Spot-Scanning Proton Radiation Therapy for Pediatric Chordoma and Chondrosarcoma: Clinical Outcome of 26 Patients Treated at Paul Scherrer Institute

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rombi, Barbara; ATreP; Ares, Carmen, E-mail: carmen.ares@psi.ch

Purpose: To evaluate the clinical results of fractionated spot-scanning proton radiation therapy (PT) in 26 pediatric patients treated at Paul Scherrer Institute for chordoma (CH) or chondrosarcoma (CS) of the skull base or axial skeleton. Methods and Materials: Between June 2000 and June 2010, 19 CH and 7 CS patients with tumors originating from the skull base (17) and the axial skeleton (9) were treated with PT. Mean age at the time of PT was 13.2 years. The mean prescribed dose was 74 Gy (relative biological effectiveness [RBE]) for CH and 66 Gy (RBE) for CS, at a dose ofmore » 1.8-2.0 Gy (RBE) per fraction. Results: Mean follow-up was 46 months. Actuarial 5-year local control (LC) rates were 81% for CH and 80% for CS. Actuarial 5-year overall survival (OS) was 89% for CH and 75% for CS. Two CH patients had local failures: one is alive with evidence of disease, while the other patient succumbed to local recurrence in the surgical pathway. One CS patient died of local progression of the disease. No high-grade late toxicities were observed. Conclusions: Spot-scanning PT for pediatric CH and CS patients resulted in excellent clinical outcomes with acceptable rates of late toxicity. Longer follow-up time and larger cohort are needed to fully assess tumor control and late effects of treatment.« less

Curative Treatment of Stage I Non-Small-Cell Lung Cancer in Patients With Severe COPD: Stereotactic Radiotherapy Outcomes and Systematic Review

DOE Office of Scientific and Technical Information (OSTI.GOV)

Palma, David, E-mail: david.palma@uwo.ca; Division of Radiation Oncology, London Regional Cancer Program, London, Ontario; Lagerwaard, Frank

2012-03-01

Objectives: Patients with severe chronic obstructive pulmonary disease (COPD) have a high risk of lung cancer and of postsurgical complications. We studied outcomes after stereotactic body radiotherapy (SBRT) in patients with severe COPD, as defined by Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, and performed a systematic review of the literature on outcomes after SBRT or surgery in these patients. Methods: A single-institution cohort of 176 patients with COPD GOLD III-IV and Stage I non-small-cell lung cancer (NSCLC) treated with SBRT was evaluated. A systematic review identified studies reporting outcomes after SBRT or surgery for Stage I NSCLCmore » in patients with GOLD III-IV or a predicted postoperative forced expiratory volume in 1 second (FEV1) of {<=}40%. Results: In the single-institution cohort, median follow-up was 21 months and median overall survival (OS) was 32 months. Actuarial 3-year local control was 89%, and 1- and 3-year OS were 79% and 47%, respectively. COPD severity correlated with OS (p = 0.01). The systematic review identified four other studies (two surgical, two SBRT, n = 196 patients). SBRT studies were published more recently and included older patients than surgical studies. Mean 30-day mortality was 0% post-SBRT and 10% after surgery. Local or locoregional control was high ({>=}89%) after both treatments. Post-SBRT, actuarial OS was 79-95% at 1 year and 43-70% at 3 years. Postsurgical actuarial OS was 45-86% at 1 year and 31-66% at 3 years. Conclusions: SBRT and surgery differ in risk of 30-day mortality in patients with severe COPD. Despite the negative selection of SBRT patients, survival at 1 and 3 years is comparable between the two treatments.« less

High-dose-rate interstitial brachytherapy for the treatment of high-volume locally recurrent endometrial carcinoma.

PubMed

Huang, Kitty; D'Souza, David; Patil, Nikhilesh; Velker, Vikram; Leung, Eric; Stitt, Larry; Whiston, Frances; Sugimoto, Akira; McGee, Jacob; Prefontaine, Michel

2016-01-01

Limited therapeutic options are available for the treatment of locally recurrent endometrial carcinoma. Our objective was to report an institutional experience using interstitial brachytherapy (IBT) to treat significant recurrent endometrial carcinoma, including previously irradiated disease. Between December 2004 and September 2012, 40 patients with high-volume locally recurrent endometrial cancer were treated by high-dose-rate IBT (± external beam radiation therapy EBRT). Sixteen patients had prior radiotherapy: EBRT alone (n = 5), intracavitary brachytherapy alone (n = 3), or EBRT with intracavitary brachytherapy boost (n = 8). Actuarial outcome rates were calculated using the Kaplan-Meier method and compared using the log-rank test. Median followup interval was 18 months. Median disease-free interval was 61 months. Actuarial local control, progression-free survival (PFS), and overall survival were 74% and 60%, 70% and 51%, and 83% and 72% at 12 and 24 months, respectively. p-Values for local control, progression-free survival, and overall survival between patient who had prior RT (n = 16) to no prior RT (n = 24) were p = 0.38, 0.32, and 0.90, respectively. Acute toxicities include Grade 1-2 pain (5%), genitourinary (7%), gastrointestinal (12%), soft tissue (5%), and dermatologic (12%). Four patients observed late Grade 3-4 toxicities, including rectal bleeding/fistula and soft tissue necrosis. High-dose-rate IBT is an effective treatment for locally recurrent endometrial carcinoma with an acceptable toxicity profile. Outcomes are similar between previously irradiated and nonirradiated patients. In women who have received prior radiotherapy and are often considered for palliative treatment, interstitial brachytherapy is a potentially curative option. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Toxicity and outcome of a phase II trial of taxane-based neoadjuvant chemotherapy and 3-dimensional, conformal, accelerated radiotherapy in locally advanced nonsmall cell lung cancer.

PubMed

Rojas, Ana M; Lyn, Basil E; Wilson, Elena M; Williams, Frances J; Shah, Nihal; Dickson, Jeanette; Saunders, Michele I

2006-09-15

The objective of this study was to evaluate prospectively the acute and late adverse effects of taxane/carboplatin neoadjuvant chemotherapy and 3-dimensional, conformal radiotherapy in patients with locally advanced nonsmall cell lung cancer (NSCLC). Forty-two patients were entered into a nonrandomized Phase II study of continuous, hyperfractionated, accelerated radiotherapy (CHART) week-end less (CHARTWEL) to a dose of 60 grays (Gy). Three cycles of chemotherapy were given over 9 weeks before radiotherapy. Dose escalation with paclitaxel was from 150 mg/m2 to 225 mg/m2. Systemic toxicity to chemotherapy was monitored throughout. Radiation-induced, early, adverse effects were assessed during the first 9 weeks from the start of radiotherapy, and late effects were assessed from 3 months onward. Overall survival, disease-free survival, and locoregional tumor control also were monitored. Twenty percent of patients failed to receive chemotherapy as planned, primarily because of neutropenia. The incidence of Dische Dictionary Grade >or=2 and Grade >or=3 dysphagia was 57.5% and 10%, respectively, with an average duration of 1.2 weeks and 1.5 days, respectively. By 9 weeks, <3% of patients were symptomatic; and, eventually, all acute reactions were healed, and there has been no evidence of consequential damage. At 6 months, the actuarial incidence of moderate-to-severe pneumonitis was 10%. During this time, all patients were free of severe pulmonary complications. Actuarial estimates of Grade >or=2 late lung dysfunction were 3% at 1 year, 10% at 2 years, and remained at this level thereafter. The actuarial 3-year locoregional control and overall survival rates were 54% and 45%, respectively. Neoadjuvant chemotherapy followed by 3-dimensional, conformal CHARTWEL 60-Gy radiotherapy in patients with advanced NSCLC was feasible and was tolerated well. Historic comparisons indicated that locoregional tumor control is not compromised by the use of conformal techniques. (c) 2006 American Cancer Society.

[Radiotherapy of squamous cell carcinomas of the tongue--a statistical review].

PubMed

Kubo, K; Furukawa, S; Fuchihata, H; Nakamura, M; Shimizutani, K; Nishiyama, K; Ikeda, H; Masaki, N

1989-01-01

The cases of 36 patients referred for radiotherapy of the tongue after an excisional biopsy or after an inadequate excision of the tongue cancer have been reviewed. In 32 patients treated by radiotherapy, the actuarial survival rate at five years was 86%, and the local rate control, was 82%. The local control rate for those treated by interstitial radiotherapy (Int. RT) was successful in 12 out of 13 cases, and the rates for those treated by external radiotherapy (Ext. RT) followed by Int. RT, or by the intraoral cone technique with electron beams (Elec.), or by Ext. RT, or by Elec. followed by Int. RT, or by no additional therapy were 7 out of 9, 4 out of 5, 2 out of 4, 1 out of 1, and 2 out of 4, respectively. For such cases of cancer, subsequent interstitial radiotherapy is advisable to maintain local control.

Outcomes of Node-positive Breast Cancer Patients Treated With Accelerated Partial Breast Irradiation Via Multicatheter Interstitial Brachytherapy: The Pooled Registry of Multicatheter Interstitial Sites (PROMIS) Experience.

PubMed

Kamrava, Mitchell; Kuske, Robert R; Anderson, Bethany; Chen, Peter; Hayes, John; Quiet, Coral; Wang, Pin-Chieh; Veruttipong, Darlene; Snyder, Margaret; Demanes, David J

2018-06-01

To report outcomes for breast-conserving therapy using adjuvant accelerated partial breast irradiation (APBI) with interstitial multicatheter brachytherapy in node-positive compared with node-negative patients. From 1992 to 2013, 1351 patients (1369 breast cancers) were treated with breast-conserving surgery and adjuvant APBI using interstitial multicatheter brachytherapy. A total of 907 patients (835 node negative, 59 N1a, and 13 N1mic) had >1 year of data available and nodal status information and are the subject of this analysis. Median age (range) was 59 years old (22 to 90 y). T stage was 90% T1 and ER/PR/Her2 was positive in 87%, 71%, and 7%. Mean number of axillary nodes removed was 12 (SD, 6). Cox multivariate analysis for local/regional control was performed using age, nodal stage, ER/PR/Her2 receptor status, tumor size, grade, margin, and adjuvant chemotherapy/antiestrogen therapy. The mean (SD) follow-up was 7.5 years (4.6). The 5-year actuarial local control (95% confidence interval) in node-negative versus node-positive patients was 96.3% (94.5-97.5) versus 95.8% (87.6-98.6) (P=0.62). The 5-year actuarial regional control in node-negative versus node-positive patients was 98.5% (97.3-99.2) versus 96.7% (87.4-99.2) (P=0.33). The 5-year actuarial freedom from distant metastasis and cause-specific survival were significantly lower in node-positive versus node-negative patients at 92.3% (82.4-96.7) versus 97.8% (96.3-98.7) (P=0.006) and 91.3% (80.2-96.3) versus 98.7% (97.3-99.3) (P=0.0001). Overall survival was not significantly different. On multivariate analysis age 50 years and below, Her2 positive, positive margin status, and not receiving chemotherapy or antiestrogen therapy were associated with a higher risk of local/regional recurrence. Patients who have had an axillary lymph node dissection and limited node-positive disease may be candidates for treatment with APBI. Further research is ultimately needed to better define specific criteria for APBI in node-positive patients.

Treatment of Locally Advanced Adenoid Cystic Carcinoma of the Trachea With Neutron Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bittner, Nathan; Koh, W.-J.; Laramore, George E.

2008-10-01

Purpose: To examine the efficacy of fast neutron radiotherapy in the treatment of locally advanced adenoid cystic carcinoma (ACC) of the trachea and to compare outcomes with and without high-dose-rate (HDR) endobronchial brachytherapy boost. Methods and Materials: Between 1989 and 2005, a total of 20 patients with ACC of the trachea were treated with fast neutron radiotherapy at University of Washington. Of these 20 patients, 19 were treated with curative intent. Neutron doses ranged from 10.7 to 19.95 Gy (median, 19.2 Gy). Six of these patients received an endobronchial brachytherapy boost using an HDR {sup 192}Ir source (3.5 Gy xmore » 2 fractions). Median duration of follow-up was 46 months (range, 10-121 months). Results: The 5-year actuarial overall survival rate and median overall survival for the entire cohort were 89.4%, and 97 months, respectively. Overall survival was not statistically different among those patients receiving an endobronchial boost compared with those receiving neutron radiotherapy alone (100% vs. 68%, p = 0.36). The 5-year actuarial locoregional control rate for the entire cohort was 54.1%. The locoregional control rate was not statistically different among patients who received an endobronchial boost compared with those who received neutron radiotherapy alone (40% vs. 58%, p 0.94). There were no cases of Grade {>=}3 acute toxicity. There were 2 cases of Grade 3/4 chronic toxicity. Conclusions: Fast neutron radiotherapy is an effective treatment for locally advanced adenoid cystic carcinoma of the trachea, with acceptable treatment-related toxicity.« less

Stereotactic Radiosurgery for the Treatment of Primary and Metastatic Spinal Sarcomas

PubMed Central

Balagamwala, Ehsan H.; Angelov, Lilyana; Suh, John H.; Djemil, Toufik; Magnelli, Anthony; Qi, Peng; Zhuang, Tingliang; Godley, Andrew

2016-01-01

Purpose: Despite advancements in local and systemic therapy, metastasis remains common in the natural history of sarcomas. Unfortunately, such metastases are the most significant source of morbidity and mortality in this heterogeneous disease. As a classically radioresistant histology, stereotactic radiosurgery has emerged to control spinal sarcomas and provide palliation. However, there is a lack of data regarding pain relief and relapse following stereotactic radiosurgery. Methods: We queried a retrospective institutional database of patients who underwent spine stereotactic radiosurgery for primary and metastatic sarcomas. The primary outcome was pain relief following stereotactic radiosurgery. Secondary outcomes included progression of pain, radiographic failure, and development of toxicities following treatment. Results: Forty treatment sites were eligible for inclusion; the median prescription dose was 16 Gy in a single fraction. Median time to radiographic failure was 14 months. At 6 and 12 months, radiographic control was 63% and 51%, respectively. Among patients presenting with pain, median time to pain relief was 1 month. Actuarial pain relief at 6 months was 82%. Median time to pain progression was 10 months; at 12 months, actuarial pain progression was 51%. Following multivariate analysis, presence of neurologic deficit at consult (hazard ratio: 2.48, P < .01) and presence of extraspinal bone metastases (hazard ratio: 2.83, P < .01) were associated with pain relief. Greater pain at consult (hazard ratio: 1.92, P < .01), prior radiotherapy (hazard ratio: 4.65, P = .02), and greater number of irradiated vertebral levels were associated with pain progression. Conclusions: Local treatment of spinal sarcomas has remained a challenge for decades, with poor rates of local control and limited pain relief following conventional radiotherapy. In this series, pain relief was achieved in 82% of treatments at 6 months, with half of patients experiencing pain progression by 12 months. Given minimal toxicity and suboptimal pain control at 12 months, dose escalation beyond 16 Gy is warranted. PMID:27074915

Clinical Outcomes of 130 Patients with Primary and Secondary Lung Tumors treated with Cyberknife Robotic Stereotactic Body Radiotherapy

PubMed Central

Jansen, Nicolas; Baart, Veronique; Devillers, Magali; Dechambre, David; Lenaerts, Eric; Seidel, Laurence; Barthelemy, Nicole; Berkovic, Patrick; Gulyban, Akos; Lakosi, Ferenc; Horvath, Zsolt; Coucke, Philippe A.

2017-01-01

Abstract Background Authors report clinical outcomes of patients treated with robotic stereotactic body radiotherapy (SBRT) for primary, recurrent and metastatic lung lesions. Patients and methods 130 patients with 160 lesions were treated with Cyberknife SBRT, including T1-3 primary lung cancers (54%), recurrent tumors (22%) and pulmonary metastases (24%). The mean biologically equivalent dose (BED10Gy) was 151 Gy (72–180 Gy). Median prescribed dose for peripheral and central lesions was 3×20 Gy and 3×15 Gy, respectively. Local control (LC), overall survival (OS), and cause-specific survival (CSS) rates, early and late toxicities are reported. Statistical analysis was performed to identify factors influencing local tumor control. Results Median follow-up time was 21 months. In univariate analysis, higher dose was associated with better LC and a cut-off value was detected at BED10Gy ≤ 112.5 Gy, resulting in 1-, 2-, and 3-year actuarial LC rates of 93%, vs 73%, 80% vs 61%, and 63% vs 54%, for the high and low dose groups, respectively (p = 0.0061, HR = 0.384). In multivariate analysis, metastatic origin, histological confirmation and larger Planning Target Volume (PTV) were associated with higher risk of local failure. Actuarial OS and CSS rates at 1, 2, and 3 years were 85%, 74% and 62%, and 93%, 89% and 80%, respectively. Acute and late toxicities ≥ Gr 3 were observed in 3 (2%) and 6 patients (5%), respectively. Conclusions Our favorable LC and survival rates after robotic SBRT, with low rates of severe toxicities, are coherent with the literature data in this mixed, non-selected study population. PMID:28740453

20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Selection of members of Actuarial Advisory Committee. 200.9 Section 200.9 Employees' Benefits RAILROAD RETIREMENT BOARD GENERAL ADMINISTRATION GENERAL... railroad subject to the Interstate Commerce Act which own or control more than 50 percent of the total...

Insights into managed care--operational, legal and actuarial.

PubMed

Melek, S P; Johnson, B A; Schryver, D

1997-01-01

Understanding the operational, legal and actuarial dimensions of managed care is essential to developing managed care contracts between managed care organizations and individual health care providers or groups such as provider-sponsored organizations or independent practice associations. Operationally, it is important to understand managed care and its trends, emphasizing business issues, knowing your practice and defining acceptable levels of reimbursement and risk. Legally, there are a number of common themes or issues relevant to all managed care contracts, including primary care vs. specialist contracts, services offered, program policies and procedures, utilization review, physician reimbursement and compensation, payment schedule, terms and conditions, term and termination, continuation of care requirements, indemnification, amendment of contract and program policies, and stop-loss insurance. Actuarial issues include membership, geography, age-gender distribution, degree of health care management, local managed care utilization levels, historical utilization levels, health plan benefit design, among others.

20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

Code of Federal Regulations, 2014 CFR

2014-04-01

... actuaries to serve on an Actuarial Advisory Committee. This section describes how the two actuaries are selected. (b) Carrier actuary. One member of the Actuarial Advisory Committee shall be selected by... railroad mileage within the United States. (c) Railway labor actuary. The other member of the Actuarial...

20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

Code of Federal Regulations, 2013 CFR

2013-04-01

... actuaries to serve on an Actuarial Advisory Committee. This section describes how the two actuaries are selected. (b) Carrier actuary. One member of the Actuarial Advisory Committee shall be selected by... railroad mileage within the United States. (c) Railway labor actuary. The other member of the Actuarial...

20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

Code of Federal Regulations, 2011 CFR

2011-04-01

... actuaries to serve on an Actuarial Advisory Committee. This section describes how the two actuaries are selected. (b) Carrier actuary. One member of the Actuarial Advisory Committee shall be selected by... railroad mileage within the United States. (c) Railway labor actuary. The other member of the Actuarial...

20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

Code of Federal Regulations, 2012 CFR

2012-04-01

... actuaries to serve on an Actuarial Advisory Committee. This section describes how the two actuaries are selected. (b) Carrier actuary. One member of the Actuarial Advisory Committee shall be selected by... railroad mileage within the United States. (c) Railway labor actuary. The other member of the Actuarial...

'Boomerang' technique: an improved method for conformal treatment of locally advanced nasopharyngeal cancer.

PubMed

Corry, June; Hornby, Colin; Fisher, Richard; D'Costa, Ieta; Porceddu, Sandro; Rischin, Danny; Peters, Lester J

2004-06-01

The primary aim of the present study was to assess radiation dosimetry and subsequent clinical outcomes in patients with locally advanced nasopharyngeal cancer using a novel radiation technique termed the 'Boomerang'. Dosimetric comparisons were made with both conventional and intensity modulated radiation therapy (IMRT) techniques. This is a study of 22 patients treated with this technique from June 1995 to October 1998. The technique used entailed delivery of 36 Gy in 18 fractions via parallel opposed fields, then 24 Gy in 12 fractions via asymmetric rotating arc fields for a total of 60 Gy in 30 fractions. Patients also received induction and concurrent chemotherapy. The radiation dosimetry was excellent. Dose-volume histograms showed that with the arc fields, 90% of the planning target volume received 94% of the prescribed dose. Relative to other conventional radiation therapy off-cord techniques, the Boomerang technique results in a 27% greater proportion of the prescribed dose being received by 90% of the planning target volume. This translates into an overall 10% greater dose received for the same prescribed dose. At 3 years, the actuarial loco-regional control rate, the failure-free survival rate and the overall survival rate were 91, 75 and 91%, respectively. At 5 years, the actuarial loco-regional control rate, the failure-free survival rate and the overall survival rate were 74, 62 and 71%, respectively. The Boomerang technique provided excellent radiation dosimetry with correspondingly good loco-regional control rates (in conjunction with chemotherapy) and very acceptable acute and late toxicity profiles. Because treatment can be delivered with conventional standard treatment planning and delivery systems, it is a validated treatment option for centres that do not have the capability or capacity for IMRT. A derivative of the Boomerang technique, excluding the parallel opposed component, is now our standard for patients with locally advanced nasopharyngeal cancer when IMRT is not available.

Extended (5-year) Outcomes of Accelerated Partial Breast Irradiation Using MammoSite Balloon Brachytherapy: Patterns of Failure, Patient Selection, and Dosimetric Correlates for Late Toxicity

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vargo, John A.; Verma, Vivek; Kim, Hayeon

2014-02-01

Purpose: Accelerated partial breast irradiation (APBI) with balloon and catheter-based brachytherapy has gained increasing popularity in recent years and is the subject of ongoing phase III trials. Initial data suggest promising local control and cosmetic results in appropriately selected patients. Long-term data continue to evolve but are limited outside of the context of the American Society of Breast Surgeons Registry Trial. Methods and Materials: A retrospective review of 157 patients completing APBI after breast-conserving surgery and axillary staging via high-dose-rate {sup 192}Ir brachytherapy from June 2002 to December 2007 was made. APBI was delivered with a single-lumen MammoSite balloon-based applicatormore » to a median dose of 34 Gy in 10 fractions over a 5-day period. Tumor coverage and critical organ dosimetry were retrospectively collected on the basis of computed tomography completed for conformance and symmetry. Results: At a median follow-up time of 5.5 years (range, 0-10.0 years), the 5-year and 7-year actuarial incidences of ipsilateral breast control were 98%/98%, of nodal control 99%/98%, and of distant control 99%/99%, respectively. The crude rate of ipsilateral breast recurrence was 2.5% (n=4); of nodal failure, 1.9% (n=3); and of distant failure, 0.6% (n=1). The 5-year and 7-year actuarial overall survival rates were 89%/86%, with breast cancer–specific survival of 100%/99%, respectively. Good to excellent cosmetic outcomes were achieved in 93.4% of patients. Telangiectasia developed in 27% of patients, with 1-year, 3-year, and 5-year actuarial incidence of 7%/24%/33%; skin dose >100% significantly predicted for the development of telangiectasia (50% vs 14%, P<.0001). Conclusions: Long-term single-institution outcomes suggest excellent tumor control, breast cosmesis, and minimal late toxicity. Skin toxicity is a function of skin dose, which may be ameliorated with dosimetric optimization afforded by newer multicatheter brachytherapy applicators and a more rigorous skin dose constraint of ≤100%.« less

Stereotactic body radiation therapy for abdominal oligometastases: a biological and clinical review

PubMed Central

2012-01-01

Advances in imaging and biological targeting have led to the development of stereotactic body radiation therapy (SBRT) as an alternative treatment of extracranial oligometastases. New radiobiological concepts, such as ceramide-induced endothelial apoptosis after hypofractionated high-dose SBRT, and the identification of patients with oligometastatic disease by microRNA expression may yet lead to further developments. Key factors in SBRT are delivery of a high dose per fraction, proper patient positioning, target localisation, and management of breathing–related motion. Our review addresses the radiation doses and schedules used to treat liver, abdominal lymph node (LN) and adrenal gland oligometastases and treatment outcomes. Reported local control (LC) rates for liver and abdominal LN oligometastases are high (median 2-year actuarial LC: 61 -100% for liver oligometastases; 4-year actuarial LC: 68% in a study of abdominal LN oligometastases). Early toxicity is low-to-moderate; late adverse effects are rare. SBRT of adrenal gland oligometastases shows promising results in the case of isolated lesions. In conclusion, properly conducted SBRT procedures are a safe and effective treatment option for abdominal oligometastases. PMID:22852764

Current Dosing Paradigm for Stereotactic Radiosurgery Alone After Surgical Resection of Brain Metastases Needs to Be Optimized for Improved Local Control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prabhu, Roshan; Shu, Hui-Kuo; Winship Cancer Institute, Emory University, Atlanta, GA

2012-05-01

Purpose: To describe the use of radiosurgery (RS) alone to the resection cavity after resection of brain metastases as an alternative to adjuvant whole-brain radiotherapy (WBRT). Methods and Materials: Sixty-two patients with 64 cavities were treated with linear accelerator-based RS alone to the resection cavity after surgical removal of brain metastases between March 2007 and August 2010. Fifty-two patients (81%) had a gross total resection. Median cavity volume was 8.5 cm{sup 3}. Forty-four patients (71%) had a single metastasis. Median marginal and maximum doses were 18 Gy and 20.4 Gy, respectively. Sixty-one cavities (95%) had gross tumor volume to planningmore » target volume expansion of {>=}1 mm. Results: Six-month and 1-year actuarial local recurrence rates were 14% and 22%, respectively, with a median follow-up period of 9.7 months. Six-month and 1-year actuarial distant brain recurrence, total intracranial recurrence, and freedom from WBRT rates were 31% and 51%, 41% and 63%, and 91% and 74%, respectively. The symptomatic cavity radiation necrosis rate was 8%, with 2 patients (3%) undergoing surgery. Of the 11 local failures, 8 were in-field, 1 was marginal, and 2 were both (defined as in-field if {>=}90% of recurrence within the prescription isodose and marginal if {>=}90% outside of the prescription isodose). Conclusions: The high rate of in-field cavity failure suggests that geographic misses with highly conformal RS are not a major contributor to local recurrence. The current dosing regimen derived from Radiation Therapy Oncology Group protocol 90-05 should be optimized in this patient population before any direct comparison with WBRT.« less

20 CFR 901.1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... during which the actuary spent a substantial amount of time in responsible actuarial experience. (d... month during which the actuary spent a substantial amount of time in responsible pension actuarial...

20 CFR 901.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... during which the actuary spent a substantial amount of time in responsible actuarial experience. (d... month during which the actuary spent a substantial amount of time in responsible pension actuarial...

20 CFR 901.1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... during which the actuary spent a substantial amount of time in responsible actuarial experience. (d... month during which the actuary spent a substantial amount of time in responsible pension actuarial...

The Casualty Actuarial Society: Helping Universities Train Future Actuaries

ERIC Educational Resources Information Center

Boa, J. Michael; Gorvett, Rick

2014-01-01

The Casualty Actuarial Society (CAS) believes that the most effective way to advance the actuarial profession is to work in partnership with universities. The CAS stands ready to assist universities in creating or enhancing courses and curricula associated with property/casualty actuarial science. CAS resources for university actuarial science…

42 CFR 422.254 - Submission of bids.

Code of Federal Regulations, 2014 CFR

2014-10-01

... accepted actuarial principles. (i) A qualified actuary must certify the plan's actuarial valuation (which may be prepared by others under his or her direction or review). (ii) To be deemed a qualified actuary, the actuary must be a member of the American Academy of Actuaries. (iii) Applicants may use qualified...

42 CFR 422.254 - Submission of bids.

Code of Federal Regulations, 2010 CFR

2010-10-01

... principles. (i) A qualified actuary must certify the plan's actuarial valuation (which may be prepared by others under his or her direction or review). (ii) To be deemed a qualified actuary, the actuary must be a member of the American Academy of Actuaries. (iii) Applicants may use qualified outside actuaries...

Are we selecting the right patients for treatment of localized prostate cancer? Results of an actuarial analysis.

PubMed

Koch, M O; Miller, D A; Butler, R; Lebos, L; Collings, D; Smith, J A

1998-02-01

To determine our accuracy in selecting patients with at least a 10-year life expectancy for aggressive treatment of localized prostate cancer. The medical records of 261 consecutive patients who underwent radical retropubic prostatectomy were submitted to the actuarial division of American General Life and Accident Insurance Company (AGLA) for estimation of life expectancy, excluding the diagnosis of prostate cancer. Survival curves were generated from predicted individual survivals. In patients with less than a 10-year life expectancy, AGLA provided us with the basis for assigning suboptimal survival rates. The mean life expectancy for the group was 15.2 years. Two hundred ten men (80%) were projected to have a life expectancy of more than 10 years, including 27 of 55 (49%) and 4 of 8 (50%) men who were older than or equal to 70 and 75 years of age, respectively. Coronary artery disease and diabetes mellitus were the most common coexisting medical conditions that adversely affected risk as single disease entities. Although clinicians do not estimate life expectancy with the scientific exactitude of an actuary, the ability to assess the patient in person and assimilate pertinent medical information in a less rigid format yields similar results. Selection of men for definitive treatment of localized prostate cancer should be based on the inherent aggressiveness of the disease and the health of the individual and should not be limited by specific age cutoffs. Populations of men undergoing radical prostatectomy are younger and healthier than those in reported series of watchful waiting for prostate cancer.

Excellent Local Control Rates and Distinctive Patterns of Failure in Myxoid Liposarcoma Treated With Conservation Surgery and Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Guadagnolo, B. Ashleigh; Zagars, Gunar K.; Ballo, Matthew T.

2008-03-01

Purpose: To evaluate the local control rates and patterns of metastatic relapse in patients with localized myxoid liposarcoma treated with conservation surgery and radiotherapy (RT). Patients and Methods: Between 1960 and 2003, 127 patients with non-metastatic myxoid liposarcoma were treated with conservation surgery and RT at our institution. The median patient age was 39 years (range, 14-79 years). Of the 127 patients, 46% underwent preoperative RT (median dose, 50 Gy) and 54% underwent postoperative RT (median dose, 60 Gy). Also, 28% received doxorubicin-based chemotherapy as a part of their treatment. Results: The median follow-up was 9.1 years. The overall survivalmore » rate at 5 and 10 years was 87% and 79%, respectively. The corresponding disease-free survival rates were 81% and 73%. The local control rate at {>=}5 years was 97%. The actuarial rate of distant metastases at 5 and 10 years was 15% and 24%, respectively. Of the 27 patients who developed distant metastases, 48% did so in the retroperitoneum, 22% in other extrapulmonary soft tissues, 22% in the lung, 15% in bone, and 4% in the liver. Conclusion: The results of our study have shown that RT and conservation surgery for localized myxoid liposarcoma provide excellent local control. Distant metastatic relapse tended to occur in the retroperitoneum and other nonpulmonary soft tissues. Therefore, staging and surveillance imaging should include the abdomen and pelvis, as well as the thorax, for patients with localized myxoid liposarcoma.« less

Effectiveness and Safety of Spot Scanning Proton Radiation Therapy for Chordomas and Chondrosarcomas of the Skull Base: First Long-Term Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ares, Carmen, E-mail: carmen.ares@psi.c; Hug, Eugen B.; Lomax, Antony J.

2009-11-15

Purpose: To evaluate effectiveness and safety of spot-scanning-based proton radiotherapy (PT) in skull-base chordomas and chondrosarcomas. Methods and Materials: Between October 1998 and November 2005, 64 patients with skull-base chordomas (n = 42) and chondrosarcomas (n = 22) were treated at Paul Scherrer Institute with PT using spot-scanning technique. Median total dose for chordomas was 73.5 Gy(RBE) and 68.4 Gy(RBE) for chondrosarcomas at 1.8-2.0 Gy(RBE) dose per fraction. Local control (LC), disease specific survival (DSS), and overall survival (OS) rates were calculated. Toxicity was assessed according to CTCAE, v. 3.0. Results: Mean follow-up period was 38 months (range, 14-92 months).more » Five patients with chordoma and one patient with chondrosarcoma experienced local recurrence. Actuarial 5-year LC rates were 81% for chordomas and 94% for chondrosarcomas. Brainstem compression at the time of PT (p = 0.007) and gross tumor volume >25 mL (p = 0.03) were associated with lower LC rates. Five years rates of DSS and OS were 81% and 62% for chordomas and 100% and 91% for chondrosarcomas, respectively. High-grade late toxicity consisted of one patient with Grade 3 and one patient with Grade 4 unilateral optic neuropathy, and two patients with Grade 3 central nervous system necrosis. No patient experienced brainstem toxicity. Actuarial 5-year freedom from high-grade toxicity was 94%. Conclusions: Our data indicate safety and efficacy of spot-scanning based PT for skull-base chordomas and chondrosarcomas. With target definition, dose prescription and normal organ tolerance levels similar to passive-scattering based PT series, complication-free, tumor control and survival rates are at present comparable.« less

20 CFR 901.70 - Records.

Code of Federal Regulations, 2013 CFR

2013-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... Joint Board for the Enrollment of Actuaries a roster of all persons enrolled to perform actuarial... applicable disclosure and privacy statutes. (b) Disciplinary procedures. A request by an enrolled actuary...

75 FR 63505 - Renewal of Advisory Committee on Actuarial Examinations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-15

... actuarial mathematics and methodology. The Joint Board administers such examinations in discharging its... JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES Renewal of Advisory Committee on Actuarial... Committee on Actuarial Examinations. FOR FURTHER INFORMATION CONTACT: Patrick W. McDonough, 202-622-8225...

20 CFR 901.0 - Scope.

Code of Federal Regulations, 2014 CFR

2014-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... perform actuarial services; subpart B of this part sets forth rules governing the enrollment of actuaries; subpart C of this part sets forth standards of performance to which enrolled actuaries must adhere...

20 CFR 901.0 - Scope.

Code of Federal Regulations, 2011 CFR

2011-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... perform actuarial services; subpart B of this part sets forth rules governing the enrollment of actuaries; subpart C of this part sets forth standards of performance to which enrolled actuaries must adhere...

20 CFR 901.0 - Scope.

Code of Federal Regulations, 2013 CFR

2013-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... perform actuarial services; subpart B of this part sets forth rules governing the enrollment of actuaries; subpart C of this part sets forth standards of performance to which enrolled actuaries must adhere...

20 CFR 901.0 - Scope.

Code of Federal Regulations, 2012 CFR

2012-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... perform actuarial services; subpart B of this part sets forth rules governing the enrollment of actuaries; subpart C of this part sets forth standards of performance to which enrolled actuaries must adhere...

20 CFR 901.0 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... perform actuarial services; subpart B of this part sets forth rules governing the enrollment of actuaries; subpart C of this part sets forth standards of performance to which enrolled actuaries must adhere...

Spinal and Paraspinal Ewing Tumors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Indelicato, Daniel J., E-mail: dindelicato@floridaproton.or; University of Florida Proton Therapy Institute, Jacksonville, FL; Keole, Sameer R.

Purpose: To perform a review of the 40-year University of Florida experience treating spinal and paraspinal Ewing tumors. Patients and Methods: A total of 27 patients were treated between 1965 and 2007. For local management, 21 patients were treated with radiotherapy (RT) alone and 6 with surgery plus RT. All patients with metastatic disease were treated with RT alone. The risk profiles of each group were otherwise similar. The median age was 17 years, and the most frequent subsite was the sacral spine (n = 9). The median potential follow-up was 16 years. Results: The 5-year actuarial overall survival, cause-specificmore » survival, and local control rate was 62%, 62%, and 90%, respectively. For the nonmetastatic subset (n = 22), the 5-year overall survival, cause-specific survival, and local control rate was 71%, 71%, and 89%, respectively. The local control rate was 84% for patients treated with RT alone vs. 100% for those treated with surgery plus RT. Patients who were >14 years old and those who were treated with intensive therapy demonstrated superior local control. Of 9 patients in our series with Frankel C or greater neurologic deficits at presentation, 7 experienced a full recovery with treatment. Of the 27 patients, 37% experienced Common Toxicity Criteria Grade 3 or greater toxicity, including 2 deaths from sepsis. Conclusion: Aggressive management of spinal and paraspinal Ewing tumors with RT with or without surgery results in high toxicity but excellent local control and neurologic outcomes. Efforts should be focused on identifying disease amenable to combined modality local therapy and improving RT techniques.« less

77 FR 63337 - Renewal of Charter of Advisory Committee on Actuarial Examinations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-16

... examinations in actuarial mathematics and methodology. The Joint Board administers such examinations in... JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES Renewal of Charter of Advisory Committee on Actuarial... the Advisory Committee on Actuarial Examinations. FOR FURTHER INFORMATION CONTACT: Patrick McDonough...

Adaptive and Optimal Control of Stochastic Dynamical Systems

DTIC Science & Technology

2015-09-14

Advances in Statistics, Probability and Actuarial Sciences , Vol. 1, World Scientific, 2012, 451- 463. [4] T. E. Duncan and B. Pasik-Duncan, A...S. N. Cohen, T. K. Siu and H. Yang) Advances in Statistics, Probability and Actuarial Sciences , Vol. 1, World Scientific, 2012, 451-463. 4. T. E...games with gen- eral noise processes, Models and Methods in Economics and Management Science : Essays in Honor of Charles S. Tapiero, (eds. F. El

Preliminary experience in treatment of papillary and macular retinoblastoma: evaluation of local control and local complications after treatment with linear accelerator-based stereotactic radiotherapy with micromultileaf collimator as second-line or salvage treatment after chemotherapy.

PubMed

Pica, Alessia; Moeckli, Raphael; Balmer, Aubin; Beck-Popovic, Maja; Chollet-Rivier, Madeleine; Do, Huu-Phuoc; Weber, Damien C; Munier, Francis L

2011-12-01

To determine the local control and complication rates for children with papillary and/or macular retinoblastoma progressing after chemotherapy and undergoing stereotactic radiotherapy (SRT) with a micromultileaf collimator. Between 2004 and 2008, 11 children (15 eyes) with macular and/or papillary retinoblastoma were treated with SRT. The mean age was 19 months (range, 2-111). Of the 15 eyes, 7, 6, and 2 were classified as International Classification of Intraocular Retinoblastoma Group B, C, and E, respectively. The delivered dose of SRT was 50.4 Gy in 28 fractions using a dedicated micromultileaf collimator linear accelerator. The median follow-up was 20 months (range, 13-39). Local control was achieved in 13 eyes (87%). The actuarial 1- and 2-year local control rates were both 82%. SRT was well tolerated. Late adverse events were reported in 4 patients. Of the 4 patients, 2 had developed focal microangiopathy 20 months after SRT; 1 had developed a transient recurrence of retinal detachment; and 1 had developed bilateral cataracts. No optic neuropathy was observed. Linear accelerator-based SRT for papillary and/or macular retinoblastoma in children resulted in excellent tumor control rates with acceptable toxicity. Additional research regarding SRT and its intrinsic organ-at-risk sparing capability is justified in the framework of prospective trials. Copyright © 2011 Elsevier Inc. All rights reserved.

Preliminary Experience in Treatment of Papillary and Macular Retinoblastoma: Evaluation of Local Control and Local Complications After Treatment With Linear Accelerator-Based Stereotactic Radiotherapy With Micromultileaf Collimator as Second-Line or Salvage Treatment After Chemotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pica, Alessia, E-mail: Alessia.Pica@chuv.ch; Moeckli, Raphael; Balmer, Aubin

2011-12-01

Purpose: To determine the local control and complication rates for children with papillary and/or macular retinoblastoma progressing after chemotherapy and undergoing stereotactic radiotherapy (SRT) with a micromultileaf collimator. Methods and Materials: Between 2004 and 2008, 11 children (15 eyes) with macular and/or papillary retinoblastoma were treated with SRT. The mean age was 19 months (range, 2-111). Of the 15 eyes, 7, 6, and 2 were classified as International Classification of Intraocular Retinoblastoma Group B, C, and E, respectively. The delivered dose of SRT was 50.4 Gy in 28 fractions using a dedicated micromultileaf collimator linear accelerator. Results: The median follow-upmore » was 20 months (range, 13-39). Local control was achieved in 13 eyes (87%). The actuarial 1- and 2-year local control rates were both 82%. SRT was well tolerated. Late adverse events were reported in 4 patients. Of the 4 patients, 2 had developed focal microangiopathy 20 months after SRT; 1 had developed a transient recurrence of retinal detachment; and 1 had developed bilateral cataracts. No optic neuropathy was observed. Conclusions: Linear accelerator-based SRT for papillary and/or macular retinoblastoma in children resulted in excellent tumor control rates with acceptable toxicity. Additional research regarding SRT and its intrinsic organ-at-risk sparing capability is justified in the framework of prospective trials.« less

42 CFR 403.258 - Statement of actuarial opinion.

Code of Federal Regulations, 2011 CFR

2011-10-01

... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions used... policy experience, if any, and reasonable expectations. (b) Qualified actuary means— (1) A member in good standing of the American Academy of Actuaries; or (2) A person who has otherwise demonstrated his or her...

42 CFR 403.258 - Statement of actuarial opinion.

Code of Federal Regulations, 2012 CFR

2012-10-01

... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions used... policy experience, if any, and reasonable expectations. (b) Qualified actuary means— (1) A member in good standing of the American Academy of Actuaries; or (2) A person who has otherwise demonstrated his or her...

42 CFR 403.258 - Statement of actuarial opinion.

Code of Federal Regulations, 2013 CFR

2013-10-01

... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions used... policy experience, if any, and reasonable expectations. (b) Qualified actuary means— (1) A member in good standing of the American Academy of Actuaries; or (2) A person who has otherwise demonstrated his or her...

42 CFR 403.258 - Statement of actuarial opinion.

Code of Federal Regulations, 2014 CFR

2014-10-01

... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions used... policy experience, if any, and reasonable expectations. (b) Qualified actuary means— (1) A member in good standing of the American Academy of Actuaries; or (2) A person who has otherwise demonstrated his or her...

20 CFR 901.2 - Eligibility to perform actuarial services.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... 901.2 Section 901.2 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS.... (a) Enrolled actuary. Subject to the standards of performance set forth in subpart C of this part, any individual who is an enrolled actuary as defined in § 901.1(g) may perform actuarial services...

20 CFR 901.2 - Eligibility to perform actuarial services.

Code of Federal Regulations, 2012 CFR

2012-04-01

.... 901.2 Section 901.2 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS.... (a) Enrolled actuary. Subject to the standards of performance set forth in subpart C of this part, any individual who is an enrolled actuary as defined in § 901.1(g) may perform actuarial services...

20 CFR 901.2 - Eligibility to perform actuarial services.

Code of Federal Regulations, 2013 CFR

2013-04-01

.... 901.2 Section 901.2 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS.... (a) Enrolled actuary. Subject to the standards of performance set forth in subpart C of this part, any individual who is an enrolled actuary as defined in § 901.1(g) may perform actuarial services...

20 CFR 901.2 - Eligibility to perform actuarial services.

Code of Federal Regulations, 2014 CFR

2014-04-01

.... 901.2 Section 901.2 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS.... (a) Enrolled actuary. Subject to the standards of performance set forth in subpart C of this part, any individual who is an enrolled actuary as defined in § 901.1(g) may perform actuarial services...

42 CFR 403.258 - Statement of actuarial opinion.

Code of Federal Regulations, 2010 CFR

2010-10-01

... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions used... policy experience, if any, and reasonable expectations. (b) Qualified actuary means— (1) A member in good standing of the American Academy of Actuaries; or (2) A person who has otherwise demonstrated his or her...

20 CFR 901.2 - Eligibility to perform actuarial services.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... 901.2 Section 901.2 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS.... (a) Enrolled actuary. Subject to the standards of performance set forth in subpart C of this part, any individual who is an enrolled actuary as defined in § 901.1(g) may perform actuarial services...

42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

Code of Federal Regulations, 2010 CFR

2010-10-01

...— (1) By an individual who is a member of the American Academy of Actuaries; (2) Using generally accepted actuarial principles and methodologies of the American Academy of Actuaries; (3) Using a... coverage. (c) The actuary who prepares the opinion must select and specify the standardized set and...

75 FR 22754 - Federal Advisory Committee; Department of Defense Board of Actuaries; Charter Renewal

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-30

... Board of Actuaries; Charter Renewal AGENCY: Department of Defense (DoD). ACTION: Renewal of Federal... Department of Defense Board of Actuaries (hereafter referred to as the Board). FOR FURTHER INFORMATION... qualified professional actuaries who are members of the Society of Actuaries. Board members shall be...

The case for an actuary.

PubMed

Renaud, Patrick N

2002-12-01

The author describes the role of the actuary, the need for qualified actuaries and how to find them. Qualified actuarial help, in the form of a Fellow of the Society of Actuaries (FSA), is necessary to ensure the best outcome when setting annual premium rates and realistic budgets for self-funded group benefit plans.

Which is the optimal risk stratification system for surgically treated localized primary GIST? Comparison of three contemporary prognostic criteria in 171 tumors and a proposal for a modified Armed Forces Institute of Pathology risk criteria.

PubMed

Goh, Brian K P; Chow, Pierce K H; Yap, Wai-Ming; Kesavan, Sittampalam M; Song, In-Chin; Paul, Pradeep G; Ooi, Boon-Swee; Chung, Yaw-Fui A; Wong, Wai-Keong

2008-08-01

This study aims to validate and compare the performance of the National Institute of Health (NIH) criteria, Huang modified NIH criteria, and Armed Forces Institute of Pathology (AFIP) risk criteria for gastrointestinal stromal tumors (GISTs) in a large series of localized primary GISTs surgically treated at a single institution to determine the ideal risk stratification system for GIST. The clinicopathological features of 171 consecutive patients who underwent surgical resection for GISTs were retrospectively reviewed. Statistical analyses were performed to compare the prognostic value of the three risk criteria by analyzing the discriminatory ability linear trend, homogeneity, monotonicity of gradients, and Akaike information criteria. The median actuarial recurrence-free survival (RFS) for all 171 patients was 70%. On multivariate analyses, size >10 cm, mitotic count >5/50 high-power field, tumor necrosis, and serosal involvement were independent prognostic factors of RFS. All three risk criteria demonstrated a statistically significant difference in the recurrence rate, median actuarial RFS, actuarial 5-year RFS, and tumor-specific death across the different stages. Comparison of the various risk-stratification systems demonstrated that our proposed modified AFIP criteria had the best independent predictive value of RFS when compared with the other systems. The NIH, modified NIH, and AFIP criteria are useful in the prognostication of GIST, and the AFIP risk criteria provided the best prognostication among the three systems for primary localized GIST. However, remarkable prognostic heterogeneity exists in the AFIP high-risk category, and with our proposed modification, this system provides the most accurate prognostic information.

20 CFR 901.32 - Receipt of information concerning enrolled actuaries.

Code of Federal Regulations, 2011 CFR

2011-04-01

... actuaries. 901.32 Section 901.32 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Suspension or Termination of Enrollment § 901.32 Receipt of information concerning enrolled actuaries. If an... Guaranty Corporation, or a member of the Joint Board has reason to believe that an enrolled actuary has...

20 CFR 901.20 - Standards of performance of actuarial services.

Code of Federal Regulations, 2011 CFR

2011-04-01

... services. 901.20 Section 901.20 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Standards of Performance for Enrolled Actuaries § 901.20 Standards of performance of actuarial services. In the discharge of duties required by ERISA of enrolled actuaries with respect to any plan to which the...

26 CFR 301.6059-1 - Periodic report of actuary.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Periodic report of actuary. 301.6059-1 Section...-1 Periodic report of actuary. (a) In general. The actuarial report described in this section must be... funding deficiency (as defined in section 412(a)) to zero, (4) A statement by the enrolled actuary signing...

20 CFR 901.20 - Standards of performance of actuarial services.

Code of Federal Regulations, 2014 CFR

2014-04-01

... services. 901.20 Section 901.20 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Standards of Performance for Enrolled Actuaries § 901.20 Standards of performance of actuarial services. In the discharge of duties required by ERISA of enrolled actuaries with respect to any plan to which the...

20 CFR 901.32 - Receipt of information concerning enrolled actuaries.

Code of Federal Regulations, 2013 CFR

2013-04-01

... actuaries. 901.32 Section 901.32 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Suspension or Termination of Enrollment § 901.32 Receipt of information concerning enrolled actuaries. If an... Guaranty Corporation, or a member of the Joint Board has reason to believe that an enrolled actuary has...

26 CFR 301.6059-1 - Periodic report of actuary.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Periodic report of actuary. 301.6059-1 Section...-1 Periodic report of actuary. (a) In general. The actuarial report described in this section must be... funding deficiency (as defined in section 412(a)) to zero, (4) A statement by the enrolled actuary signing...

20 CFR 901.32 - Receipt of information concerning enrolled actuaries.

Code of Federal Regulations, 2012 CFR

2012-04-01

... actuaries. 901.32 Section 901.32 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Suspension or Termination of Enrollment § 901.32 Receipt of information concerning enrolled actuaries. If an... Guaranty Corporation, or a member of the Joint Board has reason to believe that an enrolled actuary has...

20 CFR 901.32 - Receipt of information concerning enrolled actuaries.

Code of Federal Regulations, 2014 CFR

2014-04-01

... actuaries. 901.32 Section 901.32 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Suspension or Termination of Enrollment § 901.32 Receipt of information concerning enrolled actuaries. If an... Guaranty Corporation, or a member of the Joint Board has reason to believe that an enrolled actuary has...

26 CFR 301.6059-1 - Periodic report of actuary.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Periodic report of actuary. 301.6059-1 Section...-1 Periodic report of actuary. (a) In general. The actuarial report described in this section must be... funding deficiency (as defined in section 412(a)) to zero, (4) A statement by the enrolled actuary signing...

20 CFR 901.20 - Standards of performance of actuarial services.

Code of Federal Regulations, 2012 CFR

2012-04-01

... services. 901.20 Section 901.20 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Standards of Performance for Enrolled Actuaries § 901.20 Standards of performance of actuarial services. In the discharge of duties required by ERISA of enrolled actuaries with respect to any plan to which the...

26 CFR 301.6059-1 - Periodic report of actuary.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Periodic report of actuary. 301.6059-1 Section...-1 Periodic report of actuary. (a) In general. The actuarial report described in this section must be... funding deficiency (as defined in section 412(a)) to zero, (4) A statement by the enrolled actuary signing...

20 CFR 901.20 - Standards of performance of actuarial services.

Code of Federal Regulations, 2013 CFR

2013-04-01

... services. 901.20 Section 901.20 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Standards of Performance for Enrolled Actuaries § 901.20 Standards of performance of actuarial services. In the discharge of duties required by ERISA of enrolled actuaries with respect to any plan to which the...

20 CFR 901.32 - Receipt of information concerning enrolled actuaries.

Code of Federal Regulations, 2010 CFR

2010-04-01

... actuaries. 901.32 Section 901.32 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Suspension or Termination of Enrollment § 901.32 Receipt of information concerning enrolled actuaries. If an... Guaranty Corporation, or a member of the Joint Board has reason to believe that an enrolled actuary has...

26 CFR 301.6059-1 - Periodic report of actuary.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Periodic report of actuary. 301.6059-1 Section...-1 Periodic report of actuary. (a) In general. The actuarial report described in this section must be... funding deficiency (as defined in section 412(a)) to zero, (4) A statement by the enrolled actuary signing...

75 FR 35093 - Civil Service Retirement System; Present Value Factors

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-21

... present value factors to changes in demographic factors adopted by the Board of Actuaries of the Civil... actuarial assumptions and data to the Board of Actuaries, care of Gregory Kissel, Actuary, Office of... 1986, Public Law 99- 335, based on changed demographic factors adopted by the Board of Actuaries of the...

Intensity Modulated Radiation Therapy With Dose Painting to Treat Rhabdomyosarcoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, Joanna C.; Dharmarajan, Kavita V.; Wexler, Leonard H.

Purpose: To examine local control and patterns of failure in rhabdomyosarcoma patients treated with intensity modulated radiation therapy (RT) with dose painting (DP-IMRT). Patients and Methods: A total of 41 patients underwent DP-IMRT with chemotherapy for definitive treatment. Nineteen also underwent surgery with or without intraoperative RT. Fifty-six percent had alveolar histologic features. The median interval from beginning chemotherapy to RT was 17 weeks (range, 4-25). Very young children who underwent second-look procedures with or without intraoperative RT received reduced doses of 24-36 Gy in 1.4-1.8-Gy fractions. Young adults received 50.4 Gy to the primary tumor and lower doses ofmore » 36 Gy in 1.8-Gy fractions to at-risk lymph node chains. Results: With 22 months of median follow-up, the actuarial local control rate was 90%. Patients aged {<=}7 years who received reduced overall and fractional doses had 100% local control, and young adults had 79% (P=.07) local control. Three local failures were identified in young adults whose primary target volumes had received 50.4 Gy in 1.8-Gy fractions. Conclusions: DP-IMRT with lower fractional and cumulative doses is feasible for very young children after second-look procedures with or without intraoperative RT. DP-IMRT is also feasible in adolescents and young adults with aggressive disease who would benefit from prophylactic RT to high-risk lymph node chains, although dose escalation might be warranted for improved local control. With limited follow-up, it appears that DP-IMRT produces local control rates comparable to those of sequential IMRT in patients with rhabdomyosarcoma.« less

Cerebellar medulloblastoma: the importance of posterior fossa dose to survival and patterns of failure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Silverman, C.L.; Simpson, J.R.

1982-11-01

Fifty patients with biopsy-proven cerebellar medulloblastoma were retrospectively analyzed for prognostic factors, survival and patterns of failure. Five- and ten-year actuarial survivals for the entire group were 51% and 42%. Survival and local control were significantly better for the 21 patients who received doses greater than 5000 rad to the posterior fossa (85% and 80% respectively) than for the remaining patients (38% and 38%, respectively). Significant prognostic factors included achievement of local control in the posterior fossa (p = .0001) and dose to the posterior fossa (p = .0005). Sex, age, duration of symptoms, extent of surgery and initial T-stagemore » of disease were not significant. Posterior fossa was the predominant site of failure (71% of failures), but 10% of patients failed in the cerebrum and 12% outside the CNS. This experience confirms that survival rates of 70-80% are achievable with current treatment policies but accurate and consistent dose delivery to the posterior fossa is essential.« less

Cerebellar medulloblastoma: the importance of posterior fossa dose to survival and patterns of failure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Silverman, C.L.; Simpson, J.R.

1982-11-01

Fifty patients with biopsy-proven cerebellar medulloblastoma were retrospectively analyzed for prognostic factors, survival and patterns of failure. Five- and ten-year actuarial survivals for the entire group were 51% and 42%. Survival and local control were significantly better for the 21 patients who received doses greater that 5000 rad to the posterior fossa (85% and 80% respectively) than for the remaining patients (38% and 38%, respectively). Significant prognostic factors included achievement of local control in the posterior fossa (p = .0001) and dose to the posterior fossa (p = .0005). Sex, age, duration of symptoms, extent of surgery and initial T-stagemore » of disease were not significant. Posterior fossa was the predominant site of failure (71% of failures), but 10% of patients failed in the cerebrum and 12% outside the CNS. This experience confirms that survival rates of 70-80% are achievable with current treatment policies but accurate and consistent dose delivery to the posterior fossa is essential.« less

Intraoperative biopsy of the major cranial nerves in the surgical strategy for adenoid cystic carcinoma close to the skull base.

PubMed

Tarsitano, Achille; Pizzigallo, Angelo; Gessaroli, Manlio; Sturiale, Carmelo; Marchetti, Claudio

2012-02-01

Adenoid cystic carcinoma of the salivary glands has a propensity for perineural invasion, which could favor spread along the major cranial nerves, sometimes to the skull base and through the foramina to the brain parenchyma. This study evaluated the relationship between neural spread and relapse in the skull base. During surgery, we performed multiple biopsies with extemporaneous examination of the major nerves close to the tumor to guide the surgical resection. The percentage of actuarial local control at 5 years for patients with a positive named nerve and skull base infiltration was 12.5%, compared with 90.0% in patients who were named nerve-negative and without infiltration of the skull base (P = .001). Our study shows that local control of disease for patients who are named nerve-positive with skull base infiltration is significantly more complex compared with patients who are named nerve-negative without infiltration of the skull base. Copyright © 2012. Published by Mosby, Inc.

75 FR 47650 - Actuarial Advisory Committee With Respect to the Railroad Retirement Account; Notice of Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-06

... Chief Actuary of the U.S. Railroad Retirement Board, 844 North Rush Street, Chicago, Illinois, on the... sent by the Chief Actuary to the Committee before the meeting. The meeting will be open to the public... communications or notices to the RRB Actuarial Advisory Committee, c/o Chief Actuary, U.S. Railroad Retirement...

29 CFR 2520.101-6 - Multiemployer pension plan information made available on request.

Code of Federal Regulations, 2011 CFR

2011-07-01

... “periodic actuarial report” means any— (i) Actuarial report prepared by an actuary of the plan and received... plan from an actuary of the plan that depicts alternative funding scenarios based on a range of...

29 CFR 2520.101-6 - Multiemployer pension plan information made available on request.

Code of Federal Regulations, 2010 CFR

2010-07-01

... “periodic actuarial report” means any— (i) Actuarial report prepared by an actuary of the plan and received... plan from an actuary of the plan that depicts alternative funding scenarios based on a range of...

20 CFR 901.34 - Conferences.

Code of Federal Regulations, 2013 CFR

2013-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... § 901.34 Conferences. (a) In general. The Executive Director may confer with an enrolled actuary... of the actuary or the Executive Director. (b) Voluntary suspension or termination of enrollment. An...

20 CFR 901.45 - Evidence.

Code of Federal Regulations, 2012 CFR

2012-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... actuaries. However, the Administrative Law Judge shall exclude evidence which is irrelevant, immaterial, or... of Actuaries or the Office of the Executive Director of the Joint Board for the Enrollment of...

20 CFR 901.45 - Evidence.

Code of Federal Regulations, 2013 CFR

2013-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... actuaries. However, the Administrative Law Judge shall exclude evidence which is irrelevant, immaterial, or... of Actuaries or the Office of the Executive Director of the Joint Board for the Enrollment of...

20 CFR 901.45 - Evidence.

Code of Federal Regulations, 2011 CFR

2011-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... actuaries. However, the Administrative Law Judge shall exclude evidence which is irrelevant, immaterial, or... of Actuaries or the Office of the Executive Director of the Joint Board for the Enrollment of...

20 CFR 901.45 - Evidence.

Code of Federal Regulations, 2014 CFR

2014-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... actuaries. However, the Administrative Law Judge shall exclude evidence which is irrelevant, immaterial, or... of Actuaries or the Office of the Executive Director of the Joint Board for the Enrollment of...

20 CFR 901.34 - Conferences.

Code of Federal Regulations, 2014 CFR

2014-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... § 901.34 Conferences. (a) In general. The Executive Director may confer with an enrolled actuary... of the actuary or the Executive Director. (b) Voluntary suspension or termination of enrollment. An...

20 CFR 901.34 - Conferences.

Code of Federal Regulations, 2011 CFR

2011-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... § 901.34 Conferences. (a) In general. The Executive Director may confer with an enrolled actuary... of the actuary or the Executive Director. (b) Voluntary suspension or termination of enrollment. An...

20 CFR 901.34 - Conferences.

Code of Federal Regulations, 2012 CFR

2012-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... § 901.34 Conferences. (a) In general. The Executive Director may confer with an enrolled actuary... of the actuary or the Executive Director. (b) Voluntary suspension or termination of enrollment. An...

20 CFR 901.45 - Evidence.

Code of Federal Regulations, 2010 CFR

2010-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... actuaries. However, the Administrative Law Judge shall exclude evidence which is irrelevant, immaterial, or... of Actuaries or the Office of the Executive Director of the Joint Board for the Enrollment of...

20 CFR 901.34 - Conferences.

Code of Federal Regulations, 2010 CFR

2010-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... § 901.34 Conferences. (a) In general. The Executive Director may confer with an enrolled actuary... of the actuary or the Executive Director. (b) Voluntary suspension or termination of enrollment. An...

Intraluminal low-dose-rate 192Ir brachytherapy combined with external beam radiotherapy and biliary stenting for unresectable extrahepatic bile duct carcinoma.

PubMed

Takamura, Akio; Saito, Hiroya; Kamada, Tadashi; Hiramatsu, Kazuhide; Takeuchi, Shuhei; Hasegawa, Masakazu; Miyamoto, Noriyuki

2003-12-01

To evaluate the results of combined-modality therapy, including external beam radiotherapy, intraluminal (192)Ir, and biliary stenting for extrahepatic bile duct carcinoma. Between 1988 and 1998, 93 patients with unresectable extrahepatic bile duct carcinoma underwent definitive radiotherapy. The dose of external beam radiotherapy was 50 Gy in 25 fractions. Low-dose-rate (192)Ir was delivered at a dose of 27-50 Gy (mean 39.2) at 0.5 cm from the source. An expandable metallic endoprosthesis was used to establish an internal bile passage. The median survival was 12 months, with a 1-, 3-, and 5-year actuarial survival rate of 50%, 10%, and 4%, respectively. Tumor length, hepatic invasion, and distant metastasis significantly affected survival. Ninety-six percent of patients could successfully remove external drainage catheters. The actuarial biliary patency rate for these patients at 1, 3, and 5 years was 52%, 29%, and 18%, respectively. Tumor length, tumor diameter and T stage were significantly associated with the patency rate. Mild-to-severe gastroduodenal complications were observed in 32 patients and were significantly associated with the active length of (192)Ir and linear source activity. Eight patients had treatment-related biliary fistula. Our combined-modality therapy provided reasonable local control and improved the quality of life of patients with extrahepatic bile duct carcinoma. Because none of the treatment characteristics had any impact on survival or biliary patency, lower dose levels and/or a localized target volume are recommended to minimize morbidity.

Clinical versus actuarial judgment.

PubMed

Dawes, R M; Faust, D; Meehl, P E

1989-03-31

Professionals are frequently consulted to diagnose and predict human behavior; optimal treatment and planning often hinge on the consultant's judgmental accuracy. The consultant may rely on one of two contrasting approaches to decision-making--the clinical and actuarial methods. Research comparing these two approaches shows the actuarial method to be superior. Factors underlying the greater accuracy of actuarial methods, sources of resistance to the scientific findings, and the benefits of increased reliance on actuarial approaches are discussed.

A look inside the actuarial black box.

PubMed

Math, S E; Youngerman, H

1992-12-01

Hospital executives often rely on actuaries (and their "black boxes") to determine self-insurance program liabilities and funding contributions. Typically, the hospital supplies the actuary with a myriad of statistics, and eventually the hospital receives a liability estimate and recommended funding level. The mysterious actuarial calculations that occur in between data reporting and receipt of the actuary's report are akin to a black box--a complicated device whose internal mechanism is hidden from or mysterious to the user.

20 CFR 901.20 - Standards of performance of actuarial services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... explanation relative to any report signed or certified by such enrolled actuary. (d) Conflicts of interest. In any situation in which the enrolled actuary has a conflict of interest with respect to the performance... not of a distinctive nature. (h) Notification. An enrolled actuary shall provide written notification...

The Undergraduate Statistics Major--A Prelude to Actuarial Science Training.

ERIC Educational Resources Information Center

Ratliff, Michael I.; Williams, Raymond E.

Recently there has been increased interest related to the Actuarial Science field. An actuary is a business professional who uses mathematical skills to define, analyze, and solve financial and social problems. This paper examines: (1) the interface between Statistical and Actuarial Science training; (2) statistical courses corresponding to…

26 CFR 300.7 - Enrollment of enrolled actuary fee.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

26 CFR 300.7 - Enrollment of enrolled actuary fee.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

26 CFR 300.7 - Enrollment of enrolled actuary fee.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

26 CFR 300.7 - Enrollment of enrolled actuary fee.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

76 FR 32241 - Civil Service Retirement System; Present Value Factors

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-03

... in the economic assumptions adopted by the Board of Actuaries of the Civil Service Retirement System... data to the Board of Actuaries, care of Gregory Kissel, Actuary, Office of Planning and Policy Analysis...- 335, based on changed economic assumptions adopted by the Board of Actuaries of the CSRS. Those...

76 FR 32243 - Federal Employees' Retirement System; Present Value Factors

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-03

... adopted by the Board of Actuaries of the Civil Service Retirement System. DATES: The revised present value.... ADDRESSES: Send requests for actuarial assumptions and data to the Board of Actuaries, care of Gregory Kissel, Actuary, Office of Planning and Policy Analysis, Office of Personnel Management, Room 4307, 1900...

26 CFR 300.7 - Enrollment of enrolled actuary fee.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

75 FR 35096 - Federal Employees' Retirement System; Present Value Factors

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-21

... by the Board of Actuaries of the Civil Service Retirement System. DATES: The revised present value.... ADDRESSES: Send requests for actuarial assumptions and data to the Board of Actuaries, care of Gregory Kissel, Actuary, Office of Planning and Policy Analysis, Office of Personnel Management, Room 4307, 1900...

Stereotactic ablative radiotherapy for oligometastatic disease in liver.

PubMed

Kim, Myungsoo; Son, Seok Hyun; Won, Yong Kyun; Kay, Chul Seung

2014-01-01

Liver metastasis in solid tumors, including colorectal cancer, is the most frequent and lethal complication. The development of systemic therapy has led to prolonged survival. However, in selected patients with a finite number of discrete lesions in liver, defined as oligometastatic state, additional local therapies such as surgical resection, radiofrequency ablation, cryotherapy, and radiotherapy can lead to permanent local disease control and improve survival. Among these, an advance in radiation therapy made it possible to deliver high dose radiation to the tumor more accurately, without impairing the liver function. In recent years, the introduction of stereotactic ablative radiotherapy (SABR) has offered even more intensive tumor dose escalation in a few fractions with reduced dose to the adjacent normal liver. Many studies have shown that SABR for oligometastases is effective and safe, with local control rates widely ranging from 50% to 100% at one or two years. And actuarial survival at one and two years has been reported ranging from 72% to 94% and from 30% to 62%, respectively, without severe toxicities. In this paper, we described the definition and technical aspects of SABR, clinical outcomes including efficacy and toxicity, and related parameters after SABR in liver oligometastases from colorectal cancer.

Population projections for AIDS using an actuarial model.

PubMed

Wilkie, A D

1989-09-05

This paper gives details of a model for forecasting AIDS, developed for actuarial purposes, but used also for population projections. The model is only appropriate for homosexual transmission, but it is age-specific, and it allows variation in the transition intensities by age, duration in certain states and calendar year. The differential equations controlling transitions between states are defined, the method of numerical solution is outlined, and the parameters used in five different Bases of projection are given in detail. Numerical results for the population of England and Wales are shown.

Elective neck irradiation for nasopharyngeal carcinoma.

PubMed

Wang, C J; Chen, H C; Huang, E Y; Lee, S P

2000-07-01

This study was conducted to evaluate the effectiveness of elective neck irradiation (ENI) for nasopharyngeal carcinoma (NPC), and to analyze factors associated with ENI failure. A radiation port covering the side of a neck without gross nodal metastasis was qualified for evaluation of the effectiveness of ENI. From 1988 through 1992, a total of 261 patients with N0 (130 cases), N1 (91 cases), and N3 (40 cases) NPCs were studied. All patients were irradiated with 60Co teletherapy or 10 MV x-ray to a total dose of 46.8 Gy/26 fractions, followed by a boost treatment to the primary site to a total dose of 64.8 to 75.6 Gy/36-42 fractions. All ENI ports received irradiation to a dose of 46.8 to 60.8 Gy. The duration of follow-up was 6 to 10 years, with a median of 8.1 years. Factors associated with to the risk of ENI failure were analyzed. (1) The overall 5-year actuarial local control rate and actuarial survival rate were 74% and 63%, respectively. (2) Among the 261 cases in which ENI treatment was used, the treatment failed in 12 cases, accounting for a crude ENI failure rate of 5%. The overall 5- and 10-year cumulative risk of ENI failure was 5% and 7%, respectively. (3) Time from the start of treatment to ENI failure ranged from 9 to 66 months, with a median of 17 months. (4) Of the 12 patients for whom EMI failed, 11 (92%) had recurrence in the upper neck, and one in the lower neck. (5) Existence of prior failure at the primary site was the only factor significantly correlated with the risk of ENI failure (p < 0.001). The 5-year cumulative risk of ENI failure for patients with local failure vs. those without was 16% vs. 1% (p < 0.0001). Moderate-dose ENI was highly effective in the control of subclinical disease in the neck for NPC. ENI failure was closely associated with prior failure at the primary site, implying that local primary tumor failure may lead to an increased potential for metastasis to the neck.

The significance of size change of soft tissue sarcoma during preoperative radiotherapy.

PubMed

Miki, Y; Ngan, S; Clark, J C M; Akiyama, T; Choong, P F M

2010-07-01

To assess the significance of change in tumour size during preoperative radiotherapy in patients with soft tissue sarcoma (STS). A retrospective review of 91 cases with STS was performed. Inclusion criteria were localised extremity and truncal STS with measurable disease, older than 18 years, treated with preoperative radiotherapy and wide local excision, in the period between January 1966 and December 2005. Patients with head and neck STS, or who received neoadjuvant chemotherapy were excluded. A difference in excess of 10% of the greatest tumour diameter of the pre-radiotherapy and the post-radiotherapy MRI scans was considered as change in tumour size. Increase in tumour size was noted in 28 patients (31%) (Group 1). No change or decrease in size was observed in 63 patients (Group 2). There were no significance differences in local control or overall survival rates between the 2 groups. The estimated overall actuarial local recurrence free, event-free and overall survival rates were 90.5%, 64.4%, 62.9% in Group 1, and 85.7%, 60.8%, 68.9% in Group 2 respectively. Increase in tumour size during preoperative radiotherapy for soft tissue sarcoma does not seem to associate with inferior local tumour control or compromise survival. Lack of reduction in tumour size is not necessarily a sign of lack of response to preoperative radiotherapy.

26 CFR 601.502 - Recognized representative.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... 230; (4) Enrolled actuary. Any individual who is enrolled as an actuary by and is in active status with the Joint Board for the Enrollment of Actuaries pursuant to 29 U.S.C. 1242. (5) Other individuals... actuaries, and others); (3) I am authorized to represent the taxpayer(s) identified in the power of attorney...

26 CFR 601.502 - Recognized representative.

Code of Federal Regulations, 2012 CFR

2012-04-01

.... 230; (4) Enrolled actuary. Any individual who is enrolled as an actuary by and is in active status with the Joint Board for the Enrollment of Actuaries pursuant to 29 U.S.C. 1242. (5) Other individuals... actuaries, and others); (3) I am authorized to represent the taxpayer(s) identified in the power of attorney...

26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

26 CFR 601.502 - Recognized representative.

Code of Federal Regulations, 2014 CFR

2014-04-01

.... 230; (4) Enrolled actuary. Any individual who is enrolled as an actuary by and is in active status with the Joint Board for the Enrollment of Actuaries pursuant to 29 U.S.C. 1242. (5) Other individuals... actuaries, and others); (3) I am authorized to represent the taxpayer(s) identified in the power of attorney...

26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

26 CFR 601.502 - Recognized representative.

Code of Federal Regulations, 2013 CFR

2013-04-01

.... 230; (4) Enrolled actuary. Any individual who is enrolled as an actuary by and is in active status with the Joint Board for the Enrollment of Actuaries pursuant to 29 U.S.C. 1242. (5) Other individuals... actuaries, and others); (3) I am authorized to represent the taxpayer(s) identified in the power of attorney...

26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

The Role of an Actuarial Director in the Development of an Introductory Program

ERIC Educational Resources Information Center

Staples, Susan G.

2014-01-01

We describe the roles and duties of a director in developing an introductory actuarial program. Degree plan design, specialized exam courses, internship classes, coordination of efforts with Economics and Finance Departments, opportunities for creating a minor in actuarial mathematics, actuarial clubs, career advice, and interaction with actuarial…

Actuarial considerations of medical malpractice evaluations in M&As.

PubMed

Frese, Richard C

2014-11-01

To best project an actuarial estimate for medical malpractice exposure for a merger and acquisition, a organization's leaders should consider the following factors, among others: How to support an unbiased actuarial estimation. Experience of the actuary. The full picture of the organization's malpractice coverage. The potential for future loss development. Frequency and severity trends.

26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

77 FR 12577 - Department of Defense (DoD) Board of Actuaries; Federal Advisory Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense (DoD) Board of Actuaries... that the following Federal advisory committee meeting of the DoD Board of Actuaries will take place... Actuaries meeting or make an oral presentation or submit a written statement for consideration at the...

Spatial variation in senescence rates in a bird metapopulation.

PubMed

Holand, H; Kvalnes, T; Gamelon, M; Tufto, J; Jensen, H; Pärn, H; Ringsby, T H; Sæther, B-E

2016-07-01

Investigating factors which affect the decline in survival with age, i.e. actuarial senescence, is important in order to understand how demographic rates vary in wild populations. Although the evidence for the occurrence of actuarial senescence in wild populations is growing, very few studies have compared actuarial senescence rates between wild populations of the same species. We used data from a long-time study of demography of house sparrows (Passer domesticus) to investigate differences in rates of actuarial senescence between habitats and sub-populations. We also investigated whether rates of actuarial senescence differed between males and females. We found that rates of actuarial senescence showed large spatial variation. We also found that the onset of actuarial senescence varied between sub-populations. However, these differences were not significantly explained by a general difference in habitat type. We also found no significant difference in actuarial senescence rates between males and females. This study shows that senescence rates in natural populations may vary significantly between sub-populations and that failing to account for such differences may give a biased estimate of senescence rates of a species.

Outcomes of Proton Therapy for Patients With Functional Pituitary Adenomas

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wattson, Daniel A.; Tanguturi, Shyam K.; Spiegel, Daphna Y.

2014-11-01

Purpose/Objective(s): This study evaluated the efficacy and toxicity of proton therapy for functional pituitary adenomas (FPAs). Methods and Materials: We analyzed 165 patients with FPAs who were treated at a single institution with proton therapy between 1992 and 2012 and had at least 6 months of follow-up. All but 3 patients underwent prior resection, and 14 received prior photon irradiation. Proton stereotactic radiosurgery was used for 92% of patients, with a median dose of 20 Gy(RBE). The remainder received fractionated stereotactic proton therapy. Time to biochemical complete response (CR, defined as ≥3 months of normal laboratory values with no medical treatment), local control,more » and adverse effects are reported. Results: With a median follow-up time of 4.3 years (range, 0.5-20.6 years) for 144 evaluable patients, the actuarial 3-year CR rate and the median time to CR were 54% and 32 months among 74 patients with Cushing disease (CD), 63% and 27 months among 8 patients with Nelson syndrome (NS), 26% and 62 months among 50 patients with acromegaly, and 22% and 60 months among 9 patients with prolactinomas, respectively. One of 3 patients with thyroid stimulating hormone—secreting tumors achieved CR. Actuarial time to CR was significantly shorter for corticotroph FPAs (CD/NS) compared with other subtypes (P=.001). At a median imaging follow-up time of 43 months, tumor control was 98% among 140 patients. The actuarial 3-year and 5-year rates of development of new hypopituitarism were 45% and 62%, and the median time to deficiency was 40 months. Larger radiosurgery target volume as a continuous variable was a significant predictor of hypopituitarism (adjusted hazard ratio 1.3, P=.004). Four patients had new-onset postradiosurgery seizures suspected to be related to generously defined target volumes. There were no radiation-induced tumors. Conclusions: Proton irradiation is an effective treatment for FPAs, and hypopituitarism remains the primary adverse effect.« less

Efficacy, safety and outcome of frameless image-guided robotic radiosurgery for brain metastases after whole brain radiotherapy.

PubMed

Lohkamp, Laura-Nanna; Vajkoczy, Peter; Budach, Volker; Kufeld, Markus

2018-05-01

Estimating efficacy, safety and outcome of frameless image-guided robotic radiosurgery for the treatment of recurrent brain metastases after whole brain radiotherapy (WBRT). We performed a retrospective single-center analysis including patients with recurrent brain metastases after WBRT, who have been treated with single session radiosurgery, using the CyberKnife® Radiosurgery System (CKRS) (Accuray Inc., CA) between 2011 and 2016. The primary end point was local tumor control, whereas secondary end points were distant tumor control, treatment-related toxicity and overall survival. 36 patients with 140 recurrent brain metastases underwent 46 single session CKRS treatments. Twenty one patients had multiple brain metastases (58%). The mean interval between WBRT and CKRS accounted for 2 years (range 0.2-7 years). The median number of treated metastases per treatment session was five (range 1-12) with a tumor volume of 1.26 ccm (mean) and a median tumor dose of 18 Gy prescribed to the 70% isodose line. Two patients experienced local tumor recurrence within the 1st year after treatment and 13 patients (36%) developed novel brain metastases. Nine of these patients underwent additional one to three CKRS treatments. Eight patients (22.2%) showed treatment-related radiation reactions on MRI, three with clinical symptoms. Median overall survival was 19 months after CKRS. The actuarial 1-year local control rate was 94.2%. CKRS has proven to be locally effective and safe due to high local tumor control rates and low toxicity. Thus CKRS offers a reliable salvage treatment option for recurrent brain metastases after WBRT.

A Single-Institutional Experience of 15 Years of Treating T3 Laryngeal Cancer With Primary Radiotherapy, With or Without Chemotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Al-Mamgani, Abrahim, E-mail: a.al-mamgani@erasmusmc.nl; Tans, Lisa; Rooij, Peter van

2012-07-01

Purpose: To retrospectively analyze the outcomes, toxicity, quality of life, and voice quality of patients with T3 laryngeal cancer treated with radiotherapy and to identify subgroups of patients in whom the addition of chemotherapy to radiotherapy is necessary. Methods and Materials: Between March 1996 and November 2009, 170 consecutive patients with T3 tumor were treated with (chemo)radiotherapy. Endpoints of the study were local control (LC), locoregional control (LRC), disease-free survival (DFS), overall survival (OS), late toxicity, quality of life, and voice handicap index. Results: After a median follow-up time of 32 months (range, 7-172), the 3-year actuarial rates of LC,more » LRC, DFS, and OS were 73%, 70%, 64%, and 61%, respectively, and the 5-year figures were 68%, 65%, 60%, and 49%, respectively. At last follow-up, 84 patients (49.5%) were still alive, 65 of them (77.3%) without local progression. Laryngectomy was performed in 16 patients, leaving 49 patients with anatomic organ preservation, corresponding to an actuarial laryngectomy-free survival of 58.3% at 3 years. The figures for patients treated with chemoradiotherapy and radiotherapy alone were 76.8% and 53.5%, respectively (p = 0.001). Chemoradiotherapy was the only significant predictor for LC on multivariate analysis. The overall 5-year cumulative incidence of late Grade {>=}2 toxicity was 28.2%. Chemoradiotherapy, compared with radiotherapy alone, resulted in slight increase in late toxicity and slight deterioration of quality of life and voice-handicap-index scores. However, the differences were statistically not significant. Conclusion: The addition of chemotherapy to radiotherapy in T3 laryngeal cancer significantly improved LC and laryngectomy-free survival without statistically significant increases in late toxicity or deterioration of quality of life or voice handicap index.« less

77 FR 12577 - Department of Defense (DoD) Medicare-Eligible Retiree Health Care Board of Actuaries; Federal...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

... Retiree Health Care Board of Actuaries; Federal Advisory Committee Meeting AGENCY: DoD. ACTION: Meeting... DoD Medicare-Eligible Retiree Health Care Board of Actuaries will take place. DATES: Friday, August 3... Contact: Persons desiring to attend the DoD Medicare- Eligible Retiree Health Care Board of Actuaries...

76 FR 81362 - Regulations Governing the Performance of Actuarial Services Under the Employee Retirement Income...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-28

... JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES 20 CFR Part 901 [TD 9517] RIN 1545-BC82 Regulations...; Correction AGENCY: Joint Board for the Enrollment of Actuaries. ACTION: Correction to final regulations... Federal Register on Thursday, March 31, 2011 (76 FR 17762) relating to the enrollment of actuaries. DATES...

75 FR 6359 - Federal Advisory Committee; DoD Board of Actuaries; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-09

... DEPARTMENT OF DEFENSE Office of the Secretary Federal Advisory Committee; DoD Board of Actuaries... the DoD Board of Actuaries will meet on July 22 and 23, 2010. Subject to the availability of space...D Office of the Actuary, 4040 N. Fairfax Drive, Suite 308, Arlington, VA 22203; phone 703-696-7413...

Different actuarial risk measures produce different risk rankings for sexual offenders.

PubMed

Barbaree, Howard E; Langton, Calvin M; Peacock, Edward J

2006-10-01

Percentile ranks were computed for N=262 sex offenders using each of 5 actuarial risk instruments commonly used with adult sex offenders (RRASOR, Static-99, VRAG, SORAG, and MnSOST-R). Mean differences between percentile ranks obtained by different actuarial measures were found to vary inversely with the correlation between the actuarial scores. Following studies of factor analyses of actuarial items, we argue that the discrepancies among actuarial instruments can be substantially accounted for by the way in which the factor Antisocial Behavior and various factors reflecting sexual deviance are represented among the items contained in each instrument. In the discussion, we provide guidance to clinicians in resolving discrepancies between instruments and we discuss implications for future developments in sex offender risk assessment.

Histology-Stratified Tumor Control and Patient Survival After Stereotactic Radiosurgery for Pineal Region Tumors: A Report From the International Gamma Knife Research Foundation.

PubMed

Iorio-Morin, Christian; Kano, Hideyuki; Huang, Marshall; Lunsford, L Dade; Simonová, Gabriela; Liscak, Roman; Cohen-Inbar, Or; Sheehan, Jason; Lee, Cheng-Chia; Wu, Hsiu-Mei; Mathieu, David

2017-11-01

Pineal region tumors represent a rare and histologically diverse group of lesions. Few studies are available to guide management and the outcomes after stereotactic radiosurgery (SRS). Patients who underwent SRS for a pineal region tumor and for whom at least 6 months of imaging follow-up was available were retrospectively assessed in 5 centers. Data were collected from the medical record and histology level analyses were performed, including actuarial tumor control and survival analyses. A total of 70 patients were treated between 1989 and 2014 with a median follow-up of 47 months. Diagnoses were pineocytoma (37%), pineoblastoma (19%), pineal parenchymal tumor of intermediate differentiation (10%), papillary tumor of the pineal region (9%), germinoma (7%), teratoma (3%), embryonal carcinoma (1%), and unknown (14%). Median prescription dose was 15 Gy at the 50% isodose line. Actuarial local control and survival rates were 81% and 76% at 20 years for pineocytoma, 50% and 56% at 5 years for pineal parenchymal tumor of intermediate differentiation, 27% and 48% at 5 years for pineoblastoma, 33% and 100% at 5 years for papillary tumor of the pineal region, 80% and 80% at 20 years for germinoma, and 61% and 67% at 5 years for tumors of unknown histology. New focal neurological deficit, Parinaud syndrome, and hydrocephalus occurred in 9%, 7%, and 3% of cases, respectively. SRS is a safe modality for the management of pineal region tumors. Its specific role is highly dependent on tumor histology. As such, all efforts should be made to obtain a reliable histologic diagnosis. Copyright © 2017 Elsevier Inc. All rights reserved.

29 CFR 4010.15 - OMB control number.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 9 2011-07-01 2011-07-01 false OMB control number. 4010.15 Section 4010.15 Labor... DISCLOSURE REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.15 OMB control number... Management and Budget under OMB control number 1212-0049. [61 FR 34022, July 1, 1996. Redesignated at 74 FR...

29 CFR 4010.15 - OMB control number.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 9 2013-07-01 2013-07-01 false OMB control number. 4010.15 Section 4010.15 Labor... DISCLOSURE REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.15 OMB control number... Management and Budget under OMB control number 1212-0049. [61 FR 34022, July 1, 1996. Redesignated at 74 FR...

29 CFR 4010.15 - OMB control number.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false OMB control number. 4010.15 Section 4010.15 Labor... DISCLOSURE REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.15 OMB control number... Management and Budget under OMB control number 1212-0049. [61 FR 34022, July 1, 1996. Redesignated at 74 FR...

29 CFR 4010.15 - OMB control number.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 9 2012-07-01 2012-07-01 false OMB control number. 4010.15 Section 4010.15 Labor... DISCLOSURE REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.15 OMB control number... Management and Budget under OMB control number 1212-0049. [61 FR 34022, July 1, 1996. Redesignated at 74 FR...

Including an Exam P/1 Prep Course in a Growing Actuarial Science Program

ERIC Educational Resources Information Center

Wakefield, Thomas P.

2014-01-01

The purpose of this article is to describe the actuarial science program at our university and the development of a course to enhance students' problem solving skills while preparing them for Exam P/1 of the Society of Actuaries (SOA) and the Casualty Actuary Society (CAS). The Exam P/1 prep course, formally titled Mathematical Foundations of…

78 FR 9890 - DoD Board of Actuaries; Notice of Federal Advisory Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... DEPARTMENT OF DEFENSE Office of the Secretary DoD Board of Actuaries; Notice of Federal Advisory... Advisory Committee meeting of the DoD Board of Actuaries will take place. DATES: July 18, 2013, from 1:00 p... Defense Human Resource Activity, DoD Office of the Actuary, 4800 Mark Center Drive, STE 06J25-01...

Long-Term Outcome and Morbidity After Treatment With Accelerated Radiotherapy and Weekly Cisplatin for Locally Advanced Head-and-Neck Cancer: Results of a Multidisciplinary Late Morbidity Clinic

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ruetten, Heidi, E-mail: h.rutten@rther.umcn.nl; Pop, Lucas A.M.; Janssens, Geert O.R.J.

2011-11-15

Purpose: To evaluate the long-term outcome and morbidity after intensified treatment for locally advanced head-and-neck cancer. Methods and Materials: Between May 2003 and December 2007, 77 patients with Stage III to IV head-and-neck cancer were treated with curative intent. Treatment consisted of accelerated radiotherapy to a dose of 68 Gy and concurrent cisplatin. Long-term survivors were invited to a multidisciplinary outpatient clinic for a comprehensive assessment of late morbidity with special emphasis on dysphagia, including radiological evaluation of swallowing function in all patients. Results: Compliance with the treatment protocol was high, with 87% of the patients receiving at least fivemore » cycles of cisplatin and all but 1 patient completing the radiotherapy as planned. The 5-year actuarial disease-free survival and overall survival rates were 40% and 47%, respectively. Locoregional recurrence-free survival at 5 years was 61%. The 5-year actuarial rates of overall late Radiation Therapy Oncology Group (RTOG)/European Organization for Research and Treatment of Cancer (EORTC) Grade 3 and Grade 4 toxicity were 52% and 25% respectively. Radiologic evaluation after a median follow-up of 44 months demonstrated impaired swallowing in 57% of the patients, including 23% with silent aspiration. Subjective assessment using a systematic scoring system indicated normalcy of diet in only 15.6% of the patients. Conclusion: This regimen of accelerated radiotherapy with weekly cisplatin produced favorable tumor control rates and survival rates while compliance was high. However, comprehensive assessment by a multidisciplinary team of medical and paramedical specialists revealed significant long-term morbidity in the majority of the patients, with dysphagia being a major concern.« less

29 CFR 4007.8 - Late payment penalty charges.

Code of Federal Regulations, 2011 CFR

2011-07-01

... actuary to be a reasonable estimate that takes into account the most current data available to the enrolled actuary and that has been determined in accordance with generally accepted actuarial principles...

Macroscopic Hematuria After Conventional or Hypofractionated Radiation Therapy: Results From a Prospective Phase 3 Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sanguineti, Giuseppe, E-mail: sanguineti@ifo.it; Arcidiacono, Fabio; Landoni, Valeria

2016-10-01

Purpose: To assess the macroscopic hematuria rates within a single-institution randomized phase 3 trial comparing dose-escalated, conventionally fractionated radiation therapy (CFRT) and moderately hypofractionated radiation therapy (MHRT) for localized prostate cancer. Methods and Materials: Patients with intermediate- to high-risk localized prostate cancer were treated with conformal RT and short-course androgen deprivation. Both the prostate and the entire seminal vesicles were treated to 80 Gy in 40 fractions over 8 weeks (CFRT) or 62 Gy in 20 fractions over 5 weeks (MHRT). The endpoint of the present study was the development of any episode or grade of macroscopic hematuria. The median follow-up period was 93 monthsmore » (range 6-143). Results: Macroscopic hematuria was reported by 25 of 168 patients (14.9%). The actuarial estimate of hematuria at 8 years was 17.0% (95% confidence interval [CI] 10.7%-23.3%). The number of patients with hematuria was 6 and 19 in the CFRT and MHRT arms, respectively, for an actuarial 8-year estimate of 9.7% and 24.3%, respectively (hazard ratio 3.468, 95% CI 1.385-8.684; P=.008). Overall, 8 of 25 patients were found to have biopsy-proven urothelial carcinoma (3 in the CFRT arm and 5 in the MHRT arm; P=.27). Thus, the 8-year actuarial incidence of macroscopic hematuria (after censoring urothelial cancer–related episodes) was 4.1% and 18.2% after CFRT and MHRT, respectively (hazard ratio 4.961, 95% CI 1.426-17.263; P=.012). The results were confirmed by multivariate analysis after accounting for several patient-, treatment-, and tumor-related covariates. Conclusions: MHRT was associated with a statistically significant increased risk of macroscopic hematuria compared with CFRT.« less

20 CFR 901.53 - Notice of suspension, termination or resignation of enrollment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME... enrollment of an actuary, the Executive Director shall give notice thereof to appropriate officers and...

20 CFR 901.53 - Notice of suspension, termination or resignation of enrollment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME... enrollment of an actuary, the Executive Director shall give notice thereof to appropriate officers and...

20 CFR 901.53 - Notice of suspension, termination or resignation of enrollment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME... enrollment of an actuary, the Executive Director shall give notice thereof to appropriate officers and...

20 CFR 901.53 - Notice of suspension, termination or resignation of enrollment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME... enrollment of an actuary, the Executive Director shall give notice thereof to appropriate officers and...

20 CFR 901.53 - Notice of suspension, termination or resignation of enrollment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME... enrollment of an actuary, the Executive Director shall give notice thereof to appropriate officers and...

29 CFR 4231.10 - Actuarial calculations and assumptions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date of...

29 CFR 4231.10 - Actuarial calculations and assumptions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date of...

29 CFR 4231.10 - Actuarial calculations and assumptions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date of...

29 CFR 4231.10 - Actuarial calculations and assumptions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date of...

29 CFR 4231.10 - Actuarial calculations and assumptions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date of...

The 2014 Long-Term Budget Outlook

DTIC Science & Technology

2014-07-01

estimated to be necessary to achieve one of those goals are conceptually similar to the estimated actuarial imbalance (that is, a negative actuarial ...interest rates and some other changes have led CBO to estimate a larger fiscal gap and a greater actuarial deficit for Social Security. (The key revisions...financing in the estimate.  The actuarial shortfall for the Social Security trust funds is estimated to be significantly larger this year than was

Behavioral-Based Predictors of Workplace Violence in the Army STARRS

DTIC Science & Technology

2014-10-01

Dawes RM, Faust D, Meehl PE. Clinical versus actuarial judgment. Science . 1989;243(4899): 1668-1674. 46. Grove WM, Zald DH, Lebow BS, Snitz BE, Nelson...develop an actuarial risk algorithm predicting suicide in the 12 months after US Army soldier inpatient treatment of a psychiatric disorder to target...generate an actuarial post- hospitalization suicide risk algorithm. Previous research has revealed that actuarial suicide prediction is much more

Military Retirement: Background and Recent Developments

DTIC Science & Technology

2014-05-28

DOD Office of the Actuary , May 2011. 3 Department of Defense, Valuation of the Military Retirement System, September 30, 2010, Office of the Actuary ...January 2012, p. 13. 4 Department of Defense, Fiscal Year 2010 DOD Statistical Report on the Military Retirement System, Office of the Actuary , May... Actuary , FY2012 DOD Statistical Report on the Military Retirement System, May 2013. Statistical documents available by fiscal year for FY2005-FY2011 at

Actually, What Is an Actuary?

ERIC Educational Resources Information Center

Oudshoorn, Susan; Finkelstein, Gary

1991-01-01

The actuarial profession is described to provide secondary school mathematics teachers insights into how actuaries use mathematics in solving real life problems. Examples are provided involving compound interest, the probability of dying, and inflation with computer modeling. (MDH)

42 CFR 440.340 - Actuarial report for benchmark-equivalent coverage.

Code of Federal Regulations, 2010 CFR

2010-10-01

... individual who is a member of the American Academy of Actuaries (AAA). (2) Using generally accepted actuarial principles and methodologies of the AAA. (3) Using a standardized set of utilization and price factors. (4...

45 CFR 156.470 - Allocation of rates for advance payments of the premium tax credit.

Code of Federal Regulations, 2014 CFR

2014-10-01

... of Actuaries in accordance with generally accepted actuarial principles and methodologies; (2...) of this section is performed by a member of the American Academy of Actuaries in accordance with...

How Does Ambiguity Affect Insurance Decisions

DTIC Science & Technology

1990-05-01

actuarially fair value is C=$100. As with the actuaries, the underwriters charge higher premiums when either p and/or L is ambiguous. Even for the case where...probabilities they reacted by increasing the premium (i.e., reducing C) particularly for the perfectly correlated case. Thus when p=.01, the actuarially fair ... value is C=100. When losses are perfectly correlated and the actuary faces an ambiguous probability, the median value is C=9. The probability would

Choosing the 'best' plan in a health insurance exchange: actuarial value tells only part of the story.

PubMed

Lore, Ryan; Gabel, Jon R; McDevitt, Roland; Slover, Michael

2012-08-01

In the health insurance exchanges that will come online in 2014, consumers will be able to compare health plans with respect to actuarial value, or the percentage of health care costs that a plan would pay for a standard population. This analysis illustrates the out-of-pocket costs that might result from plans with various plan designs and actuarial values. We find that average out-of-pocket expense declines as actuarial values rise, but two plans with similar actuarial values can produce very different outcomes for a given person. The overall affordability of a plan also will be influenced by age rating, income-related premium subsidies, and out-of-pocket subsidies. Actuarial value is a useful starting point for selecting a plan, but it does not pinpoint which plan will produce the best overall value for a particular person.

Prediction of Neck Dissection Requirement After Definitive Radiotherapy for Head-and-Neck Squamous Cell Carcinoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thariat, Juliette; Department of Radiation Oncology/IBDC CNRS UMR, Cancer Center Antoine-Lacassagne, University Nice Sophia-Antipolis, Nice, Cedex 2; Ang, K. Kian

2012-03-01

Background: This analysis was undertaken to assess the need for planned neck dissection in patients with a complete response (CR) of involved nodes after irradiation and to determine the benefit of a neck dissection in those with less than CR by tumor site. Methods: Our cohort included 880 patients with T1-4, N1-3M0 squamous cell carcinoma of the oropharynx, larynx, or hypopharynx who received treatment between 1994 and 2004. Survival curves were calculated by the Kaplan-Meier Method, comparisons of rates with the log-rank test and prognostic factors by Cox's proportional hazard model. Results: Nodal CR occurred in 377 (43%) patients, ofmore » whom 365 patients did not undergo nodal dissection. The 5-year actuarial regional control rate of patients with CR was 92%. Two hundred sixty-eight of the remaining patients (53%) underwent neck dissections. The 5-year actuarial regional control rate for patients without a CR was 84%. Those who had a neck dissection fared better with 5-year actuarial regional control rates of 90% and 76% for those operated and those not operated (p < 0.001). Variables associated with poorer regional control rates included higher T and N stage, non-oropharynx cancers, non-CR, both clinical and pathological. Conclusions: With 92% 5-year neck control rate without neck dissection after CR, there is little justification for systematic neck dissection. The addition of a neck dissection resulted in higher neck control after partial response though patients with viable tumor on pathology specimens had poorer outcomes. The identification of that subgroup that benefits from additional treatment remains a challenge.« less

An Overview of the Society of Actuaries and Its Education Programs

ERIC Educational Resources Information Center

Klugman, Stuart; Long, Gena

2014-01-01

The Society of Actuaries (SOA) is the world's largest actuarial organization. This article describes the SOA with particular attention paid to its education and qualification processes and resources available for university and college programs.

26 CFR 301.6692-1 - Failure to file actuarial report.

Code of Federal Regulations, 2011 CFR

2011-04-01

... enrolled actuary (see § 301.6059-1(d)) is considered a material item of information. Further, for any report filed for a plan year ending after January 25, 1982, if the actuary seeks to materially qualify a...

26 CFR 301.6692-1 - Failure to file actuarial report.

Code of Federal Regulations, 2012 CFR

2012-04-01

... enrolled actuary (see § 301.6059-1(d)) is considered a material item of information. Further, for any report filed for a plan year ending after January 25, 1982, if the actuary seeks to materially qualify a...

26 CFR 301.6692-1 - Failure to file actuarial report.

Code of Federal Regulations, 2013 CFR

2013-04-01

... enrolled actuary (see § 301.6059-1(d)) is considered a material item of information. Further, for any report filed for a plan year ending after January 25, 1982, if the actuary seeks to materially qualify a...

26 CFR 301.6692-1 - Failure to file actuarial report.

Code of Federal Regulations, 2014 CFR

2014-04-01

... enrolled actuary (see § 301.6059-1(d)) is considered a material item of information. Further, for any report filed for a plan year ending after January 25, 1982, if the actuary seeks to materially qualify a...

26 CFR 301.6692-1 - Failure to file actuarial report.

Code of Federal Regulations, 2010 CFR

2010-04-01

... enrolled actuary (see § 301.6059-1(d)) is considered a material item of information. Further, for any report filed for a plan year ending after January 25, 1982, if the actuary seeks to materially qualify a...

Underlying theory of actuarial analyses.

PubMed

Benjamin, B

1985-05-01

The developments in theory governing the calculation of mortality rates for use in survival measurements working through the initial basic concept of exposure to risk to the later introduction of stochastic elements are reviewed. I have indicated the way in which actuaries and statisticians who work closely with those in the fields of medicine and biology have, by the exchange of methodologic ideas, come to an identity of approach. Recent new actuarial work and likely future developments in actuarial interests are reviewed.

20 CFR 901.12 - Eligibility for enrollment.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Basic actuarial knowledge. The applicant shall demonstrate knowledge of basic actuarial mathematics and... mathematics and methodology including compound interest, principles of life contingencies, commutation... concentration was actuarial mathematics, or (ii) Which included at least as many semester hours or quarter hours...

20 CFR 901.12 - Eligibility for enrollment.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Basic actuarial knowledge. The applicant shall demonstrate knowledge of basic actuarial mathematics and... mathematics and methodology including compound interest, principles of life contingencies, commutation... concentration was actuarial mathematics, or (ii) Which included at least as many semester hours or quarter hours...

20 CFR 901.12 - Eligibility for enrollment.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Basic actuarial knowledge. The applicant shall demonstrate knowledge of basic actuarial mathematics and... mathematics and methodology including compound interest, principles of life contingencies, commutation... concentration was actuarial mathematics, or (ii) Which included at least as many semester hours or quarter hours...

Strategic Curricular Decisions in Butler University's Actuarial Science Major

ERIC Educational Resources Information Center

Wilson, Christopher James

2014-01-01

We describe specific curricular decisions employed at Butler University that have resulted in student achievement in the actuarial science major. The paper includes a discussion of how these decisions might be applied in the context of a new actuarial program.

A systematic review of publications on charged particle therapy for hepatocellular carcinoma.

PubMed

Igaki, Hiroshi; Mizumoto, Masashi; Okumura, Toshiyuki; Hasegawa, Kiyoshi; Kokudo, Norihiro; Sakurai, Hideyuki

2018-06-01

Charged particle therapy (proton beam therapy and carbon ion therapy) is a form of radiotherapy which has the unique characteristic of superior depth dose distribution, and has been used for the treatment of hepatocellular carcinoma (HCC) in a limited number of patients, especially in Japan. We undertook a systematic review to define the clinical utility of charged particle therapy for patients with HCC. We searched the MEDLINE database from 1983 to June 2016 to identify clinical studies on charged particle therapy for HCC. Primary outcomes of interest were local control, overall survival, and late radiation morbidities. A total of 13 cohorts from 11 papers were selected from an initial dataset of 78 papers. They included a randomized controlled trial comparing proton beam therapy with transarterial chemoembolization, 9 phase I or II trials and 2 retrospective studies. The reported actuarial local control rates ranged from 71.4-95% at 3 years, and the overall survival rates ranged from 25-42.3% at 5 years. Late severe radiation morbidities were uncommon, and a total of 18 patients with grade ≥3 late adverse events were reported among the 787 patients included in this analysis. Charged particle therapy for HCC was associated with good local control with limited probability of severe morbidities. The cost-effectiveness and the distinctive clinical advantages of charged particle therapies should be clarified in order to become a socially accepted treatment modality for HCC.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ghafoori, A. Paiman; Nelson, John W.; Willett, Christopher G.

Purpose: Extrahepatic cholangiocarcinoma is an uncommon but lethal malignancy. We analyzed the role of definitive chemoradiotherapy for patients with nonmetastatic, locally advanced extrahepatic cholangiocarcinoma treated at a single institution. Methods and Materials: This retrospective analysis included 37 patients who underwent external beam radiation therapy (EBRT) with concurrent chemotherapy and/or brachytherapy (BT) for locally advanced extrahepatic cholangiocarcinoma. Local control (LC) and overall survival (OS) were assessed, and univariate regression analysis was used to evaluate the effects of patient- and treatment-related factors on clinical outcomes. Results: Twenty-three patients received EBRT alone, 8 patients received EBRT plus BT, and 6 patients received BTmore » alone (median follow-up of 14 months). Two patients were alive without evidence of recurrence at the time of analysis. Actuarial OS and LC rates at 1 year were 59% and 90%, respectively, and 22% and 71%, respectively, at 2 years. Two patients lived beyond 5 years without evidence of recurrence. On univariate analysis, EBRT with or without BT improved LC compared to BT alone (97% vs. 56% at 1 year; 75% vs. 56% at 2 years; p = 0.096). Patients who received EBRT alone vs. BT alone also had improved LC (96% vs. 56% at 1 year; 80% vs. 56% at 2 years; p = 0.113). Age, gender, tumor location (proximal vs. distal), histologic differentiation, EBRT dose ({<=} or >50 Gy), EBRT planning method (two-dimensional vs. three-dimensional), and chemotherapy were not associated with patient outcomes. Conclusions: Patients with locally advanced extrahepatic cholangiocarcinoma have poor survival. Long-term survival is rare. The majority of patients treated with EBRT had local control at the time of death, suggesting that symptoms due to the local tumor effect might be effectively controlled with radiation therapy, and EBRT is an important element of treatment. Novel treatment approaches are indicated in the therapy for this disease.« less

78 FR 57174 - Advisory Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-17

... recommended for inclusion on future Joint Board examinations in actuarial mathematics, pension law and... Advisory Committee on Actuarial Examinations. DATES: The meeting will be held on October 18, 2013, from 8.... SUPPLEMENTARY INFORMATION: Notice is hereby given that the Advisory Committee on Actuarial Examinations will...

78 FR 34671 - Invitation for Membership on Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-10

... by successful completion of Joint Board examinations in basic actuarial mathematics and methodology and in actuarial mathematics and methodology relating to pension plans qualifying under ERISA. The... (ERISA), is responsible for the enrollment of individuals who wish to perform actuarial services under...

20 CFR 901.43 - Administrative Law Judge.

Code of Federal Regulations, 2014 CFR

2014-04-01

....43 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... conduct proceedings upon complaints for the suspension or termination of enrolled actuaries. (b) Powers of... with any suspension or termination proceeding of an enrolled actuary, to do the following: (1...

45 CFR 156.470 - Allocation of rates and claims costs for advance payments of cost-sharing reductions and the...

Code of Federal Regulations, 2013 CFR

2013-10-01

... the American Academy of Actuaries in accordance with generally accepted actuarial principles and... paragraph (b) of this section is performed by a member of the American Academy of Actuaries in accordance...

20 CFR 903.8 - Exemptions.

Code of Federal Regulations, 2014 CFR

2014-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES ACCESS TO RECORDS Records Pertaining to Individuals § 903.8 Exemptions. (a) Names of systems: JBEA-2, Enrolled Actuary Disciplinary Records; and JBEA-4, Enrolled Actuary Enrollment Records. (b) Provisions from which exempted: These systems contain records...

20 CFR 901.43 - Administrative Law Judge.

Code of Federal Regulations, 2013 CFR

2013-04-01

....43 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... conduct proceedings upon complaints for the suspension or termination of enrolled actuaries. (b) Powers of... with any suspension or termination proceeding of an enrolled actuary, to do the following: (1...

20 CFR 903.8 - Exemptions.

Code of Federal Regulations, 2013 CFR

2013-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES ACCESS TO RECORDS Records Pertaining to Individuals § 903.8 Exemptions. (a) Names of systems: JBEA-2, Enrolled Actuary Disciplinary Records; and JBEA-4, Enrolled Actuary Enrollment Records. (b) Provisions from which exempted: These systems contain records...

20 CFR 901.43 - Administrative Law Judge.

Code of Federal Regulations, 2011 CFR

2011-04-01

....43 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... conduct proceedings upon complaints for the suspension or termination of enrolled actuaries. (b) Powers of... with any suspension or termination proceeding of an enrolled actuary, to do the following: (1...

20 CFR 903.8 - Exemptions.

Code of Federal Regulations, 2012 CFR

2012-04-01

...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES ACCESS TO RECORDS Records Pertaining to Individuals § 903.8 Exemptions. (a) Names of systems: JBEA-2, Enrolled Actuary Disciplinary Records; and JBEA-4, Enrolled Actuary Enrollment Records. (b) Provisions from which exempted: These systems contain records...

20 CFR 901.44 - Hearings.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Hearings. 901.44 Section 901.44 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... complaint for the suspension or termination of an enrolled actuary. Hearings shall be stenographically...

20 CFR 901.43 - Administrative Law Judge.

Code of Federal Regulations, 2012 CFR

2012-04-01

....43 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... conduct proceedings upon complaints for the suspension or termination of enrolled actuaries. (b) Powers of... with any suspension or termination proceeding of an enrolled actuary, to do the following: (1...

20 CFR 901.44 - Hearings.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Hearings. 901.44 Section 901.44 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... complaint for the suspension or termination of an enrolled actuary. Hearings shall be stenographically...

77 FR 24233 - Actuarial Advisory Committee With Respect to the Railroad Retirement Account; Notice of Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-23

... Actuary of the U.S. Railroad Retirement Board, 844 North Rush Street, Chicago, Illinois, on the conduct of... Actuary, U.S. Railroad Retirement Board, 844 North Rush Street, Chicago, Illinois 60611-2092. Dated: April...

Tumor Control Outcomes After Hypofractionated and Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases From Renal Cell Carcinoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zelefsky, Michael J., E-mail: zelefskm@mskcc.org; Greco, Carlo; Motzer, Robert

2012-04-01

Purpose: To report tumor local progression-free outcomes after treatment with single-dose, image-guided, intensity-modulated radiotherapy and hypofractionated regimens for extracranial metastases from renal cell primary tumors. Patients and Methods: Between 2004 and 2010, 105 lesions from renal cell carcinoma were treated with either single-dose, image-guided, intensity-modulated radiotherapy to a prescription dose of 18-24 Gy (median, 24) or hypofractionation (three or five fractions) with a prescription dose of 20-30 Gy. The median follow-up was 12 months (range, 1-48). Results: The overall 3-year actuarial local progression-free survival for all lesions was 44%. The 3-year local progression-free survival for those who received a highmore » single-dose (24 Gy; n = 45), a low single-dose (<24 Gy; n = 14), or hypofractionation regimens (n = 46) was 88%, 21%, and 17%, respectively (high single dose vs. low single dose, p = .001; high single dose vs. hypofractionation, p < .001). Multivariate analysis revealed the following variables were significant predictors of improved local progression-free survival: 24 Gy dose compared with a lower dose (p = .009) and a single dose vs. hypofractionation (p = .008). Conclusion: High single-dose, image-guided, intensity-modulated radiotherapy is a noninvasive procedure resulting in high probability of local tumor control for metastatic renal cell cancer generally considered radioresistant according to the classic radiobiologic ranking.« less

Combined treatment in carcinoma of the nasopharynx

DOE Office of Scientific and Technical Information (OSTI.GOV)

Souhami, L.; Rabinowits, M.

1988-08-01

From October 1982 to August 1984, 30 previously untreated patients with biopsy-proven carcinoma of the nasopharynx, stage III (26.5%) and stage IV (73.5%), received combined radiotherapy (6,000 to 7,000 cGy over a period of 7 to 7.5 weeks) and chemotherapy (mitomycin-C 10 mg/M2, IV; 5-fluorouracil 750 mg/M2, IV; and methotrexate 30 mg/M2, IV) concomitantly. There were 20 males and 10 females, with a median age of 40 years. Minimal follow-up duration was 24 months. Actuarial overall survival rate at 48 months was 49%. Complete local response was achieved in 75% of the patients, with 31% of the cases failing distantly.more » The complication rate was high and included severe mucositis, xerostomia, and septicemia (fatal in two cases). Despite high local disease control, survival rate did not increase. A randomized trial is urgently needed to establish whether or not combined treatment is of value in advanced carcinoma of the nasopharynx.« less

78 FR 19008 - Meeting of the Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... inclusion on future Joint Board examinations in actuarial mathematics, pension law and methodology referred... closed meeting of the Advisory Committee on Actuarial Examinations. DATES: The meeting will be held on.... SUPPLEMENTARY INFORMATION: Notice is hereby given that the Advisory Committee on Actuarial Examinations will...

75 FR 16510 - Meeting of the Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-01

... recommended for inclusion on future Joint Board examinations in actuarial mathematics, pension law and... closed meeting of the Advisory Committee on Actuarial Examinations. DATES: The meeting will be held on.... SUPPLEMENTARY INFORMATION: Notice is hereby given that the Advisory Committee on Actuarial Examinations will...

29 CFR 4041.45 - Distress termination notice.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., Single-Employer Plan Termination, with Schedule EA-D, Distress Termination Enrolled Actuary Certification... guaranteed benefits. Unless the enrolled actuary certifies, in the Schedule EA-D filed in accordance with... benefits or benefit liabilities. If the enrolled actuary certifies that the plan is sufficient either for...

29 CFR 4041.45 - Distress termination notice.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., Single-Employer Plan Termination, with Schedule EA-D, Distress Termination Enrolled Actuary Certification... guaranteed benefits. Unless the enrolled actuary certifies, in the Schedule EA-D filed in accordance with... benefits or benefit liabilities. If the enrolled actuary certifies that the plan is sufficient either for...

20 CFR 901.33 - Initiation of proceeding.

Code of Federal Regulations, 2012 CFR

2012-04-01

....33 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... believe that an enrolled actuary has violated any provision of the laws or regulations governing... the enrolled actuary that, in the opinion of the Executive Director, his/her conduct is in violation...

20 CFR 901.33 - Initiation of proceeding.

Code of Federal Regulations, 2011 CFR

2011-04-01

....33 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... believe that an enrolled actuary has violated any provision of the laws or regulations governing... the enrolled actuary that, in the opinion of the Executive Director, his/her conduct is in violation...

29 CFR 4041.45 - Distress termination notice.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., Single-Employer Plan Termination, with Schedule EA-D, Distress Termination Enrolled Actuary Certification... guaranteed benefits. Unless the enrolled actuary certifies, in the Schedule EA-D filed in accordance with... benefits or benefit liabilities. If the enrolled actuary certifies that the plan is sufficient either for...

20 CFR 901.33 - Initiation of proceeding.

Code of Federal Regulations, 2013 CFR

2013-04-01

....33 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... believe that an enrolled actuary has violated any provision of the laws or regulations governing... the enrolled actuary that, in the opinion of the Executive Director, his/her conduct is in violation...

20 CFR 901.33 - Initiation of proceeding.

Code of Federal Regulations, 2014 CFR

2014-04-01

....33 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... believe that an enrolled actuary has violated any provision of the laws or regulations governing... the enrolled actuary that, in the opinion of the Executive Director, his/her conduct is in violation...

29 CFR 4041.45 - Distress termination notice.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., Single-Employer Plan Termination, with Schedule EA-D, Distress Termination Enrolled Actuary Certification... guaranteed benefits. Unless the enrolled actuary certifies, in the Schedule EA-D filed in accordance with... benefits or benefit liabilities. If the enrolled actuary certifies that the plan is sufficient either for...

20 CFR 901.33 - Initiation of proceeding.

Code of Federal Regulations, 2010 CFR

2010-04-01

....33 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... believe that an enrolled actuary has violated any provision of the laws or regulations governing... the enrolled actuary that, in the opinion of the Executive Director, his/her conduct is in violation...

29 CFR 4041.45 - Distress termination notice.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., Single-Employer Plan Termination, with Schedule EA-D, Distress Termination Enrolled Actuary Certification... guaranteed benefits. Unless the enrolled actuary certifies, in the Schedule EA-D filed in accordance with... benefits or benefit liabilities. If the enrolled actuary certifies that the plan is sufficient either for...

Positron Emission Tomography for Assessing Local Failure After Stereotactic Body Radiotherapy for Non-Small-Cell Lung Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang Xu; Liu Hui; Balter, Peter

2012-08-01

Purpose: We analyzed whether positron emission tomography (PET)/computed tomography standardized uptake values (SUVs) after stereotactic body radiotherapy (SBRT) could predict local recurrence (LR) in non-small-cell lung cancer (NSCLC). Methods and Materials: This study comprised 128 patients with Stage I (n = 68) or isolated recurrent/secondary parenchymal (n = 60) NSCLC treated with image-guided SBRT to 50 Gy over 4 consecutive days; prior radiotherapy was allowed. PET/computed tomography scans were obtained before therapy and at 1 to 6 months after therapy, as well as subsequently as clinically indicated. Continuous variables were analyzed with Kruskal-Wallis tests and categorical variables with Pearson chi-squaremore » or Fisher exact tests. Actuarial local failure rates were calculated with the Kaplan-Meier method. Results: At a median follow-up of 31 months (range, 6-71 months), the actuarial 1-, 2-, and 3-year local control rates were 100%, 98.5%, and 98.5%, respectively, in the Stage I group and 95.8%, 87.6%, and 85.8%, respectively, in the recurrent group. The cumulative rates of regional nodal recurrence and distant metastasis were 8.8% (6 of 68) and 14.7% (10 of 68), respectively, for the Stage I group and 11.7% (7 of 60) and 16.7% (10 of 60), respectively, for the recurrent group. Univariate analysis showed that SUVs obtained 12.1 to 24 months after treatment for the Stage I group (p = 0.007) and 6.1 to 12 months and 12.1 to 24 months after treatment for the recurrent group were associated with LR (p < 0.001 for both). Of the 128 patients, 17 (13.3%) had ipsilateral consolidation after SBRT but no elevated metabolic activity on PET; none had LR. The cutoff maximum SUV of 5 was found to have 100% sensitivity, 91% specificity, a 50% positive predictive value, and a 100% negative predictive value for predicting LR. Conclusions: PET was helpful for distinguishing SBRT-induced consolidation from LR. SUVs obtained more than 6 months after SBRT for NSCLC were associated with local failure. A maximum SUV greater than 5, especially at more than 6 months after SBRT, should prompt biopsy to rule out LR.« less

Actuarial Valuation.

ERIC Educational Resources Information Center

Teachers Retirement System of Louisiana, Baton Rouge.

This report presents the results of the actuarial valuation of assets and liabilities as well as funding requirements for the Teachers Retirement System of Louisiana as of June 30, 1996. Data reported include current funding, actuarial assets and valuation assets. These include the Louisiana State University Agriculture and Extension Service Fund,…

75 FR 59292 - Meeting of the Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

... inclusion on future Joint Board examinations in actuarial mathematics, pension law and methodology referred... closed meeting of the Advisory Committee on Actuarial Examinations. DATES: The meeting will be held on... INFORMATION: Notice is hereby given that the Advisory Committee on Actuarial Examinations will meet at...

77 FR 71828 - Meeting of the Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-04

... recommended for inclusion on future Joint Board examinations in actuarial mathematics and methodology referred... meeting of the Advisory Committee on Actuarial Examinations (portions of which will be open to the public... Committee on Actuarial Examinations will meet at the Internal Revenue Service, 1111 Constitution Avenue NW...

75 FR 53716 - Invitation for Membership on Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-01

... successful completion of Joint Board examinations in basic actuarial mathematics and methodology and in actuarial mathematics and methodology relating to pension plans qualifying under ERISA. The Joint Board, the... Act of 1974 (ERISA), is responsible for the enrollment of individuals who wish to perform actuarial...

75 FR 76486 - Meeting of the Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... that may be recommended for inclusion on future Joint Board examinations in actuarial mathematics and... meeting of the Advisory Committee on Actuarial Examinations (portions of which will be open to the public... the Advisory Committee on Actuarial Examinations will meet at the Internal Revenue Service, 1111...

How Changes in Immigration Policy Might Affect the Federal Budget

DTIC Science & Technology

2015-01-01

President, 2005 (February 2005), Chapter 4, p. 107, http://tinyurl.com/c9kdark; Social Security Administration, Office of the Chief Actuary , “Letter to...Report,” Actuarial Note 148 (Social Security Administration, Office of the Chief Actuary , March 2009), http://go.usa.gov/BaRG. incorporating such

78 FR 36575 - Meeting of the Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-18

... Joint Board examinations in actuarial mathematics and methodology referred to in 29 U.S.C. 1242(a)(1)(B... meeting of the Advisory Committee on Actuarial Examinations (a portion of which will be open to the public...- 2173. SUPPLEMENTARY INFORMATION: Notice is hereby given that the Advisory Committee on Actuarial...

76 FR 75912 - Meeting of the Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

... Joint Board examinations in actuarial mathematics and methodology referred to in 29 U.S.C. 1242(a)(1)(B... Advisory Committee on Actuarial Examinations (portions of which will be open to the public) in Washington.... SUPPLEMENTARY INFORMATION: Notice is hereby given that the Advisory Committee on Actuarial Examinations will...

77 FR 19034 - Meeting of the Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-29

... Joint Board examinations in actuarial mathematics, pension law and methodology referred to in 29 U.S.C... closed meeting of the Advisory Committee on Actuarial Examinations. DATES: The meeting will be held on... INFORMATION: Notice is hereby given that the Advisory Committee on Actuarial Examinations will meet at...

Developing an Actuarial Track Utilizing Existing Resources

ERIC Educational Resources Information Center

Rodgers, Kathy V.; Sarol, Yalçin

2014-01-01

Students earning a degree in mathematics often seek information on how to apply their mathematical knowledge. One option is to follow a curriculum with an actuarial emphasis designed to prepare students as an applied mathematician in the actuarial field. By developing only two new courses and utilizing existing courses for Validation by…

76 FR 34750 - Advisory Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-14

... inclusion on future Joint Board examinations in actuarial mathematics and methodology referred to in 29 U.S... Committee on Actuarial Examinations (a portion of which will be open to the public) in Washington, DC at the... Actuarial Examinations will meet in at the Internal Revenue Service Building, 1111 Constitution Avenue, NW...

75 FR 28062 - Meeting of the Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-19

... questions which may be recommended for inclusion on future Joint Board examinations in actuarial mathematics... meeting of the Advisory Committee on Actuarial Examinations (a portion of which will be open to the public... the Advisory Committee on Actuarial Examinations will meet in at the Internal Revenue Service Building...

78 FR 73564 - Meeting of the Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-06

... Joint Board examinations in actuarial mathematics and methodology referred to in 29 U.S.C. 1242(a)(1)(B... Advisory Committee on Actuarial Examinations (portions of which will be open to the public) in Washington.... SUPPLEMENTARY INFORMATION: Notice is hereby given that the Advisory Committee on Actuarial Examinations will...

76 FR 17967 - Meeting of the Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-31

... Joint Board examinations in actuarial mathematics, pension law and methodology referred to in 29 U.S.C... closed meeting of the Advisory Committee on Actuarial Examinations. DATES: The meeting will be held on... INFORMATION: Notice is hereby given that the Advisory Committee on Actuarial Examinations will meet at Mercer...

20 CFR 901.30 - Authority to suspend or terminate enrollment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Authority to suspend or terminate enrollment. 901.30 Section 901.30 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... the enrollment of an enrolled actuary if the Joint Board finds that such enrolled actuary (a) Has...

20 CFR 901.30 - Authority to suspend or terminate enrollment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Authority to suspend or terminate enrollment. 901.30 Section 901.30 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... the enrollment of an enrolled actuary if the Joint Board finds that such enrolled actuary (a) Has...

20 CFR 901.30 - Authority to suspend or terminate enrollment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Authority to suspend or terminate enrollment. 901.30 Section 901.30 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... the enrollment of an enrolled actuary if the Joint Board finds that such enrolled actuary (a) Has...

29 CFR 4231.9 - Request for compliance determination.

Code of Federal Regulations, 2014 CFR

2014-07-01

... enrolled actuary based each certification that a plan involved in the merger or transfer satisfied a plan... by an enrolled actuary: (i) A statement that the plan satisfies one of the plan solvency tests set... actuary has determined that benefits under the plan are not reasonably expected to be subject to...

29 CFR 4231.8 - Notice of merger or transfer.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., including an enrolled actuary's certification to that effect). (3) The proposed effective date of the... statements, certified by an enrolled actuary: (i) A statement that the plan satisfies the applicable plan... on which the actuary has determined that benefits under the plan are not reasonably expected to be...

29 CFR 4231.9 - Request for compliance determination.

Code of Federal Regulations, 2012 CFR

2012-07-01

... enrolled actuary based each certification that a plan involved in the merger or transfer satisfied a plan... by an enrolled actuary: (i) A statement that the plan satisfies one of the plan solvency tests set... actuary has determined that benefits under the plan are not reasonably expected to be subject to...

20 CFR 901.30 - Authority to suspend or terminate enrollment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Authority to suspend or terminate enrollment. 901.30 Section 901.30 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... the enrollment of an enrolled actuary if the Joint Board finds that such enrolled actuary (a) Has...

29 CFR 4231.9 - Request for compliance determination.

Code of Federal Regulations, 2013 CFR

2013-07-01

... enrolled actuary based each certification that a plan involved in the merger or transfer satisfied a plan... by an enrolled actuary: (i) A statement that the plan satisfies one of the plan solvency tests set... actuary has determined that benefits under the plan are not reasonably expected to be subject to...

20 CFR 901.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... of time. (4) Actuarial gain or loss. (e) Month of responsible pension actuarial experience means a...) and (k), effective May 2, 2011. For the convenience of the user, the added text is set forth as... pension actuarial experience. (k) Enrollment cycle means the three-year period from January 1, 2011, to...

26 CFR 300.0 - User fees; in general.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the enrollment of an enrolled agent. (7) Enrolling an enrolled actuary. (8) Renewing the enrollment of an enrolled actuary. (c) Effective/applicability date. This part 300 is applicable March 16, 1995... and renewal of enrollment for enrolled actuaries is applicable January 22, 2008. [T.D. 8589, 60 FR...

29 CFR 4231.9 - Request for compliance determination.

Code of Federal Regulations, 2010 CFR

2010-07-01

... enrolled actuary based each certification that a plan involved in the merger or transfer satisfied a plan... by an enrolled actuary: (i) A statement that the plan satisfies one of the plan solvency tests set... actuary has determined that benefits under the plan are not reasonably expected to be subject to...

20 CFR 901.30 - Authority to suspend or terminate enrollment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Authority to suspend or terminate enrollment. 901.30 Section 901.30 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... the enrollment of an enrolled actuary if the Joint Board finds that such enrolled actuary (a) Has...

76 FR 8350 - Notice of Federal Advisory Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-14

... federal advisory committee meeting of the DoD Board of Actuaries will take place: DATES: July 14-15, 2011... Office of the Actuary, 4040 N. Fairfax Drive, Suite 308, Arlington, VA 22203. SUPPLEMENTARY INFORMATION... Board of Actuaries meeting or make an oral presentation or submit a written statement for consideration...

Stereotactic radiotherapy for locally recurrent nasopharyngeal carcinoma.

PubMed

Leung, To-Wai; Wong, Victy Y W; Tung, Stewart Y

2009-11-01

To study the treatment outcome in patients with locally recurrent nasopharyngeal carcinoma (NPC) who were treated with stereotactic radiotherapy (SRT). Thirty patients with non-metastatic, locally recurrent NPC who were treated with curative intent between 1998 and 2002 were retrospectively analyzed. The International Union Against Cancer T-stage distribution at recurrence (rT) was as follows: rT1-14, rT2-7, rT3-3, and rT4-6. All patients were treated with SRT with a daily fractional dose of 2.5-4.5 Gy (median, 3 Gy) in 8-22 fractions (median, 18 fractions). Total equivalent dose (TED) was calculated by the linear-quadratic formula without a time factor correction. The 5-year actuarial overall survival rate, disease-specific survival rate, and local failure-free survival (LFFS) rate for the whole group were 40%, 41.4%, and 56.8%, respectively. The 3-year LFFS rates of rT1-2 and rT3-4 diseases were 65% and 66.7%, respectively. Seven of nine patients who received a TED <55 Gy recurred locally compared with 4 of 21 patients who received > or =55 Gy. Their corresponding 5-year LFFS rates were 22.2% and 75.8% (p = 0.005). The TED was the only factor significant in affecting the local control on univariate analyses. SRT is an effective treatment for locally recurrent NPC. TED > or =55 Gy should be given to secure a higher local control rate. The late complication rates were acceptable for patients with rT1-2 disease. For patients with rT3-4 disease, more works need to be done to further decrease the late complications.

Development of a clinical prediction model to calculate patient life expectancy: the measure of actuarial life expectancy (MALE).

PubMed

Clarke, M G; Kennedy, K P; MacDonagh, R P

2009-01-01

To develop a clinical prediction model enabling the calculation of an individual patient's life expectancy (LE) and survival probability based on age, sex, and comorbidity for use in the joint decision-making process regarding medical treatment. A computer software program was developed with a team of 3 clinicians, 2 professional actuaries, and 2 professional computer programmers. This incorporated statistical spreadsheet and database access design methods. Data sources included life insurance industry actuarial rating factor tables (public and private domain), Government Actuary Department UK life tables, professional actuarial sources, and evidence-based medical literature. The main outcome measures were numerical and graphical display of comorbidity-adjusted LE; 5-, 10-, and 15-year survival probability; in addition to generic UK population LE. Nineteen medical conditions, which impacted significantly on LE in actuarial terms and were commonly encountered in clinical practice, were incorporated in the final model. Numerical and graphical representations of statistical predictions of LE and survival probability were successfully generated for patients with either no comorbidity or a combination of the 19 medical conditions included. Validation and testing, including actuarial peer review, confirmed consistency with the data sources utilized. The evidence-based actuarial data utilized in this computer program design represent a valuable resource for use in the clinical decision-making process, where an accurate objective assessment of patient LE can so often make the difference between patients being offered or denied medical and surgical treatment. Ongoing development to incorporate additional comorbidities and enable Web-based access will enhance its use further.

20 CFR 901.13 - Eligibility for enrollment of individuals applying for enrollment on or after January 1, 1976.

Code of Federal Regulations, 2011 CFR

2011-04-01

... actuarial mathematics and methodology by one of the following: (1) Joint Board basic examination. Successful... basic actuarial mathematics and methodology including compound interest, principles of life... major area of concentration was actuarial mathematics, or (ii) Which included at least as many semester...

77 FR 34408 - Meeting of the Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-11

... examinations in actuarial mathematics and methodology referred to in 29 U.S.C. 1242(a)(1)(B) and to review the... meeting of the Advisory Committee on Actuarial Examinations (a portion of which will be open to the public.... SUPPLEMENTARY INFORMATION: Notice is hereby given that the Advisory Committee on Actuarial Examinations will...

76 FR 56797 - Meeting of the Federal Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

... on Actuarial Examinations. DATES: The meeting will be held on October 21, 2011, from 8:30 a.m. to 5 p... Advisory Committee on Actuarial Examinations will meet at Deloitte, 2901 N. Central Avenue, Suite 1200... and questions that may be recommended for inclusion on future Joint Board examinations in actuarial...

77 FR 59979 - Meeting of the Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-01

... actuarial mathematics, pension law and methodology referred to in 29 U.S.C. 1242(a)(1)(B). A determination... closed meeting of the Advisory Committee on Actuarial Examinations. DATES: The meeting will be held on... is hereby given that the Advisory Committee on Actuarial Examinations will meet at Towers Watson, 800...

29 CFR 4231.8 - Notice of merger or transfer.

Code of Federal Regulations, 2012 CFR

2012-07-01

... it is a de minimis transaction as defined in § 4231.7 (and, if so, including an enrolled actuary's... that exists after the transaction, one of the following statements, certified by an enrolled actuary..., indicating which is the applicable test. (ii) A statement of the basis on which the actuary has determined...

29 CFR 4231.8 - Notice of merger or transfer.

Code of Federal Regulations, 2011 CFR

2011-07-01

... it is a de minimis transaction as defined in § 4231.7 (and, if so, including an enrolled actuary's... that exists after the transaction, one of the following statements, certified by an enrolled actuary..., indicating which is the applicable test. (ii) A statement of the basis on which the actuary has determined...

29 CFR 4231.8 - Notice of merger or transfer.

Code of Federal Regulations, 2013 CFR

2013-07-01

... it is a de minimis transaction as defined in § 4231.7 (and, if so, including an enrolled actuary's... that exists after the transaction, one of the following statements, certified by an enrolled actuary..., indicating which is the applicable test. (ii) A statement of the basis on which the actuary has determined...

75 FR 68790 - Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual Deductible...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-09

... 0938-AP81 Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual... (SMI) program beginning January 1, 2011. In addition, this notice announces the monthly premium for... beneficiaries with modified adjusted gross income above certain threshold amounts. The monthly actuarial rates...

76 FR 67572 - Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual Deductible...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

... 0938-AQ16 Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual... (SMI) program beginning January 1, 2012. In addition, this notice announces the monthly premium for... beneficiaries with modified adjusted gross income above certain threshold amounts. The monthly actuarial rates...

78 FR 64943 - Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual Deductible...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

... 0938-AR58 Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual... (SMI) program beginning January 1, 2014. In addition, this notice announces the monthly premium for... beneficiaries with modified adjusted gross income above certain threshold amounts. The monthly actuarial rates...

29 CFR 4231.8 - Notice of merger or transfer.

Code of Federal Regulations, 2010 CFR

2010-07-01

... it is a de minimis transaction as defined in § 4231.7 (and, if so, including an enrolled actuary's... that exists after the transaction, one of the following statements, certified by an enrolled actuary..., indicating which is the applicable test. (ii) A statement of the basis on which the actuary has determined...

Multidose Stereotactic Radiosurgery (9 Gy × 3) of the Postoperative Resection Cavity for Treatment of Large Brain Metastases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Minniti, Giuseppe, E-mail: gminniti@ospedalesantandrea.it; Department of Neurological Sciences, Scientific Institute IRCCS Neuromed, Pozzilli; Esposito, Vincenzo

2013-07-15

Purpose: To evaluate the clinical outcomes with linear accelerator-based multidose stereotactic radiosurgery (SRS) to large postoperative resection cavities in patients with large brain metastases. Methods and Materials: Between March 2005 to May 2012, 101 patients with a single brain metastasis were treated with surgery and multidose SRS (9 Gy × 3) for large resection cavities (>3 cm). The target volume was the resection cavity with the inclusion of a 2-mm margin. The median cavity volume was 17.5 cm{sup 3} (range, 12.6-35.7 cm{sup 3}). The primary endpoint was local control. Secondary endpoints were survival and distant failure rates, cause of death,more » performance measurements, and toxicity of treatment. Results: With a median follow-up of 16 months (range, 6-44 months), the 1-year and 2-year actuarial survival rates were 69% and 34%, respectively. The 1-year and 2-year local control rates were 93% and 84%, with respective incidences of new distant brain metastases of 50% and 66%. Local control was similar for radiosensitive (non-small cell lung cancer and breast cancer) and radioresistant (melanoma and renal cell cancer) brain metastases. On multivariate Cox analysis stable extracranial disease, breast cancer histology, and Karnofsky performance status >70 were associated with significant survival benefit. Brain radionecrosis occurred in 9 patients (9%), being symptomatic in 5 patients (5%). Conclusions: Adjuvant multidose SRS to resection cavity represents an effective treatment option that achieves excellent local control and defers the use of whole-brain radiation therapy in selected patients with large brain metastases.« less

Conformal Radiotherapy in the Treatment of Advanced Juvenile Nasopharyngeal Angiofibroma With Intracranial Extension: An Institutional Experience

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chakraborty, Santam, E-mail: drsantam@gmail.com; Ghoshal, Sushmita; Patil, Vijay Maruti

2011-08-01

Purpose: To describe the results of conformal radiotherapy in advanced juvenile nasopharyngeal angiofibroma in a tertiary care institution. Methods and Materials: Retrospective chart review was conducted for 8 patients treated with conformal radiotherapy between 2006 and 2009. The median follow-up was 17 months. All patients had Stage IIIB disease with intracranial extension. Radiotherapy was considered as treatment because patients were deemed inoperable owing to extensive intracranial/intraorbital extension or proximity to optic nerve. All but 1 patient were treated with intensity-modulated radiotherapy using seven coplanar fields. Median (range) dose prescribed was 39.6 (30-46) Gy. Actuarial analysis of local control and descriptivemore » analysis of toxicity profile was conducted. Results: Despite the large and complex target volume (median planning target volume, 292 cm{sup 3}), intensity-modulated radiotherapy achieved conformal dose distributions (median van't Reit index, 0.66). Significant sparing of the surrounding organs at risk was obtained. No significant Grade 3/4 toxicities were experienced during or after treatment. Actual local control at 2 years was 87.5%. One patient died 1 month after radiotherapy secondary to massive epistaxis. The remaining 7 patients had progressive resolution of disease and were symptom-free at last follow-up. Persistent rhinitis was the only significant toxicity, seen in 1 patient. Conclusions: Conformal radiotherapy results in good local control with minimal acute and late side effects in juvenile nasopharyngeal angiofibromas, even in the presence of advanced disease.« less

5 CFR 839.1114 - Will OPM actuarially reduce my benefit if I elect to change my retirement coverage under these...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Will OPM actuarially reduce my benefit if... General Provisions § 839.1114 Will OPM actuarially reduce my benefit if I elect to change my retirement... Basic Employee Death Benefit (see § 839.1121). ...

5 CFR 839.1115 - What is an actuarial reduction?

Code of Federal Regulations, 2010 CFR

2010-01-01

...? An actuarial reduction allows you to receive benefits without having to pay an amount due in a lump sum. OPM reduces your annuity in a way that, on average, allows the Fund to recover the amount of the... have to pay at that time. To compute an actuarial reduction, OPM divides the lump sum amount by the...

5 CFR 839.1115 - What is an actuarial reduction?

Code of Federal Regulations, 2011 CFR

2011-01-01

...? An actuarial reduction allows you to receive benefits without having to pay an amount due in a lump sum. OPM reduces your annuity in a way that, on average, allows the Fund to recover the amount of the... have to pay at that time. To compute an actuarial reduction, OPM divides the lump sum amount by the...

75 FR 6360 - Federal Advisory Committee; DoD Medicare-Eligible Retiree Health Care Board of Actuaries

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-09

... Retiree Health Care Board of Actuaries AGENCY: Department of Defense (DoD). ACTION: Meeting notice..., the Department of Defense announces that the DoD Medicare-Eligible Retiree Health Care Board of... actuarial methods and assumptions to be used in the valuation of benefits under DoD retiree health care...

Development of an Actuarial Science Program at Salisbury University

ERIC Educational Resources Information Center

Wainwright, Barbara A.

2014-01-01

This paper focuses on the development of an actuarial science track for the mathematics major at Salisbury University (SU). A timeline from the initial investigation into such a program through the proposal and approval processes is shared for those who might be interested in developing a new actuarial program. It is wise to start small and take…

Military Retirement: Alternate Final Pay and Cost of Living Indexing

DTIC Science & Technology

2014-06-01

LIST OF TABLES Table 1.  Military Retirement System Multipliers (from DOD Office of the Actuary , 2012...10  Table 2.  Number of Retirees by Rank (from DOD Office of the Actuary , 2012...Expectancy (from DOD Office of the Actuary , 2012) ..23  Table 5.  HI-3 Valuation in Millions of Dollars

20 CFR 901.31 - Grounds for suspension or termination of enrollment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... enrollment. 901.31 Section 901.31 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS...) Failure to satisfy requirements for enrollment. The enrollment of an actuary may be terminated if it is found that the actuary did not satisfy the eligibility requirements set forth in § 901.11 or § 901.12...

20 CFR 901.31 - Grounds for suspension or termination of enrollment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... enrollment. 901.31 Section 901.31 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS...) Failure to satisfy requirements for enrollment. The enrollment of an actuary may be terminated if it is found that the actuary did not satisfy the eligibility requirements set forth in § 901.11 or § 901.12...

20 CFR 901.31 - Grounds for suspension or termination of enrollment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... enrollment. 901.31 Section 901.31 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS...) Failure to satisfy requirements for enrollment. The enrollment of an actuary may be terminated if it is found that the actuary did not satisfy the eligibility requirements set forth in § 901.11 or § 901.12...

20 CFR 901.31 - Grounds for suspension or termination of enrollment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... enrollment. 901.31 Section 901.31 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS...) Failure to satisfy requirements for enrollment. The enrollment of an actuary may be terminated if it is found that the actuary did not satisfy the eligibility requirements set forth in §§ 901.12 or 901.13...

20 CFR 901.31 - Grounds for suspension or termination of enrollment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... enrollment. 901.31 Section 901.31 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS...) Failure to satisfy requirements for enrollment. The enrollment of an actuary may be terminated if it is found that the actuary did not satisfy the eligibility requirements set forth in §§ 901.12 or 901.13...

Tumor Control Outcomes Following Hypofractionated and Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases from Renal Cell Carcinoma

PubMed Central

Zelefsky, Michael J; Greco, Carlo; Motzer, Robert; Magsanoc, Juan Martin; Pei, Xin; Lovelock, Michael; Mechalakos, Jim; Zatcky, Joan; Fuks, Zvi; Yamada, Yoshiya

2014-01-01

Purpose To report tumor local progression-free outcomes following treatment with single-dose image-guided intensity-modulated radiotherapy (SD-IGRT) and hypofractionated regimens for extracranial metastases from renal cell primary tumors. Methods and Materials Between 2004 and 2010, a total of 105 lesions from renal cell carcinomas were treated with either SD-IGRT to prescription doses of 18–24 Gy (median, 24 Gy) or hypofractionation (3 or 5 fractions) with prescription doses ranging between 20 and 30 Gy. The median follow-up was 12 months (range, 1–48 months). Results The overall 3-year actuarial local progression-free survival (LPFS) for all lesions was 44%. The 3-year LPFS for those who received high single-dose (24 Gy; n = 45), low single-dose (< 24 Gy; n = 14), and hypofractionation regimens (n = 46) were 88%, 21%, and 17%, respectively (high single dose versus low single dose, p = 0.001; high single dose versus hypofractionation, p < 0.001). Multivariate analysis revealed the following variables as significant predictors of improved LPFS: dose of 24 Gy compared with lower dose (p = 0.009), and single dose versus hypofractionation (p = 0.008). Conclusion High-dose SD-IGRT is a non-invasive procedure resulting in high probability of local tumor control for metastatic renal cell cancers, generally considered radioresistant according to classical radiobiological ranking. PMID:21596489

A Comparison of Logistic Regression, Neural Networks, and Classification Trees Predicting Success of Actuarial Students

ERIC Educational Resources Information Center

Schumacher, Phyllis; Olinsky, Alan; Quinn, John; Smith, Richard

2010-01-01

The authors extended previous research by 2 of the authors who conducted a study designed to predict the successful completion of students enrolled in an actuarial program. They used logistic regression to determine the probability of an actuarial student graduating in the major or dropping out. They compared the results of this study with those…

20 CFR 903.4 - Procedures for access to records and accountings of disclosures from records, regarding individuals.

Code of Federal Regulations, 2012 CFR

2012-04-01

... BOARD FOR THE ENROLLMENT OF ACTUARIES ACCESS TO RECORDS Records Pertaining to Individuals § 903.4... addressed to the Executive Director, Joint Board for the Enrollment of Actuaries, c/o U.S. Department of the... Board for the Enrollment of Actuaries, 2401 E Street, NW., suite 1537, Washington, DC, between the hours...

20 CFR 903.4 - Procedures for access to records and accountings of disclosures from records, regarding individuals.

Code of Federal Regulations, 2011 CFR

2011-04-01

... BOARD FOR THE ENROLLMENT OF ACTUARIES ACCESS TO RECORDS Records Pertaining to Individuals § 903.4... addressed to the Executive Director, Joint Board for the Enrollment of Actuaries, c/o U.S. Department of the... Board for the Enrollment of Actuaries, 2401 E Street, NW., suite 1537, Washington, DC, between the hours...

20 CFR 903.4 - Procedures for access to records and accountings of disclosures from records, regarding individuals.

Code of Federal Regulations, 2013 CFR

2013-04-01

... BOARD FOR THE ENROLLMENT OF ACTUARIES ACCESS TO RECORDS Records Pertaining to Individuals § 903.4... addressed to the Executive Director, Joint Board for the Enrollment of Actuaries, c/o U.S. Department of the... Board for the Enrollment of Actuaries, 2401 E Street, NW., suite 1537, Washington, DC, between the hours...

20 CFR 903.4 - Procedures for access to records and accountings of disclosures from records, regarding individuals.

Code of Federal Regulations, 2014 CFR

2014-04-01

... BOARD FOR THE ENROLLMENT OF ACTUARIES ACCESS TO RECORDS Records Pertaining to Individuals § 903.4... addressed to the Executive Director, Joint Board for the Enrollment of Actuaries, c/o U.S. Department of the... Board for the Enrollment of Actuaries, 2401 E Street, NW., suite 1537, Washington, DC, between the hours...

20 CFR 903.3 - Procedures for notification with respect to records regarding individuals.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ACTUARIES ACCESS TO RECORDS Records Pertaining to Individuals § 903.3 Procedures for notification with... Director, Joint Board for the Enrollment of Actuaries, c/o U.S. Department of the Treasury, Washington, DC... Enrollment of Actuaries, 2401 E Street, NW., suite 1537, Washington, D.C. between the hours of 9 a.m. and 5 p...

Prognosis of patients after open mitral commissurotomy. Actuarial analysis of late results in 100 patients.

PubMed

Housman, L B; Bonchek, L; Lambert, L; Grunkemeier, G; Starr, A

1977-05-01

The continuing controversy between proponents of open and closed commissurotomy might be clarified by analysis of late follow-up with modern actuarial techniques that provide a true perspective of patient risk. We have used open mitral commissurotomy exclusively for 15 years in 100 patients. There was one operative death from pancreatitis and one late death from cancer; the actuarially projected survival rate (+/- the standard error) at 10 years is 97 per cent (+/- 2). Thirteen patients had preoperative emboli, 6 of whom were in sinus rhythm and 7 in atrial fibrillation. Two patients had postoperative emboli, both in sinus rhythm. The actuarial chance of remaining free of embolism at 10 years is 97 per cent (+/- 2). Sixteen patients required reoperation on the mitral valve for functional deterioration. The remaining survivors were in Class I or II when last seen. The actuarial chance of not requiring a reoperation after 5 years is 91 per cent (+/- 4) and at 10 years, 38 per cent(+/- 16). Results in different centers are difficult to compare for many reasons, but imprecise statistical methods further obscure such comparisons. The use of actuarial techniques may help to define the role of open mitral commissurotomy.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Khan, Atif J., E-mail: atif_khan@rwjuh.edu; Vicini, Frank A.; Beitsch, Peter

Purpose: The American Society of Breast Surgeons enrolled women in a registry trial to prospectively study patients treated with the MammoSite Radiation Therapy System breast brachytherapy device. The present report examined the outcomes in women aged >70 years enrolled in the trial. Methods and Materials: A total of 1,449 primary early stage breast cancers were treated in 1,440 women. Of these, 537 occurred in women >70 years old. Fisher's exact test was performed to correlate age ({<=}70 vs. >70 years) with toxicity and with cosmesis. The association of age with local recurrence (LR) failure times was investigated by fitting amore » parametric model. Results: Older women were less likely to develop telangiectasias than younger women (7.9% vs. 12.4%, p = 0.0083). The incidence of other toxicities was similar. Cosmesis was good or excellent in 92% of the women >70 years old. No significant difference was found in LR as a function of age. The 5-year actuarial LR rate with invasive disease for the older vs. younger population was 2.79% and 2.92%, respectively (p = 0.5780). In women >70 years with hormone-sensitive tumors {<=}2 cm who received hormonal therapy (n = 195), the 5-year actuarial rate of LR, overall survival, disease-free survival, and cause-specific survival was 2.06%, 89.3%, 87%, and 97.5%, respectively. These outcomes were similar in women who did not receive hormonal therapy. Women with small, estrogen receptor-negative disease had worse LR, overall survival, and disease-free survival compared with receptor-positive patients. Conclusions: Accelerated partial breast irradiation with the MammoSite radiation therapy system resulted in low toxicity and produced similar cosmesis and local control at 5 years in women >70 years compared with younger women. This treatment should be considered as an alternative to omitting adjuvant radiotherapy for older women with small-volume, early-stage breast cancer.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rimner, Andreas, E-mail: rimnera@mskcc.org; Spratt, Daniel E.; Zauderer, Marjorie G.

Purpose: We previously reported our technique for delivering intensity modulated radiation therapy (IMRT) to the entire pleura while attempting to spare the lung in patients with malignant pleural mesothelioma (MPM). Herein, we report a detailed pattern-of-failure analysis in patients with MPM who were unresectable or underwent pleurectomy/decortication (P/D), uniformly treated with hemithoracic pleural IMRT. Methods and Materials: Sixty-seven patients with MPM were treated with definitive or adjuvant hemithoracic pleural IMRT between November 2004 and May 2013. Pretreatment imaging, treatment plans, and posttreatment imaging were retrospectively reviewed to determine failure location(s). Failures were categorized as in-field (within the 90% isodose line),more » marginal (<90% and ≥50% isodose lines), out-of-field (outside the 50% isodose line), or distant. Results: The median follow-up was 24 months from diagnosis and the median time to in-field local failure from the end of RT was 10 months. Forty-three in-field local failures (64%) were found with a 1- and 2-year actuarial failure rate of 56% and 74%, respectively. For patients who underwent P/D versus those who received a partial pleurectomy or were deemed unresectable, the median time to in-field local failure was 14 months versus 6 months, respectively, with 1- and 2-year actuarial in-field local failure rates of 43% and 60% versus 66% and 83%, respectively (P=.03). There were 13 marginal failures (19%). Five of the marginal failures (38%) were located within the costomediastinal recess. Marginal failures decreased with increasing institutional experience (P=.04). Twenty-five patients (37%) had out-of-field failures. Distant failures occurred in 32 patients (48%). Conclusions: After hemithoracic pleural IMRT, local failure remains the dominant form of failure pattern. Patients treated with adjuvant hemithoracic pleural IMRT after P/D experience a significantly longer time to local and distant failure than patients treated with definitive pleural IMRT. Increasing experience and improvement in target delineation minimize the incidence of avoidable marginal failures.« less

An analysis of possible applications of fuzzy set theory to the actuarial credibility theory

NASA Technical Reports Server (NTRS)

Ostaszewski, Krzysztof; Karwowski, Waldemar

1992-01-01

In this work, we review the basic concepts of actuarial credibility theory from the point of view of introducing applications of the fuzzy set-theoretic method. We show how the concept of actuarial credibility can be modeled through the fuzzy set membership functions and how fuzzy set methods, especially fuzzy pattern recognition, can provide an alternative tool for estimating credibility.

Terrorist Networks, Money Laundering Schemes, and Nation Stability

DTIC Science & Technology

2010-06-01

Stabilization Initiative  $106,400,000.00 to recon/stab  Seven countries per fiscal year  American Academy of Actuaries insured losses (relatively...Indicators  Political Instability Task Force Report  Mathematical Model (Linear Program Optimization)  Develop a value system (utility theory) to...deeper ahead. 47 LIST OF REFERENCES American Academy of Actuaries (Finance Data). Retrieved September 20, 2009, from, http://www.actuary.org

Radiotherapy for T1-2N0 glottic cancer: a multivariate analysis of predictive factors for the long-term outcome in 1050 patients and a prospective assessment of quality of life and voice handicap index in a subset of 233 patients.

PubMed

Al-Mamgani, A; van Rooij, P H; Woutersen, D P; Mehilal, R; Tans, L; Monserez, D; Baatenburg de Jong, R J

2013-08-01

To evaluate the outcomes of patients with early stage glottic cancer (GC) treated with radiotherapy (RT). The current study report on a retrospective analysis of oncologic outcome of 1050 patients with T1-2N0 glottic cancer treated with radiotherapy. Prospective assessment of quality of life (QoL) and voice handicap index (VHI) was performed in all patients treated from 2006 onwards (n = 233). Local control (LC), regional control (RC), disease-free survival (DFS), overall survival (OS), quality of life and voice handicap index. After a median follow-up of 90 months (range 3-309), the actuarial rates of local control, regional control, disease-free survival and overall survival were 85%, 99%, 84% and 81% at 5 years and 82%, 98%, 80% and 61% at 10 years, respectively. On multivariate analysis, T2 tumours, smoking after radiotherapy and conventional radiation scheme correlated significantly with poor local control. Patients who continued smoking after radiotherapy had also significantly lower overall survival rates (OR 4.3, P < 0.001). Hypothyroidism was reported in 18% of patients. Slight and temporary deterioration of quality of life scores was reported. Patient-reported xerostomia and dysphagia at 48 months were -7.1 and -6.5, compared with baseline, respectively. Voice handicap index improved significantly from 37 at baseline to 18 at 48 months. Patients with T2b and those who continued smoking had significantly worse voice handicap index. In the current study, excellent outcome with good quality of life and voice handicap index scores were reported. T2 tumours, in particular T2b, and continuing smoking after radiotherapy correlated significantly with poor local control and worse voice handicap index. © 2013 John Wiley & Sons Ltd.

Stereotactic radiotherapy of vestibular schwannoma : Hearing preservation, vestibular function, and local control following primary and salvage radiotherapy.

PubMed

Putz, Florian; Müller, Jan; Wimmer, Caterina; Goerig, Nicole; Knippen, Stefan; Iro, Heinrich; Grundtner, Philipp; Eyüpoglu, Ilker; Rössler, Karl; Semrau, Sabine; Fietkau, Rainer; Lettmaier, Sebastian

2017-03-01

The aim of this publication is to present long-term data on functional outcomes and tumor control in a cohort of 107 patients treated with stereotactic radiotherapy (RT) for vestibular schwannoma. Included were 107 patients with vestibular schwannoma (primary or recurrent following resection) treated with stereotactic RT (either fractioned or single-dose radiosurgery) between October 2002 and December 2013. Local control and functional outcomes were determined. Analysis of hearing preservation was limited to a subgroup of patients with complete audiometric data collected before treatment and during follow-up. Vestibular function test (FVT) results could be analyzed in a subset of patients and were compared to patient-reported dizziness. After a mean follow-up of 46.3 months, actuarial local control for the whole cohort was 100% after 2, 97.6% after 5, and 94.1% after 10 years. In patients with primary RT, serviceable hearing was preserved in 72%. Predictors for preservation of serviceable hearing in multivariate analysis were time of follow-up (odds ratio, OR = 0.93 per month; p = 0.021) and pre-RT tumor size (Koos stage I-IIa vs. IIb-IV; OR = 0.15; p = 0.031). Worsening of FVT results was recorded in 17.6% (N = 3). Profound discrepancy of patient-reported dizziness and FVT results was observed after RT. In patients with primary RT, worsening of facial nerve function occurred in 1.7% (N = 1). Stereotactic RT of vestibular schwannoma provides good functional outcomes and high control rates. Dependence of hearing preservation on time of follow-up and initial tumor stage has to be considered.

Therapeutic Effect of Gamma Knife Radiosurgery for Multiple Brain Metastases

PubMed Central

Lee, Chul-Kyu; Lee, Sang Ryul; Cho, Jin Mo; Yang, Kyung Ah

2011-01-01

Objective The aim of this study is to evaluate the therapeutic effects of gamma knife radiosurgery (GKRS) in patients with multiple brain metastases and to investigate prognostic factors related to treatment outcome. Methods We retrospectively reviewed clinico-radiological and dosimetric data of 36 patients with 4-14 brain metastases who underwent GKRS for 264 lesions between August 2008 and April 2011. The most common primary tumor site was the lung (n=22), followed by breast (n=7). At GKRS, the median Karnofsky performance scale score was 90 and the mean tumor volume was 1.2 cc (0.002-12.6). The mean prescription dose of 17.8 Gy was delivered to the mean 61.1% isodose line. Among 264 metastases, 175 lesions were assessed for treatment response by at least one imaging follow-up. Results The overall median survival after GKRS was 9.1±1.7 months. Among various factors, primary tumor control was a significant prognostic factor (11.1±1.3 months vs. 3.3±2.4 months, p=0.031). The calculated local tumor control rate at 6 and 9 months after GKRS were 87.9% and 84.2%, respectively. Paddick's conformity index (>0.75) was significantly related to local tumor control. The actuarial peritumoral edema reduction rate was 22.4% at 6 months. Conclusion According to our results, GKRS can provide beneficial effect for the patients with multiple (4 or more) brain metastases, when systemic cancer is controlled. And, careful dosimetry is essential for local tumor control. Therefore, GKRS can be considered as one of the treatment modalities for multiple brain metastase. PMID:22102945

Squamous Cell Carcinoma of the Anal Canal: Patterns and Predictors of Failure and Implications for Intensity-Modulated Radiation Treatment Planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wright, Jean L., E-mail: jwright3@med.miami.ed; Patil, Sujata M.; Temple, Larissa K.F.

2010-11-15

Purpose: Intensity-modulated radiation treatment (IMRT) is increasingly used in the treatment of squamous cell carcinoma of the anal canal (SCCAC). Prevention of locoregional failure (LRF) using IMRT requires appropriate clinical target volume (CTV) definition. To better define the CTV for IMRT, we evaluated patterns and predictors of LRF in SCCAC patients given conventional radiation treatment. Methods and Materials: We reviewed records of 180 SCCAC patients treated with conventional radiation with or without chemotherapy at our institution between January 1990 and March 2007. All patients received radiation; the median primary tumor dose was 45 Gy. A total of 173 patients alsomore » received mitomycin-based chemotherapy. Results: Median follow-up was 40 months. Actuarial 3-year colostomy-free survival was 89% and overall survival (OS) 88%. Actuarial 3-year LRF was 23%. A total of 45 patients had LRF, with 35 (78%) occurring locally in the primary site (25 local only, 10 local and regional); however, 20 (44%) had regional components of failure within the pelvis or inguinal nodes (10 regional only, 10 local and regional). Cumulative sites of LRF (patients may have one or more site of failure) were as follows: primary, 35; inguinal, 8; external perianal, 5; common iliac, 4; presacral, 3; distal rectum, 2; external iliac, 2; and internal iliac, 2. All patients with common iliac failure had cT3 or N+ disease. Conclusions: The observed patterns of failure support inclusion of the inguinal and all pelvic nodal groups in the CTV for IMRT. In patients with advanced tumor or nodal stage, common iliac nodes should also be included in the CTV.« less

Stereotactic Radiation Therapy can Safely and Durably Control Sites of Extra-Central Nervous System Oligoprogressive Disease in Anaplastic Lymphoma Kinase-Positive Lung Cancer Patients Receiving Crizotinib

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gan, Gregory N., E-mail: gregory.gan@ucdenver.edu; Weickhardt, Andrew J.; Scheier, Benjamin

Purpose: To analyze the durability and toxicity of radiotherapeutic local ablative therapy (LAT) applied to extra-central nervous system (eCNS) disease progression in anaplastic lymphoma kinase-positive non-small cell lung cancer (NSCLC) patients. Methods and Materials: Anaplastic lymphoma kinase-positive NSCLC patients receiving crizotinib and manifesting ≤4 discrete sites of eCNS progression were classified as having oligoprogressive disease (OPD). If subsequent progression met OPD criteria, additional courses of LAT were considered. Crizotinib was continued until eCNS progression was beyond OPD criteria or otherwise not suitable for further LAT. Results: Of 38 patients, 33 progressed while taking crizotinib. Of these, 14 had eCNS progressionmore » meeting OPD criteria suitable for radiotherapeutic LAT. Patients with eCNS OPD received 1-3 courses of LAT with radiation therapy. The 6- and 12-month actuarial local lesion control rates with radiation therapy were 100% and 86%, respectively. The 12-month local lesion control rate with single-fraction equivalent dose >25 Gy versus ≤25 Gy was 100% versus 60% (P=.01). No acute or late grade >2 radiation therapy-related toxicities were observed. Median overall time taking crizotinib among those treated with LAT versus those who progressed but were not suitable for LAT was 28 versus 10.1 months, respectively. Patients continuing to take crizotinib for >12 months versus ≤12 months had a 2-year overall survival rate of 72% versus 12%, respectively (P<.0001). Conclusions: Local ablative therapy safely and durably eradicated sites of individual lesion progression in anaplastic lymphoma kinase-positive NSCLC patients receiving crizotinib. A dose–response relationship for local lesion control was observed. The suppression of OPD by LAT in patients taking crizotinib allowed an extended duration of exposure to crizotinib, which was associated with longer overall survival.« less

Predictors of Local Control After Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Greco, Carlo; Zelefsky, Michael J., E-mail: zelefskm@mskcc.or; Lovelock, Michael

2011-03-15

Purpose: To report tumor local control after treatment with single-dose image-guided intensity-modulated radiotherapy (SD-IGRT) to extracranial metastatic sites. Methods and Materials: A total of 126 metastases in 103 patients were treated with SD-IGRT to prescription doses of 18-24 Gy (median, 24 Gy) between 2004 and 2007. Results: The overall actuarial local relapse-free survival (LRFS) rate was 64% at a median follow-up of 18 months (range, 2-45 months). The median time to failure was 9.6 months (range, 1-23 months). On univariate analysis, LRFS was significantly correlated with prescription dose (p = 0.029). Stratification by dose into high (23 to 24 Gy),more » intermediate (21 to 22 Gy), and low (18 to 20 Gy) dose levels revealed highly significant differences in LRFS between high (82%) and low doses (25%) (p < 0.0001). Overall, histology had no significant effect on LRFS (p = 0.16). Renal cell histology displayed a profound dose-response effect, with 80% LRFS at the high dose level (23 to 24 Gy) vs. 37% with low doses ({<=}22 Gy) (p = 0.04). However, for patients who received the high dose level, histology was not a statistically significant predictor of LRFS (p = 0.90). Target organ (bone vs. lymph node vs. soft tissues) (p = 0.5) and planning target volume size (p = 0.55) were not found to be associated with long-term LRFS probability. Multivariate Cox regression analysis confirmed prescription dose to be a significant predictor of LRFS (p = 0.003). Conclusion: High-dose SD-IGRT is a noninvasive procedure resulting in high probability of local tumor control. Single-dose IGRT may be effectively used to locally control metastatic deposits regardless of histology and target organ, provided sufficiently high doses (> 22 Gy) of radiation are delivered.« less

[Actuarial analysis of time-failure data and its rrelevance for interpretation of results. Audit of the journal "Strahlentherapie und Onkologie" (Radiotherapy and Oncology)].

PubMed

Dubben, H H; Beck-Bornholdt, H P

2000-12-01

The statistical quality of the contributions to "Strahlentherapie und Onkologie" is assessed, aiming for improvement of the journal and consequently its impact factor. All 181 articles published during 1998 and 1999 in the categories "review", "original contribution", and "short communication" were analyzed concerning actuarial analysis of time-failure data. One hundred and twenty-three publications without time-failure data were excluded from analysis. Forty-five of the remaining 58 publications with time-failure data were evaluated actuarially. This corresponds to 78% (95% confidence interval: 64 to 88%) of papers, in which data were adequately analyzed. Complications were reported in 16 of 58 papers, but in only 3 cases actuarially. The number of patients at risk during the course of follow-up was documented adequately in 22 of the 45 publications with actuarial analysis. Authors, peer reviewers, and editors could contribute to improve the quality of the journal by setting value on acturial analysis of time-failure data.

Definitive Radiotherapy for Ewing Tumors of Extremities and Pelvis: Long-Term Disease Control, Limb Function, and Treatment Toxicity

DOE Office of Scientific and Technical Information (OSTI.GOV)

Indelicato, Daniel J.; Keole, Sameer R.; Shahlaee, Amir H.

2008-11-01

Purpose: More than 70% of Ewing tumors occur in the extremities and pelvis. This study identified factors influencing local control and functional outcomes after management with definitive radiotherapy (RT). Patients and Methods: A total of 75 patients with a localized Ewing tumor of the extremity or pelvis were treated with definitive RT at the University of Florida between 1970 and 2006 (lower extremity tumors in 30, pelvic tumors in 26, and upper extremity tumors in 19). RT was performed on a once-daily (40%) or twice-daily (60%) basis. The median dose was 55.2 Gy in 1.8-Gy daily fractions or 55.0 Gymore » in 1.2-Gy twice-daily fractions. The median observed follow-up was 4.7 years. Functional outcome was assessed using the Toronto Extremity Salvage Score. Results: The 10-year actuarial overall survival, cause-specific survival, freedom from relapse, and local control rate was 48%, 48%, 42%, and 71%, respectively. Of the 72 patients, 3 required salvage amputation. Inferior cause-specific survival was associated with larger tumors (81% for tumors <8 cm vs. 39% for tumors {>=}8 cm, p <0.05). No patient characteristics or treatment variables were predictive of local failure. No fractures occurred in patients treated with hyperfractionation or with tumors of the distal extremities. Severe late complications were more frequently associated with use of <8-MV photons and fields encompassing the entire bone or hemipelvis. A significantly better Toronto Extremity Salvage Score was associated with a late-effect biologically effective dose of <91.7 Gy{sub 3}. Conclusions: Limb preservation was effectively achieved through definitive RT. Treating limited field sizes with hyperfractionated high-energy RT could minimize long-term complications and provides superior functional outcomes.« less

Defense Health Care: US Family Health Plan is Duplicative and Should be Eliminated

DTIC Science & Technology

2014-07-01

including laws pertaining to the USFHP and the Federal Acquisition Regulation (FAR).12 We interviewed DOD officials and officials from DOD’s actuarial ...findings and conclusions based on our audit objectives. We believe that Additionally, we obtained information from DOD officials and its actuarial ...capitation rates for the designated providers. Overall, the consultant found that DOD’s process for establishing capitation rates was actuarially

Clinical comparison of two linear-quadratic model-based isoeffect fractionation schemes of high-dose-rate intracavitary brachytherapy for cervical cancer.

PubMed

Wang, Chong-Jong; Huang, Eng-Yen; Sun, Li-Min; Chen, Hui-Chun; Fang, Fu-Min; Hsu, Hsuan-Chih; Changchien, Chan-Chao; Leung, Stephen Wan

2004-05-01

Two linear-quadratic model-based isoeffect fractionation schemes of high-dose-rate intracavitary brachytherapy (HDR-IC) were used to treat cervical cancer in two consecutive periods. Patient outcomes and complications were analyzed and compared. Between November 1987 and December 1996, a total of 541 women diagnosed with cervical cancer were treated with curative-intent radiotherapy. Patients were categorized into two groups according to the two isoeffect schemes used. Group 1 consisted of 254 patients treated with external beam radiotherapy (EBRT) plus 7.2 Gy HDR-IC to Point A for three fractions in the first period. Group 2 consisted of 284 patients treated with EBRT plus 4.8 Gy HDR-IC for five fractions in the second period. The goal of the new scheme for the latter group was to deliver an isoeffect dose that maintained similar tumor control but reduced normal tissue complications. The calculated biologically effective dose (BED(10), assuming an alpha/beta ratio = 10) of EBRT plus HDR-IC for tumor and acute responding tissue in Groups 1 and 2 was 90 Gy(10) (52.8 + 37.2 Gy) and 88.6 Gy(10) (53.1 + 35.5 Gy), respectively. The corresponding BED(3) for late responding tissue (assuming an alpha/beta ratio = 3) in Groups 1 and 2 was 146.7 Gy(3) (73.3 + 73.4 Gy) and 134.4 Gy(3) (72 + 62.4 Gy), respectively. Patients were followed for 6.1-15.2 years (median, 9.8 years). Overall, 66 patients (12.2%) developed pelvic recurrence. Of these, 53 patients had central recurrence. Of the 53 patients with central recurrence, 24 (9.4%) were in Group 1 and 29 (10.1%) in Group 2 (p = 0.722). The actuarial pelvic control rate for Groups 1 and 2 was 88.2% and 86.3% at 5 years and 87.3% and 85.5% at 10 years, respectively (p = 0.504). The actuarial overall survival rate for Groups 1 and 2 was 63.5% and 56.1% at 5 years and 47.8% and 49.3% at 10 years, respectively (p = 0.734). The actuarial proctitis rate for Groups 1 and 2 was 49.7% and 32.7% at 5 years and 50.5% and 32.7% at 10 years, respectively (p <0.001). Most of the decrease in the rate of proctitis was a result of a decrease in the incidence of low-grade proctitis (38% vs. 22%). The incidence of high-grade complications remained unchanged, 8% vs. 7%. The actuarial cystitis rate for Groups 1 and 2 was 14.3% vs. 11.4% at 5 years and 24.1% vs. 15% at 10 years, respectively (p = 0.134). Multivariate analysis revealed that the fractionation scheme (three fractions vs. five fractions) was a significant factor influencing the proctitis rate (p = 0.004, hazard ratio = 0.807; 95% confidence interval, 0.697-0.934), but not the local pelvic control rate, overall survival rate, or cystitis rate. The treatment results of the two groups maintained similar outcomes, while the complications decreased. The linear-quadratic model correctly predicted this outcome. Biologically, the manipulation of the fraction size in our study suggested that the sensitivity of the late responding tissue to the fractional change from 7.2 Gy to 4.8 Gy in HDR-IC is high and detectable clinically. The success, however, had its limitations, and the improvement was confined to low-grade complications.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gupta, Vishal; Mychalczak, Borys; Krug, Lee

Purpose: To evaluate pleurectomy/decortication (P/D) and adjuvant radiotherapy (RT) in the treatment of malignant pleural mesothelioma (MPM). Methods and Materials: In a retrospective review, we included MPM patients treated with P/D and adjuvant RT at Memorial Sloan-Kettering Cancer Center from 1974 to 2003. When indicated, patients received intraoperative brachytherapy to residual tumor. Results: All 123 patients received external beam RT (median dose, 42.5 Gy; range, 7.2-67.8 Gy) to the ipsilateral hemithorax postoperatively. Fifty-four patients underwent brachytherapy (matched peripheral dose, 160 Gy). The median and 2-year overall survival for all patients was 13.5 months (range, 1-199 months) and 23%, respectively. One-yearmore » actuarial local control for all patients was 42%. Multivariate analysis for overall survival revealed radiation dose <40 Gy (p = 0.001), nonepithelioid histology (p = 0.002), left-sided disease (p = 0.01), and the use of an implant (p = 0.02) to be unfavorable. Two patients (1.6%) died from Grade 5 toxicity within 1 month of treatment. Conclusions: Pleurectomy/decortication with adjuvant radiotherapy is not an effective treatment option for patients with MPM. Our results imply that residual disease cannot be eradicated with external RT with or without brachytherapy and that a more extensive surgery followed by external RT might be required to improve local control and overall survival.« less

A Summary of the Foundation Research Program, Fiscal Year 1985.

DTIC Science & Technology

1986-05-12

system in the domain of actuarial science. Publication: T. R. Sivasankaran and M. Jarke, "Coupling Expert .z- Systems and Actuarial Pricing Models... Actuarial Pricing Models," Workshop on Coupling Symbolic and Numerical Computing in Expert Systems, Bellevue, Washington, August 1985. 16 Title: Application...Ramjets", AIAA-85-1177, AIAA/SAE/ ASME /ASEE 21st Joint Propulsion Conference, July 8-10, 1985. A. Gany and D. W. Netzer, "Fuel Performance Evaluation

No Failure of Imagination: Examining Foundational Flaws in America’s Homeland Security Enterprise

DTIC Science & Technology

2011-09-01

Casualty Actuarial Society Enterprise Risk Management Committee (2003) has adopted the following definition of ERM in May 2003: ERM is the...refused to go to an air- raid shelter due to the mathematical improbability of a bomb killing him out of all the people in Moscow. He changed his mind... Actuarial Society. Casualty Actuarial Society Enterprise Risk Management Committee. (2003). Technical Report. Overview of enterprise risk management

Stereotactic radiosurgery for focal leptomeningeal disease in patients with brain metastases.

PubMed

Wolf, Amparo; Donahue, Bernadine; Silverman, Joshua S; Chachoua, Abraham; Lee, Jean K; Kondziolka, Douglas

2017-08-01

Leptomeningeal disease (LMD) is well described in patients with brain metastases, presenting symptomatically in approximately 5% of patients. Conventionally, the presence of LMD is an indication for whole brain radiation therapy (WBRT) and not suitable for stereotactic radiosurgery (SRS). The purpose of the study was to evaluate the local control and overall survival of patients who underwent SRS to focal LMD. We reviewed our prospective registry and identified 32 brain metastases patients with LMD, from a total of 465 patients who underwent SRS between 2013 and 2015. Focal LMD was targeted with SRS in 16 patients. The median imaging follow-up time was 7 months. The median volume of LMD was 372 mm 3 and the median margin dose was 16 Gy. Five patients underwent prior WBRT. Histology included non-small cell lung (8), breast (5), melanoma (1), gastrointestinal (1) and ovarian cancer (1). Follow-up MR imaging was available for 14 patients. LMD was stable in 5 and partially regressed in 8 patients at follow-up. One patient had progression of LMD with hemorrhage 5 months after SRS. Seven patients developed distant LMD at a median time of 7 months. The median actuarial overall survival from SRS for LMD was 10.0 months. The 6-month and 1-year actuarial overall survival was 60% and 26% respectively. Six patients underwent WBRT after SRS for focal LMD at a median time of 6 months. Overall, focal LMD may be may be treated successfully with radiosurgery, potentially delaying WBRT in some patients.

Hypofractionated Proton Boost Combined with External Beam Radiotherapy for Treatment of Localized Prostate Cancer

PubMed Central

Johansson, Silvia; Åström, Lennart; Sandin, Fredrik; Isacsson, Ulf; Montelius, Anders; Turesson, Ingela

2012-01-01

Proton boost of 20 Gy in daily 5 Gy fractions followed by external beam radiotherapy (EBRT) of 50 Gy in daily 2 Gy fractions were given to 278 patients with prostate cancer with T1b to T4N0M0 disease. Fifty-three percent of the patients received neoadjuvant androgen deprivation therapy (N-ADT). The medium followup was 57 months. The 5-year PSA progression-free survival was 100%, 95%, and 74% for low-, intermediate-, and high-risk patients, respectively. The toxicity evaluation was supported by a patient-reported questionnaire before every consultant visit. Cumulative probability and actuarial prevalence of genitourinary (GU) and gastrointestinal (GI) toxicities are presented according to the RTOG classification. N-ADT did not influence curability. Mild pretreatment GU-symptoms were found to be a strong predictive factor for GU-toxicity attributable to treatment. The actuarial prevalence declined over 3 to 5 years for both GU and GI toxicities, indicating slow resolution of epithelial damage to the genitourinary and gastrointestinal tract. Bladder toxicities rather than gastrointestinal toxicities seem to be dose limiting. More than 5-year followup is necessary to reveal any sign of true progressive late side effects of the given treatment. Hypofractionated proton-boost combined with EBRT is associated with excellent curability of localized PC and acceptable frequencies of treatment toxicity. PMID:22848840

12 CFR 163.47 - Pension plans.

Code of Federal Regulations, 2013 CFR

2013-01-01

... by an enrolled actuary (as defined by the Employee Retirement Income Security Act of 1974) affirming... expectations, and represent the actuary's best estimate of the plan's projected experiences. ...

12 CFR 163.47 - Pension plans.

Code of Federal Regulations, 2012 CFR

2012-01-01

... by an enrolled actuary (as defined by the Employee Retirement Income Security Act of 1974) affirming... expectations, and represent the actuary's best estimate of the plan's projected experiences. ...

12 CFR 163.47 - Pension plans.

Code of Federal Regulations, 2014 CFR

2014-01-01

... by an enrolled actuary (as defined by the Employee Retirement Income Security Act of 1974) affirming... expectations, and represent the actuary's best estimate of the plan's projected experiences. ...

Methodological issues underlying multiple decrement life table analysis.

PubMed

Mode, C J; Avery, R C; Littman, G S; Potter, R G

1977-02-01

In this paper, the actuarial method of multiple decrement life table analysis of censored, longitudinal data is examined. The discussion is organized in terms of the first segment of usage of an intrauterine device. Weaknesses of the actuarial approach are pointed out, and an alternative approach, based on the classical model of competing risks, is proposed. Finally, the actuarial and the alternative method of analyzing censored data are compared, using data from the Taichung Medical Study on Intrauterine Devices.

A Policy Analysis of Reserve Retirement Reform

DTIC Science & Technology

2013-01-01

of the basic pay bill for the AC force, consistent with the practice of the DoD Actuary . This gives an amount, an accrual charge, sufficient to cover...accrual charges made during its AC service. This also follows the practice of the DoD Actuary . Specifically, the amount transferred from the AC...retirement reform. 16 The actuarial calculation is made for those leaving AC by AC year of service. For example, consider 100 AC service members in

Articulating Value: A framework for Evaluating Military Retirement Alternatives

DTIC Science & Technology

2012-11-30

Retirement System (MRS) is expensive. In FY2010, the US Government spent over $50 Billion on military retirement (DoD Office of the Actuary , Valuation...SBP is shared by the retiree and the government, thus it is not self- sustaining (DoD Office of the Actuaries , Valuation, 43-48). 1.3 Methodology...the military retirement fund and the cash paid to retirees during the year exceeded $50 billion (DoD Office of the Actuary , Valuation, 19-20). The

Incorporating Private Sector Ideas into Military Retirement Reform: A Cash Balance Plan Approach

DTIC Science & Technology

2014-06-01

OBJECTIVES The DOD Office of the Actuary defines the purpose of the system. Doing so establishes a baseline from which to judge the effectiveness of the...system in meeting its ultimate objectives. In the Valuation of the Military Retirement System—September 30, 2011, the DOD Office of the Actuary (2013...increasingly unaffordable” and “unsustainable” with the present rising costs. The OSD Office of the Actuary forecasts the annual retirement payments to

Military Retirement Fund Audited Financial Report. Fiscal Year 2013

DTIC Science & Technology

2013-12-09

accumulates funds to finance, on an actuarial basis, the liabilities of DoD under military retirement and survivor benefit programs. Within DoD, the...for the accounting, investing, payment of benefits, and reporting of the MRF. The DoD Office of the Actuary (OACT) within OUSD(P&R) calculates the... actuarial liability of the MRF. The Office of Military Personnel Policy within OUSD(P&R) issues policy related to MRS benefits. While the MRF does

Do age-specific survival patterns of wild boar fit current evolutionary theories of senescence?

PubMed

Gamelon, Marlène; Focardi, Stefano; Gaillard, Jean-Michel; Gimenez, Olivier; Bonenfant, Christophe; Franzetti, Barbara; Choquet, Rémi; Ronchi, Francesca; Baubet, Eric; Lemaître, Jean-François

2014-12-01

Actuarial senescence is widespread in age-structured populations. In growing populations, the progressive decline of Hamiltonian forces of selection with age leads to decreasing survival. As actuarial senescence is overcompensated by a high fertility, actuarial senescence should be more intense in species with high reproductive effort, a theoretical prediction that has not been yet explicitly tested across species. Wild boar (Sus scrofa) females have an unusual life-history strategy among large mammals by associating both early and high reproductive effort with potentially long lifespan. Therefore, wild boar females should show stronger actuarial senescence than similar-sized related mammals. Moreover, being polygynous and much larger than females, males should display higher senescence rates than females. Using a long-term monitoring (18 years) of a wild boar population, we tested these predictions. We provided clear evidence of actuarial senescence in both sexes. Wild boar females had earlier but not stronger actuarial senescence than similar-sized ungulates. Both sexes displayed similar senescence rates. Our study indicates that the timing of senescence, not the rate, is associated with the magnitude of fertility in ungulates. This demonstrates the importance of including the timing of senescence in addition to its rate to understand variation in senescence patterns in wild populations. © 2014 The Author(s). Evolution © 2014 The Society for the Study of Evolution.

Marketplace Plans Provide Risk Protection, But Actuarial Values Overstate Realized Coverage For Most Enrollees.

PubMed

Polyakova, Maria; Hua, Lynn Mei; Bundorf, M Kate

2017-12-01

The Affordable Care Act (ACA) has increased the number of Americans with health insurance. Yet many policy makers and consumers have questioned the value of Marketplace plan coverage because of the generally high levels of cost sharing. We simulated out-of-pocket spending for bronze, silver, or gold Marketplace plans (those having actuarial values of 60 percent, 70 percent, and 80 percent, respectively). We found that for the vast majority of consumers, the proportion of covered spending paid by the plans is likely to be far less than their actuarial values, the metric commonly used to convey plan generosity. Indeed, only when annual health care spending exceeds $16,500 for bronze plans, $19,500 for silver plans, and $21,500 for gold plans do plans in these metal tiers cover the proportion of costs matching their actuarial values. While Marketplace plans substantially reduce consumers' exposure to financial risk relative to being uninsured, the use of actuarial values to communicate plan generosity is likely to be misleading to consumers.

Throwing the baby out with the bath water: is it time for clinical judgment to supplement actuarial risk assessment?

PubMed

Abbott, Brian R

2011-01-01

The assessment of the potential for sexual violence is one of three prongs that must be met to satisfy the requirements for civil confinement of dangerous sex offenders in the 21 U.S. jurisdictions that have these laws. In a recent issue of The Journal, Sreenivasan et al. argued that, because of a host of methodological problems, actuarial risk assessment methods in general and the Static-99 and its progeny in particular are insufficient for accurate assessment of risk for dangerous sex offenders. They propose using a combination of clinical judgment with actuarial science as a solution. This analysis and review of Sreenivasan et al. reveals and corrects flaws in the arguments they employed to support their position and shows how the combination of actuarial science with clinical judgment is more error prone than the actuarial approach only, and cannot be forensically defended in court. Recommendations on reporting Static-99R data in expert testimony are provided, taking into account the limitations of the instrument.

12 CFR 390.339 - Pension plans.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., an opinion signed by an enrolled actuary (as defined by the Employee Retirement Income Security Act... plan's experience and expectations, and represent the actuary's best estimate of the plan's projected...

12 CFR 390.339 - Pension plans.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., an opinion signed by an enrolled actuary (as defined by the Employee Retirement Income Security Act... plan's experience and expectations, and represent the actuary's best estimate of the plan's projected...

12 CFR 390.339 - Pension plans.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., an opinion signed by an enrolled actuary (as defined by the Employee Retirement Income Security Act... plan's experience and expectations, and represent the actuary's best estimate of the plan's projected...

Actuarial risk assessment: commentary on Berlin et al.

PubMed

Hart, Stephen D

2003-10-01

F. S. Berlin, N. W. Galbreath, B. Geary, and G. McGlone (this issue) have raised some important questions regarding the use of acturial risk assessment instruments in sex offender civil commitment proceedings, also known as sexually violent predator or SVP proceedings. Their primary point is that interpreting the findings of existing actuarial risk assessment instruments is a tricky business because it is not certain whether the extent to which probability estimates derived from group data can be applied to individual cases. I agree completely with Berlin et al. on this point, but disagree with them concerning the extent to which probability estimates--and, therefore, actuarial instruments--are legally relevant in SVP proceedings. I outline some potential problems with respect to the legal admissibility of actuarial instruments, including their legal relevance.

Managing 'tail liability'.

PubMed

Frese, Richard C; Weber, Ryan J

2013-11-01

To reduce and control their level of tail liability, hospitals should: Utilize a self-insurance vehicle; Consider combined limits between the hospital and physicians; Communicate any program changes to the actuary, underwriter, and auditor; Continue risk management and safety practices; Ensure credit is given to the organization's own medical malpractice program.

Review of Air Force Compressor Blade and Vane Rework and It’s Impact on Performance and Costs

DTIC Science & Technology

1990-05-01

rework effort for reasons other than FOD. The actuarial data for March 1988, indicate that there are 977 J-79-17 engines and 2413 J-79-15 engines...maintenance shops about once every seven years (Engine Depot actuarial data). Consequently, the increased fuel cost to be used for rework cost comparisons...actual count made by personnel at Oklahoma City was only for the month of August. Additional information was based on actuarial data, assuming the data

Re-Irradiation of Locoregional NSCLC Recurrence Using Robotic Stereotactic Body Radiotherapy.

PubMed

Ceylan, Cemile; Hamacı, Andaç; Ayata, Hande; Berberoglu, Kezban; Kılıç, Ayhan; Güden, Metin; Engin, Kayıhan

2017-01-01

We evaluated the efficacy, toxicity, and dose responses of re-irradiation with stereotactic body radiotherapy (SBRT) in patients with recurrent non- small cell lung cancer (NSCLC) after previous irradiation. 28 patients were included. Previous median radiation doses were 54 and 66 Gy. The median interval time between previous radiotherapy and SBRT was 14 months. The median follow-up time after SBRT was 9 months (range 3-93 months). To evaluate the effectiveness of SBRT, local control, overall survival, and treatment-related toxicity were reported. SBRT doses and fractionation ranged from 60 to 30 Gy and from 3 to 8, respectively, according to previous doses, location of the recurrence, and interval time. 65% of tumor recurrences overlapped with previous treatment, while 35% of tumors recurred outside of the previous treatment. 4 patients had local progression after SBRT at their first follow-up. The Kaplan-Meier estimates of the 1- and 2-year actuarial overall survival were 71 and 42%, respectively. The mean survival following SBRT was 32.8 months, and the median survival was 21 months. No grade 3 or higher toxicities were observed. Robotic SBRT is a tolerable treatment option with manageable toxicity which can be used with radical or palliative intent in carefully selected patients with locally recurrent tumors after previous irradiation. © 2017 S. Karger GmbH, Freiburg.

12 CFR 563.47 - Pension plans.

Code of Federal Regulations, 2013 CFR

2013-01-01

... by an enrolled actuary (as defined by the Employee Retirement Income Security Act of 1974) affirming... expectations, and represent the actuary's best estimate of the plan's projected experiences. [59 FR 66159, Dec...

12 CFR 563.47 - Pension plans.

Code of Federal Regulations, 2014 CFR

2014-01-01

... by an enrolled actuary (as defined by the Employee Retirement Income Security Act of 1974) affirming... expectations, and represent the actuary's best estimate of the plan's projected experiences. [59 FR 66159, Dec...

26 CFR 300.0 - User fees; in general.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the enrollment of an enrolled agent. (7) Enrolling an enrolled actuary. (8) Renewing the enrollment of an enrolled actuary. (9) Taking the special enrollment examination to become an enrolled retirement...

26 CFR 300.0 - User fees; in general.

Code of Federal Regulations, 2012 CFR

2012-04-01

... the enrollment of an enrolled agent. (7) Enrolling an enrolled actuary. (8) Renewing the enrollment of an enrolled actuary. (9) Taking the special enrollment examination to become an enrolled retirement...

12 CFR 563.47 - Pension plans.

Code of Federal Regulations, 2011 CFR

2011-01-01

... by an enrolled actuary (as defined by the Employee Retirement Income Security Act of 1974) affirming... expectations, and represent the actuary's best estimate of the plan's projected experiences. [59 FR 66159, Dec...

26 CFR 300.0 - User fees; in general.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the enrollment of an enrolled agent. (7) Enrolling an enrolled actuary. (8) Renewing the enrollment of an enrolled actuary. (9) Taking the special enrollment examination to become an enrolled retirement...

12 CFR 563.47 - Pension plans.

Code of Federal Regulations, 2012 CFR

2012-01-01

... by an enrolled actuary (as defined by the Employee Retirement Income Security Act of 1974) affirming... expectations, and represent the actuary's best estimate of the plan's projected experiences. [59 FR 66159, Dec...

5 CFR 841.411 - Appeals procedure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... agency's actuarial analysis are sufficient and reliable (As a general rule, at least 5 years of data... reliable.); (2) The assumptions used in the agency's actuarial analysis are justified; (3) When all...

Systematic review of ablative neurosurgical techniques for the treatment of trigeminal neuralgia.

PubMed

Lopez, Benjamin C; Hamlyn, Peter J; Zakrzewska, Joanna M

2004-04-01

There are no randomized controlled trials comparing retrogasserian percutaneous radiofrequency thermocoagulation, glycerol rhizolysis, balloon compression of the gasserian ganglion, and stereotactic radiosurgery, nor are there systematic reviews using predefined quality criteria. The objective of this study was to systematically identify all of the studies reporting outcomes and complications of ablative techniques for treatment of trigeminal neuralgia, from the development of electronic databases, and to evaluate them with predefined quality criteria. Inclusion criteria for the outcome analysis included thorough demographic documentation, defined diagnostic and outcome criteria, a minimum of 30 patients treated and median/mean follow-up times of 12 months, not more than 20% of patients lost to follow-up monitoring, Kaplan-Meier actuarial analysis of individual procedures, less than 10% of patients retreated because of failure or early recurrence, and a minimal dose of 70 Gy for stereotactic radiosurgery. High-quality studies with no actuarial analysis were used for the evaluation of complications. Of 175 studies identified, 9 could be used to evaluate rates of complete pain relief on a yearly basis and 22 could be used to evaluate complications. In mixed series, radiofrequency thermocoagulation offered higher rates of complete pain relief, compared with glycerol rhizolysis and stereotactic radiosurgery, although it demonstrated the greatest number of complications. Radiofrequency thermocoagulation offers the highest rates of complete pain relief, although further data on balloon microcompression are required. It is essential that uniform outcome measures and actuarial methods be universally adopted for the reporting of surgical results. Randomized controlled trials are required to reliably evaluate new surgical techniques.

Stereotactic hypofractionated radiotherapy in stage I (T1-2 N0 M0) non-small-cell lung cancer (NSCLC).

PubMed

Zimmermann, Frank B; Geinitz, Hans; Schill, Sabine; Thamm, Reinhard; Nieder, Carsten; Schratzenstaller, Ulrich; Molls, Michael

2006-01-01

Stereotactic Radiotherapy has the potential to produce high local control rates with low risk of severe lung toxicity. From December 2000 to January 2006, 68 inoperable patients (median age 76 years) with stage I NSCLC received definitive hSRT. A mean total dose of 37.5 Gy (24-40 Gy; 60%-isodose) in 3-5 fractions was applied. Immobilisation was carried out by means of a vacuum couch and low pressure foil (Medical Intelligence, Schwab München, Germany). Staging procedures were thoracic and abdominal CT-scan, FDG-PET and CT or MRI of the brain in all patients. Clinical target volume was the tumor as seen in lung windowing of CT and in FDG-PET. Organ movements (6-22 mm) and patient positioning in the couch (3-12 mm) were added as safety margin for the definition of the planning target volume (PTV), that was enclosed by the 60%-isodose. We observed four (6%) local tumor recurrences, resulting in an actuarial local tumor control rate of 96%, 88% and 88% after 1, 2 and 3 year follow-up. Nineteen patients died, with eight patients due to cancer (12%), two to local tumor progression alone. Cancer-specific survival is 96%, 82% and 73% at 1, 2 and 3 years. Eleven patients died from comorbidities, making a 53% overall 3-year survival. Fifty five percent of the patients were affected by mild acute and subacute side effects, with only 3% experiencing pneumonitis III degrees . Late effects were pneumonitis III degrees in 1%, rib fractures in 3%, and benign pleural effusion in 2 patients. Hypofractionated SRT is safe even in elderly patients with stage I NSCLC and significantly reduced lung capacity. It leads to high local control rates and should be offered to patients not amenable for curative resection.

26 CFR 300.0 - User fees; in general.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the enrollment of an enrolled agent. (7) Enrolling an enrolled actuary. (8) Renewing the enrollment of an enrolled actuary. (9) Applying for a preparer tax identification number. [T.D. 8589, 60 FR 8299...

Impact of actuarial assumptions on pension costs: A simulation analysis

NASA Astrophysics Data System (ADS)

Yusof, Shaira; Ibrahim, Rose Irnawaty

2013-04-01

This study investigates the sensitivity of pension costs to changes in the underlying assumptions of a hypothetical pension plan in order to gain a perspective on the relative importance of the various actuarial assumptions via a simulation analysis. Simulation analyses are used to examine the impact of actuarial assumptions on pension costs. There are two actuarial assumptions will be considered in this study which are mortality rates and interest rates. To calculate pension costs, Accrued Benefit Cost Method, constant amount (CA) modification, constant percentage of salary (CS) modification are used in the study. The mortality assumptions and the implied mortality experience of the plan can potentially have a significant impact on pension costs. While for interest rate assumptions, it is inversely related to the pension costs. Results of the study have important implications for analyst of pension costs.

Exeresis and Brachytherapy as Salvage Treatment for Local Recurrence After Conservative Treatment for Breast Cancer: Results of a Ten-Year Pilot Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Guix, Benjamin, E-mail: bguix@imor.or; Lejarcegui, Jose Antonio; Tello, Jose Ignacio

2010-11-01

Purpose: To analyze the long-term results of a pilot study assessing excision and brachytherapy as salvage treatment for local recurrence after conservative treatment of breast cancer. Methods and Materials: Between December 1990 and March 2001, 36 patients with breast-only recurrence less than 3 cm in diameter after conservative treatment for Stage I or II breast carcinoma were treated with local excision followed by high-dose rate brachytherapy implants (30 Gy in 12 fractions over a period of 5 days). No patient was lost to follow-up. Special attention was paid to local, regional, or distant recurrences; survival; cosmesis; and early and latemore » side effects. Results: All patients completed treatment. During follow-up (range, 1-13 years), 8 patients presented metastases (2 regional and 6 distant) as their first site of failure, 1 had a differed local recurrence, and 1 died of the disease. Actuarial results at 10 years were as follows: local control, 89.4%; disease-free survival, 64.4%; and survival, 96.7%. Cosmetic results were satisfactory in 90.4%. No patient had Grade 3 or 4 early or late complications. Of the 11 patients followed up for at least 10 years, all but 1 still had their breast in place at the 10-year stage. Conclusions: High-dose rate brachytherapy is a safe, effective treatment for small-size, low-risk local recurrence after local excision in conservatively treated patients. The dose of 30 Gy of high-dose rate brachytherapy (12 fractions over a period of 5 days twice daily) was well tolerated. The excellent results support the use of breast preservation as salvage treatment in selected patients with local recurrence after conservative treatment for breast cancer.« less

Five-Year Biochemical Results, Toxicity, and Patient-Reported Quality of Life After Delivery of Dose-Escalated Image Guided Proton Therapy for Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bryant, Curtis, E-mail: cbryant@floridaproton.org; Smith, Tamara L.; Henderson, Randal H.

Purpose: To report clinical outcomes in patients treated with image guided proton therapy (PT) for localized prostate cancer. Methods and Materials: The medical records of 1327 men were reviewed. Each man was enrolled on an outcomes tracking study. Dual enrollment on a prospective clinical trial was allowed. Each patient was treated for localized prostate cancer with PT at our institution between 2006 and 2010. Ninety-eight percent of patients received 78 Gy (radiobiological equivalent [RBE]) or higher; 18% received androgen deprivation therapy (ADT). The 5-year freedom from biochemical progression (FFBP), distant metastasis-free survival, and cause-specific survival rates are reported for each risk group. Datamore » on patient-reported quality of life and high-grade toxicities were prospectively collected and reported. A multivariate analysis was performed to identify clinical predictors of biochemical failure and urologic toxicity. Results: The median follow-up time was 5.5 years. The 5-year FFBP rates were 99%, 94%, and 74% in low-risk, intermediate-risk, and high-risk patients, respectively. The actuarial 5-year rates of late grade 3+ Common Terminology Criteria for Adverse Events, version 4.0, gastrointestinal (GI) and genitourinary (GU) toxicity were 0.6% and 2.9%, respectively. Multivariate analysis showed a significant correlation between grade 3+ GU toxicity and pretreatment prostate reductive procedures (P<.0001), prostate volume (P=.0085), pretreatment α-blockers (P=.0067), diabetes (P=.0195), and dose–volume histogram parameters (P=.0208). The median International Prostate Symptom Scores pretreatment scores and scores at 5 years after treatment were 7 and 7, respectively. The mean Expanded Prostate Cancer Index Composite (EPIC) scores significantly declined for sexual summary for patients not receiving ADT (from 67 to 53) between baseline and 5 years. Conclusions: Image guided PT provided excellent biochemical control rates for patients with localized prostate cancer. The actuarial rates of high-grade toxicity were low after PT. From pretreatment to 5 years of follow-up, a significant decline was found only in mean EPIC sexual summary scores. Prospective clinical studies are needed to determine the comparative effectiveness of PT and other radiation treatment strategies.« less

29 CFR 4231.6 - Plan solvency tests.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... The actuary may select as the amortization period either— (i) The first 25 plan years beginning on or... determined under the funding method and assumptions expected to be used by the plan actuary for purposes of...

42 CFR 425.602 - Establishing the benchmark.

Code of Federal Regulations, 2014 CFR

2014-10-01

... claims. (5)(i) Using CMS Office of the Actuary national Medicare expenditure data for each of the years...-service program using data from CMS' Office of the Actuary. (2) To update the benchmark, CMS makes...

29 CFR 4231.6 - Plan solvency tests.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... The actuary may select as the amortization period either— (i) The first 25 plan years beginning on or... determined under the funding method and assumptions expected to be used by the plan actuary for purposes of...

42 CFR 425.602 - Establishing the benchmark.

Code of Federal Regulations, 2012 CFR

2012-10-01

... claims. (5)(i) Using CMS Office of the Actuary national Medicare expenditure data for each of the years...-service program using data from CMS' Office of the Actuary. (2) To update the benchmark, CMS makes...

42 CFR 425.602 - Establishing the benchmark.

Code of Federal Regulations, 2013 CFR

2013-10-01

... claims. (5)(i) Using CMS Office of the Actuary national Medicare expenditure data for each of the years...-service program using data from CMS' Office of the Actuary. (2) To update the benchmark, CMS makes...

29 CFR 4231.6 - Plan solvency tests.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... The actuary may select as the amortization period either— (i) The first 25 plan years beginning on or... determined under the funding method and assumptions expected to be used by the plan actuary for purposes of...

Gamma Knife radiosurgery for intracranial hemangioblastoma.

PubMed

Silva, Danilo; Grabowski, Mathew M; Juthani, Rupa; Sharma, Mayur; Angelov, Lilyana; Vogelbaum, Michael A; Chao, Samuel; Suh, John; Mohammadi, Alireza; Barnett, Gene H

2016-09-01

Gamma knife radiosurgery (GKRS) has become a treatment option for intracranial hemangioblastomas, especially in patients with poor clinical status and also high-risk surgical candidates. The objective of this study was to analyze clinical outcome and tumor control rates. Retrospective chart review revealed 12 patients with a total of 20 intracranial hemangioblastomas treated with GKRS from May 1998 until December 2014. Kaplan-Meier plots were used to calculate the actuarial local tumor control rates and rate of recurrence following GKRS. Univariate analysis, including log rank test and Wilcoxon test were used on the Kaplan-Meier plots to evaluate the predictors of tumor progression. Two-tailed p value of <0.05 was considered as significant. Median follow-up was 64months (2-184). Median tumor volume pre-GKRS was 946mm(3) (79-15970), while median tumor volume post-GKRS was 356mm(3) (30-5404). Complications were seen in two patients. Tumor control rates were 100% at 1year, 90% at 3years, and 85% at 5years, using the Kaplan-Meier method. There were no statistically significant univariate predictors of progression identified, although there was a trend towards successful tumor control in solid tumors (p=0.07). GKRS is an effective and safe option for treating intracranial hemangioblastoma with favorable tumor control rates. Copyright © 2016 Elsevier Ltd. All rights reserved.

Preparing for the Implementation of the TRICARE Senior Demonstration Project at the TRICARE Region 11 Lead Agency and Madigan Army Medical Center: A Cast Study.

DTIC Science & Technology

1997-03-01

Network 5. Actuarial Analysis 6. Administration, Staffing and Costs 7. Operations i. Appeals ii. Grievances iii. Enrollment Requirements iv...Security Act as of 8/23/96 with data for 1995." Office of the Actuary (OACT), Health Care Financing Administration. Ware, John, Martha Bayliss, William...8217?’ actuaries consider the inDatient methodology for assessing Lüzz to oe aoequaic, anc p-. methods. DoD Medicare Modeling and Impact Study fWPEHr^* ft 11

The impact of overall treatment time on outcomes in radiation therapy for non-small cell lung cancer.

PubMed

Chen, M; Jiang, G L; Fu, X L; Wang, L J; Qian, H; Chen, G Y; Zhao, S; Liu, T F

2000-04-01

A retrospective study was carried out to evaluate the impact of overall treatment time (OTT) on the results of radiation therapy for non-small cell lung cancer (NSCLC). From Jan. 1990 to Dec. 1996, 256 patients with stages I-IIIb NSCLC entered this analysis. All patients received definitive radiotherapy. Biologically effective dose (BED) was used to standardize the irradiation effects. The correlation between OTT and local progression-free survival was analyzed by linear-regression and Cox proportional hazard models. The prognostic variables for survival and distant metastasis were also briefly studied. OTT had been shortened in 64 patients because of an accelerated hyperfractioned irradiation, while OTT was prolonged i n 114 patients due to interruptions of irradiation courses. The main ca uses of interruption were machine breakdown or delayed preparations of c errobend block for boost fields (55%), holidays (11%) and treatment toxi city and side effects (34%). Patients tre ated with prolonged OTT (> 45 days) had significant poorer local progression-free survival than whom with OTT of

Actuarial Science.

ERIC Educational Resources Information Center

Warren, Bette

1982-01-01

Details are provided of a program on actuarial training developed at the State University of New York (SUNY) at Binghamton through the Department of Mathematical Sciences. An outline of its operation, including a few statistics on students in the program, is included. (MP)

75 FR 70925 - Office of the Assistant Secretary for Planning and Evaluation; Medicare Program; Meeting of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-19

... estimation involving economics and actuarial science. Panelists are not restricted, however, in the topics... actuarial and economic assumptions and methods by which Trustees might more accurately measure health...

76 FR 558 - Office of the Assistant Secretary for Planning and Evaluation; Medicare Program; Meeting of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-05

... technical aspects of estimation involving economics and actuarial science. Panelists are not restricted... actuarial and economic assumptions and methods by which Trustees might more accurately measure health...

76 FR 65195 - Office of the Assistant Secretary for Planning and Evaluation; Medicare Program; Meeting of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-20

... estimation involving economics and actuarial science. Panelists are not restricted, however, in the topics... actuarial and economic assumptions and methods by which Trustees might more accurately project health...

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nelson, John W.; Ghafoori, A. Paiman; Willett, Christopher G.

Purpose: Extrahepatic cholangiocarcinoma is a rare malignancy. Despite radical resection, survival remains poor, with high rates of local and distant failure. To clarify the role of radiotherapy with chemotherapy, we performed a retrospective analysis of resected patients who had undergone chemoradiotherapy. Methods and Materials: A total of 45 patients (13 with proximal and 32 with distal disease) underwent resection plus radiotherapy (median dose, 50.4 Gy). All but 1 patient received concurrent fluoropyrimidine-based chemotherapy. The median follow-up was 30 months for all patients and 40 months for survivors. Results: Of the 45 patients, 33 underwent adjuvant radiotherapy, and 12 were treatedmore » neoadjuvantly. The 5-year actuarial overall survival, disease-free survival, metastasis-free survival, and locoregional control rates were 33%, 37%, 42%, and 78%, respectively. The median survival was 34 months. No patient died perioperatively. Patient age {<=}60 years and perineural involvement adversely affected survival on univariate analysis. Patients undergoing R0 resection had a significantly improved rate of local control but no survival advantage. Despite having more advanced disease at presentation, patients treated neoadjuvantly had a longer survival (5-year survival 53% vs. 23%, p = 0.16) and similar rates of Grade 2-3 surgical morbidity (16% vs. 33%, p = 0.24) compared with those treated in the postoperative setting. Conclusion: These study results suggest a possible local control benefit from chemoradiotherapy combined with surgery in patients with advanced, resected biliary cancer. Furthermore, our results suggest that a treatment strategy that includes preoperative chemoradiotherapy might result in improved tumor resectability with similar surgical morbidity compared with patients treated postoperatively, as well as potentially improved survival outcomes. Distant failure remains a significant failure pattern, suggesting the need for more effective systemic therapy.« less

A feasibility study of [sup 252]Cf neutron brachytherapy, cisplatin + 5-FU chemo-adjuvant and accelerated hyperfractionated radiotherapy for advanced cervical cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Murayama, Y.; Wierzbicki, J.; Bowen, M.G.

The purpose was to evaluate the feasibility and toxicity of [sup 252]Cf neutron brachytherapy combined with hyperaccelerated chemoradiotherapy for Stage III and IV cervical cancers. Eleven patients with advanced Stage IIIB-IVA cervical cancers were treated with [sup 252]Cf neutron brachytherapy in an up-front schedule followed by cisplatin (CDDP; 50 mg/m[sup 2]) chemotherapy and hyperfractionated accelerated (1.2 Gy bid) radiotherapy given concurrently with intravenous infusion of 5-Fluorouracil (5-FU) (1000 mg/m[sup 2]/day [times] 4 days) in weeks 1 and 4 with conventional radiation (weeks 2, 3, 5, and 6). Total dose at a paracervical point A isodose surface was 80-85 Gy-eq bymore » external and intracavitary therapy and 60 Gy at the pelvic sidewalls. Patients tolerated the protocol well. There was 91% compliance with the chemotherapy and full compliance with the [sup 252]Cf brachytherapy and the external beam radiotherapy. There were no problems with acute chemo or radiation toxicity. One patient developed a rectovaginal fistula (Grade 3-4 RTOG criteria) but no other patients developed significant late cystitis, proctitis or enteritis. There was complete response (CR) observed in all cases. With mean follow-up to 26 months, local control has been achieved with 90% actuarial 3-year survival with no evidence of disease (NED). [sup 252]Cf neutrons can be combined with cisplatin and 5-FU infusion chemotherapy plus hyperaccelerated chemoradiotherapy without unusual side effects or toxicity and with a high local response and tumor control rate. Further study of [sup 252]Cf neutron-chemoradiotherapy for advanced and bulky cervical cancer are indicated. The authors found chemotherapy was more effective with the improved local tumor control. 18 refs., 2 tabs.« less

Cyberknife hypofractionated stereotactic radiosurgery (HSRS) of resection cavity after excision of large cerebral metastasis: efficacy and safety of an 800 cGy × 3 daily fractions regimen.

PubMed

Wang, Che-Chuan; Floyd, Scott R; Chang, Chin-Hong; Warnke, Peter C; Chio, Chung-Ching; Kasper, Ekkehard M; Mahadevan, Anand; Wong, Eric T; Chen, Clark C

2012-02-01

Development of hypofractionated stereotactic radiosurgery (HSRS) has expanded the size of lesion that can be safely treated by focused radiation in a limited number of treatment sessions. However, clinical data regarding the efficacy and morbidity of HSRS in the treatment of cerebral metastasis is lacking. Here, we review our experience with CyberKnife(®) HSRS for this indication. From 2005 to 2010, we identified 37 patients with large (>3 cm in diameter) cerebral metastases resection cavity that was treated with HSRS. This constituted approximately 8% of all treated resection cavities. We reviewed dose regimens, local control, distal control, and treatment associated morbidities. Primary sites for the metastatic lesions included: lung (n = 10), melanoma (n = 12), breast (n = 9), kidney (n = 4), and colon (n = 2). All patients underwent resection of the cerebral metastasis and received 800 cGy × 3 daily fractions to the resection cavity. Of the 37 patients treated, one-year follow-up data was available for 35 patients. The median survival was 5.5 months. Actuarial local control rate at 6 months was 80%. Local failures did not correlate with prior WBRT, or tumor histology. Distant recurrence occurred in 7 of the 35 patients. Morbidities associated with HSRS totaled 9%, including radiation necrosis (n = 1, 2.9%), prolonged steroid use (n = 1, 2.9%), and new-onset seizures (n = 1, 2.9%). This study demonstrates the safety and efficacy of an 800 cGy × 3 daily fractions CyberKnife(®) HSRS regimen for irradiation of large resection cavity. The efficacy compares favorably to historical data derived from patients undergoing WBRT, SRS, or brachytherapy.

Connecting clinical and actuarial prediction with rule-based methods.

PubMed

Fokkema, Marjolein; Smits, Niels; Kelderman, Henk; Penninx, Brenda W J H

2015-06-01

Meta-analyses comparing the accuracy of clinical versus actuarial prediction have shown actuarial methods to outperform clinical methods, on average. However, actuarial methods are still not widely used in clinical practice, and there has been a call for the development of actuarial prediction methods for clinical practice. We argue that rule-based methods may be more useful than the linear main effect models usually employed in prediction studies, from a data and decision analytic as well as a practical perspective. In addition, decision rules derived with rule-based methods can be represented as fast and frugal trees, which, unlike main effects models, can be used in a sequential fashion, reducing the number of cues that have to be evaluated before making a prediction. We illustrate the usability of rule-based methods by applying RuleFit, an algorithm for deriving decision rules for classification and regression problems, to a dataset on prediction of the course of depressive and anxiety disorders from Penninx et al. (2011). The RuleFit algorithm provided a model consisting of 2 simple decision rules, requiring evaluation of only 2 to 4 cues. Predictive accuracy of the 2-rule model was very similar to that of a logistic regression model incorporating 20 predictor variables, originally applied to the dataset. In addition, the 2-rule model required, on average, evaluation of only 3 cues. Therefore, the RuleFit algorithm appears to be a promising method for creating decision tools that are less time consuming and easier to apply in psychological practice, and with accuracy comparable to traditional actuarial methods. (c) 2015 APA, all rights reserved).

Local Failure in Parameningeal Rhabdomyosarcoma Correlates With Poor Response to Induction Chemotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ladra, Matthew M.; Mandeville, Henry C.; Niemierko, Andrzej

2015-06-01

Background: Local control remains a challenge in pediatric parameningeal rhabdomyosarcoma (PM-RMS), and survival after local failure (LF) is poor. Identifying patients with a high risk of LF is of great interest to clinicians. In this study, we examined whether tumor response to induction chemotherapy (CT) could predict LF in embryonal PM-RMS. Methods: We identified 24 patients with embryonal PM-RMS, age 2 to 18 years, with complete magnetic resonance imaging and gross residual disease after surgical resection. All patients received proton radiation therapy (RT), median dose 50.4 Gy{sub RBE} (50.4-55.8 Gy{sub RBE}). Tumor size was measured before initial CT and before RT. Results:more » With a median follow-up time of 4.1 years for survivors, LF was seen in 9 patients (37.5%). The median time from the initiation of CT to the start of RT was 4.8 weeks. Patients with LF had a similar initial (pre-CT) tumor volume compared with patients with local controlled (LC) (54 cm{sup 3} vs 43 cm{sup 3}, P=.9) but a greater median volume before RT (pre-RT) (40 cm{sup 3} vs 7 cm{sup 3}, P=.009) and a smaller median relative percent volume reduction (RPVR) in tumor size (0.4% vs 78%, P<.001). Older age (P=.05), larger pre-RT tumor volume (P=.03), and smaller RPVR (P=.003) were significantly associated with actuarial LF on univariate Cox analysis. Conclusions: Poor response to induction CT appears to be associated with an increased risk of LF in pediatric embryonal PM-RMS.« less

Gleason grade remains an important prognostic predictor in men diagnosed with prostate cancer while on finasteride therapy

PubMed Central

CARVER, BRETT S.; KATTAN, MICHAEL W.; SCARDINO, PETER T.; EASTHAM, JAMES A.

2007-01-01

OBJECTIVE To evaluate men treated with finasteride for lower urinary tract symptoms, who subsequently were diagnosed with prostate cancer and had a radical prostatectomy (RP) at our institution, to determine if finasteride therapy prevented accurate Gleason grade assignment and prediction of biochemical recurrence. PATIENTS AND METHODS Between May 1996 and July 2003, 45 men were identified who had RP and had previously been treated with finasteride for ≥6 months before the diagnosis of prostate cancer. Clinical and pathological information was gathered from a RP database. Serum prostate-specific antigen (PSA) level, duration of finasteride therapy, biopsy Gleason grade, clinical stage, RP Gleason grade and pathological stage were reviewed. Freedom from recurrence was predicted using validated nomograms before and after RP, and compared against actuarial 5-year freedom from recurrence using the Kaplan-Meier method. RESULTS The mean duration of finasteride therapy before diagnosis was 23.6 months, the mean serum PSA (doubled to account for finasteride use) 11.02 ng/mL and mean biopsy Gleason score 6. When comparing the biopsy and RP specimen Gleason score, it was downgraded by 1 point in six men, upgraded by 1 point in eight, and upgraded by 2 points in one. The Gleason score was constant in 30 patients. The nomograms predicted freedom from recurrence in 83% and 85%, respectively; the 5-year actuarial freedom from recurrence was 86%. CONCLUSION Finasteride does not appear to compromise the assignment of Gleason grade for use in prediction tools before or after RP in men undergoing prostate biopsy or RP. The actuarial 5-year freedom from recurrence was similar to that predicted by the validated nomograms. Gleason grade remains an important prognostic predictor in men treated with finasteride and undergoing RP for clinically localized prostate cancer. PMID:15705069

24 CFR 1000.139 - What are the standards for insurance entities owned and controlled by recipients?

Code of Federal Regulations, 2013 CFR

2013-04-01

... management staff; (A) The underwriting staff must be composed of insurance professionals with an average of... professional every three years. These audits, actuarial reviews, and management reviews must be submitted to... generally accepted accounting principles (GAAP) and audited by an independent auditor in accordance with...

24 CFR 1000.139 - What are the standards for insurance entities owned and controlled by recipients?

Code of Federal Regulations, 2011 CFR

2011-04-01

... management staff; (A) The underwriting staff must be composed of insurance professionals with an average of... professional every three years. These audits, actuarial reviews, and management reviews must be submitted to... generally accepted accounting principles (GAAP) and audited by an independent auditor in accordance with...

24 CFR 1000.139 - What are the standards for insurance entities owned and controlled by recipients?

Code of Federal Regulations, 2014 CFR

2014-04-01

... management staff; (A) The underwriting staff must be composed of insurance professionals with an average of... professional every three years. These audits, actuarial reviews, and management reviews must be submitted to... generally accepted accounting principles (GAAP) and audited by an independent auditor in accordance with...

42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

Code of Federal Regulations, 2013 CFR

2013-10-01

... standardized set of utilization and price factors; (4) Using a standardized population that is representative... means of cost control or utilization used; and (7) Taking into account the ability of a State to reduce... population to be used under paragraphs (b)(3) and (b)(4) of this section. (d) The State must provide...

42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

Code of Federal Regulations, 2014 CFR

2014-10-01

... standardized set of utilization and price factors; (4) Using a standardized population that is representative... means of cost control or utilization used; and (7) Taking into account the ability of a State to reduce... population to be used under paragraphs (b)(3) and (b)(4) of this section. (d) The State must provide...

42 CFR 440.340 - Actuarial report for benchmark-equivalent coverage.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Using a standardized population that is representative of the population involved. (5) Applying the same... taking into account any differences in coverage based on the method of delivery or means of cost control... population to be used in paragraphs (b)(3) and (b)(4) of this section. (d) The State must provide sufficient...

42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

Code of Federal Regulations, 2011 CFR

2011-10-01

... standardized set of utilization and price factors; (4) Using a standardized population that is representative... means of cost control or utilization used; and (7) Taking into account the ability of a State to reduce... population to be used under paragraphs (b)(3) and (b)(4) of this section. (d) The State must provide...

42 CFR 440.340 - Actuarial report for benchmark-equivalent coverage.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Using a standardized population that is representative of the population involved. (5) Applying the same... taking into account any differences in coverage based on the method of delivery or means of cost control... population to be used in paragraphs (b)(3) and (b)(4) of this section. (d) The State must provide sufficient...

42 CFR 440.340 - Actuarial report for benchmark-equivalent coverage.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Using a standardized population that is representative of the population involved. (5) Applying the same... taking into account any differences in coverage based on the method of delivery or means of cost control... population to be used in paragraphs (b)(3) and (b)(4) of this section. (d) The State must provide sufficient...

42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

Code of Federal Regulations, 2012 CFR

2012-10-01

... standardized set of utilization and price factors; (4) Using a standardized population that is representative... means of cost control or utilization used; and (7) Taking into account the ability of a State to reduce... population to be used under paragraphs (b)(3) and (b)(4) of this section. (d) The State must provide...

42 CFR 440.340 - Actuarial report for benchmark-equivalent coverage.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Using a standardized population that is representative of the population involved. (5) Applying the same... taking into account any differences in coverage based on the method of delivery or means of cost control... population to be used in paragraphs (b)(3) and (b)(4) of this section. (d) The State must provide sufficient...

76 FR 7569 - Office of the Assistant Secretary for Planning and Evaluation; Medicare Program; Meeting of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-10

... economics and actuarial science. Panelists are not restricted, however, in the topics that they choose to... actuarial and economic assumptions and methods by which Trustees might more accurately measure health...

Management Sciences Division Annual Report (9th)

DTIC Science & Technology

1992-01-01

41 Actuarial Process Consolidation and Review ....................................... 43 How M alfunction Code Reduction...47 Sun W ork Stations ............................................................................... 48 Actuarial Process Consolidation and...Information System (WSMIS). Dyna-METRIC is used for wartime supply support capability assessments. The Aircraft Sustainability Model ( ASM ) is the

76 FR 30170 - Office of the Assistant Secretary for Planning and Evaluation; Medicare Program; Meeting of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

... estimation involving economics and actuarial science. Panelists are not restricted, however, in the topics... discussion is expected to be very technical in nature and will focus on the actuarial and economic...

A Macro Analysis of DoD Logistics Systems. Volume 2. Structure and Analysis of the Air Force Logistics System

DTIC Science & Technology

1977-09-01

performance measures discussed earlier is the "Engine Actuarial Data Summary" (EADS) (AFLC Form 992), compiled from D024F actuarial data. EADS is...3.2,452.3 PlyLWn M"Is, 404.670 432.603 408,553. 413.940 PMiSMA-00023 AF asm -haiw pua-flywa hma tread =100% PTtU94411 "Weul ’A101) 16,839.6 1.6,308.0...Engine Actuarial Data Summary. ENORS - 2ngine Not Operationally Ready, Supply. EOQ Items - Economic Order Quantity Items; i.e., expense-type items, not

Projecting long term medical spending growth.

PubMed

Borger, Christine; Rutherford, Thomas F; Won, Gregory Y

2008-01-01

We present a dynamic general equilibrium model of the U.S. economy and the medical sector in which the adoption of new medical treatments is endogenous and the demand for medical services is conditional on the state of technology. We use this model to prepare 75-year medical spending forecasts and a projection of the Medicare actuarial balance, and we compare our results to those obtained from a method that has been used by government actuaries. Our baseline forecast predicts slower health spending growth in the long run and a lower Medicare actuarial deficit relative to the previous projection methodology.

Actuarial senescence in a long-lived orchid challenges our current understanding of ageing

PubMed Central

Colchero, Fernando; Jones, Owen R.; Øien, Dag-Inge; Moen, Asbjørn; Sletvold, Nina

2016-01-01

The dominant evolutionary theory of actuarial senescence—an increase in death rate with advancing age—is based on the concept of a germ cell line that is separated from the somatic cells early in life. However, such a separation is not clear in all organisms. This has been suggested to explain the paucity of evidence for actuarial senescence in plants. We used a 32 year study of Dactylorhiza lapponica that replaces its organs each growing season, to test whether individuals of this tuberous orchid senesce. We performed a Bayesian survival trajectory analysis accounting for reproductive investment, for individuals under two types of land use, in two climatic regions. The mortality trajectory was best approximated by a Weibull model, showing clear actuarial senescence. Rates of senescence in this model declined with advancing age, but were slightly higher in mown plots and in the more benign climatic region. At older ages, senescence was evident only when accounting for a positive effect of reproductive investment on mortality. Our results demonstrate actuarial senescence as well as a survival–reproduction trade-off in plants, and indicate that environmental context may influence senescence rates. This knowledge is crucial for understanding the evolution of demographic senescence and for models of plant population dynamics. PMID:27852801

Has actuarial aging “slowed” over the past 250 years? A comparison of small-scale subsistence populations and European cohorts

PubMed Central

Gurven, Michael; Fenelon, Andrew

2012-01-01

G.C. Williams’ 1957 hypothesis famously argues that higher age-independent, or “extrinsic”, mortality should select for faster rates of senescence. Long-lived species should therefore show relatively few deaths from extrinsic causes such as predation and starvation. Theoretical explorations and empirical tests of Williams’ hypothesis have flourished in the past decade but it has not yet been tested empirically among humans. We test Williams’ hypothesis using mortality data from subsistence populations and from historical cohorts from Sweden and England/Wales, and examine whether rates of actuarial aging declined over the past two centuries. We employ three aging measures: mortality rate doubling time (MRDT), Ricklef’s ω, and the slope of mortality hazard from ages sixty to seventy, m’60–70, and model mortality using both Weibull and Gompertz-Makeham hazard models. We find that (1) actuarial aging in subsistence societies is similar to that of early Europe, (2) actuarial senescence has slowed in later European cohorts, (3) reductions in extrinsic mortality associate with slower actuarial aging in longitudinal samples, and (4) men senesce more rapidly than women, especially in later cohorts. To interpret these results, we attempt to bridge population-based evolutionary analysis with individual-level proximate mechanisms. PMID:19220451

Actuarial senescence in a long-lived orchid challenges our current understanding of ageing.

PubMed

Dahlgren, Johan Petter; Colchero, Fernando; Jones, Owen R; Øien, Dag-Inge; Moen, Asbjørn; Sletvold, Nina

2016-11-16

The dominant evolutionary theory of actuarial senescence-an increase in death rate with advancing age-is based on the concept of a germ cell line that is separated from the somatic cells early in life. However, such a separation is not clear in all organisms. This has been suggested to explain the paucity of evidence for actuarial senescence in plants. We used a 32 year study of Dactylorhiza lapponica that replaces its organs each growing season, to test whether individuals of this tuberous orchid senesce. We performed a Bayesian survival trajectory analysis accounting for reproductive investment, for individuals under two types of land use, in two climatic regions. The mortality trajectory was best approximated by a Weibull model, showing clear actuarial senescence. Rates of senescence in this model declined with advancing age, but were slightly higher in mown plots and in the more benign climatic region. At older ages, senescence was evident only when accounting for a positive effect of reproductive investment on mortality. Our results demonstrate actuarial senescence as well as a survival-reproduction trade-off in plants, and indicate that environmental context may influence senescence rates. This knowledge is crucial for understanding the evolution of demographic senescence and for models of plant population dynamics. © 2016 The Author(s).

78 FR 773 - Hartford Financial Services Group, Inc., Commercial/Actuarial/Information Delivery Services (IDS...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-04

...., Commercial/ Actuarial/Information Delivery Services (IDS)/Corporate & Financial Reporting group, Hartford... financial reporting. The group develops databases for creating reports for corporate, regulatory, and... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-81,815] Hartford Financial...

42 CFR 440.335 - Benchmark-equivalent health benefits coverage.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Aggregate actuarial value. Benchmark-equivalent coverage is health benefits coverage that has an aggregate... planning services and supplies and other appropriate preventive services, as designated by the Secretary... State for purposes of comparison in establishing the aggregate actuarial value of the benchmark...

48 CFR 31.001 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... determine the actuarial value of the assets of a pension plan. Actuarial gain and loss means the effect on... cost accounting period. Cost objective means (except for subpart 31.6) a function, organizational... operations. It usually performs management, supervisory, or administrative functions, and may also perform...

48 CFR 31.001 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... determine the actuarial value of the assets of a pension plan. Actuarial gain and loss means the effect on... cost accounting period. Cost objective means (except for subpart 31.6) a function, organizational... operations. It usually performs management, supervisory, or administrative functions, and may also perform...

48 CFR 31.001 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... determine the actuarial value of the assets of a pension plan. Actuarial gain and loss means the effect on... cost accounting period. Cost objective means (except for subpart 31.6) a function, organizational... operations. It usually performs management, supervisory, or administrative functions, and may also perform...

20 CFR 901.42 - Representation.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Representation. 901.42 Section 901.42 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.72 - Additional rules.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Additional rules. 901.72 Section 901.72 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF... additional rules regarding the enrollment of actuaries. [76 FR 17776, Mar. 31, 2011] ...

20 CFR 901.72 - Additional rules.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Additional rules. 901.72 Section 901.72 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF... additional rules regarding the enrollment of actuaries. [76 FR 17776, Mar. 31, 2011] ...

20 CFR 901.42 - Representation.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Representation. 901.42 Section 901.42 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.42 - Representation.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Representation. 901.42 Section 901.42 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.42 - Representation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Representation. 901.42 Section 901.42 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.72 - Additional rules.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Additional rules. 901.72 Section 901.72 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF... additional rules regarding the enrollment of actuaries. [76 FR 17776, Mar. 31, 2011] ...

77 FR 69850 - Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual Deductible...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-21

... percent reserve has been the normal target used to calculate the Part B premium. In view of the strong... 0938-AR16 Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual...

20 CFR 901.42 - Representation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Representation. 901.42 Section 901.42 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dirix, Piet; Nuyts, Sandra; Geussens, Yasmyne

Purpose: To evaluate the long-term clinical outcome and toxicity of conventional and three-dimensional conformal radiotherapy for malignancies of the nasal cavity and paranasal sinuses. Methods and Materials: Between January 1976 and February 2003, 127 patients with histologically proven cancer of the paranasal sinuses (n = 119) or nasal cavity (n = 8) were treated with preoperative (n = 61), postoperative (n = 51), or primary (n = 15) radiotherapy, using conventional (n = 74) or three-dimensional conformal (n = 53) techniques. No elective neck irradiation of the cervical lymph nodes was performed in N0 patients. Results: Median follow-up was 5.6more » years (range, 3-307 months) for all patients, and 7.3 years (range, 47-307 months) for patients still alive at the close-out date. The actuarial 5-year local control, overall survival, and disease-free survival rates were 53%, 54%, and 37%, respectively. Only 6 (5%) of all 127 patients and 4 (3%) of 122 originally N0 patients developed a regional failure in the neck. Distant metastasis occurred in 20% of patients. Both primary tumor extent and lymph node involvement were the most important prognostic factors, together with squamous cell carcinoma histology. Conclusion: Local failure remains the dominant cause of poor outcome for patients with sinonasal cancer, despite aggressive local treatment with combined surgery and radiotherapy in operable patients. Distant metastasis and certainly regional relapse were much less common sites of failure. Overall survival remains poor, suggesting the need for more efficacious local and possibly systemic therapy.« less

Outcomes of proton therapy for the treatment of uveal metastases.

PubMed

Kamran, Sophia C; Collier, John M; Lane, Anne Marie; Kim, Ivana; Niemierko, Andrzej; Chen, Yen-Lin E; MacDonald, Shannon M; Munzenrider, John E; Gragoudas, Evangelos; Shih, Helen A

2014-12-01

Radiation therapy can be used to treat uveal metastases with the goal of local control and improvement of quality of life. Proton therapy can be used to treat uveal tumors efficiently and with expectant minimization of normal tissue injury. Here, we report the use of proton beam therapy for the management of uveal metastases. A retrospective chart review was made of all patients with uveal metastases treated at our institution with proton therapy between June 2002 and June 2012. Patient and tumor characteristics, fractionation and dose schemes, local control, and toxicities are reported. Ninety patients were identified. Of those, 13 were excluded because of missing information. We report on 77 patients with 99 affected eyes with available data. Patients were 68% female, and the most common primary tumor was breast carcinoma (49%). The median age at diagnosis of uveal metastasis was 57.9 years. Serous retinal detachment was seen in 38% of treated eyes. The median follow-up time was 7.7 months. The median dose delivered to either eye was 20 Gy(relative biological effectiveness [RBE]) in 2 fractions. Local control was 94%. The median survival after diagnosis of uveal metastases was 12.3 months (95% confidence interval, 7.7-16.8). Death in all cases was secondary to systemic disease. Radiation vasculopathy, measured decreased visual acuity, or both was observed in 50% of evaluable treated eyes. The actuarial rate of radiation vasculopathy, measured decreased visual acuity, or both was 46% at 6 months and 73% at 1 year. The 6 eyes with documented local failure were successfully salvaged with retreatment. Proton therapy is an effective and efficient means of treating uveal metastases. Acutely, the majority of patients experience minor adverse effects. For longer-term survivors, the risk of retinal injury with vision loss increases significantly over the first year. Copyright © 2014 Elsevier Inc. All rights reserved.

Outcomes of Proton Therapy for the Treatment of Uveal Metastases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kamran, Sophia C.; Collier, John M.; Lane, Anne Marie

2014-12-01

Purpose/Objective(s): Radiation therapy can be used to treat uveal metastases with the goal of local control and improvement of quality of life. Proton therapy can be used to treat uveal tumors efficiently and with expectant minimization of normal tissue injury. Here, we report the use of proton beam therapy for the management of uveal metastases. Methods and Materials: A retrospective chart review was made of all patients with uveal metastases treated at our institution with proton therapy between June 2002 and June 2012. Patient and tumor characteristics, fractionation and dose schemes, local control, and toxicities are reported. Results: Ninety patientsmore » were identified. Of those, 13 were excluded because of missing information. We report on 77 patients with 99 affected eyes with available data. Patients were 68% female, and the most common primary tumor was breast carcinoma (49%). The median age at diagnosis of uveal metastasis was 57.9 years. Serous retinal detachment was seen in 38% of treated eyes. The median follow-up time was 7.7 months. The median dose delivered to either eye was 20 Gy(relative biological effectiveness [RBE]) in 2 fractions. Local control was 94%. The median survival after diagnosis of uveal metastases was 12.3 months (95% confidence interval, 7.7-16.8). Death in all cases was secondary to systemic disease. Radiation vasculopathy, measured decreased visual acuity, or both was observed in 50% of evaluable treated eyes. The actuarial rate of radiation vasculopathy, measured decreased visual acuity, or both was 46% at 6 months and 73% at 1 year. The 6 eyes with documented local failure were successfully salvaged with retreatment. Conclusions: Proton therapy is an effective and efficient means of treating uveal metastases. Acutely, the majority of patients experience minor adverse effects. For longer-term survivors, the risk of retinal injury with vision loss increases significantly over the first year.« less

Radiation Therapy for Control of Soft-Tissue Sarcomas Resected With Positive Margins

DOE Office of Scientific and Technical Information (OSTI.GOV)

DeLaney, Thomas F.; Kepka, Lucyna; Goldberg, Saveli I.

Purpose: Positive margins (PM) remain after surgery in some soft-tissue sarcoma (STS) patients. We investigated the efficacy of radiation therapy (RT) in STS patients with PM. Methods and Materials: A retrospective chart review was performed on 154 patients with STS at various anatomic sites with PM, defined as tumor on ink, who underwent RT with curative intent between 1970 and 2001. Local control (LC), disease-free survival (DFS), and overall survival (OS) rates were evaluated by univariate (log-rank) and multivariate analysis of prognostic and treatment factors. Results: At 5 years, actuarial LC, DFS, and OS rates were: 76%, 46.7%, and 65.2%,more » respectively. LC was highest with extremity lesions (p < 0.01), radiation dose >64 Gy (p < 0.05), microscopically (vs. grossly visible) positive margin (p = 0.03), and superficial lesions (p = 0.05). Patients receiving >64 Gy had higher 5-year LC, DFS, and OS rates of 85%, 52.1%, and 67.8% vs. 66.1%, 41.8%, and 62.9% if {<=}64 Gy, p < 0.04. OS was worse in patients with G2/G3 tumors with local failure (LF), p < 0.001. Other known prognostic factors, including grade, stage, size, and age (>50), also significantly influenced OS. By multivariate analysis, the best predictors of LC were site (extremity vs. other), p < 0.01 and dose (>64 vs. {<=}64 Gy), p < 0.05; the best predictors for OS were size, p < 0.001, gross vs. microscopic PM, p < 0.05, and LF, p < 0.01. Conclusion: Local control is achieved in most PM STS patients undergoing RT. Doses >64 Gy, superficial location, and extremity site are associated with improved LC. OS is worse in patients with tumors with lesions >5 cm, grossly positive margins, and after local failure.« less

Further Improvement in Outcomes of Nasopharyngeal Carcinoma With Optimized Radiotherapy and Induction Plus Concomitant Chemotherapy: An Update of the Milan Experience

DOE Office of Scientific and Technical Information (OSTI.GOV)

Palazzi, Mauro; Orlandi, Ester; Bossi, Paolo

2009-07-01

Purpose: To report the outcome of a consecutive series of patients with nonmetastatic nasopharyngeal carcinoma (NPC), focusing on the impact of treatment-related factors. Methods and Materials: Between 2000 and 2006, 87 patients with NPC were treated with either conventional (two- or three-dimensional) radiotherapy (RT) or with intensity-modulated RT (IMRT). Of these patients, 81 (93%) received either concomitant CHT (24%) or both induction and concomitant chemotherapy (CHT) (69%). Stage was III in 36% and IV in 39% of patients. Outcomes in this study population were compared with those in the previous series of 171 patients treated during 1990 to 1999. Results:more » With a median follow-up of 46 months, actuarial rates at 3 years were the following: local control, 96%; local-regional control, 93%; distant control (DC), 90%; disease-free survival (DFS), 82%; overall survival, 90%. In Stage III to IV patients, distant control at 3 years was 56% in patients treated with concomitant CHT only and 92% in patients treated with both induction and concomitant CHT (p = 0.014). At multivariate analysis, histology, N-stage, RT technique, and total RT dose had the strongest independent impact on DFS (p < 0.05). Induction CHT had a borderline effect on DC (p = 0.07). Most dosimetric statistics were improved in the group of patients treated with IMRT compared with conventional 3D technique. All outcome endpoints were substantially better in the study population compared with those in the previous series. Conclusions: Outcome of NPC has further improved in the study period compared with the previous decade, with a significant effect of RT technique optimization. The impact of induction CHT remains to be demonstrated in controlled trials.« less

78 FR 8596 - Hartford Financial Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-06

... Delivery Services (IDS)/Corporate & Financial Reporting group, Hartford, Connecticut (The Hartford-IDS... technology applications for corporate, regulatory, and financial reporting. Pursuant to 29 CFR 90.18(c...., Commercial/Actuarial/Information Delivery Services (IDS)/ Corporate & Financial Reporting group, Hartford...

20 CFR 901.54 - Petition for reinstatement.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Petition for reinstatement. 901.54 Section 901.54 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or...

20 CFR 901.37 - Answer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Answer. 901.37 Section 901.37 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of Enrollment...

20 CFR 901.46 - Depositions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Depositions. 901.46 Section 901.46 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of Enrollment...

20 CFR 901.37 - Answer.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Answer. 901.37 Section 901.37 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of Enrollment...

20 CFR 901.46 - Depositions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Depositions. 901.46 Section 901.46 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of Enrollment...

20 CFR 901.47 - Transcript.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Transcript. 901.47 Section 901.47 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of Enrollment...

20 CFR 901.54 - Petition for reinstatement.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Petition for reinstatement. 901.54 Section 901.54 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or...

20 CFR 901.37 - Answer.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Answer. 901.37 Section 901.37 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of Enrollment...

20 CFR 901.54 - Petition for reinstatement.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Petition for reinstatement. 901.54 Section 901.54 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or...

20 CFR 901.47 - Transcript.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Transcript. 901.47 Section 901.47 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of Enrollment...

20 CFR 901.37 - Answer.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Answer. 901.37 Section 901.37 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of Enrollment...

20 CFR 901.54 - Petition for reinstatement.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Petition for reinstatement. 901.54 Section 901.54 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or...

20 CFR 901.46 - Depositions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Depositions. 901.46 Section 901.46 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of Enrollment...

20 CFR 901.47 - Transcript.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Transcript. 901.47 Section 901.47 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of Enrollment...

20 CFR 901.47 - Transcript.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Transcript. 901.47 Section 901.47 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of Enrollment...

20 CFR 901.54 - Petition for reinstatement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Petition for reinstatement. 901.54 Section 901.54 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or...

20 CFR 901.37 - Answer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Answer. 901.37 Section 901.37 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of Enrollment...

Whole lot of parts: stress in extreme environments.

PubMed

Steel, G Daniel

2005-06-01

Stress has been a central interest for researchers of human behavior in extreme and unusual environments and also for those who are responsible for planning and carrying out expeditions involving such environments. This paper compares the actuarial and case study methods for predicting reactions to stress. Actuarial studies are useful, but do not tap enough variables to allow us to predict how a specific individual will cope with the rigors of an individual mission. Case histories provide a wealth of detail, but few investigators understand the challenges of properly applying this method. This study reviews some of the strengths and weaknesses of the actuarial and case history methods, and presents a four celled taxonomy of stress based on method (actuarial and case history) and effects (distress and eustress). For both research and operational purposes, the person, the setting, and time should not be considered independently; rather, it is an amalgam of these variables that provides the proper basis of analysis.

Robotic Radiosurgery for Adrenal Gland Metastases

PubMed Central

Heidorn, Sarah-Charlotta; Kremer, Nikolaus; Muacevic, Alexander; Fürweger, Christoph

2017-01-01

Introduction The purpose of this study was to investigate the safety and efficacy of CyberKnife (CK) robotic radiosurgery for treatment of adrenal metastases. Methods We performed a retrospective analysis of 23 patients with adrenal metastases who had been treated with CK between October 2006 and December 2015. Fifteen patients received chemotherapy prior to radiosurgery, all patients underwent computer tomography (CT) fluoroscopically guided percutaneous placement of one to three gold fiducials into the adrenal gland. Nineteen patients were selected for single-fraction radiosurgery with a median dose of 22 Gy, four patients were treated in three fractions with a median dose of 13.5 Gy. Results Median follow-up time was 23.6 months. Four patients (17%) experienced local relapse during the evaluation period with a mean time of 19 months to tumor progression. The actuarial local tumor control rate was 95% after one year and 81% after two years. Three of the four patients with local recurrence were retreated with CK radiosurgery. Dynamic tumor tracking enabled accurate treatment with correlation errors less than 2 mm, despite extensive respiration-induced target motion up to 22 mm. Apart from nausea directly after treatment in five patients, we observed no early or late treatment-related side effects. Conclusions Single fraction robotic radiosurgery for adrenal gland metastases is a safe and effective treatment option for patients who are not eligible for surgical resection. PMID:28451479

Deductibles in health insurance: can the actuarially fair premium reduction exceed the deductible?

PubMed

Bakker, F M; van Vliet, R C; van de Ven, W P

2000-09-01

The actuarially fair premium reduction in case of a deductible relative to full insurance is affected by: (1) out-of-pocket payments, (2) moral hazard, (3) administrative costs, and, in case of a voluntary deductible, (4) adverse selection. Both the partial effects and the total effect of these factors are analyzed. Moral hazard and adverse selection appear to have a substantial effect on the expected health care costs above a deductible but a small effect on the expected out-of-pocket expenditure. A premium model indicates that for a broad range of deductible amounts the actuarially fair premium reduction exceeds the deductible.

20 CFR 901.10 - Application for enrollment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Application for enrollment. 901.10 Section 901.10 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Actuaries § 901.10 Application for enrollment. (a) Form. As a requirement for enrollment, an applicant shall...

20 CFR 901.10 - Application for enrollment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Application for enrollment. 901.10 Section 901.10 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Actuaries § 901.10 Application for enrollment. (a) Form. As a requirement for enrollment, an applicant shall...

20 CFR 901.48 - Proposed findings and conclusions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Proposed findings and conclusions. 901.48 Section 901.48 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or...

20 CFR 901.40 - Proof; variance; amendment of pleadings.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Proof; variance; amendment of pleadings. 901.40 Section 901.40 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974...

20 CFR 901.48 - Proposed findings and conclusions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Proposed findings and conclusions. 901.48 Section 901.48 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or...

20 CFR 901.41 - Motions and requests.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Motions and requests. 901.41 Section 901.41 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.10 - Application for enrollment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Application for enrollment. 901.10 Section 901.10 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Actuaries § 901.10 Application for enrollment. (a) Form. As a requirement for enrollment, an applicant shall...

20 CFR 901.35 - Contents of complaint.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Contents of complaint. 901.35 Section 901.35 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.72 - Additional rules.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Additional rules. 901.72 Section 901.72 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF... additional rules regarding the enrollment of actuaries. Effective Date Note: At 76 FR 17776, Mar. 31, 2011...

20 CFR 901.41 - Motions and requests.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Motions and requests. 901.41 Section 901.41 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.39 - Reply to answer.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Reply to answer. 901.39 Section 901.39 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.41 - Motions and requests.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Motions and requests. 901.41 Section 901.41 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.10 - Application for enrollment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Application for enrollment. 901.10 Section 901.10 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Actuaries § 901.10 Application for enrollment. (a) Form. As a requirement for enrollment, an applicant shall...

20 CFR 901.71 - Special orders.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Special orders. 901.71 Section 901.71 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 General Provisions § 901.71...

20 CFR 901.39 - Reply to answer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Reply to answer. 901.39 Section 901.39 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.48 - Proposed findings and conclusions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Proposed findings and conclusions. 901.48 Section 901.48 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or...

20 CFR 901.40 - Proof; variance; amendment of pleadings.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Proof; variance; amendment of pleadings. 901.40 Section 901.40 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974...

20 CFR 901.35 - Contents of complaint.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Contents of complaint. 901.35 Section 901.35 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.40 - Proof; variance; amendment of pleadings.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Proof; variance; amendment of pleadings. 901.40 Section 901.40 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974...

20 CFR 901.48 - Proposed findings and conclusions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Proposed findings and conclusions. 901.48 Section 901.48 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or...

20 CFR 901.41 - Motions and requests.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Motions and requests. 901.41 Section 901.41 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.71 - Special orders.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Special orders. 901.71 Section 901.71 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 General Provisions § 901.71...

20 CFR 901.35 - Contents of complaint.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Contents of complaint. 901.35 Section 901.35 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.71 - Special orders.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Special orders. 901.71 Section 901.71 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 General Provisions § 901.71...

20 CFR 901.39 - Reply to answer.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Reply to answer. 901.39 Section 901.39 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.39 - Reply to answer.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Reply to answer. 901.39 Section 901.39 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.40 - Proof; variance; amendment of pleadings.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Proof; variance; amendment of pleadings. 901.40 Section 901.40 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974...

20 CFR 901.71 - Special orders.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Special orders. 901.71 Section 901.71 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 General Provisions § 901.71...

75 FR 9334 - Multiemployer Pension Plan Information Made Available on Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-02

..., strategies) that, if disclosed by the plan, may cause, or increase a reasonable risk of, financial harm to... certain actuarial and financial documents about the plan to participants, beneficiaries, employee... request, shall furnish copies of certain actuarial and financial documents to any plan participant...

20 CFR 901.35 - Contents of complaint.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Contents of complaint. 901.35 Section 901.35 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.71 - Special orders.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Special orders. 901.71 Section 901.71 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 General Provisions § 901.71...

20 CFR 901.40 - Proof; variance; amendment of pleadings.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Proof; variance; amendment of pleadings. 901.40 Section 901.40 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974...

20 CFR 901.41 - Motions and requests.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Motions and requests. 901.41 Section 901.41 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.35 - Contents of complaint.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Contents of complaint. 901.35 Section 901.35 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

20 CFR 901.10 - Application for enrollment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Application for enrollment. 901.10 Section 901.10 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Actuaries § 901.10 Application for enrollment. (a) Form. As a requirement for enrollment, an applicant shall...

20 CFR 901.39 - Reply to answer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Reply to answer. 901.39 Section 901.39 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Suspension or Termination of...

77 FR 61001 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-05

... currently approved collection; Title of Information Collection: Bid Pricing Tool (BPT) for Medicare... organizations (MAO) and Prescription Drug Plans (PDP) are required to submit an actuarial pricing ``bid'' for... PDPs use the Bid Pricing Tool (BPT) software to develop their actuarial pricing bid. The information...

77 FR 33241 - Advisory Council on Employee Welfare and Pension Benefit Plans; Nominations for Vacancies

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-05

... fields of insurance, corporate trust, actuarial counseling, investment counseling, investment management... groups or fields they represent are as follows: (1) Employee organizations; (2) employers; (3) investment counseling; (4) actuarial counseling; and (5) the general public. The Department of Labor is committed to...

Should Actuarial Risk Assessments Be Used with Sex Offenders Who Are Intellectually Disabled?

ERIC Educational Resources Information Center

Harris, Andrew J. R.; Tough, Susan

2004-01-01

Background: Objective actuarial assessments are critical for making risk decisions, determining the necessary level of supervision and intensity of treatment ( Andrews & Bonta 2003). This paper reviews the history of organized risk assessment and discusses some issues in current attitudes towards sexual offenders with intellectual disabilities.…

75 FR 81454 - Privacy Act of 1974; Implementation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

... JOINT BOARD FOR ENROLLMENT OF ACTUARIES 20 CFR Part 903 Privacy Act of 1974; Implementation AGENCY... requirements of the Privacy Act of 1974, as amended, the Joint Board for the Enrollment of Actuaries (Joint... Privacy Act, from certain of the Privacy Act's provisions, to revise language that incorrectly implies...

Starting an Actuarial Science Major at a Liberal Arts College

ERIC Educational Resources Information Center

Mills, Mark A.

2014-01-01

The article provides details of the process of starting an actuarial science major at a small, liberal arts college. Some critique of the major is included, as well as some challenges that may be faced by others wanting to start such a major at their institution.

Soldier Decision-Making for Allocation of Intelligence, Surveillance, and Reconnaissance Assets

DTIC Science & Technology

2014-06-01

Judgments; also called Algoritmic or Statistical Judgements Computer Science , Psychology, and Statistics Actuarial or algorithmic...Jan. 2011. [17] R. M. Dawes, D. Faust, and P. E. Meehl, “Clinical versus Actuarial Judgment,” Science , vol. 243, no. 4899, pp. 1668–1674, 1989. [18...School of Computer Science

Recruiting and Advising Challenges in Actuarial Science

ERIC Educational Resources Information Center

Case, Bettye Anne; Guan, Yuanying Michelle; Paris, Stephen

2014-01-01

Some challenges to increasing actuarial science program size through recruiting broadly among potential students are identified. Possible solutions depend on the structures and culture of the school. Up to three student cohorts may result from partition of potential students by the levels of academic progress before program entry: students…

20 CFR 902.1 - Scope.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Scope. 902.1 Section 902.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES RULES REGARDING AVAILABILITY OF INFORMATION § 902.1 Scope. This part is issued by the Joint Board for the Enrollment of Actuaries (the “Joint Board...

20 CFR 903.1 - Purpose and scope of regulations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Purpose and scope of regulations. 903.1 Section 903.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES ACCESS TO RECORDS Records... all records maintained by the Joint Board for the Enrollment of Actuaries (Joint Board) which are...

20 CFR 902.1 - Scope.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Scope. 902.1 Section 902.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES RULES REGARDING AVAILABILITY OF INFORMATION § 902.1 Scope. This part is issued by the Joint Board for the Enrollment of Actuaries (the “Joint Board...

20 CFR 901.36 - Service of complaint and other papers.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Service of complaint and other papers. 901.36 Section 901.36 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Actuaries, Treasury Department, Washington, D.C. 20220. All papers shall be filed in duplicate. ...

20 CFR 900.1 - Basis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Basis. 900.1 Section 900.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES STATEMENT OF ORGANIZATION § 900.1 Basis. This statement is issued by the Joint Board for the Enrollment of Actuaries (the Joint Board) pursuant to the...

20 CFR 901.36 - Service of complaint and other papers.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Service of complaint and other papers. 901.36 Section 901.36 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Actuaries, Treasury Department, Washington, D.C. 20220. All papers shall be filed in duplicate. ...

20 CFR 900.1 - Basis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Basis. 900.1 Section 900.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES STATEMENT OF ORGANIZATION § 900.1 Basis. This statement is issued by the Joint Board for the Enrollment of Actuaries (the Joint Board) pursuant to the...

20 CFR 900.6 - Offices.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Offices. 900.6 Section 900.6 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES STATEMENT OF ORGANIZATION § 900.6 Offices. The Joint... post office address is Joint Board for the Enrollment of Actuaries, c/o Department of the Treasury...

20 CFR 901.50 - Appeal to the Joint Board.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Appeal to the Joint Board. 901.50 Section 901.50 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Administrative Law Judge's decision, either party may appeal to the Joint Board for the Enrollment of Actuaries...

20 CFR 901.51 - Decision of the Joint Board.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Decision of the Joint Board. 901.51 Section 901.51 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... decision of the Administrative Law Judge, the Joint Board for the Enrollment of Actuaries will make the...

20 CFR 901.51 - Decision of the Joint Board.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Decision of the Joint Board. 901.51 Section 901.51 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... decision of the Administrative Law Judge, the Joint Board for the Enrollment of Actuaries will make the...

20 CFR 900.6 - Offices.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Offices. 900.6 Section 900.6 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES STATEMENT OF ORGANIZATION § 900.6 Offices. The Joint... post office address is Joint Board for the Enrollment of Actuaries, c/o Department of the Treasury...

20 CFR 901.51 - Decision of the Joint Board.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Decision of the Joint Board. 901.51 Section 901.51 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... decision of the Administrative Law Judge, the Joint Board for the Enrollment of Actuaries will make the...

20 CFR 901.36 - Service of complaint and other papers.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Service of complaint and other papers. 901.36 Section 901.36 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Actuaries, Treasury Department, Washington, D.C. 20220. All papers shall be filed in duplicate. ...

20 CFR 903.1 - Purpose and scope of regulations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Purpose and scope of regulations. 903.1 Section 903.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES ACCESS TO RECORDS Records... all records maintained by the Joint Board for the Enrollment of Actuaries (Joint Board) which are...

20 CFR 901.49 - Decision of the Administrative Law Judge.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Decision of the Administrative Law Judge. 901.49 Section 901.49 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974...

20 CFR 901.51 - Decision of the Joint Board.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Decision of the Joint Board. 901.51 Section 901.51 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... decision of the Administrative Law Judge, the Joint Board for the Enrollment of Actuaries will make the...

20 CFR 901.50 - Appeal to the Joint Board.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Appeal to the Joint Board. 901.50 Section 901.50 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Administrative Law Judge's decision, either party may appeal to the Joint Board for the Enrollment of Actuaries...

20 CFR 901.50 - Appeal to the Joint Board.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Appeal to the Joint Board. 901.50 Section 901.50 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Administrative Law Judge's decision, either party may appeal to the Joint Board for the Enrollment of Actuaries...

20 CFR 902.1 - Scope.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Scope. 902.1 Section 902.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES RULES REGARDING AVAILABILITY OF INFORMATION § 902.1 Scope. This part is issued by the Joint Board for the Enrollment of Actuaries (the “Joint Board...

20 CFR 900.1 - Basis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Basis. 900.1 Section 900.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES STATEMENT OF ORGANIZATION § 900.1 Basis. This statement is issued by the Joint Board for the Enrollment of Actuaries (the Joint Board) pursuant to the...

20 CFR 900.6 - Offices.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Offices. 900.6 Section 900.6 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES STATEMENT OF ORGANIZATION § 900.6 Offices. The Joint... post office address is Joint Board for the Enrollment of Actuaries, c/o Department of the Treasury...

20 CFR 901.36 - Service of complaint and other papers.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Service of complaint and other papers. 901.36 Section 901.36 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Actuaries, Treasury Department, Washington, D.C. 20220. All papers shall be filed in duplicate. ...

20 CFR 901.49 - Decision of the Administrative Law Judge.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Decision of the Administrative Law Judge. 901.49 Section 901.49 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974...

20 CFR 901.49 - Decision of the Administrative Law Judge.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Decision of the Administrative Law Judge. 901.49 Section 901.49 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974...

20 CFR 903.1 - Purpose and scope of regulations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Purpose and scope of regulations. 903.1 Section 903.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES ACCESS TO RECORDS Records... all records maintained by the Joint Board for the Enrollment of Actuaries (Joint Board) which are...

20 CFR 901.50 - Appeal to the Joint Board.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Appeal to the Joint Board. 901.50 Section 901.50 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Administrative Law Judge's decision, either party may appeal to the Joint Board for the Enrollment of Actuaries...

20 CFR 903.1 - Purpose and scope of regulations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Purpose and scope of regulations. 903.1 Section 903.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES ACCESS TO RECORDS Records... all records maintained by the Joint Board for the Enrollment of Actuaries (Joint Board) which are...

20 CFR 902.1 - Scope.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Scope. 902.1 Section 902.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES RULES REGARDING AVAILABILITY OF INFORMATION § 902.1 Scope. This part is issued by the Joint Board for the Enrollment of Actuaries (the “Joint Board...

20 CFR 900.6 - Offices.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Offices. 900.6 Section 900.6 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES STATEMENT OF ORGANIZATION § 900.6 Offices. The Joint... post office address is Joint Board for the Enrollment of Actuaries, c/o Department of the Treasury...

20 CFR 900.1 - Basis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Basis. 900.1 Section 900.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES STATEMENT OF ORGANIZATION § 900.1 Basis. This statement is issued by the Joint Board for the Enrollment of Actuaries (the Joint Board) pursuant to the...

20 CFR 901.49 - Decision of the Administrative Law Judge.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Decision of the Administrative Law Judge. 901.49 Section 901.49 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974...

20 CFR 903.1 - Purpose and scope of regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Purpose and scope of regulations. 903.1 Section 903.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES ACCESS TO RECORDS Records... all records maintained by the Joint Board for the Enrollment of Actuaries (Joint Board) which are...

20 CFR 901.36 - Service of complaint and other papers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Service of complaint and other papers. 901.36 Section 901.36 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Actuaries, Treasury Department, Washington, D.C. 20220. All papers shall be filed in duplicate. ...

Conversations with your actuary: getting to the right number.

PubMed

Frese, Richard C

2013-05-01

A healthcare finance leader can guarantee recognition of his or her organization's insurance program and better manage the program's liability by discussing changes in the following areas with an actuary: Claims management. Exposure. Coverage or retention Financial reporting of losses. Management goals. Other insurance and operational matters.

20 CFR 902.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Scope. 902.1 Section 902.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES RULES REGARDING AVAILABILITY OF INFORMATION § 902.1 Scope. This part is issued by the Joint Board for the Enrollment of Actuaries (the “Joint Board...

20 CFR 901.49 - Decision of the Administrative Law Judge.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Decision of the Administrative Law Judge. 901.49 Section 901.49 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974...

20 CFR 901.50 - Appeal to the Joint Board.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Appeal to the Joint Board. 901.50 Section 901.50 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE... Administrative Law Judge's decision, either party may appeal to the Joint Board for the Enrollment of Actuaries...

20 CFR 900.1 - Basis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Basis. 900.1 Section 900.1 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES STATEMENT OF ORGANIZATION § 900.1 Basis. This statement is issued by the Joint Board for the Enrollment of Actuaries (the Joint Board) pursuant to the...

Stereotactic body radiotherapy for de novo spinal metastases: systematic review.

PubMed

Husain, Zain A; Sahgal, Arjun; De Salles, Antonio; Funaro, Melissa; Glover, Janis; Hayashi, Motohiro; Hiraoka, Masahiro; Levivier, Marc; Ma, Lijun; Martínez-Alvarez, Roberto; Paddick, J Ian; Régis, Jean; Slotman, Ben J; Ryu, Samuel

2017-09-01

OBJECTIVE The aim of this systematic review was to provide an objective summary of the published literature pertaining to the use of stereotactic body radiation therapy (SBRT) specific to previously untreated spinal metastases. METHODS The authors performed a systematic review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, of the literature found in a search of Medline, PubMed, Embase, and the Cochrane Library up to March 2015. The search strategy was limited to publications in the English language. RESULTS A total of 14 full-text articles were included in the analysis. All studies were retrospective except for 2 studies, which were prospective. A total of 1024 treated spinal lesions were analyzed. The median follow-up time ranged from 9 to 49 months. A range of dose-fractionation schemes was used, the most common of which were 16-24 Gy/1 fraction (fx), 24 Gy/2 fx, 24-27 Gy/3 fx, and 30-35 Gy/5 fx. In studies that reported crude results regarding in-field local tumor control, 346 (85%) of 407 lesions remained controlled. For studies that reported actuarial values, the weighted average revealed a 90% 1-year local control rate. Only 3 studies reported data on complete pain response, and the weighted average of these results yielded a complete pain response rate of 54%. The most common toxicity was new or progressing vertebral compression fracture, which was observed in 9.4% of cases; 2 cases (0.2%) of neurologic injury were reported. CONCLUSION There is a paucity of prospective data specific to SBRT in patients with spinal metastases not otherwise irradiated. This systematic review found that SBRT is associated with favorable rates of local control (approximately 90% at 1 year) and complete pain response (approximately 50%), and low rates of serious adverse events were found. Practice guidelines are summarized based on these data and International Stereotactic Radiosurgery Society consensus.

Microwave ablation versus transarterial chemoembolization in large hepatocellular carcinoma: prospective analysis.

PubMed

Abdelaziz, Ashraf Omar; Nabeel, Mohamed Mahmoud; Elbaz, Tamer Mahmoud; Shousha, Hend Ibrahim; Hassan, Eman Medhat; Mahmoud, Sherif Hamdy; Rashed, Noha Ali; Ibrahim, Mostafa Mohamed; Abdelmaksoud, Ahmed Hosni

2015-04-01

Limited therapies are offered for large hepatocellular carcinoma (HCC). It carries dismal prognosis and efforts tried changing its management from a palliative to a curative mode. Transarterial chemoembolization (TACE) is a palliative procedure that may have survival benefit if compared to non-management of large lesions. Microwave ablation (MWA) has emerged as a relatively new technique with promise of larger and faster ablation. We aim to evaluate the efficacy and safety of percutaneous MWA versus TACE for large tumors (5-7 cm) and to assess their effects on local tumor progression and survival. Sixty-four patients with large lesions are managed in our multidisciplinary HCC clinic and were divided into two groups treated either by MWA or TACE. Complete response rate, local recurrence, de novo lesions, and overall survival analysis are compared between both procedures. Both groups were comparable as regards the demographic and ultrasonographic features. MWA showed higher rates of complete ablation (75%) with fewer sessions, lower incidence of tumor recurrence (p = 0.02), development of de novo lesions (p = 0.03), occurrence of post-treatment ascites (p = 0.003), and higher survival rates (p = 0.04). The mean survival of the microwave group was 21.7 months with actuarial probability of survival at 12 and 18 months 78.2% and 68.4%, respectively. The mean survival of the TACE group was 13.7 months with actuarial probability of survival at 12 and 18 months being 52.4% and 28.6%, respectively. MWA showed better results than TACE in the management of large HCC lesions.

Dermatofibrosarcoma Protuberans: Long-term Outcomes of 53 Patients Treated With Conservative Surgery and Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Castle, Katherine O.; Guadagnolo, B. Ashleigh, E-mail: aguadagn@mdanderson.org; Tsai, C. Jillian

Purpose: To evaluate outcomes of conservative surgery and radiation therapy (RT) treatment in patients with dermatofibrosarcoma protuberans. Methods and Materials: We retrospectively reviewed the medical records of 53 consecutive dermatofibrosarcoma protuberans patients treated with surgery and preoperative or postoperative radiation therapy between 1972 and 2010. Median tumor size was 4 cm (range, 1-25 cm). Seven patients (13%) were treated with preoperative RT (50-50.4 Gy) and 46 patients (87%) with postoperative RT (60-66 Gy). Of the 46 patients receiving postoperative radiation, 3 (7%) had gross disease, 14 (30%) positive margins, 26 (57%) negative margins, and 3 (7%) uncertain margin status. Radiationmore » dose ranged from 50 to 66 Gy (median dose, 60 Gy). Results: At a median follow-up time of 6.5 years (range, 0.5 months-23.5 years), 2 patients (4%) had disease recurrence, and 3 patients (6%) had died. Actuarial overall survival was 98% at both 5 and 10 years. Local control was 98% and 93% at 5 and 10 years, respectively. Disease-free survival was 98% and 93% at 5 and 10 years, respectively. The presence of fibrosarcomatous change was not associated with increased risk of local or distant relapse (P=.43). One of the patients with a local recurrence had gross residual disease at the time of RT and despite RT to 65 Gy developed both an in-field recurrence and a nodal and distant recurrence 3 months after RT. The other patient with local recurrence was found to have in-field recurrence 10 years after initial treatment. Thirteen percent of patients had an RT complication at 5 and 10 years, and 9% had a moderate or severe complication at 5 and 10 years. Conclusions: Dermatofibrosarcoma protuberans is a radioresponsive disease with excellent local control after conservative surgery and radiation therapy. Adjuvant RT should be considered for patients with large or recurrent tumors or when attempts at wide surgical margins would result in significant morbidity.« less

MRI-Guided High–Dose-Rate Intracavitary Brachytherapy for Treatment of Cervical Cancer: The University of Pittsburgh Experience

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gill, Beant S.; Kim, Hayeon; Houser, Christopher J.

2015-03-01

Purpose: Image-based brachytherapy is increasingly used for gynecologic malignancies. We report early outcomes of magnetic resonance imaging (MRI)-guided brachytherapy. Methods and Materials: Consecutive patient cases with FIGO stage IB1 to IVA cervical cancer treated at a single institution were retrospectively reviewed. All patients received concurrent cisplatin with external beam radiation therapy along with interdigitated high–dose-rate intracavitary brachytherapy. Computed tomography or MRI was completed after each application, the latter acquired for at least 1 fraction. High-risk clinical target volume (HRCTV) and organs at risk were identified by Groupe Européen de Curiethérapie and European SocieTy for Radiotherapy and Oncology guidelines. Doses weremore » converted to equivalent 2-Gy doses (EQD{sub 2}) with planned HRCTV doses of 75 to 85 Gy. Results: From 2007 to 2013, 128 patients, median 52 years of age, were treated. Predominant characteristics included stage IIB disease (58.6%) with a median tumor size of 5 cm, squamous histology (82.8%), and no radiographic nodal involvement (53.1%). Most patients (67.2%) received intensity modulated radiation therapy (IMRT) at a median dose of 45 Gy, followed by a median brachytherapy dose of 27.5 Gy (range, 25-30 Gy) in 5 fractions. At a median follow up of 24.4 months (range, 2.1-77.2 months), estimated 2-year local control, disease-free survival, and cancer-specific survival rates were 91.6%, 81.8%, and 87.6%, respectively. Predictors of local failure included adenocarcinoma histology (P<.01) and clinical response at 3 months (P<.01). Among the adenocarcinoma subset, receiving HRCTV D{sub 90} EQD{sub 2} ≥84 Gy was associated with improved local control (2-year local control rate 100% vs 54.5%, P=.03). Grade 3 or greater gastrointestinal or genitourinary late toxicity occurred at a 2-year actuarial rate of 0.9%. Conclusions: This study constitutes one of the largest reported series of MRI-guided brachytherapy in North America, demonstrating excellent local control with acceptable morbidity. Dose escalation may be warranted when feasible for adenocarcinomas to offset the risk of local failure.« less

Merkel Cell Carcinoma: 27-Year Experience at the Peter MacCallum Cancer Centre

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hui, Andrew C., E-mail: achui@bigpond.net.au; Stillie, Alison L.; Seel, Matthew

2011-08-01

Purpose: To retrospectively evaluate the treatment outcome of patients with Merkel cell carcinoma after local and/or regional treatment. Methods and Materials: Patients presenting to our center between January 1980 and July 2006 with Merkel cell carcinoma and without distant metastases were reviewed. The primary endpoint was locoregional control. Secondary endpoints were distant recurrence, survival and treatment toxicity. Results: A total of 176 patients were identified. The median age was 79 years. The median follow-up was 2.2 years for all patients and 3.9 years for those alive at the last follow-up visit. The most common primary site was the head andmore » neck (56%), and 62 patients(35%) had regional disease at presentation. The initial surgery to the primary tumor involved (wide) local excision in 140 patients and biopsy only in 28 patients (8 patients had no identifiable primary tumor); 33 patients underwent nodal surgery. Of the 176 patients, 165 (94%) underwent radiotherapy (RT) and 29 of them also underwent concurrent chemotherapy. The median radiation dose was 50 Gy (range, 18-60). Locoregional recurrence developed in 33 patients(19%), with a median interval to recurrence of 8 months. Distant metastases developed in 43 patients(24%). Age, primary tumor size, and RT (no RT vs. <45 Gy vs. {>=}45 Gy) were predictive of locoregional control on univariate analysis. However, only RT remained significant on multivariate analysis. The estimated 5-year actuarial rate for locoregional control, progression-free survival, and overall survival was 76%, 60%, and 45%, respectively. Conclusion: The locoregional control rate for Merkel cell carcinoma in our study was comparable to those from other series using combined modality treatment with RT an integral part of treatment.« less

Sexual Reconviction Rates in the United Kingdom and Actuarial Risk Estimates

ERIC Educational Resources Information Center

Craig, Leam A.; Browne, Kevin D.; Stringer, Ian; Hogue, Todd E.

2008-01-01

Objective: Assessing the risk of further offending behavior by adult sexual perpetrators of children is highly relevant and important to professionals involved in child protection. Recent progress in assessing risk in sexual offenders has established the validity of actuarial measures, although there continues to be some debate about the…

29 CFR 2520.104-42 - Waiver of certain actuarial information in the annual report.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ERISA that the annual report include as part of the actuarial statement (Schedule B) 1 the present value of all of the plan's liabilities for nonforfeitable pension benefits allocated by termination... report. 2520.104-42 Section 2520.104-42 Labor Regulations Relating to Labor (Continued) EMPLOYEE BENEFITS...

76 FR 81362 - Regulations Governing the Performance of Actuarial Services Under the Employee Retirement Income...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-28

... Governing the Performance of Actuarial Services Under the Employee Retirement Income Security Act of 1974... regulations (TD 9517) that are the subject of this correction are under section 3042 of the Employee... EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 0 Paragraph 1. The authority citation for part 901...

48 CFR 9904.412-50 - Techniques for application.

Code of Federal Regulations, 2012 CFR

2012-10-01

... shall be separately amortized over no more than 30 years nor less than 10 years. (v) Actuarial gains and... pursuant to the provisions of this Standard. The accounting treatment to be afforded to such gains and... cost accounting periods shall be measured by an immediate-gain actuarial cost method. (2) Where the...

Characteristics of the Navy Laboratory Warfare Center Technical Workforce

DTIC Science & Technology

2013-09-29

Mathematics and Information Science (M&IS) Actuarial Science 1510 Computer Science 1550 Gen. Math & Statistics 1501 Mathematics 1520 Operations...Admin. Network Systems & Data Communication Analysts Actuaries Mathematicians Operations Research Analyst Statisticians Social Science (SS...workforce was sub-divided into six broad occupational groups: Life Science , Physical Science , Engineering, Mathematics, Computer Science and Information

76 FR 52955 - Medicare Program; Meeting of the Technical Advisory Panel on Medicare Trustee Reports

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-24

... Panel's discussion is expected to be very technical in nature and will focus on the actuarial and... discussion is expected to focus on highly technical aspects of estimation involving economics and actuarial science. Panelists are not restricted, however, in the topics that they choose to discuss. Procedure and...

76 FR 58514 - Medicare Program; Meeting of the Technical Advisory Panel on Medicare Trustee Reports

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-21

... to be very technical in nature and will focus on the actuarial and economic assumptions and methods... discussion is expected to focus on highly technical aspects of estimation involving economics and actuarial science. Panelists are not restricted, however, in the topics that they choose to discuss. Procedure and...

Actuarial Science at One Four-Year Comprehensive University

ERIC Educational Resources Information Center

Charlwood, Kevin E.

2014-01-01

Building an Actuarial Science program designated as advanced requires dedicated faculty, support from the administration, and a core group of strong students. Washburn University may serve as a model for those wishing to start or enhance such a program at their institution. We face three main ongoing challenges: first, the hiring and retention of…

Predicting Success for Actuarial Students in Undergraduate Mathematics Courses

ERIC Educational Resources Information Center

Smith, Richard Manning; Schumacher, Phyllis A.

2005-01-01

A study of undergraduate actuarial graduates found that math SAT scores, verbal SAT scores, percentile rank in high school graduating class, and percentage score on a college mathematics placement exam had some relevance to forecasting the students' grade point averages in their major. For both males and females, percentile rank in high school…

20 CFR 901.52 - Effect of suspension, termination or resignation of enrollment; surrender of enrollment certificate.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Effect of suspension, termination or resignation of enrollment; surrender of enrollment certificate. 901.52 Section 901.52 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES...