainties. Specifically relating to brain metastases, this work investigates where in the brain metastases are likely to form, and how the primary cancer site is related. We will show that the cerebellum is at high risk for metastases and that non-uniform dose distributions may be advantageous when delivering prophylactic cranial irradiation for patients with small cell lung cancer in complete remission.

  18. Delivering Online Examinations: A Case Study

    ERIC Educational Resources Information Center

    Howarth, Jason; Messing, John; Altas, Irfan

    2004-01-01

    This paper represents a brief case study of delivering online examinations to a worldwide audience. These examinations are delivered in partnership with a commercial online testing company as part of the Industry Master's degree at Charles Sturt University (CSU). The Industry Master's degree is an academic program for students currently employed…

  19. 12 CFR 332.9 - Delivering privacy and opt out notices.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... GENERAL POLICY PRIVACY OF CONSUMER FINANCIAL INFORMATION Privacy and Opt Out Notices § 332.9 Delivering... not, however, reasonably expect that a consumer will receive actual notice of your privacy policies... advertisements of your privacy policies and practices; or (ii) Send the notice via electronic mail to a...

  20. SU-E-J-97: Pretreatment Test and Post-Treatment Evaluation for Iso-NTCP Dose Guided Adapive Radiotherapy (DGART), Experience with Prostate Cancer Patients Treated with Rectal Balloons

    SciTech Connect

    Yu, J; Hardcastle, N; Bender, E; Jeong, K; Tome', M

    2014-06-01

    Purpose: To explore the feasibility of pretreatment test for iso-NTCP DGART and to compare the pretreatment test results with post-treatment evaluations. Methods: NTCP here refers to late rectal wall toxicity only and is calculated with the ring rectal wall DVH. Simulation for one time iso- NTCP DGART starts after half of the total dose was done for 10 patients to investigate if TCP gains could be achieved. Six patients were treated using a 12-fraction 4.3Gy technique and four using 16-fraction 3.63Gy technique. For each of the 12-fraction cases a VMAT plan was generated in Pinnacle3™ using the daily CT obtained prior to the 6th fraction. A pretreatment simulation was performed using only the first 6 daily CTs. The idea is to add the 6 original plan delivered doses with 6 DGART plan delivered doses by deformable dose accumulation (DDA) on each of the first 6 CTs, resulting in 6 rectal wall doses (RWDs) and NTCPs. The 95% confidence interval (95%CI) for the 6 NTCPs were computed.The posttreatment evaluation was done by: a) copy the DGART plan to 6 CTs for fraction 7–12 and calculate the 6 actual DGART delivered fractional doses; b) sum the 6 actual DGART doses with the 6 original plan delivered doses by DDA on each of the 12 CTs resulting in 12 post-treatment RWDs and NTCPs; c) boxplot the 12 post-treatment NTCPs. Results: Target dose gain is 0.76–1.93 Gy. The 95%CI widths of the pretreatment tests NTCPs were 1.1–2.7%. For 5 patients, the planned NTCP fell within the 95%CI. For 4 patients, the planned NTCP was lower than the 95%CI lines. Post-treatment results show that for 7 patients, the upper quartile was within the 95%CI; for 2 patients, the upper quartile were higher than the 95%CI. Conclusion: The pretreatment test yields conservative prediction of the actual delivered NTCP.

  1. Delivering non-hormonal contraceptives to men: advances and obstacles

    PubMed Central

    Mruk, Dolores D.; Cheng, C. Yan

    2014-01-01

    There have been major advances in male contraceptive research during the past two decades. However, for a contraceptive to be used by men, its safety requires more stringent scrutiny than therapeutic compounds for treatment of illnesses because the contraceptives will be used by healthy individuals for an extended period of time, perhaps decades. A wide margin is therefore required between the effective dose range and doses that cause toxicity. It might be preferable that a male contraceptive, in particular a non-hormone-based compound, is delivered specifically and/or directly to the testis and has a rapid metabolic clearance rate, reducing the length of exposure in the liver and kidney. In this article, we highlight the latest developments regarding contraceptive delivery to men and with the aim of providing useful information for investigators in future studies. PMID:18191256

  2. Self-Actualization, Liberalism, and Humanistic Education.

    ERIC Educational Resources Information Center

    Porter, Charles Mack

    1979-01-01

    The relationship between personality factors and political orientation has long been of interest to psychologists. This study tests the hypothesis that there is no significant relationship between self-actualization and liberalism-conservatism. The hypothesis is supported. (Author)

  3. Drones Could Deliver Vaccines in Developing Countries

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_159549.html Drones Could Deliver Vaccines in Developing Countries Machines might ... Right now, people often associate the use of drones with warfare. But in the future they could ...

  4. Dose mapping of the rectal wall during brachytherapy with an array of scintillation dosimeters

    SciTech Connect

    Cartwright, L. E.; Suchowerska, N.; Yin, Y.; Lambert, J.; Haque, M.; McKenzie, D. R.

    2010-05-15

    Purpose: In pelvic brachytherapy treatments, the rectum is an organ at risk. The authors have developed an array of scintillation dosimeters suitable for in vivo use that enables quality assurance of the treatment delivery and provides an alert to potential radiation accidents. Ultimately, this will provide evidence to direct treatment planning and dose escalation and correlate dose with the rectal response. Methods: An array of 16 scintillation dosimeters in an insertable applicator has been developed. The dosimeters were calibrated simultaneously in a custom designed circular jig before use. Each dosimeter is optically interfaced to a set of pixels on a CCD camera located outside the treatment bunker. A customized software converts pixel values into dose rate and accumulates dose for presentation during treatment delivery. The performance of the array is tested by simulating brachytherapy treatments in a water phantom. The treatment plans were designed to deliver a known dose distribution on the surface of the rectal applicator, assumed to represent the dose to the rectal wall. Results: The measured doses were compared to those predicted by the treatment plan and found to be in agreement to within the uncertainty in measurement, usually within 3%. The array was also used to track the progression of the source as it moved along the catheter. The measured position was found to agree with the position reported by the afterloader to within the measurement uncertainty, usually within 2 mm. Conclusions: This array is capable of measuring the actual dose received by each region of the rectal wall during brachytherapy treatments. It will provide real time monitoring of treatment delivery and raise an alert to a potential radiation accident. Real time dose mapping in the clinical environment will give the clinician additional confidence to carry out dose escalation to the tumor volume while avoiding rectal side effects.

  5. Determination of gonad doses during robotic stereotactic radiosurgery for various tumor sites

    SciTech Connect

    Zorlu, Faruk; Dugel, Gozde; Ozyigit, Gokhan; Hurmuz, Pervin; Cengiz, Mustafa; Yildiz, Ferah; Akyol, Fadil; Gurkaynak, Murat

    2013-04-15

    Purpose: The authors evaluated the absorbed dose received by the gonads during robotic stereotactic radiosurgery (SRS) for the treatment of different tumor localizations. Methods: The authors measured the gonad doses during the treatment of head and neck, thoracic, abdominal, or pelvic tumors in both RANDO phantom and actual patients. The computerized tomography images were transferred to the treatment planning system. The contours of tumor and critical organs were delineated on each slice, and treatment plans were generated. Measurements for gonad doses were taken from the geometric projection of the ovary onto the skin for female patients, and from the scrotal skin for male patients by attaching films and Thermoluminescent dosimeters (TLDs). SRS was delivered with CyberKnife (Accuray Inc., Sunnyvale, CA). Results: The median gonadal doses with TLD and film dosimeter in actual patients were 0.19 Gy (range, 0.035-2.71 Gy) and 0.34 Gy (range, 0.066-3.18 Gy), respectively. In the RANDO phantom, the median ovarian doses with TLD and film dosimeter were 0.08 Gy (range, 0.03-0.159 Gy) and 0.05 Gy (range, 0.015-0.13 Gy), respectively. In the RANDO phantom, the median testicular doses with TLD and film dosimeter were 0.134 Gy (range 0.056-1.97 Gy) and 0.306 Gy (range, 0.065-2.25 Gy). Conclusions: Gonad doses are below sterility threshold in robotic SRS for different tumor localizations. However, particular attention should be given to gonads during robotic SRS for pelvic tumors.

  6. Validation of modulated electron radiotherapy delivered with photon multileaf collimation

    NASA Astrophysics Data System (ADS)

    Klein, Eric E.

    There is a challenge in radiotherapy to treat shallow targets due to the inability to provide dose heterogeneity while simultaneously minimizing dose to distal critical organs. There is a niche for Modulated Electron Radiotherapy (MERT) to complement a photon IMRT program. Disease sites such as post-mastectomy chest wall, and subcutaneous lymphoma of the scalp, etc. are better suited for modulated electrons rather than photons, or perhaps a combination. Inherent collimation systems are not conducive for electron beam delivery (in lieu of extended applicators), nor do commercial treatment planning systems model electrons collimated without applicators. The purpose of this study is to evaluate modulation of electrons by inherent photon multileaf collimators, and calculated and optimized by means of Monte Carlo. Modulated electron radiotherapy (MERT) evaluation was conducted with a Trilogy 120 leaf MLC for 6-20 MeV. To provide a sharp penumbra, modulated beams were delivered with short SSDs (70-85cm). Segment widths (SW) ranging from 1 to 10cm were configured for delivery and planning, using BEAMnrc MC code with 109 particles, and DOSXYZnrc calculations. Calculations were set with: voxel size 0.2 x 0.2 x 0.1cm3, and photon/electron transport energy cutoffs of 0.01 MeV/0.521 MeV. Dosimetry was performed with film and micro chambers. Calculated and measured data were analyzed in MatLab. Once validation of static fields was successfully completed, modulated portals (segmented and dynamic) were configured for treatment and calculations. Optimization for target coverage and OAR sparing was achieved by choosing energies according to target depth, and SW according to spatial coverage. Intensity for each segment was optimized by MC methods. Beam sharpness (penumbra) degraded with: decreasing energy and SW, and increasing SSD. PDD decreased significantly with decreasing SW. We have demonstrated excellent calculation/measurement agreement (<3mm). Equal dose profiles were

  7. Realizing actual feedback control of complex network

    NASA Astrophysics Data System (ADS)

    Tu, Chengyi; Cheng, Yuhua

    2014-06-01

    In this paper, we present the concept of feedbackability and how to identify the Minimum Feedbackability Set of an arbitrary complex directed network. Furthermore, we design an estimator and a feedback controller accessing one MFS to realize actual feedback control, i.e. control the system to our desired state according to the estimated system internal state from the output of estimator. Last but not least, we perform numerical simulations of a small linear time-invariant dynamics network and a real simple food network to verify the theoretical results. The framework presented here could make an arbitrary complex directed network realize actual feedback control and deepen our understanding of complex systems.

  8. Mean dose to lymphocytes during radiotherapy treatments

    SciTech Connect

    Brandan, M.E.; Perez-Pastenes, M.A.; Ostrosky-Wegman, P.; Gonsebatt, M.E.; Diaz-Perches, R.

    1994-10-01

    Using a probabilistic model with parameters from four radiotherapy protocols used in Mexican hospitals for the treatment of cervical cancer, the authors have calculated the distribution of dose to cells in peripheral blood of patients. Values of the mean dose to the lymphocytes during and after a {sup 60}Co treatment are compared to estimates from an in vivo chromosome aberration study performed on five patients. Calculations indicate that the mean dose to the circulating blood is about 2% of the tumor dose, while the mean dose to recirculating lymphocytes may reach up to 7% of the tumor dose. Differences up to a factor of two in the dose to the blood are predicted for different protocols delivering equal tumor doses. The data suggest mean doses higher than the predictions of the model. 10 refs., 3 figs., 2 tabs.

  9. EPID-guided 3D dose verification of lung SBRT

    SciTech Connect

    Aristophanous, M.; Rottmann, J.; Court, L. E.; Berbeco, R. I.

    2011-01-15

    Purpose: To investigate the feasibility of utilizing tumor tracks from electronic portal imaging device (EPID) images taken during treatment to verify the delivered dose. Methods: The proposed method is based on a computation of the delivered fluence by utilizing the planned fluence and the tumor motion track for each field. A phantom study was designed to assess the feasibility of the method. The CIRS dynamic thorax phantom was utilized with a realistic soft resin tumor, modeled after a real patient tumor. The dose calculated with the proposed method was compared to direct measurements taken with 15 metal oxide semiconductor field effect transistors (MOSFETs) inserted in small fissures made in the tumor model. The phantom was irradiated with the tumor static and moved with different range of motions and setup errors. EPID images were recorded throughout all deliveries and the tumor model was tracked post-treatment with in-house developed software. The planned fluence for each field was convolved with the tumor motion tracks to obtain the delivered fluence. Utilizing the delivered fluence from each field, the delivered dose was calculated. The estimated delivered dose was compared to the dose directly measured with the MOSFETs. The feasibility of the proposed method was also demonstrated on a real lung cancer patient, treated with stereotactic body radiotherapy. Results: The calculation of delivered dose with the delivered fluence method was in good agreement with the MOSFET measurements, with average differences ranging from 0.8% to 8.3% depending on the proximity of a dose gradient. For the patient treatment, the planned and delivered dose volume histograms were compared and verified the overall good coverage of the target volume. Conclusions: The delivered fluence method was applied successfully on phantom and clinical data and its accuracy was evaluated. Verifying each treatment fraction may enable correction strategies that can be applied during the course of

  10. SU-E-T-422: Correlation Between 2D Passing Rates and 3D Dose Differences for Pretreatment VMAT QA

    SciTech Connect

    Jin, X; Xie, C

    2014-06-01

    Purpose: Volumetric modulated arc therapy (VMAT) quality assurance (QA) is typically using QA methods and action levels taken from fixedbeam intensity-modulated radiotherapy (IMRT) QA methods. However, recent studies demonstrated that there is no correlation between the percent gamma passing rate (%GP) and the magnitude of dose discrepancy between the planned dose and the actual delivered dose for IMRT. The purpose of this study is to investigate whether %GP is correlated with clinical dosimetric difference for VMAT. Methods: Twenty nasopharyngeal cancer (NPC) patients treated with dual-arc simultaneous integrated boost VMAT and 20 esophageal cancer patients treated with one-arc VMAT were enrolled in this study. Pretreatment VMAT QA was performed by a 3D diode array ArcCheck. Acceptance criteria of 2%/2mm, 3%/3mm, and 4%/4mm were applied for 2D %GP. Dose values below 10% of the per-measured normalization maximum dose were ignored.Mean DVH values obtained from 3DVH software and TPS were calculated and percentage dose differences were calculated. Statistical correlation between %GP and percent dose difference was studied by using Pearson correlation. Results: The %GP for criteria 2%/2mm, 3%/3mm, and 4%/4mm were 82.33±4.45, 93.47±2.31, 97.13±2.41, respectively. Dose differences calculated from 3DVH and TPS for beam isocenter, mean dose of PTV, maximum dose of PTV, D2 of PTV and D98 of PTV were -1.04±3.24, -0.74±1.71, 2.92±3.62, 0.89±3.29, -1.46±1.97, respectively. No correction were found between %GP and dose differences. Conclusion: There are weak correlations between the 2D %GP and dose differences calculated from 3DVH. The %GP acceptance criteria of 3%/3mm usually applied for pretreatment QA of IMRT and VMAT is not indicating strong clinical correlation with 3D dose difference. 3D dose reconstructions on patient anatomy may be necessary for physicist to predict the accuracy of delivered dose for VMAT QA.

  11. Developing Human Resources through Actualizing Human Potential

    ERIC Educational Resources Information Center

    Clarken, Rodney H.

    2012-01-01

    The key to human resource development is in actualizing individual and collective thinking, feeling and choosing potentials related to our minds, hearts and wills respectively. These capacities and faculties must be balanced and regulated according to the standards of truth, love and justice for individual, community and institutional development,…

  12. [Actual diet of patients with gastrointestinal diseases].

    PubMed

    Loranskaia, T I; Shakhovskaia, A K; Pavliuchkova, M S

    2000-01-01

    The study of actual nutrition of patients with erosive-ulcerative lesions in the gastroduodenal zone and of patients with operated ulcer has revealed defects in intake of essential nutrients by these patients: overeating of animal fat and refined carbohydrates, deficiency of oil, vitamins A, B2, C, D and food fibers.

  13. Humanistic Education and Self-Actualization Theory.

    ERIC Educational Resources Information Center

    Farmer, Rod

    1984-01-01

    Stresses the need for theoretical justification for the development of humanistic education programs in today's schools. Explores Abraham Maslow's hierarchy of needs and theory of self-actualization. Argues that Maslow's theory may be the best available for educators concerned with educating the whole child. (JHZ)

  14. Group Counseling for Self-Actualization.

    ERIC Educational Resources Information Center

    Streich, William H.; Keeler, Douglas J.

    Self-concept, creativity, growth orientation, an integrated value system, and receptiveness to new experiences are considered to be crucial variables to the self-actualization process. A regular, year-long group counseling program was conducted with 85 randomly selected gifted secondary students in the Farmington, Connecticut Public Schools. A…

  15. Teenagers' Perceived and Actual Probabilities of Pregnancy.

    ERIC Educational Resources Information Center

    Namerow, Pearila Brickner; And Others

    1987-01-01

    Explored adolescent females' (N=425) actual and perceived probabilities of pregnancy. Subjects estimated their likelihood of becoming pregnant the last time they had intercourse, and indicated the dates of last intercourse and last menstrual period. Found that the distributions of perceived probability of pregnancy were nearly identical for both…

  16. Validation of contour-driven thin-plate splines for tracking fraction-to-fraction changes in anatomy and radiation therapy dose mapping

    NASA Astrophysics Data System (ADS)

    Schaly, B.; Bauman, G. S.; Battista, J. J.; Van Dyk, J.

    2005-02-01

    The goal of this study is to validate a deformable model using contour-driven thin-plate splines for application to radiation therapy dose mapping. Our testing includes a virtual spherical phantom as well as real computed tomography (CT) data from ten prostate cancer patients with radio-opaque markers surgically implanted into the prostate and seminal vesicles. In the spherical mathematical phantom, homologous control points generated automatically given input contour data in CT slice geometry were compared to homologous control point placement using analytical geometry as the ground truth. The dose delivered to specific voxels driven by both sets of homologous control points were compared to determine the accuracy of dose tracking via the deformable model. A 3D analytical spherically symmetric dose distribution with a dose gradient of ~10% per mm was used for this phantom. This test showed that the uncertainty in calculating the delivered dose to a tissue element depends on slice thickness and the variation in defining homologous landmarks, where dose agreement of 3-4% in high dose gradient regions was achieved. In the patient data, radio-opaque marker positions driven by the thin-plate spline algorithm were compared to the actual marker positions as identified in the CT scans. It is demonstrated that the deformable model is accurate (~2.5 mm) to within the intra-observer contouring variability. This work shows that the algorithm is appropriate for describing changes in pelvic anatomy and for the dose mapping application with dose gradients characteristic of conformal and intensity modulated radiation therapy.

  17. Investigation of Advanced Dose Verification Techniques for External Beam Radiation Treatment

    NASA Astrophysics Data System (ADS)

    Asuni, Ganiyu Adeniyi

    Intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) have been introduced in radiation therapy to achieve highly conformal dose distributions around the tumour while minimizing dose to surrounding normal tissues. These techniques have increased the need for comprehensive quality assurance tests, to verify that customized patient treatment plans are accurately delivered during treatment. in vivo dose verification, performed during treatment delivery, confirms that the actual dose delivered is the same as the prescribed dose, helping to reduce treatment delivery errors. in vivo measurements may be accomplished using entrance or exit detectors. The objective of this project is to investigate a novel entrance detector designed for in vivo dose verification. This thesis is separated into three main investigations, focusing on a prototype entrance transmission detector (TRD) developed by IBA Dosimetry, Germany. First contaminant electrons generated by the TRD in a 6 MV photon beam were investigated using Monte Carlo (MC) simulation. This study demonstrates that modification of the contaminant electron model in the treatment planning system is required for accurate patient dose calculation in buildup regions when using the device. Second, the ability of the TRD to accurately measure dose from IMRT and VMAT was investigated by characterising the spatial resolution of the device. This was accomplished by measuring the point spread function with further validation provided by MC simulation. Comparisons of measured and calculated doses show that the spatial resolution of the TRD allows for measurement of clinical IMRT fields within acceptable tolerance. Finally, a new general research tool was developed to perform MC simulations for VMAT and IMRT treatments, simultaneously tracking dose deposition in both the patient CT geometry and an arbitrary planar detector system, generalized to handle either entrance or exit orientations. It was

  18. Cable Television: A Method for Delivering Information.

    ERIC Educational Resources Information Center

    Nebraska Univ., Lincoln. Cooperative Extension Service.

    This report presents the recommendations of a committee that was formed to explore the possibility of using cable television networks as a method of delivering extension education programs to urban audiences. After developing and testing a pilot project that used cable television as a mode to disseminate horticulture and 4-H leader training…

  19. Is International Accounting Education Delivering Pedagogical Value?

    ERIC Educational Resources Information Center

    Patel, Chris; Millanta, Brian; Tweedie, Dale

    2016-01-01

    This paper examines whether universities are delivering pedagogical value to international accounting students commensurate with the costs of studying abroad. The paper uses survey and interview methods to explore the extent to which Chinese Learners (CLs) in an Australian postgraduate accounting subject have distinct learning needs. The paper…

  20. Delivering Solutions for the Knowledge Economy.

    ERIC Educational Resources Information Center

    Ribbler, Judith

    1996-01-01

    By placing integrated access to online information on the desktop, companies gain a competitive edge, empower their employees, and deliver higher-quality service at less cost. Information audits, focus groups, and employee interviews can determine the information needs of organizations and enhance their information infrastructure. In this light,…

  1. Delivering Images for Mars Rover Science Planning

    NASA Technical Reports Server (NTRS)

    Edmonds, Karina

    2008-01-01

    A methodology has been developed for delivering, via the Internet, images transmitted to Earth from cameras on the Mars Explorer Rovers, the Phoenix Mars Lander, the Mars Science Laboratory, and the Mars Reconnaissance Orbiter spacecraft. The images in question are used by geographically dispersed scientists and engineers in planning Rover scientific activities and Rover maneuvers pertinent thereto.

  2. Collection Management: Electronically-Delivered Information.

    ERIC Educational Resources Information Center

    Trawick, Theresa C.; And Others

    Issues in the management of library collections of electronically delivered information are discussed, focusing on the library at Troy State University (Alabama). Because of the library's selective depository status, expensive compact disk-read only memory (CD-ROM) products are received, which the library could not normally afford. At the Troy…

  3. Delivering best care in war and peace.

    PubMed

    Moore, Alison

    2014-06-24

    Col Alan Finnegan, the fi rst Ministry of Defence professor of nursing, is driving forward research into preparing nurses for deployment and ensuring they deliver the best care possible in war and peace. Research topics range from the role of autonomous practitioners to the effects on soldiers of injuries to their genitalia.

  4. Delivering Multimedia Teaching Modules via the Internet.

    ERIC Educational Resources Information Center

    Mudge, Stephen M.

    1999-01-01

    Discusses advantages and disadvantages of using the Internet for delivering teaching modules and makes recommendations for successful use of the Internet. Highlights include the availability of information at all times and from remote locations, multimedia capabilities, infrastructure needed, security issues, updating, needed skills, and…

  5. Evaluation of uncertainty predictions and dose output for model-based dose calculations for megavoltage photon beams

    SciTech Connect

    Olofsson, Joergen; Nyholm, Tufve; Georg, Dietmar; Ahnesjoe, Anders; Karlsson, Mikael

    2006-07-15

    In many radiotherapy clinics an independent verification of the number of monitor units (MU) used to deliver the prescribed dose to the target volume is performed prior to the treatment start. Traditionally this has been done by using methods mainly based on empirical factors which, at least to some extent, try to separate the influence from input parameters such as field size, depth, distance, etc. The growing complexity of modern treatment techniques does however make this approach increasingly difficult, both in terms of practical application and in terms of the reliability of the results. In the present work the performance of a model-based approach, describing the influence from different input parameters through actual modeling of the physical effects, has been investigated in detail. The investigated model is based on two components related to megavoltage photon beams; one describing the exiting energy fluence per delivered MU, and a second component describing the dose deposition through a pencil kernel algorithm solely based on a measured beam quality index. Together with the output calculations, the basis of a method aiming to predict the inherent calculation uncertainties in individual treatment setups has been developed. This has all emerged from the intention of creating a clinical dose/MU verification tool that requires an absolute minimum of commissioned input data. This evaluation was focused on irregular field shapes and performed through comparison with output factors measured at 5, 10, and 20 cm depth in ten multileaf collimated fields on four different linear accelerators with varying multileaf collimator designs. The measurements were performed both in air and in water and the results of the two components of the model were evaluated separately and combined. When compared with the corresponding measurements the resulting deviations in the calculated output factors were in most cases smaller than 1% and in all cases smaller than 1.7%. The

  6. Evaluation of uncertainty predictions and dose output for model-based dose calculations for megavoltage photon beams.

    PubMed

    Olofsson, Jörgen; Nyholm, Tufve; Georg, Dietmar; Ahnesjö, Anders; Karlsson, Mikael

    2006-07-01

    In many radiotherapy clinics an independent verification of the number of monitor units (MU) used to deliver the prescribed dose to the target volume is performed prior to the treatment start. Traditionally this has been done by using methods mainly based on empirical factors which, at least to some extent, try to separate the influence from input parameters such as field size, depth, distance, etc. The growing complexity of modern treatment techniques does however make this approach increasingly difficult, both in terms of practical application and in terms of the reliability of the results. In the present work the performance of a model-based approach, describing the influence from different input parameters through actual modeling of the physical effects, has been investigated in detail. The investigated model is based on two components related to megavoltage photon beams; one describing the exiting energy fluence per delivered MU, and a second component describing the dose deposition through a pencil kernel algorithm solely based on a measured beam quality index. Together with the output calculations, the basis of a method aiming to predict the inherent calculation uncertainties in individual treatment setups has been developed. This has all emerged from the intention of creating a clinical dose/MU verification tool that requires an absolute minimum of commissioned input data. This evaluation was focused on irregular field shapes and performed through comparison with output factors measured at 5, 10, and 20 cm depth in ten multileaf collimated fields on four different linear accelerators with varying multileaf collimator designs. The measurements were performed both in air and in water and the results of the two components of the model were evaluated separately and combined. When compared with the corresponding measurements the resulting deviations in the calculated output factors were in most cases smaller than 1% and in all cases smaller than 1.7%. The

  7. A topographic leaf-sequencing algorithm for delivering intensity modulated radiation therapy.

    PubMed

    Desai, Dharmin; Ramsey, Chester R; Breinig, Marianne; Mahan, Stephen L

    2006-08-01

    Topographic treatment is a radiation therapy delivery technique for fixed-gantry (nonrotational) treatments on a helical tomotherapy system. The intensity-modulated fields are created by moving the treatment couch relative to a fan-beam positioned at fixed gantry angles. The delivered dose distribution is controlled by moving multileaf collimator (MLC) leaves into and out of the fan beam. The purpose of this work was to develop a leaf-sequencing algorithm for creating topographic MLC sequences. Topographic delivery was modeled using the analogy of a water faucet moving over a collection of bottles. The flow rate per unit length of the water from the faucet represented the photon fluence per unit length along the width of the fan beam, the collection of bottles represented the pixels in the treatment planning fluence map, and the volume of water collected in each bottle represented the delivered fluence. The radiation fluence per unit length delivered to the target at a given position is given by the convolution of the intensity distribution per unit length over the width of the beam and the time per unit distance along the direction of travel that an MLC leaf is open. The MLC opening times for the desired dose profiles were determined using a technique based on deconvolution using a genetic algorithm. The MLC opening times were expanded in terms of a Fourier series, and a genetic algorithm was used to find the best expansion coefficients for a given dose distribution. A series of wedge shapes (15, 30, 45, and 60 deg) and "dose well" test fluence maps were created to test the algorithm's ability to generate topographic leaf sequences. The accuracy of the leaf-sequencing algorithm was measured on a helical tomotherapy system using radiographic film placed at depth in water equivalent material. The measured dose profiles were compared with the desired dose distributions. The agreement was within +/- 2% or 2 mm distance-to-agreement (DTA) in the high dose gradient

  8. A topographic leaf-sequencing algorithm for delivering intensity modulated radiation therapy

    SciTech Connect

    Desai, Dharmin; Ramsey, Chester R.; Breinig, Marianne; Mahan, Stephen L.

    2006-08-15

    Topographic treatment is a radiation therapy delivery technique for fixed-gantry (nonrotational) treatments on a helical tomotherapy system. The intensity-modulated fields are created by moving the treatment couch relative to a fan-beam positioned at fixed gantry angles. The delivered dose distribution is controlled by moving multileaf collimator (MLC) leaves into and out of the fan beam. The purpose of this work was to develop a leaf-sequencing algorithm for creating topographic MLC sequences. Topographic delivery was modeled using the analogy of a water faucet moving over a collection of bottles. The flow rate per unit length of the water from the faucet represented the photon fluence per unit length along the width of the fan beam, the collection of bottles represented the pixels in the treatment planning fluence map, and the volume of water collected in each bottle represented the delivered fluence. The radiation fluence per unit length delivered to the target at a given position is given by the convolution of the intensity distribution per unit length over the width of the beam and the time per unit distance along the direction of travel that an MLC leaf is open. The MLC opening times for the desired dose profiles were determined using a technique based on deconvolution using a genetic algorithm. The MLC opening times were expanded in terms of a Fourier series, and a genetic algorithm was used to find the best expansion coefficients for a given dose distribution. A series of wedge shapes (15, 30, 45, and 60 deg) and 'dose well' test fluence maps were created to test the algorithm's ability to generate topographic leaf sequences. The accuracy of the leaf-sequencing algorithm was measured on a helical tomotherapy system using radiographic film placed at depth in water equivalent material. The measured dose profiles were compared with the desired dose distributions. The agreement was within {+-}2% or 2 mm distance-to-agreement (DTA) in the high dose gradient

  9. In vivo verification of superficial dose for head and neck treatments using intensity-modulated techniques

    SciTech Connect

    Qi Zhenyu; Deng Xiaowu; Huang Shaomin; Zhang Li; He Zhichun; Allen Li, X.; Kwan, Ian; Lerch, Michael; Cutajar, Dean; Metcalfe, Peter; Rosenfeld, Anatoly

    2009-01-15

    Skin dose is one of the key issues for clinical dosimetry in radiation therapy. Currently planning computer systems are unable to accurately predict dose in the buildup region, leaving ambiguity as to the dose levels actually received by the patient's skin during radiotherapy. This is one of the prime reasons why in vivo measurements are necessary to estimate the dose in the buildup region. A newly developed metal-oxide-semiconductor-field-effect-transistor (MOSFET) detector designed specifically for dose measurements in rapidly changing dose gradients was introduced for accurate in vivo skin dosimetry. The feasibility of this detector for skin dose measurements was verified in comparison with plane parallel ionization chamber and radiochromic films. The accuracy of a commercial treatment planning system (TPS) in skin dose calculations for intensity-modulated radiation therapy treatment of nasopharyngeal carcinoma was evaluated using MOSFET detectors in an anthropomorphic phantom as well as on the patients. Results show that this newly developed MOSFET detector can provide a minimal but highly reproducible intrinsic buildup of 7 mg cm{sup -2} corresponding to the requirements of personal surface dose equivalent Hp (0.07). The reproducibility of the MOSFET response, in high sensitivity mode, is found to be better than 2% at the phantom surface for the doses normally delivered to the patients. The MOSFET detector agrees well with the Attix chamber and the EBT Gafchromic registered film in terms of surface and buildup region dose measurements, even for oblique incident beams. While the dose difference between MOSFET measurements and TPS calculations is within measurement uncertainty for the depths equal to or greater than 0.5 cm, an overestimation of up to 8.5% was found for the surface dose calculations in the anthropomorphic phantom study. In vivo skin dose measurements reveal that the dose difference between the MOSFET results and the TPS calculations was on

  10. Nuclear Energy and Health: And the Benefits of Low-Dose Radiation Hormesis

    PubMed Central

    Cuttler, Jerry M.; Pollycove, Myron

    2009-01-01

    Energy needs worldwide are expected to increase for the foreseeable future, but fuel supplies are limited. Nuclear reactors could supply much of the energy demand in a safe, sustainable manner were it not for fear of potential releases of radioactivity. Such releases would likely deliver a low dose or dose rate of radiation, within the range of naturally occurring radiation, to which life is already accustomed. The key areas of concern are discussed. Studies of actual health effects, especially thyroid cancers, following exposures are assessed. Radiation hormesis is explained, pointing out that beneficial effects are expected following a low dose or dose rate because protective responses against stresses are stimulated. The notions that no amount of radiation is small enough to be harmless and that a nuclear accident could kill hundreds of thousands are challenged in light of experience: more than a century with radiation and six decades with reactors. If nuclear energy is to play a significant role in meeting future needs, regulatory authorities must examine the scientific evidence and communicate the real health effects of nuclear radiation. Negative images and implications of health risks derived by unscientific extrapolations of harmful effects of high doses must be dispelled. PMID:19343116

  11. Nuclear energy and health: and the benefits of low-dose radiation hormesis.

    PubMed

    Cuttler, Jerry M; Pollycove, Myron

    2009-01-01

    Energy needs worldwide are expected to increase for the foreseeable future, but fuel supplies are limited. Nuclear reactors could supply much of the energy demand in a safe, sustainable manner were it not for fear of potential releases of radioactivity. Such releases would likely deliver a low dose or dose rate of radiation, within the range of naturally occurring radiation, to which life is already accustomed. The key areas of concern are discussed. Studies of actual health effects, especially thyroid cancers, following exposures are assessed. Radiation hormesis is explained, pointing out that beneficial effects are expected following a low dose or dose rate because protective responses against stresses are stimulated. The notions that no amount of radiation is small enough to be harmless and that a nuclear accident could kill hundreds of thousands are challenged in light of experience: more than a century with radiation and six decades with reactors. If nuclear energy is to play a significant role in meeting future needs, regulatory authorities must examine the scientific evidence and communicate the real health effects of nuclear radiation. Negative images and implications of health risks derived by unscientific extrapolations of harmful effects of high doses must be dispelled.

  12. Reproducing Actual Morphology of Planetary Lava Flows

    NASA Astrophysics Data System (ADS)

    Miyamoto, H.; Sasaki, S.

    1996-03-01

    Assuming that lava flows behave as non-isothermal laminar Bingham fluids, we developed a numerical code of lava flows. We take the self gravity effects and cooling mechanisms into account. The calculation method is a kind of cellular automata using a reduced random space method, which can eliminate the mesh shape dependence. We can calculate large scale lava flows precisely without numerical instability and reproduce morphology of actual lava flows.

  13. The Actual Apollo 13 Prime Crew

    NASA Technical Reports Server (NTRS)

    1970-01-01

    The actual Apollo 13 lunar landing mission prime crew from left to right are: Commander, James A. Lovell Jr., Command Module pilot, John L. Swigert Jr.and Lunar Module pilot, Fred W. Haise Jr. The original Command Module pilot for this mission was Thomas 'Ken' Mattingly Jr. but due to exposure to German measles he was replaced by his backup, Command Module pilot, John L. 'Jack' Swigert Jr.

  14. Development of anthropomorphic hand phantoms for personal dosimetry in 90Y-Zevalin preparation and patient delivering.

    PubMed

    Ciolini, R; d'Errico, F; Traino, A C; Paternostro, E; Laganà, A; Romei, C; Pazzagli, F; Del Gratta, A

    2014-01-01

    Anthropomorphic tissue-equivalent hand phantoms were achieved to measure the extremity dose involved in Zevalin (90)Y-labelling and patient delivering procedure for radioimmunotherapy treatment of non-Hodgkin lymphoma. The extremity doses to hands and wrists of operators were measured by using thermoluminescent detectors mounted on the developed phantoms. Measurements of chest- and lens-equivalent doses performed on a Rando phantom are also reported.

  15. Dynamically accumulated dose and 4D accumulated dose for moving tumors

    SciTech Connect

    Li Heng; Li Yupeng; Zhang Xiaodong; Li Xiaoqiang; Liu Wei; Gillin, Michael T.; Zhu, X. Ronald

    2012-12-15

    Purpose: The purpose of this work was to investigate the relationship between dynamically accumulated dose (dynamic dose) and 4D accumulated dose (4D dose) for irradiation of moving tumors, and to quantify the dose uncertainty induced by tumor motion. Methods: The authors established that regardless of treatment modality and delivery properties, the dynamic dose will converge to the 4D dose, instead of the 3D static dose, after multiple deliveries. The bounds of dynamic dose, or the maximum estimation error using 4D or static dose, were established for the 4D and static doses, respectively. Numerical simulations were performed (1) to prove the principle that for each phase, after multiple deliveries, the average number of deliveries for any given time converges to the total number of fractions (K) over the number of phases (N); (2) to investigate the dose difference between the 4D and dynamic doses as a function of the number of deliveries for deliveries of a 'pulsed beam'; and (3) to investigate the dose difference between 4D dose and dynamic doses as a function of delivery time for deliveries of a 'continuous beam.' A Poisson model was developed to estimate the mean dose error as a function of number of deliveries or delivered time for both pulsed beam and continuous beam. Results: The numerical simulations confirmed that the number of deliveries for each phase converges to K/N, assuming a random starting phase. Simulations for the pulsed beam and continuous beam also suggested that the dose error is a strong function of the number of deliveries and/or total deliver time and could be a function of the breathing cycle, depending on the mode of delivery. The Poisson model agrees well with the simulation. Conclusions: Dynamically accumulated dose will converge to the 4D accumulated dose after multiple deliveries, regardless of treatment modality. Bounds of the dynamic dose could be determined using quantities derived from 4D doses, and the mean dose difference

  16. TMS delivered for A-3 Test Stand

    NASA Technical Reports Server (NTRS)

    2010-01-01

    A state-of-the-art thrust measurement system for the A-3 Test Stand under construction at NASA's John C. Stennis Space Center was delivered March 17. Once completed, the A-3 stand (seen in background) will allow simulated high-altitude testing on the next generation of rocket engines for America's space program. Work on the stand began in 2007, with activation scheduled for 2012. The stand is the first major test structure to be built at Stennis since the 1960s. The recently delivered TMS was fabricated by Thrust Measurement Systems in Illinois. It is an advanced calibration system capable of measuring vertical and horizontal thrust loads with an accuracy within 0.15 percent at 225,000 pounds.

  17. Magnetic Fluids Deliver Better Speaker Sound Quality

    NASA Technical Reports Server (NTRS)

    2015-01-01

    In the 1960s, Glenn Research Center developed a magnetized fluid to draw rocket fuel into spacecraft engines while in space. Sony has incorporated the technology into its line of slim speakers by using the fluid as a liquid stand-in for the speaker's dampers, which prevent the speaker from blowing out while adding stability. The fluid helps to deliver more volume and hi-fidelity sound while reducing distortion.

  18. A simple circuit to deliver bubbling CPAP.

    PubMed

    Kaur, Charanjit; Sema, Akatoli; Beri, Rajbir S; Puliyel, Jacob M

    2008-04-01

    Nasal continuous positive airway pressure (CPAP), especially bubbling CPAP, is known to reduce the need for more invasive ventilation. We here describe a circuit that can deliver bubbling CPAP in resource poor settings. We describe how the oxygen concentration can be altered from 98% to 21% oxygen using this system. Addition of a humidifier in the circuit has the effect of reducing the oxygen concentration by 1 to 5%. The cost of putting together the system is approximately Rs 5000.

  19. Treatment planning and dose analysis for interstitial photodynamic therapy of prostate cancer

    NASA Astrophysics Data System (ADS)

    Davidson, Sean R. H.; Weersink, Robert A.; Haider, Masoom A.; Gertner, Mark R.; Bogaards, Arjen; Giewercer, David; Scherz, Avigdor; Sherar, Michael D.; Elhilali, Mostafa; Chin, Joseph L.; Trachtenberg, John; Wilson, Brian C.

    2009-04-01

    With the development of new photosensitizers that are activated by light at longer wavelengths, interstitial photodynamic therapy (PDT) is emerging as a feasible alternative for the treatment of larger volumes of tissue. Described here is the application of PDT treatment planning software developed by our group to ensure complete coverage of larger, geometrically complex target volumes such as the prostate. In a phase II clinical trial of TOOKAD vascular targeted photodynamic therapy (VTP) for prostate cancer in patients who failed prior radiotherapy, the software was used to generate patient-specific treatment prescriptions for the number of treatment fibres, their lengths, their positions and the energy each delivered. The core of the software is a finite element solution to the light diffusion equation. Validation against in vivo light measurements indicated that the software could predict the location of an iso-fluence contour to within approximately ±2 mm. The same software was used to reconstruct the treatments that were actually delivered, thereby providing an analysis of the threshold light dose required for TOOKAD-VTP of the post-irradiated prostate. The threshold light dose for VTP-induced prostate damage, as measured one week post-treatment using contrast-enhanced MRI, was found to be highly heterogeneous, both within and between patients. The minimum light dose received by 90% of the prostate, D90, was determined from each patient's dose-volume histogram and compared to six-month sextant biopsy results. No patient with a D90 less than 23 J cm-2 had complete biopsy response, while 8/13 (62%) of patients with a D90 greater than 23 J cm-2 had negative biopsies at six months. The doses received by the urethra and the rectal wall were also investigated.

  20. Air resistance measurements on actual airplane parts

    NASA Technical Reports Server (NTRS)

    Weiselsberger, C

    1923-01-01

    For the calculation of the parasite resistance of an airplane, a knowledge of the resistance of the individual structural and accessory parts is necessary. The most reliable basis for this is given by tests with actual airplane parts at airspeeds which occur in practice. The data given here relate to the landing gear of a Siemanms-Schuckert DI airplane; the landing gear of a 'Luftfahrzeug-Gesellschaft' airplane (type Roland Dlla); landing gear of a 'Flugzeugbau Friedrichshafen' G airplane; a machine gun, and the exhaust manifold of a 269 HP engine.

  1. Explosive Percolation Transition is Actually Continuous

    NASA Astrophysics Data System (ADS)

    da Costa, R. A.; Dorogovtsev, S. N.; Goltsev, A. V.; Mendes, J. F. F.

    2010-12-01

    Recently a discontinuous percolation transition was reported in a new “explosive percolation” problem for irreversible systems [D. Achlioptas, R. M. D’Souza, and J. Spencer, Science 323, 1453 (2009)SCIEAS0036-807510.1126/science.1167782] in striking contrast to ordinary percolation. We consider a representative model which shows that the explosive percolation transition is actually a continuous, second order phase transition though with a uniquely small critical exponent of the percolation cluster size. We describe the unusual scaling properties of this transition and find its critical exponents and dimensions.

  2. Estimation of Rectal Dose Using Daily Megavoltage Cone-Beam Computed Tomography and Deformable Image Registration

    SciTech Connect

    Akino, Yuichi; Yoshioka, Yasuo; Fukuda, Shoichi; Maruoka, Shintaroh; Takahashi, Yutaka; Yagi, Masashi; Mizuno, Hirokazu; Isohashi, Fumiaki; Ogawa, Kazuhiko

    2013-11-01

    Purpose: The actual dose delivered to critical organs will differ from the simulated dose because of interfractional organ motion and deformation. Here, we developed a method to estimate the rectal dose in prostate intensity modulated radiation therapy with consideration to interfractional organ motion using daily megavoltage cone-beam computed tomography (MVCBCT). Methods and Materials: Under exemption status from our institutional review board, we retrospectively reviewed 231 series of MVCBCT of 8 patients with prostate cancer. On both planning CT (pCT) and MVCBCT images, the rectal contours were delineated and the CT value within the contours was replaced by the mean CT value within the pelvis, with the addition of 100 Hounsfield units. MVCBCT images were rigidly registered to pCT and then nonrigidly registered using B-Spline deformable image registration (DIR) with Velocity AI software. The concordance between the rectal contours on MVCBCT and pCT was evaluated using the Dice similarity coefficient (DSC). The dose distributions normalized for 1 fraction were also deformed and summed to estimate the actual total dose. Results: The DSC of all treatment fractions of 8 patients was improved from 0.75±0.04 (mean ±SD) to 0.90 ±0.02 by DIR. Six patients showed a decrease of the generalized equivalent uniform dose (gEUD) from total dose compared with treatment plans. Although the rectal volume of each treatment fraction did not show any correlation with the change in gEUD (R{sup 2}=0.18±0.13), the displacement of the center of gravity of rectal contours in the anterior-posterior (AP) direction showed an intermediate relationship (R{sup 2}=0.61±0.16). Conclusion: We developed a method for evaluation of rectal dose using DIR and MVCBCT images and showed the necessity of DIR for the evaluation of total dose. Displacement of the rectum in the AP direction showed a greater effect on the change in rectal dose compared with the rectal volume.

  3. Utirik Atoll Dose Assessment

    SciTech Connect

    Robison, W.L.; Conrado, C.L.; Bogen, K.T

    1999-10-06

    radionuclides. However, we continually see {sup 137}Cs in the groundwater at all contaminated atolls; the turnover time of the groundwater is about 5 y. The {sup 137}Cs can only get to the groundwater by leaching through the soil column when a portion of the soluble fraction of {sup 137}Cs inventory in the soil is transported to the groundwater when rainfall is heavy enough to cause recharge of the aquifer. This process is causing a loss of {sup 137}Cs out of the root zone of the plants that provides an environmental loss constant ({lambda}{sub env}) in addition to radiological decay {lambda}{sub rad}. Consequently, there is an effective rate of loss, {lambda}{sub eff} = {lambda}{sub rad} + {lambda}{sub env} that is the sum of the radiological and environmental-loss decay constants. We have had, and continue to have, a vigorous program to determine the rate of the environmental loss process. What we do know at this time is that the loss of {sup 137}Cs over time is greater than the estimate based on radiological decay only, and that the actual dose received by the Utirik people over 30-, 50-, or 70-y will be less than those presented in this report.

  4. Radiation dose descriptors: BERT, COD, DAP, and other strange creatures.

    PubMed

    Nickoloff, Edward L; Lu, Zheng Feng; Dutta, Ajoy K; So, James C

    2008-01-01

    Over the years, a number of terms have been used to describe radiation dose. Eight common radiation dose descriptors include background equivalent radiation time (BERT), critical organ dose (COD), surface absorbed dose (SAD), dose area product (DAP), diagnostic acceptable reference level (DARLing), effective dose (ED), fetal absorbed dose (FAD), and total imparted energy (TIE). BERT is compared to the annual natural background radiation (about 3 mSv per year) and is easily understandable for the general public. COD refers to the radiation dose delivered to an individual critical organ. SAD is the radiation dose delivered at the skin surface. DAP is a product of the irradiated surface area multiplied by the radiation dose at the surface. DARLing is usually the radiation level that encompasses 75% (the third quartile) of the data derived from a nationwide or regional survey. DARLings are meant for voluntary guidance. Consistently higher patient doses should be investigated for possible equipment deficiencies or suboptimal protocols. ED is obtained by multiplying the radiation dose delivered to each organ by its weighting factor and then by adding those values to get the sum. It can be used to assess the risk of radiation-induced cancers and serious hereditary effects to future generations, regardless of the procedure being performed, and is the most useful radiation dose descriptor. FAD is the radiation dose delivered to the fetus, and TIE is the sum of the energy imparted to all irradiated tissue. Each of these descriptors is intended to relate radiation dose ultimately to potential biologic effects. To avoid confusion, the key is to avoid using the terms interchangeably. It is important to understand each of the radiation dose descriptors and their derivation in order to correctly evaluate radiation dose and to consult with patients concerned about the risks of radiation.

  5. An in vivo dose verification method for SBRT–VMAT delivery using the EPID

    SciTech Connect

    McCowan, P. M.; Van Uytven, E.; Van Beek, T.; Asuni, G.; McCurdy, B. M. C.

    2015-12-15

    Purpose: Radiation treatments have become increasingly more complex with the development of volumetric modulated arc therapy (VMAT) and the use of stereotactic body radiation therapy (SBRT). SBRT involves the delivery of substantially larger doses over fewer fractions than conventional therapy. SBRT–VMAT treatments will strongly benefit from in vivo patient dose verification, as any errors in delivery can be more detrimental to the radiobiology of the patient as compared to conventional therapy. Electronic portal imaging devices (EPIDs) are available on most commercial linear accelerators (Linacs) and their documented use for dosimetry makes them valuable tools for patient dose verification. In this work, the authors customize and validate a physics-based model which utilizes on-treatment EPID images to reconstruct the 3D dose delivered to the patient during SBRT–VMAT delivery. Methods: The SBRT Linac head, including jaws, multileaf collimators, and flattening filter, were modeled using Monte Carlo methods and verified with measured data. The simulation provides energy spectrum data that are used by their “forward” model to then accurately predict fluence generated by a SBRT beam at a plane above the patient. This fluence is then transported through the patient and then the dose to the phosphor layer in the EPID is calculated. Their “inverse” model back-projects the EPID measured focal fluence to a plane upstream of the patient and recombines it with the extra-focal fluence predicted by the forward model. This estimate of total delivered fluence is then forward projected onto the patient’s density matrix and a collapsed cone convolution algorithm calculates the dose delivered to the patient. The model was tested by reconstructing the dose for two prostate, three lung, and two spine SBRT–VMAT treatment fractions delivered to an anthropomorphic phantom. It was further validated against actual patient data for a lung and spine SBRT–VMAT plan. The

  6. Delivering hazard information: from misunderstandings to mayhem

    NASA Astrophysics Data System (ADS)

    Kilburn, Christopher; Solana, Carmen; Michnowicz, Sabina; Edwards, Stephen

    2014-05-01

    Misunderstandings between monitoring specialists, decision makers and the public can transform a volcanic emergency into a disaster. They are especially likely to occur during unrest at long-quiescent volcanoes, where few, if any, of the key groups may have experience of such behaviour. The potential for misunderstanding strongly depends on the quality of scientific information and the manner in which it is delivered. The same factors determine the nature of a misunderstanding, which, in turn, affects the perception and response of vulnerable communities. As we illustrate with selected case studies, four classes of response can be recognised: realistic, overconfident, confused and sceptical. A response is realistic when good information has been delivered effectively and, as a result, has been well understood. Overconfidence occurs when a recipient overestimates how well they have understood the information supplied. Overestimation may not be immediately evident, so that the provider erroneously believes that the information has been understood and no further action is necessary. Confused and sceptical responses occur when the information delivered is insufficient or ambiguous. In the first case, the impact of poor information is compounded by a poor understanding; in the second, the information is recognised as being inadequate and so engenders a lack of trust. The realistic response represents an ideal outcome for hazard-mitigation procedures and is often implicitly anticipated when the procedures are being developed. In practice, however, one of the other responses usually prevails. Crucial improvements will follow when account is taken explicitly of the full range of potential response and will require raising awareness among key groups of the needs and limitations of each other.

  7. The actual status of Astronomy in Moldova

    NASA Astrophysics Data System (ADS)

    Gaina, A.

    The astronomical research in the Republic of Moldova after Nicolae Donitch (Donici)(1874-1956(?)) were renewed in 1957, when a satellites observations station was open in Chisinau. Fotometric observations and rotations of first Soviet artificial satellites were investigated under a program SPIN put in action by the Academy of Sciences of former Socialist Countries. The works were conducted by Assoc. prof. Dr. V. Grigorevskij, which conducted also research in variable stars. Later, at the beginning of 60-th, an astronomical Observatory at the Chisinau State University named after Lenin (actually: the State University of Moldova), placed in Lozovo-Ciuciuleni villages was open, which were coordinated by Odessa State University (Prof. V.P. Tsesevich) and the Astrosovet of the USSR. Two main groups worked in this area: first conducted by V. Grigorevskij (till 1971) and second conducted by L.I. Shakun (till 1988), both graduated from Odessa State University. Besides this research areas another astronomical observations were made: Comets observations, astroclimate and atmospheric optics in collaboration with the Institute of the Atmospheric optics of the Siberian branch of the USSR (V. Chernobai, I. Nacu, C. Usov and A.F. Poiata). Comets observations were also made since 1988 by D. I. Gorodetskij which came to Chisinau from Alma-Ata and collaborated with Ukrainean astronomers conducted by K.I. Churyumov. Another part of space research was made at the State University of Tiraspol since the beggining of 70-th by a group of teaching staff of the Tiraspol State Pedagogical University: M.D. Polanuer, V.S. Sholokhov. No a collaboration between Moldovan astronomers and Transdniestrian ones actually exist due to War in Transdniestria in 1992. An important area of research concerned the Radiophysics of the Ionosphere, which was conducted in Beltsy at the Beltsy State Pedagogical Institute by a group of teaching staff of the University since the beginning of 70-th: N. D. Filip, E

  8. MODIS Solar Diffuser: Modelled and Actual Performance

    NASA Technical Reports Server (NTRS)

    Waluschka, Eugene; Xiong, Xiao-Xiong; Esposito, Joe; Wang, Xin-Dong; Krebs, Carolyn (Technical Monitor)

    2001-01-01

    The Moderate Resolution Imaging Spectroradiometer (MODIS) instrument's solar diffuser is used in its radiometric calibration for the reflective solar bands (VIS, NTR, and SWIR) ranging from 0.41 to 2.1 micron. The sun illuminates the solar diffuser either directly or through a attenuation screen. The attenuation screen consists of a regular array of pin holes. The attenuated illumination pattern on the solar diffuser is not uniform, but consists of a multitude of pin-hole images of the sun. This non-uniform illumination produces small, but noticeable radiometric effects. A description of the computer model used to simulate the effects of the attenuation screen is given and the predictions of the model are compared with actual, on-orbit, calibration measurements.

  9. 7 CFR 1437.101 - Actual production history.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Actual production history. 1437.101 Section 1437.101... Determining Yield Coverage Using Actual Production History § 1437.101 Actual production history. Actual production history (APH) is the unit's record of crop yield by crop year for the APH base period. The...

  10. 7 CFR 1437.101 - Actual production history.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Actual production history. 1437.101 Section 1437.101... Determining Yield Coverage Using Actual Production History § 1437.101 Actual production history. Actual production history (APH) is the unit's record of crop yield by crop year for the APH base period. The...

  11. 7 CFR 1437.101 - Actual production history.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Actual production history. 1437.101 Section 1437.101... Determining Yield Coverage Using Actual Production History § 1437.101 Actual production history. Actual production history (APH) is the unit's record of crop yield by crop year for the APH base period. The...

  12. 7 CFR 1437.101 - Actual production history.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Actual production history. 1437.101 Section 1437.101... Determining Yield Coverage Using Actual Production History § 1437.101 Actual production history. Actual production history (APH) is the unit's record of crop yield by crop year for the APH base period. The...

  13. 7 CFR 1437.101 - Actual production history.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Actual production history. 1437.101 Section 1437.101... Determining Yield Coverage Using Actual Production History § 1437.101 Actual production history. Actual production history (APH) is the unit's record of crop yield by crop year for the APH base period. The...

  14. Helical tomotherapy superficial dose measurements

    SciTech Connect

    Ramsey, Chester R.; Seibert, Rebecca M.; Robison, Benjamin; Mitchell, Martha

    2007-08-15

    Helical tomotherapy is a treatment technique that is delivered from a 6 MV fan beam that traces a helical path while the couch moves linearly into the bore. In order to increase the treatment delivery dose rate, helical tomotherapy systems do not have a flattening filter. As such, the dose distributions near the surface of the patient may be considerably different from other forms of intensity-modulated delivery. The purpose of this study was to measure the dose distributions near the surface for helical tomotherapy plans with a varying separation between the target volume and the surface of an anthropomorphic phantom. A hypothetical planning target volume (PTV) was defined on an anthropomorphic head phantom to simulate a 2.0 Gy per fraction IMRT parotid-sparing head and neck treatment of the upper neck nodes. A total of six target volumes were created with 0, 1, 2, 3, 4, and 5 mm of separation between the surface of the phantom and the outer edge of the PTV. Superficial doses were measured for each of the treatment deliveries using film placed in the head phantom and thermoluminescent dosimeters (TLDs) placed on the phantom's surface underneath an immobilization mask. In the 0 mm test case where the PTV extends to the phantom surface, the mean TLD dose was 1.73{+-}0.10 Gy (or 86.6{+-}5.1% of the prescribed dose). The measured superficial dose decreases to 1.23{+-}0.10 Gy (61.5{+-}5.1% of the prescribed dose) for a PTV-surface separation of 5 mm. The doses measured by the TLDs indicated that the tomotherapy treatment planning system overestimates superficial doses by 8.9{+-}3.2%. The radiographic film dose for the 0 mm test case was 1.73{+-}0.07 Gy, as compared to the calculated dose of 1.78{+-}0.05 Gy. Given the results of the TLD and film measurements, the superficial calculated doses are overestimated between 3% and 13%. Without the use of bolus, tumor volumes that extend to the surface may be underdosed. As such, it is recommended that bolus be added for these

  15. Carbon-ion pencil beam scanning for thoracic treatment – initiation report and dose metrics evaluation

    PubMed Central

    Karube, Masataka; Mori, Shinichiro; Tsuji, Hiroshi; Yamamoto, Naoyoshi; Nakajima, Mio; Nakagawa, Keiichi; Kamada, Tadashi

    2016-01-01

    Carbon-ion beam scanning has not previously been used for moving tumor treatments. We have commenced respiratory-gated carbon-ion radiotherapy (CIRT) in the thoracic and abdominal regions under free-breathing conditions as a clinical trial. This study aimed to investigate this treatment in the lungs in comparison with passive scattering CIRT. Five patients had thoracic tumors treated with carbon-ion scanned beams using respiratory gating. We analyzed the actual treatments and calculated passive scattering treatment plans based on the same planning CT. We evaluated tumor size until 3 months post treatment and each treatment plan regarding dose delivered to 95% of the clinical target volume (CTV-D95), mean lung dose, percentage of lung receiving at least 5 Gy (RBE) (Lung-V5), Lung-V10, Lung-V20, heart maximum dose (Dmax), esophagus Dmax, cord Dmax and skin Dmax. Obvious tumor deterioration was not observed up to 3 months post treatment. The dose evaluation metrics were similar item by item between respiratory-gated scanned CIRT and passive scattering CIRT. In conclusion, scanned beam CIRT provided treatments equivalent to passive scattering CIRT for thoracic tumors. Increased sample numbers and longer-term observation are needed. PMID:27380799

  16. A dose error evaluation study for 4D dose calculations

    NASA Astrophysics Data System (ADS)

    Milz, Stefan; Wilkens, Jan J.; Ullrich, Wolfgang

    2014-10-01

    Previous studies have shown that respiration induced motion is not negligible for Stereotactic Body Radiation Therapy. The intrafractional breathing induced motion influences the delivered dose distribution on the underlying patient geometry such as the lung or the abdomen. If a static geometry is used, a planning process for these indications does not represent the entire dynamic process. The quality of a full 4D dose calculation approach depends on the dose coordinate transformation process between deformable geometries. This article provides an evaluation study that introduces an advanced method to verify the quality of numerical dose transformation generated by four different algorithms. The used transformation metric value is based on the deviation of the dose mass histogram (DMH) and the mean dose throughout dose transformation. The study compares the results of four algorithms. In general, two elementary approaches are used: dose mapping and energy transformation. Dose interpolation (DIM) and an advanced concept, so called divergent dose mapping model (dDMM), are used for dose mapping. The algorithms are compared to the basic energy transformation model (bETM) and the energy mass congruent mapping (EMCM). For evaluation 900 small sample regions of interest (ROI) are generated inside an exemplary lung geometry (4DCT). A homogeneous fluence distribution is assumed for dose calculation inside the ROIs. The dose transformations are performed with the four different algorithms. The study investigates the DMH-metric and the mean dose metric for different scenarios (voxel sizes: 8 mm, 4 mm, 2 mm, 1 mm 9 different breathing phases). dDMM achieves the best transformation accuracy in all measured test cases with 3-5% lower errors than the other models. The results of dDMM are reasonable and most efficient in this study, although the model is simple and easy to implement. The EMCM model also achieved suitable results, but the approach requires a more complex

  17. On voxel-by-voxel accumulated dose for prostate radiation therapy using deformable image registration

    PubMed Central

    Yu, Jialu; Hardcastle, Nicholas; Jeong, Kyoungkeun; Bender, Edward T.; Ritter, Mark A.; Tomé, Wolfgang A.

    2015-01-01

    Since delivered dose is rarely the same with planned, we calculated the delivered total dose to ten prostate radiotherapy patients treated with rectal balloons using deformable dose accumulation (DDA) and compared it with the planned dose. The patients were treated with TomoTherapy using two rectal balloon designs: five patients had the Radiadyne balloon (balloon A), and five patients had the EZ-EM balloon (balloon B). Prostate and rectal wall contours were outlined on each pre-treatment MVCT for all patients. Delivered fractional doses were calculated using the MVCT taken immediately prior to delivery. Dose grids were accumulated to the last MVCT using DDA tools in Pinnacle3 ™ (v9.100, Philips Radiation Oncology Systems, Fitchburg, USA). Delivered total doses were compared with planned doses using prostate and rectal wall DVHs. The rectal NTCP was calculated based on total delivered and planned doses for all patients using the Lyman model. For 8/10 patients, the rectal wall NTCP calculated using the delivered total dose was less than planned, with seven patients showing a decrease of more than 5% in NTCP. For 2/10 patients studied, the rectal wall NTCP calculated using total delivered dose was 2% higher than planned. This study indicates that for patients receiving hypofractionated radiotherapy for prostate cancer with a rectal balloon, total delivered doses to prostate is similar with planned while delivered dose to rectal walls may be significantly different from planned doses. 8/10 patients show significant correlation between rectal balloon anterior-posterior positions and some VD values. PMID:24354754

  18. Parameterization of solar flare dose

    SciTech Connect

    Lamarche, A.H.; Poston, J.W.

    1996-12-31

    A critical aspect of missions to the moon or Mars will be the safety and health of the crew. Radiation in space is a hazard for astronauts, especially high-energy radiation following certain types of solar flares. A solar flare event can be very dangerous if astronauts are not adequately shielded because flares can deliver a very high dose in a short period of time. The goal of this research was to parameterize solar flare dose as a function of time to see if it was possible to predict solar flare occurrence, thus providing a warning time. This would allow astronauts to take corrective action and avoid receiving a dose greater than the recommended limit set by the National Council on Radiation Protection and Measurements (NCRP).

  19. Rebamipide Delivered by Brushite Cement Enhances Osteoblast and Macrophage Proliferation

    PubMed Central

    Pujari-Palmer, Michael; Pujari-Palmer, Shiuli; Engqvist, Håkan; Karlsson Ott, Marjam

    2015-01-01

    Many of the bioactive agents capable of stimulating osseous regeneration, such as bone morphogenetic protein-2 (BMP-2) or prostaglandin E2 (PGE2), are limited by rapid degradation, a short bioactive half-life at the target site in vivo, or are prohibitively expensive to obtain in large quantities. Rebamipide, an amino acid modified hydroxylquinoline, can alter the expression of key mediators of bone anabolism, cyclo-oxygenase 2 (COX-2), BMP-2 and vascular endothelial growth factor (VEGF), in diverse cell types such as mucosal and endothelial cells or chondrocytes. The present study investigates whether Rebamipide enhances proliferation and differentiation of osteoblasts when delivered from brushite cement. The reactive oxygen species (ROS) quenching ability of Rebampide was tested in macrophages as a measure of bioactivity following drug release incubation times, up to 14 days. Rebamipide release from brushite occurrs via non-fickian diffusion, with a rapid linear release of 9.70% ±0.37% of drug per day for the first 5 days, and an average of 0.5%-1% per day thereafter for 30 days. Rebamipide slows the initial and final cement setting time by up to 3 and 1 minute, respectively, but does not significantly reduce the mechanical strength below 4% (weight percentage). Pre-osteoblast proliferation increases by 24% upon exposure to 0.4uM Rebamipide, and by up to 73% when Rebamipide is delivered via brushite cement. Low doses of Rebamipide do not adversely affect peak alkaline phosphatase activity in differentiating pre-osteoblasts. Rebamipide weakly stimulates proliferation in macrophages at low concentrations (118 ±7.4% at 1uM), and quenches ROS by 40-60%. This is the first investigation of Rebamipide in osteoblasts. PMID:26023912

  20. Tutorial on Actual Space Environmental Hazards For Space Systems (Invited)

    NASA Astrophysics Data System (ADS)

    Mazur, J. E.; Fennell, J. F.; Guild, T. B.; O'Brien, T. P.

    2013-12-01

    It has become common in the space science community to conduct research on diverse physical phenomena because they are thought to contribute to space weather. However, satellites contend with only three primary environmental hazards: single event effects, vehicle charging, and total dose, and not every physical phenomenon that occurs in space contributes in substantial ways to create these hazards. One consequence of the mismatch between actual threats and all-encompassing research is the often-described gap between research and operations; another is the creation of forecasts that provide no actionable information for design engineers or spacecraft operators. An example of the latter is the physics of magnetic field emergence on the Sun; the phenomenon is relevant to the formation and launch of coronal mass ejections and is also causally related to the solar energetic particles that may get accelerated in the interplanetary shock. Unfortunately for the research community, the engineering community mitigates the space weather threat (single-event effects from heavy ions above ~50 MeV/nucleon) with a worst-case specification of the environment and not with a prediction. Worst-case definition requires data mining of past events, while predictions involve large-scale systems science from the Sun to the Earth that is compelling for scientists and their funding agencies but not actionable for design or for most operations. Differing priorities among different space-faring organizations only compounds the confusion over what science research is relevant. Solar particle impacts to human crew arise mainly from the total ionizing dose from the solar protons, so the priority for prediction in the human spaceflight community is therefore much different than in the unmanned satellite community, while both communities refer to the fundamental phenomenon as space weather. Our goal in this paper is the presentation of a brief tutorial on the primary space environmental phenomena

  1. Caustic-Side Solvent Extraction: Prediction of Cesium Extraction for Actual Wastes and Actual Waste Simulants

    SciTech Connect

    Delmau, L.H.; Haverlock, T.J.; Sloop, F.V., Jr.; Moyer, B.A.

    2003-02-01

    This report presents the work that followed the CSSX model development completed in FY2002. The developed cesium and potassium extraction model was based on extraction data obtained from simple aqueous media. It was tested to ensure the validity of the prediction for the cesium extraction from actual waste. Compositions of the actual tank waste were obtained from the Savannah River Site personnel and were used to prepare defined simulants and to predict cesium distribution ratios using the model. It was therefore possible to compare the cesium distribution ratios obtained from the actual waste, the simulant, and the predicted values. It was determined that the predicted values agree with the measured values for the simulants. Predicted values also agreed, with three exceptions, with measured values for the tank wastes. Discrepancies were attributed in part to the uncertainty in the cation/anion balance in the actual waste composition, but likely more so to the uncertainty in the potassium concentration in the waste, given the demonstrated large competing effect of this metal on cesium extraction. It was demonstrated that the upper limit for the potassium concentration in the feed ought to not exceed 0.05 M in order to maintain suitable cesium distribution ratios.

  2. OZONE UPTAKE IN THE INTACT HUMAN RESPIRATORY TRACT - RELATIONSHIP BETWEEN INHALED AND ACTUAL DOSE

    EPA Science Inventory

    Inhaled concentration (C), minute volume (MV), and exposure duration (T) are factors that may affect the uptake of ozone (03) within the respiratory tract. Ten healthy adult nonsmokers participated in four sessions, inhaling 0.2 or 0.4 ppm 03 through an oral mask while exercisi...

  3. COMPARISON OF MEDIUM CONCENTRATION VS. ACTUAL TISSUE DOSE IN IN VITRO NEUROTOXICANT MODELS.

    EPA Science Inventory

    In vitro methods have long been used to model the effects of toxicants on the nervous system. Generally, it is assumed that concentrations of toxicant present in the medium surrounding cells in in vitro models are an adequate biomarker of cell or tissue levels. However, this assu...

  4. Low Dose Suppression of Neoplastic Transformation in Vitro

    SciTech Connect

    John Leslie Redpath

    2012-05-01

    This grant was to study the low dose suppression of neoplastic transformation in vitro and the shape of the dose-response curve at low doses and dose-rates of ionizing radiation. Previous findings had indicated a suppression of transformation at dose <10cGy of low-LET radiation when delivered at high dose-rate. The present study indicates that such suppression extends out to doses in excess of 100cGy when the dose (from I-125 photons) is delivered at dose-rates as low as 0.2 mGy/min and out to in excess of {approx}25cGy the highest dose studied at the very low dose-rate of 0.5 mGy/day. We also examined dose-rate effects for high energy protons (which are a low-LET radiation) and suppression was evident below {approx}10cGy for high dose-rate delivery and at least out to 50cGy for low dose-rate (20cGy/h) delivery. Finally, we also examined the effect of low doses of 1 GeV/n iron ions (a high-LET radiation) delivered at high dose-rate on transformation at low doses and found a suppression below {approx}10cGy that could be attributable to an adaptive response in bystander cells induced by the associated low-LET delta rays. These results have implications for cancer risk assessment at low doses.

  5. Estimating peak skin and eye lens dose from neuroperfusion examinations: Use of Monte Carlo based simulations and comparisons to CTDIvol, AAPM Report No. 111, and ImPACT dosimetry tool values

    PubMed Central

    Zhang, Di; Cagnon, Chris H.; Villablanca, J. Pablo; McCollough, Cynthia H.; Cody, Dianna D.; Zankl, Maria; Demarco, John J.; McNitt-Gray, Michael F.

    2013-01-01

    Purpose: CT neuroperfusion examinations are capable of delivering high radiation dose to the skin or lens of the eyes of a patient and can possibly cause deterministic radiation injury. The purpose of this study is to: (a) estimate peak skin dose and eye lens dose from CT neuroperfusion examinations based on several voxelized adult patient models of different head size and (b) investigate how well those doses can be approximated by some commonly used CT dose metrics or tools, such as CTDIvol, American Association of Physicists in Medicine (AAPM) Report No. 111 style peak dose measurements, and the ImPACT organ dose calculator spreadsheet. Methods: Monte Carlo simulation methods were used to estimate peak skin and eye lens dose on voxelized patient models, including GSF's Irene, Frank, Donna, and Golem, on four scanners from the major manufacturers at the widest collimation under all available tube potentials. Doses were reported on a per 100 mAs basis. CTDIvol measurements for a 16 cm CTDI phantom, AAPM Report No. 111 style peak dose measurements, and ImPACT calculations were performed for available scanners at all tube potentials. These were then compared with results from Monte Carlo simulations. Results: The dose variations across the different voxelized patient models were small. Dependent on the tube potential and scanner and patient model, CTDIvol values overestimated peak skin dose by 26%–65%, and overestimated eye lens dose by 33%–106%, when compared to Monte Carlo simulations. AAPM Report No. 111 style measurements were much closer to peak skin estimates ranging from a 14% underestimate to a 33% overestimate, and with eye lens dose estimates ranging from a 9% underestimate to a 66% overestimate. The ImPACT spreadsheet overestimated eye lens dose by 2%–82% relative to voxelized model simulations. Conclusions: CTDIvol consistently overestimates dose to eye lens and skin. The ImPACT tool also overestimated dose to eye lenses. As such they are still

  6. Delivering Hubble Discoveries to the Classroom

    NASA Astrophysics Data System (ADS)

    Eisenhamer, B.; Villard, R.; Weaver, D.; Cordes, K.; Knisely, L.

    2013-04-01

    Today's classrooms are significantly influenced by current news events, delivered instantly into the classroom via the Internet. Educators are challenged daily to transform these events into student learning opportunities. In the case of space science, current news events may be the only chance for educators and students to explore the marvels of the Universe. Inspired by these circumstances, the education and news teams developed the Star Witness News science content reading series. These online news stories (also available in downloadable PDF format) mirror the content of Hubble press releases and are designed for upper elementary and middle school level readers to enjoy. Educators can use Star Witness News stories to reinforce students' reading skills while exposing students to the latest Hubble discoveries.

  7. Scientific Publishing: Adding Value, Delivering Impact

    NASA Astrophysics Data System (ADS)

    Mayes, Beth

    2015-08-01

    Publishers are developing new services and applying new technologies to improve publication and reading experiences for the scholarly community. This needs to be implemented with care to avoid adding technology-driven complexity. Our publishing processes need to be widely accessible to both authors and readers and to maintain the scientific record. Beth Mayes will outline new developments at IOP Publishing delivering (1) improvements to the presentation of articles and their commitment to formats that go beyond the PDF, improving the understanding of research. (2) How IOP Publishing is responding to the growing calls for metadata and linking that involve being central to the shared information ecosystem for astronomy. (3) After publication, discuss how publishers invest in metrics and new initiatives for discovery that improve the impact of published research.

  8. ISES Experience in Delivering Space Weather Services

    NASA Astrophysics Data System (ADS)

    Boteler, David

    The International Space Environment Service has over eighty years experience in providing space weather services to meet a wide variety of user needs. This started with broadcast on December 1, 2008 from the Eiffel Tower about radio conditions. The delivery of information about ionospheric effects on high frequency (HF) radio propagation continue to be a major concern in many parts of the world. The movement into space brought requirements for a new set of space weather services, ranging from radiation dangers to man in space, damage to satellites and effects on satellite communication and navigation systems. On the ground magnetic survey, power system and pipeline operators require information about magnetic disturbances that can affect their operations. In the past these services have been delivered by individual Regional Warning Centres. However, the needs of new trans-national users are stimulating the development of new collaborative international space weather services.

  9. Improving the Blanco Telescope's delivered image quality

    NASA Astrophysics Data System (ADS)

    Abbott, Timothy M. C.; Montane, Andrés; Tighe, Roberto; Walker, Alistair R.; Gregory, Brooke; Smith, R. Christopher; Cisternas, Alfonso

    2010-07-01

    The V. M. Blanco 4-m telescope at Cerro Tololo Inter-American Observatory is undergoing a number of improvements in preparation for the delivery of the Dark Energy Camera. The program includes upgrades having potential to deliver gains in image quality and stability. To this end, we have renovated the support structure of the primary mirror, incorporating innovations to improve both the radial support performance and the registration of the mirror and telescope top end. The resulting opto-mechanical condition of the telescope is described. We also describe some improvements to the environmental control. Upgrades to the telescope control system and measurements of the dome environment are described in separate papers in this conference.

  10. Empathic engineering: helping deliver dignity through design.

    PubMed

    Hosking, Ian; Cornish, Katie; Bradley, Mike; Clarkson, P John

    2014-01-01

    Dignity is a key value within healthcare. Technology is also recognized as being a fundamental part of healthcare delivery, but also a potential cause of dehumanization of the patient. Therefore, understanding how medical devices can be designed to help deliver dignity is important. This paper explores the role of empathy tools as a way of engendering empathy in engineers and designers to enable them to design for dignity. A framework is proposed that makes the link between empathy tools and outcomes of feelings of dignity. It represents a broad systems view that provides a structure for reviewing the evidence for the efficacy of empathy tools and also how dignity can be systematically understood for particular medical devices.

  11. LNG carrier using membrane tank system delivered

    SciTech Connect

    Not Available

    1993-12-06

    The world's first LNG carrier that incorporates the Technigaz Mark 3 membrane tank system was delivered in October to its owner, Asia LNG Transport Sdn. Bhd., a joint venture between Nippon Yusen K.K. and Perbadanan Nasional Shipping Line Berhad of Malaysia. NKK built the 18,800 cu m, fully double-hull carrier Aman Bintulu at its Tsu works. Construction was completed in September with more than 2 months of sea trials and gas tests using [minus]190 C. Liquid nitrogen and final gas trails with LNG. The orthogonally corrugated stainless membrane primary barrier and the triplex (aluminum foil/fiber glass cloth) composite-material secondary barrier prevent LNG from leaking in the event of an accident.

  12. Delivering Astronomy Software with Minimal user Maintenance

    NASA Astrophysics Data System (ADS)

    Fabbro, S.; Goliath, S.

    2013-10-01

    We present an approach to deliver astronomy processing software using virtualization and a network file system. User-requested astronomy software applications are built and tested on a dedicated server, and distributed on-demand to cloud-based worker clients using a fast HTTP read-only cache file system. The worker clients are light virtual machines which keep overheads to processing resources very small, while still ensuring the portability of all software applications. The goal is to limit the need for astronomers to carry out software maintenance tasks and to keep consistency between batch processing and interactive analysis sessions. We describe the design and infrastructure of the system, the software building process on the server, and show an application with a multi-frame automated transient detection on a wide field survey, with a batch processing on a cloud infrastructure.

  13. Empathic engineering: helping deliver dignity through design

    PubMed Central

    Hosking, Ian; Cornish, Katie; Bradley, Mike; Clarkson, P. John

    2015-01-01

    Abstract Dignity is a key value within healthcare. Technology is also recognized as being a fundamental part of healthcare delivery, but also a potential cause of dehumanization of the patient. Therefore, understanding how medical devices can be designed to help deliver dignity is important. This paper explores the role of empathy tools as a way of engendering empathy in engineers and designers to enable them to design for dignity. A framework is proposed that makes the link between empathy tools and outcomes of feelings of dignity. It represents a broad systems view that provides a structure for reviewing the evidence for the efficacy of empathy tools and also how dignity can be systematically understood for particular medical devices. PMID:26453036

  14. Independent dose calculations for commissioning, quality assurance and dose reconstruction of PBS proton therapy

    NASA Astrophysics Data System (ADS)

    Meier, G.; Besson, R.; Nanz, A.; Safai, S.; Lomax, A. J.

    2015-04-01

    Pencil beam scanning proton therapy allows the delivery of highly conformal dose distributions by delivering several thousand pencil beams. These beams have to be individually optimised and accurately delivered requiring a significant quality assurance workload. In this work we describe a toolkit for independent dose calculations developed at Paul Scherrer Institut which allows for dose reconstructions at several points in the treatment workflow. Quality assurance based on reconstructed dose distributions was shown to be favourable to pencil beam by pencil beam comparisons for the detection of delivery uncertainties and estimation of their effects. Furthermore the dose reconstructions were shown to have a sensitivity of the order of or higher than the measurements currently employed in the clinical verification procedures. The design of the independent dose calculation tool allows for a high modifiability of the dose calculation parameters (e.g. depth dose profiles, angular spatial distributions) allowing for a safe environment outside of the clinical treatment planning system for investigating the effect of such parameters on the resulting dose distributions and thus distinguishing between different contributions to measured dose deviations. The presented system could potentially reduce the amount of patient-specific quality assurance measurements which currently constitute a bottleneck in the clinical workflow.

  15. Independent dose calculations for commissioning, quality assurance and dose reconstruction of PBS proton therapy.

    PubMed

    Meier, G; Besson, R; Nanz, A; Safai, S; Lomax, A J

    2015-04-01

    Pencil beam scanning proton therapy allows the delivery of highly conformal dose distributions by delivering several thousand pencil beams. These beams have to be individually optimised and accurately delivered requiring a significant quality assurance workload. In this work we describe a toolkit for independent dose calculations developed at Paul Scherrer Institut which allows for dose reconstructions at several points in the treatment workflow. Quality assurance based on reconstructed dose distributions was shown to be favourable to pencil beam by pencil beam comparisons for the detection of delivery uncertainties and estimation of their effects. Furthermore the dose reconstructions were shown to have a sensitivity of the order of or higher than the measurements currently employed in the clinical verification procedures. The design of the independent dose calculation tool allows for a high modifiability of the dose calculation parameters (e.g. depth dose profiles, angular spatial distributions) allowing for a safe environment outside of the clinical treatment planning system for investigating the effect of such parameters on the resulting dose distributions and thus distinguishing between different contributions to measured dose deviations. The presented system could potentially reduce the amount of patient-specific quality assurance measurements which currently constitute a bottleneck in the clinical workflow. PMID:25779992

  16. The impact of inter-fraction dose variations on biological equivalent dose (BED): the concept of equivalent constant dose

    NASA Astrophysics Data System (ADS)

    Zavgorodni, S.

    2004-12-01

    Inter-fraction dose fluctuations, which appear as a result of setup errors, organ motion and treatment machine output variations, may influence the radiobiological effect of the treatment even when the total delivered physical dose remains constant. The effect of these inter-fraction dose fluctuations on the biological effective dose (BED) has been investigated. Analytical expressions for the BED accounting for the dose fluctuations have been derived. The concept of biological effective constant dose (BECD) has been introduced. The equivalent constant dose (ECD), representing the constant physical dose that provides the same cell survival fraction as the fluctuating dose, has also been introduced. The dose fluctuations with Gaussian as well as exponential probability density functions were investigated. The values of BECD and ECD calculated analytically were compared with those derived from Monte Carlo modelling. The agreement between Monte Carlo modelled and analytical values was excellent (within 1%) for a range of dose standard deviations (0-100% of the dose) and the number of fractions (2 to 37) used in the comparison. The ECDs have also been calculated for conventional radiotherapy fields. The analytical expression for the BECD shows that BECD increases linearly with the variance of the dose. The effect is relatively small, and in the flat regions of the field it results in less than 1% increase of ECD. In the penumbra region of the 6 MV single radiotherapy beam the ECD exceeded the physical dose by up to 35%, when the standard deviation of combined patient setup/organ motion uncertainty was 5 mm. Equivalently, the ECD field was ~2 mm wider than the physical dose field. The difference between ECD and the physical dose is greater for normal tissues than for tumours.

  17. The impact of image-guided radiation therapy on the dose distribution in prostate cancer using deformable registration

    NASA Astrophysics Data System (ADS)

    Schaly, Bryan

    Dosimetric uncertainties due to variable anatomy and beam setup variability pose a significant limitation in modern precision radiotherapy. These uncertainties may lead to discrepancies between the planned and actual dose distribution delivered to the patient. This may have an adverse impact on the treatment outcome in terms of recurrent tumour growth and/or causing complications in normal tissues. This work investigates the hypothesis that image-guided radiation therapy is needed to reduce the detrimental effects of changes in anatomy on the delivered dose distribution in cancer patients. To test this hypothesis, a deformable model is developed to enable the quantification of dose differences due to patient repositioning and variable anatomy. The deformable model is based on contour-driven thin-plate splines to track the position of tissue elements within the patient. This is combined with recalculation of the treatment plan using frequent computed tomography (CT) image data acquired at different times during treatment. It is demonstrated using a clinical prostate case that dose differences in the rectum and bladder are significant (˜25%) after a multiple fraction treatment. The deformable model is validated using phantom and clinical prostate CT data. A mathematical phantom is used to demonstrate that the accuracy in tracking the dose delivered to a tissue element is 3--4% in high dose gradient regions. Ten prostate cancer patients with radio-opaque markers implanted in the prostate and seminal vesicles are used to demonstrate that the deformable model is accurate (˜2.5 mm) to within the intra-observer contouring variability. The impact of correcting for setup uncertainty and inter-fraction tumour motion is explored by comparing treatment scenarios that would employ current image guidance technology to conventional treatment (i.e., alignment to external markers). This work demonstrates that geographic tumour miss is remedied using image-guided treatment and day

  18. [Indications for low-dose CT in the emergency setting].

    PubMed

    Poletti, Pierre-Alexandre; Andereggen, Elisabeth; Rutschmann, Olivier; de Perrot, Thomas; Caviezel, Alessandro; Platon, Alexandra

    2009-08-19

    CT delivers a large dose of radiation, especially in abdominal imaging. Recently, a low-dose abdominal CT protocol (low-dose CT) has been set-up in our institution. "Low-dose CT" is almost equivalent to a single standard abdominal radiograph in term of dose of radiation (about one sixth of those delivered by a standard CT). "Low-dose CT" is now used routinely in our emergency service in two main indications: patients with a suspicion of renal colic and those with right lower quadrant pain. It is obtained without intravenous contrast media. Oral contrast is given to patients with suspicion of appendicitis. "Low-dose CT" is used in the frame of well defined clinical algorithms, and does only replace standard CT when it can reach a comparable diagnostic quality.

  19. Consequences of Predicted or Actual Asteroid Impacts

    NASA Astrophysics Data System (ADS)

    Chapman, C. R.

    2003-12-01

    Earth impact by an asteroid could have enormous physical and environmental consequences. Impactors larger than 2 km diameter could be so destructive as to threaten civilization. Since such events greatly exceed any other natural or man-made catastrophe, much extrapolation is necessary just to understand environmental implications (e.g. sudden global cooling, tsunami magnitude, toxic effects). Responses of vital elements of the ecosystem (e.g. agriculture) and of human society to such an impact are conjectural. For instance, response to the Blackout of 2003 was restrained, but response to 9/11 terrorism was arguably exaggerated and dysfunctional; would society be fragile or robust in the face of global catastrophe? Even small impacts, or predictions of impacts (accurate or faulty), could generate disproportionate responses, especially if news media reports are hyped or inaccurate or if responsible entities (e.g. military organizations in regions of conflict) are inadequately aware of the phenomenology of small impacts. Asteroid impact is the one geophysical hazard of high potential consequence with which we, fortunately, have essentially no historical experience. It is thus important that decision makers familiarize themselves with the hazard and that society (perhaps using a formal procedure, like a National Academy of Sciences study) evaluate the priority of addressing the hazard by (a) further telescopic searches for dangerous but still-undiscovered asteroids and (b) development of mitigation strategies (including deflection of an oncoming asteroid and on- Earth civil defense). I exemplify these issues by discussing several representative cases that span the range of parameters. Many of the specific physical consequences of impact involve effects like those of other geophysical disasters (flood, fire, earthquake, etc.), but the psychological and sociological aspects of predicted and actual impacts are distinctive. Standard economic cost/benefit analyses may not

  20. Multiple anatomy optimization of accumulated dose

    SciTech Connect

    Watkins, W. Tyler Siebers, Jeffrey V.; Moore, Joseph A.; Gordon, James; Hugo, Geoffrey D.

    2014-11-01

    Purpose: To investigate the potential advantages of multiple anatomy optimization (MAO) for lung cancer radiation therapy compared to the internal target volume (ITV) approach. Methods: MAO aims to optimize a single fluence to be delivered under free-breathing conditions such that the accumulated dose meets the plan objectives, where accumulated dose is defined as the sum of deformably mapped doses computed on each phase of a single four dimensional computed tomography (4DCT) dataset. Phantom and patient simulation studies were carried out to investigate potential advantages of MAO compared to ITV planning. Through simulated delivery of the ITV- and MAO-plans, target dose variations were also investigated. Results: By optimizing the accumulated dose, MAO shows the potential to ensure dose to the moving target meets plan objectives while simultaneously reducing dose to organs at risk (OARs) compared with ITV planning. While consistently superior to the ITV approach, MAO resulted in equivalent OAR dosimetry at planning objective dose levels to within 2% volume in 14/30 plans and to within 3% volume in 19/30 plans for each lung V20, esophagus V25, and heart V30. Despite large variations in per-fraction respiratory phase weights in simulated deliveries at high dose rates (e.g., treating 4/10 phases during single fraction beams) the cumulative clinical target volume (CTV) dose after 30 fractions and per-fraction dose were constant independent of planning technique. In one case considered, however, per-phase CTV dose varied from 74% to 117% of prescription implying the level of ITV-dose heterogeneity may not be appropriate with conventional, free-breathing delivery. Conclusions: MAO incorporates 4DCT information in an optimized dose distribution and can achieve a superior plan in terms of accumulated dose to the moving target and OAR sparing compared to ITV-plans. An appropriate level of dose heterogeneity in MAO plans must be further investigated.

  1. Multiple anatomy optimization of accumulated dose

    PubMed Central

    Watkins, W. Tyler; Moore, Joseph A.; Gordon, James; Hugo, Geoffrey D.; Siebers, Jeffrey V.

    2014-01-01

    Purpose: To investigate the potential advantages of multiple anatomy optimization (MAO) for lung cancer radiation therapy compared to the internal target volume (ITV) approach. Methods: MAO aims to optimize a single fluence to be delivered under free-breathing conditions such that the accumulated dose meets the plan objectives, where accumulated dose is defined as the sum of deformably mapped doses computed on each phase of a single four dimensional computed tomography (4DCT) dataset. Phantom and patient simulation studies were carried out to investigate potential advantages of MAO compared to ITV planning. Through simulated delivery of the ITV- and MAO-plans, target dose variations were also investigated. Results: By optimizing the accumulated dose, MAO shows the potential to ensure dose to the moving target meets plan objectives while simultaneously reducing dose to organs at risk (OARs) compared with ITV planning. While consistently superior to the ITV approach, MAO resulted in equivalent OAR dosimetry at planning objective dose levels to within 2% volume in 14/30 plans and to within 3% volume in 19/30 plans for each lung V20, esophagus V25, and heart V30. Despite large variations in per-fraction respiratory phase weights in simulated deliveries at high dose rates (e.g., treating 4/10 phases during single fraction beams) the cumulative clinical target volume (CTV) dose after 30 fractions and per-fraction dose were constant independent of planning technique. In one case considered, however, per-phase CTV dose varied from 74% to 117% of prescription implying the level of ITV-dose heterogeneity may not be appropriate with conventional, free-breathing delivery. Conclusions: MAO incorporates 4DCT information in an optimized dose distribution and can achieve a superior plan in terms of accumulated dose to the moving target and OAR sparing compared to ITV-plans. An appropriate level of dose heterogeneity in MAO plans must be further investigated. PMID:25370619

  2. Automated administration of intermittent intravenous doses.

    PubMed

    Lutomski, D M; Schwartz-Fulton, J; Rivera, J O

    1985-11-01

    The cost difference of administering cimetidine 300 mg via intravenous piggyback (IVPB) every six hours by a conventional separate container system versus using an automated intermittent i.v. administration system was evaluated. The study was conducted in two phases. Phase 1 documented the amount of drug waste with the two systems, and phase 2 examined the practical use of the IVAC Multi Dose System. Nurses who administered the medication using the multiple-dose system completed a questionnaire on its operation. A materials cost analysis was performed to compare the two methods. The two systems were found to have approximately equivalent amounts of drug waste over the 30-day evaluation period of phase 1. The mean percentage of doses wasted was 12.2% with the conventional single-dose minibag method and 12.7% with the automated multiple-dose method. The multiple-dose system had a lower cost per dose of cimetidine ($2.25 versus $3.47). These savings appear to outweigh the cost of the additional equipment necessary for the automated system. The majority of nurses preferred the multiple-dose system. Potential problems encountered in accurately delivering doses with the multiple-dose automated system were identified, and possible solutions are suggested. The use of an automated multiple-dose i.v. administration system can potentially decrease the materials cost portion of drug administration. The total impact on hospital costs needs to be evaluated, and other comparisons with alternative administration systems need to be performed.

  3. Simulation of dose reduction in tomosynthesis

    SciTech Connect

    Svalkvist, Angelica; Baath, Magnus

    2010-01-15

    Purpose: Methods for simulating dose reduction are valuable tools in the work of optimizing radiographic examinations. Using such methods, clinical images can be simulated to have been collected at other, lower, dose levels without the need of additional patient exposure. A recent technology introduced to healthcare that needs optimization is tomosynthesis, where a number of low-dose projection images collected at different angles is used to reconstruct section images of an imaged object. The aim of the present work was to develop a method of simulating dose reduction for digital radiographic systems, suitable for tomosynthesis. Methods: The developed method uses information about the noise power spectrum (NPS) at the original dose level and the simulated dose level to create a noise image that is added to the original image to produce an image that has the same noise properties as an image actually collected at the simulated dose level. As the detective quantum efficiency (DQE) of digital detectors operating at the low dose levels used for tomosynthesis may show a strong dependency on the dose level, it is important that a method for simulating dose reduction for tomosynthesis takes this dependency into account. By applying an experimentally determined relationship between pixel mean and pixel variance, variations in both dose and DQE in relevant dose ranges are taken into account. Results: The developed method was tested on a chest tomosynthesis system and was shown to produce NPS of simulated dose-reduced projection images that agreed well with the NPS of images actually collected at the simulated dose level. The simulated dose reduction method was also applied to tomosynthesis examinations of an anthropomorphic chest phantom, and the obtained noise in the reconstructed section images was very similar to that of an examination actually performed at the simulated dose level. Conclusions: In conclusion, the present article describes a method for simulating dose

  4. Leveraging Gaming Technology to Deliver Effective Training

    NASA Technical Reports Server (NTRS)

    Cimino, James D.

    2011-01-01

    The best way to engage a soldier is to present them with training content consistent with their learning preference. Blended Interactive Multimedia Instruction (IMI) can be used to leach soldiers what they need to do, how to do each step, and utilize a COTS game engine to actually practices the skills learned. Blended IMI provides an enjoyable experience for the soldier, thereby increasing retention rates and motivation while decreasing the time to subject mastery. And now mobile devices have emerged as an exciting new platform, literally placing the training into the soldier's hands. In this paper, we will discuss how we leveraged commercial game engine technology, tightly integrated with the Blended IMI, to train soldiers on both laptops and mobile devices. We will provide a recent case study of how this training is being utilized, benefits and student/instructor feedback.

  5. Design Environment for Novel Vertical Lift Vehicles: DELIVER

    NASA Technical Reports Server (NTRS)

    Theodore, Colin

    2016-01-01

    This is a 20 minute presentation discussing the DELIVER vision. DELIVER is part of the ARMD Transformative Aeronautics Concepts Program, particularly the Convergent Aeronautics Solutions Project. The presentation covers the DELIVER vision, transforming markets, conceptual design process, challenges addressed, technical content, and FY2016 key activities.

  6. Impact of Drug Therapy, Radiation Dose, and Dose Rate on Renal Toxicity Following Bone Marrow Transplantation

    SciTech Connect

    Cheng, Jonathan C.; Schultheiss, Timothy E. Wong, Jeffrey Y.C.

    2008-08-01

    Purpose: To demonstrate a radiation dose response and to determine the dosimetric and chemotherapeutic factors that influence the incidence of late renal toxicity following total body irradiation (TBI). Methods and Materials: A comprehensive retrospective review was performed of articles reporting late renal toxicity, along with renal dose, fractionation, dose rate, chemotherapy regimens, and potential nephrotoxic agents. In the final analysis, 12 articles (n = 1,108 patients), consisting of 24 distinct TBI/chemotherapy conditioning regimens were included. Regimens were divided into three subgroups: adults (age {>=}18 years), children (age <18 years), and mixed population (both adults and children). Multivariate logistic regression was performed to identify dosimetric and chemotherapeutic factors significantly associated with late renal complications. Results: Individual analysis was performed on each population subgroup. For the purely adult population, the only significant variable was total dose. For the mixed population, the significant variables included total dose, dose rate, and the use of fludarabine. For the pediatric population, only the use of cyclosporin or teniposide was significant; no dose response was noted. A logistic model was generated with the exclusion of the pediatric population because of its lack of dose response. This model yielded the following significant variables: total dose, dose rate, and number of fractions. Conclusion: A dose response for renal damage after TBI was identified. Fractionation and low dose rates are factors to consider when delivering TBI to patients undergoing bone marrow transplantation. Drug therapy also has a major impact on kidney function and can modify the dose-response function.

  7. 40 CFR 74.22 - Actual SO2 emissions rate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 17 2012-07-01 2012-07-01 false Actual SO2 emissions rate. 74.22... (CONTINUED) SULFUR DIOXIDE OPT-INS Allowance Calculations for Combustion Sources § 74.22 Actual SO2 emissions... actual SO2 emissions rate shall be 1985. (2) For combustion sources that commenced operation...

  8. Actualization and the Fear of Death: Retesting an Existential Hypothesis.

    ERIC Educational Resources Information Center

    Wood, Keith; Robinson, Paul J.

    1982-01-01

    Demonstrates that within a group of highly actualized individuals, the degree to which "own death" is integrated into constructs of self is a far more powerful predictor of fear of death than actualization. Findings suggest that actualization and integration are independent in their overall effect on fear of death. (Author)

  9. Boron self-shielding effects on dose delivery of neutron capture therapy using epithermal beam and boronophenylalanine.

    PubMed

    Ye, S J

    1999-11-01

    Previous dosimetry studies for boron neutron capture therapy have often neglected the thermal neutron self-shielding effects caused by the 10B accumulation in the brain and the tumor. The neglect of thermal neutron flux depression, therefore, results in an overestimation of the actual dose delivery. The relevant errors are expected to be more pronounced when boronophenylalanine is used in conjunction with an epithermal neutron beam. In this paper, the boron self-shielding effects are calculated in terms of the thermal neutron flux depression across the brain and the dose delivered to the tumors. The degree of boron self-shielding is indicated by the difference between the thermal neutron fluxes calculated with and without considering a 10B concentration as part of the head phantom composition. The boron self-shielding effect is found to increase with increasing 10B concentrations and penetration depths from the skin. The calculated differences for 10B concentrations of 7.5-30 ppm are 2.3%-8.3% at 2.3 cm depth (depth of the maximum brain dose) and 4.6%-17% at 7.3 cm depth (the center of the brain). The additional self-shielding effects by the 10B concentration in a bulky tumor are investigated for a 3-cm-diam spherical tumor located either near the surface (3.3 cm depth) or at the center of the brain (7.3 cm depth) along the beam centerline. For 45 ppm of 10B in the tumor and 15 ppm of 10B in the brain, the dose delivered to the tumors is approximately 10% lower at 3.3 cm depth and 20% lower at the center of the brain, compared to the dose neglecting the boron self-shielding in transport calculations.

  10. Strategies to improve clinical outcomes in peritoneal dialysis patients: delivered dose and membrane transport.

    PubMed

    Churchill, D N

    1998-12-01

    For patients with end-stage renal disease treated with peritoneal dialysis, prospective cohort studies using multivariate statistical analysis have shown an association between greater urea clearance and a decreased relative risk for death. The recommended weekly Kt/V for urea is 2.0, with the corresponding creatinine clearance (CrCl) of 60 L/1.73 m2. This is considered adequate dialysis but fails to define optimum urea and CrCl targets. The assumption that renal and peritoneal clearances are equivalent has been challenged by circumstantial data and is probably untenable. The relative importance of these clearances requires definition. The suggestion that CrCl is a more important indicator of adequacy of dialysis is confounded by association with renal, rather than peritoneal, clearance and perhaps by the early referral and initiation of dialysis. Recent reports have shown an association between increased peritoneal membrane transport and an increased relative risk for technique failure and/or death. Patients with higher peritoneal transport should have greater clearance of urea and creatinine and better clinical outcomes. Possible explanations for this apparent contradiction include the adverse effects of increased glucose absorption, malnutrition, and fluid overload, the latter caused by decreased ultrafiltration. Available data suggest an important role for the failure of ultrafiltration among patients treated with continuous ambulatory peritoneal dialysis (CAPD). Strategies to improve the clearance of urea and creatinine include the preservation of residual renal function and increased peritoneal clearance. Loss of residual renal function may be delayed by the avoidance of nephrotoxic drugs and angiographic dye. Peritoneal clearance can be enhanced by a combination of increased volume and frequency of peritoneal dialysis cycles. Ultrafiltration failure, but not protein loss, can be addressed with shorter cycles with nocturnal peritoneal dialysis. Development of an alternative to glucose as an osmotic agent is an important strategy.

  11. Delivering a Healthy Dose of Health Education: An Interview with Betsy Aumiller

    ERIC Educational Resources Information Center

    Curriculum Review, 2006

    2006-01-01

    Learn to Be Healthy is a new interactive health curriculum for grades 1-6 created by the Susan R. Byrnes Health Education Center, which has offered on-site health education for central and southern Pennsylvania and northern Maryland schools since 1995. The free online resource, developed with funding from the Highmark Foundation, is available at…

  12. Physiotherapist Delivered Preparticipation Examination: Rationale and Evidence

    PubMed Central

    Emery, Carolyn

    2006-01-01

    Preparticipation examinations are often performed based on the assumption that the exam contributes to the identification of risk factors for injury and, therefore, lead to the implementation of appropriate injury prevention strategies for athletes. Research evidence supporting the components, benefits, and limitations of the preparticipation examination performed by a physiotherapist is the focus of this paper. Evidence exists that some specific preparticipation examination components will identify known risk factors which may be addressed in the context of injury prevention strategies for that athlete. Examinations should use existing evidence-based practice to identify valid and appropriate tests examining known risk factors. Physiotherapists are encouraged to continue development, implementation, and evaluation of appropriate training techniques for the athletes to minimize their risk of injury. Physiotherapists need to be aware of athlete confidentiality issues as well as the importance of cost effectiveness of preparticipation examinations. The future of physiotherapist delivered preparticipation examinations may lie in the utilization of an evidence-based approach to risk factor identification, development and evaluation of prevention strategies, and development and evaluation of performance enhancement strategies for the athlete. PMID:21522220

  13. Integral dose: Comparison between four techniques for prostate radiotherapy

    PubMed Central

    Ślosarek, Krzysztof; Osewski, Wojciech; Grządziel, Aleksandra; Radwan, Michał; Dolla, Łukasz; Szlag, Marta; Stąpór-Fudzińska, Małgorzata

    2014-01-01

    Aim Comparisons of integral dose delivered to the treatment planning volume and to the whole patient body during stereotactic, helical and intensity modulated radiotherapy of prostate. Background Multifield techniques produce large volumes of low dose inside the patient body. Delivered dose could be the result of the cytotoxic injuries of the cells even away from the treatment field. We calculated the total dose absorbed in the patient body for four radiotherapy techniques to investigate whether some methods have a potential to reduce the exposure to the patient. Materials and methods We analyzed CyberKnife plans for 10 patients with localized prostate cancer. Five alternative plans for each patient were calculated with the VMAT, IMRT and TomoTherapy techniques. Alternative dose distributions were calculated to achieve the same coverage for PTV. Integral Dose formula was used to calculate the total dose delivered to the PTV and whole patient body. Results Analysis showed that the same amount of dose was deposited to the treated volume despite different methods of treatment delivery. The mean values of total dose delivered to the whole patient body differed significantly for each treatment technique. The highest integral dose in the patient's body was at the TomoTherapy and CyberKnife treatment session. VMAT was characterized by the lowest integral dose deposited in the patient body. Conclusions The highest total dose absorbed in normal tissue was observed with the use of a robotic radiosurgery system and TomoTherapy. These results demonstrate that the exposure of healthy tissue is a dosimetric factor which differentiates the dose delivery methods. PMID:25859398

  14. Global cancer surgery: delivering safe, affordable, and timely cancer surgery.

    PubMed

    Sullivan, Richard; Alatise, Olusegun Isaac; Anderson, Benjamin O; Audisio, Riccardo; Autier, Philippe; Aggarwal, Ajay; Balch, Charles; Brennan, Murray F; Dare, Anna; D'Cruz, Anil; Eggermont, Alexander M M; Fleming, Kenneth; Gueye, Serigne Magueye; Hagander, Lars; Herrera, Cristian A; Holmer, Hampus; Ilbawi, André M; Jarnheimer, Anton; Ji, Jia-Fu; Kingham, T Peter; Liberman, Jonathan; Leather, Andrew J M; Meara, John G; Mukhopadhyay, Swagoto; Murthy, Shilpa S; Omar, Sherif; Parham, Groesbeck P; Pramesh, C S; Riviello, Robert; Rodin, Danielle; Santini, Luiz; Shrikhande, Shailesh V; Shrime, Mark; Thomas, Robert; Tsunoda, Audrey T; van de Velde, Cornelis; Veronesi, Umberto; Vijaykumar, Dehannathparambil Kottarathil; Watters, David; Wang, Shan; Wu, Yi-Long; Zeiton, Moez; Purushotham, Arnie

    2015-09-01

    Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.

  15. Global cancer surgery: delivering safe, affordable, and timely cancer surgery.

    PubMed

    Sullivan, Richard; Alatise, Olusegun Isaac; Anderson, Benjamin O; Audisio, Riccardo; Autier, Philippe; Aggarwal, Ajay; Balch, Charles; Brennan, Murray F; Dare, Anna; D'Cruz, Anil; Eggermont, Alexander M M; Fleming, Kenneth; Gueye, Serigne Magueye; Hagander, Lars; Herrera, Cristian A; Holmer, Hampus; Ilbawi, André M; Jarnheimer, Anton; Ji, Jia-Fu; Kingham, T Peter; Liberman, Jonathan; Leather, Andrew J M; Meara, John G; Mukhopadhyay, Swagoto; Murthy, Shilpa S; Omar, Sherif; Parham, Groesbeck P; Pramesh, C S; Riviello, Robert; Rodin, Danielle; Santini, Luiz; Shrikhande, Shailesh V; Shrime, Mark; Thomas, Robert; Tsunoda, Audrey T; van de Velde, Cornelis; Veronesi, Umberto; Vijaykumar, Dehannathparambil Kottarathil; Watters, David; Wang, Shan; Wu, Yi-Long; Zeiton, Moez; Purushotham, Arnie

    2015-09-01

    Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning. PMID:26427363

  16. Phage therapy dosing: The problem(s) with multiplicity of infection (MOI)

    PubMed Central

    Abedon, Stephen T.

    2016-01-01

    ABSTRACT The concept of bacteriophage multiplicity of infection (MOI) – ratios of phages to bacteria – historically has been less easily applied than many phage workers would prefer or, perhaps, may be aware. Here, toward clarification of the concept, I discuss multiplicity of infection in terms of semantics, history, mathematics, pharmacology, and actual practice. For phage therapy and other biocontrol purposes it is desirable, especially, not to solely employ MOI to describe what phage quantities have been applied during dosing. Why? Bacterial densities can change between bacterial challenge and phage application, may not be easily determined immediately prior to phage dosing, and/or target bacterial populations may not be homogeneous with regard to phage access and thereby inconsistent in terms of what MOI individual bacteria experience. Toward experiment reproducibility and as practiced generally for antibacterial application, phage dosing instead should be described in terms of concentrations of formulations (phage titers) as well as volumes applied and, in many cases, absolute numbers of phages delivered. Such an approach typically will be far more desirable from a pharmacological perspective than solely indicating ratios of agents to bacteria. This essay was adapted, with permission, from an appendix of the 2011 monograph, Bacteriophages and Biofilms, Nova Science Publishers.

  17. More Soil Delivered to Phoenix Lab

    NASA Technical Reports Server (NTRS)

    2008-01-01

    This image, taken by NASA's Phoenix Mars Lander's Surface Stereo Imager, documents the delivery of a soil sample from the 'Snow White' trench to the Wet Chemistry Laboratory. A small pile of soil is visible on the lower edge of the second cell from the top.This deck-mounted lab is part of Phoenix's Microscopy, Electrochemistry and Conductivity Analyzer (MECA).

    The delivery was made on Sept. 12, 2008, which was Sol 107 (the 107th Martian day) of the mission, which landed on May 25, 2008.

    The Wet Chemistry Laboratory mixes Martian soil with an aqueous solution from Earth as part of a process to identify soluble nutrients and other chemicals in the soil. Preliminary analysis of this soil confirms that it is alkaline, and composed of salts and other chemicals such as perchlorate, sodium, magnesium, chloride and potassium. This data validates prior results from that same location, said JPL's Michael Hecht, the lead scientist for MECA.

    In the coming days, the Phoenix team will also fill the final four of eight single-use ovens on another soil-analysis instrument, the Thermal and Evolved Gas Analyzer, or TEGA. The team's strategy is to deliver as many samples as possible before the power produced by Phoenix's solar panels declines due to the end of the Martian summer.

    The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  18. Costs of delivering human papillomavirus vaccination to schoolgirls in Mwanza Region, Tanzania

    PubMed Central

    2012-01-01

    Background Cervical cancer is the leading cause of female cancer-related deaths in Tanzania. Vaccination against human papillomavirus (HPV) offers a new opportunity to control this disease. This study aimed to estimate the costs of a school-based HPV vaccination project in three districts in Mwanza Region (NCT ID: NCT01173900), Tanzania and to model incremental scaled-up costs of a regional vaccination program. Methods We first conducted a top-down cost analysis of the vaccination project, comparing observed costs of age-based (girls born in 1998) and class-based (class 6) vaccine delivery in a total of 134 primary schools. Based on the observed project costs, we then modeled incremental costs of a scaled-up vaccination program for Mwanza Region from the perspective of the Tanzanian government, assuming that HPV vaccines would be delivered through the Expanded Programme on Immunization (EPI). Results Total economic project costs for delivering 3 doses of HPV vaccine to 4,211 girls were estimated at about US$349,400 (including a vaccine price of US$5 per dose). Costs per fully-immunized girl were lower for class-based delivery than for age-based delivery. Incremental economic scaled-up costs for class-based vaccination of 50,290 girls in Mwanza Region were estimated at US$1.3 million. Economic scaled-up costs per fully-immunized girl were US$26.41, including HPV vaccine at US$5 per dose. Excluding vaccine costs, vaccine could be delivered at an incremental economic cost of US$3.09 per dose and US$9.76 per fully-immunized girl. Financial scaled-up costs, excluding costs of the vaccine and salaries of existing staff were estimated at US$1.73 per dose. Conclusions Project costs of class-based vaccination were found to be below those of age-based vaccination because of more eligible girls being identified and higher vaccine uptake. We estimate that vaccine can be delivered at costs that would make HPV vaccination a very cost-effective intervention. Potentially

  19. SU-E-T-506: Dosimetric Verification of Photon MLC Delivered Electron Fields for Implementing MERT On An Artiste Linac

    SciTech Connect

    Jin, L; Eldib, A; Li, J; Wang, L; Ma, C; Fan, J

    2014-06-01

    Purpose: To verify the dose accuracy of photon MLC delivered electron fields for implementing energy-intensity modulated electron radiotherapy (MERT) on an Artiste linac. Methods: It was proposed to deliver MERT on an Artiste linac at a short SSD (60 cm) to reduce beam penumbra caused by electron scatters. An in-house developed Monte Carlo (MC)-based dose calculation/optimization planning code was used for treatment planning. Our previous study showed that the measured dose distribution of a breast plan showed good agreement with the calculations in low-medium dose regions while the differences in high dose regions were outstanding. A continuous work found that the discrepancy is mainly caused by improper modeling in MC for the single focused MLC in the Artiste which was simplified as double focused in the previous MC simulations. With this remodeled MLC in the calculations, an energy-intensity modulated electron plan using 6, 9, 12 and 15 MeV was generated for a breast treatment on a breast phantom at a 60 cm SSD and recalculated regarding a solid water phantom. For a test study, four of MLC segments (each with a different energy) generated in the plan were delivered to the phantom and a film measurement was performed at the depth of 2 cm. The measured 2D dose distribution was then compared with calculations. Results: For composite doses of the four segments, measured 2D dose distributions overall agree well with the calculations (3mm/3%) in most area. The separate measurement for a single MLC segment for each of energies also showed the consistence with the calculations. Conclusion: After remodeling MLC in the MC calculations, the measured dose distribution for a subset of MLC segments from a MERT plan showed good agreement. Further detailed verification for the full plan will be the work in the next step.

  20. Dose evaluation from multiple detector outputs using convex optimisation.

    PubMed

    Hashimoto, Makoto; Iimoto, Takeshi; Kosako, Toshiso

    2011-07-01

    A dose evaluation using multiple radiation detectors can be improved by the convex optimisation method. It enables flexible dose evaluation corresponding to the actual radiation energy spectrum. An application to the neutron ambient dose equivalent evaluation is investigated using a mixed-gas proportional counter. The convex derives the certain neutron ambient dose with certain width corresponding to the true neutron energy spectrum. The range of the evaluated dose is comparable to the error of conventional neutron dose measurement equipments. An application to the neutron individual dose equivalent measurement is also investigated. Convexes of particular dosemeter combinations evaluate the individual dose equivalent better than the dose evaluation of a single dosemeter. The combinations of dosemeters with high orthogonality of their response characteristics tend to provide a good suitability for dose evaluation.

  1. Tumour dose estimation using automated TLD techniques.

    PubMed

    Ferguson, H M; Lambert, G D; Gustard, D; Harrison, R M

    1998-01-01

    Lithium fluoride (TLD-700) dosimeters were used to measure exit surface absorbed doses in external beam radiotherapy using an automated TLD reader. Delivered tumour absorbed doses were derived from these measurements for head and neck, pelvis and breast treatments. For the head and neck treatments (first fraction only), the mean percentage difference between prescribed and delivered tumour absorbed doses was -0.15 +/- 3.0% (+/- 1 SD), for the pelvic treatments -0.83 +/- 2.8% and for the breast treatments +0.26 +/- 2.9%. The spread of results is approximately +/- 3% (+/- 1 SD). This is comparable with the estimated uncertainty in a single TLD absorbed dose measurement in phantom (+/- 2%; +/- 1 SD). Thus, ICRU recommended tolerances for absorbed dose delivery of +/- 5% may not be unequivocally detectable using this method. An action level of +/- 10% is suggested, allowing investigation of possible gross errors in treatment delivery at an early stage, before the course of treatment has progressed to a point at which absorbed dose compensation is impossible.

  2. Delivering wasp venom for cancer therapy.

    PubMed

    Moreno, Miguel; Zurita, Esther; Giralt, Ernest

    2014-05-28

    Cytolytic peptides with potential therapeutic properties have appeared during the last three decades. However, the use of these natural weapons is relatively narrow due to their non-specific cytolytic activity as well as their rapid degradation and excretion when injected in blood. In order to rescue the use of these lytic peptides, we have designed pro-cytotoxic systems based on cytotoxic peptides conjugated to poly(l-glutamic acid) PGA polymer through specific cleavage sequences that are sensitive over-expressed tumor proteases, such as the metalloproteinase-2 (MMP-2) or cathepsin B. The potent cytotoxic peptide tested here, Mitoparan, is inactive when conjugated to the polymer and then become active again once released through the tumor proteases. Furthermore, this pro-cytotoxic system was decorated by a particular targeting peptide which binds to HER2 receptors over-expressed in some types of breast tumor cells, thereby increasing the selective release of cytolytic peptides inside tumor cell with exquisite spatiotemporal control. In this way, the system would improve the maximum tolerated dose and the pharmacokinetic parameters of cytotoxic peptides in vivo. PMID:24631864

  3. Comparison of dose distributions around the pulsed-dose-rate Fletcher Williamson and the low-dose-rate Fletcher Suit Delclos ovoids: a Monte Carlo study

    NASA Astrophysics Data System (ADS)

    Price, Michael J.; Gifford, Kent A.; Horton, John; Lawyer, Ann; Eifel, Patricia; Mourtada, Firas

    2006-08-01

    We performed a Monte Carlo study to compare dose distributions for a Fletcher-Suit-Delclos (FSD) ovoid used with 137Cs low-dose-rate (LDR) sources with those for a Fletcher-Williamson (FW) ovoid used with an 192Ir pulsed-dose-rate (PDR) source for intracavitary brachytherapy of cervical cancer. We recently reported on extensive validation of Monte Carlo MCNPX models of these ovoids using radiochromic film measurements. Here, we compared these models assuming identical loading of 10, 15 and 20 mgRaEq (72, 108 and 145 cGy cm2 h-1, respectively) in three dose mesh planes: one perpendicular to the ovoid long axis bisecting the ovoid, one parallel to and displaced 2 cm medially from the long axis of the ovoid, and a 'rectal' plane perpendicular to the long axis located 1 cm distal to the distal face of the ovoid cap. The FW ovoid delivered slightly higher doses (within 10%) over all loadings to regions away from the bladder and rectal shields when compared to the FSD ovoid. However, the FW ovoid delivered much higher doses (>50%) in regions near these shields. In the rectal plane, the FW ovoid delivered a slightly higher dose, but within the region directly behind the rectal shield, the FW ovoid delivered a dose ranging from +35% to -35% of the FSD dose distribution. We attribute these differences to intrinsic differences in source characteristics (radial dose function and anisotropy factors) and extrinsic factors such as the solid-angle effect between sources and shields and applicator design.

  4. SU-E-T-416: VMAT Dose Calculations Using Cone Beam CT Images: A Preliminary Study

    SciTech Connect

    Yu, S; Sehgal, V; Kuo, J; Daroui, P; Ramsinghani, N; Al-Ghazi, M

    2014-06-01

    Purpose: Cone beam CT (CBCT) images have been used routinely for patient positioning throughout the treatment course. However, use of CBCT for dose calculation is still investigational. The purpose of this study is to assess the utility of CBCT images for Volumetric Modulated Arc Therapy (VMAT) plan dose calculation. Methods: A CATPHAN 504 phantom (The Phantom Laboratory, Salem, NY) was used to compare the dosimetric and geometric accuracy between conventional CT and CBCT (in both full and half fan modes). Hounsfield units (HU) profiles at different density areas were evaluated. A C shape target that surrounds a central avoidance structure was created and a VMAT plan was generated on the CT images and copied to the CBCT phantom images. Patient studies included three brain patients, and one head and neck (H'N) patient. VMAT plans generated on the patients treatment planning CT was applied to CBCT images obtained during the first treatment. Isodose distributions and dosevolume- histograms (DVHs) were compared. Results: For the phantom study, the HU difference between CT and CBCT is within 100 (maximum 96 HU for Teflon CBCT images in full fan mode). The impact of these differences on the calculated dose distributions was clinically insignificant. In both phantom and patient studies, target DVHs based on CBCT images were in excellent agreement with those based on planning CT images. Mean, Median, near minimum (D98%), and near maximum (D2%) doses agreed within 0-2.5%. A slightly larger discrepancy is observed in the patient studies compared to that seen in the phantom study, (0-1% vs. 0 - 2.5%). Conclusion: CBCT images can be used to accurately predict dosimetric results, without any HU correction. It is feasible to use CBCT to evaluate the actual dose delivered at each fraction. The dosimetric consequences resulting from tumor response and patient geometry changes could be monitored.

  5. Relationship between perceived and actual motor competence among college students.

    PubMed

    Wang, Jianyu; Liu, Wenhao; Bian, Wei

    2013-02-01

    The relationship between perceived and actual motor competence was examined among college students. Participants were 114 college students (55 men, 59 women; M age = 22.3 yr., SD = 3.9). All participants completed a short survey on perception of motor competence in basketball and took a Control Basketball Dribble Test to assess their actual motor skill. Perceived motor competence in basketball was significantly related to basketball dribbling performance. Given the positive relationship between actual motor competence and perceived competence, enhancing an individual's actual motor competence may contribute to their perceived competence, which may improve an individual's physical activity participation.

  6. Evaluations of an adaptive planning technique incorporating dose feedback in image-guided radiotherapy of prostate cancer

    SciTech Connect

    Liu Han; Wu Qiuwen

    2011-12-15

    Purpose: Online image guidance (IG) has been used to effectively correct the setup error and inter-fraction rigid organ motion for prostate cancer. However, planning margins are still necessary to account for uncertainties such as deformation and intra-fraction motion. The purpose of this study is to investigate the effectiveness of an adaptive planning technique incorporating offline dose feedback to manage inter-fraction motion and residuals from online correction. Methods: Repeated helical CT scans from 28 patients were included in the study. The contours of prostate and organs-at-risk (OARs) were delineated on each CT, and online IG was simulated by matching center-of-mass of prostate between treatment CTs and planning CT. A seven beam intensity modulated radiation therapy (IMRT) plan was designed for each patient on planning CT for a total of 15 fractions. Dose distribution at each fraction was evaluated based on actual contours of the target and OARs from that fraction. Cumulative dose up to each fraction was calculated by tracking each voxel based on a deformable registration algorithm. The cumulative dose was compared with the dose from initial plan. If the deviation exceeded the pre-defined threshold, such as 2% of the D{sub 99} to the prostate, an adaptive planning technique called dose compensation was invoked, in which the cumulative dose distribution was fed back to the treatment planning system and the dose deficit was made up through boost radiation in future treatment fractions. The dose compensation was achieved by IMRT inverse planning. Two weekly compensation delivery strategies were simulated: one intended to deliver the boost dose in all future fractions (schedule A) and the other in the following week only (schedule B). The D{sub 99} to prostate and generalized equivalent uniform dose (gEUD) to rectal wall and bladder were computed and compared with those without the dose compensation. Results: If only 2% underdose is allowed at the end of the

  7. Characterization, Leaching, and Filtration Testing for Tributyl Phosphate (TBP, Group 7) Actual Waste Sample Composites

    SciTech Connect

    Edwards, Matthew K.; Billing, Justin M.; Blanchard, David L.; Buck, Edgar C.; Casella, Amanda J.; Casella, Andrew M.; Crum, J. V.; Daniel, Richard C.; Draper, Kathryn E.; Fiskum, Sandra K.; Jagoda, Lynette K.; Jenson, Evan D.; Kozelisky, Anne E.; MacFarlan, Paul J.; Peterson, Reid A.; Shimskey, Rick W.; Snow, Lanee A.; Swoboda, Robert G.

    2009-03-09

    .A testing program evaluating actual tank waste was developed in response to Task 4 from the M-12 External Flowsheet Review Team (EFRT) issue response plan. The bulk water-insoluble solid wastes that are anticipated to be delivered to the Waste Treatment and Immobilization Plant (WTP) were identified according to type such that the actual waste testing could be targeted to the relevant categories. Eight broad waste groupings were defined. Samples available from the 222S archive were identified and obtained for testing. The actual waste-testing program included homogenizing the samples by group, characterizing the solids and aqueous phases, and performing parametric leaching tests. The tributyl phosphate sludge (TBP, Group 7) is the subject of this report. The Group 7 waste was anticipated to be high in phosphorus as well as aluminum in the form of gibbsite. Both are believed to exist in sufficient quantities in the Group 7 waste to address leaching behavior. Thus, the focus of the Group 7 testing was on the removal of both P and Al. The waste-type definition, archived sample conditions, homogenization activities, characterization (physical, chemical, radioisotope, and crystal habit), and caustic leaching behavior as functions of time, temperature, and hydroxide concentration are discussed in this report. Testing was conducted according to TP-RPP-WTP-467.

  8. Randomized trials on consider this, a tailored, internet-delivered smoking prevention program for adolescents.

    PubMed

    Buller, David B; Borland, Ron; Woodall, W Gill; Hall, John R; Hines, Joan M; Burris-Woodall, Patricia; Cutter, Gary R; Miller, Caroline; Balmford, James; Starling, Randall; Ax, Bryan; Saba, Laura

    2008-04-01

    The Internet may be an effective medium for delivering smoking prevention to children. Consider This, an Internet-based program, was hypothesized to reduce expectations concerning smoking and smoking prevalence. Group-randomized pretest-posttest controlled trials were conducted in Australia (n = 2,077) and the United States (n = 1,234) in schools containing Grades 6 through 9. Australian children using Consider This reported reduced 30-day smoking prevalence. This reduction was mediated by decreased subjective norms. The amount of program exposure was low in many classes, but program use displayed a dose-response relationship with reduced smoking prevalence. American children only reported lower expectations for smoking in the future. Intervening to prevent smoking is a challenge, and this data suggest small benefits from an Internet-based program that are unlikely to be of practical significance unless increased by improved implementation. Implementation remains the major challenge to delivering interventions via the Internet, both for health educators and researchers.

  9. SU-E-J-106: The Use of Deformable Image Registration with Cone-Beam CT for a Better Evaluation of Cumulative Dose to Organs

    SciTech Connect

    Fillion, O; Gingras, L; Archambault, L

    2015-06-15

    Purpose: The knowledge of dose accumulation in the patient tissues in radiotherapy helps in determining the treatment outcomes. This project aims at providing a workflow to map cumulative doses that takes into account interfraction organ motion without the need for manual re-contouring. Methods: Five prostate cancer patients were studied. Each patient had a planning CT (pCT) and 5 to 13 CBCT scans. On each series, a physician contoured the prostate, rectum, bladder, seminal vesicles and the intestine. First, a deformable image registration (DIR) of the pCTs onto the daily CBCTs yielded registered CTs (rCT) . This rCT combined the accurate CT numbers of the pCT with the daily anatomy of the CBCT. Second, the original plans (220 cGy per fraction for 25 fractions) were copied on the rCT for dose re-calculation. Third, the DIR software Elastix was used to find the inverse transform from the rCT to the pCT. This transformation was then applied to the rCT dose grid to map the dose voxels back to their pCT location. Finally, the sum of these deformed dose grids for each patient was applied on the pCT to calculate the actual dose delivered to organs. Results: The discrepancy between the planned D98 and D2 and these indices re-calculated on the rCT, are, on average, of −1 ± 1 cGy and 1 ± 2 cGy per fraction, respectively. For fractions with large anatomical motion, the D98 discrepancy on the re-calculated dose grid mapped onto the pCT can raise to −17 ± 4 cGy. The obtained cumulative dose distributions illustrate the same behavior. Conclusion: This approach allowed the evaluation of cumulative doses to organs with the help of uncontoured daily CBCT scans. With this workflow, the easy evaluation of doses delivered for EBRT treatments could ultimately lead to a better follow-up of prostate cancer patients.

  10. Dose calculation for electron therapy

    NASA Astrophysics Data System (ADS)

    Gebreamlak, Wondesen T.

    The dose delivered by electron beams has a complex dependence on the shape of the field; any field shaping shields, design of collimator systems, and energy of the beam. This complicated dependence is due to multiple scattering of the electron beam as the beam travels from the accelerator head to the patient. The dosimetry of only regular field shapes (circular, square, or rectangular) is well developed. However, most tumors have irregular shapes and their dosimetry is calculated by direct measurement. This is laborious and time consuming. In addition, error can be introduced during measurements. The lateral build up ratio method (LBR), which is based on the Fermi-Eyges multiple scattering theory, calculates the dosimetry of irregular electron beam shapes. The accuracy of this method depends on the function sigma r(r,E) (the mean square radial displacement of the electron beam in the medium) used in the calculation. This research focuses on improving the accuracy of electron dose calculations using lateral build up ratio method by investigating the properties of sigmar(r,E). The percentage depth dose curves of different circular cutouts were measured using four electron beam energies (6, 9, 12, and 15 MeV), four electron applicator sizes (6x6, 10x10, 14x14, and 20x20 cm), three source-surface distance values (100, 105, 110 cm). The measured percentage depth dose curves were normalized at a depth of 0.05 cm. Using the normalized depth dose, the lateral build up ratio curves were determined. Using the cutout radius and the lateral build up ratio values, sigmar(z,E) were determined. It is shown that the sigma value increases linearly with cutout size until the cutout radius reaches the equilibrium range of the electron beam. The sigma value of an arbitrary circular cutout was determined from the interpolation of sigma versus cutout curve. The corresponding LBR value of the circular cutout was determined using its radius and sigma values. The depth dose distribution of

  11. Actual and prescribed energy and protein intakes for very low birth weight infants: An observational study

    NASA Astrophysics Data System (ADS)

    Allevato, Anthony J.

    Objectives: To determine (1) whether prescribed and delivered energy and protein intakes during the first two weeks of life met Ziegler's estimated requirements for Very Low Birth Weight (VLBW) infants, (2) if actual energy during the first week of life correlated with time to regain birth weight and reach full enteral nutrition (EN) defined as 100 kcal/kg/day, (3) if growth velocity from time to reach full EN to 36 weeks' postmenstrual age (PMA) met Ziegler's estimated fetal growth velocity (16 g/kg/day), and (4) growth outcomes at 36 weeks' PMA. Study design: Observational study of feeding, early nutrition and early growth of 40 VLBW infants <30 weeks GA at birth in three newborn intensive care units NICUs. Results: During the first week of life, the percentages of prescribed and delivered energy (69% [65 kcal/kg/day]) and protein (89% [3.1 g/kg/day]) were significantly less than theoretical estimated requirements. Delivered intakes were 15% less than prescribed because of numerous interruptions in delivery and medical complications. During the second week, the delivered intakes of energy (90% [86 kcal/kg/day]) and protein (102% [3.5 g/kg/day]) improved although the differences between prescribed and delivered were consistently 15%. Energy but not protein intake during the first week was significantly related to time to reach full EN. Neither energy nor protein intake significantly correlated with days to return to birth weight. The average growth velocity from the age that full EN was attained to 36 weeks' PMA (15 g/kg/day) was significantly less than the theoretical estimated fetal growth velocity (16 g/kg/day) (p<0.03). A difference of 1 g/kg/day represents a total deficit of 42 - 54 grams over the course of a month. At 36 weeks' PMA, 53% of the VLBW infants had extrauterine growth restriction, or EUGR (<10th percentile) on the Fenton growth grid and 34% had EUGR on the Lubchenco growth grid. Conclusions: The delivered nutrient intakes were consistently less

  12. Evaluation of nanoparticle delivered cisplatin in beagles

    NASA Astrophysics Data System (ADS)

    Feldhaeusser, Brittany; Platt, Simon R.; Marrache, Sean; Kolishetti, Nagesh; Pathak, Rakesh K.; Montgomery, David J.; Reno, Lisa R.; Howerth, Elizabeth; Dhar, Shanta

    2015-08-01

    -1 or 2.2 mg kg-1 (with respect to Platin-M) of T-Platin-M-NPs. At all doses over the 14-day period, no neurotoxicity was observed based upon periodic neurological examinations and cerebrospinal fluid analysis. These studies demonstrated the translational nature of T-Platin-M-NPs for applications in the treatment of brain tumors.Intracranial neoplasia is a significant cause of morbidity and mortality in both human and veterinary patients, and is difficult to treat with traditional therapeutic methods. Cisplatin is a platinum (Pt)-containing chemotherapeutic agent approved by the Food and Drug Administration; however, substantial limitations exist for its application in canine brain tumor treatment due to the difficulty in crossing the blood-brain barrier (BBB), development of resistance, and toxicity. A modified Pt(iv)-prodrug of cisplatin, Platin-M, was recently shown to be deliverable to the brain via a biocompatible mitochondria-targeted lipophilic polymeric nanoparticle (NP) that carries the drug across the BBB and to the mitochondria. NP mediated controlled release of Platin-M and subsequent reduction of this prodrug to cisplatin allowed cross-links to be formed with the mitochondrial DNA, which have no nucleotide excision repair system, forcing the overactive cancer cells to undergo apoptosis. Here, we report in vitro effects of targeted Platin-M NPs (T-Platin-M-NPs) in canine glioma and glioblastoma cell lines with results indicating that this targeted NP formulation is more effective than cisplatin. In both the cell lines, T-Platin-M-NP was significantly more efficacious compared to carboplatin, another Pt-based chemotherapy, which is used in the settings of recurrent high-grade glioblastoma. Mitochondrial stress analysis indicated that T-Platin-M-NP is more effective in disrupting the mitochondrial bioenergetics in both the cell types. A 14-day distribution study in healthy adult beagles using a single intravenous injection at 0.5 mg kg-1 (with respect to

  13. Self-Actualization Effects Of A Marathon Growth Group

    ERIC Educational Resources Information Center

    Jones, Dorothy S.; Medvene, Arnold M.

    1975-01-01

    This study examined the effects of a marathon group experience on university student's level of self-actualization two days and six weeks after the experience. Gains in self-actualization as a result of marathon group participation depended upon an individual's level of ego strength upon entering the group. (Author)

  14. The Self-Actualization of Polk Community College Students.

    ERIC Educational Resources Information Center

    Pearsall, Howard E.; Thompson, Paul V., Jr.

    This article investigates the concept of self-actualization introduced by Abraham Maslow (1954). A summary of Maslow's Needs Hierarchy, along with a description of the characteristics of the self-actualized person, is presented. An analysis of humanistic education reveals it has much to offer as a means of promoting the principles of…

  15. Depression and Self-Actualization in Gifted Adolescents.

    ERIC Educational Resources Information Center

    Berndt, David J.; And Others

    1982-01-01

    Investigated the relationship between depressive affect and self-actualization in gifted adolescents (N=248). Found that gifted students who were not self-actualizing types were more depressed; and guilt, low self-esteem, learned helplessness, and cognitive difficulty were important symptoms. Gifted adolescents tended to be more socially…

  16. 24 CFR 200.96 - Certificates of actual cost.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Endorsement Generally Applicable to Multifamily and Health Care Facility Mortgage Insurance Programs; and Continuing Eligibility Requirements for Existing Projects Cost Certification § 200.96 Certificates of actual... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Certificates of actual cost....

  17. 24 CFR 200.96 - Certificates of actual cost.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Endorsement Generally Applicable to Multifamily and Health Care Facility Mortgage Insurance Programs; and Continuing Eligibility Requirements for Existing Projects Cost Certification § 200.96 Certificates of actual... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Certificates of actual cost....

  18. 24 CFR 200.96 - Certificates of actual cost.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Endorsement Generally Applicable to Multifamily and Health Care Facility Mortgage Insurance Programs; and Continuing Eligibility Requirements for Existing Projects Cost Certification § 200.96 Certificates of actual... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Certificates of actual cost....

  19. 24 CFR 200.96 - Certificates of actual cost.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Endorsement Generally Applicable to Multifamily and Health Care Facility Mortgage Insurance Programs; and Continuing Eligibility Requirements for Existing Projects Cost Certification § 200.96 Certificates of actual... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Certificates of actual cost....

  20. 24 CFR 200.96 - Certificates of actual cost.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Endorsement Generally Applicable to Multifamily and Health Care Facility Mortgage Insurance Programs; and Continuing Eligibility Requirements for Existing Projects Cost Certification § 200.96 Certificates of actual... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Certificates of actual cost....

  1. SELF-ACTUALIZATION AND THE UTILIZATION OF TALENT.

    ERIC Educational Resources Information Center

    FRENCH, JOHN R.P.; MILLER, DANIEL R.

    THIS STUDY ATTEMPTED (1) TO DEVELOP A THEORY OF THE CAUSES AND CONSEQUENCES OF SELF-ACTUALIZATION AS RELATED TO THE UTILIZATION OF TALENT, (2) TO FIT THE THEORY TO EXISTING DATA, AND (3) TO PLAN ONE OR MORE RESEARCH PROJECTS TO TEST THE THEORY. TWO ARTICLES ON IDENTITY AND MOTIVATION AND SELF-ACTUALIZATION AND SELF-IDENTITY THEORY REPORTED THE…

  2. Facebook as a Library Tool: Perceived vs. Actual Use

    ERIC Educational Resources Information Center

    Jacobson, Terra B.

    2011-01-01

    As Facebook has come to dominate the social networking site arena, more libraries have created their own library pages on Facebook to create library awareness and to function as a marketing tool. This paper examines reported versus actual use of Facebook in libraries to identify discrepancies between intended goals and actual use. The results of a…

  3. A Study of Self-Actualization and Facilitative Communication.

    ERIC Educational Resources Information Center

    Omizo, Michael M.

    1981-01-01

    Examined the relationship between self-actualization measures and ability in facilitative communication of trainees from counseling, social work, and psychology programs to determine if differences existed between the three groups. Self-actualization indexes were significantly correlated with ability in facilitative communication. (RC)

  4. 26 CFR 1.962-3 - Treatment of actual distributions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 10 2013-04-01 2013-04-01 false Treatment of actual distributions. 1.962-3... TAX (CONTINUED) INCOME TAXES (CONTINUED) Controlled Foreign Corporations § 1.962-3 Treatment of actual... a foreign corporation. (ii) Treatment of section 962 earnings and profits under § 1.959-3....

  5. A Randomized Trial of Contingency Management Delivered by Community Therapists

    ERIC Educational Resources Information Center

    Petry, Nancy M.; Alessi, Sheila M.; Ledgerwood, David M.

    2012-01-01

    Objective: Contingency management (CM) is an evidence-based treatment, but few clinicians deliver this intervention in community-based settings. Method: Twenty-three clinicians from 3 methadone maintenance clinics received training in CM. Following a didactics seminar and a training and supervision period in which clinicians delivered CM to pilot…

  6. 20 CFR 663.155 - How are core services delivered?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... and the Governor in accordance with the requirements of WIA section 117(f)(2) and 20 CFR 661.310. ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How are core services delivered? 663.155... Worker Services Through the One-Stop Delivery System § 663.155 How are core services delivered?...

  7. The Use of Freshmen Seminar Programs to Deliver Personalized Feedback

    ERIC Educational Resources Information Center

    Henslee, Amber M.; Correia, Christopher J.

    2009-01-01

    The current study tested the effectiveness of delivering personalized feedback to first-semester college freshmen in a group lecture format. Participants enrolled in semester-long courses were randomly assigned to receive either personalized feedback or general information about alcohol. Both lecture conditions were delivered during a standard…

  8. 14 CFR 221.91 - Delivering tariff publications to Department.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Delivering tariff publications to... (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TARIFFS Filing Tariff Publications With Department § 221.91 Delivering tariff publications to Department. Tariff publications will be received for filing only...

  9. 14 CFR 221.91 - Delivering tariff publications to Department.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Delivering tariff publications to... (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TARIFFS Filing Tariff Publications With Department § 221.91 Delivering tariff publications to Department. Tariff publications will be received for filing only...

  10. 14 CFR 221.91 - Delivering tariff publications to Department.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Delivering tariff publications to... (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TARIFFS Filing Tariff Publications With Department § 221.91 Delivering tariff publications to Department. Tariff publications will be received for filing only...

  11. 14 CFR 221.91 - Delivering tariff publications to Department.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Delivering tariff publications to... (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TARIFFS Filing Tariff Publications With Department § 221.91 Delivering tariff publications to Department. Tariff publications will be received for filing only...

  12. Some aspects of the fetal doses given in ICRP Publication 88.

    PubMed

    Phipps, A W; Harrison, J D; Fell, T P; Eckerman, K F; Nosske, D

    2003-01-01

    The International Commission on Radiological Protection (ICRP) has recently published dose coefficients (dose per unit intake, Sv Bq(-1)) for the offspring of women exposed to radionuclides during or before pregnancy. These dose estimates include in utero doses to the embryo and fetus and doses delivered postnatally to the newborn child from radionuclides retained at birth. This paper considers the effect on doses of the time of radionuclide intake and examines the proportion of dose delivered in utero and postnatally for different radionuclides. Methods used to calculate doses to the fetal skeleton are compared. For many radionuclides, doses are greatest for intakes early in pregnancy but important exceptions, for which doses are greatest for intakes later in pregnancy, are iodine isotopes and isotopes of the alkaline earth elements, including strontium. While radionuclides such as 131I deliver dose largely in utero, even for intakes late in pregnancy, others such as 239Pu deliver dose largely postnatally, even for intakes early during pregnancy. For alpha emitters deposited in the skeleton, the assumption made is of uniform distribution of the radionuclide and of target cells for leukaemia and bone cancer in utero; that is, the developing bone structure is not considered. However, for beta emitters, the bone structure was considered. Both approaches can be regarded as reasonably conservative, given uncertainties in particular in the location of the target cells and the rapid growth and remodelling of the skeleton at this stage of development. PMID:14526971

  13. Electroporation-delivered transdermal neostigmine in rats: equivalent action to intravenous administration

    PubMed Central

    Berkó, Szilvia; Szűcs, Kálmán F; Balázs, Boglárka; Csányi, Erzsébet; Varju, Gábor; Sztojkov-Ivanov, Anita; Budai-Szűcs, Mária; Bóta, Judit; Gáspár, Róbert

    2016-01-01

    Purpose Transdermal electroporation has become one of the most promising noninvasive methods for drug administration, with greatly increased transport of macromolecules through the skin. The cecal-contracting effects of repeated transdermal electroporation delivery and intravenous administration of neostigmine were compared in anesthetized rats. Methods The cecal contractions were detected with implantable strain gauge sensors, and the plasma levels of neostigmine were followed by high-performance liquid chromatography. Results Both intravenously and EP-administered neostigmine (0.2–66.7 μg/kg) increased the cecal contractions in a dose-dependent manner. For both the low doses and the highest dose, the neostigmine plasma concentrations were the same after the two modes of administration, while an insignificantly higher level was observed at a dose of 20 μg/kg after intravenous administration as compared with the electroporation route. The contractile responses did not differ significantly after the two administration routes. Conclusion The results suggest that electroporation-delivered neostigmine elicits action equivalent to that observed after intravenous administration as concerning both time and intensity. Electroporation permits the delivery of even lower doses of water-soluble compounds through the skin, which is very promising for clinical practice. PMID:27274203

  14. Ir-192 HDR transit dose and radial dose function determination using alanine/EPR dosimetry

    NASA Astrophysics Data System (ADS)

    Guzmán Calcina, Carmen S.; de Almeida, Adelaide; Oliveira Rocha, José R.; Abrego, Felipe Chen; Baffa, Oswaldo

    2005-03-01

    Source positioning close to the tumour in high dose rate (HDR) brachytherapy is not instantaneous. An increment of dose will be delivered during the movement of the source in the trajectory to its static position. This increment is the transit dose, often not taken into account in brachytherapeutic treatment planning. The transit dose depends on the prescribed dose, number of treatment fractions, velocity and activity of the source. Combining all these factors, the transit dose can be 5% higher than the prescribed absorbed dose value (Sang-Hyun and Muller-Runkel, 1994 Phys. Med. Biol. 39 1181 8, Nath et al 1995 Med. Phys. 22 209 34). However, it cannot exceed this percentage (Nath et al 1995). In this work, we use the alanine-EPR (electron paramagnetic resonance) dosimetric system using analysis of the first derivative of the signal. The transit dose was evaluated for an HDR system and is consistent with that already presented for TLD dosimeters (Bastin et al 1993 Int. J. Radiat. Oncol. Biol. Phys. 26 695 702). Also using the same dosimetric system, the radial dose function, used to evaluate the geometric dose degradation around the source, was determined and its behaviour agrees better with those obtained by Monte Carlo simulations (Nath et al 1995, Williamson and Nath 1991 Med. Phys. 18 434 48, Ballester et al 1997 Med. Phys. 24 1221 8, Ballester et al 2001 Phys. Med. Biol. 46 N79 90) than with TLD measurements (Nath et al 1990 Med. Phys. 17 1032 40).

  15. Radiological Dose Assessment - Nonuniform Skin Dose, Radioactive Skin Contamination, and Multiple Dosimetry

    SciTech Connect

    W. C. Inkret; M. E. Schillaci

    1999-03-01

    Radioactive skin contamination with {beta}- and {gamma}-emitting radionuclides may result in biologically significant absorbed doses to the skin. A specific exposure scenario of interest is a nonuniform skin dose delivered by {beta}- and {gamma}-emissions from radioactive skin contamination. The United States Department of Energy requires a formal evaluation and reporting of nonuniform skin doses. The United States Department of Energy also requires specific, formal procedures for evaluating the results from the placement or use of multiple dosimeters. Action levels relative to potential absorbed doses for the contamination survey instrumentation in use at Los Alamos and formal procedures for evaluating nonuniform skin doses and multiple dosimeters are developed and presented here.

  16. How accurate is image guided radiation therapy (IGRT) delivered with a micro-irradiator?

    PubMed Central

    Oldham, M; Newton, J; Rankine, L; Adamovics, J; Kirsch, D; Das, S

    2013-01-01

    There is significant interest in delivering precisely targeted small-volume radiation treatments, in the pre-clinical setting, to study dose-volume relationships with tumor control and normal tissue damage. In this work we investigate the IGRT targeting accuracy of the XRad225Cx system from Precision x-Ray using high resolution 3D dosimetry techniques. Initial results revealed a significant targeting error of about 2.4mm. This error was reduced to within 0.5mm after the IGRT hardware and software had been recalibrated. The facility for 3D dosimetry was essential to gain a comprehensive understanding of the targeting error in 3D. PMID:24454521

  17. Radiation dose rates from UF{sub 6} cylinders

    SciTech Connect

    Friend, P.J.

    1991-12-31

    This paper describes the results of many studies, both theoretical and experimental, which have been carried out by Urenco over the last 15 years into radiation dose rates from uranium hexafluoride (UF{sub 6}) cylinders. The contents of the cylinder, its history, and the geometry all affect the radiation dose rate. These factors are all examined in detail. Actual and predicted dose rates are compared with levels permitted by IAEA transport regulations.

  18. Evaluation of nanoparticle delivered cisplatin in beagles

    NASA Astrophysics Data System (ADS)

    Feldhaeusser, Brittany; Platt, Simon R.; Marrache, Sean; Kolishetti, Nagesh; Pathak, Rakesh K.; Montgomery, David J.; Reno, Lisa R.; Howerth, Elizabeth; Dhar, Shanta

    2015-08-01

    -1 or 2.2 mg kg-1 (with respect to Platin-M) of T-Platin-M-NPs. At all doses over the 14-day period, no neurotoxicity was observed based upon periodic neurological examinations and cerebrospinal fluid analysis. These studies demonstrated the translational nature of T-Platin-M-NPs for applications in the treatment of brain tumors.Intracranial neoplasia is a significant cause of morbidity and mortality in both human and veterinary patients, and is difficult to treat with traditional therapeutic methods. Cisplatin is a platinum (Pt)-containing chemotherapeutic agent approved by the Food and Drug Administration; however, substantial limitations exist for its application in canine brain tumor treatment due to the difficulty in crossing the blood-brain barrier (BBB), development of resistance, and toxicity. A modified Pt(iv)-prodrug of cisplatin, Platin-M, was recently shown to be deliverable to the brain via a biocompatible mitochondria-targeted lipophilic polymeric nanoparticle (NP) that carries the drug across the BBB and to the mitochondria. NP mediated controlled release of Platin-M and subsequent reduction of this prodrug to cisplatin allowed cross-links to be formed with the mitochondrial DNA, which have no nucleotide excision repair system, forcing the overactive cancer cells to undergo apoptosis. Here, we report in vitro effects of targeted Platin-M NPs (T-Platin-M-NPs) in canine glioma and glioblastoma cell lines with results indicating that this targeted NP formulation is more effective than cisplatin. In both the cell lines, T-Platin-M-NP was significantly more efficacious compared to carboplatin, another Pt-based chemotherapy, which is used in the settings of recurrent high-grade glioblastoma. Mitochondrial stress analysis indicated that T-Platin-M-NP is more effective in disrupting the mitochondrial bioenergetics in both the cell types. A 14-day distribution study in healthy adult beagles using a single intravenous injection at 0.5 mg kg-1 (with respect to

  19. Bait-delivered pimozide causes precocious embryo implantation in mink: a fertility control option for the exotic stoat?

    PubMed

    Marks, Clive A; Lindeberg, Heli; Van Cleeff, Judy

    2006-01-01

    Stoats (Mustela erminea), an exotic pest in New Zealand, threaten the conservation of several ground-nesting bird species and broad-scale methods for their control are sought. Females are seasonally monestrous, show a 9-month period of obligatory diapause and usually do not breed more than once in their lives. A bait-delivered agent that terminates diapause and results in a non-viable embryo may have a significant impact on their reproductive success. Prolactin (PRL) is hypothesised to be the only gonadotrophin required for renewal of luteal activity and blastocyst implantation in some mustelids. We investigated the effects of bait-delivered dopamine (DA) antagonists (which stimulate the release of PRL) using a mink model (Mustela vison), a species that maintains a short period of diapause. A bait dose of 0.8 mg kg(-1) of pimozide was more effective in elevating PRL levels than equivalent doses of fluphenazine, sulpiride (P < 0.01) or haloperidol (P < 0.05). Bait doses of 1.6 mg kg(-1) pimozide given at Days 0, 3, 9 and 11 after mating caused a significant reduction in the length of pregnancy compared with a positive control and placebo (46 days v. 51 days), indicating early termination of diapause (P < 0.01). Pimozide doses caused higher elevations in PRL concentration relative to the oral placebo by Day 12, but mean PRL levels fell below all other groups by Day 18. A borderline significant increase in progesterone (P4) secretion compared with the oral placebo was detected at Day 18. These results suggest that bait-delivered pimozide can elevate PRL outside of the normal breeding season and doses of 1.6 mg kg(-1) are effective in terminating embryonic diapause in mink. The implications and limitations of these data are discussed with reference to the use of bait-delivered DA antagonists as a possible means to affect the reproductive success of wild stoats. PMID:16930517

  20. CT dose optimisation and reduction in osteoarticular disease.

    PubMed

    Gervaise, A; Teixeira, P; Villani, N; Lecocq, S; Louis, M; Blum, A

    2013-04-01

    With an improvement in the temporal and spatial resolution, computed tomography (CT) is indicated in the evaluation of a great many osteoarticular diseases. New exploration techniques such as the dynamic CT and CT bone perfusion also provide new indications. However, CT is still an irradiating imaging technique and dose optimisation and reduction remains primordial. In this paper, the authors first present the typical doses delivered during CT in osteoarticular disease. They then discuss the different ways to optimise and reduce these doses by distinguishing the behavioural factors from the technical factors. Among the latter, the optimisation of the milliamps and kilovoltage is indispensable and should be adapted to the type of exploration and the morphotype of each individual. These technical factors also benefit from recent technological evolutions with the distribution of iterative reconstructions. In this way, the dose may be divided by two and provide an image of equal quality. With these dose optimisation and reduction techniques, it is now possible, while maintaining an excellent quality of the image, to obtain low-dose or even very low-dose acquisitions with a dose sometimes similar that of a standard X-ray assessment. Nevertheless, although these technical factors provide a major reduction in the dose delivered, behavioural factors, such as compliance with the indications, remain fundamental. Finally, the authors describe how to optimise and reduce the dose with specific applications in musculoskeletal imaging such as the dynamic CT, CT bone perfusion and dual energy CT.

  1. In vitro study of cell survival following dynamic MLC intensity-modulated radiation therapy dose delivery

    SciTech Connect

    Moiseenko, Vitali; Duzenli, Cheryl; Durand, Ralph E.

    2007-04-15

    The possibility of reduced cell kill following intensity-modulated radiation therapy (IMRT) compared to conventional radiation therapy has been debated in the literature. This potential reduction in cell kill relates to prolonged treatment times typical of IMRT dose delivery and consequently increased repair of sublethal lesions. While there is some theoretical support to this reduction in cell kill published in the literature, direct experimental evidence specific to IMRT dose delivery patterns is lacking. In this study we present cell survival data for three cell lines: Chinese hamster V79 fibroblasts, human cervical carcinoma, SiHa and colon adenocarcinoma, WiDr. Cell survival was obtained for 2.1 Gy delivered as acute dose with parallel-opposed pair (POP), irradiation time 75 s, which served as a reference; regular seven-field IMRT, irradiation time 5 min; and IMRT with a break for multiple leaf collimator (MLC) re-initialization after three fields were delivered, irradiation time 10 min. An actual seven-field dynamic MLC IMRT plan for a head and neck patient was used. The IMRT plan was generated for a Varian EX or iX linear accelerator with 120 leaf Millenium MLC. Survival data were also collected for doses 1x, 2x, 3x, 4x, and 5x 2.1 Gy to establish parameters of the linear-quadratic equation describing survival following acute dose delivery. Cells were irradiated inside an acrylic cylindrical phantom specifically designed for this study. Doses from both IMRT and POP were validated using ion chamber measurements. A reproducible increase in cell survival was observed following IMRT dose delivery. This increase varied from small for V79, with a surviving fraction of 0.8326 following POP vs 0.8420 following uninterrupted IMRT, to very pronounced for SiHa, with a surviving fraction of 0.3903 following POP vs 0.5330 for uninterrupted IMRT. When compared to IMRT or IMRT with a break for MLC initialization, cell survival following acute dose delivery was

  2. Deformable Dose Reconstruction to Optimize the Planning and Delivery of Liver Cancer Radiotherapy

    NASA Astrophysics Data System (ADS)

    Velec, Michael

    The precise delivery of radiation to liver cancer patients results in improved control with higher tumor doses and minimized normal tissues doses. A margin of normal tissue around the tumor requires irradiation however to account for treatment delivery uncertainties. Daily image-guidance allows targeting of the liver, a surrogate for the tumor, to reduce geometric errors. However poor direct tumor visualization, anatomical deformation and breathing motion introduce uncertainties between the planned dose, calculated on a single pre-treatment computed tomography image, and the dose that is delivered. A novel deformable image registration algorithm based on tissue biomechanics was applied to previous liver cancer patients to track targets and surrounding organs during radiotherapy. Modeling these daily anatomic variations permitted dose accumulation, thereby improving calculations of the delivered doses. The accuracy of the algorithm to track dose was validated using imaging from a deformable, 3-dimensional dosimeter able to optically track absorbed dose. Reconstructing the delivered dose revealed that 70% of patients had substantial deviations from the initial planned dose. An alternative image-guidance technique using respiratory-correlated imaging was simulated, which reduced both the residual tumor targeting errors and the magnitude of the delivered dose deviations. A planning and delivery strategy for liver radiotherapy was then developed that minimizes the impact of breathing motion, and applied a margin to account for the impact of liver deformation during treatment. This margin is 38% smaller on average than the margin used clinically, and permitted an average dose-escalation to liver tumors of 9% for the same risk of toxicity. Simulating the delivered dose with deformable dose reconstruction demonstrated the plans with smaller margins were robust as 90% of patients' tumors received the intended dose. This strategy can be readily implemented with widely

  3. Absorbed Dose and Dose Equivalent Calculations for Modeling Effective Dose

    NASA Technical Reports Server (NTRS)

    Welton, Andrew; Lee, Kerry

    2010-01-01

    While in orbit, Astronauts are exposed to a much higher dose of ionizing radiation than when on the ground. It is important to model how shielding designs on spacecraft reduce radiation effective dose pre-flight, and determine whether or not a danger to humans is presented. However, in order to calculate effective dose, dose equivalent calculations are needed. Dose equivalent takes into account an absorbed dose of radiation and the biological effectiveness of ionizing radiation. This is important in preventing long-term, stochastic radiation effects in humans spending time in space. Monte carlo simulations run with the particle transport code FLUKA, give absorbed and equivalent dose data for relevant shielding. The shielding geometry used in the dose calculations is a layered slab design, consisting of aluminum, polyethylene, and water. Water is used to simulate the soft tissues that compose the human body. The results obtained will provide information on how the shielding performs with many thicknesses of each material in the slab. This allows them to be directly applicable to modern spacecraft shielding geometries.

  4. Acceptability of Interventions Delivered Online and Through Mobile Phones for People Who Experience Severe Mental Health Problems: A Systematic Review

    PubMed Central

    Lobban, Fiona; Emsley, Richard; Bucci, Sandra

    2016-01-01

    Background Psychological interventions are recommended for people with severe mental health problems (SMI). However, barriers exist in the provision of these services and access is limited. Therefore, researchers are beginning to develop and deliver interventions online and via mobile phones. Previous research has indicated that interventions delivered in this format are acceptable for people with SMI. However, a comprehensive systematic review is needed to investigate the acceptability of online and mobile phone-delivered interventions for SMI in depth. Objective This systematic review aimed to 1) identify the hypothetical acceptability (acceptability prior to or without the delivery of an intervention) and actual acceptability (acceptability where an intervention was delivered) of online and mobile phone-delivered interventions for SMI, 2) investigate the impact of factors such as demographic and clinical characteristics on acceptability, and 3) identify common participant views in qualitative studies that pinpoint factors influencing acceptability. Methods We conducted a systematic search of the databases PubMed, Embase, PsycINFO, CINAHL, and Web of Science in April 2015, which yielded a total of 8017 search results, with 49 studies meeting the full inclusion criteria. Studies were included if they measured acceptability through participant views, module completion rates, or intervention use. Studies delivering interventions were included if the delivery method was online or via mobile phones. Results The hypothetical acceptability of online and mobile phone-delivered interventions for SMI was relatively low, while actual acceptability tended to be high. Hypothetical acceptability was higher for interventions delivered via text messages than by emails. The majority of studies that assessed the impact of demographic characteristics on acceptability reported no significant relationships between the two. Additionally, actual acceptability was higher when

  5. Reconfiguring health workforce policy so that education, training, and actual delivery of care are closely connected.

    PubMed

    Ricketts, Thomas C; Fraher, Erin P

    2013-11-01

    There is growing consensus that the health care workforce in the United States needs to be reconfigured to meet the needs of a health care system that is being rapidly and permanently redesigned. Accountable care organizations and patient-centered medical homes, for instance, will greatly alter the mix of caregivers needed and create new roles for existing health care workers. The focus of health system innovation, however, has largely been on reorganizing care delivery processes, reengineering workflows, and adopting electronic technology to improve outcomes. Little attention has been paid to training workers to adapt to these systems and deliver patient care in ever more coordinated systems, such as integrated health care networks that harmonize primary care with acute inpatient and postacute long-term care. This article highlights how neither regulatory policies nor market forces are keeping up with a rapidly changing delivery system and argues that training and education should be connected more closely to the actual delivery of care.

  6. Impact of small MU/segment and dose rate on delivery accuracy of volumetric-modulated arc therapy (VMAT).

    PubMed

    Huang, Long; Zhuang, Tingliang; Mastroianni, Anthony; Djemil, Toufik; Cui, Taoran; Xia, Ping

    2016-05-08

    Volumetric-modulated arc therapy (VMAT) plans may require more control points (or segments) than some of fixed-beam IMRT plans that are created with a limited number of segments. Increasing number of control points in a VMAT plan for a given prescription dose could create a large portion of the total number of segments with small number monitor units (MUs) per segment. The purpose of this study is to investigate the impact of the small number MU/segment on the delivery accuracy of VMAT delivered with various dose rates. Ten patient datasets were planned for hippocampus sparing for whole brain irradiation. For each dataset, two VMAT plans were created with maximum dose rates of 600 MU/min (the maximum field size of 21 × 40 cm2) and 1000 MU/min (the maximum field size of 15 × 15 cm2) for a daily dose of 3 Gy. Without reoptimization, the daily dose of these plans was purposely reduced to 1.5 Gy and 1.0 Gy while keeping the same total dose. Using the two dose rates and three different daily doses, six VMAT plans for each dataset were delivered to a physical phantom to investigate how the changes of dose rate and daily doses impact on delivery accuracy. Using the gamma index, we directly compared the delivered planar dose profiles with the reduced daily doses (1.5 Gy and 1.0 Gy) to the delivered planar dose at 3 Gy daily dose, delivered at dose rate of 600 MU/min and 1000 MU/min, respectively. The average numbers of segments with MU/segment ≤ 1 were 35 ± 8, 87 ± 6 for VMAT-600 1.5 Gy, VMAT-600 1 Gy plans, and 30 ± 7 and 42 ± 6 for VMAT-1000 1.5 Gy and VMAT-1000 1 Gy plans, respectively. When delivered at 600 MU/min dose rate, the average gamma index passing rates (1%/1 mm criteria) of comparing delivered 1.5 Gy VMAT planar dose profiles to 3.0 Gy VMAT delivered planar dose profiles was 98.28% ± 1.66%, and the average gamma index passing rate of comparing delivered 1.0 Gy VMAT planar dose to 3.0 Gy VMAT delivered planar dose was 83.75% ± 4.86%. If using 2%/2mm

  7. Using Google Analytics as a process evaluation method for Internet-delivered interventions: an example on sexual health.

    PubMed

    Crutzen, Rik; Roosjen, Johanna L; Poelman, Jos

    2013-03-01

    The study aimed to demonstrate the potential of Google Analytics as a process evaluation method for Internet-delivered interventions, using a website about sexual health as an example. This study reports visitors' behavior until 21 months after the release of the website (March 2009-December 2010). In total, there were 850 895 visitors with an average total visiting time (i.e. dose) of 5:07 min. Google Analytics provided data to answer three key questions in terms of process evaluation of an Internet-delivered intervention: (i) How do visitors behave?; (ii) Where do visitors come from? and (iii) What content are visitors exposed to? This real-life example demonstrated the potential of Google Analytics as a method to be used in a process evaluation of Internet-delivered interventions. This is highly relevant given the current expansion of these interventions within the field of health promotion.

  8. A method to correct for temperature dependence and measure simultaneously dose and temperature using a plastic scintillation detector

    PubMed Central

    Therriault-Proulx, Francois; Wootton, Landon; Beddar, Sam

    2015-01-01

    Plastic scintillation detectors (PSDs) work well for radiation dosimetry. However, they show some temperature dependence, and a priori knowledge of the temperature surrounding the PSD is required to correct for this dependence. We present a novel approach to correct PSD response values for temperature changes instantaneously and without the need for prior knowledge of the temperature value. In addition to rendering the detector temperature-independent, this approach allows for actual temperature measurement using solely the PSD apparatus. With a temperature-controlled water tank, the temperature was varied from room temperature to more than 40°C and the PSD was used to measure the dose delivered from a cobalt-60 photon beam unit to within an average of 0.72% from the expected value. The temperature was measured during each acquisition with the PSD and a thermocouple and values were within 1°C of each other. The depth-dose curve of a 6-MV photon beam was also measured under warm non-stable conditions and this curve agreed to within an average of −0.98% from the curve obtained at room temperature. The feasibility of rendering PSDs temperature-independent was demonstrated with our approach, which also enabled simultaneous measurement of both dose and temperature. This novel approach improves both the robustness and versatility of PSDs. PMID:26407188

  9. Safety of patients--actual problem of modern medicine (review).

    PubMed

    Tsintsadze, Neriman; Samnidze, L; Beridze, T; Tsintsadze, M; Tsintsadze, Nino

    2011-09-01

    Safety of patients is actual problem of up-to-date medicine. The current successful treatment of various sicknesses is achieved by implementation in clinical practice such medical preparations (medications), which are characterized with the high therapeutic activity, low toxicity and prolonged effects. In spite of evidence of the pharmacotherapeutical advances, the frequency of complications after medication has grown - that is why the safety of patients is the acute actual problem of medicine and ecological state of human population today. PMID:22156680

  10. Benchmark Dose Modeling

    EPA Science Inventory

    Finite doses are employed in experimental toxicology studies. Under the traditional methodology, the point of departure (POD) value for low dose extrapolation is identified as one of these doses. Dose spacing necessarily precludes a more accurate description of the POD value. ...

  11. Delivering Twins At 37 Weeks May Help Prevent Stillbirths

    MedlinePlus

    ... news/fullstory_160834.html Delivering Twins at 37 Weeks May Help Prevent Stillbirths If babies share placenta, delivery should probably occur a week earlier, research suggests To use the sharing features ...

  12. Developing and delivering biofortified Rice to the consumer

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Biofortified rice varieties include those that have been enhanced for protein, vitamins, minerals, or other nutritional compounds. Delivering biofortified rice varieties carries with it extra challenges as compared to conventional varieties. Nutritional compounds must be present at significantly hig...

  13. Contacts May One Day Be Used to Deliver Glaucoma Medication

    MedlinePlus

    ... drug-administering contact lenses have a medicated polymer film that slowly delivered the glaucoma medication, latanoprost, to ... release it quickly, our lens uses a polymer film to house the drug, and the film has ...

  14. Fine Guidance System for the James Webb Space Telescope Delivered

    NASA Video Gallery

    Video has music in the background but no dialogue. The second of four main instruments to fly aboard NASA's James Webb Space Telescope (Webb) has been delivered to NASA. The Fine Guidance Sensor (F...

  15. CLINICIAN PROFICIENCY IN DELIVERING MANUAL TREATMENT FOR NECK PAIN WITHIN SPECIFIED FORCE RANGES

    PubMed Central

    Gudavalli, Maruti Ram; Vining, Robert D.; Salsbury, Stacie A.; Corber, Lance; Long, Cynthia R.; Patwardhan, Avinash G.; Goertz, Christine M.

    2015-01-01

    Background Context Neck pain is a common musculoskeletal complaint responsive to manual therapies. Doctors of chiropractic commonly use manual cervical distraction, a mobilization procedure, to treat neck pain patients. However, it is unknown if clinicians can consistently apply standardized cervical traction forces, a critical step toward identifying an optimal therapeutic dose. Purpose The purpose of this study was to assess clinicians’ proficiency in delivering manually applied traction forces within specified ranges to neck pain patients. Study Design/Setting Observational study nested within a randomized clinical trial. Sample Two research clinicians provided study interventions to 48 participants with neck pain. Outcome Measures Clinician proficiency in delivering cervical traction forces within three specified ranges (low force <20 newtons (N); medium force 21–50N; and high force 51–100N). Methods This study was funded by a grant from the National Center for Complementary and Alternative Medicine, National Institutes of Health (Grant # 1 U19AT004663-01), and conducted in a facility funded by National Center for Research Resources, National Institutes of Health (Grant # C06 RR15433-01), and approved by an Institutional Review Board for the protection of human subjects. Senior author receives approximately $400–600 travel reimbursements per year for giving research presentations at certification seminars. The table manufacturer (Haven Innovations) sold the treatment table at a discounted price ($5000 discount) for research purposes. Participants were randomly allocated to three force-based treatment groups. Participants received five manual cervical distraction treatments over two weeks while lying prone on a treatment table instrumented with force sensors. Two clinicians delivered manual traction forces by treatment group. Clinicians treated participants first without real-time visual feedback displaying traction force and then with visual feedback

  16. Hanford Dose Overview Program: standardized methods and data for Hanford environmental dose calculations. Rev. 1

    SciTech Connect

    McCormack, W.D.; Ramsdell, J.V.; Napier, B.A.

    1984-05-01

    This document serves as a guide to Hanford contractors for obtaining or performing Hanford-related environmental dose calculations. Because environmental dose estimation techniques are state-of-the-art and are continually evolving, the data and standard methods presented herein will require periodic revision. This document is scheduled to be updated annually, but actual changes to the program will be made more frequently if required. For this reason, PNL's Occupational and Environmental Protection Department should be contacted before any Hanford-related environmental dose calculation is performed. This revision of the Hanford Dose Overview Program Report primarily reflects changes made to the data and models used in calculating atmospheric dispersion of airborne effluents at Hanford. The modified data and models are described in detail. In addition, discussions of dose calculation methods and the review of calculation results have been expanded to provide more explicit guidance to the Hanford contractors. 19 references, 30 tables.

  17. Dose Escalated Liver Stereotactic Body Radiation Therapy at the Mean Respiratory Position

    SciTech Connect

    Velec, Michael; Moseley, Joanne L.; Dawson, Laura A.; Brock, Kristy K.

    2014-08-01

    Purpose: The dosimetric impact of dose probability based planning target volume (PTV) margins for liver cancer patients receiving stereotactic body radiation therapy (SBRT) was compared with standard PTV based on the internal target volume (ITV). Plan robustness was evaluated by accumulating the treatment dose to ensure delivery of the intended plan. Methods and Materials: Twenty patients planned on exhale CT for 27 to 50 Gy in 6 fractions using an ITV-based PTV and treated free-breathing were retrospectively evaluated. Isotoxic, dose escalated plans were created on midposition computed tomography (CT), representing the mean breathing position, using a dose probability PTV. The delivered doses were accumulated using biomechanical deformable registration of the daily cone beam CT based on liver targeting at the exhale or mean breathing position, for the exhale and midposition CT plans, respectively. Results: The dose probability PTVs were on average 38% smaller than the ITV-based PTV, enabling an average ± standard deviation increase in the planned dose to 95% of the PTV of 4.0 ± 2.8 Gy (9 ± 5%) on the midposition CT (P<.01). For both plans, the delivered minimum gross tumor volume (GTV) doses were greater than the planned nominal prescribed dose in all 20 patients and greater than the planned dose to 95% of the PTV in 18 (90%) patients. Nine patients (45%) had 1 or more GTVs with a delivered minimum dose more than 5 Gy higher with the midposition CT plan using dose probability PTV, compared with the delivered dose with the exhale CT plan using ITV-based PTV. Conclusions: For isotoxic liver SBRT planned and delivered at the mean respiratory, reduced dose probability PTV enables a mean escalation of 4 Gy (9%) in 6 fractions over ITV-based PTV. This may potentially improve local control without increasing the risk of tumor underdosing.

  18. 40 CFR Appendix A to Part 197 - Calculation of Annual Committed Effective Dose Equivalent

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., being gradually delivered as the radionuclide decays. The time distribution of the absorbed dose rate... following an intake of radioactive material into the body: ER15OC08.002 for a single intake of activity...

  19. The effect of surgical titanium rods on proton therapy delivered for cervical bone tumors: experimental validation using an anthropomorphic phantom

    NASA Astrophysics Data System (ADS)

    Dietlicher, Isabelle; Casiraghi, Margherita; Ares, Carmen; Bolsi, Alessandra; Weber, Damien C.; Lomax, Antony J.; Albertini, Francesca

    2014-12-01

    To investigate the effect of metal implants in proton radiotherapy, dose distributions of different, clinically relevant treatment plans have been measured in an anthropomorphic phantom and compared to treatment planning predictions. The anthropomorphic phantom, which is sliced into four segments in the cranio-caudal direction, is composed of tissue equivalent materials and contains a titanium implant in a vertebral body in the cervical region. GafChromic® films were laid between the different segments to measure the 2D delivered dose. Three different four-field plans have then been applied: a Single-Field-Uniform-Dose (SFUD) plan, both with and without artifact correction implemented, and an Intensity-Modulated-Proton-Therapy (IMPT) plan with the artifacts corrected. For corrections, the artifacts were manually outlined and the Hounsfield Units manually set to an average value for soft tissue. Results show a surprisingly good agreement between prescribed and delivered dose distributions when artifacts have been corrected, with > 97% and 98% of points fulfilling the gamma criterion of 3%/3 mm for both SFUD and the IMPT plans, respectively. In contrast, without artifact corrections, up to 18% of measured points fail the gamma criterion of 3%/3 mm for the SFUD plan. These measurements indicate that correcting manually for the reconstruction artifacts resulting from metal implants substantially improves the accuracy of the calculated dose distribution.

  20. Inactivated poliovirus type 2 vaccine delivered to rat skin via high density microprojection array elicits potent neutralising antibody responses

    PubMed Central

    Muller, David A.; Pearson, Frances E.; Fernando, Germain J.P.; Agyei-Yeboah, Christiana; Owens, Nick S.; Corrie, Simon R.; Crichton, Michael L.; Wei, Jonathan C.J.; Weldon, William C.; Oberste, M. Steven; Young, Paul R.; Kendall, Mark A. F.

    2016-01-01

    Polio eradication is progressing rapidly, and the live attenuated Sabin strains in the oral poliovirus vaccine (OPV) are being removed sequentially, starting with type 2 in April 2016. For risk mitigation, countries are introducing inactivated poliovirus vaccine (IPV) into routine vaccination programs. After April 2016, monovalent type 2 OPV will be available for type 2 outbreak control. Because the current IPV is not suitable for house-to-house vaccination campaigns (the intramuscular injections require health professionals), we developed a high-density microprojection array, the Nanopatch, delivered monovalent type 2 IPV (IPV2) vaccine to the skin. To assess the immunogenicity of the Nanopatch, we performed a dose-matched study in rats, comparing the immunogenicity of IPV2 delivered by intramuscular injection or Nanopatch immunisation. A single dose of 0.2 D-antigen units of IPV2 elicited protective levels of poliovirus antibodies in 100% of animals. However, animals receiving IPV2 by IM required at least 3 immunisations to reach the same neutralising antibody titres. This level of dose reduction (1/40th of a full dose) is unprecedented for poliovirus vaccine delivery. The ease of administration coupled with the dose reduction observed in this study points to the Nanopatch as a potential tool for facilitating inexpensive IPV for mass vaccination campaigns. PMID:26911254

  1. Assessing patient dose in interventional fluoroscopy using patient-dependent hybrid phantoms

    NASA Astrophysics Data System (ADS)

    Johnson, Perry Barnett

    Interventional fluoroscopy uses ionizing radiation to guide small instruments through blood vessels or other body pathways to sites of clinical interest. The technique represents a tremendous advantage over invasive surgical procedures, as it requires only a small incision, thus reducing the risk of infection and providing for shorter recovery times. The growing use and increasing complexity of interventional procedures, however, has resulted in public health concerns regarding radiation exposures, particularly with respect to localized skin dose. Tracking and documenting patient-specific skin and internal organ dose has been specifically identified for interventional fluoroscopy where extended irradiation times, multiple projections, and repeat procedures can lead to some of the largest doses encountered in radiology. Furthermore, inprocedure knowledge of localized skin doses can be of significant clinical importance to managing patient risk and in training radiology residents. In this dissertation, a framework is presented for monitoring the radiation dose delivered to patients undergoing interventional procedures. The framework is built around two key points, developing better anthropomorphic models, and designing clinically relevant software systems for dose estimation. To begin, a library of 50 hybrid patient-dependent computational phantoms was developed based on the UF hybrid male and female reference phantoms. These phantoms represent a different type of anthropomorphic model whereby anthropometric parameters from an individual patient are used during phantom selection. The patient-dependent library was first validated and then used in two patient-phantom matching studies focused on cumulative organ and local skin dose. In terms of organ dose, patient-phantom matching was shown most beneficial for estimating the dose to large patients where error associated with soft tissue attenuation differences could be minimized. For small patients, inherent difference

  2. The Dose Response Relationship for Radiation Carcinogenesis

    NASA Astrophysics Data System (ADS)

    Hall, Eric

    2008-03-01

    Recent surveys show that the collective population radiation dose from medical procedures in the U.S. has increased by 750% in the past two decades. It would be impossible to imagine the practice of medicine today without diagnostic and therapeutic radiology, but nevertheless the widespread and rapidly increasing use of a modality which is a known human carcinogen is a cause for concern. To assess the magnitude of the problem it is necessary to establish the shape of the dose response relationship for radiation carcinogenesis. Information on radiation carcinogenesis comes from the A-bomb survivors, from occupationally exposed individuals and from radiotherapy patients. The A-bomb survivor data indicates a linear relationship between dose and the risk of solid cancers up to a dose of about 2.5 Sv. The lowest dose at which there is a significant excess cancer risk is debatable, but it would appear to be between 40 and 100 mSv. Data from the occupation exposure of nuclear workers shows an excess cancer risk at an average dose of 19.4 mSv. At the other end of the dose scale, data on second cancers in radiotherapy patients indicates that cancer risk does not continue to rise as a linear function of dose, but tends towards a plateau of 40 to 60 Gy, delivered in a fractionated regime. These data can be used to estimate the impact of diagnostic radiology at the low dose end of the dose response relationship, and the impact of new radiotherapy modalities at the high end of the dose response relationship. In the case of diagnostic radiology about 90% of the collective population dose comes from procedures (principally CT scans) which involve doses at which there is credible evidence of an excess cancer incidence. While the risk to the individual is small and justified in a symptomatic patient, the same is not true of some screening procedures is asymptomatic individuals, and in any case the huge number of procedures must add up to a potential public health problem. In the

  3. Peripheral doses in CyberKnife radiosurgery

    SciTech Connect

    Petti, Paula L.; Chuang, Cynthia F.; Smith, Vernon; Larson, David A.

    2006-06-15

    The purpose of this work is to measure the dose outside the treatment field for conformal CyberKnife treatments, to compare the results to those obtained for similar treatments delivered with gamma knife or intensity-modulated radiation therapy (IMRT), and to investigate the sources of peripheral dose in CyberKnife radiosurgery. CyberKnife treatment plans were developed for two hypothetical lesions in an anthropomorphic phantom, one in the thorax and another in the brain, and measurements were made with LiF thermoluminescent dosimeters (TLD-100 capsules) placed within the phantom at various depths and distances from the irradiated volume. For the brain lesion, gamma knife and 6-MV IMRT treatment plans were also developed, and peripheral doses were measured at the same locations as for the CyberKnife plan. The relative contribution to the CyberKnife peripheral dose from inferior- or superior-oblique beams entering or exiting through the body, internally scattered radiation, and leakage radiation was assessed through additional experiments using the single-isocenter option of the CyberKnife treatment-planning program with different size collimators. CyberKnife peripheral doses (in cGy) ranged from 0.16 to 0.041 % ({+-}0.003%) of the delivered number of monitor units (MU) at distances between 18 and 71 cm from the field edge. These values are two to five times larger than those measured for the comparable gamma knife brain treatment, and up to a factor of four times larger those measured in the IMRT experiment. Our results indicate that the CyberKnife peripheral dose is due largely to leakage radiation, however at distances less than 40 cm from the field edge, entrance, or exit dose from inferior- or superior-oblique beams can also contribute significantly. For distances larger than 40 cm from the field edge, the CyberKnife peripheral dose is directly related to the number of MU delivered, since leakage radiation is the dominant component.

  4. Filtration and Leach Testing for REDOX Sludge and S-Saltcake Actual Waste Sample Composites

    SciTech Connect

    Shimskey, Rick W.; Billing, Justin M.; Buck, Edgar C.; Daniel, Richard C.; Draper, Kathryn E.; Edwards, Matthew K.; Geeting, John GH; Hallen, Richard T.; Jenson, Evan D.; Kozelisky, Anne E.; MacFarlan, Paul J.; Peterson, Reid A.; Snow, Lanee A.; Swoboda, Robert G.

    2009-02-20

    A testing program evaluating actual tank waste was developed in response to Task 4 from the M-12 External Flowsheet Review Team (EFRT) issue response plan.( ) The test program was subdivided into logical increments. The bulk water-insoluble solid wastes that are anticipated to be delivered to the Waste Treatment and Immobilization Plant (WTP) were identified according to type such that the actual waste testing could be targeted to the relevant categories. Under test plan TP-RPP-WTP-467, eight broad waste groupings were defined. Samples available from the 222S archive were identified and obtained for testing. Under this test plan, a waste-testing program was implemented that included: • Homogenizing the archive samples by group as defined in the test plan • Characterizing the homogenized sample groups • Performing parametric leaching testing on each group for compounds of interest • Performing bench-top filtration/leaching tests in the hot cell for each group to simulate filtration and leaching activities if they occurred in the UFP2 vessel of the WTP Pretreatment Facility. This report focuses on filtration/leaching tests performed on two of the eight waste composite samples and follow-on parametric tests to support aluminum leaching results from those tests.

  5. Novel brachytherapy treatment planning system utilizing dose rate dependent average cell survival, CT-simulator, and dose-volume histogram

    SciTech Connect

    Mayer, R.; Fong, W.; Frankel, T.

    1995-12-31

    This report describes a new brachytherapy planning program that provides an evaluation of a given low or high dose rate treatment taking into account spatial dose heterogeneity and cell response to radiation. This brachytherapy scheme uses the images from a CT-Simulator (AcQSim, Picker International, Cleveland, Ohio) to simultaneously localize the seed positions and to axially scan the patient. This procedure helps to ensure accurate registration of the putative seed positions with the patient tissues and organs. The seed positions are determined by back-projecting positions of seeds or dummy seeds from the CT-Simulator setup scout images. Physicians delineate the tissues of interest on the axial slices. Dose is computed after assigning activity (low dose rate) of dwell times (high dose rate) to the Ir{sup 192} or I{sup 125} seed. The planar isodose distribution is superimposed onto axial cuts of the tissues and onto coronal or sagital views of the tissues following image reconstruction. Areal or volumetric calculations of the dose distribution within a given tissue are computed from the tissue outlines. The treatment plan computes (1) volume differential and cummulative dose histograms of the dose delivered to individual tissues, (2) the average, standard deviation, and coefficient of skewness of the dose distribution delivered to the individual tissues, (3) the average survival probability for a given radiation treatment.

  6. SEBAL-based Daily Actual Evapotranspiration Forecasting using Wavelets Decomposition Analysis and Multivariate Relevance Vector Machines

    NASA Astrophysics Data System (ADS)

    Torres, A. F.

    2011-12-01

    two excellent tools from the Learning Machine field know as the Wavelet Decomposition Analysis (WDA) and the Multivariate Relevance Vector Machine (MVRVM) to forecast the results obtained from the SEBAL algorithm using LandSat imagery and soil moisture maps. The predictive capability of this novel hybrid WDA-RVM actual evapotranspiration forecasting technique is tested by comparing the crop water requirements and delivered crop water in the Lower Sevier River Basin, Utah, for the period 2007-2011. This location was selected because of their success increasing the efficiency of water use and control along the entire irrigation system. Research is currently on going to assess the efficacy of the WDA-RVM technique along the irrigation season, which is required to enhance the water use efficiency and minimize climate change impact on the Sevier River Basin.

  7. From cellular doses to average lung dose.

    PubMed

    Hofmann, W; Winkler-Heil, R

    2015-11-01

    Sensitive basal and secretory cells receive a wide range of doses in human bronchial and bronchiolar airways. Variations of cellular doses arise from the location of target cells in the bronchial epithelium of a given airway and the asymmetry and variability of airway dimensions of the lung among airways in a given airway generation and among bronchial and bronchiolar airway generations. To derive a single value for the average lung dose which can be related to epidemiologically observed lung cancer risk, appropriate weighting scenarios have to be applied. Potential biological weighting parameters are the relative frequency of target cells, the number of progenitor cells, the contribution of dose enhancement at airway bifurcations, the promotional effect of cigarette smoking and, finally, the application of appropriate regional apportionment factors. Depending on the choice of weighting parameters, detriment-weighted average lung doses can vary by a factor of up to 4 for given radon progeny exposure conditions.

  8. NUNDO: a numerical model of a human torso phantom and its application to effective dose equivalent calculations for astronauts at the ISS.

    PubMed

    Puchalska, Monika; Bilski, Pawel; Berger, Thomas; Hajek, Michael; Horwacik, Tomasz; Körner, Christine; Olko, Pawel; Shurshakov, Vyacheslav; Reitz, Günther

    2014-11-01

    The health effects of cosmic radiation on astronauts need to be precisely quantified and controlled. This task is important not only in perspective of the increasing human presence at the International Space Station (ISS), but also for the preparation of safe human missions beyond low earth orbit. From a radiation protection point of view, the baseline quantity for radiation risk assessment in space is the effective dose equivalent. The present work reports the first successful attempt of the experimental determination of the effective dose equivalent in space, both for extra-vehicular activity (EVA) and intra-vehicular activity (IVA). This was achieved using the anthropomorphic torso phantom RANDO(®) equipped with more than 6,000 passive thermoluminescent detectors and plastic nuclear track detectors, which have been exposed to cosmic radiation inside the European Space Agency MATROSHKA facility both outside and inside the ISS. In order to calculate the effective dose equivalent, a numerical model of the RANDO(®) phantom, based on computer tomography scans of the actual phantom, was developed. It was found that the effective dose equivalent rate during an EVA approaches 700 μSv/d, while during an IVA about 20 % lower values were observed. It is shown that the individual dose based on a personal dosimeter reading for an astronaut during IVA results in an overestimate of the effective dose equivalent of about 15 %, whereas under an EVA conditions the overestimate is more than 200 %. A personal dosemeter can therefore deliver quite good exposure records during IVA, but may overestimate the effective dose equivalent received during an EVA considerably. PMID:25119442

  9. NUNDO: a numerical model of a human torso phantom and its application to effective dose equivalent calculations for astronauts at the ISS.

    PubMed

    Puchalska, Monika; Bilski, Pawel; Berger, Thomas; Hajek, Michael; Horwacik, Tomasz; Körner, Christine; Olko, Pawel; Shurshakov, Vyacheslav; Reitz, Günther

    2014-11-01

    The health effects of cosmic radiation on astronauts need to be precisely quantified and controlled. This task is important not only in perspective of the increasing human presence at the International Space Station (ISS), but also for the preparation of safe human missions beyond low earth orbit. From a radiation protection point of view, the baseline quantity for radiation risk assessment in space is the effective dose equivalent. The present work reports the first successful attempt of the experimental determination of the effective dose equivalent in space, both for extra-vehicular activity (EVA) and intra-vehicular activity (IVA). This was achieved using the anthropomorphic torso phantom RANDO(®) equipped with more than 6,000 passive thermoluminescent detectors and plastic nuclear track detectors, which have been exposed to cosmic radiation inside the European Space Agency MATROSHKA facility both outside and inside the ISS. In order to calculate the effective dose equivalent, a numerical model of the RANDO(®) phantom, based on computer tomography scans of the actual phantom, was developed. It was found that the effective dose equivalent rate during an EVA approaches 700 μSv/d, while during an IVA about 20 % lower values were observed. It is shown that the individual dose based on a personal dosimeter reading for an astronaut during IVA results in an overestimate of the effective dose equivalent of about 15 %, whereas under an EVA conditions the overestimate is more than 200 %. A personal dosemeter can therefore deliver quite good exposure records during IVA, but may overestimate the effective dose equivalent received during an EVA considerably.

  10. Relationship of perceived and actual motor competence in children.

    PubMed

    Raudsepp, Lennart; Liblik, Raino

    2002-06-01

    The purpose of this study was to examine the relationship between children's actual and perceived motor competence. 280 children between the ages of 10 and 13 years individually completed the Children's Physical Self-perception Profile which assesses perceptions of sport competence, physical conditioning, strength, body attractiveness, and general physical self-worth. The internal reliabilities (a) of the subscales ranged from .75 to .82. After completing the profile, the subject's actual motor competence was measured using tests of aerobic fitness and functional strength. Body fatness (sum of five skinfolds) was measured as an objective measure of perceived body attractiveness. Analysis of variance showed that boys and girls differed in perceived competence and actual motor competence. The boys showed higher perceived competence on four scores, but there was no sex difference in perception of body attractiveness. Correlations and regression analysis showed that actual and perceived motor competence were significantly but only moderately (r =.25-.56) correlated. In addition, items of perceived physical competence and age accounted for 17% (sit-ups) to 25% (endurance shuttle run) of the variance in actual motor competence of the children. These findings showed that 10- to 13-yr-old children can only moderately assess personal motor competence. PMID:12186225

  11. SU-E-I-25: Determining Tube Current, Tube Voltage and Pitch Suitable for Low- Dose Lung Screening CT

    SciTech Connect

    Williams, K; Matthews, K

    2014-06-01

    Purpose: The quality of a computed tomography (CT) image and the dose delivered during its acquisition depend upon the acquisition parameters used. Tube current, tube voltage, and pitch are acquisition parameters that potentially affect image quality and dose. This study investigated physicians' abilities to characterize small, solid nodules in low-dose CT images for combinations of current, voltage and pitch, for three CT scanner models. Methods: Lung CT images was acquired of a Data Spectrum anthropomorphic torso phantom with various combinations of pitch, tube current, and tube voltage; this phantom was used because acrylic beads of various sizes could be placed within the lung compartments to simulate nodules. The phantom was imaged on two 16-slice scanners and a 64-slice scanner. The acquisition parameters spanned a range of estimated CTDI levels; the CTDI estimates from the acquisition software were verified by measurement. Several experienced radiologists viewed the phantom lung CT images and noted nodule location, size and shape, as well as the acceptability of overall image quality. Results: Image quality for assessment of nodules was deemed unsatisfactory for all scanners at 80 kV (any tube current) and at 35 mA (any tube voltage). Tube current of 50 mA or more at 120 kV resulted in similar assessments from all three scanners. Physician-measured sphere diameters were closer to actual diameters for larger spheres, higher tube current, and higher kV. Pitch influenced size measurements less for larger spheres than for smaller spheres. CTDI was typically overestimated by the scanner software compared to measurement. Conclusion: Based on this survey of acquisition parameters, a low-dose CT protocol of 120 kV, 50 mA, and pitch of 1.4 is recommended to balance patient dose and acceptable image quality. For three models of scanners, this protocol resulted in estimated CTDIs from 2.9–3.6 mGy.

  12. Intensity modulating and other radiation therapy devices for dose painting.

    PubMed

    Galvin, James M; De Neve, Wilfried

    2007-03-10

    The introduction of intensity-modulated radiation therapy (IMRT) in the early 1990s created the possibility of generating dramatically improved dose distributions that could be tailored to fit a complex geometric arrangement of targets that push against or even surround healthy critical structures. IMRT is a new treatment paradigm that goes beyond the capabilities of the earlier technology called three-dimensional radiation therapy (3DCRT). IMRT took the older approach of using fields that conformed to the silhouette of the target to deliver a relatively homogeneous intensity of radiation and separated the conformal fields into many subfields so that intensity could be varied to better control the final dose distribution. This technique makes it possible to generate radiation dose clouds that have indentations in their surface. Initially, this technology was mainly used to avoid and thus control the dose delivered to critical structures so that they are not seriously damaged in the process of irradiating nearby targets to an appropriately high dose. Avoidance of critical structures allowed homogeneous dose escalation that led to improved local control for small tumors. However, the normal tissue component of large tumors often prohibits homogeneous dose escalation. A newer concept of dose-painting IMRT is aimed at exploiting inhomogeneous dose distributions adapted to tumor heterogeneity. Tumor regions of increased radiation resistance receive escalated dose levels, whereas radiation-sensitive regions receive conventional or even de-escalated dose levels. Dose painting relies on biologic imaging such as positron emission tomography, functional magnetic resonance imaging, and magnetic resonance spectroscopy. This review will describe the competing techologies for dose painting with an emphasis on their commonalities.

  13. Image-guided adaptive radiation therapy (IGART): Radiobiological and dose escalation considerations for localized carcinoma of the prostate

    SciTech Connect

    Song, William; Schaly, Bryan; Bauman, Glenn; Battista, Jerry; Van Dyk, Jake

    2005-07-15

    The goal of this work was to evaluate the efficacy of various image-guided adaptive radiation therapy (IGART) techniques to deliver and escalate dose to the prostate in the presence of geometric uncertainties. Five prostate patients with 15-16 treatment CT studies each were retrospectively analyzed. All patients were planned with an 18 MV, six-field conformal technique with a 10 mm margin size and an initial prescription of 70 Gy in 35 fractions. The adaptive strategy employed in this work for patient-specific dose escalation was to increase the prescription dose in 2 Gy-per-fraction increments until the rectum normal tissue complication probability (NTCP) reached a level equal to that of the nominal plan NTCP (i.e., iso-NTCP dose escalation). The various target localization techniques simulated were: (1) daily laser-guided alignment to skin tattoo marks that represents treatment without image-guidance, (2) alignment to bony landmarks with daily portal images, and (3) alignment to the clinical target volume (CTV) with daily CT images. Techniques (1) and (3) were resimulated with a reduced margin size of 5 mm to investigate further dose escalation. When delivering the original clinical prescription dose of 70 Gy in 35 fractions, the 'CTV registration' technique yielded the highest tumor control probability (TCP) most frequently, followed by the 'bone registration' and 'tattoo registration' techniques. However, the differences in TCP among the three techniques were minor when the margin size was 10 mm ({<=}1.1%). Reducing the margin size to 5 mm significantly degraded the TCP values of the 'tattoo registration' technique in two of the five patients, where a large difference was found compared to the other techniques ({<=}11.8%). The 'CTV registration' technique, however, did maintain similar TCP values compared to their 10 mm margin counterpart. In terms of normal tissue sparing, the technique producing the lowest NTCP varied from patient to patient. Reducing the

  14. Pharmacogenetic-guided Warfarin Dosing Algorithm in African-Americans.

    PubMed

    Alzubiedi, Sameh; Saleh, Mohammad I

    2016-01-01

    We aim to develop warfarin dosing algorithm for African-Americans. We explored demographic, clinical, and genetic data from a previously collected cohort of 163 African-American patients with a stable warfarin dose. We explored 2 approaches to develop the algorithm: multiple linear regression and artificial neural network (ANN). The clinical significance of the 2 dosing algorithms was evaluated by calculating the percentage of patients whose predicted dose of warfarin was within 20% of the actual dose. Linear regression model and ANN model predicted the ideal dose in 52% and 48% of the patients, respectively. The mean absolute error using linear regression model was estimated to be 10.8 mg compared with 10.9 mg using ANN. Linear regression and ANN models identified several predictors of warfarin dose including age, weight, CYP2C9 genotype *1/*1, VKORC1 genotype, rs12777823 genotype, rs2108622 genotype, congestive heart failure, and amiodarone use. In conclusion, we developed a warfarin dosing algorithm for African-Americans. The proposed dosing algorithm has the potential to recommend warfarin doses that are close to the appropriate doses. The use of more sophisticated ANN approach did not result in improved predictive performance of the dosing algorithm except for patients of a dose of ≥49 mg/wk.

  15. Pharmacogenetic-guided Warfarin Dosing Algorithm in African-Americans.

    PubMed

    Alzubiedi, Sameh; Saleh, Mohammad I

    2016-01-01

    We aim to develop warfarin dosing algorithm for African-Americans. We explored demographic, clinical, and genetic data from a previously collected cohort of 163 African-American patients with a stable warfarin dose. We explored 2 approaches to develop the algorithm: multiple linear regression and artificial neural network (ANN). The clinical significance of the 2 dosing algorithms was evaluated by calculating the percentage of patients whose predicted dose of warfarin was within 20% of the actual dose. Linear regression model and ANN model predicted the ideal dose in 52% and 48% of the patients, respectively. The mean absolute error using linear regression model was estimated to be 10.8 mg compared with 10.9 mg using ANN. Linear regression and ANN models identified several predictors of warfarin dose including age, weight, CYP2C9 genotype *1/*1, VKORC1 genotype, rs12777823 genotype, rs2108622 genotype, congestive heart failure, and amiodarone use. In conclusion, we developed a warfarin dosing algorithm for African-Americans. The proposed dosing algorithm has the potential to recommend warfarin doses that are close to the appropriate doses. The use of more sophisticated ANN approach did not result in improved predictive performance of the dosing algorithm except for patients of a dose of ≥49 mg/wk. PMID:26355760

  16. Hole drilling with fiber-optically delivered visible lasers

    SciTech Connect

    Kautz, D.D.; Berzins, L.V.; Dragon, E.P.

    1994-12-31

    The use of lasers for high-speed drilling of holes in materials is well documented. To allow easier use of lasers in manufacturing processes, fiber-optically delivered beams are preferable to the use of conventional optics. Lawrence Livermore National Laboratory (LLNL) has adapted fiber-optic technology to its visible light, copper vapor lasers for use in hole drilling studies. Visible lasers afford better coupling of light to the workpiece and when fiber-optically delivered, allow high quality holes to be drilled in difficult accessibility areas and with easier setup. A fiber-optic delivery system was attached to the presently hard-optic copper vapor laser system. This system consisted of a 0.6 mm (0.024 in.) fiber that was then telescoped and refocused by a hard optics package at the workstation end of the fiber. The optics package produced a 0.2 mm (0.008 in.) focused spot size at the workpiece. This system was then run down to a 3-axis CNC machining table to allow part movement for these studies. The fiber-optically delivered light was found to work extremely well for drilling small diameter holes. In summary, it was found that fiber-optically delivered, visible laser beams have several advantages in drilling over those same beams delivered through conventional hard optics. These include much easier setup, reduced system maintenance, and typically higher hole quality.

  17. Radiographer Delivered Fluoroscopy Reduces Radiation Exposure During Endoscopic Urological Procedures

    PubMed Central

    Hennessey, DB; Young, M; Pahuja, A

    2016-01-01

    Introduction The 1999 Ionising Radiation Regulations recommend that medical professionals using ionising radiation should aim to keep exposure as ‘low as reasonably practicable’. Urologists regularly use fluoroscopy during endoscopic surgical procedures. In some institutions, this is delivered by a radiographer whereas in others, it is delivered by the urological surgeon. Objectives To determine if radiographer-delivered fluoroscopy can reduce the exposure to ionising radiation during urological procedures. Methods An analysis of 395 consecutive patients, who underwent endoscopic urological procedures requiring fluoroscopy, was performed simultaneously across two institutions, over a 4 month period. 321 patients were matched and included in the analysis. Results Radiographer delivered fluoroscopy was associated with reduced ionising radiation exposure for retrograde pyelography procedures ED 0.09626 vs. 1.323 mSev, p= 0.0003, and endoscopic stone surgeries ED 0.3066 Vs. 0.5416 mSev, p=0.0039, but not for ureterorenoscopic stone surgeries 0.4880 vs. 0.2213 mSev, p=0.8292. Conclusion Radiographer delivered fluoroscopy could reduce the patient’s exposure to ionising radiation for some urological procedures. PMID:27158158

  18. Pilot Eye Scanning under Actual Single Pilot Instrument Flight

    NASA Astrophysics Data System (ADS)

    Rinoie, Kenichi; Sunada, Yasuto

    Operations under single pilot instrument flight rules for general aviation aircraft is known to be one of the most demanding pilot tasks. Scanning numerous instruments plays a key role for perception and decision-making during flight. Flight experiments have been done by a single engine light airplane to investigate the pilot eye scanning technique for IFR flights. Comparisons between the results by an actual flight and those by a PC-based flight simulator are made. The experimental difficulties of pilot eye scanning measurements during the actual IFR flight are discussed.

  19. Meditation and college students' self-actualization and rated stress.

    PubMed

    Janowiak, J J; Hackman, R

    1994-10-01

    This paper concerns the efficacy of meditation and relaxation in promoting self-actualization and changes in self-reported stress among 62 college students. Two groups were given mantra meditation and a yogic relaxation technique referred to as Shavasana. Pre- and posttest measures were taken on the Personal Orientation Inventory and the Behavioral Relaxation Scale. Both groups showed significant increases in scores on self-actualization; however, no differences were found between groups. Meditation training was associated with larger gains in scores on measures of systematic relaxed behavior than of the relaxation training.

  20. Comparison of simulated and actual wind shear radar data products

    NASA Technical Reports Server (NTRS)

    Britt, Charles L.; Crittenden, Lucille H.

    1992-01-01

    Prior to the development of the NASA experimental wind shear radar system, extensive computer simulations were conducted to determine the performance of the radar in combined weather and ground clutter environments. The simulation of the radar used analytical microburst models to determine weather returns and synthetic aperture radar (SAR) maps to determine ground clutter returns. These simulations were used to guide the development of hazard detection algorithms and to predict their performance. The structure of the radar simulation is reviewed. Actual flight data results from the Orlando and Denver tests are compared with simulated results. Areas of agreement and disagreement of actual and simulated results are shown.

  1. [Delineation of organs at risk and dose constraints].

    PubMed

    Noël, G; Antoni, D; Barillot, I; Chauvet, B

    2016-09-01

    From a review of literature, the objective of this paper is to define limits for delineation of organs at risk and dose constraints in this latter when radiotherapy is delivered with conventional fractionation or with hypofractionation as for stereotactic body radiation therapy. PMID:27516050

  2. Delivering Faster Congestion Feedback with the Mark-Front Strategy

    NASA Technical Reports Server (NTRS)

    Liu, Chunlei; Jain, Raj

    2001-01-01

    Computer networks use congestion feedback from the routers and destinations to control the transmission load. Delivering timely congestion feedback is essential to the performance of networks. Reaction to the congestion can be more effective if faster feedback is provided. Current TCP/IP networks use timeout, duplicate Acknowledgement Packets (ACKs) and explicit congestion notification (ECN) to deliver the congestion feedback, each provides a faster feedback than the previous method. In this paper, we propose a markfront strategy that delivers an even faster congestion feedback. With analytical and simulation results, we show that mark-front strategy reduces buffer size requirement, improves link efficiency and provides better fairness among users. Keywords: Explicit Congestion Notification, mark-front, congestion control, buffer size requirement, fairness.

  3. Peer-delivered services: Current trends and innovations.

    PubMed

    Rogers, E Sally; Swarbrick, Margaret

    2016-09-01

    In this special issue entitled , we provide further information about the growing peer workforce, as well as new and innovative developments in peer-delivered services. In order to do that, we must first define our terms: We consider peer-delivered services to be a broad umbrella of services designed and delivered by individuals with a "lived experience" of mental or substance use challenges. We offer new information to the field in this special issue about peer support and how peer support specialists have evolved to address unmet needs and to attend to social determinants that affect wellness and recovery. We also address the challenges that a relatively new workforce and service innovation can present, as well as directions for continued research, evaluation, and growth. Our intention in this special issue is to examine the and of peer support specialist services as they currently exist in the United States. (PsycINFO Database Record PMID:27618456

  4. Analysis of Incidental Radiation Dose to Uninvolved Mediastinal/Supraclavicular Lymph Nodes in Patients with Limited-Stage Small Cell Lung Cancer Treated Without Elective Nodal Irradiation

    SciTech Connect

    Ahmed, Irfan; DeMarco, Marylou; Stevens, Craig W.; Fulp, William J.; Dilling, Thomas J.

    2011-01-01

    lymph nodes within the mediastinum. The ENI{sub on} plans demonstrate that intergroup-style treatments, as actually delivered, had statistically reduced coverage to the mediastinum and tumor volumes than was reported. Furthermore, SNI leads to improved tumor coverage and reduced esophageal/spinal cord dose, which suggests the possibility of dose escalation using SNI.

  5. Toward an organ based dose prescription method for the improved accuracy of murine dose in orthovoltage x-ray irradiators

    PubMed Central

    Belley, Matthew D.; Wang, Chu; Nguyen, Giao; Gunasingha, Rathnayaka; Chao, Nelson J.; Chen, Benny J.; Dewhirst, Mark W.; Yoshizumi, Terry T.

    2014-01-01

    Purpose: Accurate dosimetry is essential when irradiating mice to ensure that functional and molecular endpoints are well understood for the radiation dose delivered. Conventional methods of prescribing dose in mice involve the use of a single dose rate measurement and assume a uniform average dose throughout all organs of the entire mouse. Here, the authors report the individual average organ dose values for the irradiation of a 12, 23, and 33 g mouse on a 320 kVp x-ray irradiator and calculate the resulting error from using conventional dose prescription methods. Methods: Organ doses were simulated in the Geant4 application for tomographic emission toolkit using the MOBY mouse whole-body phantom. Dosimetry was performed for three beams utilizing filters A (1.65 mm Al), B (2.0 mm Al), and C (0.1 mm Cu + 2.5 mm Al), respectively. In addition, simulated x-ray spectra were validated with physical half-value layer measurements. Results: Average doses in soft-tissue organs were found to vary by as much as 23%–32% depending on the filter. Compared to filters A and B, filter C provided the hardest beam and had the lowest variation in soft-tissue average organ doses across all mouse sizes, with a difference of 23% for the median mouse size of 23 g. Conclusions: This work suggests a new dose prescription method in small animal dosimetry: it presents a departure from the conventional approach of assigning a single dose value for irradiation of mice to a more comprehensive approach of characterizing individual organ doses to minimize the error and uncertainty. In human radiation therapy, clinical treatment planning establishes the target dose as well as the dose distribution, however, this has generally not been done in small animal research. These results suggest that organ dose errors will be minimized by calibrating the dose rates for all filters, and using different dose rates for different organs. PMID:24593746

  6. Toward an organ based dose prescription method for the improved accuracy of murine dose in orthovoltage x-ray irradiators

    SciTech Connect

    Belley, Matthew D.; Wang, Chu; Nguyen, Giao; Gunasingha, Rathnayaka; Chao, Nelson J.; Chen, Benny J.; Dewhirst, Mark W.; Yoshizumi, Terry T.

    2014-03-15

    Purpose: Accurate dosimetry is essential when irradiating mice to ensure that functional and molecular endpoints are well understood for the radiation dose delivered. Conventional methods of prescribing dose in mice involve the use of a single dose rate measurement and assume a uniform average dose throughout all organs of the entire mouse. Here, the authors report the individual average organ dose values for the irradiation of a 12, 23, and 33 g mouse on a 320 kVp x-ray irradiator and calculate the resulting error from using conventional dose prescription methods. Methods: Organ doses were simulated in the Geant4 application for tomographic emission toolkit using the MOBY mouse whole-body phantom. Dosimetry was performed for three beams utilizing filters A (1.65 mm Al), B (2.0 mm Al), and C (0.1 mm Cu + 2.5 mm Al), respectively. In addition, simulated x-ray spectra were validated with physical half-value layer measurements. Results: Average doses in soft-tissue organs were found to vary by as much as 23%–32% depending on the filter. Compared to filters A and B, filter C provided the hardest beam and had the lowest variation in soft-tissue average organ doses across all mouse sizes, with a difference of 23% for the median mouse size of 23 g. Conclusions: This work suggests a new dose prescription method in small animal dosimetry: it presents a departure from the conventional approach of assigninga single dose value for irradiation of mice to a more comprehensive approach of characterizing individual organ doses to minimize the error and uncertainty. In human radiation therapy, clinical treatment planning establishes the target dose as well as the dose distribution, however, this has generally not been done in small animal research. These results suggest that organ dose errors will be minimized by calibrating the dose rates for all filters, and using different dose rates for different organs.

  7. Use of effective dose.

    PubMed

    Harrison, J D; Balonov, M; Martin, C J; Ortiz Lopez, P; Menzel, H-G; Simmonds, J R; Smith-Bindman, R; Wakeford, R

    2016-06-01

    International Commission on Radiological Protection (ICRP) Publication 103 provided a detailed explanation of the purpose and use of effective dose and equivalent dose to individual organs and tissues. Effective dose has proven to be a valuable and robust quantity for use in the implementation of protection principles. However, questions have arisen regarding practical applications, and a Task Group has been set up to consider issues of concern. This paper focusses on two key proposals developed by the Task Group that are under consideration by ICRP: (1) confusion will be avoided if equivalent dose is no longer used as a protection quantity, but regarded as an intermediate step in the calculation of effective dose. It would be more appropriate for limits for the avoidance of deterministic effects to the hands and feet, lens of the eye, and skin, to be set in terms of the quantity, absorbed dose (Gy) rather than equivalent dose (Sv). (2) Effective dose is in widespread use in medical practice as a measure of risk, thereby going beyond its intended purpose. While doses incurred at low levels of exposure may be measured or assessed with reasonable reliability, health effects have not been demonstrated reliably at such levels but are inferred. However, bearing in mind the uncertainties associated with risk projection to low doses or low dose rates, it may be considered reasonable to use effective dose as a rough indicator of possible risk, with the additional consideration of variation in risk with age, sex and population group. PMID:26980800

  8. Use of effective dose.

    PubMed

    Harrison, J D; Balonov, M; Martin, C J; Ortiz Lopez, P; Menzel, H-G; Simmonds, J R; Smith-Bindman, R; Wakeford, R

    2016-06-01

    International Commission on Radiological Protection (ICRP) Publication 103 provided a detailed explanation of the purpose and use of effective dose and equivalent dose to individual organs and tissues. Effective dose has proven to be a valuable and robust quantity for use in the implementation of protection principles. However, questions have arisen regarding practical applications, and a Task Group has been set up to consider issues of concern. This paper focusses on two key proposals developed by the Task Group that are under consideration by ICRP: (1) confusion will be avoided if equivalent dose is no longer used as a protection quantity, but regarded as an intermediate step in the calculation of effective dose. It would be more appropriate for limits for the avoidance of deterministic effects to the hands and feet, lens of the eye, and skin, to be set in terms of the quantity, absorbed dose (Gy) rather than equivalent dose (Sv). (2) Effective dose is in widespread use in medical practice as a measure of risk, thereby going beyond its intended purpose. While doses incurred at low levels of exposure may be measured or assessed with reasonable reliability, health effects have not been demonstrated reliably at such levels but are inferred. However, bearing in mind the uncertainties associated with risk projection to low doses or low dose rates, it may be considered reasonable to use effective dose as a rough indicator of possible risk, with the additional consideration of variation in risk with age, sex and population group.

  9. Do We Deliver the Pressures We Intend to When Using a T-Piece Resuscitator?

    PubMed Central

    Walther, Frans J.; Roehr, Charles C.; te Pas, Arjan B.

    2013-01-01

    Background A T-piece resuscitator (TPR) uses a built-in manometer to set the inflation pressures, but we are not informed what pressures are actually delivered distally. Aim of this study was to measure the proximal and distal pressures under different gas conditions when using a TPR. Methodology/Findings A test lung was ventilated using a TPR (PIP 25 cmH2O, PEEP 5 cmH2O) with a gas flow rate of 8 L/min. A) Pressure delivered by six different TPRs was tested. To test variability 20 participants were asked to set PEEP and PIP pressures to 25/5 cmH2O. B) PIP and PEEP were measured proximal and distal of the TPR when using standard tubing or heated tubing with or without a humidifier. In experiment A mean (SD) proximal PIP and PEEP of the TPRs were respectively 20.3 (0.3) cmH2O (19.9–20.6 cmH2O) and 4.9 (0.1) cmH2O. When 20 participants set pressures; PIP 26.7 (0.5) cm H2O and PEEP 5.9 (0.44) cmH2O were measured. Experiment B showed that the decrease of PIP between proximal and distal pressures was not clinically significant. However there was a significant decrease of PEEP using the standard tubing (5.1 (0.1) cmH2O proximally versus 4.8 (0.2) cmH2O distally; p<0.001) compared to, when using a humidifier with associated tubing and the humidifier turned on, 5.1 (0.1) proximally versus 3.9 (0.2) cmH2O distally; (p<0.001). Conclusion/Significance The accuracy of the built-in manometer of a TPR is acceptable. Most pressures set proximally are comparable to the actual pressures delivered distally. However, when using tubing associated with the humidifier PEEP decreases distally by 1.1–1.2 cmH2O and users should anticipate on this. PMID:23717652

  10. Computing proton dose to irregularly moving targets

    NASA Astrophysics Data System (ADS)

    Phillips, Justin; Gueorguiev, Gueorgui; Shackleford, James A.; Grassberger, Clemens; Dowdell, Stephen; Paganetti, Harald; Sharp, Gregory C.

    2014-08-01

    Purpose: While four-dimensional computed tomography (4DCT) and deformable registration can be used to assess the dose delivered to regularly moving targets, there are few methods available for irregularly moving targets. 4DCT captures an idealized waveform, but human respiration during treatment is characterized by gradual baseline shifts and other deviations from a periodic signal. This paper describes a method for computing the dose delivered to irregularly moving targets based on 1D or 3D waveforms captured at the time of delivery. Methods: The procedure uses CT or 4DCT images for dose calculation, and 1D or 3D respiratory waveforms of the target position at time of delivery. Dose volumes are converted from their Cartesian geometry into a beam-specific radiological depth space, parameterized in 2D by the beam aperture, and longitudinally by the radiological depth. In this new frame of reference, the proton doses are translated according to the motion found in the 1D or 3D trajectory. These translated dose volumes are weighted and summed, then transformed back into Cartesian space, yielding an estimate of the dose that includes the effect of the measured breathing motion. The method was validated using a synthetic lung phantom and a single representative patient CT. Simulated 4DCT was generated for the phantom with 2 cm peak-to-peak motion. Results: A passively-scattered proton treatment plan was generated using 6 mm and 5 mm smearing for the phantom and patient plans, respectively. The method was tested without motion, and with two simulated breathing signals: a 2 cm amplitude sinusoid, and a 2 cm amplitude sinusoid with 3 cm linear drift in the phantom. The tumor positions were equally weighted for the patient calculation. Motion-corrected dose was computed based on the mid-ventilation CT image in the phantom and the peak exhale position in the patient. Gamma evaluation was 97.8% without motion, 95.7% for 2 cm sinusoidal motion, 95.7% with 3 cm drift in the

  11. Computing Proton Dose to Irregularly Moving Targets

    PubMed Central

    Phillips, Justin; Gueorguiev, Gueorgui; Shackleford, James A.; Grassberger, Clemens; Dowdell, Stephen; Paganetti, Harald; Sharp, Gregory C.

    2014-01-01

    Purpose While four-dimensional computed tomography (4DCT) and deformable registration can be used to assess the dose delivered to regularly moving targets, there are few methods available for irregularly moving targets. 4DCT captures an idealized waveform, but human respiration during treatment is characterized by gradual baseline shifts and other deviations from a periodic signal. This paper describes a method for computing the dose delivered to irregularly moving targets based on 1D or 3D waveforms captured at the time of delivery. Methods The procedure uses CT or 4DCT images for dose calculation, and 1D or 3D respiratory waveforms of the target position at time of delivery. Dose volumes are converted from their Cartesian geometry into a beam-specific radiological depth space, parameterized in 2D by the beam aperture, and longitudinally by the radiological depth. In this new frame of reference, the proton doses are translated according to the motion found in the 1D or 3D trajectory. These translated dose volumes are weighted and summed, then transformed back into Cartesian space, yielding an estimate of the dose that includes the effect of the measured breathing motion. The method was validated using a synthetic lung phantom and a single representative patient CT. Simulated 4DCT was generated for the phantom with 2 cm peak-to-peak motion. Results A passively-scattered proton treatment plan was generated using 6 mm and 5 mm smearing for the phantom and patient plans, respectively. The method was tested without motion, and with two simulated breathing signals: a 2 cm amplitude sinusoid, and a 2 cm amplitude sinusoid with 3 cm linear drift in the phantom. The tumor positions were equally weighted for the patient calculation. Motion-corrected dose was computed based on the mid-ventilation CT image in the phantom and the peak exhale position in the patient. Gamma evaluation was 97.8% without motion, 95.7% for 2 cm sinusoidal motion, and 95.7% with 3 cm drift in the

  12. MLCMS Actual Use, Perceived Use, and Experiences of Use

    ERIC Educational Resources Information Center

    Asiimwe, Edgar Napoleon; Grönlund, Åke

    2015-01-01

    Mobile learning involves use of mobile devices to participate in learning activities. Most e-learning activities are available to participants through learning systems such as learning content management systems (LCMS). Due to certain challenges, LCMS are not equally accessible on all mobile devices. This study investigates actual use, perceived…

  13. Actual Leisure Participation of Norwegian Adolescents with Down Syndrome

    ERIC Educational Resources Information Center

    Dolva, Anne-Stine; Kleiven, Jo; Kollstad, Marit

    2014-01-01

    This article reports the actual participation in leisure activities by a sample of Norwegian adolescents with Down syndrome aged 14. Representing a first generation to grow up in a relatively inclusive context, they live with their families, attend mainstream schools, and are part of common community life. Leisure information was obtained in…

  14. Reported vs. Actual Job Search by Unemployment Insurance Claimants.

    ERIC Educational Resources Information Center

    St. Louis, Robert D.; And Others

    1986-01-01

    Compares self-reported job search contacts of unemployment insurance recipients with independently verified job-search contacts. The separate equations estimated for reported and actual job contacts suggest that systematic misreporting may distort the conclusions. Some implications of the findings for reported unemployment rates also are explored.…

  15. Progressive Digressions: Home Schooling for Self-Actualization.

    ERIC Educational Resources Information Center

    Rivero, Lisa

    2002-01-01

    Maslow's (1971) theory of primary creativeness is used as the basis for a self-actualization model of education. Examples of how to use the model in creative homeschooling are provided. Key elements include digressive and immersion learning, self-directed learning, and the integration of work and play. Teaching suggestions are provided. (Contains…

  16. 40 CFR 74.22 - Actual SO2 emissions rate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ....6 for natural gas For other fuels, the combustion source must specify the SO2 emissions factor. (c... (2) For a combustion source submitting annual data: ER04AP95.005 where, “quantity of fuel consumed... (CONTINUED) SULFUR DIOXIDE OPT-INS Allowance Calculations for Combustion Sources § 74.22 Actual SO2...

  17. 40 CFR 74.22 - Actual SO2 emissions rate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ....6 for natural gas For other fuels, the combustion source must specify the SO2 emissions factor. (c... (2) For a combustion source submitting annual data: ER04AP95.005 where, “quantity of fuel consumed... (CONTINUED) SULFUR DIOXIDE OPT-INS Allowance Calculations for Combustion Sources § 74.22 Actual SO2...

  18. The Implications of Language for Facilitating Self-Actualization.

    ERIC Educational Resources Information Center

    Davis, Charleen Katharine

    The purpose of this study was to delineate the implications of language within an educational context as a means of facilitating self-actualization. Three premises identified in a priori fashion were drawn from the literature in linguistics, psychology, and general semantics, creating a three-part language continuum--acquisition, development, and…

  19. Student Exposure to Actual Patients in the Classroom.

    ERIC Educational Resources Information Center

    Chisholm, Marie A.; McCall, Charles Y.; Francisco, George E., Jr.; Poirier, Sylvie

    1997-01-01

    Two clinical courses for first-year dental students were designed to develop students' interaction skills through actual patient case presentations and discussions and an interdisciplinary teaching approach. Results indicate students preferred the case presentations, with or without lecture, to the lecture-only approach and felt they learned more…

  20. Stability Tests with Actual Savannah River Site Radioactive Waste

    SciTech Connect

    Walker, D.D.

    2002-09-09

    solutions in two laboratory experiments. The first experiment tested four waste solutions for supersaturation of aluminum by monitoring the aluminum concentration after seeding with gibbsite. The second experiment tested two waste samples for precipitation of aluminosilicates by heating the solutions to accelerate solids formation. The results of the experiments with actual waste solutions are supported in this report.

  1. What Does the Force Concept Inventory Actually Measure?

    ERIC Educational Resources Information Center

    Huffman, Douglas; Heller, Patricia

    1995-01-01

    The Force Concept Inventory (FCI) is a 29-question, multiple-choice test designed to assess students' Newtonian and non-Newtonian conceptions of force. Presents an analysis of FCI results as one way to determine what the inventory actually measures. (LZ)

  2. 24 CFR 242.42 - Certificates of actual cost.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES MORTGAGE INSURANCE FOR HOSPITALS Endorsement for Insurance § 242.42 Certificates of actual cost. (a) The... cost, such certification shall be final and incontestable except for fraud or...

  3. 24 CFR 242.42 - Certificates of actual cost.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES MORTGAGE INSURANCE FOR HOSPITALS Endorsement for Insurance § 242.42 Certificates of actual cost. (a) The... cost, such certification shall be final and incontestable except for fraud or...

  4. Commitment to Change Statements Can Predict Actual Change in Practice

    ERIC Educational Resources Information Center

    Wakefield, Jacqueline; Herbert, Carol P.; Maclure, Malcolm; Dormuth, Colin; Wright, James M.; Legare, Jeanne; Brett-MacLean, Pamela; Premi, John

    2003-01-01

    Introduction: Statements of commitment to change are advocated both to promote and to assess continuing education interventions. However, most studies of commitment to change have used self-reported outcomes, and self-reports may significantly overestimate actual performance. As part of an educational randomized controlled trial, this study…

  5. A Taxometric Analysis of Actual Internet Sports Gambling Behavior

    ERIC Educational Resources Information Center

    Braverman, Julia; LaBrie, Richard A.; Shaffer, Howard J.

    2011-01-01

    This article presents findings from the first taxometric study of actual gambling behavior to determine whether we can represent the characteristics of extreme gambling as qualitatively distinct (i.e., taxonic) or as a point along a dimension. We analyzed the bets made during a 24-month study period by the 4,595 most involved gamblers among a…

  6. Improving Dose Determination Accuracy in Nonstandard Fields of the Varian TrueBeam Accelerator

    NASA Astrophysics Data System (ADS)

    Hyun, Megan A.

    In recent years, the use of flattening-filter-free (FFF) linear accelerators in radiation-based cancer therapy has gained popularity, especially for hypofractionated treatments (high doses of radiation given in few sessions). However, significant challenges to accurate radiation dose determination remain. If physicists cannot accurately determine radiation dose in a clinical setting, cancer patients treated with these new machines will not receive safe, accurate and effective treatment. In this study, an extensive characterization of two commonly used clinical radiation detectors (ionization chambers and diodes) and several potential reference detectors (thermoluminescent dosimeters, plastic scintillation detectors, and alanine pellets) has been performed to investigate their use in these challenging, nonstandard fields. From this characterization, reference detectors were identified for multiple beam sizes, and correction factors were determined to improve dosimetric accuracy for ionization chambers and diodes. A validated computational (Monte Carlo) model of the TrueBeam(TM) accelerator, including FFF beam modes, was also used to calculate these correction factors, which compared favorably to measured results. Small-field corrections of up to 18 % were shown to be necessary for clinical detectors such as microionization chambers. Because the impact of these large effects on treatment delivery is not well known, a treatment planning study was completed using actual hypofractionated brain, spine, and lung treatments that were delivered at the UW Carbone Cancer Center. This study demonstrated that improperly applying these detector correction factors can have a substantial impact on patient treatments. This thesis work has taken important steps toward improving the accuracy of FFF dosimetry through rigorous experimentally and Monte-Carlo-determined correction factors, the validation of an important published protocol (TG-51) for use with FFF reference fields, and a

  7. Biotin-targeted Pluronic(®) P123/F127 mixed micelles delivering niclosamide: A repositioning strategy to treat drug-resistant lung cancer cells.

    PubMed

    Russo, Annapina; Pellosi, Diogo Silva; Pagliara, Valentina; Milone, Maria Rita; Pucci, Biagio; Caetano, Wilker; Hioka, Noboru; Budillon, Alfredo; Ungaro, Francesca; Russo, Giulia; Quaglia, Fabiana

    2016-09-10

    With the aim to develop alternative therapeutic tools for the treatment of resistant cancers, here we propose targeted Pluronic(®) P123/F127 mixed micelles (PMM) delivering niclosamide (NCL) as a repositioning strategy to treat multidrug resistant non-small lung cancer cell lines. To build multifunctional PMM for targeting and imaging, Pluronic(®) F127 was conjugated with biotin, while Pluronic(®) P123 was fluorescently tagged with rhodamine B, in both cases at one of the two hydroxyl end groups. This design intended to avoid any interference of rhodamine B on biotin exposition on PMM surface, which is a key fundamental for cell trafficking studies. Biotin-decorated PMM were internalized more efficiently than non-targeted PMM in A549 lung cancer cells, while very low internalization was found in NHI3T3 normal fibroblasts. Biotin-decorated PMM entrapped NCL with good efficiency, displayed sustained drug release in protein-rich media and improved cytotoxicity in A549 cells as compared to free NCL (P<0.01). To go in depth into the actual therapeutic potential of NCL-loaded PMM, a cisplatin-resistant A549 lung cancer cell line (CPr-A549) was developed and its multidrug resistance tested against common chemotherapeutics. Free NCL was able to overcome chemoresistance showing cytotoxic effects in this cell line ascribable to nucleolar stress, which was associated to a significant increase of the ribosomal protein rpL3 and consequent up-regulation of p21. It is noteworthy that biotin-decorated PMM carrying NCL at low doses demonstrated a significantly higher cytotoxicity than free NCL in CPr-A549. These results point at NCL-based regimen with targeted PMM as a possible second-line chemotherapy for lung cancer showing cisplatin or multidrug resistance.

  8. Biotin-targeted Pluronic(®) P123/F127 mixed micelles delivering niclosamide: A repositioning strategy to treat drug-resistant lung cancer cells.

    PubMed

    Russo, Annapina; Pellosi, Diogo Silva; Pagliara, Valentina; Milone, Maria Rita; Pucci, Biagio; Caetano, Wilker; Hioka, Noboru; Budillon, Alfredo; Ungaro, Francesca; Russo, Giulia; Quaglia, Fabiana

    2016-09-10

    With the aim to develop alternative therapeutic tools for the treatment of resistant cancers, here we propose targeted Pluronic(®) P123/F127 mixed micelles (PMM) delivering niclosamide (NCL) as a repositioning strategy to treat multidrug resistant non-small lung cancer cell lines. To build multifunctional PMM for targeting and imaging, Pluronic(®) F127 was conjugated with biotin, while Pluronic(®) P123 was fluorescently tagged with rhodamine B, in both cases at one of the two hydroxyl end groups. This design intended to avoid any interference of rhodamine B on biotin exposition on PMM surface, which is a key fundamental for cell trafficking studies. Biotin-decorated PMM were internalized more efficiently than non-targeted PMM in A549 lung cancer cells, while very low internalization was found in NHI3T3 normal fibroblasts. Biotin-decorated PMM entrapped NCL with good efficiency, displayed sustained drug release in protein-rich media and improved cytotoxicity in A549 cells as compared to free NCL (P<0.01). To go in depth into the actual therapeutic potential of NCL-loaded PMM, a cisplatin-resistant A549 lung cancer cell line (CPr-A549) was developed and its multidrug resistance tested against common chemotherapeutics. Free NCL was able to overcome chemoresistance showing cytotoxic effects in this cell line ascribable to nucleolar stress, which was associated to a significant increase of the ribosomal protein rpL3 and consequent up-regulation of p21. It is noteworthy that biotin-decorated PMM carrying NCL at low doses demonstrated a significantly higher cytotoxicity than free NCL in CPr-A549. These results point at NCL-based regimen with targeted PMM as a possible second-line chemotherapy for lung cancer showing cisplatin or multidrug resistance. PMID:27374195

  9. Oxymetazoline Metered Dose Spray: Factors Affecting Delivery Volume

    PubMed Central

    Walia, Hina; Rafiq, Mahmood; Grannell, Timothy; Cartabuke, Richard S.; Tobias, Joseph D.

    2016-01-01

    OBJECTIVES: The current study compared the amount of oxymetazoline delivered by various anesthesia providers when holding the bottle in the upright and inverted position. Additionally, the amount delivered from a full bottle and a half-full bottle was also investigated. METHODS: Using an analytical balance that was calibrated to zero, we evaluated the impact the position of the bottle and the volume of oxymetazoline in the bottle had on the amount being delivered by both anesthesia staff and trainees. RESULTS: When using both filled and half-filled bottles, the amount delivered increased significantly when comparing the upright versus inverted position. With a full bottle, the amount delivered when the bottle was inverted increased almost 10-fold from 62 ± 80 to 606 ± 366 μL (p < 0.0001). Similarly, even with a half-filled bottle, the amount delivered increased in the inverted positions from 41 ± 48 to 645 ± 393 μL. Regardless of the scenario, we also noted significant variation from provider to provider. CONCLUSIONS: Our results demonstrate that several factors may affect the amount of oxymetazoline delivered for metered dose bottles. Given the potential for severe end-organ effects with excessive dosage, alternative means of delivery are needed for its perioperative use. PMID:27453703

  10. Right dose, right now: using big data to optimize antibiotic dosing in the critically ill.

    PubMed

    Elbers, Paul W G; Girbes, Armand; Malbrain, Manu L N G; Bosman, Rob

    2015-01-01

    Antibiotics save lives and are essential for the practice of intensive care medicine. Adequate antibiotic treatment is closely related to outcome. However this is challenging in the critically ill, as their pharmacokinetic profile is markedly altered. Therefore, it is surprising that critical care physicians continue to rely on standard dosing regimens for every patient, regardless of the actual clinical situation. This review outlines the pharmacokinetic and pharmacodynamic principles that underlie the need for individualized and personalized drug dosing. At present, therapeutic drug monitoring may be of help, but has major disadvantages, remains unavailable for most antibiotics and has produced mixed results. We therefore propose the AutoKinetics concept, taking decision support for antibiotic dosing back to the bedside. By direct interaction with electronic patient records, this opens the way for the use of big data for providing the right dose at the right time in each patient.

  11. Bringing Loyalty to E-health: Theory Validation Using Three Internet-Delivered Interventions

    PubMed Central

    Cyr, Dianne; de Vries, Nanne K

    2011-01-01

    Background Internet-delivered interventions can effectively change health risk behaviors, but the actual use of these interventions by the target group once they access the website is often very low (high attrition, low adherence). Therefore, it is relevant and necessary to focus on factors related to use of an intervention once people arrive at the intervention website. We focused on user perceptions resulting in e-loyalty (ie, intention to visit an intervention again and to recommend it to others). A background theory for e-loyalty, however, is still lacking for Internet-delivered interventions. Objective The objective of our study was to propose and validate a conceptual model regarding user perceptions and e-loyalty within the field of eHealth. Methods We presented at random 3 primary prevention interventions aimed at the general public and, subsequently, participants completed validated measures regarding user perceptions and e-loyalty. Time on each intervention website was assessed by means of server registrations. Results Of the 592 people who were invited to participate, 397 initiated the study (response rate: 67%) and 351 (48% female, mean age 43 years, varying in educational level) finished the study (retention rate: 88%). Internal consistency of all measures was high (Cronbach alpha > .87). The findings demonstrate that the user perceptions regarding effectiveness (betarange .21–.41) and enjoyment (betarange .14–.24) both had a positive effect on e-loyalty, which was mediated by active trust (betarange .27–.60). User perceptions and e-loyalty had low correlations with time on the website (r range .04–.18). Conclusions The consistent pattern of findings speaks in favor of their robustness and contributes to theory validation regarding e-loyalty. The importance of a theory-driven solution to a practice-based problem (ie, low actual use) needs to be stressed in view of the importance of the Internet in terms of intervention development. Longitudinal

  12. Bronchodilator delivery with metered-dose inhaler during mechanical ventilation.

    PubMed

    Georgopoulos, D; Mouloudi, E; Kondili, E; Klimathianaki, M

    2000-01-01

    The delivery of bronchodilators with metered-dose inhaler (MDI) in mechanically ventilated patients has attracted considerable interest in recent years. This is because the use of the MDI has several advantages over the nebulizer, such as reduced cost, ease of administration, less personnel time, reliability of dosing and a lower risk of contamination. A spacer device is fundamental in order to demonstrate the efficacy of the bronchodilatory therapy delivered by MDI. Provided that the technique of administration is appropriate, MDIs are as effective as nebulizers, despite a significantly lower dose of bronchodilator given by the MDI.

  13. Bronchodilator delivery with metered-dose inhaler during mechanical ventilation

    PubMed Central

    Georgopoulos, Dimitris; Mouloudi, Eleni; Kondili, Eumorfia; Klimathianaki, Maria

    2000-01-01

    The delivery of bronchodilators with metered-dose inhaler (MDI) in mechanically ventilated patients has attracted considerable interest in recent years. This is because the use of the MDI has several advantages over the nebulizer, such as reduced cost, ease of administration, less personnel time, reliability of dosing and a lower risk of contamination. A spacer device is fundamental in order to demonstrate the efficacy of the bronchodilatory therapy delivered by MDI. Provided that the technique of administration is appropriate, MDIs are as effective as nebulizers, despite a significantly lower dose of bronchodilator given by the MDI. PMID:11094505

  14. Population dose near the Semipalatinsk test site.

    PubMed

    Hille, R; Hill, P; Bouisset, P; Calmet, D; Kluson, J; Seisebaev, A; Smagulov, S

    1998-10-01

    To determine the consequences of atmospheric atomic bomb tests for the population in the surroundings of the former nuclear weapons test site near Semipalatinsk in Kazakhstan, a pilot study was performed by an international cooperation between Kazakh, French, Czech and German institutions at two villages, Mostik and Maisk. Together with Kazakh scientists, eight experts from Europe carried out a field mission in September 1995 to assess, within the framework of a NATO supported project, the radiological situation as far as external doses, environmental contamination and body burden of man were concerned. A summary of the results obtained is presented. The actual radiological situation near the test site is characterized by fallout contaminations. Cs was found in upper soil layers in concentrations similar to those of the global fallout. Also Sr, Am and Co were observed. The resulting present dose to the population is low. Mean external doses from soil contamination for Maisk and Mostik (0.60-0.63 mSv/year) presently correspond to mean external doses in normal environments. Mean values of the annual internal doses observed in these two villages are below 2 microSv/year for 90Sr. For other radionuclides the internal doses are also negligible.

  15. The role of Cobalt-60 source in Intensity Modulated Radiation Therapy: From modeling finite sources to treatment planning and conformal dose delivery

    NASA Astrophysics Data System (ADS)

    Dhanesar, Sandeep Kaur

    Cobalt-60 (Co-60) units played an integral role in radiation therapy from the mid-1950s to the 1970s. Although they continue to be used to treat cancer in some parts of the world, their role has been significantly reduced due to the invention of medical linear accelerators. A number of groups have indicated a strong potential for Co-60 units in modern radiation therapy. The Medical Physics group at the Cancer Center of the Southeastern Ontario and Queen's University has shown the feasibility of Intensity Modulated Radiation Therapy (IMRT) via simple conformal treatment planning and dose delivery using a Co-60 unit. In this thesis, initial Co-60 tomotherapy planning investigations on simple uniform phantoms are extended to actual clinical cases based on patient CT data. The planning is based on radiation dose data from a clinical Co-60 unit fitted with a multileaf collimator (MLC) and modeled in the EGSnrc Monte Carlo system. An in house treatment planning program is used to calculate IMRT dose distributions. Conformal delivery in a single slice on a uniform phantom based on sequentially delivered pencil beams is verified by Gafchromic film. Volumetric dose distributions for Co-60 serial tomotherapy are then generated for typical clinical sites that had been treated at our clinic by conventional 6MV IMRT using Varian Eclipse treatment plans. The Co-60 treatment plans are compared with the clinical IMRT plans using conventional matrices such as dose volume histograms (DVH). Dose delivery based on simultaneously opened MLC leaves is also explored and a novel MLC segmentation method is proposed. In order to increase efficiency of dose calculations, a novel convolution based fluence model for treatment planning is also proposed. The ion chamber measurements showed that the Monte Carlo modeling of the beam data under the MIMiC MLC is accurate. The film measurements from the uniform phantom irradiations confirm that IMRT plans from our in-house treatment planning system

  16. Wildlife toxicity extrapolations: Dose metric

    SciTech Connect

    Fairbrother, A.; Berg, M. van den

    1995-12-31

    Ecotoxicological assessments must rely on the extrapolation of toxicity data from a few indicator species to many species of concern. Data are available from laboratory studies (e.g., quail, mallards, rainbow trout, fathead minnow) and some planned or serendipitous field studies of a broader, but by no means comprehensive, suite of species. Yet all ecological risk assessments begin with an estimate of risk based on information gleaned from the literature. One is then confronted with the necessity of extrapolating toxicity information from a limited number of indicator species to all organisms of interest. This is a particularly acute problem when trying to estimate hazards to wildlife in terrestrial systems as there is an extreme paucity of data for most chemicals in all but a handful of species. This section continues the debate by six panelists of the ``correct`` approach for determining wildlife toxicity thresholds by examining which dose metric to use for threshold determination and interspecific extrapolation, Since wild animals are exposed to environmental contaminants primarily through ingestion, should threshold values be expressed as amount of chemical in the diet (e.g., ppm) or as a body weight-adjusted dose (mg/kg/day)? Which of these two approaches is most relevant for ecological risk assessment decision making? Which is best for interspecific extrapolations? Converting from one metric to the other can compound uncertainty if the actual consumption rates of a species is unknown. How should this be dealt with? Is it of sufficient magnitude to be of concern?

  17. Government & Private Enterprise--A Model Partnership Delivering Outstanding Schools

    ERIC Educational Resources Information Center

    Ross, Mick

    2011-01-01

    In the Australian state of Victoria, the State Government is responsible for delivering a public education system for the compulsory school years. It uses the Department of Education and Early Childhood Development (DEECD) as its agency to develop its educational curriculum, engage with local communities, develop and maintain a portfolio of…

  18. VET Providers Planning to Deliver Degrees: Good Practice Guide

    ERIC Educational Resources Information Center

    National Centre for Vocational Education Research (NCVER), 2015

    2015-01-01

    This good practice guide is intended to assist public and private registered training organisations (RTOs) planning to commence higher education (HE) delivery. The guide is based on research undertaken by Victor Callan and Kaye Bowman, who completed case studies with six providers currently delivering higher education qualifications in addition to…

  19. Designing and Delivering Intensive Interventions: A Teacher's Toolkit

    ERIC Educational Resources Information Center

    Murray, Christy S.; Coleman, Meghan A.; Vaughn, Sharon; Wanzek, Jeanne; Roberts, Greg

    2012-01-01

    This toolkit provides activities and resources to assist practitioners in designing and delivering intensive interventions in reading and mathematics for K-12 students with significant learning difficulties and disabilities. Grounded in research, this toolkit is based on the Center on Instruction's "Intensive Interventions for Students Struggling…

  20. Lessons from VET Providers Delivering Degrees: Case Studies. Support Document

    ERIC Educational Resources Information Center

    Callan, Victor J.; Bowman, Kaye

    2015-01-01

    The recent growth in the number of registered vocational education and training (VET) providers delivering associate degrees and bachelor degrees in their own right has been well publicized. However, little is known about why these VET providers have made this transition, what support is being provided to their staff and students, and how the…

  1. Dealing with Learner Resistance to Technology-Delivered Training.

    ERIC Educational Resources Information Center

    McCormick, Patricia

    2001-01-01

    Discussion of student resistance to technology-delivered training focuses on strategies at the IRS (Internal Revenue Service) that overcame learner resistance by maintaining a personal relationship with each student and flexibly addressing each student's personal style and concerns. Considers reasons for student resistance and the continued need…

  2. Faculty Compensation for Developing and Delivering Online Courses

    ERIC Educational Resources Information Center

    Burleson, Jeffrey Allen

    2011-01-01

    The intent of this dissertation was to determine the most common compensation practices higher education institutions provided faculty for developing and delivering online courses. Many higher education institutions provided compensation as motivational tools to elicit faculty participation in new online learning initiatives; however, limited…

  3. 76 FR 35295 - Delivering an Efficient, Effective, and Accountable Government

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-16

    ... is spent. To strengthen that trust and deliver a smarter and leaner Government, my Administration..., its officers, employees, or agents, or any other person. (Presidential Sig.) THE WHITE HOUSE, June 13, 2011. [FR Doc. 2011-15181 Filed 6-15-11; 11:15 am] Billing code 3195-W1-P...

  4. Effectiveness of an Electronic Booster Session Delivered to Mandated Students.

    PubMed

    Linowski, Sally A; DiFulvio, Gloria T; Fedorchak, Diane; Puleo, Elaine

    2016-01-01

    College student drinking continues to be a problem in the United States. Students who have violated campus alcohol policy are at particularly high risk for dangerous drinking. While Brief Alcohol Screening and Intervention for College Students (BASICS) has been found to be an effective strategy in reducing high-risk drinking and associated consequences, questions remain about ways to further reduce risk or sustain changes associated with a face-to face intervention. The purpose of this study was to assess the effectiveness of a computer-delivered personalized feedback (electronic booster) delivered to policy violators who completed a mandated BASICS program. At 3-month post-intervention, 346 participants (60.4% male and 39.6% female) were randomized to one of two conditions: assessment only (n = 171) or electronic booster feedback (n = 175). Follow-up assessments were given to all participants at 3, 6, and 12-month post-initial intervention. Both groups showed reductions in drinking after the in-person BASICS intervention, but no additional reductions were seen with the addition of an electronic booster session. Findings suggest that although brief motivational interventions delivered in person to mandated students have been shown to be effective with mandated students, there is no additional benefit from an electronic booster session delivered 3-month post-intervention for this population.

  5. The Role of Universities in Supporting and Delivering Enterprise Education

    ERIC Educational Resources Information Center

    Edwards, Louise-Jayne; Muir, Elizabeth J.

    2007-01-01

    While the academic debate has moved beyond the question of whether or not entrepreneurship can be taught and whether or not there is a need or demand for it, there is still considerable debate as to the most appropriate methods of delivering entrepreneurship education. This paper provides an overview of teaching strategies, pedagogies and methods…

  6. Delivering Technical Education in Wisconsin in the Information Age.

    ERIC Educational Resources Information Center

    Brumm, Loren

    Educational services are now, and will be in the future, delivered via many alternative technologies. In Wisconsin, a variety of video-based alternative delivery systems are being used, such as broadcast television, instructional television fixed service, cable television, interactive computer video, and satellite earth stations. The primary need…

  7. Delivering Alert Messages to Members of a Work Force

    NASA Technical Reports Server (NTRS)

    Loftis, Julia; Nickens, Stephanie; Pell, Melissa; Pell, Vince

    2008-01-01

    Global Alert Resolution Network (GARNET) is a software system for delivering emergency alerts as well as less-urgent messages to members of the Goddard Space Flight Center work force via an intranet or the Internet, and can be adapted to similar use in other large organizations.

  8. Use of an Interactive Telecommunications Network to Deliver Inservice Education.

    ERIC Educational Resources Information Center

    Slaton, Deborah Bott; Lacefield, Warren E.

    1991-01-01

    A total of 155 educators in rural Kentucky participated in 4 inservice education sessions on learning disabilities and adaptive teaching, delivered via an interactive telecommunications network. Participants' reactions indicated that interactive television was an acceptable format for delivery of inservice education. (Author/JDD)

  9. 6. VIEW OF INSIDE OF RAIL CAR CONTAINING GRAPHITE DELIVERED ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. VIEW OF INSIDE OF RAIL CAR CONTAINING GRAPHITE DELIVERED TO BUILDING 444. THE GRAPHITE WAS FORMED INTO MOLDS AND CRUCIBLE FOR USE IN THE FOUNDRY. (1/12/54) - Rocky Flats Plant, Non-Nuclear Production Facility, South of Cottonwood Avenue, west of Seventh Avenue & east of Building 460, Golden, Jefferson County, CO

  10. An American College in China Struggles to Deliver

    ERIC Educational Resources Information Center

    Mooney, Paul

    2008-01-01

    This article reports that language barriers and faculty turnover are the major challenges to an American college's struggles to deliver value to students in China. The Liaoning Normal University-Missouri State University (LNU-MSU) College of International Business, a collaboration between MSU and a local university in China, is designed to mirror…

  11. Effectiveness of an Electronic Booster Session Delivered to Mandated Students.

    PubMed

    Linowski, Sally A; DiFulvio, Gloria T; Fedorchak, Diane; Puleo, Elaine

    2016-01-01

    College student drinking continues to be a problem in the United States. Students who have violated campus alcohol policy are at particularly high risk for dangerous drinking. While Brief Alcohol Screening and Intervention for College Students (BASICS) has been found to be an effective strategy in reducing high-risk drinking and associated consequences, questions remain about ways to further reduce risk or sustain changes associated with a face-to face intervention. The purpose of this study was to assess the effectiveness of a computer-delivered personalized feedback (electronic booster) delivered to policy violators who completed a mandated BASICS program. At 3-month post-intervention, 346 participants (60.4% male and 39.6% female) were randomized to one of two conditions: assessment only (n = 171) or electronic booster feedback (n = 175). Follow-up assessments were given to all participants at 3, 6, and 12-month post-initial intervention. Both groups showed reductions in drinking after the in-person BASICS intervention, but no additional reductions were seen with the addition of an electronic booster session. Findings suggest that although brief motivational interventions delivered in person to mandated students have been shown to be effective with mandated students, there is no additional benefit from an electronic booster session delivered 3-month post-intervention for this population. PMID:26857563

  12. The Role of the Postgraduate Student in Delivering Bioscience Teaching

    ERIC Educational Resources Information Center

    Scott, Jon; Maw, Stephen J.

    2009-01-01

    There has been much recent interest in the extent to which the teaching in higher education delivered by non-academic staff has increased in the recent past. Within the Biosciences there has always been a tradition of engaging postgraduate students to support the delivery of some forms of teaching. In this paper we report on the findings of a…

  13. Towards a Computer-Delivered Test of Productive Grammatical Ability

    ERIC Educational Resources Information Center

    Chapelle, Carol A.; Chung, Yoo-Ree; Hegelheimer, Volker; Pendar, Nick; Xu, Jing

    2010-01-01

    This study piloted test items that will be used in a computer-delivered and scored test of productive grammatical ability in English as a second language (ESL). Findings from research on learners' development of morphosyntactic, syntactic, and functional knowledge were synthesized to create a framework of grammatical features. We outline the…

  14. Factors for converting dose measured in polystyrene phantoms to dose reported in water phantoms for incident proton beams

    SciTech Connect

    Moyers, M. F.; Vatnitsky, A. S.; Vatnitsky, S. M.

    2011-10-15

    Purpose: Previous dosimetry protocols allowed calibrations of proton beamline dose monitors to be performed in plastic phantoms. Nevertheless, dose determinations were referenced to absorbed dose-to-muscle or absorbed dose-to-water. The IAEA Code of Practice TRS 398 recommended that dose calibrations be performed with ionization chambers only in water phantoms because plastic-to-water dose conversion factors were not available with sufficient accuracy at the time of its writing. These factors are necessary, however, to evaluate the difference in doses delivered to patients if switching from calibration in plastic to a protocol that only allows calibration in water. Methods: This work measured polystyrene-to-water dose conversion factors for this purpose. Uncertainties in the results due to temperature, geometry, and chamber effects were minimized by using special experimental set-up procedures. The measurements were validated by Monte Carlo simulations. Results: At the peak of non-range-modulated beams, measured polystyrene-to-water factors ranged from 1.015 to 1.024 for beams with ranges from 36 to 315 mm. For beams with the same ranges and medium sized modulations, the factors ranged from 1.005 to 1.019. The measured results were used to generate tables of polystyrene-to-water dose conversion factors. Conclusions: The dose conversion factors can be used at clinical proton facilities to support beamline and patient specific dose per monitor unit calibrations performed in polystyrene phantoms.

  15. 19 CFR 162.79b - Recovery of actual loss of duties, taxes and fees or actual loss of revenue.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... case in which a monetary penalty is not assessed or a written notification of claim of monetary penalty is not issued, the port director will issue a written notice to the person of the liability for the... actual loss of revenue. Whether or not a monetary penalty is assessed under this subpart, the...

  16. Experimental verification of a real-time compensation functionality for dose changes due to target motion in scanned particle therapy

    SciTech Connect

    Luechtenborg, Robert; Saito, Nami; Durante, Marco; Bert, Christoph

    2011-10-15

    Purpose: Implementation and experimental assessment of a real-time dose compensation system for beam tracking in scanned carbon beam therapy of intrafractionally moving targets. Methods: A real-time dose compensation functionality has been developed and implemented at the experimental branch of the beam tracking system at GSI Helmholtzzentrum fuer Schwerionenforschung (GSI). Treatment plans for different target geometries have been optimized. They have been delivered using scanned carbon ions with beam tracking (BT) and real-time dose compensation combined with beam tracking (RDBT), respectively. Target motion was introduced by a rotating table. Dose distributions were assessed by ionization chamber measurements and dose reconstructions. These distributions have been compared to stationary delivery for BT as well as RDBT. Additionally simulations have been performed to investigate the dependence of delivered dose distributions on varying motion starting phases for BT and RDBT, respectively. Results: Average measured dose differences between static delivery and motion influenced delivery could be reduced from 27-68 mGy when BT was used to 12-37 mGy when RDBT was used. Nominal dose was 1000 mGy. Simulated dose deliveries showed improvements in dose delivery and robustness against varying starting motion phases when RDBT was used. Conclusions: A real-time dose compensation functionality extending the existing beam tracking functionality has been implemented and verified by measurements. Measurements and simulated dose deliveries show that real-time dose compensation can substantially improve delivered dose distributions for large rotational target motion compared to beam tracking alone.

  17. Delivering an evidence-based outdoor journey intervention to people with stroke: Barriers and enablers experienced by community rehabilitation teams

    PubMed Central

    2010-01-01

    Background Transferring knowledge from research into practice can be challenging, partly because the process involves a change in attitudes, roles and behaviour by individuals and teams. Helping teams to identify then target potential barriers may aid the knowledge transfer process. The aim of this study was to identify barriers and enablers, as perceived by allied health professionals, to delivering an evidence-based (Level 1) outdoor journey intervention for people with stroke. Methods A qualitative design and semi-structured interviews were used. Allied health professionals (n = 13) from two community rehabilitation teams were interviewed, before and after receiving feedback from a medical record audit and attending a training workshop. Interviews allowed participants to identify potential and actual barriers, as well as enablers to delivering the intervention. Qualitative data were analysed using theoretical domains described by Michie and colleagues. Results Two barriers to delivery of the intervention were the social influence of people with stroke and their family, and professionals' beliefs about their capabilities. Other barriers included professionals' knowledge and skills, their role identity, availability of resources, whether professionals remembered to provide the intervention, and how they felt about delivering the intervention. Enablers to delivering the intervention included a belief that they could deliver the intervention, a willingness to expand and share professional roles, procedures that reminded them what to do, and feeling good about helping people with stroke to participate. Conclusions This study represents one step in the quality improvement process. The interviews encouraged reflection by staff. We obtained valuable data which have been used to plan behaviour change interventions addressing identified barriers. Our methods may assist other researchers who need to design similar behaviour change interventions. PMID:20082725

  18. Metallofullerene-Nanoplatform-Delivered Interstitial Brachytherapy Improved Survival in a Murine Model of Glioblastoma Multiforme

    PubMed Central

    Wilson, John D.; Broaddus, William C.; Dorn, Harry C.; Fatouros, Panos P.; Chalfant, Charles E.; Shultz, Michael D.

    2012-01-01

    Fullerenes are used across scientific disciplines because of their diverse properties gained by altering encapsulated or surface bound components. In this study, the recently developed theranostic agent based on a radiolabeled functionalized metallofullerene (177Lu-DOTA-f-Gd3N@C80) was synthesized with high radiochemical yield and purity. The efficacy of this agent was demonstrated in two orthotopic xenograft brain tumor models of glioblastoma multiforme (GBM). A dose-dependent improvement in survival was also shown. The in vivo stability of the agent was verified through dual label measurements of biological elimination from the tumor. Overall, these results provide evidence that nanomaterial platforms can be used to deliver effective interstitial brachytherapy. PMID:22881865

  19. Evaluation of the Immunogenicity of Mycobacterium bovis BCG Delivered by Aerosol to the Lungs of Macaques.

    PubMed

    White, A D; Sarfas, C; West, K; Sibley, L S; Wareham, A S; Clark, S; Dennis, M J; Williams, A; Marsh, P D; Sharpe, S A

    2015-09-01

    Nine million cases of tuberculosis (TB) were reported in 2013, with a further 1.5 million deaths attributed to the disease. When delivered as an intradermal (i.d.) injection, the Mycobacterium bovis BCG vaccine provides limited protection, whereas aerosol delivery has been shown to enhance efficacy in experimental models. In this study, we used the rhesus macaque model to characterize the mucosal and systemic immune response induced by aerosol-delivered BCG vaccine. Aerosol delivery of BCG induced both Th1 and Th17 cytokine responses. Polyfunctional CD4 T cells were detected in bronchoalveolar lavage (BAL) fluid and peripheral blood mononuclear cells (PBMCs) 8 weeks following vaccination in a dose-dependent manner. A similar trend was seen in peripheral gamma interferon (IFN-γ) spot-forming units measured by enzyme-linked immunosorbent spot (ELISpot) assay and serum anti-purified protein derivative (PPD) IgG levels. CD8 T cells predominantly expressed cytokines individually, with pronounced tumor necrosis factor alpha (TNF-α) production by BAL fluid cells. T-cell memory phenotype analysis revealed that CD4 and CD8 populations isolated from BAL fluid samples were polarized toward an effector memory phenotype, whereas the frequencies of peripheral central memory T cells increased significantly and remained elevated following aerosol vaccination. Expression patterns of the α4β1 integrin lung homing markers remained consistently high on CD4 and CD8 T cells isolated from BAL fluid and varied on peripheral T cells. This characterization of aerosol BCG vaccination highlights features of the resulting mycobacterium-specific immune response that may contribute to the enhanced protection previously reported in aerosol BCG vaccination studies and will inform future studies involving vaccines delivered to the mucosal surfaces of the lung. PMID:26108288

  20. Actual curriculum development practices instrument: Testing for factorial validity

    NASA Astrophysics Data System (ADS)

    Foi, Liew Yon; Bakar, Kamariah Abu; Hamzah, Mohd Sahandri Gani; Alwi, Nor Hayati

    2014-09-01

    The Actual Curriculum Development Practices Instrument (ACDP-I) was developed and the factorial validity of the ACDP-I was tested (n = 107) using exploratory factor analysis procedures in the earlier work of [1]. Despite the ACDP-I appears to be content and construct valid instrument with very high internal reliability qualities for using in Malaysia, the accumulated evidences are still needed to provide a sound scientific basis for the proposed score interpretations. Therefore, the present study addresses this concern by utilising the confirmatory factor analysis to further confirm the theoretical structure of the variable Actual Curriculum Development Practices (ACDP) and enrich the psychometrical properties of ACDP-I. Results of this study have practical implication to both researchers and educators whose concerns focus on teachers' classroom practices and the instrument development and validation process.

  1. New Strategies for Delivering Library Resources to Users: Rethinking the Mechanisms in which Libraries Are Processing and Delivering Bibliographic Records

    ERIC Educational Resources Information Center

    El-Sherbini, Magda; Wilson, Amanda J

    2007-01-01

    The focus of this paper is to examine the current library practice of processing and delivering information and to introduce alternative scenarios that may keep librarians relevant in the technological era. In the scenarios presented here, the authors will attempt to challenge basic assumptions about the usefulness of and need for OPAC systems,…

  2. Toxicity Assessment of Air-delivered Particle-bound Polybrominated Diphenyl Ethers

    PubMed Central

    Kim, Jong Sung; Klösener, Johannes; Flor, Susanne; Peters, Thomas M.; Ludewig, Gabriele; Thorne, Peter S.; Robertson, Larry W.; Luthe, Gregor

    2014-01-01

    Human exposure to polybrominated diphenyl ether (PBDE) can occur via ingestion of indoor dust, inhalation of PBDE-contaminated air and dust-bound PBDEs. However, few studies have examined the pulmonary toxicity of particle-bound PBDEs, mainly due to the lack of an appropriate particle-cell exposure system. In this study we developed an in vitro exposure system capable of generating particle-bound PBDEs mimicking dusts containing PBDE congeners (BDEs 35, 47, 99) and delivering them directly onto lung cells grown at an air-liquid interface (ALI). The silica particles and particle-coated with PBDEs ranged in diameter from 4.3 to 4.5 μm and were delivered to cells with no apparent aggregation. This experimental set up demonstrated high reproducibility and sensitivity for dosing control and distribution of particles. ALI exposure of cells to PBDE-bound particles significantly decreased cell viability and induced reactive oxygen species generation in A549 and NCI-H358 cells. In male Sprague-Dawley rats exposed via intratracheal insufflation (0.6 mg/rat), particle-bound PBDE exposures induced inflammatory responses with increased recruitment of neutrophils to the lungs compared to sham-exposed rats. The present study clearly indicates the potential of our exposure system for studying the toxicity of particle-bound compounds. PMID:24451063

  3. Validation of an in vitro exposure system for toxicity assessment of air-delivered nanomaterials

    PubMed Central

    Kim, Jong Sung; Peters, Thomas M.; O’Shaughnessy, Patrick T.; Adamcakova-Dodd, Andrea; Thorne, Peter S.

    2013-01-01

    To overcome the limitations of in vitro exposure of submerged lung cells to nanoparticles (NPs), we validated an integrated low flow system capable of generating and depositing airborne NPs directly onto cells at an air–liquid interface (ALI). The in vitro exposure system was shown to provide uniform and controlled dosing of particles with 70.3% efficiency to epithelial cells grown on transwells. This system delivered a continuous airborne exposure of NPs to lung cells without loss of cell viability in repeated 4 h exposure periods. We sequentially exposed cells to air-delivered copper (Cu) NPs in vitro to compare toxicity results to our prior in vivo inhalation studies. The evaluation of cellular dosimetry indicated that a large amount of Cu was taken up, dissolved and released into the basolateral medium (62% of total mass). Exposure to Cu NPs decreased cell viability to 73% (p < 0.01) and significantly (p < 0.05) elevated levels of lactate dehydrogenase, intracellular reactive oxygen species and interleukin-8 that mirrored our findings from subacute in vivo inhalation studies in mice. Our results show that this exposure system is useful for screening of NP toxicity in a manner that represents cellular responses of the pulmonary epithelium in vivo. PMID:22981796

  4. 63. VIEW OF AUTOTRANSFERS. THE ACTUAL AUTOTRANSFERS ARE ENCLOSED IN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    63. VIEW OF AUTOTRANSFERS. THE ACTUAL AUTOTRANSFERS ARE ENCLOSED IN THE OIL FILLED CYLINDERS ON THE RIGHT OF THE PHOTOGRAPH. THESE ELECTRICAL DEVICES BOOSTED THE GENERATOR OUTPUT OF 11,000 VOLTS TO 22,000 VOLTS PRIOR TO TRANSMISSION OUT TO THE MAIN FEEDER LINES. A SPARE INNER UNIT IS CONTAINED IN THE METAL BOX AT THE LEFT OF THE PHOTOGRAPH. - New York, New Haven & Hartford Railroad, Cos Cob Power Plant, Sound Shore Drive, Greenwich, Fairfield County, CT

  5. FRACTIONAL CRYSTALLIZATION FLOWSHEET TESTS WITH ACTUAL TANK WASTE

    SciTech Connect

    HERTING, D.L.

    2006-10-18

    Laboratory-scale flowsheet tests of the fractional crystallization process were conducted with actual tank waste samples in a hot cell at the 222-S Laboratory. The process is designed to separate medium-curie liquid waste into a low-curie stream for feeding to supplemental treatment and a high-curie stream for double-shell tank storage. Separations criteria (for Cs-137 sulfate, and sodium) were exceeded in all three of the flowsheet tests that were performed.

  6. FRACTIONAL CRYSTALLIZATION FLOWSHEET TESTS WITH ACTUAL TANK WASTE

    SciTech Connect

    HERTING, D.L.

    2007-04-13

    Laboratory-scale flowsheet tests of the fractional crystallization process were conducted with actual tank waste samples in a hot cell at the 2224 Laboratory. The process is designed to separate medium-curie liquid waste into a low-curie stream for feeding to supplemental treatment and a high-curie stream for double-shell tank storage. Separations criteria (for Cesium-137 sulfate and sodium) were exceeded in all three of the flowsheet tests that were performed.

  7. SU-E-T-636: Investigation of Dose Variation in High Dose Radiation Brachytherapy

    SciTech Connect

    Hyvarinen, M; Leventouri, T; Casey, C; Long, S; Pella, S; Dumitru, N; Herrera, R

    2014-06-15

    Purpose: The purpose of this study is to revise most of the HDR types of treatments with their applicators and their localization challenges. Since every millimeter of misplacement counts the study will look into the necessity of increasing the immobilization for several types of applicators Methods: The study took over 136 plans generated by the treatment planning system (TPS) looking into the applicator's placement in regard to the organs at risk (OR) and simulated the three possible displacements at the hottest dose point on the critical organ for several accessories to evaluate the variation of the delivered dose at the point due to the displacement. Results: Significant dose variation was obtained for the Contura, Savi, MLM and Prostate applicators. Conclusion: This study data indicates that an improvement of the immobilization devices for HDR is absolutely necessary. Better applicator fixation devices are required too. Developing new immobilization devices for all the applicators is recommended. Florida Atlantic University may provide Travel reimbursements.

  8. Randomized Trial of Ciliary Neurotrophic Factor Delivered by Encapsulated Cell Intraocular Implants for Retinitis Pigmentosa

    PubMed Central

    BIRCH, DAVID G.; WELEBER, RICHARD G.; DUNCAN, JACQUE L.; JAFFE, GLENN J.; TAO, WENG

    2014-01-01

    PURPOSE To evaluate the safety and effect on visual function of ciliary neurotrophic factor delivered via an intraocular encapsulated cell implant for the treatment of retinitis pigmentosa (RP). DESIGN Ciliary neurotrophic factor for late-stage retinitis pigmentosa study 3 (CNTF3; n = 65) and ciliary neurotrophic factor for early-stage retinitis pigmentosa study 4 (CNTF4; n = 68) were multicenter, sham-controlled dose-ranging studies. METHODS Patients were randomly assigned to receive a high- or low-dose implant in 1 eye and sham surgery in the fellow eye. The primary endpoints were change in best-corrected visual acuity (BCVA) at 12 months for CNTF3 and change in visual field sensitivity at 12 months for CNTF4. Patients had the choice of retaining or removing the implant at 12 months for CNTF3 and 24 months for CNTF4. RESULTS There were no serious adverse events related to either the encapsulated cell implant or the surgical procedure. In CNTF3, there was no change in acuity in either ciliary neurotrophic factor–or sham-treated eyes at 1 year. In CNTF4, eyes treated with the high-dose implant showed a significant decrease in sensitivity while no change was seen in sham- and low dose–treated eyes at 12 months. The decrease in sensitivity was reversible upon implant removal. In both studies, ciliary neurotrophic factor treatment resulted in a dose-dependent increase in retinal thickness. CONCLUSIONS Long-term intraocular delivery of ciliary neurotrophic factor is achieved by the encapsulated cell implant. Neither study showed therapeutic benefit in the primary outcome variable. PMID:23668681

  9. Long-term Clinical Outcomes of Whole-Breast Irradiation Delivered in the Prone Position

    SciTech Connect

    Stegman, Lauren D.; Beal, Katherine P.; Hunt, Margie A.; Fornier, Monica N.; McCormick, Beryl . E-mail: mccormib@mskcc.org

    2007-05-01

    Purpose: The aim of this study was to evaluate retrospectively the effectiveness and toxicity of post-lumpectomy whole-breast radiation therapy delivered with prone positioning. Methods and Materials: Between September 1992 and August 2004, 245 women with 248 early-stage invasive or in situ breast cancers were treated using a prone breast board. Photon fields treated the whole breast to 46 to 50.4 Gy with standard fractionation. The target volume was clinically palpable breast tissue; no attempt was made to irradiate chest wall lymphatics. Tumor bed boosts were delivered in 85% of cases. Adjuvant chemotherapy and hormonal therapy were administered to 42% and 62% of patients, respectively. Results: After a median follow-up of 4.9 years, the 5 year actuarial true local and elsewhere ipsilateral breast tumor recurrence rates were 4.8% and 1.3%, respectively. The 5-year actuarial rates of regional nodal recurrence and distant metastases were 1.6% and 7.4%. Actuarial disease-free, disease-specific, and overall survival rates at 5 years were 89.4%, 97.3%, and 93%, respectively. Treatment breaks were required by 2.4% of patients. Grade 3 acute dermatitis and edema were each limited to 2% of patients. Only 4.9% of patients complained of acute chest wall discomfort. Chronic Grade 2 to 3 skin and subcutaneous tissue toxicities were reported in 4.4% and 13.7% of patients, respectively. Conclusions: Prone position breast radiation results in similar long-term disease control with a favorable toxicity profile compared with standard supine tangents. The anatomic advantages of prone positioning may contribute to improving the therapeutic ratio of post-lumpectomy radiation by improving dose homogeneity and minimizing incidental cardiac and lung dose.

  10. Perceived accessibility versus actual physical accessibility of healthcare facilities.

    PubMed

    Sanchez, J; Byfield, G; Brown, T T; LaFavor, K; Murphy, D; Laud, P

    2000-01-01

    This study addressed how healthcare clinics perceive themselves in regard to accessibility for persons with spinal cord injuries (SCI). All 40 of the clinics surveyed reported that they were wheelchair accessible; however, there was significant variability in the number of sites that actually met the guidelines of the Americans with Disability Act. In general, a person using a wheelchair could enter the building, the examination room, and the bathroom. The majority of sites did not have an examination table that could be lowered to wheelchair level. Most reported limited experience in working with persons with (SCI), yet they claimed to be able to assist with difficult transfers. Only one site knew about autonomic dysreflexia. Problems of accessibility appeared to be seriously compounded by the clinics' perception of how they met physical accessibility guidelines without consideration of the actual needs of persons with SCI. This study addressed the perception of accessibility as reported by clinic managers versus actual accessibility in healthcare clinics in a Midwestern metropolitan area for persons using wheelchairs. PMID:10754921

  11. The actual citation impact of European oncological research.

    PubMed

    López-Illescas, Carmen; de Moya-Anegón, Félix; Moed, Henk F

    2008-01-01

    This study provides an overview of the research performance of major European countries in the field Oncology, the most important journals in which they published their research articles, and the most important academic institutions publishing them. The analysis was based on Thomson Scientific's Web of Science (WoS) and calculated bibliometric indicators of publication activity and actual citation impact. Studying the time period 2000-2006, it gives an update of earlier studies, but at the same time it expands their methodologies, using a broader definition of the field, calculating indicators of actual citation impact, and analysing new and policy relevant aspects. Findings suggest that the emergence of Asian countries in the field Oncology has displaced European articles more strongly than articles from the USA; that oncologists who have published their articles in important, more general journals or in journals covering other specialties, rather than in their own specialist journals, have generated a relatively high actual citation impact; and that universities from Germany, and--to a lesser extent--those from Italy, the Netherlands, UK, and Sweden, dominate a ranking of European universities based on number of articles in oncology. The outcomes illustrate that different bibliometric methodologies may lead to different outcomes, and that outcomes should be interpreted with care.

  12. Radiochromic film based transit dosimetry for verification of dose delivery with intensity modulated radiotherapy

    SciTech Connect

    Chung, Kwangzoo; Lee, Kiho; Shin, Dongho; Kyung Lim, Young; Byeong Lee, Se; Yoon, Myonggeun; Son, Jaeman; Yong Park, Sung

    2013-02-15

    Purpose: To evaluate the transit dose based patient specific quality assurance (QA) of intensity modulated radiation therapy (IMRT) for verification of the accuracy of dose delivered to the patient. Methods: Five IMRT plans were selected and utilized to irradiate a homogeneous plastic water phantom and an inhomogeneous anthropomorphic phantom. The transit dose distribution was measured with radiochromic film and was compared with the computed dose map on the same plane using a gamma index with a 3% dose and a 3 mm distance-to-dose agreement tolerance limit. Results: While the average gamma index for comparisons of dose distributions was less than one for 98.9% of all pixels from the transit dose with the homogeneous phantom, the passing rate was reduced to 95.0% for the transit dose with the inhomogeneous phantom. Transit doses due to a 5 mm setup error may cause up to a 50% failure rate of the gamma index. Conclusions: Transit dose based IMRT QA may be superior to the traditional QA method since the former can show whether the inhomogeneity correction algorithm from TPS is accurate. In addition, transit dose based IMRT QA can be used to verify the accuracy of the dose delivered to the patient during treatment by revealing significant increases in the failure rate of the gamma index resulting from errors in patient positioning during treatment.

  13. Neutron dose equivalent meter

    DOEpatents

    Olsher, Richard H.; Hsu, Hsiao-Hua; Casson, William H.; Vasilik, Dennis G.; Kleck, Jeffrey H.; Beverding, Anthony

    1996-01-01

    A neutron dose equivalent detector for measuring neutron dose capable of accurately responding to neutron energies according to published fluence to dose curves. The neutron dose equivalent meter has an inner sphere of polyethylene, with a middle shell overlying the inner sphere, the middle shell comprising RTV.RTM. silicone (organosiloxane) loaded with boron. An outer shell overlies the middle shell and comprises polyethylene loaded with tungsten. The neutron dose equivalent meter defines a channel through the outer shell, the middle shell, and the inner sphere for accepting a neutron counter tube. The outer shell is loaded with tungsten to provide neutron generation, increasing the neutron dose equivalent meter's response sensitivity above 8 MeV.

  14. Effect of Scanning Beam for Superficial Dose in Proton Therapy.

    PubMed

    Moskvin, Vadim P; Estabrook, Neil C; Cheng, Chee-Wai; Das, Indra J; Johnstone, Peter A S

    2015-10-01

    Proton beam delivery technology is under development to minimize the scanning spot size for uniform dose to target, but it is also known that the superficial dose could be as high as the dose at Bragg peak for narrow and small proton beams. The objective of this study is to explore the characteristics of dose distribution at shallow depths using Monte Carlo simulation with the FLUKA code for uniform scanning (US) and discrete spot scanning (DSS) proton beams. The results show that the superficial dose for DSS is relatively high compared to US. Additionally, DSS delivers a highly heterogeneous dose to the irradiated surface for comparable doses at Bragg peak. Our simulation shows that the superficial dose can become as high as the Bragg peak when the diameter of the proton beam is reduced. This may compromise the advantage of proton beam therapy for sparing normal tissue, making skin dose a limiting factor for the clinical use of DSS. Finally, the clinical advantage of DSS may not be essential for treating uniform dose across a large target, as in craniospinal irradiation (CSI).

  15. Direct dose mapping versus energy/mass transfer mapping for 4D dose accumulation: fundamental differences and dosimetric consequences

    NASA Astrophysics Data System (ADS)

    Li, Haisen S.; Zhong, Hualiang; Kim, Jinkoo; Glide-Hurst, Carri; Gulam, Misbah; Nurushev, Teamour S.; Chetty, Indrin J.

    2014-01-01

    The direct dose mapping (DDM) and energy/mass transfer (EMT) mapping are two essential algorithms for accumulating the dose from different anatomic phases to the reference phase when there is organ motion or tumor/tissue deformation during the delivery of radiation therapy. DDM is based on interpolation of the dose values from one dose grid to another and thus lacks rigor in defining the dose when there are multiple dose values mapped to one dose voxel in the reference phase due to tissue/tumor deformation. On the other hand, EMT counts the total energy and mass transferred to each voxel in the reference phase and calculates the dose by dividing the energy by mass. Therefore it is based on fundamentally sound physics principles. In this study, we implemented the two algorithms and integrated them within the Eclipse treatment planning system. We then compared the clinical dosimetric difference between the two algorithms for ten lung cancer patients receiving stereotactic radiosurgery treatment, by accumulating the delivered dose to the end-of-exhale (EE) phase. Specifically, the respiratory period was divided into ten phases and the dose to each phase was calculated and mapped to the EE phase and then accumulated. The displacement vector field generated by Demons-based registration of the source and reference images was used to transfer the dose and energy. The DDM and EMT algorithms produced noticeably different cumulative dose in the regions with sharp mass density variations and/or high dose gradients. For the planning target volume (PTV) and internal target volume (ITV) minimum dose, the difference was up to 11% and 4% respectively. This suggests that DDM might not be adequate for obtaining an accurate dose distribution of the cumulative plan, instead, EMT should be considered.

  16. Contralateral breast dose from partial breast brachytherapy.

    PubMed

    Robinson, R Cole; Nelson, Christopher L; Bloom, Elizabeth S; Kisling, Kelly D; Mason, Bryan E; Fisher, Gary D; Kirsner, Steven M

    2015-01-01

    The purpose of this study was to determine the dose to the contralateral breast during accelerated partial breast irradiation (APBI) and to compare it to external beam-published values. Thermoluminescent dosimeter (TLD) packets were used to measure the dose to the most medial aspect of the contralateral breast during APBI simulation, daily quality assurance (QA), and treatment. All patients in this study were treated with a single-entry, multicatheter device for 10 fractions to a total dose of 34 Gy. A mark was placed on the patient's skin on the medial aspect of the opposite breast. Three TLD packets were taped to this mark during the pretreatment simulation. Simulations consisted of an AP and Lateral scout and a limited axial scan encompassing the lumpectomy cavity (miniscan), if rotation was a concern. After the simulation the TLD packets were removed and the patients were moved to the high-dose-rate (HDR) vault where three new TLD packets were taped onto the patients at the skin mark. Treatment was administered with a Nucletron HDR afterloader using Iridium-192 as the treatment source. Post-treatment, TLDs were read (along with the simulation and QA TLD and a set of standards exposed to a known dose of 6 MV photons). Measurements indicate an average total dose to the contralateral breast of 70 cGy for outer quadrant implants and 181 cGy for inner quadrant implants. Compared to external beam breast tangents, these results point to less dose being delivered to the contralateral breast when using APBI. PMID:26699549

  17. Radiation dose aspects in the handling of emerging nuclear fuels.

    PubMed

    Nicolaou, G

    2014-12-01

    The occupational annual dose levels, encountered at fabrication of emerging nuclear fuels, have been studied. Emerging fuels for the single and multiple recycling of Pu and MA have resulted in considerably higher gamma and neutron doses in comparison with commercial fuels. The occupational dose limit is exceeded at fabrication by a single fuel rod in all fuel cases with (241)Am and Cm isotopes present in their composition. In the absence of these isotopes, 2-4 adjacent fuel rods are sufficient to exceed the limit. Self-shielding within the fuel reduces significantly only the gamma dose that would have been delivered otherwise. Hence, only the first row of fuel rods in an assembly contributes to the dose, whereas in the case of neutrons, all fuel rods contribute.

  18. Low-dose computed tomography image restoration using previous normal-dose scan

    SciTech Connect

    Ma, Jianhua; Huang, Jing; Feng, Qianjin; Zhang, Hua; Lu, Hongbing; Liang, Zhengrong; Chen, Wufan

    2011-10-15

    Purpose: In current computed tomography (CT) examinations, the associated x-ray radiation dose is of a significant concern to patients and operators. A simple and cost-effective means to perform the examinations is to lower the milliampere-seconds (mAs) or kVp parameter (or delivering less x-ray energy to the body) as low as reasonably achievable in data acquisition. However, lowering the mAs parameter will unavoidably increase data noise and the noise would propagate into the CT image if no adequate noise control is applied during image reconstruction. Since a normal-dose high diagnostic CT image scanned previously may be available in some clinical applications, such as CT perfusion imaging and CT angiography (CTA), this paper presents an innovative way to utilize the normal-dose scan as a priori information to induce signal restoration of the current low-dose CT image series. Methods: Unlike conventional local operations on neighboring image voxels, nonlocal means (NLM) algorithm utilizes the redundancy of information across the whole image. This paper adapts the NLM to utilize the redundancy of information in the previous normal-dose scan and further exploits ways to optimize the nonlocal weights for low-dose image restoration in the NLM framework. The resulting algorithm is called the previous normal-dose scan induced nonlocal means (ndiNLM). Because of the optimized nature of nonlocal weights calculation, the ndiNLM algorithm does not depend heavily on image registration between the current low-dose and the previous normal-dose CT scans. Furthermore, the smoothing parameter involved in the ndiNLM algorithm can be adaptively estimated based on the image noise relationship between the current low-dose and the previous normal-dose scanning protocols. Results: Qualitative and quantitative evaluations were carried out on a physical phantom as well as clinical abdominal and brain perfusion CT scans in terms of accuracy and resolution properties. The gain by the use

  19. Can State Policy Deliver Equitable and Adequate Funding?

    ERIC Educational Resources Information Center

    Quinn, Rand; Steinberg, Matthew P.

    2015-01-01

    Sooner or later, talk of closing achievement gaps turns to education finance--specifically, fixing widespread disparities in school funding within individual states. The difference between the resources that a district needs to educate all students and the amount the district actually spends is called an adequacy gap. The availability and use of…

  20. Delivering distance training to rural health care professionals.

    PubMed

    Li, Jie; Runderson, Robert A; Burnham, Judy F; Staggs, Geneva Bush; Robertson, Justin C; Williams, Thomas L

    2005-01-01

    This article reports on a project that delivers distance training to rural health care professionals. Traveling to provide training on information-seeking skills to rural health professionals is time consuming and costly. In addition to face-to-face training, the University of South Alabama Biomedical Library's SAMNet project seeks to deliver multimedia training to rural health care professionals. The project uses information technology to package training courses combining PowerPoint slides and video instructions. This article describes the rationale, training module design and development, and the information technology and software used in the project. Multimedia packaged distance training courses provide a practical alternative to on-site training for rural health care professionals. It enables librarians to provide training without traveling long distance, thus saving time and money. Additionally, rural health care professionals may access the modules at a time convenient to them and proceed at a pace suitable to their learning style. PMID:15760832

  1. Satellite-delivered continuing medical education in Europe.

    PubMed

    Geraghty, J G; Young, H L

    1996-04-01

    There is increasing recognition of the need for continuing medical education in the medical profession. There are now many ways of delivering medical education including conferences, books, journals amongst others. This paper describes a novel method of delivering medical education using satellite transmission. This medium allows live medical education programmes to be broadcast to over 150 receiver sites in Europe. It also enables two-way live satellite links to be made between countries during the broadcast. EuroTransMed has an editorial board, in much the same way as a journal, which is representative of the differing medical societies in Europe. As the barriers between the various countries fall, EuroTransMed is an ideal medium to promote high quality, easily accessible, continuing medical education at a pan-European level.

  2. Computer-Delivered Social Norm Message Increases Pain Tolerance

    PubMed Central

    Pulvers, Kim; Schroeder, Jacquelyn; Limas, Eleuterio F.; Zhu, Shu-Hong

    2013-01-01

    Background Few experimental studies have been conducted on social determinants of pain tolerance. Purpose This study tests a brief, computer-delivered social norm message for increasing pain tolerance. Methods Healthy young adults (N=260; 44 % Caucasian; 27 % Hispanic) were randomly assigned into a 2 (social norm)×2 (challenge) cold pressor study, stratified by gender. They received standard instructions or standard instructions plus a message that contained artifically elevated information about typical performance of others. Results Those receiving a social norm message displayed significantly higher pain tolerance, F(1, 255)=26.95, p<.001, ηp2=.10 and pain threshold F(1, 244)=9.81, p=.002, ηp2=.04, but comparable pain intensity, p>.05. There were no interactions between condition and gender on any outcome variables, p>.05. Conclusions Social norms can significantly increase pain tolerance, even with a brief verbal message delivered by a video. PMID:24146086

  3. A randomized trial of contingency management delivered by community therapists

    PubMed Central

    Petry, Nancy M.; Alessi, Sheila M.; Ledgerwood, David M.

    2013-01-01

    Objective Contingency management (CM) is an evidence-based treatment, but few clinicians deliver this intervention in community-based settings. Method Twenty-three clinicians from three methadone maintenance clinics received training in CM. Following a didactics seminar and a training and supervision period in which clinicians delivered CM to pilot patients, a randomized trial evaluated the efficacy of CM when delivered entirely by clinicians. Sixteen clinicians treated 130 patients randomized to CM or standard care. In both conditions, urine and breath samples were collected twice weekly for 12 weeks. In the CM condition, patients earned the opportunity to win prizes ranging in value from $1 to $100 for submitting samples negative for cocaine and alcohol. Primary treatment outcomes were retention, longest continuous period of abstinence, and proportion of negative samples submitted. Results Patients randomized to CM remained in the study longer (9.5 ± 3.6 versus 6.7 ± 5.0 weeks), achieved greater durations of abstinence (4.7 ± 4.7 versus 1.7 ± 2.7 weeks), and submitted a higher proportion of negative samples (57.7% ± 40.0% versus 29.4% ± 33.3%) than those assigned to standard care. Conclusions These data indicate that, with appropriate training, community-based clinicians can effectively administer CM. This study suggests that resources ought to be directed toward training and supervising community-based providers in delivering CM, as patient outcomes can be significantly improved by integrating CM in methadone clinics. PMID:22250852

  4. Virtual vision system with actual flavor by olfactory display

    NASA Astrophysics Data System (ADS)

    Sakamoto, Kunio; Kanazawa, Fumihiro

    2010-11-01

    The authors have researched multimedia system and support system for nursing studies on and practices of reminiscence therapy and life review therapy. The concept of the life review is presented by Butler in 1963. The process of thinking back on one's life and communicating about one's life to another person is called life review. There is a famous episode concerning the memory. It is called as Proustian effects. This effect is mentioned on the Proust's novel as an episode that a story teller reminds his old memory when he dipped a madeleine in tea. So many scientists research why smells trigger the memory. The authors pay attention to the relation between smells and memory although the reason is not evident yet. Then we have tried to add an olfactory display to the multimedia system so that the smells become a trigger of reminding buried memories. An olfactory display is a device that delivers smells to the nose. It provides us with special effects, for example to emit smell as if you were there or to give a trigger for reminding us of memories. The authors have developed a tabletop display system connected with the olfactory display. For delivering a flavor to user's nose, the system needs to recognition and measure positions of user's face and nose. In this paper, the authors describe an olfactory display which enables to detect the nose position for an effective delivery.

  5. Linearized oncolytic adenoviral plasmid DNA delivered by bioreducible polymers

    PubMed Central

    Kim, Jaesung; Kim, Pyung-Hwan; Nam, Hye Yeong; Lee, Jung-Sun; Yun, Chae-Ok; Kim, Sung Wan

    2011-01-01

    As an effort to overcome limits of adenovirus (Ad) as a systemic delivery vector for cancer therapy, we developed a novel system using oncolytic Ad plasmid DNA with two bioreducible polymers: arginine-grafted bioreducible poly(disulfide amine)polymer (ABP) and PEG5k-conjugated ABP (ABP5k) in expectation of oncolytic effect caused by progeny viral production followed by replication. The linearized Ad DNAs for active viral replication polyplexed with each polymer were able to replicate only in humancancer cells and produce progeny viruses. The non-immunogenic polymers delivering the DNAs markedly elicited to evade the innate and adaptive immune response. The biodistribution ratio of the polyplexes administered systemically was approximately 99% decreased in liver when compared with naked Ad. Moreover, tumor-to-liver ratio of the Ad DNA delivered by ABP or ABP5k was significantly elevated at 229- or 419-fold greater than that of naked Ad, respectively. The ABP5k improved the chance of the DNA to localize within tumor versus liver with 1.8-fold increased ratio. In conclusion, the innovative and simple system for delivering oncolytic Ad plasmid DNA with the bioreducible polymers, skipping time-consuming steps such as generation and characterization of oncolytic Ad vectors, can be utilized as an alternative approach for cancer therapy. PMID:22207073

  6. Enhancing family physician capacity to deliver quality palliative home care

    PubMed Central

    Marshall, Denise; Howell, Doris; Brazil, Kevin; Howard, Michelle; Taniguchi, Alan

    2008-01-01

    ABSTRACT PROBLEM BEING ADDRESSED Family physicians face innumerable challenges to delivering quality palliative home care to meet the complex needs of end-of-life patients and their families. OBJECTIVE OF PROGRAM To implement a model of shared care to enhance family physicians’ ability to deliver quality palliative home care, particularly in a community-based setting. PROGRAM DESCRIPTION Family physicians in 3 group practices (N = 21) in Ontario’s Niagara West region collaborated with an interprofessional palliative care team (including a palliative care advanced practice nurse, a palliative medicine physician, a bereavement counselor, a psychosocial-spiritual advisor, and a case manager) in a shared-care partnership to provide comprehensive palliative home care. Key features of the program included systematic and timely identification of end-of-life patients, needs assessments, symptom and psychosocial support interventions, regular communication between team members, and coordinated care guided by outcome-based assessment in the home. In addition, educational initiatives were provided to enhance family physicians’ knowledge and skills. CONCLUSION Because of the program, participants reported improved communication, effective interprofessional collaboration, and the capacity to deliver palliative home care, 24 hours a day, 7 days a week, to end-of-life patients in the community. PMID:19074714

  7. Modeling Patients' Acceptance of Provider-delivered E-health

    PubMed Central

    Wilson, E. Vance; Lankton, Nancy K.

    2004-01-01

    Objective: Health care providers are beginning to deliver a range of Internet-based services to patients; however, it is not clear which of these e-health services patients need or desire. The authors propose that patients' acceptance of provider-delivered e-health can be modeled in advance of application development by measuring the effects of several key antecedents to e-health use and applying models of acceptance developed in the information technology (IT) field. Design: This study tested three theoretical models of IT acceptance among patients who had recently registered for access to provider-delivered e-health. Measurements: An online questionnaire administered items measuring perceptual constructs from the IT acceptance models (intrinsic motivation, perceived ease of use, perceived usefulness/extrinsic motivation, and behavioral intention to use e-health) and five hypothesized antecedents (satisfaction with medical care, health care knowledge, Internet dependence, information-seeking preference, and health care need). Responses were collected and stored in a central database. Results: All tested IT acceptance models performed well in predicting patients' behavioral intention to use e-health. Antecedent factors of satisfaction with provider, information-seeking preference, and Internet dependence uniquely predicted constructs in the models. Conclusion: Information technology acceptance models provide a means to understand which aspects of e-health are valued by patients and how this may affect future use. In addition, antecedents to the models can be used to predict e-health acceptance in advance of system development. PMID:15064290

  8. Decreasing Methadone Dose Via Anxiety Reduction: A Treatment Manual.

    ERIC Educational Resources Information Center

    Kushner, Marlene; And Others

    This manual describes a Relaxation-Information Presentation program based on the clinical observation that anxiety is a serious barrier to detoxification for many methadone clients, and on experimental evidence indicating that expectations may play a greater role in the discomfort experienced during detoxification than the actual methadone dose.…

  9. SU-E-J-93: Parametrisation of Dose to the Mucosa of the Anterior Rectal Wall in Transrectal Ultrasound Guided High-Dose-Rate Brachytherapy of the Prostate

    SciTech Connect

    Aitkenhead, A; Hamlett, L; Wood, D; Choudhury, A

    2014-06-01

    Purpose: In high-dose-rate (HDR) brachytherapy of the prostate, radiation is delivered from a number of radioactive sources which are inserted via catheter into the target volume. The rectal mucosa also receives dose during the treatment, which may lead to late toxicity effects. To allow possible links between rectal dose and toxicity to be investigated, suitable methods of parametrising the rectal dose are needed. Methods: During treatment of a series of 95 patients, anatomy and catheter locations were monitored by transrectal ultrasound, and target volume positions were contoured on the ultrasound scan by the therapist. The anterior rectal mucosal wall was identified by contouring the transrectal ultrasound balloon within the ultrasound scan. Source positions and dwell times, along with the dose delivered to the patient were computed using the Oncentra Prostate treatment planning system (TPS). Data for the series of patients were exported from the TPS in Dicom format, and a series of parametrisation methods were developed in a Matlab environment to assess the rectal dose. Results: Contours of the anterior rectal mucosa were voxelised within Matlab to allow the dose to the rectal mucosa to be analysed directly from the 3D dose grid. Dose parametrisations based on dose-surface (DSH) and dose-line (DLH) histograms were obtained. Both lateral and longitudinal extents of the mucosal dose were parametrised using dose-line histograms in the relevant directions. Conclusion: We have developed a series of dose parametrisations for quantifying the dose to the rectal mucosa during HDR prostate brachytherapy which are suitable for future studies investigating potential associations between mucosal dose and late toxicity effects. The geometry of the transrectal probe standardises the rectal anatomy, making this treatment technique particularly suited to studies of this nature.

  10. Doses from radiation exposure.

    PubMed

    Menzel, H-G; Harrison, J D

    2012-01-01

    Practical implementation of the International Commission on Radiological Protection's (ICRP) system of protection requires the availability of appropriate methods and data. The work of Committee 2 is concerned with the development of reference data and methods for the assessment of internal and external radiation exposure of workers and members of the public. This involves the development of reference biokinetic and dosimetric models, reference anatomical models of the human body, and reference anatomical and physiological data. Following ICRP's 2007 Recommendations, Committee 2 has focused on the provision of new reference dose coefficients for external and internal exposure. As well as specifying changes to the radiation and tissue weighting factors used in the calculation of protection quantities, the 2007 Recommendations introduced the use of reference anatomical phantoms based on medical imaging data, requiring explicit sex averaging of male and female organ-equivalent doses in the calculation of effective dose. In preparation for the calculation of new dose coefficients, Committee 2 and its task groups have provided updated nuclear decay data (ICRP Publication 107) and adult reference computational phantoms (ICRP Publication 110). New dose coefficients for external exposures of workers are complete (ICRP Publication 116), and work is in progress on a series of reports on internal dose coefficients to workers from inhaled and ingested radionuclides. Reference phantoms for children will also be provided and used in the calculation of dose coefficients for public exposures. Committee 2 also has task groups on exposures to radiation in space and on the use of effective dose.

  11. Reconfiguring health workforce policy so that education, training, and actual delivery of care are closely connected.

    PubMed

    Ricketts, Thomas C; Fraher, Erin P

    2013-11-01

    There is growing consensus that the health care workforce in the United States needs to be reconfigured to meet the needs of a health care system that is being rapidly and permanently redesigned. Accountable care organizations and patient-centered medical homes, for instance, will greatly alter the mix of caregivers needed and create new roles for existing health care workers. The focus of health system innovation, however, has largely been on reorganizing care delivery processes, reengineering workflows, and adopting electronic technology to improve outcomes. Little attention has been paid to training workers to adapt to these systems and deliver patient care in ever more coordinated systems, such as integrated health care networks that harmonize primary care with acute inpatient and postacute long-term care. This article highlights how neither regulatory policies nor market forces are keeping up with a rapidly changing delivery system and argues that training and education should be connected more closely to the actual delivery of care. PMID:24191074

  12. SU-E-J-36: Combining CBCT Dose Into IMRT Treatment Planning

    SciTech Connect

    Grelewicz, Z; Wiersma, R

    2014-06-01

    Purpose: Cone beam CT (CBCT) is increasingly used in patient setup for IMRT. Daily CBCT may provide effective localization, however, it introduces concern over excessive imaging dose. Previous studies investigated the calculation of excess CBCT dose, however, no study has yet treated this dose as a source of therapeutic radiation, optimized in consideration of PTV and OARs constrains. Here we present a novel combined MV+kV inverse optimization engine to weave the CBCT and MV dose together such that CBCT dose is used for both imaging and therapeutic purposes. This may mitigate some of the excess imaging dose effects of daily CBCT and allow complete evaluation of the CBCT dose prior to treatment. Methods: The EGSnrc Monte Carlo system was used to model a Varian Trilogy CBCT system and 6 MV treatment beam. Using the model, the dose to patient from treatment beam and imaging beam was calculated for ten patients. The standard IMRT objective function was modified to include CBCT dose. Treatment plan optimization using the MOSEK optimization tool was performed retrospectively with and without assuming kV radiation dose from CBCT, assuming one CBCT per fraction. Results: Across ten patients, the CBCT delivered peaks of between .4% and 3.0% of the prescription dose to the PTV, with average CBCT dose to the PTV between .3% and .8%. By including CBCT dose to skin as a constraint during optimization, peak skin dose is reduced by between 1.9% and 7.4%, and average skin dose is reduced by .2% to 3.3%. Conclusions: Pre-treatment CBCT may deliver a substantial amount of radiation dose to the target volume. By considering CBCT dose to skin at the point of treatment planning, it is possible to reduce patient skin dose from current clinical levels, and to provide patient treatment with the improved accuracy that daily CBCT provides.

  13. Determination of the Actual Contact Surface of a Brush Contact

    NASA Technical Reports Server (NTRS)

    Holm, Ragnar

    1944-01-01

    The number of partial contact surfaces of a brush-ring contact is measured by means of a statistical method. The particular brush is fitted with wicks - that is, insulated and cemented cylinders of brush material, terminating in the brush surface. The number of partial contact surfaces can be computed from the length of the rest periods in which such wicks remain without current. Resistance measurements enable the determination of the size of the contact surfaces. The pressure in the actual contact surface of a recently bedded brush is found to be not much lower than the Brinell hardness of the brush.

  14. Power Delivery from an Actual Thermoelectric Generation System

    NASA Astrophysics Data System (ADS)

    Kaibe, Hiromasa; Kajihara, Takeshi; Nagano, Kouji; Makino, Kazuya; Hachiuma, Hirokuni; Natsuume, Daisuke

    2014-06-01

    Similar to photovoltaic (PV) and fuel cells, thermoelectric generators (TEGs) supply direct-current (DC) power, essentially requiring DC/alternating current (AC) conversion for delivery as electricity into the grid network. Use of PVs is already well established through power conditioning systems (PCSs) that enable DC/AC conversion with maximum-power-point tracking, which enables commercial use by customers. From the economic, legal, and regulatory perspectives, a commercial PCS for PVs should also be available for TEGs, preferably as is or with just simple adjustment. Herein, we report use of a PV PCS with an actual TEG. The results are analyzed, and proper application for TEGs is proposed.

  15. Dieting: really harmful, merely ineffective or actually helpful?

    PubMed

    Lowe, Michael R; Timko, C Alix

    2004-08-01

    Dieting has developed a negative reputation among many researchers and health care professionals. However, 'dieting' can refer to a variety of behavioural patterns that are associated with different effects on eating and body weight. The wisdom of dieting depends on what kind of dieting is involved, who is doing it, and why. Thus, depending on what one means by the term, dieting can be quite harmful, merely ineffective or actually beneficial. The present paper considers examples of all three. In particular, we argue that judgements about the desirability of dieting should consider the likely consequences to particular individuals of engaging in, or not engaging in, dieting behaviour. PMID:15384317

  16. A laser syringe aimed at delivering drug into the outer layer of human skin

    NASA Astrophysics Data System (ADS)

    Yoh, Jack J.; Jang, Hun-jae; Park, Mi-ae; Han, Tae-hee; Hah, Jung-moo

    2012-07-01

    A desire to eliminate hypodermic needle in transdermal drug delivery may now be realized. Imaging of the skin after injection of fluorescent probe and biotin via the bio-ballistic technique revealed the epidermal and dermal layers which were stained well below 60 μm underneath the abdominal skin of the guinea-pig. An extensive network of cells are shown in the deeper layer of the stained dermis as the distributed fluorescein isothiocyanate (FITC) dose is administered by repeated injection via the laser-based microjet. Here, we show our method of laser-based microjet drug delivery is capable of breaching guinea-pig's skin tissue and then delivering controlled dose of drug to the targeted region between 10 to 400 μm underneath the outermost layer of the skin. While minimizing pain and tissue damage by reducing the injection volume to ˜100 nl per pulse and the microjet diameter of half the conventional syringe needle in 100 μm, the optimally controlled delivery of liquid drug by the irradiated laser pulse is shown possible.

  17. 29 CFR 4000.27 - What if I hand deliver my submission or issuance?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false What if I hand deliver my submission or issuance? 4000.27... § 4000.27 What if I hand deliver my submission or issuance? Your filing or issuance date is the date of receipt of your hand-delivered submission or issuance at the proper address. A hand-delivered...

  18. 29 CFR 4000.27 - What if I hand deliver my submission or issuance?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false What if I hand deliver my submission or issuance? 4000.27... § 4000.27 What if I hand deliver my submission or issuance? Your filing or issuance date is the date of receipt of your hand-delivered submission or issuance at the proper address. A hand-delivered...

  19. 29 CFR 4000.27 - What if I hand deliver my submission or issuance?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false What if I hand deliver my submission or issuance? 4000.27... § 4000.27 What if I hand deliver my submission or issuance? Your filing or issuance date is the date of receipt of your hand-delivered submission or issuance at the proper address. A hand-delivered...

  20. 29 CFR 4000.27 - What if I hand deliver my submission or issuance?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false What if I hand deliver my submission or issuance? 4000.27... § 4000.27 What if I hand deliver my submission or issuance? Your filing or issuance date is the date of receipt of your hand-delivered submission or issuance at the proper address. A hand-delivered...

  1. 29 CFR 4000.27 - What if I hand deliver my submission or issuance?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false What if I hand deliver my submission or issuance? 4000.27... § 4000.27 What if I hand deliver my submission or issuance? Your filing or issuance date is the date of receipt of your hand-delivered submission or issuance at the proper address. A hand-delivered...

  2. Intraocular tissue ablation using an optical fibre to deliver the 5th harmonic of a Nd:YAG

    NASA Astrophysics Data System (ADS)

    Miller, Joseph; Yu, Xiaobo; Yu, Paula K.; Cringle, Stephen J.; Yu, Dao-Yi

    2009-02-01

    We report the evaluation of a system which delivers the 5th harmonic of an Nd:YAG (213nm) via optical fibre to ocular tissue sites. The 213nm beam is concentrated, using a hollow glass taper, prior to launch into 200 μm or 600 μm core diameter silica/silica optical fibre. The fibre tip was tapered to enhance the fluence delivered. An operating window of fluence values that could be delivered via 330 - 1100mm lengths of optical fibre was determined. The lower value of 0.2J/cm2 determined by the ablation threshold of the tissue and the upper value of 1.3J/cm2 by the launch, transmission and tip characteristics of the optical fibre. The fluence output decreased as a function of both transmitted pulse energy and number of pulses transmitted. Fresh retinal tissue was cleanly ablated with minimal damage to the surrounding tissue. Lesions were generated using 1, 3 and 10 pulses with fluences from 0.2 to 1.0J/cm2. The lesion depth demonstrated clear dose dependence. Lesions generated in ex vivo preparations of human trabecular meshwork in a fluid environment also demonstrated dose dependence, 50 pulses being sufficient to create a hole within the trabecular meshwork extending to Schlemm's canal. The dose dependence of the ablation depth combined with the ability of this technique to create a conduit through to Schlemm's canal demonstrates the potential of this technique for ophthalmological applications requiring precise and controlled intraocular tissue removal and has potential applications in the treatment and management of glaucoma.

  3. Generating arbitrary one-dimensional dose profiles using rotational therapy

    NASA Astrophysics Data System (ADS)

    Zhuang, Tingliang; Wu, Qiuwen

    2010-10-01

    Conformal radiation therapy can be delivered using several methods: intensity-modulated radiotherapy (IMRT) at fixed gantry angles, through the continuous gantry rotation of linac (rotational arc therapy), or by a dedicated treatment unit such as tomotherapy. The recently developed volumetric modulated arc therapy (VMAT), a form of rotational arc therapy, has attracted lots of attention from investigators to explore its capability of generating highly conformal dose to the target. The main advanced features of VMAT are the variable dose rate and gantry rotation speed. In this paper, we present a theoretical framework of generating arbitrary one-dimensional dose profiles using rotational arc therapy to further explore the new degree of freedom of the VMAT technique. This framework was applied to design a novel technique for total body irradiation (TBI) treatment, where the desired dose distribution can be simplified by a one-dimensional profile. The technique was validated using simulations and experimental measurements. The preliminary results demonstrated that the new TBI technique using either dynamic MLC only, variable dose rate only, or a combination of dynamic MLC and variable dose rate can achieve arbitrary dose distribution in one dimension, such as uniform dose to target and lower dose to critical organ. This technique does not require the use of customized compensators, nor large treatment rooms as in the conventional extended SSD technique.

  4. Tradeoffs between image quality and dose.

    PubMed

    Seibert, J Anthony

    2004-10-01

    Image quality takes on different perspectives and meanings when associated with the concept of as low as reasonably achievable (ALARA), which is chiefly focused on radiation dose delivered as a result of a medical imaging procedure. ALARA is important because of the increased radiosensitivity of children to ionizing radiation and the desire to keep the radiation dose low. By the same token, however, image quality is also important because of the need to provide the necessary information in a radiograph in order to make an accurate diagnosis. Thus, there are tradeoffs to be considered between image quality and radiation dose, which is the main topic of this article. ALARA does not necessarily mean the lowest radiation dose, nor, when implemented, does it result in the least desirable radiographic images. With the recent widespread implementation of digital radiographic detectors and displays, a new level of flexibility and complexity confronts the technologist, physicist, and radiologist in optimizing the pediatric radiography exam. This is due to the separation of the acquisition, display, and archiving events that were previously combined by the screen-film detector, which allows for compensation for under- and overexposures, image processing, and on-line image manipulation. As explained in the article, different concepts must be introduced for a better understanding of the tradeoffs encountered when dealing with digital radiography and ALARA. In addition, there are many instances during the image acquisition/display/interpretation process in which image quality and associated dose can be compromised. This requires continuous diligence to quality control and feedback mechanisms to verify that the goals of image quality, dose and ALARA are achieved.

  5. Measuring pacemaker dose: A clinical perspective

    SciTech Connect

    Studenski, Matthew T.; Xiao Ying; Harrison, Amy S.

    2012-07-01

    Recently in our clinic, we have seen an increased number of patients presenting with pacemakers and defibrillators. Precautions are taken to develop a treatment plan that minimizes the dose to the pacemaker because of the adverse effects of radiation on the electronics. Here we analyze different dosimeters to determine which is the most accurate in measuring pacemaker or defibrillator dose while at the same time not requiring a significant investment in time to maintain an efficient workflow in the clinic. The dosimeters analyzed here were ion chambers, diodes, metal-oxide-semiconductor field effect transistor (MOSFETs), and optically stimulated luminescence (OSL) dosimeters. A simple phantom was used to quantify the angular and energy dependence of each dosimeter. Next, 8 patients plans were delivered to a Rando phantom with all the dosimeters located where the pacemaker would be, and the measurements were compared with the predicted dose. A cone beam computed tomography (CBCT) image was obtained to determine the dosimeter response in the kilovoltage energy range. In terms of the angular and energy dependence of the dosimeters, the ion chamber and diode were the most stable. For the clinical cases, all the dosimeters match relatively well with the predicted dose, although the ideal dosimeter to use is case dependent. The dosimeters, especially the MOSFETS, tend to be less accurate for the plans, with many lateral beams. Because of their efficiency, we recommend using a MOSFET or a diode to measure the dose. If a discrepancy is observed between the measured and expected dose (especially when the pacemaker to field edge is <10 cm), we recommend analyzing the treatment plan to see whether there are many lateral beams. Follow-up with another dosimeter rather than repeating multiple times with the same type of dosimeter. All dosimeters should be placed after the CBCT has been acquired.

  6. What do tests of formal reasoning actually measure?

    NASA Astrophysics Data System (ADS)

    Lawson, Anton E.

    Tests of formal operational reasoning derived from Piagetian theory have been found to be effective predictors of academic achievement. Yet Piaget's theory regarding the underlying nature of formal operations and their employment in specific contexts has run into considerable empirical difficulty. The primary purpose of this study was to present the core of an alternative theory of the nature of advanced scientific reasoning. That theory, referred to as the multiple-hypothesis theory, argues that tests of formal operational reasoning actually measure the extent to which persons have acquired the ability to initiate reasoning with more than one specific antecedent condition, or if they are unable to imagine more than one antecedent condition, they are aware that more than one is possible; therefore conclusions that are drawn are tempered by this possibility. As a test of this multiple-hypothesis theory of advanced reasoning and the contrasting Piagetian theory of formal operations, a sample of 922 college students were first classified as concrete operational, transitional, or formal operational, based upon responses to standard Piagetian measures of formal operational reasoning. They were then administered seven logic tasks. Actual response patterns to the tasks were analyzed and found to be similar to predicted response patterns derived from the multiple-hypothesis theory and were different from those predicted by Piagetian theory. Therefore, support was obtained for the multiple-hypothesis theory. The terms intuitive and reflective were suggested to replace the terms concrete operational and formal operational to refer to persons at varying levels of intellectual development.

  7. Extracorporeal adsorption therapy: A Method to improve targeted radiation delivered by radiometal-labeled monoclonal antibodies.

    SciTech Connect

    Nemecek, Eneida R.; Green, Damian J.; Fisher, Darrell R.; Pagal, John M.; Lin, Yukang; Gopal, A. K.; Durack, Lawrence D.; Rajendran, Joseph G.; Wilbur, D. S.; Nilsson, Rune; Sandberg, Bengt; Press, Oliver W.

    2008-04-01

    Many investigators have demonstrated the ability to treat hematologic malignancies with radiolabeled monoclonal antibodies targeting hematopoietic antigens such as anti-CD20 and anti-CD45. [1-5] Although the remission rates achieved with radioimmunotherapy (RIT) are relatively high, many patients subsequently relapse presumably due to suboptimal delivery of enough radiation to eradicate the malignancy. The dose-response of leukemia and lymphoma to radiation has been proven. Substantial amounts of radiation can be delivered by RIT if followed by hematopoietic cell transplantation to rescue the bone marrow from myeloablation.[ref] However, the maximum dose of RIT that can be used is still limited by toxicity to normal tissues affected by nonspecific delivery of radiation. Efforts to improve RIT focus on improving the therapeutic ratios of radiation in target versus non-target tissues by removing the fraction of radioisotope that fails to bind to target tissues and circulates freely in the bloodstream perfusing non-target tissues. Our group and others have explored several alternatives for removal of unbound circulating antibody. [refs] One such method, extracorporeal adsorption therapy (ECAT) consists of removing unbound antibody by a method similar to plasmapheresis after critical circulation time and distribution of antibody into target tissues have been achieved. Preclinical studies of ECAT in murine xenograft models demonstrated significant improvement in therapeutic ratios of radioactivity. Chen and colleagues demonstrated that a 2-hour ECAT procedure could remove 40 to 70% of the radioactivity from liver, lung and spleen. [ref] Although isotope concentration in the tumor was initially unaffected, a 50% decrease was noted approximately 36 hours after the procedure. This approach was also evaluated in a limited phase I pilot study of patients with refractory B-cell lymphoma. [ref] After radiographic confirmation of tumor localization of a test dose of anti-CD20

  8. DMLC tracking and gating can improve dose coverage for prostate VMAT

    SciTech Connect

    Colvill, E.; Poulsen, P. R.; Booth, J. T.; O’Brien, R. T.; Keall, P. J.; Ng, J. A.

    2014-09-15

    Purpose: To assess and compare the dosimetric impact of dynamic multileaf collimator (DMLC) tracking and gating as motion correction strategies to account for intrafraction motion during conventionally fractionated prostate radiotherapy. Methods: A dose reconstruction method was used to retrospectively assess the dose distributions delivered without motion correction during volumetric modulated arc therapy fractions for 20 fractions of five prostate cancer patients who received conventionally fractionated radiotherapy. These delivered dose distributions were compared with the dose distributions which would have been delivered had DMLC tracking or gating motion correction strategies been implemented. The delivered dose distributions were constructed by incorporating the observed prostate motion with the patient's original treatment plan to simulate the treatment delivery. The DMLC tracking dose distributions were constructed using the same dose reconstruction method with the addition of MLC positions from Linac log files obtained during DMLC tracking simulations with the observed prostate motions input to the DMLC tracking software. The gating dose distributions were constructed by altering the prostate motion to simulate the application of a gating threshold of 3 mm for 5 s. Results: The delivered dose distributions showed that dosimetric effects of intrafraction prostate motion could be substantial for some fractions, with an estimated dose decrease of more than 19% and 34% from the planned CTVD{sub 99%} and PTV D{sub 95%} values, respectively, for one fraction. Evaluation of dose distributions for DMLC tracking and gating deliveries showed that both interventions were effective in improving the CTV D{sub 99%} for all of the selected fractions to within 4% of planned value for all fractions. For the delivered dose distributions the difference in rectum V{sub 65%} for the individual fractions from planned ranged from −44% to 101% and for the bladder V{sub 65

  9. Kilovoltage cone-beam CT imaging dose during breast radiotherapy: A dose comparison between a left and right breast setup

    SciTech Connect

    Quinn, Alexandra; Holloway, Lois; Begg, Jarrad; Nelson, Vinod; Metcalfe, Peter

    2014-07-01

    The purpose of this study was to investigate the delivered dose from a kilovoltage cone-beam computed tomography (kV-CBCT) acquired in breast treatment position for a left and right breast setup. The dose was measured with thermoluminescent dosimeters positioned within a female anthropomorphic phantom at organ locations. Imaging was performed on an Elekta Synergy XVI system with the phantom setup on a breast board. The image protocol involved 120 kVp, 140 mAs, and a 270° arc rotation clockwise 0° to 270° for the left breast setup and 270° to 180° for the right breast setup (maximum arc rotations possible). The dose delivered to the left breast, right breast, and heart was 5.1 mGy, 3.9 mGy, and 4.0 mGy for the left breast setup kV-CBCT, and 6.4 mGy, 6.0 mGy, and 4.8 mGy for the right breast setup kV-CBCT, respectively. The rotation arc of the kV-CBCT influenced the dose delivered, with the right breast setup kV-CBCT found to deliver a dose of up to 4 mGy or 105% higher to the treated breast′s surface in comparison with the left breast setup. This is attributed to the kV-CBCT source being more proximal to the anterior of the phantom for a right breast setup, whereas the source is more proximal to the posterior of the patient for a left-side scan.

  10. CY 1995 radiation dose reconciliation report and resulting CY 1996 dose estimate for the 324 nuclear facility

    SciTech Connect

    Landsman, S.D.; Thornhill, R.E.; Peterson, C.A.

    1996-04-01

    In this report, the dose estimate for CY 1995 is reconciled by month wih actual doses received. Results of the reconciliation were used to revise estimates of worker dose for CY 1996. Resulting dose estimate for the facility is also included. Support for two major programs (B-Cell Cleanout and Surveillance and Maintenance) accounts for most of the exposure received by workers in the faility. Most of the expousre received by workers comes from work in the Radiochemical Engineering Complex airlock. In spite of schedule and work scope changes during CY 1995, dose estimates were close to actual exposures received. A number of ALARA measures were taken throughout the year; exposure reduction due to those was 20.6 Man-Rem, a 28% reduction from the CY 1995 estimate. Baseline estimates for various tasks in the facility were used to compile the CY 1996 dose estimate of 45.4 Man-Rem; facility goal for CY 1996 is to reduce worker dose by 20%, to 36.3 Man-Rem.

  11. Know your dose: RADDOSE

    PubMed Central

    Paithankar, Karthik S.; Garman, Elspeth F.

    2010-01-01

    The program RADDOSE is widely used to compute the dose absorbed by a macromolecular crystal during an X-ray diffraction experiment. A number of factors affect the absorbed dose, including the incident X-ray flux density, the photon energy and the composition of the macromolecule and of the buffer in the crystal. An experimental dose limit for macromolecular crystallography (MX) of 30 MGy at 100 K has been reported, beyond which the biological information obtained may be compromised. Thus, for the planning of an optimized diffraction experiment the estimation of dose has become an additional tool. A number of approximations were made in the original version of RADDOSE. Recently, the code has been modified in order to take into account fluorescent X-­ray escape from the crystal (version 2) and the inclusion of incoherent (Compton) scattering into the dose calculation is now reported (version 3). The Compton cross-section, although negligible at the energies currently commonly used in MX, should be considered in dose calculations for incident energies above 20 keV. Calculations using version 3 of RADDOSE reinforce previous studies that predict a reduction in the absorbed dose when data are collected at higher energies compared with data collected at 12.4 keV. Hence, a longer irradiation lifetime for the sample can be achieved at these higher energies but this is at the cost of lower diffraction intensities. The parameter ‘diffraction-dose efficiency’, which is the diffracted intensity per absorbed dose, is revisited in an attempt to investigate the benefits and pitfalls of data collection using higher and lower energy radiation, particularly for thin crystals. PMID:20382991

  12. A conceptual design of rotating board technique for delivering total skin electron therapy

    SciTech Connect

    Wu, Jia-Ming; Yeh, Shyh-An; Hsiao, Kuan-Yin; Chao, Max Min; Hargrove, Ishiuan

    2010-04-15

    Purpose: This study presents a novel technique in which a uniform radiation dose to the whole body, soles, and scalp vertex can be achieved in one electron beam treatment fraction. Methods: The patient was treated at a machine with a home-made rotating board. The patients were treated in two groups in the prone and supine positions by leaning onto an inner rotational board in the prone and supine positions. Each group can further be separated into two subgroups using tilting and rotational positions for treatment. Results: One of the beams was directed 15.5 deg. upward and 15.5 deg. downward from the horizontal axis to provide a field size of as large as 200 cm in height and 140 cm in width. An incline angle of 31.5 deg. anteriorly (forward) or posteriorly (backward) of the outer frame at an angle rotated 60 deg. clockwise or counterclockwise to the inner frame was found to be most appropriate. The output for the rotating board total skin electron therapy (RB-TSET) was 0.046 cGy/MU at ISD of 350 cm. The beam characteristics of the RB-TSET depth dose curves were R{sub 50}=2.48 cm, d{sub max}=0.7 cm, E{sub 0}=5.78 MeV, and R{sub p}=3.4 cm. Conclusions: The RB-TSET technique presented in this study is able to deliver a uniform radiation dose to the patient's skin surface, the scalp vertex, and soles of the feet all at one time, eliminating the trouble of having to further irradiate these two regions separately when using the Stanford six field technique.

  13. A method to evaluate dose errors introduced by dose mapping processes for mass conserving deformations

    PubMed Central

    Yan, C.; Hugo, G.; Salguero, F. J.; Saleh-Sayah, N.; Weiss, E.; Sleeman, W. C.; Siebers, J. V.

    2012-01-01

    Purpose: To present a method to evaluate the dose mapping error introduced by the dose mapping process. In addition, apply the method to evaluate the dose mapping error introduced by the 4D dose calculation process implemented in a research version of commercial treatment planning system for a patient case. Methods: The average dose accumulated in a finite volume should be unchanged when the dose delivered to one anatomic instance of that volume is mapped to a different anatomic instance—provided that the tissue deformation between the anatomic instances is mass conserving. The average dose to a finite volume on image S is defined as dS¯=es/mS, where eS is the energy deposited in the mass mS contained in the volume. Since mass and energy should be conserved, when dS¯ is mapped to an image R(dS→R¯=dR¯), the mean dose mapping error is defined as Δdm¯=|dR¯-dS¯|=|eR/mR-eS/mS|, where the eR and eS are integral doses (energy deposited), and mR and mS are the masses within the region of interest (ROI) on image R and the corresponding ROI on image S, where R and S are the two anatomic instances from the same patient. Alternatively, application of simple differential propagation yields the differential dose mapping error, Δdd¯=|∂d¯∂e*Δe+∂d¯∂m*Δm|=|(eS-eR)mR-(mS-mR)mR2*eR|=α|dR¯-dS¯| with α=mS/mR. A 4D treatment plan on a ten-phase 4D-CT lung patient is used to demonstrate the dose mapping error evaluations for a patient case, in which the accumulated dose, DR¯=∑S=09dS→R¯, and associated error values (ΔDm¯ and ΔDd¯) are calculated for a uniformly spaced set of ROIs. Results: For the single sample patient dose distribution, the average accumulated differential dose mapping error is 4.3%, the average absolute differential dose mapping error is 10.8%, and the average accumulated mean dose mapping error is 5.0%. Accumulated differential dose mapping errors within the gross tumor volume (GTV) and planning target volume (PTV) are lower, 0

  14. Novel lung IMRT planning algorithms with nonuniform dose delivery strategy to account for respiratory motion.

    PubMed

    Li, Xiang; Zhang, Pengpeng; Mah, Dennis; Gewanter, Richard; Kutcher, Gerald

    2006-09-01

    To effectively deliver radiation dose to lung tumors, respiratory motion has to be considered in treatment planning. In this paper we first present a new lung IMRT planning algorithm, referred as the dose shaping (DS) method, that shapes the dose distribution according to the probability distribution of the tumor over the breathing cycle to account for respiratory motion. In IMRT planning a dose-based convolution method was generally adopted to compensate for random organ motion by performing 4-D dose calculations using a tumor motion probability density function. We modified the CON-DOSE method to a dose volume histogram based convolution method (CON-DVH) that allows nonuniform dose distribution to account for respiratory motion. We implemented the two new planning algorithms on an in-house IMRT planning system that uses the Eclipse (Varian, Palo Alto, CA) planning workstation as the dose calculation engine. The new algorithms were compared with (1) the conventional margin extension approach in which margin is generated based on the extreme positions of the tumor, (2) the dose-based convolution method, and (3) gating with 3 mm residual motion. Dose volume histogram, tumor control probability, normal tissue complication probability, and mean lung dose were calculated and used to evaluate the relative performance of these approaches at the end-exhale phase of the respiratory cycle. We recruited six patients in our treatment planning study. The study demonstrated that the two new methods could significantly reduce the ipsilateral normal lung dose and outperformed the margin extension method and the dose-based convolution method. Compared with the gated approach that has the best performance in the low dose region, the two methods we proposed have similar potential to escalate tumor dose, but could be more efficient because dose is delivered continuously. PMID:17022235

  15. Apparatus and method for delivering a fluid to a container

    DOEpatents

    Turner, Terry D.

    2002-01-01

    An apparatus for delivering a fluid into a container has a carriage movably associated with a holding mechanism along an axis. A piston is attached to the carriage and a cylinder is slidably attached to the piston along the axis. The cylinder has a hole formed therein that extends along the axis. A needle extending along the axis is attached to the piston and passes through the cylinder hole. The needle has a first operative position relative to the piston when the needle is retracted within the cylinder and a second operative position relative to the piston when the needle extends from the cylinder.

  16. “Second-Generation” Medicaid Managed Care: Can It Deliver?

    PubMed Central

    Gold, Marsha; Mittler, Jessica

    2000-01-01

    This article offers insight into what we term “second-generation” Medicaid managed care. In case studies of seven States, we examined three critical questions: (1) Does managed care experience facilitate program operations? (2) Can Medicaid managed care deliver on important goals? and (3) Can States extend the program beyond low-income families and children to others? The answers are encouraging but also suggest caution. Medicaid managed care is not a solution to fundamental problems facing the Medicaid program. It may be a tool to encourage better delivery of care. This requires a long-term commitment and adequate financing to develop stable partnerships with all stakeholders. PMID:12500319

  17. Clinton delivers bare bones plan for 1997 budget

    NASA Astrophysics Data System (ADS)

    Carlowicz, Michael

    1996-02-01

    Congress and the White House have yet to finish negotiating and haggling over the U.S. federal budget for 1996, but the calendar and the law say that they ought to start thinking about 1997. On February 5, President Bill Clinton issued a preliminary budget plan for 1997 that reflected his fiscal priorities as they were last stated in January, before budget talks with congressional Republicans broke down. Required by law to propose a spending plan by the first Monday in February, Clinton delivered to Congress what he termed a "thematic document," one that gives a minimally detailed outline of how the federal government should spend the taxpayers' money in 1997.

  18. Capturing, Harmonizing and Delivering Data and Quality Provenance

    NASA Technical Reports Server (NTRS)

    Leptoukh, Gregory; Lynnes, Christopher

    2011-01-01

    Satellite remote sensing data have proven to be vital for various scientific and applications needs. However, the usability of these data depends not only on the data values but also on the ability of data users to assess and understand the quality of these data for various applications and for comparison or inter-usage of data from different sensors and models. In this paper, we describe some aspects of capturing, harmonizing and delivering this information to users in the framework of distributed web-based data tools.

  19. Bench Crater Meteorite: Hydrated Asteroidal Material Delivered to the Moon

    NASA Technical Reports Server (NTRS)

    Joy, K. H.; Messenger, S.; Zolensky, M. E.; Frank, D. R.; Kring, D. A.

    2013-01-01

    D/H measurements from the lunar regolith agglutinates [8] indicate mixing between a low D/H solar implanted component and additional higher D/H sources (e.g., meteoritic/ cometary/volcanic gases). We have determined the range and average D/H ratio of Bench Crater meteorite, which is the first direct D/H analysis of meteoritic material delivered to the lunar surface. This result provides an important ground truth for future investigations of lunar water resources by missions to the Moon.

  20. Color View of 'Rosy Red' Delivered to TEGA

    NASA Technical Reports Server (NTRS)

    2008-01-01

    NASA's Phoenix Mars Lander's Surface Stereo Imager took this false color image on Sol 72 (August 7, 2008), the 72nd Martian day after landing. It shows a soil sample from a trench informally called 'Rosy Red' after being delivered to a gap between partially opened doors on the lander's Thermal and Evolved-Gas Analyzer, or TEGA.

    The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  1. Childhood TB: can the End TB Strategy deliver?

    PubMed

    Seddon, James A; Graham, Stephen M

    2016-03-01

    The accelerated reductions in global TB incidence required to achieve the End TB Strategy goal will result in reductions in the burden of childhood TB. Contact screening and preventive therapy have emerged as important components of TB burden reduction, and family-centered approaches could be an effective route in delivering these activities. Lack of accurate diagnostics for children remains a critical barrier and a need remains for better collaborative and supportive links between the child health and TB control sectors. Irrespective of whether the ambitious targets can be achieved, the unprecedented opportunities provided by the End TB Strategy must be embraced.

  2. Curtailing patient-specific IMRT QA procedures from 2D dose error distribution

    PubMed Central

    Kurosu, Keita; Sumida, Iori; Mizuno, Hirokazu; Otani, Yuki; Oda, Michio; Isohashi, Fumiaki; Seo, Yuji; Suzuki, Osamu; Ogawa, Kazuhiko

    2016-01-01

    A patient-specific quality assurance (QA) test is conducted to verify the accuracy of dose delivery. It generally consists of three verification processes: the absolute point dose difference, the planar dose differences at each gantry angle, and the planar dose differences by 3D composite irradiation. However, this imposes a substantial workload on medical physicists. The objective of this study was to determine whether our novel method that predicts the 3D delivered dose allows certain patient-specific IMRT QAs to be curtailed. The object was IMRT QA for the pelvic region with regard to point dose and composite planar dose differences. We compared measured doses, doses calculated in the treatment planning system, and doses predicted by in-house software. The 3D predicted dose was reconstructed from the per-field measurement by incorporating the relative dose error distribution into the original dose grid of each beam. All point dose differences between the measured and the calculated dose were within ±3%, whereas 93.3% of them between the predicted and the calculated dose were within ±3%. As for planar dose differences, the gamma passing rates between the calculated and the predicted dose were higher than those between the calculated and the measured dose. Comparison and statistical analysis revealed a correlation between the predicted and the measured dose with regard to both point dose and planar dose differences. We concluded that the prediction-based approach is an accurate substitute for the conventional measurement-based approach in IMRT QA for the pelvic region. Our novel approach will help medical physicists save time on IMRT QA. PMID:26661854

  3. Manufactured Metal Oxide Nanoparticles In Vitro Vascular Toxicity: Role of Size Profile and Cellular Specificity on Delivered Dose and Cytotoxicity

    EPA Science Inventory

    Metal oxide nanoparticles (NPs) are used in a range of products and applications due to their unique physicochemical properties. In vivo studies have demonstrated the ability of NPs to translocate to the distal organs, including the cardiovascular system, following various routes...

  4. PET-CT in Determining the Radioembolization Dose Delivered to Patients With Liver Metastasis, Primary Liver Cancer, or Biliary Cancer

    ClinicalTrials.gov

    2016-03-01

    Adult Primary Hepatocellular Carcinoma; Advanced Adult Primary Liver Cancer; Metastatic Extrahepatic Bile Duct Cancer; Recurrent Adult Primary Liver Cancer; Recurrent Extrahepatic Bile Duct Cancer; Stage D Adult Primary Liver Cancer (BCLC); Unspecified Adult Solid Tumor, Protocol Specific

  5. Estimation of effective imaging dose for kilovoltage intratreatment monitoring of the prostate position during cancer radiotherapy

    NASA Astrophysics Data System (ADS)

    Ng, J. A.; Booth, J.; Poulsen, P.; Kuncic, Z.; Keall, P. J.

    2013-09-01

    Kilovoltage intratreatment monitoring (KIM) is a novel real-time localization modality where the tumor position is continuously measured during intensity modulated radiation therapy (IMRT) or intensity modulated arc therapy (IMAT) by a kilovoltage (kV) x-ray imager. Adding kV imaging during therapy adds radiation dose. The additional effective dose is quantified for prostate radiotherapy and compared to dose from other localization modalities. The software PCXMC 2.0 was used to calculate the effective dose delivered to a phantom as a function of imager angle and field size for a Varian On-Board Imager. The average angular effective dose was calculated for a field size of 6 cm × 6 cm. The average angular effective dose was used in calculations for different treatment scenarios. Treatment scenarios considered were treatment type and fractionation. For all treatment scenarios, (i.e. conventionally fractionated and stereotactic body radiotherapy (SBRT), IMRT and IMAT), the total KIM dose at 1 Hz ranged from 2-10 mSv. This imaging dose is less than the Navotek radioactive implant dose (64 mSv) and a standard SBRT cone beam computed tomography pretreatment scan dose (22 mSv) over an entire treatment regime. KIM delivers an acceptably low effective dose for daily use as a real-time image-guidance method for prostate radiotherapy.

  6. Calculating drug doses.

    PubMed

    2016-09-01

    Numeracy and calculation are key skills for nurses. As nurses are directly accountable for ensuring medicines are prescribed, dispensed and administered safely, they must be able to understand and calculate drug doses. PMID:27615351

  7. Ibuprofen dosing for children

    MedlinePlus

    Motrin; Advil ... Ibuprofen is a type of nonsteroidal anti-inflammatory drug (NSAID). It can help: Reduce aches, pain, sore ... Ibuprofen can be taken as liquid or chewable tablets. To give the correct dose, you need to ...

  8. Photovoltaic performance models: an evaluation with actual field data

    NASA Astrophysics Data System (ADS)

    TamizhMani, Govindasamy; Ishioye, John-Paul; Voropayev, Arseniy; Kang, Yi

    2008-08-01

    Prediction of energy production is crucial to the design and installation of the building integrated photovoltaic systems. This prediction should be attainable based on the commonly available parameters such as system size, orientation and tilt angle. Several commercially available as well as free downloadable software tools exist to predict energy production. Six software models have been evaluated in this study and they are: PV Watts, PVsyst, MAUI, Clean Power Estimator, Solar Advisor Model (SAM) and RETScreen. This evaluation has been done by comparing the monthly, seasonaly and annually predicted data with the actual, field data obtained over a year period on a large number of residential PV systems ranging between 2 and 3 kWdc. All the systems are located in Arizona, within the Phoenix metropolitan area which lies at latitude 33° North, and longitude 112 West, and are all connected to the electrical grid.

  9. Hawaii requires actual exposure to validate distress claims.

    PubMed

    1999-10-29

    The "actual exposure" rule can now be applied in Hawaii to cases involving the recovery of damages for HIV exposure even if the virus is not transmitted. This ruling came as a result of the case of three airport baggage handlers who were exposed to a leaking container of HIV-positive blood. The Hawaii Supreme Court ruled that a plaintiff has to prove that the exposure involves a "scientifically accepted" method of transmission and that the fluid in question contained HIV. Furthermore, the court ruled, any liability for mental distress is limited to the time between discovery of contamination and confirmation that no infection resulted. With current testing standards, the time period between discovery and a negative test result is approximately 3 to 6 months.

  10. Illinois adopts 'actual exposure' rule for distress claims.

    PubMed

    1998-10-30

    The Illinois Supreme Court has ruled that plaintiffs must prove actual exposure to HIV if they hope to recover damages in fear-of-AIDS lawsuits. Most state courts accept that as the standard for determining if a claim is legitimate. Two cases were addressed in the ruling. In one case, [name removed] sued Dr. [name removed] and the estate of [name removed]'s late partner, who died of AIDS-related complications in 1991. While [name removed] was employed by the doctors, she cut herself on a used scalpel in a waste basket. The scalpel was not tested, but she has had three HIV tests which have shown negative results. The other case involved six people who sued Northwestern University after learning that a dental student who treated them was HIV-positive. The six people have also tested negative.

  11. Throwing patterns used by collegiate baseball players in actual games.

    PubMed

    Barrett, David D; Burton, Allen W

    2002-03-01

    The form of 3,684 throws made by 100 players in 7 collegiate baseball games was examined in relation to position, distance, and active and inactive situations. All throws made from the first pitch to the last out for 94 half innings were videotaped from the stands. The results showed that the interrater reliability of task, environment, and performance measures were all acceptable to excellent (percentage of agreement was at least 80%), indicating that qualitative aspects of throwing can be reliably measured in an actual sport context. Alternatives to the most advanced pattern were observed at least half the time for catchers and infielders at most distances in both active and inactive situations andfor pitchers and outfielders only in inactive situations.

  12. Catalytic combustion of actual low and medium heating value gases

    NASA Technical Reports Server (NTRS)

    Bulzan, D. L.

    1982-01-01

    Catalytic combustion of both low and medium heating value gases using actual coal derived gases obtained from operating gasifiers was demonstrated. A fixed bed gasifier with a complete product gas cleanup system was operated in an air blown mode to produce low heating value gas. A fluidized bed gasifier with a water quench product gas cleanup system was operated in both an air enriched and an oxygen blown mode to produce low and medium, heating value gas. Noble metal catalytic reactors were evaluated in 12 cm flow diameter test rigs on both low and medium heating value gases. Combustion efficiencies greater than 99.5% were obtained with all coal derived gaseous fuels. The NOx emissions ranged from 0.2 to 4 g NO2 kg fuel.

  13. Actual leisure participation of Norwegian adolescents with Down syndrome.

    PubMed

    Dolva, Anne-Stine; Kleiven, Jo; Kollstad, Marit

    2014-02-01

    This article reports the actual participation in leisure activities by a sample of Norwegian adolescents with Down syndrome aged 14. Representing a first generation to grow up in a relatively inclusive context, they live with their families, attend mainstream schools, and are part of common community life. Leisure information was obtained in individual, structured parent interviews, and added to existing longitudinal data from a project following the sample. Generally, the leisure activity may be viewed as varying along a continuum-reaching from formal, organized, and assisted activity participation outside home, to informal, self-organized, and independent participation at home. Formal leisure activities were either organized "for all" or "adapted for disabled." The adolescents' leisure appears as active and social. However, social participation largely involved parents and family, while socializing with other adolescents mainly took place within formal activities adapted for disabled. Clearly, formal and informal activities provide rather different opportunities for social encounters and assistance. PMID:24515503

  14. An evaluation of contractor projected and actual costs

    NASA Technical Reports Server (NTRS)

    Kwiatkowski, K. A.; Buffalano, C.

    1974-01-01

    GSFC contractors with cost-plus contracts provide cost estimates for each of the next four quarters on a quarterly basis. Actual expenditures over a two-year period were compared to the estimates, and the data were sorted in different ways to answer several questions and give quantification to observations, such as how much does the accuracy of estimates degrade as they are made further into the future? Are estimates made for small dollar amounts more accurate than for large dollar estimates? Other government agencies and private companies with cost-plus contracts may be interested in this analysis as potential methods of contract management for their organizations. It provides them with the different methods one organization is beginning to use to control costs.

  15. Actual and desired computer literacy among allied health students.

    PubMed

    Agho, A O; Williams, A M

    1995-01-01

    The purpose of this study was to examine the level of computer literacy among allied health students, with specific focus on physical therapy, occupational therapy, and respiratory therapy students, and to investigate the perceived differences between actual computer literacy and desired computer literacy. Two established measurement instruments were used to collect data from a sample of 377 allied health students. T-tests and Pearson product-moment correlations were conducted to analyze the data. Results show that allied health students take very few computer courses, but they are generally aware of the applications of computers in the practice of allied health and they desire a higher level of computer literacy than they currently have.

  16. Non-actual motion: phenomenological analysis and linguistic evidence.

    PubMed

    Blomberg, Johan; Zlatev, Jordan

    2015-09-01

    Sentences with motion verbs describing static situations have been seen as evidence that language and cognition are geared toward dynamism and change (Talmy in Toward a cognitive semantics, MIT Press, Cambridge, 2000; Langacker in Concept, image, and symbol: the cognitive basis of grammar, Mouton de Gruyter, Berlin and New York, 1990). Different concepts have been used in the literature, e.g., fictive motion, subjective motion and abstract motion to denote this. Based on phenomenological analysis, we reinterpret such concepts as reflecting different motivations for the use of such constructions (Blomberg and Zlatev in Phenom Cogn Sci 13(3):395-418, 2014). To highlight the multifaceted character of the phenomenon, we propose the concept non-actual motion (NAM), which we argue is more compatible with the situated cognition approach than explanations such as "mental simulation" (e.g., Matlock in Studies in linguistic motivation, Mouton de Gruyter, Berlin, 2004). We investigate the expression of NAM by means of a picture-based elicitation task with speakers of Swedish, French and Thai. Pictures represented figures that either afford human motion or not (±afford); crossed with this, the figure extended either across the picture from a third-person perspective (3 pp) or from a first-person perspective (1 pp). All picture types elicited NAM-sentences with the combination [+afford, 1 pp] producing most NAM-sentences in all three languages. NAM-descriptions also conformed to language-specific patterns for the expression of actual motion. We conclude that NAM shows interaction between pre-linguistic motivations and language-specific conventions.

  17. Plume temperature emitted from metered dose inhalers.

    PubMed

    Brambilla, G; Church, T; Lewis, D; Meakin, B

    2011-02-28

    The temperature of the drug cloud emitted from a pressurised metered dose inhaler (pMDI) may result in patient discomfort and inconsistent or non-existent dose delivery to the lungs. The effects of variations in formulation (drug, propellant, co-solvent content) and device hardware (metering volume, actuator orifice diameter, add-on devices) upon the temperature of pMDI plumes, expressed as replicate mean minimum values (MMPT), collected into a pharmacopoeial dose unit sampling apparatus (DUSA), have been investigated. Ten commercially available and two development products, including chlorofluorocarbon (CFC) suspensions and hydrofluoroalkane (HFA) solutions or suspensions, were examined together with a number of drug products in late stage development and a variety of HFA 134a placebo pMDIs. Plume temperatures were observed to be lowest in the proximity of the product's actuator mouthpiece where rapid flashing and evaporation of the formulation's propellant and volatile excipients cause cooling. The ability to control plume temperature by judicious choice of formulation co-solvent content, metering volume and the actuator orifice diameter is identified. An ethanol based HFA 134a formulation delivered through a fine orifice is inherently warmer than one with 100% HFA 134a vehicle delivered through a coarse actuator orifice. Of the 10 commercial products evaluated, MMPTs ranged from -54 to +4°C and followed the formulation class rank order, HFA suspensions

  18. Delivering Current Hubble Space Telescope (HST) News to the Classroom

    NASA Astrophysics Data System (ADS)

    Villard, R.; Eisenhamer, B.; Weaver, D.

    2004-05-01

    Today's classrooms are significantly influenced by current news events, delivered instantly into the classroom via the Internet. Educators are challenged daily to transform these events into student learning opportunities. In the case of space science, current news events may be the only chance for educators and students to explore the marvels of the universe. Inspired by these circumstances, the Formal Education and News Divisions at STScI's Office of Public Outreach joined forces to deliver current Hubble Space Telescope (HST) news events that have an educational backbone. Starting with the momentum of HST scientific discoveries, the team blends their skill for producing timely news pieces with educational expertise to maximize the potential learning impact of an HST news event. The partnership also allows the Office of Public Outreach to maximize cost effectiveness and efficiency of staff resources for a stellar product that brings the universe a little closer into view for the classroom. This poster will demonstrate how the two divisions draw on their talents to create their unique educational material as well as the various types of educational material produced by the partnership.

  19. Femoral venous catheters: a safe alternative for delivering parenteral alimentation.

    PubMed

    Friedman, B; Kanter, G; Titus, D

    1994-04-01

    Femoral vein catheterization is an alternative method of obtaining central venous access. Placement of femoral venous catheters (FVCs) is possible in the majority of patients, suitable for most indications, and associated with a low complication rate during insertion. We wished to determine the incidence of infections or other complications resulting when parenteral nutrition was delivered through FVCs. Fifty-two patients were followed from a hospital-wide population including patients in the critical care units. Triple-lumen catheters were placed by using the sterile Seldinger technique, and sites were examined daily for inflammation. Bacteriologic surveillance was accomplished by submitting the catheter tip for semiquantitative cultures. If catheter line sepsis was suspected, blood samples for cultures were drawn through the catheter and peripherally. The rate of occurrence of colonized catheters was 9.6% (five of 52), and catheter sepsis was found in one case (1.9%). Other than inflammation at six (11.5%) of 52 catheter sites, noninfectious complications of FVCs were not found. On the basis of these findings, we consider FVC-delivered parenteral alimentation a safe and effective alternative to other forms of central venous access.

  20. Expert assessment concludes negative emissions scenarios may not deliver

    NASA Astrophysics Data System (ADS)

    Vaughan, Naomi E.; Gough, Clair

    2016-09-01

    Many integrated assessment models (IAMs) rely on the availability and extensive use of biomass energy with carbon capture and storage (BECCS) to deliver emissions scenarios consistent with limiting climate change to below 2 °C average temperature rise. BECCS has the potential to remove carbon dioxide (CO2) from the atmosphere, delivering ‘negative emissions’. The deployment of BECCS at the scale assumed in IAM scenarios is highly uncertain: biomass energy is commonly used but not at such a scale, and CCS technologies have been demonstrated but not commercially established. Here we present the results of an expert elicitation process that explores the explicit and implicit assumptions underpinning the feasibility of BECCS in IAM scenarios. Our results show that the assumptions are considered realistic regarding technical aspects of CCS but unrealistic regarding the extent of bioenergy deployment, and development of adequate societal support and governance structures for BECCS. The results highlight concerns about the assumed magnitude of carbon dioxide removal achieved across a full BECCS supply chain, with the greatest uncertainty in bioenergy production. Unrealistically optimistic assumptions regarding the future availability of BECCS in IAM scenarios could lead to the overshoot of critical warming limits and have significant impacts on near-term mitigation options.

  1. Effectively Delivering a Unique Hsp90 Inhibitor Using Star Polymers

    PubMed Central

    2013-01-01

    We report the synthesis of a novel heat shock protein 90 (hsp90) inhibitor conjugated to a star polymer. Using reversible addition–fragmentation chain-transfer (RAFT) polymerization, we prepared star polymers comprising PEG attached to a predesigned functional core. The stars were cross-linked using disulfide linkers, and a tagged version of our hsp90 inhibitor was conjugated to the polymer core to generate nanoparticles (14 nm). Dynamic light scattering showed that the nanoparticles were stable in cell growth media for 5 days, and high-performance liquid chromatography (HPLC) analysis of compound-release at 3 different pH values showed that release was pH dependent. Cell cytotoxicity studies and confocal microscopy verify that our hsp90 inhibitor was delivered to cells using this nanoparticle delivery system. Further, delivery of our hsp90 inhibitor using star polymer induces apoptosis by a caspase 3-dependent pathway. These studies show that we can deliver our hsp90 inhibitor effectively using star polymers and induce apoptosis by the same pathway as the parent compound. PMID:24379910

  2. Delivering the Goods for Genome Engineering and Editing.

    PubMed

    Skipper, Kristian Alsbjerg; Mikkelsen, Jacob Giehm

    2015-08-01

    A basic understanding of genome evolution and the life and impact of microorganisms, like viruses and bacteria, has been fundamental in the quest for efficient genetic therapies. The expanding tool box for genetic engineering now contains transposases, recombinases, and nucleases, all created from naturally occurring genome-modifying proteins. Whereas conventional gene therapies have sought to establish sustained expression of therapeutic genes, genomic tools are needed only in a short time window and should be delivered to cells ideally in a balanced "hit-and-run" fashion. Current state-of-the-art delivery strategies are based on intracellular production of protein from transfected plasmid DNA or in vitro-transcribed RNA, or from transduced viral templates. Here, we discuss advantages and challenges of intracellular production strategies and describe emerging approaches based on the direct delivery of protein either by transfer of recombinant protein or by lentiviral protein transduction. With focus on adapting viruses for protein delivery, we describe the concept of "all-in-one" lentiviral particles engineered to codeliver effector proteins and donor sequences for DNA transposition or homologous recombination. With optimized delivery methods-based on transferring DNA, RNA, or protein-it is no longer far-fetched that researchers in the field will indeed deliver the goods for somatic gene therapies.

  3. Delivering Agents Locally into Articular Cartilage by Intense MHz Ultrasound

    PubMed Central

    Nieminen, Heikki J.; Ylitalo, Tuomo; Suuronen, Jussi-Petteri; Rahunen, Krista; Salmi, Ari; Saarakkala, Simo; Serimaa, Ritva; Hæggström, Edward

    2015-01-01

    There is no cure for osteoarthritis. Current drug delivery relies on systemic delivery or injections into the joint. Because articular cartilage (AC) degeneration can be local and drug exposure outside the lesion can cause adverse effects, localized drug delivery could permit new drug treatment strategies. We investigated whether intense megahertz ultrasound (frequency: 1.138 MHz, peak positive pressure: 2.7 MPa, Ispta: 5 W/cm2, beam width: 5.7 mm at −6 dB, duty cycle: 5%, pulse repetition frequency: 285 Hz, mechanical index: 1.1) can deliver agents into AC without damaging it. Using ultrasound, we delivered a drug surrogate down to a depth corresponding to 53% depth of the AC thickness without causing histologically detectable damage to the AC. This may be important because early osteoarthritis typically exhibits histopathologic changes in the superficial AC. In conclusion, we identify intense megahertz ultrasound as a technique that potentially enables localized non-destructive delivery of osteoarthritis drugs or drug carriers into articular cartilage. PMID:25922135

  4. Refugee health: a new model for delivering primary health care.

    PubMed

    Kay, Margaret; Jackson, Claire; Nicholson, Caroline

    2010-01-01

    Providing health care to newly arrived refugees within the primary health care system has proved challenging. The primary health care sector needs enhanced capacity to provide quality health care for this population. The Primary Care Amplification Model has demonstrated its capacity to deliver effective health care to patients with chronic disease such as diabetes. This paper describes the adaption ofthe model to enhance the delivery ofhealth care to the refugee community. A 'beacon' practice with an expanded clinical capacity to deliver health care for refugees has been established. Partnerships link this practice with existing local general practices and community services. Governance involves collaboration between clinical leadership and relevant government and non-government organisations including local refugee communities. Integration with tertiary and community health sectors is facilitated and continuing education of health care providers is an important focus. Early incorporation of research in this model ensures effective feedback to inform providers of current health needs. Although implementation is currently in its formative phase, the Primary Care Amplification Model offers a flexible, yet robust framework to facilitate the delivery of quality health care to refugee patients.

  5. Developing community networks to deliver HIV prevention interventions.

    PubMed

    Guenther-Grey, C; Noroian, D; Fonseka, J; Higgins, D

    1996-01-01

    Outreach has a long history in health and social service programs as an important method for reaching at-risk persons within their communities. One method of "outreach" is based on the recruitment of networks of community members (or "networkers") to deliver HIV prevention messages and materials in the context of their social networks and everyday lives. This paper documents the experiences of the AIDS Community Demonstration Projects in recruiting networkers to deliver HIV prevention interventions to high-risk populations, including injecting drug users not in treatment; female sex partners of injecting drug users; female sex traders; men who have sex with men but do not self-identify as gay; and youth in high-risk situations. The authors interviewed project staff and reviewed project records of the implementation of community networks in five cities. Across cities, the projects successfully recruited persons into one or more community networks to distribute small media materials, condoms, and bleach kits, and encourage risk-reduction behaviors among community members. Networkers' continuing participation was enlisted through a variety of monetary and nonmonetary incentives. While continuous recruitment of networkers was necessary due to attrition, most interventions reported maintaining a core group of networkers. In addition, the projects appeared to serve as a starting point for some networkers to become more active in other community events and issues.

  6. Aspects of the relationship between drug dose and drug effect.

    PubMed

    Peper, Abraham

    2009-02-09

    It is generally assumed that there exists a well-defined relationship between drug dose and drug effect and that this can be expressed by a dose-response curve. This paper argues that there is no such clear relation and that the dose-response curve provides only limited information about the drug effect. It is demonstrated that tolerance development during the measurement of the dose-response curve may cause major distortion of the curve and it is argued that the curve may only be used to indicate the response to the first administration of a drug, before tolerance has developed. The precise effect of a drug on an individual depends on the dynamic relation between several variables, particularly the level of tolerance, the dose anticipated by the organism and the actual drug dose. Simulations with a previously published mathematical model of drug tolerance demonstrate that the effect of a dose smaller than the dose the organism has developed tolerance to is difficult to predict and may be opposite to the action of the usual dose.

  7. TH-A-19A-10: Fast Four Dimensional Monte Carlo Dose Computations for Proton Therapy of Lung Cancer

    SciTech Connect

    Mirkovic, D; Titt, U; Mohan, R; Yepes, P

    2014-06-15

    Purpose: To develop and validate a fast and accurate four dimensional (4D) Monte Carlo (MC) dose computation system for proton therapy of lung cancer and other thoracic and abdominal malignancies in which the delivered dose distributions can be affected by respiratory motion of the patient. Methods: A 4D computer tomography (CT) scan for a lung cancer patient treated with protons in our clinic was used to create a time dependent patient model using our in-house, MCNPX-based Monte Carlo system (“MC{sup 2}”). The beam line configurations for two passively scattered proton beams used in the actual treatment were extracted from the clinical treatment plan and a set of input files was created automatically using MC{sup 2}. A full MC simulation of the beam line was computed using MCNPX and a set of phase space files for each beam was collected at the distal surface of the range compensator. The particles from these phase space files were transported through the 10 voxelized patient models corresponding to the 10 phases of the breathing cycle in the 4DCT, using MCNPX and an accelerated (fast) MC code called “FDC”, developed by us and which is based on the track repeating algorithm. The accuracy of the fast algorithm was assessed by comparing the two time dependent dose distributions. Results: The error of less than 1% in 100% of the voxels in all phases of the breathing cycle was achieved using this method with a speedup of more than 1000 times. Conclusion: The proposed method, which uses full MC to simulate the beam line and the accelerated MC code FDC for the time consuming particle transport inside the complex, time dependent, geometry of the patient shows excellent accuracy together with an extraordinary speed.

  8. Oral hepatitis B vaccine candidates produced and delivered in plant material.

    PubMed

    Streatfield, Stephen J

    2005-06-01

    Hepatitis B is a major global health problem; approximately two billion people are infected with the virus worldwide, despite the fact that safe and efficacious vaccines have been developed and used for nearly 20 years. Prohibitive costs for vaccine purchase and administration restrict uptake in many developing nations. Agencies such as the Global Alliance for Vaccination and Immunization are helping to make current vaccines more available, but reduced costs would greatly aid this effort. Oral delivery is an option to reduce the expense of administering hepatitis B vaccines. It may also improve compliance, and orally delivered vaccines may be more efficacious among poor responders to current vaccines. However, to induce protective efficacy, oral administration may require encapsulation of antigen and delivery of large doses. Plant-based expression systems offer an oral delivery alternative with low production costs, and they also encapsulate the antigen. Some plant-based systems also stabilize antigen and therefore reduce storage and distribution costs. The hepatitis B major surface antigen has been expressed in several plant systems. A variety of regulatory sequences and subcellular targets have been used to achieve expression suitable for early stage clinical trials. However, further increase in expression will be necessary for practical and efficacious products. Appropriate processing can yield palatable products with uniform antigen concentration. The antigen expressed in plant systems shows extensive disulphide cross-linking and oligomerization and forms virus-like particles. Oral delivery of the antigen in plant material can induce a serum antibody response, prime the immune system for a subsequent injection of antigen and give a boosted response to a prior injection. Small scale clinical trials in which the antigen has been delivered orally in edible plant material indicate safety and immunogenicity.

  9. Internet-delivered lifestyle physical activity intervention: limited inflammation and antioxidant capacity efficacy in overweight adults.

    PubMed

    Smith, Derek T; Carr, Lucas J; Dorozynski, Chris; Gomashe, Chirag

    2009-01-01

    Overweight and physical inactivity are associated with elevated reactive oxygen species and chronic low-grade inflammation. Exercise training studies have measured changes in systemic inflammatory and oxidative/antioxidative biomarkers but predominantly at moderate-high intensities. Few low-intensity, lifestyle-based physical activity (PA) studies have been conducted. The purpose of this study was to determine whether improvements in lifestyle-oriented PA resulting from a 16-wk Internet-delivered PA program [Active Living Every Day-Internet (ALED-I)] elicit cardioprotective improvements in measures of inflammation, oxidation, or antioxidant enzyme capacity. Forty-one men and women (age 23-62 yr) were randomized to either the ALED-I intervention [n = 19; age = 40.4 +/- 1.9 yr; body mass index (BMI) = 31.4 +/- 1.1 kg/m(2)] or a delayed intent-to-treat control condition (n = 22; age = 46.6 +/- 1.3 yr; BMI = 31.0 +/- 0.7 kg/m(2)). TNF-alpha, C-reactive protein, myeloperoxidase, superoxide dismutase, catalase, total antioxidative capacity, change in PA, and other cardiometabolic disease risk factors were measured at baseline and postintervention. The ALED-I group increased PA and decreased central adiposity without changes in the control group. There was no change in the control group for any inflammation, oxidation, or antioxidant biomarkers. TNF-alpha decreased (P = 0.01) in the intervention group but was not statistically different from the control group. In conclusion, modest improvements in daily low-intensity ambulatory PA as a result of an Internet-delivered lifestyle PA intervention may be cardioprotective in sedentary and overweight adults through reductions in central adiposity and inflammation. However, the absence of favorable changes in other inflammation, oxidation, and antioxidant biomarkers highlights the need for further attention to the dose response of lifestyle-structured PA promotion strategies for health maintenance/improvement.

  10. Esophageal Cancer Dose Escalation Using a Simultaneous Integrated Boost Technique

    SciTech Connect

    Welsh, James; Palmer, Matthew B.; Ajani, Jaffer A.; Liao Zhongxing; Swisher, Steven G.; Hofstetter, Wayne L.; Allen, Pamela K.; Settle, Steven H.; Gomez, Daniel; Likhacheva, Anna; Cox, James D.; Komaki, Ritsuko

    2012-01-01

    Purpose: We previously showed that 75% of radiation therapy (RT) failures in patients with unresectable esophageal cancer are in the gross tumor volume (GTV). We performed a planning study to evaluate if a simultaneous integrated boost (SIB) technique could selectively deliver a boost dose of radiation to the GTV in patients with esophageal cancer. Methods and Materials: Treatment plans were generated using four different approaches (two-dimensional conformal radiotherapy [2D-CRT] to 50.4 Gy, 2D-CRT to 64.8 Gy, intensity-modulated RT [IMRT] to 50.4 Gy, and SIB-IMRT to 64.8 Gy) and optimized for 10 patients with distal esophageal cancer. All plans were constructed to deliver the target dose in 28 fractions using heterogeneity corrections. Isodose distributions were evaluated for target coverage and normal tissue exposure. Results: The 50.4 Gy IMRT plan was associated with significant reductions in mean cardiac, pulmonary, and hepatic doses relative to the 50.4 Gy 2D-CRT plan. The 64.8 Gy SIB-IMRT plan produced a 28% increase in GTV dose and comparable normal tissue doses as the 50.4 Gy IMRT plan; compared with the 50.4 Gy 2D-CRT plan, the 64.8 Gy SIB-IMRT produced significant dose reductions to all critical structures (heart, lung, liver, and spinal cord). Conclusions: The use of SIB-IMRT allowed us to selectively increase the dose to the GTV, the area at highest risk of failure, while simultaneously reducing the dose to the normal heart, lung, and liver. Clinical implications warrant systematic evaluation.

  11. Correlation of Point B and Lymph Node Dose in 3D-Planned High-Dose-Rate Cervical Cancer Brachytherapy

    SciTech Connect

    Lee, Larissa J.; Sadow, Cheryl A.; Russell, Anthony; Viswanathan, Akila N.</