A comparison of methods for monitoring photon beam energy constancy.

PubMed

Gao, Song; Balter, Peter A; Rose, Mark; Simon, William E

2016-11-08

In extension of a previous study, we compared several photon beam energy metrics to determine which was the most sensitive to energy change; in addition to those, we accounted for both the sensitivity of each metric and the uncertainty in determining that metric for both traditional flattening filter (FF) beams (4, 6, 8, and 10 MV) and for flattening filter-free (FFF) beams (6 and 10 MV) on a Varian TrueBeam. We examined changes in these energy metrics when photon energies were changed to ± 5% and ± 10% from their nominal energies: 1) an attenuation-based metric (the percent depth dose at 10 cm depth, PDD(10)) and, 2) profile-based metrics, including flatness (Flat) and off-axis ratios (OARs) measured on the orthogonal axes or on the diagonals (diagonal normalized flatness, FDN). Profile-based metrics were measured near dmax and also near 10 cm depth in water (using a 3D scanner) and with ioniza-tion chamber array (ICA). PDD(10) was measured only in water. Changes in PDD, OAR, and FDN were nearly linear to the changes in the bend magnet current (BMI) over the range from -10% to +10% for both FF and FFF beams: a ± 10% change in energy resulted in a ± 1.5% change in PDD(10) for both FF and FFF beams, and changes in OAR and FDN were > 3.0% for FF beams and > 2.2% for FFF beams. The uncertainty in determining PDD(10) was estimated to be 0.15% and that for OAR and FDN about 0.07%. This resulted in minimally detectable changes in energy of 2.5% for PDD(10) and 0.5% for OAR and FDN. We found that the OAR- or FDN- based metrics were the best for detecting energy changes for both FF and FFF beams. The ability of the OAR-based metrics determined with a water scanner to detect energy changes was equivalent to that using an ionization chamber array. We recommend that OAR be measured either on the orthogonal axes or the diagonals, using an ionization chamber array near the depth of maximum dose, as a sensitive and efficient way to confirm stability of photon beam energy. © 2016 The Authors.

SU-F-T-279: Impact of Beam Energy Drifts On IMRT Delivery Accuracy

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

Goddu, S; Kamal, G; Herman, A

Purpose: According to TG-40 percent-depth-dose (PDD) tolerance is ±2% but TG-142 is ±1%. Now the question is, which one is relevant in IMRT era? The primary objective of this study is to evaluate dosimetric impact of beam-energy-drifts on IMRT-delivery. Methods: Beam-energy drifts were simulated by adjusting Linac’s bending-magnet-current (BMC) followed by tuning the pulse-forming network and adjusting gun-current. PDD change of −0.6% and +1.2% were tested. Planar-dosimetry measurements were performed using an ionization-chamber-array in solid-water phantoms. Study includes 10-head-and-neck and 3-breast cancer patients. en-face beam-deliveries were also tested at 1.3cm and 5.3cm depths. Composite and single-field dose-distributions were compared againstmore » the plans to determine %Gamma pass-rates (%GPRs). For plan dose comparisons, changes in %Gamma pass-rates (cPGPRs) were computed/reported to exclude the differences between dose-computation and delivery. Dose distributions of the drifted-energies were compared against their baseline measurements to determine the% GPRs. A Gamma criteria of 3%/3mm was considered for plan-dose comparisons while 3%/1mm used for measured dose intercomparisons. Results: For composite-dose delivery, average cPGPRs were 0.41%±2.48% and −2.54%±3.65% for low-energy (LE) and high-energy (HE) drifts, respectively. For measured dose inter-comparisons, the average%GPRs were 98.4%±2.2% (LE-drift) and 95.8%±4.0 (HE-drift). The average %GPR of 92.6%±4.3% was noted for the worst-case scenario comparing LE-drift to HE-drift. All en-face beams at 5.3 cm depth have cPGPRs within ±4% of the baseline-energy measurements. However, greater variations were noted for 1.3cm depth. Average %GPRs for drifted energies were >99% at 5.3cm and >97% at 1.3cm depths. However, for the worst-case scenario (LE-drift to HE-drift) these numbers dropped to 95.2% at 5.3cm and 93.1% at 1.3cm depths. Conclusion: The dosimetric impact of beam-energy drifts was found to be within clinically acceptable tolerance. However, this study includes a single energy with limited range of PDD change. Further studies are on going and the results will be presented. Received funding from Varian Medical Systems, Palo Alto, CA.« less

SU-F-T-515: Increased Skin Dose in Supine Craniospinal Irradiation Due to Carbon Fiber Couch and Vacuum Bag Immobilization Device

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

Robertson, D; Zhao, Z; Wang, X

2016-06-15

Purpose: To measure the surface dose for supine craniospinal irradiation employing posterior beams, treating through an imaging couch and BlueBag immobilization device. Methods: The percentage depth dose (PDD) in the buildup region of a clinical 6 MV photon beam was measured using an Advanced Markus parallel plate ionization chamber in a solid water phantom. The PDD from a 10×10 cm{sup 2} anterior beam was measured at 100 cm SSD, simulating a traditional prone craniospinal technique. The measurements were compared to commissioning and treatment planning system data. The PDD was also measured in a posterior setup with the phantom surface layingmore » directly on the Brainlab carbon fiber imaging couch, with the phantom surface 100 cm from the source, simulating a supine craniospinal setup. The posterior measurements were repeated with a BlueBag vacuum immobilization device between the couch and phantom, with thicknesses of 1.7 cm and 5 cm. The PDD from a 10×10 cm{sup 2} field and a typical 6×30 cm{sup 2} craniospinal field were also compared. The PDDs were normalized at 5 cm to reflect typical craniospinal prescription dose normalization. Results: The measured PDD curve from the anterior setup agreed well with commissioning and treatment planning data, with surface doses of 19.9%, 28.8% and 27.7%, respectively. The surface doses of the 10×10 cm{sup 2} and 6×30 cm{sup 2} fields delivered through the imaging couch were both 122.4%. The supine setup yielded surface doses of 122.4%, 121.6%, and 119.6% for the couch only, 1.7 cm bag, and 5 cm bag setups, respectively. Conclusion: Delivering craniospinal irradiation through a carbon fiber couch removes the majority of skin sparing. The addition of a vacuum bag immobilization device restores some skin sparing, but the magnitude of this effect is negligible.« less

MCMEG: Simulations of both PDD and TPR for 6 MV LINAC photon beam using different MC codes

NASA Astrophysics Data System (ADS)

Fonseca, T. C. F.; Mendes, B. M.; Lacerda, M. A. S.; Silva, L. A. C.; Paixão, L.; Bastos, F. M.; Ramirez, J. V.; Junior, J. P. R.

2017-11-01

The Monte Carlo Modelling Expert Group (MCMEG) is an expert network specializing in Monte Carlo radiation transport and the modelling and simulation applied to the radiation protection and dosimetry research field. For the first inter-comparison task the group launched an exercise to model and simulate a 6 MV LINAC photon beam using the Monte Carlo codes available within their laboratories and validate their simulated results by comparing them with experimental measurements carried out in the National Cancer Institute (INCA) in Rio de Janeiro, Brazil. The experimental measurements were performed using an ionization chamber with calibration traceable to a Secondary Standard Dosimetry Laboratory (SSDL). The detector was immersed in a water phantom at different depths and was irradiated with a radiation field size of 10×10 cm2. This exposure setup was used to determine the dosimetric parameters Percentage Depth Dose (PDD) and Tissue Phantom Ratio (TPR). The validation process compares the MC calculated results to the experimental measured PDD20,10 and TPR20,10. Simulations were performed reproducing the experimental TPR20,10 quality index which provides a satisfactory description of both the PDD curve and the transverse profiles at the two depths measured. This paper reports in detail the modelling process using MCNPx, MCNP6, EGSnrc and Penelope Monte Carlo codes, the source and tally descriptions, the validation processes and the results.

Development of a silicon diode detector for skin dosimetry in radiotherapy.

PubMed

Vicoroski, Nikolina; Espinoza, Anthony; Duncan, Mitchell; Oborn, Bradley M; Carolan, Martin; Metcalfe, Peter; Menichelli, David; Perevertaylo, Vladimir L; Lerch, Michael L F; Rosenfeld, Anatoly B; Petasecca, Marco

2017-10-01

The aim of in vivo skin dosimetry was to measure the absorbed dose to the skin during radiotherapy, when treatment planning calculations cannot be relied on. It is of particularly importance in hypo-fractionated stereotactic modalities, where excessive dose can lead to severe skin toxicity. Currently, commercial diodes for such applications are with water equivalent depths ranging from 0.5 to 0.8 mm. In this study, we investigate a new detector for skin dosimetry based on a silicon epitaxial diode, referred to as the skin diode. The skin diode is manufactured on a thin epitaxial layer and packaged using the "drop-in" technology. It was characterized in terms of percentage depth dose, dose linearity, and dose rate dependence, and benchmarked against the Attix ionization chamber. The response of the skin diode in the build-up region of the percentage depth dose (PDD) curve of a 6 MV clinical photon beam was investigated. Geant4 radiation transport simulations were used to model the PDD in order to estimate the water equivalent measurement depth (WED) of the skin diode. Measured output factors using the skin diode were compared with the MOSkin detector and EBT3 film at 10 cm depth and at surface at isocenter of a water equivalent phantom. The intrinsic angular response of the skin diode was also quantified in charge particle equilibrium conditions (CPE) and at the surface of a solid water phantom. Finally, the radiation hardness of the skin diode up to an accumulated dose of 80 kGy using photons from a Co-60 gamma source was evaluated. The PDD curve measured with the skin diode was within 0.5% agreement of the equivalent Geant4 simulated curve. When placed at the phantom surface, the WED of the skin diode was estimated to be 0.075 ± 0.005 mm from Geant4 simulations and was confirmed using the response of a corrected Attix ionization chamber placed at water equivalent depth of 0.075 mm, with the measurement agreement to within 0.3%. The output factor measurements at 10 cm depth were within 2% of those measured with film and the MOSkin detector down to a field size of 2 × 2 cm 2 . The dose-response for all detector samples was linear and with a repeatability within 0.2%. The skin diode intrinsic angular response showed a maximum deviation of 8% at 90 degrees and from 0 to 60 degree is less than 5%. The radiation sensitivity reduced by 25% after an accumulated dose of 20 kGy but after was found to stabilize. At 60 kGy total accumulated dose the response was within 2% of that measured at 20 kGy total accumulated dose. This work characterizes an innovative detector for in vivo and real-time skin dose measurements that is based on an epitaxial silicon diode combined with the Centre for Medical Radiation Physics (CMRP) "drop-in" packaging technology. The skin diode proved to have a water equivalent depth of measurement of 0.075 ± 0.005 mm and the ability to measure doses accurately relative to reference detectors. © 2017 American Association of Physicists in Medicine.

SU-F-T-431: Dosimetric Validation of Acuros XB Algorithm for Photon Dose Calculation in Water

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

Kumar, L; Yadav, G; Kishore, V

2016-06-15

Purpose: To validate the Acuros XB algorithm implemented in Eclipse Treatment planning system version 11 (Varian Medical System, Inc., Palo Alto, CA, USA) for photon dose calculation. Methods: Acuros XB is a Linear Boltzmann transport equation (LBTE) solver that solves LBTE equation explicitly and gives result equivalent to Monte Carlo. 6MV photon beam from Varian Clinac-iX (2300CD) was used for dosimetric validation of Acuros XB. Percentage depth dose (PDD) and profiles (at dmax, 5, 10, 20 and 30 cm) measurements were performed in water for field size ranging from 2×2,4×4, 6×6, 10×10, 20×20, 30×30 and 40×40 cm{sup 2}. Acuros XBmore » results were compared against measurements and anisotropic analytical algorithm (AAA) algorithm. Results: Acuros XB result shows good agreement with measurements, and were comparable to AAA algorithm. Result for PDD and profiles shows less than one percent difference from measurements, and from calculated PDD and profiles by AAA algorithm for all field size. TPS calculated Gamma error histogram values, average gamma errors in PDD curves before dmax and after dmax were 0.28, 0.15 for Acuros XB and 0.24, 0.17 for AAA respectively, average gamma error in profile curves in central region, penumbra region and outside field region were 0.17, 0.21, 0.42 for Acuros XB and 0.10, 0.22, 0.35 for AAA respectively. Conclusion: The dosimetric validation of Acuros XB algorithms in water medium was satisfactory. Acuros XB algorithm has potential to perform photon dose calculation with high accuracy, which is more desirable for modern radiotherapy environment.« less

SU-F-T-69: Correction Model of NIPAM Gel and Presage for Electron and Proton PDD Measurement

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

Lin, C; Lin, C; Tu, P

Purpose: The current standard equipment for proton PDD measurement is multilayer-parallel-ion-chamber. Disadvantage of multilayer-parallel-ion-chamber is expensive and complexity manipulation. NIPAM-gel and Presage are options for PDD measurement. Due to different stopping power, the result of NIPAM-gel and Presage need to be corrected. This study aims to create a correction model for NIPAM-gel and Presage PDD measurement. Methods: Standard water based PDD profiles of electron 6MeV, 12MeV, and proton 90MeV were acquired. Electron PDD profile after 1cm thickness of NIPAM-gel added on the top of water was measured. Electron PDD profile with extra 1cm thickness of solid water, PTW RW3, wasmore » measured. The distance shift among standard PDD, NIPAM-gel PDD, and solid water PDD at R50% was compared and water equivalent thickness correction factor (WET) was calculated. Similar process was repeated. WETs for electron with Presage, proton with NIPAM-gel, and proton with Presage were calculated. PDD profiles of electron and proton with NIPAM-gel and Presage columns were corrected with each WET. The corrected profiles were compared with standard profiles. Results: WET for electron 12MeV with NIPAM-gel was 1.135, and 1.034 for electron 12Mev with Presage. After correction, PDD profile matched to the standard profile at the fall-off range well. The difference at R50% was 0.26mm shallower and 0.39mm deeper. The same WET was used to correct electron 6MeV profile. Energy independence of electron WET was observed. The difference at R50% was 0.17mm deeper for NIPAM-gel and 0.54mm deeper for Presage. WET for proton 90MeV with NIPAM-gel was 1.056. The difference at R50% was 0.37 deeper. Quenching effect at Bragg peak was revealed. The underestimated dose percentage at Bragg peak was 27%. Conclusion: This correction model can be used to modify PDD profile with depth error within 1mm. With this correction model, NIPAM-gel and Presage can be practical at PDD profile measurement.« less

The effect of voxel size on dose distribution in Varian Clinac iX 6 MV photon beam using Monte Carlo simulation

NASA Astrophysics Data System (ADS)

Yani, Sitti; Dirgayussa, I. Gde E.; Rhani, Moh. Fadhillah; Haryanto, Freddy; Arif, Idam

2015-09-01

Recently, Monte Carlo (MC) calculation method has reported as the most accurate method of predicting dose distributions in radiotherapy. The MC code system (especially DOSXYZnrc) has been used to investigate the different voxel (volume elements) sizes effect on the accuracy of dose distributions. To investigate this effect on dosimetry parameters, calculations were made with three different voxel sizes. The effects were investigated with dose distribution calculations for seven voxel sizes: 1 × 1 × 0.1 cm3, 1 × 1 × 0.5 cm3, and 1 × 1 × 0.8 cm3. The 1 × 109 histories were simulated in order to get statistical uncertainties of 2%. This simulation takes about 9-10 hours to complete. Measurements are made with field sizes 10 × 10 cm2 for the 6 MV photon beams with Gaussian intensity distribution FWHM 0.1 cm and SSD 100.1 cm. MC simulated and measured dose distributions in a water phantom. The output of this simulation i.e. the percent depth dose and dose profile in dmax from the three sets of calculations are presented and comparisons are made with the experiment data from TTSH (Tan Tock Seng Hospital, Singapore) in 0-5 cm depth. Dose that scored in voxels is a volume averaged estimate of the dose at the center of a voxel. The results in this study show that the difference between Monte Carlo simulation and experiment data depend on the voxel size both for percent depth dose (PDD) and profile dose. PDD scan on Z axis (depth) of water phantom, the big difference obtain in the voxel size 1 × 1 × 0.8 cm3 about 17%. In this study, the profile dose focused on high gradient dose area. Profile dose scan on Y axis and the big difference get in the voxel size 1 × 1 × 0.1 cm3 about 12%. This study demonstrated that the arrange voxel in Monte Carlo simulation becomes important.

SU-E-T-75: A Simple Technique for Proton Beam Range Verification

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

Burgdorf, B; Kassaee, A; Garver, E

2015-06-15

Purpose: To develop a measurement-based technique to verify the range of proton beams for quality assurance (QA). Methods: We developed a simple technique to verify the proton beam range with in-house fabricated devices. Two separate devices were fabricated; a clear acrylic rectangular cuboid and a solid polyvinyl chloride (PVC) step wedge. For efficiency in our clinic, we used the rectangular cuboid for double scattering (DS) beams and the step wedge for pencil beam scanning (PBS) beams. These devices were added to our QA phantom to measure dose points along the distal fall-off region (between 80% and 20%) in addition tomore » dose at mid-SOBP (spread out Bragg peak) using a two-dimensional parallel plate chamber array (MatriXX™, IBA Dosimetry, Schwarzenbruck, Germany). This method relies on the fact that the slope of the distal fall-off is linear and does not vary with small changes in energy. Using a multi-layer ionization chamber (Zebra™, IBA Dosimetry), percent depth dose (PDD) curves were measured for our standard daily QA beams. The range (energy) for each beam was then varied (i.e. ±2mm and ±5mm) and additional PDD curves were measured. The distal fall-off of all PDD curves was fit to a linear equation. The distal fall-off measured dose for a particular beam was used in our linear equation to determine the beam range. Results: The linear fit of the fall-off region for the PDD curves, when varying the range by a few millimeters for a specific QA beam, yielded identical slopes. The calculated range based on measured point dose(s) in the fall-off region using the slope resulted in agreement of ±1mm of the expected beam range. Conclusion: We developed a simple technique for accurately verifying the beam range for proton therapy QA programs.« less

SU-D-209-02: Percent Depth Dose Curves for Fluoroscopic X-Ray Beam Qualities Incorporating Copper Filtration

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

Wunderle, K; Wayne State University School of Medicine, Detroit, MI; Godley, A

Purpose: The purpose of this investigation was to quantify percent depth dose (PDD) curves for fluoroscopic x-ray beam qualities incorporating added copper filtration. Methods: A PTW (Freiburg, Germany) MP3 water tank was used with a Standard Imaging (Middleton, WI) Exradin Model 11 Spokas Chamber to measure PDD curves for 60, 80, 100 and 120 kVp x-ray beams with copper filtration ranging from 0.0–0.9 mm at 22cm and 42cm fields of view from 0 to 150 mm of water. A free-in-air monitor chamber was used to normalize the water tank data to fluctuations in output from the fluoroscope. The measurements weremore » acquired on a Siemens (Erlangen, Germany) Artis ZeeGo fluoroscope. The fluoroscope was inverted from the typical orientation providing an x-ray beam originating from above the water tank. The water tank was positioned so that the water level was located at 60cm from the focal spot; which also represents the focal spot to interventional reference plane distance for that fluoroscope. Results: PDDs for 60, 80, 100, and 120 kVp with 0 mm of copper filtration compared well to previously published data by Fetterly et al. [Med Phys, 28, 205 (2001)] for those beam qualities given differences in fluoroscopes, geometric orientation, type of ionization chamber, and the water tank used for data collection. PDDs for 60, 80, 100, and 120 kVp with copper filtration were obtained and are presented, which have not been previously investigated and published. Conclusion: The equipment and processes used to acquire the reported data were sound and compared well with previously published data for PDDs without copper filtration. PDD data for the fluoroscopic x-ray beams incorporating copper filtration can be used as reference data for estimating organ or soft tissue dose at depth involving similar beam qualities or for comparison with mathematical models.« less

Output calculation of electron therapy at extended SSD using an improved LBR method.

PubMed

Alkhatib, Hassaan A; Gebreamlak, Wondesen T; Tedeschi, David J; Mihailidis, Dimitris; Wright, Ben W; Neglia, William J; Sobash, Philip T; Fontenot, Jonas D

2015-02-01

To calculate the output factor (OPF) of any irregularly shaped electron beam at extended SSD. Circular cutouts were prepared from 2.0 cm diameter to the maximum possible size for 15 × 15 applicator cone. In addition, two irregular cutouts were prepared. For each cutout, percentage depth dose (PDD) at the standard SSD and doses at different SSD values were measured using 6, 9, 12, and 16 MeV electron beam energies on a Varian 2100C LINAC and the distance at which the central axis electron fluence becomes independent of cutout size was determined. The measurements were repeated with an ELEKTA Synergy LINAC using 14 × 14 applicator cone and electron beam energies of 6, 9, 12, and 15 MeV. The PDD measurements were performed using a scanning system and two diodes-one for the signal and the other a stationary reference outside the tank. The doses of the circular cutouts at different SSDs were measured using PTW 0.125 cm(3) Semiflex ion-chamber and EDR2 films. The electron fluence was measured using EDR2 films. For each circular cutout, the lateral buildup ratio (LBR) was calculated from the measured PDD curve using the open applicator cone as the reference field. The effective SSD (SSDeff) of each circular cutout was calculated from the measured doses at different SSD values. Using the LBR value and the radius of the circular cutout, the corresponding lateral spread parameter [σR(z)] was calculated. Taking the cutout size dependence of σR(z) into account, the PDD curves of the irregularly shaped cutouts at the standard SSD were calculated. Using the calculated PDD curve of the irregularly shaped cutout along with the LBR and SSDeff values of the circular cutouts, the output factor of the irregularly shaped cutout at extended SSD was calculated. Finally, both the calculated PDD curves and output factor values were compared with the measured values. The improved LBR method has been generalized to calculate the output factor of electron therapy at extended SSD. The percentage difference between the calculated and the measured output factors of irregularly shaped cutouts in a clinical useful SSD region was within 2%. Similar results were obtained for all available electron energies of both Varian 2100C and ELEKTA Synergy machines.

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

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

Bazalova-Carter, Magdalena; Liu, Michael; Palma, Bianey

2015-04-15

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

The visible signal responsible for proton therapy dosimetry using bare optical fibers is not Čerenkov radiation.

PubMed

Darafsheh, Arash; Taleei, Reza; Kassaee, Alireza; Finlay, Jarod C

2016-11-01

Proton beam dosimetry using bare plastic optical fibers has emerged as a simple approach to proton beam dosimetry. The source of the signal in this method has been attributed to Čerenkov radiation. The aim of this work was a phenomenological study of the nature of the visible light responsible for the signal in bare fiber optic dosimetry of proton therapy beams. Plastic fiber optic probes embedded in solid water phantoms were irradiated with proton beams of energies 100, 180, and 225 MeV produced by a proton therapy cyclotron. Luminescence spectroscopy was performed by a CCD-coupled spectrometer. The spectra were acquired at various depths in phantom to measure the percentage depth dose (PDD) for each beam energy. For comparison, the PDD curves were acquired using a standard multilayer ion chamber device. In order to further analyze the contribution of the Čerenkov radiation in the spectra, Monte Carlo simulation was performed using fluka Monte Carlo code to stochastically simulate radiation transport, ionizing radiation dose deposition, and optical emission of Čerenkov radiation. The measured depth doses using the bare fiber are in agreement with measurements performed by the multilayer ion chamber device, indicating the feasibility of using bare fiber probes for proton beam dosimetry. The spectroscopic study of proton-irradiated fibers showed a continuous spectrum with a shape different from that of Čerenkov radiation. The Monte Carlo simulations confirmed that the amount of the generated Čerenkov light does not follow the radiation absorbed dose in a medium. The source of the optical signal responsible for the proton dose measurement using bare optical fibers is not Čerenkov radiation. It is fluorescence of the plastic material of the fiber.

Calculation of midplane dose for total body irradiation from entrance and exit dose MOSFET measurements.

PubMed

Satory, P R

2012-03-01

This work is the development of a MOSFET based surface in vivo dosimetry system for total body irradiation patients treated with bilateral extended SSD beams using PMMA missing tissue compensators adjacent to the patient. An empirical formula to calculate midplane dose from MOSFET measured entrance and exit doses has been derived. The dependency of surface dose on the air-gap between the spoiler and the surface was investigated by suspending a spoiler above a water phantom, and taking percentage depth dose measurements (PDD). Exit and entrances doses were measured with MOSFETs in conjunction with midplane doses measured with an ion chamber. The entrance and exit doses were combined using an exponential attenuation formula to give an estimate of midplane dose and were compared to the midplane ion chamber measurement for a range of phantom thicknesses. Having a maximum PDD at the surface simplifies the prediction of midplane dose, which is achieved by ensuring that the air gap between the compensator and the surface is less than 10 cm. The comparison of estimated midplane dose and measured midplane dose showed no dependence on phantom thickness and an average correction factor of 0.88 was found. If the missing tissue compensators are kept within 10 cm of the patient then MOSFET measurements of entrance and exit dose can predict the midplane dose for the patient.

Single-Dose Primaquine in a Preclinical Model of Glucose-6-Phosphate Dehydrogenase Deficiency: Implications for Use in Malaria Transmission-Blocking Programs

PubMed Central

Wickham, Kristina S.; Baresel, Paul C.; Sousa, Jason; Vuong, Chau T.; Reichard, Gregory A.; Campo, Brice; Tekwani, Babu L.; Walker, Larry A.

2016-01-01

Individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd) are at risk for developing hemolytic anemia when given the antimalarial drug primaquine (PQ). The WHO Evidence Review Group released a report suggesting that mass administration of a single dose of PQ at 0.25 mg of base/kg of body weight (mpk) (mouse equivalent of 3.125 mpk) could potentially reduce malaria transmission based on its gametocytocidal activity and could be safely administered to G6PD-deficient individuals, but there are limited safety data available confirming the optimum single dose of PQ. A single-dose administration of PQ was therefore assessed in our huRBC-SCID mouse model used to predict hemolytic toxicity with respect to G6PD deficiency. In this model, nonobese diabetic (NOD)/SCID mice are engrafted with human red blood cells (huRBC) from donors with the African or Mediterranean variant of G6PDd (A-G6PDd or Med-G6PDd, respectively) and demonstrate dose-dependent sensitivity to PQ. In mice engrafted with A-G6PD-deficient huRBC, single-dose PQ at 3.125, 6.25, or 12.5 mpk had no significant loss of huRBC compared to the vehicle control group. In contrast, in mice engrafted with Med-G6PDd huRBC, a single dose of PQ at 3.125, 6.25, or 12.5 mpk resulted in a significant, dose-dependent loss of huRBC compared to the value for the vehicle control group. Our data suggest that administration of a single low dose of 0.25 mpk of PQ could induce hemolytic anemia in Med-G6PDd individuals but that use of single-dose PQ at 0.25 mpk as a gametocytocidal drug to block transmission would be safe in areas where A-G6PDd predominates. PMID:27458212

Single-Dose Primaquine in a Preclinical Model of Glucose-6-Phosphate Dehydrogenase Deficiency: Implications for Use in Malaria Transmission-Blocking Programs.

PubMed

Wickham, Kristina S; Baresel, Paul C; Marcsisin, Sean R; Sousa, Jason; Vuong, Chau T; Reichard, Gregory A; Campo, Brice; Tekwani, Babu L; Walker, Larry A; Rochford, Rosemary

2016-10-01

Individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd) are at risk for developing hemolytic anemia when given the antimalarial drug primaquine (PQ). The WHO Evidence Review Group released a report suggesting that mass administration of a single dose of PQ at 0.25 mg of base/kg of body weight (mpk) (mouse equivalent of 3.125 mpk) could potentially reduce malaria transmission based on its gametocytocidal activity and could be safely administered to G6PD-deficient individuals, but there are limited safety data available confirming the optimum single dose of PQ. A single-dose administration of PQ was therefore assessed in our huRBC-SCID mouse model used to predict hemolytic toxicity with respect to G6PD deficiency. In this model, nonobese diabetic (NOD)/SCID mice are engrafted with human red blood cells (huRBC) from donors with the African or Mediterranean variant of G6PDd (A-G6PDd or Med-G6PDd, respectively) and demonstrate dose-dependent sensitivity to PQ. In mice engrafted with A-G6PD-deficient huRBC, single-dose PQ at 3.125, 6.25, or 12.5 mpk had no significant loss of huRBC compared to the vehicle control group. In contrast, in mice engrafted with Med-G6PDd huRBC, a single dose of PQ at 3.125, 6.25, or 12.5 mpk resulted in a significant, dose-dependent loss of huRBC compared to the value for the vehicle control group. Our data suggest that administration of a single low dose of 0.25 mpk of PQ could induce hemolytic anemia in Med-G6PDd individuals but that use of single-dose PQ at 0.25 mpk as a gametocytocidal drug to block transmission would be safe in areas where A-G6PDd predominates. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Source to Skin Distance (SSD) Characteristics from Varian CX Linear Accelerator

NASA Astrophysics Data System (ADS)

Bahari Nurdin, Wira; Purnomo, Aji; Dewang, Syamsir

2018-03-01

This study aims to describe the characteristics of the source to skin distance (SSD) of Varian CX linear accelerator (LINAC) using the X-ray beam of 6 MV and 10 MV. The variation of the source to the SSD are 90, 100 and 110 cms; the depth of the water phantom used are 5, 10, 15, 20, and 25 cms, respectively. The depth of the water phantom was created for analysis of percentage depth dose (PDD) and profile dose. It can be concluded from the tests that from the measured SSD, SSD of 110 cm with the depth water phantom of 20-25 cm for energy beam of 6 MV and at all levels of depth for 10 MV energy corresponding tolerance limits to be used in clinical radiotherapy. For the SSD 90 and 100, the values beam symmetry and flatness obtained slightly beyond the limits of tolerance.

Dosimetric characteristics with spatial fractionation using electron grid therapy.

PubMed

Meigooni, A S; Parker, S A; Zheng, J; Kalbaugh, K J; Regine, W F; Mohiuddin, M

2002-01-01

Recently, promising clinical results have been shown in the delivery of palliative treatments using megavoltage photon grid therapy. However, the use of megavoltage photon grid therapy is limited in the treatment of bulky superficial lesions where critical radiosensitive anatomical structures are present beyond tumor volumes. As a result, spatially fractionated electron grid therapy was investigated in this project. Dose distributions of 1.4-cm-thick cerrobend grid blocks were experimentally determined for electron beams ranging from 6 to 20 MeV. These blocks were designed and fabricated at out institution to fit into a 20 x 20-cm(2) electron cone of a commercially available linear accelerator. Beam profiles and percentage depth dose (PDD) curves were measured in Solid Water phantom material using radiographic film, LiF TLD, and ionometric techniques. Open-field PDD curves were compared with those of single holes grid with diameters of 1.5, 2.0, 2.5, 3.0, and 3.5 cm to find the optimum diameter. A 2.5-cm hole diameter was found to be the optimal size for all electron energies between 6 and 20 MeV. The results indicate peak-to-valley ratios decrease with depth and the largest ratio is found at Dmax. Also, the TLD measurements show that the dose under the blocked regions of the grid ranged from 9.7% to 39% of the dose beneath the grid holes, depending on the measurement location and beam energy.

Design and characterization of a new high-dose-rate brachytherapy Valencia applicator for larger skin lesions

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

Candela-Juan, C., E-mail: ccanjuan@gmail.com; Niatsetski, Y.; Laarse, R. van der

Purpose: The aims of this study were (i) to design a new high-dose-rate (HDR) brachytherapy applicator for treating surface lesions with planning target volumes larger than 3 cm in diameter and up to 5 cm in size, using the microSelectron-HDR or Flexitron afterloader (Elekta Brachytherapy) with a {sup 192}Ir source; (ii) to calculate by means of the Monte Carlo (MC) method the dose distribution for the new applicator when it is placed against a water phantom; and (iii) to validate experimentally the dose distributions in water. Methods: The PENELOPE2008 MC code was used to optimize dwell positions and dwell times.more » Next, the dose distribution in a water phantom and the leakage dose distribution around the applicator were calculated. Finally, MC data were validated experimentally for a {sup 192}Ir mHDR-v2 source by measuring (i) dose distributions with radiochromic EBT3 films (ISP); (ii) percentage depth–dose (PDD) curve with the parallel-plate ionization chamber Advanced Markus (PTW); and (iii) absolute dose rate with EBT3 films and the PinPoint T31016 (PTW) ionization chamber. Results: The new applicator is made of tungsten alloy (Densimet) and consists of a set of interchangeable collimators. Three catheters are used to allocate the source at prefixed dwell positions with preset weights to produce a homogenous dose distribution at the typical prescription depth of 3 mm in water. The same plan is used for all available collimators. PDD, absolute dose rate per unit of air kerma strength, and off-axis profiles in a cylindrical water phantom are reported. These data can be used for treatment planning. Leakage around the applicator was also scored. The dose distributions, PDD, and absolute dose rate calculated agree within experimental uncertainties with the doses measured: differences of MC data with chamber measurements are up to 0.8% and with radiochromic films are up to 3.5%. Conclusions: The new applicator and the dosimetric data provided here will be a valuable tool in clinical practice, making treatment of large skin lesions simpler, faster, and safer. Also the dose to surrounding healthy tissues is minimal.« less

A targeted and adjuvanted nanocarrier lowers the effective dose of liposomal amphotericin B and enhances adaptive immunity in murine cutaneous leishmaniasis.

PubMed

Daftarian, Pirouz M; Stone, Geoffrey W; Kovalski, Leticia; Kumar, Manoj; Vosoughi, Aram; Urbieta, Maitee; Blackwelder, Pat; Dikici, Emre; Serafini, Paolo; Duffort, Stephanie; Boodoo, Richard; Rodríguez-Cortés, Alhelí; Lemmon, Vance; Deo, Sapna; Alberola, Jordi; Perez, Victor L; Daunert, Sylvia; Ager, Arba L

2013-12-01

Amphotericin B (AmB), the most effective drug against leishmaniasis, has serious toxicity. As Leishmania species are obligate intracellular parasites of antigen presenting cells (APC), an immunopotentiating APC-specific AmB nanocarrier would be ideally suited to reduce the drug dosage and regimen requirements in leishmaniasis treatment. Here, we report a nanocarrier that results in effective treatment shortening of cutaneous leishmaniasis in a mouse model, while also enhancing L. major specific T-cell immune responses in the infected host. We used a Pan-DR-binding epitope (PADRE)-derivatized-dendrimer (PDD), complexed with liposomal amphotericin B (LAmB) in an L. major mouse model and analyzed the therapeutic efficacy of low-dose PDD/LAmB vs full dose LAmB. PDD was shown to escort LAmB to APCs in vivo, enhanced the drug efficacy by 83% and drug APC targeting by 10-fold and significantly reduced parasite burden and toxicity. Fortuitously, the PDD immunopotentiating effect significantly enhanced parasite-specific T-cell responses in immunocompetent infected mice. PDD reduced the effective dose and toxicity of LAmB and resulted in elicitation of strong parasite specific T-cell responses. A reduced effective therapeutic dose was achieved by selective LAmB delivery to APC, bypassing bystander cells, reducing toxicity and inducing antiparasite immunity.

Mammography dosimetry using an in-house developed polymethyl methacrylate phantom.

PubMed

Sharma, Reena; Sharma, Sunil Dutt; Mayya, Y S; Chourasiya, G

2012-08-01

Phantom-based measurements in mammography are well-established for quality assurance (QA) and quality control (QC) procedures involving equipment performance and comparisons of X-ray machines. Polymethyl methacrylate (PMMA) is among the best suitable materials for simulation of the breast. For carrying out QA/QC exercises in India, a mammographic PMMA phantom with engraved slots for keeping thermoluminescence dosemeters (TLD) has been developed. The radiation transmission property of the developed phantom was compared with the commercially available phantoms for verifying its suitability for mammography dosimetry. The breast entrance exposure (BEE), mean glandular dose (MGD), percentage depth dose (PDD), percentage surface dose distribution (PSDD), calibration testing of automatic exposure control (AEC) and density control function of a mammography machine were measured using this phantom. MGD was derived from the measured BEE following two different methodologies and the results were compared. The PDD and PSDD measurements were carried out using LiF: Mg, Cu, P chips. The in-house phantom was found comparable with the commercially available phantoms. The difference in the MGD values derived using two different methods were found in the range of 17.5-32.6 %. Measured depth ranges in the phantom lie between 0.32 and 0.40 cm for 75 % depth dose, 0.73 and 0.92 cm for 50 % depth dose, and 1.54 and 1.78 cm for 25 % depth dose. Higher PSDD value was observed towards chest wall edge side of the phantom, which is due to the orientation of cathode-anode axis along the chest wall to the nipple direction. Results obtained for AEC configuration testing shows that the observed mean optical density (O.D) of the phantom image was 1.59 and O.D difference for every successive increase in thickness of the phantom was within±0.15 O.D. Under density control function testing, at -2 and -1 density settings, the variation in film image O.D was within±0.15 O.D of the normal density setting '0' and at +2 and +1 density setting, it was observed to be within±0.30 O.D. This study indicates that the locally made PMMA TLD slot phantom can be used to measure various mammography QC parameters which are essentially required for better outcomes in mammography.

Variation of k{sub Q{sub c{sub l{sub i{sub n,Q{sub m{sub s{sub r}{sup f{sub c}{sub l}{sub i}{sub n},f{sub m}{sub s}{sub r}}}}}}}}} for the small-field dosimetric parameters percentage depth dose, tissue-maximum ratio, and off-axis ratio

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

Francescon, Paolo, E-mail: paolo.francescon@ulssvicenza.it; Satariano, Ninfa; Beddar, Sam

Purpose: Evaluate the ability of different dosimeters to correctly measure the dosimetric parameters percentage depth dose (PDD), tissue-maximum ratio (TMR), and off-axis ratio (OAR) in water for small fields. Methods: Monte Carlo (MC) simulations were used to estimate the variation of k{sub Q{sub c{sub l{sub i{sub n,Q{sub m{sub s{sub r}{sup f{sub c}{sub l}{sub i}{sub n},f{sub m}{sub s}{sub r}}}}}}}}} for several types of microdetectors as a function of depth and distance from the central axis for PDD, TMR, and OAR measurements. The variation of k{sub Q{sub c{sub l{sub i{sub n,Q{sub m{sub s{sub r}{sup f{sub c}{sub l}{sub i}{sub n},f{sub m}{sub s}{sub r}}}}}}}}}more » enables one to evaluate the ability of a detector to reproduce the PDD, TMR, and OAR in water and consequently determine whether it is necessary to apply correction factors. The correctness of the simulations was verified by assessing the ratios between the PDDs and OARs of 5- and 25-mm circular collimators used with a linear accelerator measured with two different types of dosimeters (the PTW 60012 diode and PTW PinPoint 31014 microchamber) and the PDDs and the OARs measured with the Exradin W1 plastic scintillator detector (PSD) and comparing those ratios with the corresponding ratios predicted by the MC simulations. Results: MC simulations reproduced results with acceptable accuracy compared to the experimental results; therefore, MC simulations can be used to successfully predict the behavior of different dosimeters in small fields. The Exradin W1 PSD was the only dosimeter that reproduced the PDDs, TMRs, and OARs in water with high accuracy. With the exception of the EDGE diode, the stereotactic diodes reproduced the PDDs and the TMRs in water with a systematic error of less than 2% at depths of up to 25 cm; however, they produced OAR values that were significantly different from those in water, especially in the tail region (lower than 20% in some cases). The microchambers could be used for PDD measurements for fields greater than those produced using a 10-mm collimator. However, with the detector stem parallel to the beam axis, the microchambers could be used for TMR measurements for all field sizes. The microchambers could not be used for OAR measurements for small fields. Conclusions: Compared with MC simulation, the Exradin W1 PSD can reproduce the PDDs, TMRs, and OARs in water with a high degree of accuracy; thus, the correction used for converting dose is very close to unity. The stereotactic diode is a viable alternative because it shows an acceptable systematic error in the measurement of PDDs and TMRs and a significant underestimation in only the tail region of the OAR measurements, where the dose is low and differences in dose may not be therapeutically meaningful.« less

Projection imaging of photon beams by the Cerenkov effect

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

Glaser, Adam K.; Davis, Scott C.; McClatchy, David M.

2013-01-15

Purpose: A novel technique for beam profiling of megavoltage photon beams was investigated for the first time by capturing images of the induced Cerenkov emission in water, as a potential surrogate for the imparted dose in irradiated media. Methods: A high-sensitivity, intensified CCD camera (ICCD) was configured to acquire 2D projection images of Cerenkov emission from a 4 Multiplication-Sign 4 cm{sup 2} 6 MV linear accelerator (LINAC) x-ray photon beam operating at a dose rate of 400 MU/min incident on a water tank with transparent walls. The ICCD acquisition was gated to the LINAC sync pulse to reduce background lightmore » artifacts, and the measurement quality was investigated by evaluating the signal to noise ratio and measurement repeatability as a function of delivered dose. Monte Carlo simulations were used to derive a calibration factor for differences between the optical images and deposited dose arising from the anisotropic angular dependence of Cerenkov emission. Finally, Cerenkov-based beam profiles were compared to a percent depth dose (PDD) and lateral dose profile at a depth of d{sub max} from a reference dose distribution generated from the clinical Varian ECLIPSE treatment planning system (TPS). Results: The signal to noise ratio was found to be 20 at a delivered dose of 66.6 cGy, and proportional to the square root of the delivered dose as expected from Poisson photon counting statistics. A 2.1% mean standard deviation and 5.6% maximum variation in successive measurements were observed, and the Monte Carlo derived calibration factor resulted in Cerenkov emission images which were directly correlated to deposited dose, with some spatial issues. The dose difference between the TPS and PDD predicted by Cerenkov measurements was within 20% in the buildup region with a distance to agreement (DTA) of 1.5-2 mm and {+-}3% at depths beyond d{sub max}. In the lateral profile, the dose difference at the beam penumbra was within {+-}13% with a DTA of 0-2 mm, {+-}5% in the central beam region, and 2%-3% in the beam umbra. Conclusions: The results from this initial study demonstrate the first documented use of Cerenkov emission imaging to profile x-ray photon LINAC beams in water. The proposed modality has several potential advantages over alternative methods, and upon future refinement may prove to be a robust and novel dosimetry method.« less

[Relation between defined daily doses (DDD) and prescribed daily doses: a 3-month analysis of outpatient data from a statutory health insurance company].

PubMed

Grimmsmann, T; Himmel, W

2010-07-01

Defined daily doses (DDD) are used to analyse drug utilisation. For frequently prescribed drug groups, we studied to what extent the DDD correspond to the average prescribed daily doses (PDD). We analysed all drugs prescribed for more than three months to insured of a large health insurance fund in Mecklenburg-Vorpommern, one federal state in Germany. PDD for plain ACE inhibitors, selective beta-antagonists and some antidiabetics (sulfonylurea compounds) were calculated and compared with their DDD. During the study period, about 38 500 patients received continuous prescriptions of each ACE inhibitors or selective beta-antagonists, and about 9 000 of sulfonylurea compounds. PDD differed from DDD in varying degrees. For ACE inhibitors, PDD ranged between 1.5 DDD (for captopril) and 3.5 (for ramipril). The PDD for beta antagonists were on average 0.9 DDD, similar for bisoprolol (0.8 DDD) and metoprolol (0.9 DDD). As for oral antidiabetics, doctors prescribed 1.0 DDD glibenclamid per day and patient and 2.0 DDD glimepirid. Depending on differences between DDD and PDD, real daily costs for drug therapy differed from the theoretical costs per DDD, for example in the case of ramipril they were 0.24 euros compared to 0.07 euros. The PDD were much higher than the DDD for several frequently prescribed drugs. Consequently, the daily drug costs exceeded the drug costs based on DDD. Evaluations of drug costs on the basis for DDD require careful interpretation. Moreover, the number of DDD alone is not a valid measurement for the appropriateness of drug therapy and can only give a rough estimate of the number of patients treated, at least for the drug groups in this study. Copyright Georg Thieme Verlag KG Stuttgart . New York

Towards dosimetry for photodynamic diagnosis with the low-level dose of photosensitizer.

PubMed

Buzalewicz, Igor; Hołowacz, Iwona; Ulatowska-Jarża, Agnieszka; Podbielska, Halina

2017-08-01

Contemporary medicine does not concern the issue of dosimetry in photodynamic diagnosis (PDD) but follows the photosensitizer (PS) producers recommendation. Most preclinical and clinical PDD studies indicate a considerable variation in the possibility of visualization and treatment, as e.g. in case of cervix lesions. Although some of these variations can be caused by the different histological subtypes or various tumor geometries, the issue of varying PS concentration in the tumor tissue volume is definitely an important factor. Therefore, there is a need to establish the objective and systematic PDD dosimetry protocol regarding doses of light and photosensitizers. Four different irradiation sources investigated in PDD (literature) were used for PS excitation. The PS luminescence was examined by means of the non-imaging (spectroscopic) and imaging (wide- and narrow-field of view) techniques. The methodology for low-level intensity photoluminescence (PL) characterization and dedicated image processing algorithm for PS luminescence images analysis were proposed. Further, HeLa cells' cultures penetration by PS was studied by a confocal microscopy. Reducing the PS dose with the choice of proper photoexcitation conditions decreases the PDD procedure costs and the side effects, not affecting the diagnostic efficiency. We determined in vitro the minimum incubation time and photosensitizer concentration of Photolon for diagnostic purposes, for which the Photolon PL can still be observed. It was demonstrated that quantification of PS concentration, choice of proper photoexcitation source, appropriate adjustment of light dose and PS penetration of cancer cells may improve the low-level luminescence photodynamic diagnostics performance. Practical effectiveness of the PDD strongly depends on irradiation source parameters (bandwidth, maximum intensity, half-width) and their optimization is the main conditioning factor for low-level intensity and low-cost PDD. Copyright © 2017 Elsevier B.V. All rights reserved.

Beam characteristics of energy-matched flattening filter free beams.

PubMed

Paynter, D; Weston, S J; Cosgrove, V P; Evans, J A; Thwaites, D I

2014-05-01

Flattening filter free (FFF) linear accelerators can increase treatment efficiency and plan quality. There are multiple methods of defining a FFF beam. The Elekta control system supports tuning of the delivered FFF beam energy to enable matching of the percentage depth-dose (PDD) of the flattened beam at 10 cm depth. This is compared to FFF beams where the linac control parameters are identical to those for the flattened beam. All beams were delivered on an Elekta Synergy accelerator with an Agility multi-leaf collimator installed and compared to the standard, flattened beam. The aim of this study is to compare "matched" FFF beams to both "unmatched" FFF beams and flattened beams to determine the benefits of matching beams. For the three modes of operation 6 MV flattened, 6 MV matched FFF, 6 MV unmatched FFF, 10 MV flattened, 10 MV matched FFF, and 10 MV unmatched FFF beam profiles were obtained using a plotting tank and were measured in steps of 0.1 mm in the penumbral region. Beam penumbra was defined as the distance between the 80% and 20% of the normalized dose when the inflection points of the unflattened and flattened profiles were normalized with the central axis dose of the flattened field set as 100%. PDD data was obtained at field sizes ranging from 3 cm × 3 cm to 40 cm × 40 cm. Radiation protection measurements were additionally performed to determine the head leakage and environmental monitoring through the maze and primary barriers. No significant change is made to the beam penumbra for FFF beams with and without PDD matching, the maximum change in penumbra for a 10 cm × 10 cm field was within the experimental error of the study. The changes in the profile shape with increasing field size are most significant for the matched FFF beam, and both FFF beams showed less profile shape variation with increasing depth when compared to flattened beams, due to consistency in beam energy spectra across the radiation field. The PDDs of the FFF beams showed less variation with field size, the d(max) value was deeper for the matched FFF beam than the FFF beam and deeper than the flattened beam for field sizes greater than 5 cm × 5 cm. The head leakage when using the machine in FFF mode is less than half that for a flattened beam, but comparable for both FFF modes. The radiation protection dose-rate measurements show an increase of instantaneous dose-rates when operating the machines in FFF mode but that increase is less than the ratio of MU/min produced by the machine. The matching of a FFF beam to a flattened beam at a depth of 10 cm in water by increasing the FFF beam energy does not reduce any of the reported benefits of FFF beams. Conversely, there are a number of potential benefits resulting from matching the FFF beam; the depth of maximum dose is deeper, the out of field dose is potentially reduced, and the beam quality and penetration more closely resembles the flattened beams currently used in clinical practice, making dose distributions in water more alike. Highlighted in this work is the fact that some conventional specifications and methods for measurement of beam parameters such as penumbra are not relevant and further work is required to address this situation with respect to "matched" FFF beams and to determine methods of measurement that are not reliant on an associated flattened beam.

Dosimetric characteristics of a new unit for electronic skin brachytherapy

PubMed Central

Garcia-Martinez, Teresa; Chan, Jan-Pieter; Perez-Calatayud, Jose

2014-01-01

Purpose Brachytherapy with radioactive high dose rate (HDR) 192Ir source is applied to small skin cancer lesions, using surface applicators, i.e. Leipzig or Valencia type. New developments in the field of radiotherapy for skin cancer include electronic brachytherapy. This technique involves the placement of an HDR X-ray source close to the skin, therefore combining the benefits of brachytherapy with the reduced shielding requirements and targeted energy of low energy X-rays. Recently, the Esteya® Electronic Brachytherapy System (Esteya EBS, Elekta AB-Nucletron, Stockholm, Sweden) has been developed specifically for HDR brachytherapy treatment of surface lesions. The system provides radionuclide free HDR brachytherapy by means of a small 69.5 kV X-ray source. The purpose of this study is to obtain the dosimetric characterization required for clinical implementation, providing the detailed methodology to perform the commissioning. Material and methods Flatness, symmetry and penumbra, percentage of depth dose (PDD), kV stability, HVL, output, spectrum, linearity, and leakage have been evaluated for a set of applicators (from 10 mm to 30 mm in diameter). Results Flatness and symmetry resulted better than 5% with around 1 mm of penumbra. The depth dose gradient is about 7%/mm. A kV value of 68.4 ± 1.0 kV (k = 1) was obtained, in good agreement with manufacturer data (69.5 kV). HVL was 1.85 mm Al. Dose rate for a typical 6 Gy to 7 Gy prescription resulted about 3.3 Gy/min and the leakage value was < 100 µGy/min. Conclusions The new Esteya® Electronic Brachytherapy System presents excellent flatness and penumbra as with the Valencia applicator case, combined with an improved PDD, allowing treatment of lesions of up to a depth of 5 mm in combination with reduced treatment duration. The Esteya unit allows HDR brachytherapy superficial treatment within a minimally shielded environment due its low energy. PMID:24790622

SU-E-T-167: Characterization of In-House Plastic Scintillator Detectors Array for Radiation Therapy

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

Zhu, T; Liu, H; Dimofte, A

Purpose: To characterize basic performance of plastic scintillator detectors (PSD) array designed for dosimetry of radiation therapy. Methods: An in-house PSD array has been developed by placing single point PSD into customized 2D holder. Each point PSD is a plastic scintillating fiber-based detector designed for highly accurate measurement of small radiotherapy fields used in patient plan verification and machine commissioning and QA procedures. A parallel fiber without PSD is used for Cerenkov separation by subtracting from PSD readings. Cerenkov separation was confirmed by optical spectroscopy. Alternative Cerenkov separation approaches are also investigated. The optical signal was converted to electronic signalmore » with a photodiode and then subsequently amplified. We measured its dosimetry performance, including percentage depth dose and output factor, and compared with reference ion chamber measurements. The PSD array is then placed along the radiation beam for multiple point dose measurement, representing subsets of PDD measurements, or perpendicular to the beam for profile measurements. Results: The dosimetry results of PSD point measurements agree well with reference ion chamber measurements. For percentage depth dose, the maximal differences between PSD and ion chamber results are 3.5% and 2.7% for 6MV and 15MV beams, respectively. For the output factors, PSD measurements are within 3% from ion chamber results. PDD and profile measurement with PSD array are also performed. Conclusions: The current design of multichannel PSD array is feasible for the dosimetry measurement in radiation therapy. Dose distribution along or perpendicular to the beam path could be measured. It might as well be used as range verification in proton therapy.A PS hollow fiber detector will be investigated to eliminate the Cerenkov radiation effect so that all 32 channels can be used.« less

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

González, M. A. Pagnan, E-mail: miguelangel.pagnan@hotmail.com; Mitsoura, E., E-mail: meleni@uaemex.mx; Oviedo, J.O. Hernández

Mycosis fungoides is a cutaneous lymphoma that accounts for 2–3% of all lymphomas. Several clinical studies have demonstrated the effectiveness of TSEBT (Total Skin Electron Beam Therapy) in patients with mycosis fungoides. It is important to develop this technique and make it available to a larger number of patients in Mexico. Because large fields for electron TSEBT are required in order to cover the entire body of the patient, beam characterization at conventional treatment distances is not sufficient and a calibration distance of 500cm or higher is required. Materials and methods: Calibration of radiochromic Gafchromic® EBT2 film (RCF) for electronsmore » was performed in a solid water phantom (Scanditronix Wellhöfer) at a depth of 1.4cm and a Source Axis Distance (SAD) of 100cm. A polynomial fit was applied to the calibration curve, in order to obtain the equation relating dose response with optical density. The spatial distribution is obtained in terms of percentage of the dose, placing 3×3cm samples of RCF on the acrylic screen, which is placed in front of the patient in order to obtain maximum absorbed dose on the skin, covering an area of 200×100cm{sup 2}. The Percentage Depth Dose (PDD) curve was obtained placing RCF samples at depths of 0, 1, 1.2, 1.4, 1.5, 2, 3, 4, 5, 6, 7, 8 and 9cm in the solid water phantom, irradiated with an ELEKTA SINERGY Linear Accelerator electron beam, with an energy of 6 MeV, at a Source Skin Distance (SSD) of 500cm, with 1000MU = 100Gy, with a cone of 40×40cm and gantry angle of 90°. The RCFs were scanned on a flatbed scanner (EPSON EXPRESSION 10000 XL) and the images were processed with the ImageJ program using a region of interest (ROI) of 1×1cm{sup 2}. Results: The relative spatial dose distribution and the percentage depth dose for a SSD of 500±0.5cm, over an area of 200×100cm{sup 2} was obtained, resulting to an effective maximum dose depth (Z{sub ref}) for electrons of 1.4±0.05cm. Using the same experimental data, horizontal and vertical beam profiles were also graphed, showing a horizontal symmetry of ±035%, horizontal flatness of ±3.62%, vertical symmetry of ±2.1% and vertical flatness of ±14.2%. Conclusions: The electron beam was characterized and the data obtained were useful to determine the spatial dose distribution to a SSD of 500±0.5cm, in an area of 200×100cm{sup 2}. Dose profiles were obtained both horizontally and vertically, thus allowing to assess electron beam symmetry and flatness. PDD analysis up to a depth of 9±0.05cm, has made possible to establish the depth of electron penetration, assuring an only skin irradiation treatment.« less

Monte Carlo simulated corrections for beam commissioning measurements with circular and MLC shaped fields on the CyberKnife M6 System: a study including diode, microchamber, point scintillator, and synthetic microdiamond detectors.

PubMed

Francescon, P; Kilby, W; Noll, J M; Masi, L; Satariano, N; Russo, S

2017-02-07

Monte Carlo simulation was used to calculate correction factors for output factor (OF), percentage depth-dose (PDD), and off-axis ratio (OAR) measurements with the CyberKnife M6 System. These include the first such data for the InCise MLC. Simulated detectors include diodes, air-filled microchambers, a synthetic microdiamond detector, and point scintillator. Individual perturbation factors were also evaluated. OF corrections show similar trends to previous studies. With a 5 mm fixed collimator the diode correction to convert a measured OF to the corresponding point dose ratio varies between  -6.1% and  -3.5% for the diode models evaluated, while in a 7.6 mm  ×  7.7 mm MLC field these are  -4.5% to  -1.8%. The corresponding microchamber corrections are  +9.9% to  +10.7% and  +3.5% to  +4.0%. The microdiamond corrections have a maximum of  -1.4% for the 7.5 mm and 10 mm collimators. The scintillator corrections are  <1% in all beams. Measured OF showed uncorrected inter-detector differences  >15%, reducing to  <3% after correction. PDD corrections at d  >  d max were  <2% for all detectors except IBA Razor where a maximum 4% correction was observed at 300 mm depth. OAR corrections were smaller inside the field than outside. At the beam edge microchamber OAR corrections were up to 15%, mainly caused by density perturbations, which blurs the measured penumbra. With larger beams and depths, PTW and IBA diode corrections outside the beam were up to 20% while the Edge detector needed smaller corrections although these did vary with orientation. These effects are most noticeable for large field size and depth, where they are dominated by fluence and stopping power perturbations. The microdiamond OAR corrections were  <3% outside the beam. This paper provides OF corrections that can be used for commissioning new CyberKnife M6 Systems and retrospectively checking estimated corrections used previously. We recommend the PDD and OAR corrections are used to guide detector selection and inform the evaluation of results rather than to explicitly correct measurements.

Monte Carlo simulated corrections for beam commissioning measurements with circular and MLC shaped fields on the CyberKnife M6 System: a study including diode, microchamber, point scintillator, and synthetic microdiamond detectors

NASA Astrophysics Data System (ADS)

Francescon, P.; Kilby, W.; Noll, J. M.; Masi, L.; Satariano, N.; Russo, S.

2017-02-01

Monte Carlo simulation was used to calculate correction factors for output factor (OF), percentage depth-dose (PDD), and off-axis ratio (OAR) measurements with the CyberKnife M6 System. These include the first such data for the InCise MLC. Simulated detectors include diodes, air-filled microchambers, a synthetic microdiamond detector, and point scintillator. Individual perturbation factors were also evaluated. OF corrections show similar trends to previous studies. With a 5 mm fixed collimator the diode correction to convert a measured OF to the corresponding point dose ratio varies between  -6.1% and  -3.5% for the diode models evaluated, while in a 7.6 mm  ×  7.7 mm MLC field these are  -4.5% to  -1.8%. The corresponding microchamber corrections are  +9.9% to  +10.7% and  +3.5% to  +4.0%. The microdiamond corrections have a maximum of  -1.4% for the 7.5 mm and 10 mm collimators. The scintillator corrections are  <1% in all beams. Measured OF showed uncorrected inter-detector differences  >15%, reducing to  <3% after correction. PDD corrections at d  >  d max were  <2% for all detectors except IBA Razor where a maximum 4% correction was observed at 300 mm depth. OAR corrections were smaller inside the field than outside. At the beam edge microchamber OAR corrections were up to 15%, mainly caused by density perturbations, which blurs the measured penumbra. With larger beams and depths, PTW and IBA diode corrections outside the beam were up to 20% while the Edge detector needed smaller corrections although these did vary with orientation. These effects are most noticeable for large field size and depth, where they are dominated by fluence and stopping power perturbations. The microdiamond OAR corrections were  <3% outside the beam. This paper provides OF corrections that can be used for commissioning new CyberKnife M6 Systems and retrospectively checking estimated corrections used previously. We recommend the PDD and OAR corrections are used to guide detector selection and inform the evaluation of results rather than to explicitly correct measurements.

Study the sensitivity of dose calculation in prism treatment planning system using Monte Carlo simulation of 6 MeV electron beam

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

Hardiansyah, D.; Haryanto, F.; Male, S.

2014-09-30

Prism is a non-commercial Radiotherapy Treatment Planning System (RTPS) develop by Ira J. Kalet from Washington University. Inhomogeneity factor is included in Prism TPS dose calculation. The aim of this study is to investigate the sensitivity of dose calculation on Prism using Monte Carlo simulation. Phase space source from head linear accelerator (LINAC) for Monte Carlo simulation is implemented. To achieve this aim, Prism dose calculation is compared with EGSnrc Monte Carlo simulation. Percentage depth dose (PDD) and R50 from both calculations are observed. BEAMnrc is simulated electron transport in LINAC head and produced phase space file. This file ismore » used as DOSXYZnrc input to simulated electron transport in phantom. This study is started with commissioning process in water phantom. Commissioning process is adjusted Monte Carlo simulation with Prism RTPS. Commissioning result is used for study of inhomogeneity phantom. Physical parameters of inhomogeneity phantom that varied in this study are: density, location and thickness of tissue. Commissioning result is shown that optimum energy of Monte Carlo simulation for 6 MeV electron beam is 6.8 MeV. This commissioning is used R50 and PDD with Practical length (R{sub p}) as references. From inhomogeneity study, the average deviation for all case on interest region is below 5 %. Based on ICRU recommendations, Prism has good ability to calculate the radiation dose in inhomogeneity tissue.« less

SU-F-T-330: Characterization of the Clinically Released ScandiDos Discover Diode Array for In-Vivo Dose Monitoring

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

Saenz, D; Gutierrez, A

Purpose: The ScandiDos Discover has obtained FDA clearance and is now clinically released. We studied the essential attenuation and beam hardening components as well as tested the diode array’s ability to detect changes in absolute dose and MLC leaf positions. Methods: The ScandiDos Discover was mounted on the heads of an Elekta VersaHD and a Varian 23EX. Beam attenuation measurements were made at 10 cm depth for 6 MV and 18 MV beam energies. The PDD(10) was measured as a metric for the effect on beam quality. Next, a plan consisting of two orthogonal 10 × 10 cm2 fields wasmore » used to adjust the dose per fraction by scaling monitor units to test the absolute dose detection sensitivity of the Discover. A second plan (conformal arc) was then delivered several times independently on the Elekta VersaHD. Artificially introduced MLC position errors in the four central leaves were then added. The errors were incrementally increased from 1 mm to 4 mm and back across seven control points. Results: The absolute dose measured at 10 cm depth decreased by 1.2% and 0.7% for 6 MV and 18 MV beam with the Discover, respectively. Attenuation depended slightly on the field size but only changed the attenuation by 0.1% across 5 × 5 cm{sup 2} and 20 − 20 cm{sup 2} fields. The change in PDD(10) for a 10 − 10 cm{sup 2} field was +0.1% and +0.6% for 6 MV and 18 MV, respectively. Changes in monitor units from −5.0% to 5.0% were faithfully detected. Detected leaf errors were within 1.0 mm of intended errors. Conclusion: A novel in-vivo dosimeter monitoring the radiation beam during treatment was examined through its attenuation and beam hardening characteristics. The device tracked with changes in absolute dose as well as introduced leaf position deviations.« less

Correlation between prescribed daily dose, seizure freedom and defined daily dose in antiepileptic drug treatment.

PubMed

Horváth, László; Fekete, Klára; Márton, Sándor; Fekete, István

2017-04-01

Background Although defined daily doses (DDD) for antiepileptic drugs (AED) have been assigned only in combination therapy, based on the literature, most patients take them in monotherapy. Furthermore, discrepancies between DDD and prescribed daily dose (PDD) were observed. Objective First, to determine PDDs of AEDs and to reveal PDD/DDD ratio among seizure free versus not seizure free patients in everyday clinical practice. Second, to test the applicability of 75% cut-off of DDD to achieve seizure freedom. Furthermore, to find out what factors might influence PDD. Setting Outpatient data files at a Hungarian university hospital were studied. Methods A retrospective, 20-year cross-sectional database was compiled from 1282 epileptic outpatients' files. Main outcome measure Seizure freedom and PDD were used as outcome measures. Results The mean DDD% of all prescribed AEDs increased steadily from monotherapy, through bitherapy towards polytherapy (p < 0.0001). Most seizure free patients took AEDs in doses in the range of ≤75% of DDDs in monotherapy and bitherapy. Older AEDs (carbamazepine and valproate) were given in a significantly higher mean dose in bitherapy in the seizure free group. Among the newer types, only levetiracetam and lamotrigine had a significantly higher DDD% in mono-, bi-, and polytherapy. Confirmed by logistic regression analysis, gender, age, type of epilepsy, and number of AEDs had a significant impact on the value of 75% DDD. Conclusion No significant unfavourable impact of the lower ratio of PDD/DDD on the outcome of achieving seizure freedom has been confirmed. As a measure of seizure freedom, 75% of DDD may be used, although individual therapy must be emphasised. Precisely quantified DDD would provide a more accurate calculation of other derived values.

Quality assurance of proton beams using a multilayer ionization chamber system

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

Dhanesar, Sandeep; Sahoo, Narayan; Kerr, Matthew

2013-09-15

Purpose: The measurement of percentage depth-dose (PDD) distributions for the quality assurance of clinical proton beams is most commonly performed with a computerized water tank dosimetry system with ionization chamber, commonly referred to as water tank. Although the accuracy and reproducibility of this method is well established, it can be time-consuming if a large number of measurements are required. In this work the authors evaluate the linearity, reproducibility, sensitivity to field size, accuracy, and time-savings of another system: the Zebra, a multilayer ionization chamber system.Methods: The Zebra, consisting of 180 parallel-plate ionization chambers with 2 mm resolution, was used tomore » measure depth-dose distributions. The measurements were performed for scattered and scanned proton pencil beams of multiple energies delivered by the Hitachi PROBEAT synchrotron-based delivery system. For scattered beams, the Zebra-measured depth-dose distributions were compared with those measured with the water tank. The principal descriptors extracted for comparisons were: range, the depth of the distal 90% dose; spread-out Bragg peak (SOBP) length, the region between the proximal 95% and distal 90% dose; and distal-dose fall off (DDF), the region between the distal 80% and 20% dose. For scanned beams, the Zebra-measured ranges were compared with those acquired using a Bragg peak chamber during commissioning.Results: The Zebra demonstrated better than 1% reproducibility and monitor unit linearity. The response of the Zebra was found to be sensitive to radiation field sizes greater than 12.5 × 12.5 cm; hence, the measurements used to determine accuracy were performed using a field size of 10 × 10 cm. For the scattered proton beams, PDD distributions showed 1.5% agreement within the SOBP, and 3.8% outside. Range values agreed within −0.1 ± 0.4 mm, with a maximum deviation of 1.2 mm. SOBP length values agreed within 0 ± 2 mm, with a maximum deviation of 6 mm. DDF values agreed within 0.3 ± 0.1 mm, with a maximum deviation of 0.6 mm. For the scanned proton pencil beams, Zebra and Bragg peak chamber range values demonstrated agreement of 0.0 ± 0.3 mm with a maximum deviation of 1.3 mm. The setup and measurement time for all Zebra measurements was 3 and 20 times less, respectively, compared to the water tank measurements.Conclusions: Our investigation shows that the Zebra can be useful not only for fast but also for accurate measurements of the depth-dose distributions of both scattered and scanned proton beams. The analysis of a large set of measurements shows that the commonly assessed beam quality parameters obtained with the Zebra are within the acceptable variations specified by the manufacturer for our delivery system.« less

Comparison of doses calculated by the Monte Carlo method and measured by LiF TLD in the buildup region for a 60Co photon beam.

PubMed

Budanec, M; Knezević, Z; Bokulić, T; Mrcela, I; Vrtar, M; Vekić, B; Kusić, Z

2008-12-01

This work studied the percent depth doses of (60)Co photon beams in the buildup region of a plastic phantom by LiF TLD measurements and by Monte Carlo calculations. An agreement within +/-1.5% was found between PDDs measured by TLD and calculated by the Monte Carlo method with the TLD in a plastic phantom. The dose in the plastic phantom was scored in voxels, with thickness scaled by physical and electron density. PDDs calculated by electron density scaling showed a better match with PDD(TLD)(MC); the difference is within +/-1.5% in the buildup region for square and rectangular field sizes.

Production and dosimetry of simultaneous therapeutic photons and electrons beam by linear accelerator: A Monte Carlo study

NASA Astrophysics Data System (ADS)

Khledi, Navid; Arbabi, Azim; Sardari, Dariush; Mohammadi, Mohammad; Ameri, Ahmad

2015-02-01

Depending on the location and depth of tumor, the electron or photon beams might be used for treatment. Electron beam have some advantages over photon beam for treatment of shallow tumors to spare the normal tissues beyond of the tumor. In the other hand, the photon beam are used for deep targets treatment. Both of these beams have some limitations, for example the dependency of penumbra with depth, and the lack of lateral equilibrium for small electron beam fields. In first, we simulated the conventional head configuration of Varian 2300 for 16 MeV electron, and the results approved by benchmarking the Percent Depth Dose (PDD) and profile of the simulation and measurement. In the next step, a perforated Lead (Pb) sheet with 1mm thickness placed at the top of the applicator holder tray. This layer producing bremsstrahlung x-ray and a part of the electrons passing through the holes, in result, we have a simultaneous mixed electron and photon beam. For making the irradiation field uniform, a layer of steel placed after the Pb layer. The simulation was performed for 10×10, and 4×4 cm2 field size. This study was showed the advantages of mixing the electron and photon beam by reduction of pure electron's penumbra dependency with the depth, especially for small fields, also decreasing of dramatic changes of PDD curve with irradiation field size.

Glucose-6-Phosphate Dehydrogenase Deficiency A− Variant in Febrile Patients in Haiti

PubMed Central

Carter, Tamar E.; Maloy, Halley; von Fricken, Michael; St. Victor, Yves; Romain, Jean R.; Okech, Bernard A.; Mulligan, Connie J.

2014-01-01

Haiti is one of two remaining malaria-endemic countries in the Caribbean. To decrease malaria transmission in Haiti, primaquine was recently added to the malaria treatment public health policy. One limitation of primaquine is that, at certain doses, primaquine can cause hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd). In this study, we genotyped two mutations (A376G and G202A), which confer the most common G6PDd variant in West African populations, G6PDd A−. We estimated the frequency of G6PDd A− in a sample of febrile patients enrolled in an on-going malaria study who represent a potential target population for a primaquine mass drug administration. We found that 33 of 168 individuals carried the G6PDd A− allele (includes A− hemizygous males, A− homozygous or heterozygous females) and could experience toxicity if treated with primaquine. These data inform discussions on safe and effective primaquine dosing and future malaria elimination strategies for Haiti. PMID:24891465

Glucose-6-phosphate dehydrogenase deficiency A- variant in febrile patients in Haiti.

PubMed

Carter, Tamar E; Maloy, Halley; von Fricken, Michael; St Victor, Yves; Romain, Jean R; Okech, Bernard A; Mulligan, Connie J

2014-08-01

Haiti is one of two remaining malaria-endemic countries in the Caribbean. To decrease malaria transmission in Haiti, primaquine was recently added to the malaria treatment public health policy. One limitation of primaquine is that, at certain doses, primaquine can cause hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd). In this study, we genotyped two mutations (A376G and G202A), which confer the most common G6PDd variant in West African populations, G6PDd A-. We estimated the frequency of G6PDd A- in a sample of febrile patients enrolled in an on-going malaria study who represent a potential target population for a primaquine mass drug administration. We found that 33 of 168 individuals carried the G6PDd A- allele (includes A- hemizygous males, A- homozygous or heterozygous females) and could experience toxicity if treated with primaquine. These data inform discussions on safe and effective primaquine dosing and future malaria elimination strategies for Haiti. © The American Society of Tropical Medicine and Hygiene.

Dual ring multilayer ionization chamber and theory-based correction technique for scanning proton therapy.

PubMed

Takayanagi, Taisuke; Nihongi, Hideaki; Nishiuchi, Hideaki; Tadokoro, Masahiro; Ito, Yuki; Nakashima, Chihiro; Fujitaka, Shinichiro; Umezawa, Masumi; Matsuda, Koji; Sakae, Takeji; Terunuma, Toshiyuki

2016-07-01

To develop a multilayer ionization chamber (MLIC) and a correction technique that suppresses differences between the MLIC and water phantom measurements in order to achieve fast and accurate depth dose measurements in pencil beam scanning proton therapy. The authors distinguish between a calibration procedure and an additional correction: 1-the calibration for variations in the air gap thickness and the electrometer gains is addressed without involving measurements in water; 2-the correction is addressed to suppress the difference between depth dose profiles in water and in the MLIC materials due to the nuclear interaction cross sections by a semiempirical model tuned by using measurements in water. In the correction technique, raw MLIC data are obtained for each energy layer and integrated after multiplying them by the correction factor because the correction factor depends on incident energy. The MLIC described here has been designed especially for pencil beam scanning proton therapy. This MLIC is called a dual ring multilayer ionization chamber (DRMLIC). The shape of the electrodes allows the DRMLIC to measure both the percentage depth dose (PDD) and integrated depth dose (IDD) because ionization electrons are collected from inner and outer air gaps independently. IDDs for which the beam energies were 71.6, 120.6, 159, 180.6, and 221.4 MeV were measured and compared with water phantom results. Furthermore, the measured PDDs along the central axis of the proton field with a nominal field size of 10 × 10 cm(2) were compared. The spread out Bragg peak was 20 cm for fields with a range of 30.6 and 3 cm for fields with a range of 6.9 cm. The IDDs measured with the DRMLIC using the correction technique were consistent with those that of the water phantom; except for the beam energy of 71.6 MeV, all of the points satisfied the 1% dose/1 mm distance to agreement criterion of the gamma index. The 71.6 MeV depth dose profile showed slight differences in the shallow region, but 94.5% of the points satisfied the 1%/1 mm criterion. The 90% ranges, defined at the 90% dose position in distal fall off, were in good agreement with those in the water phantom, and the range differences from the water phantom were less than ±0.3 mm. The PDDs measured with the DRMLIC were also consistent with those that of the water phantom; 97% of the points passed the 1%/1 mm criterion. It was demonstrated that the new correction technique suppresses the difference between the depth dose profiles obtained with the MLIC and those obtained from a water phantom, and a DRMLIC enabling fast measurements of both IDD and PDD was developed. The IDDs and PDDs measured with the DRMLIC and using the correction technique were in good agreement with those that of the water phantom, and it was concluded that the correction technique and DRMLIC are useful for depth dose profile measurements in pencil beam scanning proton therapy.

Dual ring multilayer ionization chamber and theory-based correction technique for scanning proton therapy

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

Takayanagi, Taisuke, E-mail: taisuke.takayanagi.wd

2016-07-15

Purpose: To develop a multilayer ionization chamber (MLIC) and a correction technique that suppresses differences between the MLIC and water phantom measurements in order to achieve fast and accurate depth dose measurements in pencil beam scanning proton therapy. Methods: The authors distinguish between a calibration procedure and an additional correction: 1—the calibration for variations in the air gap thickness and the electrometer gains is addressed without involving measurements in water; 2—the correction is addressed to suppress the difference between depth dose profiles in water and in the MLIC materials due to the nuclear interaction cross sections by a semiempirical modelmore » tuned by using measurements in water. In the correction technique, raw MLIC data are obtained for each energy layer and integrated after multiplying them by the correction factor because the correction factor depends on incident energy. The MLIC described here has been designed especially for pencil beam scanning proton therapy. This MLIC is called a dual ring multilayer ionization chamber (DRMLIC). The shape of the electrodes allows the DRMLIC to measure both the percentage depth dose (PDD) and integrated depth dose (IDD) because ionization electrons are collected from inner and outer air gaps independently. Results: IDDs for which the beam energies were 71.6, 120.6, 159, 180.6, and 221.4 MeV were measured and compared with water phantom results. Furthermore, the measured PDDs along the central axis of the proton field with a nominal field size of 10 × 10 cm{sup 2} were compared. The spread out Bragg peak was 20 cm for fields with a range of 30.6 and 3 cm for fields with a range of 6.9 cm. The IDDs measured with the DRMLIC using the correction technique were consistent with those that of the water phantom; except for the beam energy of 71.6 MeV, all of the points satisfied the 1% dose/1 mm distance to agreement criterion of the gamma index. The 71.6 MeV depth dose profile showed slight differences in the shallow region, but 94.5% of the points satisfied the 1%/1 mm criterion. The 90% ranges, defined at the 90% dose position in distal fall off, were in good agreement with those in the water phantom, and the range differences from the water phantom were less than ±0.3 mm. The PDDs measured with the DRMLIC were also consistent with those that of the water phantom; 97% of the points passed the 1%/1 mm criterion. Conclusions: It was demonstrated that the new correction technique suppresses the difference between the depth dose profiles obtained with the MLIC and those obtained from a water phantom, and a DRMLIC enabling fast measurements of both IDD and PDD was developed. The IDDs and PDDs measured with the DRMLIC and using the correction technique were in good agreement with those that of the water phantom, and it was concluded that the correction technique and DRMLIC are useful for depth dose profile measurements in pencil beam scanning proton therapy.« less

Safety of single low-dose primaquine in glucose-6-phosphate dehydrogenase deficient falciparum-infected African males: Two open-label, randomized, safety trials.

PubMed

Bastiaens, Guido J H; Tiono, Alfred B; Okebe, Joseph; Pett, Helmi E; Coulibaly, Sam A; Gonçalves, Bronner P; Affara, Muna; Ouédraogo, Alphonse; Bougouma, Edith C; Sanou, Guillaume S; Nébié, Issa; Bradley, John; Lanke, Kjerstin H W; Niemi, Mikko; Sirima, Sodiomon B; d'Alessandro, Umberto; Bousema, Teun; Drakeley, Chris

2018-01-01

Primaquine (PQ) actively clears mature Plasmodium falciparum gametocytes but in glucose-6-phosphate dehydrogenase deficient (G6PDd) individuals can cause hemolysis. We assessed the safety of low-dose PQ in combination with artemether-lumefantrine (AL) or dihydroartemisinin-piperaquine (DP) in G6PDd African males with asymptomatic P. falciparum malaria. In Burkina Faso, G6PDd adult males were randomized to treatment with AL alone (n = 10) or with PQ at 0.25 (n = 20) or 0.40 mg/kg (n = 20) dosage; G6PD-normal males received AL plus 0.25 (n = 10) or 0.40 mg/kg (n = 10) PQ. In The Gambia, G6PDd adult males and boys received DP alone (n = 10) or with 0.25 mg/kg PQ (n = 20); G6PD-normal males received DP plus 0.25 (n = 10) or 0.40 mg/kg (n = 10) PQ. The primary study endpoint was change in hemoglobin concentration during the 28-day follow-up. Cytochrome P-450 isoenzyme 2D6 (CYP2D6) metabolizer status, gametocyte carriage, haptoglobin, lactate dehydrogenase levels and reticulocyte counts were also determined. In Burkina Faso, the mean maximum absolute change in hemoglobin was -2.13 g/dL (95% confidence interval [CI], -2.78, -1.49) in G6PDd individuals randomized to 0.25 PQ mg/kg and -2.29 g/dL (95% CI, -2.79, -1.79) in those receiving 0.40 PQ mg/kg. In The Gambia, the mean maximum absolute change in hemoglobin concentration was -1.83 g/dL (95% CI, -2.19, -1.47) in G6PDd individuals receiving 0.25 PQ mg/kg. After adjustment for baseline concentrations, hemoglobin reductions in G6PDd individuals in Burkina Faso were more pronounced compared to those in G6PD-normal individuals receiving the same PQ doses (P = 0.062 and P = 0.022, respectively). Hemoglobin levels normalized during follow-up. Abnormal haptoglobin and lactate dehydrogenase levels provided additional evidence of mild transient hemolysis post-PQ. Single low-dose PQ in combination with AL and DP was associated with mild and transient reductions in hemoglobin. None of the study participants developed moderate or severe anemia; there were no severe adverse events. This indicates that single low-dose PQ is safe in G6PDd African males when used with artemisinin-based combination therapy. Clinicaltrials.gov NCT02174900 Clinicaltrials.gov NCT02654730.

Safety of single low-dose primaquine in glucose-6-phosphate dehydrogenase deficient falciparum-infected African males: Two open-label, randomized, safety trials

PubMed Central

Pett, Helmi E.; Coulibaly, Sam A.; Gonçalves, Bronner P.; Affara, Muna; Ouédraogo, Alphonse; Bougouma, Edith C.; Sanou, Guillaume S.; Nébié, Issa; Bradley, John; Lanke, Kjerstin H. W.; Niemi, Mikko; Sirima, Sodiomon B.; d’Alessandro, Umberto; Bousema, Teun; Drakeley, Chris

2018-01-01

Background Primaquine (PQ) actively clears mature Plasmodium falciparum gametocytes but in glucose-6-phosphate dehydrogenase deficient (G6PDd) individuals can cause hemolysis. We assessed the safety of low-dose PQ in combination with artemether-lumefantrine (AL) or dihydroartemisinin-piperaquine (DP) in G6PDd African males with asymptomatic P. falciparum malaria. Methods and findings In Burkina Faso, G6PDd adult males were randomized to treatment with AL alone (n = 10) or with PQ at 0.25 (n = 20) or 0.40 mg/kg (n = 20) dosage; G6PD-normal males received AL plus 0.25 (n = 10) or 0.40 mg/kg (n = 10) PQ. In The Gambia, G6PDd adult males and boys received DP alone (n = 10) or with 0.25 mg/kg PQ (n = 20); G6PD-normal males received DP plus 0.25 (n = 10) or 0.40 mg/kg (n = 10) PQ. The primary study endpoint was change in hemoglobin concentration during the 28-day follow-up. Cytochrome P-450 isoenzyme 2D6 (CYP2D6) metabolizer status, gametocyte carriage, haptoglobin, lactate dehydrogenase levels and reticulocyte counts were also determined. In Burkina Faso, the mean maximum absolute change in hemoglobin was -2.13 g/dL (95% confidence interval [CI], -2.78, -1.49) in G6PDd individuals randomized to 0.25 PQ mg/kg and -2.29 g/dL (95% CI, -2.79, -1.79) in those receiving 0.40 PQ mg/kg. In The Gambia, the mean maximum absolute change in hemoglobin concentration was -1.83 g/dL (95% CI, -2.19, -1.47) in G6PDd individuals receiving 0.25 PQ mg/kg. After adjustment for baseline concentrations, hemoglobin reductions in G6PDd individuals in Burkina Faso were more pronounced compared to those in G6PD-normal individuals receiving the same PQ doses (P = 0.062 and P = 0.022, respectively). Hemoglobin levels normalized during follow-up. Abnormal haptoglobin and lactate dehydrogenase levels provided additional evidence of mild transient hemolysis post-PQ. Conclusions Single low-dose PQ in combination with AL and DP was associated with mild and transient reductions in hemoglobin. None of the study participants developed moderate or severe anemia; there were no severe adverse events. This indicates that single low-dose PQ is safe in G6PDd African males when used with artemisinin-based combination therapy. Trial registration Clinicaltrials.gov NCT02174900 Clinicaltrials.gov NCT02654730 PMID:29324864

Sensitivity calibration procedures in optical-CT scanning of BANG 3 polymer gel dosimeters

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

Xu, Y.; Wuu, Cheng-Shie; Maryanski, Marek J.

2010-02-15

The dose response of the BANG 3 polymer gel dosimeter (MGS Research Inc., Madison, CT) was studied using the OCTOPUS laser CT scanner (MGS Research Inc., Madison, CT). Six 17 cm diameter and 12 cm high Barex cylinders, and 18 small glass vials were used to house the gel. The gel phantoms were irradiated with 6 and 10 MV photons, as well as 12 and 16 MeV electrons using a Varian Clinac 2100EX. Three calibration methods were used to obtain the dose response curves: (a) Optical density measurements on the 18 glass vials irradiated with graded doses from 0 tomore » 4 Gy using 6 or 10 MV large field irradiations; (b) optical-CT scanning of Barex cylinders irradiated with graded doses (0.5, 1, 1.5, and 2 Gy) from four adjacent 4x4 cm{sup 2} photon fields or 6x6 cm{sup 2} electron fields; and (c) percent depth dose (PDD) comparison of optical-CT scans with ion chamber measurements for 6x6 cm{sup 2}, 12 and 16 MeV electron fields. The dose response of the BANG 3 gel was found to be linear and energy independent within the uncertainties of the experimental methods (about 3%). The slopes of the linearly fitted dose response curves (dose sensitivities) from the four field irradiations (0.0752{+-}3%, 0.0756{+-}3%, 0.0767{+-}3%, and 0.0759{+-}3% cm{sup -1} Gy{sup -1}) and the PDD matching methods (0.0768{+-}3% and 0.0761{+-}3% cm{sup -1} Gy{sup -1}) agree within 2.2%, indicating a good reproducibility of the gel dose response within phantoms of the same geometry. The dose sensitivities from the glass vial approach are different from those of the cylindrical Barex phantoms by more than 30%, owing probably to the difference in temperature inside the two types of phantoms during gel formation and irradiation, and possible oxygen contamination of the glass vial walls. The dose response curve obtained from the PDD matching approach with 16 MeV electron field was used to calibrate the gel phantom irradiated with the 12 MeV, 6x6 cm{sup 2} electron field. Three-dimensional dose distributions from the gel measurement and the Eclipse planning system (Varian Corporation, Palo Alto, CA) were compared and evaluated using 3% dose difference and 2 mm distance-to-agreement criteria.« less

Characterization of a microDiamond detector in high-dose-per-pulse electron beams for intra operative radiation therapy.

PubMed

Di Venanzio, C; Marinelli, Marco; Tonnetti, A; Verona-Rinati, G; Falco, M D; Pimpinella, M; Ciccotelli, A; De Stefano, S; Felici, G; Marangoni, F

2015-12-01

To characterize a synthetic diamond dosimeter (PTW Freiburg microDiamond 60019) in high dose-per-pulse electron beams produced by an Intra Operative Radiation Therapy (IORT) dedicated accelerator. The dosimetric properties of the microDiamond were assessed under 6, 8 and 9 MeV electron beams by a NOVAC11 mobile accelerator (Sordina IORT Technologies S.p.A.). The characterization was carried out with dose-per-pulse ranging from 26 to 105 mGy per pulse. The microDiamond performance was compared with an Advanced Markus ionization chamber and a PTW silicon diode E in terms of dose linearity, percentage depth dose (PDD) curves, beam profiles and output factors. A good linearity of the microDiamond response was verified in the dose range from 0.2 Gy to 28 Gy. A sensitivity of 1.29 nC/Gy was measured under IORT electron beams, resulting within 1% with respect to the one obtained in reference condition under (60)Co gamma irradiation. PDD measurements were found in agreement with the ones by the reference dosimeters, with differences in R50 values below 0.3 mm. Profile measurements evidenced a high spatial resolution of the microDiamond, slightly worse than the one of the silicon diode. The penumbra widths measured by the microDiamond resulted approximately 0.5 mm larger than the ones by the Silicon diode. Output factors measured by the microDiamond were found within 2% with those obtained by the Advanced Markus down to 3 cm diameter field sizes. The microDiamond dosimeter was demonstrated to be suitable for precise dosimetry in IORT applications under high dose-per-pulse conditions. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

SU-C-204-06: Monte Carlo Dose Calculation for Kilovoltage X-Ray-Psoralen Activated Cancer Therapy (X-PACT): Preliminary Results

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

Mein, S; Gunasingha, R; Nolan, M

Purpose: X-PACT is an experimental cancer therapy where kV x-rays are used to photo-activate anti-cancer therapeutics through phosphor intermediaries (phosphors that absorb x-rays and re-radiate as UV light). Clinical trials in pet dogs are currently underway (NC State College of Veterinary Medicine) and an essential component is the ability to model the kV dose in these dogs. Here we report the commissioning and characterization of a Monte Carlo (MC) treatment planning simulation tool to calculate X-PACT radiation doses in canine trials. Methods: FLUKA multi-particle MC simulation package was used to simulate a standard X-PACT radiation treatment beam of 80kVp withmore » the Varian OBI x-ray source geometry. The beam quality was verified by comparing measured and simulated attenuation of the beam by various thicknesses of aluminum (2–4.6 mm) under narrow beam conditions (HVL). The beam parameters at commissioning were then corroborated using MC, characterized and verified with empirically collected commissioning data, including: percent depth dose curves (PDD), back-scatter factors (BSF), collimator scatter factor(s), and heel effect, etc. All simulations were conducted for N=30M histories at M=100 iterations. Results: HVL and PDD simulation data agreed with an average percent error of 2.42%±0.33 and 6.03%±1.58, respectively. The mean square error (MSE) values for HVL and PDD (0.07% and 0.50%) were low, as expected; however, longer simulations are required to validate convergence to the expected values. Qualitatively, pre- and post-filtration source spectra matched well with 80kVp references generated via SPEKTR software. Further validation of commissioning data simulation is underway in preparation for first-time 3D dose calculations with canine CBCT data. Conclusion: We have prepared a Monte Carlo simulation capable of accurate dose calculation for use with ongoing X-PACT canine clinical trials. Preliminary results show good agreement with measured data and hold promise for accurate quantification of dose for this novel psoralen X-ray therapy. Funding Support, Disclosures, & Conflict of Interest: The Monte Carlo simulation work was not funded; Drs. Adamson & Oldham have received funding from Immunolight LLC for X-PACT research.« less

SU-E-T-162: Characterization of a New Oblong Cone for Use with the Intraoperative Mobetron Unit

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

Cantley, J; Colussi, V

Purpose: To evaluate the dosimetric characteristics of a new flat 7 cm x 12 cm oblong cone for intraoperative radiation therapy (IORT) procedures. Methods: Percent depth dose (PDD) curves and profile measurements at dose depths of D100, D90, D80, D50, and D30 were measured using a parallel-plate ion chamber and a 3-D water tank Blue phantom II (iba) for the three energies (6, 9, and 12 MeV) available with the new generation Mobetron 2000. In addition, PDD curves and profiles were made with Gafchromic EBT3 films in solid water phantom. H&D curves were created for each energy for absolute calibration.more » The films were analyzed using the RIT image analysis software and then compared with the ion chamber results. Output values were obtained by normalizing the dose/MU at D100 at the clinical axis of the oblong cone by the dose/MU at D100 for the flat 10cm cylindrical standard cone using ion chamber measurements. Results: Ion chamber results show that the PDDs from the flat oblong cone, at the clinical axis, match with the PDDs for its “cylindrical brother” 7cm flat cone. These PDDs are comparable with those from the 10cm standard cone. The D100 coincides for all three energies. The cone output factors for the oblong cone are 1.07 for all energies. Ion chamber profiles measurements and film analysis show that the use of flat oblong cone with the 6 and 9 MeV energies Result in horns of approximately 12% and 8%, respectively. Conversely, 12 MeV profiles show loss of flatness near the field edge. Conclusion: The potential advantage of the oblong cones is the elimination of the well-known difficulties of electron field matching, both dosimetrically and in clinical setup.« less

SU-F-T-28: Evaluation of BEBIG HDR Co-60 After-Loading System for Skin Cancer Treatment Using Conical Surface Applicator

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

Safigholi, H; Soliman, A; Song, W Y

Purpose: To evaluate the possibility of utilizing the BEBIG HDR 60Co remote after-loading system for malignant skin surface treatment using Monte Carlo (MC) simulation technique. Methods: First TG-43 parameters of BEBIG-Co-60 and Nucletron Ir-192-mHDR-V2 brachytherapy sources were simulated using MCNP6 code to benchmark the sources against the literature. Second a conical tungsten-alloy with 3-cm diameter of Planning-Target-Volume (PTV) at surface for use with a single stepping HDR source is designed. The HDR source is modeled parallel to treatment plane at the center of the conical applicator with a source surface distance (SSD) of 1.5-cm and a removable plastic end-cap withmore » a 1-mm thickness. Third, MC calculated dose distributions from HDR Co-60 for conical surface applicator were compared with the simulated data using HDR Ir-192 source. The initial calculations were made with the same conical surface applicator (standard-applicator) dimensions as the ones used with the Ir-192 system. Fourth, the applicator wall-thickness for the Co-60 system was increased (doubled) to diminish leakage dose to levels received when using the Ir-192 system. With this geometry, percentage depth dose (PDD), and relative 2D-dose profiles in transverse/coronal planes were normalized at 3-mm prescription-depth evaluated along the central axis. Results: PDD for Ir-192 and Co-60 were similar with standard and thick-walled applicator. 2D-relative dose distribution of Co-60, inside the standard-conical-applicator, generated higher penumbra (7.6%). For thick-walled applicator, it created smaller penumbra (<4%) compared to Ir-192 source in the standard-conicalapplicator. Dose leakage outside of thick-walled applicator with Co-60 source was approximately equal (≤3%) with standard applicator using Ir-192 source. Conclusion: Skin cancer treatment with equal quality can be performed with Co-60 source and thick-walled conical applicators instead of Ir-192 with standard applicators. These conical surface applicator must be used with a protective plastic end-cap to eliminate electron contamination and over-dosage of the skin.« less

Influence of the Integral Quality Monitor transmission detector on high energy photon beams: A multi-centre study.

PubMed

Casar, Bozidar; Pasler, Marlies; Wegener, Sonja; Hoffman, David; Talamonti, Cinzia; Qian, Jianguo; Mendez, Ignasi; Brojan, Denis; Perrin, Bruce; Kusters, Martijn; Canters, Richard; Pallotta, Stefania; Peterlin, Primoz

2017-09-01

The influence of the Integral Quality Monitor (IQM) transmission detector on photon beam properties was evaluated in a preclinical phase, using data from nine participating centres: (i) the change of beam quality (beam hardening), (ii) the influence on surface dose, and (iii) the attenuation of the IQM detector. For 6 different nominal photon energies (4 standard, 2 FFF) and square field sizes from 1×1cm 2 to 20×20cm 2 , the effect of IQM on beam quality was assessed from the PDD 20,10 values obtained from the percentage dose depth (PDD) curves, measured with and without IQM in the beam path. The change in surface dose with/without IQM was assessed for all available energies and field sizes from 4×4cm 2 to 20×20cm 2 . The transmission factor was calculated by means of measured absorbed dose at 10cm depth for all available energies and field sizes. (i) A small (0.11-0.53%) yet statistically significant beam hardening effect was observed, depending on photon beam energy. (ii) The increase in surface dose correlated with field size (p<0.01) for all photon energies except for 18MV. The change in surface dose was smaller than 3.3% in all cases except for the 20×20cm 2 field and 10MV FFF beam, where it reached 8.1%. (iii) For standard beams, transmission of the IQM showed a weak dependence on the field size, and a pronounced dependence on the beam energy (0.9412 for 6MV to 0.9578 for 18MV and 0.9440 for 6MV FFF; 0.9533 for 10MV FFF). The effects of the IQM detector on photon beam properties were found to be small yet statistically significant. The magnitudes of changes which were found justify treating IQM either as tray factors within the treatment planning system (TPS) for a particular energy or alternatively as modified outputs for specific beam energy of linear accelerators, which eases the introduction of the IQM into clinical practice. Copyright © 2017. Published by Elsevier GmbH.

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

Reynoso, F; Cho, S

Purpose: To develop an external beam surrogate of the Yb-169 brachytherapy source applying a filter-based spectrum modulation technique to 250 kVp x-rays. In-vitro/vivo studies performed with the modulated 250 kVp beam will help gauge the benefits of implementing gold nanoparticle-aided radiotherapy with the Yb-169 source. Methods: A previously validated MCNP5 model of the Phillips RT-250 orthovoltage unit was used to obtain the percentage depth dose (PDD) and filtered photon spectra for a variety of filtration and irradiation conditions. Photon spectra were obtained using the average flux F4 tally in air right after all collimation. A 30 x 30 x 30more » cm{sup 3} water phantom was used to compute the PDD along the central axis (CAX) under the standards conditions of a 10 x 10 cm{sup 2} field size at 50 cm SSD. Cylindrical cells of 4 cm in diameter and the energy deposition F6 tally were used along the CAX to score the doses down to 20 cm depth. The number of particle history was set to 2 x 10{sup 8} in order to keep the relative uncertainty within each cell < 0.3%. The secondary electron spectrum within a gold-loaded tissue due to each photon spectrum was also calculated using EGSnrc and compared with that due to Yb-169 gamma rays. Results: Under the practical constraints for the spectrum modulation task, 250 kVp x-rays filtered by a 0.25 mm Erbium (Er) foil produced the best match with Yb-169 gamma rays, in terms of PDD and, more importantly, secondary electron spectrum. Conclusion: Modulation of 250kVp x-ray spectrum by an Er-filter was found effective in emulating the gamma ray spectrum of Yb-169. Possible benefits as predicted from the current MC model such as enhanced radiosensitization with the Er-filtered beam (as a surrogate of Yb-169) was confirmed with a separate in-vitro study. Supported by DOD/PCRP grant W81XWH-12-1-0198.« less

SU-F-T-460: Dosimetric Matching Between Trilogy Tx and TrueBeam STx

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

Choi, Y; Kwak, J; Jeong, C

Purpose: To compare the commissioned beam data for one flattening filter photon mode (6 MV) and two flattening filter-free (FFF) photon modes (6 and 10 MV-FFF) between Trilogy Tx and TrueBeam STx and evaluate the possibility of dosimetric matching Methods: Dosimetric characteristics of the new Trilogy Tx including percent depth doses (PDDs), profiles, and output factors were measured for commissioning. Linear diode array detector and ion chambers were used to measure dosimetric data. The depth of dose maximum (dmax) and PDD at 10 cm (PDD10) were evaluated: 3×3 cm{sup 2}, 10×10 cm{sup 2}, and 40×40 cm{sup 2}. The beam profilesmore » were compared and then penumbras were evaluated. As a further test of the dosimetric matching, the same VMAT plans were delivered, measured with film, and compared with TPS calculation. Results: All the measured PDDs matched well across the two units. PDD10 showed less than 0.5% variation and dmax were within 1.5 mm at the field sizes evaluated. Within the central 80% of transverse axis, profile data were almost identical. TrueBeam data resulted in a slightly greater penumbra width (up to 1.9 mm). The greatest differences of output factors were found at 40 × 40 cm{sup 2}: 2.40%, 2.03%, and 2.22% for 6 MV, 6 MV-FFF, and 10 MV-FFF, respectively. For smaller field sizes, less than 1% differences were observed. The film measurements demonstrated over 97.3% pixels passing-gamma analysis (2%/2mm). The results showed excellent agreement between measurements of two machines. Conclusion: The differences between Trilogy Tx and TrueBeam STx found could possibly affect small field and also very large field sizes in dosimetric matching considerations. These differences encountered are mostly related with the changes in the head design of the TrueBeam. Although it cannot guarantee full interchangeability of two machines, dosimetric matching by field size of 25 × 25 cm{sup 2} might be clinically acceptable.« less

A comparison of small-field tissue phantom ratio data generation methods for an Elekta Agility 6 MV photon beam

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

Richmond, Neil, E-mail: neil.richmond@stees.nhs.uk; Brackenridge, Robert

2014-04-01

Tissue-phantom ratios (TPRs) are a common dosimetric quantity used to describe the change in dose with depth in tissue. These can be challenging and time consuming to measure. The conversion of percentage depth dose (PDD) data using standard formulae is widely employed as an alternative method in generating TPR. However, the applicability of these formulae for small fields has been questioned in the literature. Functional representation has also been proposed for small-field TPR production. This article compares measured TPR data for small 6 MV photon fields against that generated by conversion of PDD using standard formulae to assess the efficacymore » of the conversion data. By functionally fitting the measured TPR data for square fields greater than 4 cm in length, the TPR curves for smaller fields are generated and compared with measurements. TPRs and PDDs were measured in a water tank for a range of square field sizes. The PDDs were converted to TPRs using standard formulae. TPRs for fields of 4 × 4 cm{sup 2} and larger were used to create functional fits. The parameterization coefficients were used to construct extrapolated TPR curves for 1 × 1 cm{sup 2}, 2 × 2-cm{sup 2}, and 3 × 3-cm{sup 2} fields. The TPR data generated using standard formulae were in excellent agreement with direct TPR measurements. The TPR data for 1 × 1-cm{sup 2}, 2 × 2-cm{sup 2}, and 3 × 3-cm{sup 2} fields created by extrapolation of the larger field functional fits gave inaccurate initial results. The corresponding mean differences for the 3 fields were 4.0%, 2.0%, and 0.9%. Generation of TPR data using a standard PDD-conversion methodology has been shown to give good agreement with our directly measured data for small fields. However, extrapolation of TPR data using the functional fit to fields of 4 × 4 cm{sup 2} or larger resulted in generation of TPR curves that did not compare well with the measured data.« less

True beam commissioning experience at Nordland Hospital Trust, Norway

NASA Astrophysics Data System (ADS)

Daci, Lulzime; Malkaj, Partizan

2016-03-01

To evaluate the measured of all photon beam data of first Varian True Beam version 2.0 slim model, recently commissioned at Nordland Hospital Trust, Bodø. To compare and evaluate the possibility of beam matching with the Clinac2300, for the energies of 6MV and 15 MV. Materials/Methods: Measurements of PDD, OAR, and Output factors were realized with the IBA Blue-phantom with different detectors and evaluated between them for all photon energies: 6MV, 15MV, 6MV FFF and 10MV FFF. The ionization chambers used were Pin Point CC01, CC04, Semiflex CC13 and photon diode by Iba dosimetry. The data were processed using Beizer algorithm with a resolution of 1 mm. The measured depth dose curves, diagonals, OAR, and output factors were imported into Eclipse in order to calculate beam data for the anisotropic analytical algorithm (AAA version 10.0.28) for both the dataset measured with CC04 and CC13 and compared. The model head of 23EX was selected as the most near model to True Beam as a restriction of our version of Aria. It was seen that better results were achieved with the CC04 measured data as a result of better resolution. For the biggest field after 10 cm depth a larger difference is seen between measured and calculated for both dataset, but it is within the criteria for acceptance. Results: The Beam analysis criteria of 2 mm at 50% dose is achieved for all the fields accept for 40x40 that is within 3%. Depth difference at maximum dose is within 1 mm for all the fields and dose difference at 100 mm and 200 mm is lower than 1% for or all the fields. The PDD between two machines for all the fields differ after Dmax with less than 1%. For profiles in the field zone and outside field the difference is within 1% for all the fields. In the penumbra region the difference is from 2% up to 12% for big fields. As for diagonals they differ as a result of the head construction at the edge of the field and the penumbra region. The output factors differ for big fields within 5% and for the small fields within 3%. MU and dose distribution does not change for plans recalculated with the new modeled machine.

Technical Note: Out‐of‐field dose measurement at near surface with plastic scintillator detector

PubMed Central

Bourgouin, Alexandra; Varfalvy, Nicolas

2016-01-01

Out‐of‐field dose depends on multiple factors, making peripheral dosimetry complex. Only a few dosimeters have the required features for measuring peripheral dose. Plastic scintillator dosimeters (PSDs) offer numerous dosimetric advantages as required for out‐of‐field dosimetry. The purpose of this study is to determine the potential of using PSD as a surface peripheral dosimeter. Measurements were performed with a parallel‐plate ion chamber, a small volume ion chamber, and with a PSD. Lateral‐dose measurements (LDM) at 0.5 cm depth and depth‐dose curve (PDD) were made and compared to the dose calculation provided by a treatment planning system (TPS). This study shows that a PSD can measure a dose as low as 0.51±0.17cGy for photon beam and 0.58±0.20cGy for electron beam with a difference of 0.2 and 0.1 cGy compared to a parallel‐plate ion chamber. This study demonstrates the potential of using PSD as an out‐of‐field dosimeter since measurements with PSD avoid averaging over a too‐large depth, at 1 mm diameter, and can make precise measurement at very low dose. Also, electronic equilibrium is easier to reach with PSD due to its small sensitive volume and its water equivalence. PACS number(s): 87.55.N, 87.55.km PMID:27685131

SU-E-T-354: Peak Temperature Ratio of TLD Glow Curves to Investigate the Spatial Dependence of LET in a Clinical Proton Beam

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

Reft, C; Pankuch, M; Ramirez, H

Purpose: Use the ratio of the two high temperature peaks (HTR) in TLD 700 glow curves to investigate spatial dependence of the linear energy transfer (LET) in proton beams. Studies show that the relative biological effectiveness (RBE) depends upon the physical dose as well as its spatial distribution. Although proton therapy uses a spatially invariant RBE of 1.1, studies suggest that the RBE increases in the distal edge of a spread out Bragg peak (SOBP) due to the increased LET. Methods: Glow curve studies in TLD 700 show that the 280 C temperature peak is more sensitive to LET radiationmore » than the 210 C temperature peak. Therefore, the areas under the individual temperature peaks for TLDs irradiated in a proton beam normalized to the peak ratio for 6 MV photons are used to determine the HTR to obtain information on its LET. TLD 700 chips with dimensions 0.31×0.31×0.038 cc are irradiated with 90 MeV protons at varying depths in a specially designed blue wax phantom to investigate LET spatial dependence. Results: Five TLDs were placed at five different depths of the percent depth dose curve (PDD) of range 16.2 cm: center of the SOPB and approximately at the 99% distal edge, 90%, 75% and 25% of the PDD, respectively. HTR was 1.3 at the center of the SOBP and varied from 2.2 to 3.9 which can be related to an LET variation from 0.5 to 18 KeV/μ via calibration with radiation beams of varying LET. Conclusion: HTR data show a spatially invariant LET slightly greater than the 6 MV radiations in the SOBP, but a rapidly increasing LET at the end of the proton range. These results indicate a spatial variation in RBE with potential treatment consequences when selecting treatment margins to minimize the uncertainties in proton RBE.« less

SU-F-T-66: Characteristics of Electron Beams From Varian Trubeam

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

Dimofte, A; Kennedy, C; Zhu, T

2016-06-15

Purpose: The purpose of this study was to compare the electron beam data between Truebeam and 2300ix Varian accelerators for percent depth dose for broad beam and small circular cutouts, cone factors, head scatter factor as a function of cone size and SSD, phantom scatter factor, blocking factor, distance factor and virtual source position. Methods: Measurements were performed for Truebeam and 2300ix Varian accelerators. The main energies used were: 6, 9, 12, 16 and 20 MeV. PDD was measured at SSD = 100 cm for open beam and small circular cutouts (r = 0.5, 1.0, 1.5, 2.0, 3.0, 4.0 andmore » 6.6cm) for different energies. Measurements to determine the head scatter factor (H) were done as a function of radius for six representative energies and five cone sizes (6, 10, 15, 20 and 25cm2). The phantom scatter factor (PSF) is defined as the ratio of blocking factor in water at reference depth and head scatter factor in air. PSF was measured as a function of radius and electron energy. Distance factor was measured for all energies and cones for three SSD’s (100, 110 and 120cm). Results: The percent depth dose (PDD) was measured for small cutouts of radius r = 0.5, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0 and 5.6cm. Blocking factor (BF) was measured for Truebeam and 2300ix accelerators, for different circular cutouts and energies for a 10×10 cone. Cone factors were compared between the two accelerators for different energies and applicator sizes. Conclusion: Cone factors measured for the two accelerator types differ by up to 5% for the largest applicator size. Blocking factors differs by up to 3%, with the largest variation for the smallest field size (0.5cm). Distance factor for different SSD’s differ by up to 4.5%.« less

SU-E-T-756: Tissue Inhomogeneity Corrections in Intra-Operative Radiotherapy

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

Sethi, A; Chinsky, B; Gros, S

Purpose: Investigate the impact of tissue inhomogeneities on dose distributions produced by low-energy X-rays in intra-operative radiotherapy (IORT). Methods: A 50-kV INTRABEAM X-ray device with superficial (Flat and Surface) applicators was commissioned at our institution. For each applicator, percent depth-dose (PDD), dose-profiles (DP) and output factors (OF) were obtained. Calibrated GaFchromic (EBT3) films were used to measure dose distributions in solid water phantom at various depths (2, 5, 10, and 15 mm). All recommended precautions for film-handling, film-exposure and scanning were observed. The effects of tissue inhomogeneities on dose distributions were examined by placing air-cavities and bone and tissue equivalentmore » materials of different density (ρ), atomic number (Z), and thickness (t = 0–4mm) between applicator and film detector. All inhomogeneities were modeled as a cylindrical cavity (diameter 25 mm). Treatment times were calculated to deliver 1Gy dose at 5mm depth. Film results were verified by repeat measurements with a thin-window parallel plate ion-chamber (PTW 34013A) in a water tank. Results: For a Flat-4cm applicator, the measured dose rate at 5mm depth in solid water was 0.35 Gy/min. Introduction of a cylindrical air-cavity resulted in an increased dose past the inhomogeneity. Compared to tissue equivalent medium, dose enhancement due to 1mm, 2mm, 3mm and 4mm air cavities was 10%, 16%, 24%, and 35% respectively. X-ray attenuation by 2mm thick cortical bone resulted in a significantly large (58%) dose decrease. Conclusion: IORT dose calculations assume homogeneous tissue equivalent medium. However, soft X-rays are easily affected by non-tissue equivalent materials. The results of this study may be used to estimate and correct IORT dose delivered in the presence of tissue inhomogeneities.« less

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

Lee, Y; Kumar, P; Mitchell, M

Purpose: Breast cancer patients who undergo a mastectomy often require post-mastectomy radiation therapy (PMRT) due to high risk disease characteristics. PMRT usually accompanies scar boost irradiation (10–16Gy in 5–8 fractions) using en face electrons, which often results in increased dose to the underlying lungs, thereby potentially increasing the risk of radiation pneumonitis. Hence, this study evaluated water-equivalent phantoms as energy degraders and as an alternative to a bolus to reduce radiation dose to the underlying lungs for electron scar boost irradiation. Methods: Percent depth dose (PDD) profiles of 6 MeV (the lowest electron energy available in most clinics) were obtainedmore » without and with commercial solid water phantoms (1 to 5mm by 1mm increments) placed on top of electron cones. Phantom attenuation was measured by taking a ratio of outputs with to without the phantoms in 10×10cm2 cone size for monitor unit (MU) calculation. In addition, scatter dose to contralateral breast was measured on a human-like phantom using two selected scar (short and long) boost patient setups. Results: The PDD plots showed that the solid water phantoms and the bolus had similar dosimetric effects for the same thickness. Lower skin dose (up to 3%) to ipsilateral breast was observed with a 5mm phantom compared with a 5mm bolus (up to 10%) for all electron cones. Phantom attenuation was increased by 50% with about a 4.5mm phantom. Also, the energy degraders caused scatter dose to contralateral breast by a factor of 3 with a 5mm phantom. Conclusion: Our results demonstrate the feasibility of using water-equivalent phantoms to reduce lung dose using en face electrons in patients with a thin chest wall undergoing PMRT. The disadvantages of this treatment approach (i.e., the increase in MUs and treatment time, and clinically insignificant scatter dose to the contralateral breast given usually 10Gy) are outweighed by its above clinical benefits.« less

Linear array measurements of enhanced dynamic wedge and treatment planning system (TPS) calculation for 15 MV photon beam and comparison with electronic portal imaging device (EPID) measurements.

PubMed

Petrovic, Borislava; Grzadziel, Aleksandra; Rutonjski, Laza; Slosarek, Krzysztof

2010-09-01

Enhanced dynamic wedges (EDW) are known to increase drastically the radiation therapy treatment efficiency. This paper has the aim to compare linear array measurements of EDW with the calculations of treatment planning system (TPS) and the electronic portal imaging device (EPID) for 15 MV photon energy. The range of different field sizes and wedge angles (for 15 MV photon beam) were measured by the linear chamber array CA 24 in Blue water phantom. The measurement conditions were applied to the calculations of the commercial treatment planning system XIO CMS v.4.2.0 using convolution algorithm. EPID measurements were done on EPID-focus distance of 100 cm, and beam parameters being the same as for CA24 measurements. Both depth doses and profiles were measured. EDW linear array measurements of profiles to XIO CMS TPS calculation differ around 0.5%. Profiles in non-wedged direction and open field profiles practically do not differ. Percentage depth doses (PDDs) for all EDW measurements show the difference of not more than 0.2%, while the open field PDD is almost the same as EDW PDD. Wedge factors for 60 deg wedge angle were also examined, and the difference is up to 4%. EPID to linear array differs up to 5%. The implementation of EDW in radiation therapy treatments provides clinicians with an effective tool for the conformal radiotherapy treatment planning. If modelling of EDW beam in TPS is done correctly, a very good agreement between measurements and calculation is obtained, but EPID cannot be used for reference measurements.

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

Kuess, Peter, E-mail: Peter.kuess@meduniwien.ac.at

Purpose: For commercially available linear accelerators (Linacs), the electron energies of flattening filter free (FFF) and flattened (FF) beams are either identical or the electron energy of the FFF beam is increased to match the percentage depth dose curve (PDD) of the FF beam (in reference geometry). This study focuses on the primary dose components of FFF beams for both kinds of settings, studied on the same Linac. Methods: The measurements were conducted on a VersaHD Linac (Elekta, Crawley, UK) for both FF and FFF beams with nominal energies of 6 and 10 MV. In the clinical setting of themore » VersaHD, the energy of FFF{sub M} (Matched) beams is set to match the PDDs of the FF beams. In contrast the incident electron beam of the FFF{sub U} beam was set to the same energy as for the FF beam. Half value layers (HVLs) and a dual parameter beam quality specifier (DPBQS) were determined. Results: For the 6 MV FFF{sub M} beam, HVL and DPBQS values were very similar compared to those of the 6 MV FF beam, while for the 10 MV FFF{sub M} and FF beams, only %dd(10){sub x} and HVL values were comparable (differences below 1.5%). This shows that matching the PDD at one depth does not guarantee other beam quality dependent parameters to be matched. For FFF{sub U} beams, all investigated beam quality specifiers were significantly different compared to those for FF beams of the same nominal accelerator potential. The DPBQS of the 6 MV FF and FFF{sub M} beams was equal within the measurement uncertainty and was comparable to published data of a machine with similar TPR{sub 20,10} and %dd(10){sub x}. In contrast to that, the DPBQS’s two parameters of the 10 MV FFF{sub M} beam were substantially higher compared to those for the 10 MV FF beam. Conclusions: PDD-matched FF and FFF beams of both nominal accelerator potentials were observed to have similar HVL values, indicating similarity of their primary dose components. Using the DPBQS revealed that the mean attenuation coefficient was found to be the same within the uncertainty of 0.8% for 6 MV FF and 6 MV FFF{sub M} beams, while for 10 MV beams, they differed by 6.4%. This shows that the DPBQS can provide a differentiation of photon beam characteristics that would remain hidden by the use of a single beam quality specifier, such as %dd(10){sub x} or HVL.« less

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

Lessard, Francois; Archambault, Louis; Plamondon, Mathieu

Purpose: Photon dosimetry in the kilovolt (kV) energy range represents a major challenge for diagnostic and interventional radiology and superficial therapy. Plastic scintillation detectors (PSDs) are potentially good candidates for this task. This study proposes a simple way to obtain accurate correction factors to compensate for the response of PSDs to photon energies between 80 and 150 kVp. The performance of PSDs is also investigated to determine their potential usefulness in the diagnostic energy range. Methods: A 1-mm-diameter, 10-mm-long PSD was irradiated by a Therapax SXT 150 unit using five different beam qualities made of tube potentials ranging from 80more » to 150 kVp and filtration thickness ranging from 0.8 to 0.2 mmAl + 1.0 mmCu. The light emitted by the detector was collected using an 8-m-long optical fiber and a polychromatic photodiode, which converted the scintillation photons to an electrical current. The PSD response was compared with the reference free air dose rate measured with a calibrated Farmer NE2571 ionization chamber. PSD measurements were corrected using spectra-weighted corrections, accounting for mass energy-absorption coefficient differences between the sensitive volumes of the ionization chamber and the PSD, as suggested by large cavity theory (LCT). Beam spectra were obtained from x-ray simulation software and validated experimentally using a CdTe spectrometer. Correction factors were also obtained using Monte Carlo (MC) simulations. Percent depth dose (PDD) measurements were compensated for beam hardening using the LCT correction method. These PDD measurements were compared with uncorrected PSD data, PDD measurements obtained using Gafchromic films, Monte Carlo simulations, and previous data. Results: For each beam quality used, the authors observed an increase of the energy response with effective energy when no correction was applied to the PSD response. Using the LCT correction, the PSD response was almost energy independent, with a residual 2.1% coefficient of variation (COV) over the 80-150-kVp energy range. Monte Carlo corrections reduced the COV to 1.4% over this energy range. All PDD measurements were in good agreement with one another except for the uncorrected PSD data, in which an over-response was observed with depth (13% at 10 cm with a 100 kVp beam), showing that beam hardening had a non-negligible effect on the PSD response. A correction based on LCT compensated very well for this effect, reducing the over-response to 3%.Conclusion: In the diagnostic energy range, PSDs show high-energy dependence, which can be corrected using spectra-weighted mass energy-absorption coefficients, showing no considerable sign of quenching between these energies. Correction factors obtained by Monte Carlo simulations confirm that the approximations made by LCT corrections are valid. Thus, PSDs could be useful for real-time dosimetry in radiology applications.« less

Design and dosimetry characteristics of a commercial applicator system for intra-operative electron beam therapy utilizing ELEKTA Precise accelerator.

PubMed

Nevelsky, Alexander; Bernstein, Zvi; Bar-Deroma, Raquel; Kuten, Abraham; Orion, Itzhak

2010-07-19

The design concept and dosimetric characteristics of a new applicator system for intraoperative radiation therapy (IORT) are presented in this work. A new hard-docking commercial system includes polymethylmethacrylate (PMMA) applicators with different diameters and applicator end angles and a set of secondary lead collimators. A telescopic device allows changing of source-to-surface distance (SSD). All measurements were performed for 6, 9, 12 and 18 MeV electron energies. Output factors and percentage depth doses (PDD) were measured in a water phantom using a plane-parallel ion chamber. Isodose contours and radiation leakage were measured using a solid water phantom and radiographic films. The dependence of PDD on SSD was checked for the applicators with the smallest and the biggest diameters. SSD dependence of the output factors was measured. Hardcopies of PDD and isodose contours were prepared to help the team during the procedure on deciding applicator size and energy to be chosen. Applicator output factors are a function of energy, applicator size and applicator type. Dependence of SSD correction factors on applicator size and applicator type was found to be weak. The same SSD correction will be applied for all applicators in use for each energy. The radiation leakage through the applicators is clinically acceptable. The applicator system enables effective collimation of electron beams for IORT. The data presented are sufficient for applicator, energy and monitor unit selection for IORT treatment of a patient.

Characterization and attenuation study on tannin-added Rhizophora spp. particleboard at high energy photon and electron

NASA Astrophysics Data System (ADS)

Yusof, Mohd Fahmi Mohd; Hamid, Puteri Nor Khatijah Abd; Tajuddin, Abd Aziz; Abdullah, Reduan; Hashim, Rokiah; Bauk, Sabar; Isa, Norriza Mohd; Isa, Muhammad Jamal Md

2017-01-01

The effective atomic number of tannin-added Rhizophora spp. particleboards was determined based on elemental composition using Energy Dispersive X-ray Analysis (EDXA). The value of mass attenuation coefficients were measured using 137Cs and 60Co gamma energies. The attenuation properties of PDD curves and beam profile of tannin-added Rhizophora spp. particleboards were investigated using Gafchromic EBT2 film at 6 MV photon and 6 MeV electrons and compared to the value in water and solid water phantoms. The results showed that tannin-added Rhizophora spp. particleboards having effective atomic number close to the value of water. The mass attenuation coefficients were near to the value of water with χ2 values of 0.018 and 0.357 to 137Cs and 60Co gamma energies respectively. The PDD of tannin-added Rhizophora spp. particleboards at 6 MV photons showed good agreement within 3.21 and 5.91% to that in solid water phantoms and water respectively. The PDD at 6 MeV electrons showed a good agreement within 3.32 and 3.12% to that in solid water phantoms and water respectively. The depth of R50 and R90 in tannin-added Rhizophora spp. also showed a good agreement to that in water and solid water pahtoms. Lower surface dose was observed in tannin-added Rhizophora spp. particleboards at electron beams in comparison to solid water phantoms and water.

Toward acquiring comprehensive radiosurgery field commissioning data using the PRESAGE®/ optical-CT 3D dosimetry system

NASA Astrophysics Data System (ADS)

Clift, Corey; Thomas, Andrew; Adamovics, John; Chang, Zheng; Das, Indra; Oldham, Mark

2010-03-01

Achieving accurate small field dosimetry is challenging. This study investigates the utility of a radiochromic plastic PRESAGE® read with optical-CT for the acquisition of radiosurgery field commissioning data from a Novalis Tx system with a high-definition multileaf collimator (HDMLC). Total scatter factors (Sc, p), beam profiles, and penumbrae were measured for five different radiosurgery fields (5, 10, 20, 30 and 40 mm) using a commercially available optical-CT scanner (OCTOPUS, MGS Research). The percent depth dose (PDD), beam profile and penumbra of the 10 mm field were also measured using a higher resolution in-house prototype CCD-based scanner. Gafchromic EBT® film was used for independent verification. Measurements of Sc, p made with PRESAGE® and film agreed with mini-ion chamber commissioning data to within 4% for every field (range 0.2-3.6% for PRESAGE®, and 1.6-3.6% for EBT). PDD, beam profile and penumbra measurements made with the two PRESAGE®/optical-CT systems and film showed good agreement with the high-resolution diode commissioning measurements with a competitive resolution (0.5 mm pixels). The in-house prototype optical-CT scanner allowed much finer resolution compared with previous applications of PRESAGE®. The advantages of the PRESAGE® system for small field dosimetry include 3D measurements, negligible volume averaging, directional insensitivity, an absence of beam perturbations, energy and dose rate independence.

Toward acquiring comprehensive radiosurgery field commissioning data using the PRESAGE®/optical-CT 3D dosimetry system

PubMed Central

Clift, Corey; Thomas, Andrew; Adamovics, John; Chang, Zheng; Das, Indra; Oldham, Mark

2010-01-01

Achieving accurate small field dosimetry is challenging. This study investigates the utility of a radiochromic plastic PRESAGE® read with optical-CT for the acquisition of radiosurgery field commissioning data from a Novalis Tx system with a high-definition multileaf collimator (HDMLC). Total scatter factors (Sc, p), beam profiles, and penumbrae were measured for five different radiosurgery fields (5, 10, 20, 30 and 40 mm) using a commercially available optical-CT scanner (OCTOPUS, MGS Research). The percent depth dose (PDD), beam profile and penumbra of the 10 mm field were also measured using a higher resolution in-house prototype CCD-based scanner. Gafchromic EBT® film was used for independent verification. Measurements of Sc, p made with PRESAGE® and film agreed with mini-ion chamber commissioning data to within 4% for every field (range 0.2–3.6% for PRESAGE®, and 1.6–3.6% for EBT). PDD, beam profile and penumbra measurements made with the two PRESAGE®/optical-CT systems and film showed good agreement with the high-resolution diode commissioning measurements with a competitive resolution (0.5 mm pixels). The in-house prototype optical-CT scanner allowed much finer resolution compared with previous applications of PRESAGE®. The advantages of the PRESAGE® system for small field dosimetry include 3D measurements, negligible volume averaging, directional insensitivity, an absence of beam perturbations, energy and dose rate independence. PMID:20134082

SU-E-T-781: Using An Electronic Portal Imaging Device (EPID) for Correlating Linac Photon Beam Energies

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

Yaddanapudi, S; Cai, B; Sun, B

2015-06-15

Purpose: Electronic portal imaging devices (EPIDs) have proven to be useful for measuring several parameters of interest in linear accelerator (linac) quality assurance (QA). The purpose of this project was to evaluate the feasibility of using EPIDs for determining linac photon beam energies. Methods: Two non-clinical Varian TrueBeam linacs (Varian Medical Systems, Palo Alto, CA) with 6MV and 10MV photon beams were used to perform the measurements. The linacs were equipped with an amorphous silicon based EPIDs (aSi1000) that were used for the measurements. We compared the use of flatness versus percent depth dose (PDD) for predicting changes in linacmore » photon beam energy. PDD was measured in 1D water tank (Sun Nuclear Corporation, Melbourne FL) and the profiles were measured using 2D ion-chamber array (IC-Profiler, Sun Nuclear) and the EPID. Energy changes were accomplished by varying the bending magnet current (BMC). The evaluated energies conformed with the AAPM TG142 tolerance of ±1% change in PDD. Results: BMC changes correlating with a ±1% change in PDD corresponded with a change in flatness of ∼1% to 2% from baseline values on the EPID. IC Profiler flatness values had the same correlation. We observed a similar trend for the 10MV beam energy changes. Our measurements indicated a strong correlation between changes in linac photon beam energy and changes in flatness. For all machines and energies, beam energy changes produced change in the uniformity (AAPM TG-142), varying from ∼1% to 2.5%. Conclusions: EPID image analysis of beam profiles can be used to determine linac photon beam energy changes. Flatness-based metrics or uniformity as defined by AAPM TG-142 were found to be more sensitive to linac photon beam energy changes than PDD. Research funding provided by Varian Medical Systems. Dr. Sasa Mutic receives compensation for providing patient safety training services from Varian Medical Systems, the sponsor of this study.« less

Dosimetric studies of cadmium free alloy used in compensator based intensity modulated radiotherapy

NASA Astrophysics Data System (ADS)

Kaushik, Sandeep; Punia, Rajesh; Tyagi, Atul; Singh, Mann P.

2017-10-01

Aim of this study was to investigate dosimetric properties of cadmium free alloy which is used in compensator based intensity modulated radiotherapy (cIMRT). A mixture of lead, bismuth and tin was used to prepare the alloy whose melting point is 90-95 °C. Slabs of different thicknesses ranging from 0.71 cm to 6.14 cm were prepared. Density of alloy was measured by Archimedes' principle using water. For six megavolt (6 MV) photon beam energy transmission, linear effective attenuation coefficient (μeff), tissue phantom ratio (TPR1020), beam hardening, surface dose (Ds), percentage depth dose (PDD) and effect of scatter has been measured and analyzed for different field sizes and different thickness of compensator. Effect of extended source to detector distance (SDD) on transmissions and μeff was measured. The density of alloy was found to be 9.5456 g/cm3. At SDD of 100 cm, μeff was observed 0.4253 cm-1 for a field size of 10×10 cm 2. Calculated TPR1020 was found to be within 3% of experimental TPR1020 . It was found to be increasing with increasing thickness of compensator. Ds was found to decrease with thickness of compensator and increase with wider collimator opening due to increased scattered dose. Compensator slabs of 1 cm, 1.98 cm and 4.16 cm decreased surface dose by 4.2%, 6.1% and 9.5% respectively for a field size of 10×10 cm2 at 100 cm SDD. For small field size of 3×3 cm2 and 5×5 cm2 PDDs are increased from 3.0% to 5.5% of open beam PDDs as compensator thickness increased from 1 cm to 6.14 cm at a depth of 10 cm in water while variation in PDD is insignificant in for larger field sizes 10×10 cm2 to 20×20 cm2. A high degree of intensity modulation is essential in cIMRT and it can be achieved with this compensator material. Dosimetric properties analyzed in this study establish this alloy as a reliable, reusable, optimally dense and cost effective compensator material.

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

Capacio, B.R.; Harris, L.W.; Anderson, D.R.

The accelerating rotarod was used to assess motor performance decrement in rats after administration of candidate anticonvulsant compounds (acetazolamide, amitriptyline, chlordiazepoxide, diazepan, diazepam-lysine, lorazepam, loprazolam, midazolam, phenobarbital and scopolamine) against nerve agent poisoning. AH compounds were tested as the commercially available injectable preparation except for diazepam-lysine and loprazolam, which are not FDA approved. A peak effect time, as well as a dose to decrease performance time by 50% from control (PDD50), was determined. The calculated PDD50 (micrometer ol/kg) values and peak effect tunes were midazolam, 1.16 at 15 min; loprazolam, 1.17 at 15 min; diazepam-lysine, 4.17 at 30 min; lorazepwn,more » 4.98 at 15 min; diazepam, 5.27 at 15 min; phenobarbital, 101.49 at 45 min; chlordiazepoxide, 159.21 at 30 min; scopolamine, amitriptyline and acetazolamide did not demonstrate a performance decrement at any of the doses tested. The PDD50 values were compared with doses which have been utilized against nerve agent-induced convulsions or published ED50 values from standard anticonvulsant screening tests (maximal electroshock MES and subcutaneous pentylenetetrazol (scMET)). I serve agents, anticonvulsants, diazepam, accelerating rotarod, motor performance.« less

Novel PDD-PDT system based on spectrophotometric real-time fluorescence monitoring and MALDI-TOF-MS analysis of tumors

NASA Astrophysics Data System (ADS)

Yoshida, Takato O.; Kohno, Eiji; Dodeller, Marc; Sakurai, Takashi; Yamamoto, Seiji; Terakawa, Susumu

2009-06-01

In the PDT practice for tumor patients, the dose and irradiation time for the treatment are chosen by experience and not by real need. To establish advanced PDD-PDT model system for patients, we developed a method for monitoring the cell-death based on a spectrophotometric real-time change in fluorescence in HeLa-tumors during Photofrin®-PDT and ALA-PDT. Here, we describe the results of application of the new PDD-PDT system to human tumors. The fluorescence spectra obtained from human tumors were analyzed by the differential spectral analysis. The mass-spectral changes of tumor tissues during PDD-PDT were also examined by MALDI-TOF-MS/MS. The first author's seborrheic keratosis was monitored with this system during the PDD-PDT with a topically applied ALA-ointment. The changes in fluorescence spectrum were successfully detected, and the tumor regressed completely within 5 months. The differential spectral analysis of PDD-PDT-fluorescence monitoring spectra of tumors and isolated mitochondria showed a marked decrease of three peaks in the red region indicative of the PDD (600 - 720 nm), and a transient rise followed by a decline of peaks in the green region indicative of the PDT (450 - 580 nm). The MALDI-TOF-MS analysis of PDD-PDT HeLa-tumors showed a consumption of Photofrin-deuteroporphyrin and ALA-PpIX, and decreases in protein mass in the range of 4,000 - 16,000 Da, m/z 4929, 8564, 10089, 15000, and an increase in m/z 7002 in a Photofrin® PDD-PDT monitoring tumor.

True beam commissioning experience at Nordland Hospital Trust, Norway

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

Daci, Lulzime, E-mail: lulzime.daci@nodlandssykehuset.no; Malkaj, Partizan, E-mail: malkaj-p@hotmail.com

To evaluate the measured of all photon beam data of first Varian True Beam version 2.0 slim model, recently commissioned at Nordland Hospital Trust, Bodø. To compare and evaluate the possibility of beam matching with the Clinac2300, for the energies of 6MV and 15 MV. Materials/Methods: Measurements of PDD, OAR, and Output factors were realized with the IBA Blue-phantom with different detectors and evaluated between them for all photon energies: 6MV, 15MV, 6MV FFF and 10MV FFF. The ionization chambers used were Pin Point CC01, CC04, Semiflex CC13 and photon diode by Iba dosimetry. The data were processed using Beizermore » algorithm with a resolution of 1 mm. The measured depth dose curves, diagonals, OAR, and output factors were imported into Eclipse in order to calculate beam data for the anisotropic analytical algorithm (AAA version 10.0.28) for both the dataset measured with CC04 and CC13 and compared. The model head of 23EX was selected as the most near model to True Beam as a restriction of our version of Aria. It was seen that better results were achieved with the CC04 measured data as a result of better resolution. For the biggest field after 10 cm depth a larger difference is seen between measured and calculated for both dataset, but it is within the criteria for acceptance. Results: The Beam analysis criteria of 2 mm at 50% dose is achieved for all the fields accept for 40x40 that is within 3%. Depth difference at maximum dose is within 1 mm for all the fields and dose difference at 100 mm and 200 mm is lower than 1% for or all the fields. The PDD between two machines for all the fields differ after Dmax with less than 1%. For profiles in the field zone and outside field the difference is within 1% for all the fields. In the penumbra region the difference is from 2% up to 12% for big fields. As for diagonals they differ as a result of the head construction at the edge of the field and the penumbra region. The output factors differ for big fields within 5% and for the small fields within 3%. MU and dose distribution does not change for plans recalculated with the new modeled machine.« less

Calibration of EBT2 film by the PDD method with scanner non-uniformity correction.

PubMed

Chang, Liyun; Chui, Chen-Shou; Ding, Hueisch-Jy; Hwang, Ing-Ming; Ho, Sheng-Yow

2012-09-21

The EBT2 film together with a flatbed scanner is a convenient dosimetry QA tool for verification of clinical radiotherapy treatments. However, it suffers from a relatively high degree of uncertainty and a tedious film calibration process for every new lot of films, including cutting the films into several small pieces, exposing with different doses, restoring them back and selecting the proper region of interest (ROI) for each piece for curve fitting. In this work, we present a percentage depth dose (PDD) method that can accurately calibrate the EBT2 film together with the scanner non-uniformity correction and provide an easy way to perform film dosimetry. All films were scanned before and after the irradiation in one of the two homemade 2 mm thick acrylic frames (one portrait and the other landscape), which was located at a fixed position on the scan bed of an Epson 10 000XL scanner. After the pre-irradiated scan, the film was placed parallel to the beam central axis and sandwiched between six polystyrene plates (5 cm thick each), followed by irradiation of a 20 × 20 cm² 6 MV photon beam. Two different beams on times were used on two different films to deliver a dose to the film ranging from 32 to 320 cGy. After the post-irradiated scan, the net optical densities for a total of 235 points on the beam central axis on the films were auto-extracted and compared with the corresponding depth doses that were calculated through the measurement of a 0.6 cc farmer chamber and the related PDD table to perform the curve fitting. The portrait film location was selected for routine calibration, since the central beam axis on the film is parallel to the scanning direction, where non-uniformity correction is not needed (Ferreira et al 2009 Phys. Med. Biol. 54 1073-85). To perform the scanner non-uniformity calibration, the cross-beam profiles of the film were analysed by referencing the measured profiles from a Profiler™. Finally, to verify our method, the films were exposed to 60° physical wedge fields and the compositive fields, and their relative dose profiles were compared with those from the water phantom measurement. The fitting uncertainty was less than 0.5% due to the many calibration points, and the overall calibration uncertainty was within 3% for doses above 50 cGy, when the average of four films were used for the calibration. According to our study, the non-uniformity calibration factor was found to be independent of the given dose for the EBT2 film and the relative dose differences between the profiles measured by the film and the Profiler were within 1.5% after applying the non-uniformity correction. For the verification tests, the relative dose differences between the measurements by films and in the water phantom, when the average of three films were used, were generally within 3% for the 60° wedge fields and compositive fields, respectively. In conclusion, our method is convenient, time-saving and cost-effective, since no film cutting is needed and only two films with two exposures are needed.

Calculation of organ doses from breast cancer radiotherapy: a Monte Carlo study

PubMed Central

Berris, T.; Mazonakis, M.; Stratakis, J.; Tzedakis, A.; Fasoulaki, A.

2013-01-01

The current study aimed to: a) utilize Monte Carlo simulation methods for the assessment of radiation doses imparted to all organs at risk to develop secondary radiation induced cancer, for patients undergoing radiotherapy for breast cancer; and b) evaluate the effect of breast size on dose to organs outside the irradiation field. A simulated linear accelerator model was generated. The in‐field accuracy of the simulated photon beam properties was verified against percentage depth dose (PDD) and dose profile measurements on an actual water phantom. Off‐axis dose calculations were verified with thermoluminescent dosimetry (TLD) measurements on a humanoid physical phantom. An anthropomorphic mathematical phantom was used to simulate breast cancer radiotherapy with medial and lateral fields. The effect of breast size on the calculated organ dose was investigated. Local differences between measured and calculated PDDs and dose profiles did not exceed 2% for the points at depths beyond the depth of maximum dose and the plateau region of the profile, respectively. For the penumbral regions of the dose profiles, the distance to agreement (DTA) did not exceed 2 mm. The mean difference between calculated out‐of‐field doses and TLD measurements was 11.4%±5.9%. The calculated doses to peripheral organs ranged from 2.32 cGy up to 161.41 cGy depending on breast size and thus the field dimensions applied, as well as the proximity of the organs to the primary beam. An increase to the therapeutic field area by 50% to account for the large breast led to a mean organ dose elevation by up to 85.2% for lateral exposure. The contralateral breast dose ranged between 1.4% and 1.6% of the prescribed dose to the tumor. Breast size affects dose deposition substantially. PACS numbers: 87.10.rt, 87.56.bd, 87.53.Bn, 87.55.K‐, 87.55.ne, 87.56.jf, 87.56.J‐ PMID:23318389

Comparison of selected dose calculation algorithms in radiotherapy treatment planning for tissues with inhomogeneities

NASA Astrophysics Data System (ADS)

Woon, Y. L.; Heng, S. P.; Wong, J. H. D.; Ung, N. M.

2016-03-01

Inhomogeneity correction is recommended for accurate dose calculation in radiotherapy treatment planning since human body are highly inhomogeneous with the presence of bones and air cavities. However, each dose calculation algorithm has its own limitations. This study is to assess the accuracy of five algorithms that are currently implemented for treatment planning, including pencil beam convolution (PBC), superposition (SP), anisotropic analytical algorithm (AAA), Monte Carlo (MC) and Acuros XB (AXB). The calculated dose was compared with the measured dose using radiochromic film (Gafchromic EBT2) in inhomogeneous phantoms. In addition, the dosimetric impact of different algorithms on intensity modulated radiotherapy (IMRT) was studied for head and neck region. MC had the best agreement with the measured percentage depth dose (PDD) within the inhomogeneous region. This was followed by AXB, AAA, SP and PBC. For IMRT planning, MC algorithm is recommended for treatment planning in preference to PBC and SP. The MC and AXB algorithms were found to have better accuracy in terms of inhomogeneity correction and should be used for tumour volume within the proximity of inhomogeneous structures.

Commissioning Varian enhanced dynamic wedge in the PINNACLE treatment planning system using Gafchromic EBT film.

PubMed

Fontanarosa, Davide; Orlandini, Lucia Clara; Andriani, Italo; Bernardi, Luca

2009-10-01

In external photon beam therapies, the technique of dynamic wedge is a well established method for dose inhomogeneity compensation. The introduction of the enhanced dynamic wedge (EDW) on Varian LINACs considerably improved the pre-existing techniques. In the process of commissioning a Varian LINAC into a PINNACLE3 treatment planning system (TPS), the user is required to import quite a few measurements of EDW profiles and percentage depth doses (PDDs). Standard measurement devices like ionization chambers in a water phantom are not the most indicated ones for this situation where each measurement point is obtained by integrating during the entire exposure: Measurements would result to be a very laborious and time consuming operation, most of the times not practically possible. The goal of the present work is to introduce an alternative and hands-on procedure to perform the measurements using a combination of GafchromicTM EBT films, irradiated sideways in one single shot for both profiles and PDDs, and a single standard ionization chamber. The scanned profiles obtained at different depths have easily been imported in the TPS; for the PDD measurements, a correction was proven necessary to account for a "self-shielding" effect introduced by the presence of the films themselves, when irradiated sideways, resulting in an underestimation of the dose at deeper depths. A correction curve was derived comparing TPS open field validated measurements with the curves extracted from GafchromicTM EBT films. Finally, the curve was applied to all the wedged fields PDD measurements and could minimize the errors. The comparison for the 15 MV photon beam between the measured and the calculated 48 profiles and 12 PDDs (field sizes from 5 x 5 to 20 x 20 cm2, wedge angles ranging from 15 degrees to 60 degrees) was acceptable. The confidence limit (CL) was used as fit indicator, as suggested by the ESTRO Booklet No. 7: For the investigated PDDs the maximum value was 6.40 in the build up region and 2.83 beyond the maximum dose point; regarding cross beam profiles, the CLs were below 3 for 85% of the points within the field and for 96% of the points outside the field; in the penumbra region, a more appropriate parameter to evaluate the agreement between calculated and measured doses is the distance to agreement; only 73% of the profiles had CLs below 15, but for the remaining ones, distance-to-agreement values were within 3 mm. A hundred ionization chamber point dose measurements (for square and elongated fields at different depth and for points in field and out of field) were performed in a water phantom and 98 of them confirmed the TPS calculations with differences lower than 3% and considerably lower in most of the cases. This article gives valuable guidance and insight to other physicists attempting to approach EDW commissioning in the PINNACLE TPS software using Gafchromic EBT films.

Final Aperture Superposition Technique applied to fast calculation of electron output factors and depth dose curves

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

Faddegon, B.A.; Villarreal-Barajas, J.E.; Mt. Diablo Regional Cancer Center, 2450 East Street, Concord, California

2005-11-15

The Final Aperture Superposition Technique (FAST) is described and applied to accurate, near instantaneous calculation of the relative output factor (ROF) and central axis percentage depth dose curve (PDD) for clinical electron beams used in radiotherapy. FAST is based on precalculation of dose at select points for the two extreme situations of a fully open final aperture and a final aperture with no opening (fully shielded). This technique is different than conventional superposition of dose deposition kernels: The precalculated dose is differential in position of the electron or photon at the downstream surface of the insert. The calculation for amore » particular aperture (x-ray jaws or MLC, insert in electron applicator) is done with superposition of the precalculated dose data, using the open field data over the open part of the aperture and the fully shielded data over the remainder. The calculation takes explicit account of all interactions in the shielded region of the aperture except the collimator effect: Particles that pass from the open part into the shielded part, or visa versa. For the clinical demonstration, FAST was compared to full Monte Carlo simulation of 10x10,2.5x2.5, and 2x8 cm{sup 2} inserts. Dose was calculated to 0.5% precision in 0.4x0.4x0.2 cm{sup 3} voxels, spaced at 0.2 cm depth intervals along the central axis, using detailed Monte Carlo simulation of the treatment head of a commercial linear accelerator for six different electron beams with energies of 6-21 MeV. Each simulation took several hours on a personal computer with a 1.7 Mhz processor. The calculation for the individual inserts, done with superposition, was completed in under a second on the same PC. Since simulations for the pre calculation are only performed once, higher precision and resolution can be obtained without increasing the calculation time for individual inserts. Fully shielded contributions were largest for small fields and high beam energy, at the surface, reaching a maximum of 5.6% at 21 MeV. Contributions from the collimator effect were largest for the large field size, high beam energy, and shallow depths, reaching a maximum of 4.7% at 21 MeV. Both shielding contributions and the collimator effect need to be taken into account to achieve an accuracy of 2%. FAST takes explicit account of the shielding contributions. With the collimator effect set to that of the largest field in the FAST calculation, the difference in dose on the central axis (product of ROF and PDD) between FAST and full simulation was generally under 2%. The maximum difference of 2.5% exceeded the statistical precision of the calculation by four standard deviations. This occurred at 18 MeV for the 2.5x2.5 cm{sup 2} field. The differences are due to the method used to account for the collimator effect.« less

Commissioning of a Varian Clinac iX 6 MV photon beam using Monte Carlo simulation

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

Dirgayussa, I Gde Eka, E-mail: ekadirgayussa@gmail.com; Yani, Sitti; Haryanto, Freddy, E-mail: freddy@fi.itb.ac.id

2015-09-30

Monte Carlo modelling of a linear accelerator is the first and most important step in Monte Carlo dose calculations in radiotherapy. Monte Carlo is considered today to be the most accurate and detailed calculation method in different fields of medical physics. In this research, we developed a photon beam model for Varian Clinac iX 6 MV equipped with MilleniumMLC120 for dose calculation purposes using BEAMnrc/DOSXYZnrc Monte Carlo system based on the underlying EGSnrc particle transport code. Monte Carlo simulation for this commissioning head LINAC divided in two stages are design head Linac model using BEAMnrc, characterize this model using BEAMDPmore » and analyze the difference between simulation and measurement data using DOSXYZnrc. In the first step, to reduce simulation time, a virtual treatment head LINAC was built in two parts (patient-dependent component and patient-independent component). The incident electron energy varied 6.1 MeV, 6.2 MeV and 6.3 MeV, 6.4 MeV, and 6.6 MeV and the FWHM (full width at half maximum) of source is 1 mm. Phase-space file from the virtual model characterized using BEAMDP. The results of MC calculations using DOSXYZnrc in water phantom are percent depth doses (PDDs) and beam profiles at depths 10 cm were compared with measurements. This process has been completed if the dose difference of measured and calculated relative depth-dose data along the central-axis and dose profile at depths 10 cm is ≤ 5%. The effect of beam width on percentage depth doses and beam profiles was studied. Results of the virtual model were in close agreement with measurements in incident energy electron 6.4 MeV. Our results showed that photon beam width could be tuned using large field beam profile at the depth of maximum dose. The Monte Carlo model developed in this study accurately represents the Varian Clinac iX with millennium MLC 120 leaf and can be used for reliable patient dose calculations. In this commissioning process, the good criteria of dose difference in PDD and dose profiles were achieve using incident electron energy 6.4 MeV.« less

SU-C-BRE-04: Microbeam-Radiation-Therapy (MRT): Characterizing a Novel MRT Device Using High Resolution 3D Dosimetry

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

Li, Q; Juang, T; Bache, S

2014-06-15

Purpose: The feasibility of MRT has recently been demonstrated utilizing a new technology of Carbon-Nano-Tube(CNT) field emission x-ray sources.This approach can deliver very high dose(10's of Gy) in narrow stripes(sub-mm) of radiation which enables the study of novel radiation treatment approaches. Here we investigate the application of highresolution (50um isotropic) PRESAGE/Optical-CT 3D dosimetry techniques to characterize the radiation delivered in this extremely dosimetrically challenging scenario. Methods: The CNT field emission x-ray source irradiator comprises of a linear cathode array and a novel collimator alignment system. This allows a precise delivery of high-energy small beams up to 160 kVp. A cylindricalmore » dosimeter (∼2.2cm in height ∼2.5cm in diameter) was irradiated by CNT MRT delivering 3 strips of radiation with a nominal entrance dose of 32 Gy.A second dosimeter was irradiated with similar entrance dose, with a regular x-ray irradiator collimated to microscopical strip-beams. 50um (isotropic) 3D dosimetry was performed using an in-house optical-CT system designed and optimized for high resolution imaging (including a stray light deconvolution correction).The percentage depth dose (PDD), peak-to-valley ratio (PVR) and beam width (FWHM) data were obtained and analyzed in both cases. Results: High resolution 3D images were successfully achieved with the prototype system, enabling extraction of PDD and dose profiles. The PDDs for the CNT irradiation showed pronounced attenuation, but less build-up effect than that from the multibeam irradiation. The beam spacing between the three strips has an average value of 0.9mm while that for the 13 strips is 1.5 mm at a depth of 16.5 mm. The stray light corrected image shows line profiles with reduced noise and consistent PVR values. Conclusion: MRT dosimetry is extremely challenging due to the ultra small fields involved.This preliminary application of a novel, ultra-high resolution, optical-CT 3D dosimetry system shows promise, but further work is required to validate and investigate accuracy and artifacts. This work was supported by NIH R01CA100835.« less

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

Alkhatib, H; Oves, S; Gebreamlak, W

Purpose: To investigate discrepancies between measured percent depth dose curves of a linear accelerator at depths beyond the commissioning data and those generated by the treatment planning system (TPS) via extrapolation. Methods: Relative depth doses were measured on an Elekta Synergy™ linac for photon beams of 6 -MV and 10-MV. SSDs for all curves were 100-cm and field sizes ranged from 4×4 to 35×35-cm{sup 2}. As most scanning tanks cannot provide depths greater than about 30-cm, percent depth dose measurements, extending 45-cm depths, were performed in Solid Water™ using a 0.125-cc ionization chamber (PTW model TN31012). The buildup regions ofmore » the curves were acquired with a parallel plate chamber (PTW model TN34001). Extrapolated curves were generated by the TPS (Phillips Pinnacle{sup 3} v. 9.6) by applying beams to CT images of 50-cm of Solid Water™ with density override set to 1.0-g/cc. Results: Percent difference between the two sets of curves (measured and TPS) was investigated. There is significant discrepancy in the buildup region to a depth of 7-mm. Beyond this depth, the two sets show good agreement. When analyzing the tail end of the curves, we saw percent difference of between 1.2% and 3.2%. The highest disagreement for the 6-MV curves was 10×10-cm{sup 2} (3%) and for the 10-MV curves it was the 35×35-cm{sup 2} (3.2%). Conclusion: A qualitative analysis of the measured data versus PDD curves generated by the TPS shows generally good agreement beyond 1-cm. However, a measurable percent difference was observed when comparing curves at depths beyond that provided by the commissioning data and at depths in the buildup region. Possible explanations for this include inaccuracies in modeling of the Solid Water™ or drift in beam energy since commissioning. Additionally, closer attention must be paid for measurements in the buildup region.« less

High Plasma Concentrations of Zidovudine (AZT) Do Not Parallel Intracellular Concentrations of AZT-Triphosphates in Infants During Prevention of Mother-to-Child HIV-1 Transmission.

PubMed

Kinai, Ei; Kato, Shingo; Hosokawa, Shinichi; Sadatsuki, Miyuki; Gatanaga, Hiroyuki; Kikuchi, Yoshimi; Lam, Nguyen Van; Ha, Do Quan; Kinh, Nguyen Van; Liem, Nguyen Thanh; Oka, Shinichi

2016-07-01

Zidovudine (AZT) is mainly used to prevent mother-to-child HIV-1 transmission (PMTCT). Despite serious concerns on AZT-associated toxicity, there is little information on pharmacokinetics of intracellular AZT metabolites in infants. We conducted a prospective study in 31 HIV-uninfected infants who received AZT for PMTCT. Blood samples were obtained from 14 infants on postdelivery days (PDD) 1, 7, 14, and 28 and from 17 infants at 0 and 4 hours after dosing on PDD-1. Plasma AZT concentrations (pAZT) and intracellular concentrations of AZT-monophosphate (icAZT-MP), diphosphate (icAZT-DP), and triphosphate (icAZT-TP) were determined. Plasma AZT and icAZT-MP concentrations were 2713 nmol/L and 79 fmol/10 cells in PDD-1, but decreased to 1437 nmol/L and 31 fmol/10 cells by PDD-28 (P = 0.02 and P = 0.07 for all PDDs, respectively), whereas those of icAZT-DP and icAZT-TP remained low throughout the sampling period (P = 0.29 and P = 0.61 for all PDDs, respectively) There were no differences in icAZT-TP between infants of the 2 mg/kg 4 times a day dose and 4 mg/kg twice daily dose (P = 0.25), whereas pAZT and icAZT-MP levels were higher in the latter (P < 0.01 and <0.01, respectively). The pAZT and icAZT-MP significantly increased from 0 to 4 hours after dosing (P < 0.001 and <0.001, respectively), whereas icAZT-DP, icAZT-TP levels were not changed (P = 0.41 and 0.33, respectively). The level of icAZT-TP did not change with age, time, or a single dose despite the wide range of pAZT concentration. A safer dosage needs to be determined because high pAZT levels do not parallel those of icAZT-TP.

Experimental induction of proventricular dilatation disease in cockatiels (Nymphicus hollandicus) inoculated with brain homogenates containing avian bornavirus 4

PubMed Central

Gancz, Ady Y; Kistler, Amy L; Greninger, Alexander L; Farnoushi, Yigal; Mechani, Sara; Perl, Shmuel; Berkowitz, Asaf; Perez, Noa; Clubb, Susan; DeRisi, Joseph L; Ganem, Don; Lublin, Avishai

2009-01-01

Background Proventricular dilatation disease (PDD) is a fatal disorder of psittacine birds worldwide. The disease is characterized by lymphoplasmacytic infiltration of the central and peripheral nervous systems, leading to gastrointestinal motility and/or central nervous system dysfunction. Recently, we detected a significant association between avian bornavirus (ABV) infection and clinical signs of PDD in psittacines. However, it remains unclear whether ABV infection actually causes PDD. To address this question, we examined the impact of ABV inoculation on the cockatiel (Nymphicus hollandicus). Results Five cockatiels were inoculated via multiple routes (intramuscular, intraocular, intranasal, and oral) with a brain homogenate derived from either a PDD(+) avian bornavirus 4 (ABV4) (+) case (n = 3 inoculees) or from a PDD(-) ABV(-) control (n = 2 inoculees). The control birds remained free of clinical or pathological signs of PDD, and tested ABV(-) by RT-PCR and immunohistochemistry (IHC). In contrast, all three cockatiels inoculated with ABV4(+) brain homogenate developed gross and microscopic PDD lesions, and two exhibited overt clinical signs. In numerous tissues, ABV RT-PCR and sequence analysis demonstrated the presence of ABV4 RNA nearly identical to that in the inoculum. ABV was detected in the central nervous system of the three ABV-inoculees by IHC. Pyrosequencing to investigate the viral flora in the ABV4(+) inoculum uncovered 7 unique reads sharing 73–100% nucleotide sequence identity with previously identified ABV sequences and 24 reads sharing 40–89% amino acid sequence identity with viruses in the Retroviridae and Astroviridae families. Of these candidate viral species, only ABV RNA was recovered from tissues of the inoculated birds. Conclusion In this study, the clinical and pathological manifestations of PDD were induced by inoculation of cockatiels with brain homogenates containing avian bornavirus 4. By using high throughput pyrosequencing an in-depth view of the viral content of the inoculum was achieved, revealing that of 3 candidate virus families detected, only the presence of ABV RNA correlated with the development of PDD. This study provides evidence of a causal association between ABV4 infection and PDD in cockatiels. PMID:19589169

SU-F-T-75: Dosimetry Considerations in the Use of Hanging-Eye Block for Lesions of the Conjunctiva

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

Grelewicz, Z; Lee, B; Cutright, D

Purpose: Superficial lesions in the conjunctiva are frequently treated with en face electrons, using a hanging block to spare dose to the lens of the eye. Dose to the tumor and lens depend on the design and setup of the block and supporting apparatus. We performed in phantom measurements in order to characterize the dose sparing effects of the block as well as the under-dosing effect under the supporting apparatus for 6 MeV treatment. Methods: The commercial hanging block studied uses a 1.2 cm diameter tungsten cylinder supported by a 3 mm diameter acrylic rod. Point dose measurements under themore » hanging block, under an unblocked part of the field, and under the acrylic rod were performed using MOSFET detectors. In addition, EBT3 film was used for both PDD and profile measurements at a depth in phantom of 3 mm for both 105 and 103 cm SSD. Results: MOSFET measurements reported a dose reduction of 95% under the tungsten block when using an SSD of 103 cm, and 86% when using an SSD of 105 cm at a depth in phantom of 3 mm. Film measurements showed that the area under the acrylic rod may be under-dosed by as much as 30% when using 103 SSD. MOSFET measurements confirmed that when using an SSD of 103 cm, the area under the acrylic rod is under-dosed by up to 30% at 3mm depth, compared to the unblocked part of the field. Conclusion: The effectiveness of the commercial hanging block apparatus depends on setup, with 95% lens sparing possible with an SSD of 103 cm. This short SSD is necessary for sharp penumbra. At this SSD, substantial under-dosing under the acrylic support rod is possible. This must be mitigated with either feathering, or using an alternative method of support for the tungsten block.« less

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

NASA Astrophysics Data System (ADS)

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

2015-03-01

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

Feasibility study of a lead(II) iodide-based dosimeter for quality assurance in therapeutic radiology

NASA Astrophysics Data System (ADS)

Heo, Y. J.; Kim, K. T.; Oh, K. M.; Lee, Y. K.; Ahn, K. J.; Cho, H. L.; Kim, J. Y.; Min, B. I.; Mun, C. W.; Park, S. K.

2017-09-01

The most widely used form of radiotherapy to treat tumors uses a linear accelerator, and the apparatus requires regular quality assurance (QA). QA for a linear accelerator demands accuracy throughout, from mock treatment and treatment planning, up to treatment itself. Therefore, verifying a radiation dose is essential to ensure that the radiation is being applied as planned. In current clinical practice, ionization chambers and diodes are used for QA. However, using conventional gaseous ionization chambers presents drawbacks such as complex analytical procedures, difficult measurement procedures, and slow response time. In this study, we discuss the potential of a lead(II) iodide (PbI2)-based radiation dosimeter for radiotherapy QA. PbI2 is a semiconductor material suited to measurements of X-rays and gamma rays, because of its excellent response properties to radiation signals. Our results show that the PbI2-based dosimeter offers outstanding linearity and reproducibility, as well as dose-independent characteristics. In addition, percentage depth dose (PDD) measurements indicate that the error at a fixed reference depth Dmax was 0.3%, very similar to the measurement results obtained using ionization chambers. Based on these results, we confirm that the PbI2-based dosimeter has all the properties required for radiotherapy: stable dose detection, dose linearity, and rapid response time. Based on the evidence of this experimental verification, we believe that the PbI2-based dosimeter could be used commercially in various fields for precise measurements of radiation doses in the human body and for measuring the dose required for stereotactic radiosurgery or localized radiosurgery.

Beam characterisation of the 1.5 T MRI-linac

NASA Astrophysics Data System (ADS)

Woodings, S. J.; Bluemink, J. J.; de Vries, J. H. W.; Niatsetski, Y.; van Veelen, B.; Schillings, J.; Kok, J. G. M.; Wolthaus, J. W. H.; Hackett, S. L.; van Asselen, B.; van Zijp, H. M.; Pencea, S.; Roberts, D. A.; Lagendijk, J. J. W.; Raaymakers, B. W.

2018-04-01

As a prerequisite for clinical treatments it was necessary to characterize the Elekta 1.5 T MRI-linac 7 MV FFF radiation beam. Following acceptance testing, beam characterization data were acquired with Semiflex 3D (PTW 31021), microDiamond (PTW 60019), and Farmer-type (PTW 30013 and IBA FC65-G) detectors in an Elekta 3D scanning water phantom and a PTW 1D water phantom. EBT3 Gafchromic film and ion chamber measurements in a buildup cap were also used. Special consideration was given to scan offsets, detector effective points of measurement and avoiding air gaps. Machine performance has been verified and the system satisfied the relevant beam requirements of IEC60976. Beam data were acquired for field sizes between 1  ×  1 and 57  ×  22 cm2. New techniques were developed to measure percentage depth dose (PDD) curves including the electron return effect at beam exit, which exhibits an electron-type practical range of cm. The Lorentz force acting on the secondary charged particles creates an asymmetry in the crossline profiles with an average shift of  +0.24 cm. For a 10  ×  10 cm2 beam, scatter from the cryostat contributes 1% of the dose at isocentre. This affects the relative output factors, scatter factors and beam profiles, both in-field and out-of-field. The average 20%–80% penumbral width measured for small fields with a microDiamond detector at 10 cm depth is 0.50 cm. MRI-linac penumbral widths are very similar to that of the Elekta Agility linac MLC, as is the near-surface dose PDD(0.2 cm)  =  57%. The entrance surface dose is  ∼36% of . Cryostat transmission is quantified for inclusion within the treatment planning system. As a result, the 1.5 T MRI-linac 7 MV FFF beam has been characterised for the first time and is suitable for clinical use. This was a key step towards the first clinical treatments with the MRI-linac, which were delivered at University Medical Center Utrecht in May 2017 (Raaymakers et al 2017 Phys. Med. Biol. 62 L41–50).

Laser welding of polymers: phenomenological model for a quick and reliable process quality estimation considering beam shape influences

NASA Astrophysics Data System (ADS)

Timpe, Nathalie F.; Stuch, Julia; Scholl, Marcus; Russek, Ulrich A.

2016-03-01

This contribution presents a phenomenological, analytical model for laser welding of polymers which is suited for a quick process quality estimation for the practitioner. Besides material properties of the polymer and processing parameters like welding pressure, feed rate and laser power the model is based on a simple few parameter description of the size and shape of the laser power density distribution (PDD) in the processing zone. The model allows an estimation of the weld seam tensile strength. It is based on energy balance considerations within a thin sheet with the thickness of the optical penetration depth on the surface of the absorbing welding partner. The joining process itself is modelled by a phenomenological approach. The model reproduces the experimentally known process windows for the main process parameters correctly. Using the parameters describing the shape of the laser PDD the critical dependence of the process windows on the PDD shape will be predicted and compared with experiments. The adaption of the model to other laser manufacturing processes where the PDD influence can be modelled comparably will be discussed.

TU-H-BRC-08: Use and Validation of Flexible 3D Printed Tissue Compensators for Post-Mastectomy Radiation Therapy

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

Craft, D; Kry, S; Salehpour, M

Purpose: Patient-specific tissue equivalent compensators can be used for post-mastectomy radiation therapy (PMRT) to achieve homogenous dose distributions with single-field treatments. However, current fabrication methods are time consuming and expensive. 3D-printing technology could overcome these limitations. The purposes of this study were to [1] evaluate materials for 3D-printed compensators [2] design and print a compensator to achieve a uniform thickness to a clinical target volume (CTV), and [3] demonstrate that a single-field electron compensator plan is a clinically feasible treatment option for PMRT. Methods: Blocks were printed with three materials; print accuracy, density, Hounsfield units (HU), and percent depth dosesmore » (PDD) were evaluated. For a CT scan of an anthropomorphic phantom, we used a ray-tracing method to design a compensator that achieved uniform thickness from compensator surface to CTV. The compensator was printed with flexible tissue equivalent material whose physical and radiological properties were most similar to soft tissue. A single-field electron compensator plan was designed and compared with two standard-of-care techniques. The compensator plan was validated with thermoluminescent dosimeter (TLD) measurements. Results: We identified an appropriate material for 3D-printed compensators that had high print accuracy (99.6%) and was similar to soft tissue; density was 1.04, HU was - 45 ± 43, and PDD curves agreed with clinical curves within 3 mm. We designed and printed a compensator that conformed well to the phantom surface and created a uniform thickness to the CTV. In-house fabrication was simple and inexpensive (<$75). Compared with the two standard plans, the compensator plan resulted in overall more homogeneous dose distributions and performed similarly in terms of lung/heart doses and 90% isodose coverage of the CTV. TLD measurements agreed well with planned doses (within 5 %). Conclusions: We have demonstrated that 3D-printed compensators make single-field electron therapy a clinically feasible treatment option for PMRT.« less

Experimental determination of the effective point of measurement of cylindrical ionization chambers for high-energy photon and electron beams.

PubMed

Huang, Yanxiao; Willomitzer, Christian; Zakaria, Golam Abu; Hartmann, Guenther H

2010-01-01

Measurements of depth-dose curves in water phantom using a cylindrical ionization chamber require that its effective point of measurement is located at the measuring depth. Recommendations for the position of the effective point of measurement with respect to the central axis valid for high-energy electron and photon beams are given in dosimetry protocols. According to these protocols, the use of a constant shift P(eff) is currently recommended. However, this is still based on a very limited set of experimental results. It is therefore expected that an improved knowledge of the exact position of the effective point of measurement will further improve the accuracy of dosimetry. Recent publications have revealed that the position of the effective point of measurement is indeed varying with beam energy, field size and also with chamber geometry. The aim of this study is to investigate whether the shift of P(eff) can be taken to be constant and independent from the beam energy. An experimental determination of the effective point of measurement is presented based on a comparison between cylindrical chambers and a plane-parallel chamber using conventional dosimetry equipment. For electron beams, the determination is based on the comparison of halfvalue depth R(50) between the cylindrical chamber of interest and a well guarded plane-parallel Roos chamber. For photon beams, the depth of dose maximum, d(max), the depth of 80% dose, d(80), and the dose parameter PDD(10) were used. It was again found that the effective point of measurement for both, electron and photon beams Dosimetry, depends on the beam energy. The deviation from a constant value remains very small for photons, whereas significant deviations were found for electrons. It is therefore concluded that use of a single upstream shift value from the centre of the cylindrical chamber as recommended in current dosimetry protocols is adequate for photons, however inadequate for accurate electron beam dosimetry.

SU-E-T-577: Commissioning of a Deterministic Algorithm for External Photon Beams

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

Zhu, T; Finlay, J; Mesina, C

Purpose: We report commissioning results for a deterministic algorithm for external photon beam treatment planning. A deterministic algorithm solves the radiation transport equations directly using a finite difference method, thus improve the accuracy of dose calculation, particularly under heterogeneous conditions with results similar to that of Monte Carlo (MC) simulation. Methods: Commissioning data for photon energies 6 – 15 MV includes the percentage depth dose (PDD) measured at SSD = 90 cm and output ratio in water (Spc), both normalized to 10 cm depth, for field sizes between 2 and 40 cm and depths between 0 and 40 cm. Off-axismore » ratio (OAR) for the same set of field sizes was used at 5 depths (dmax, 5, 10, 20, 30 cm). The final model was compared with the commissioning data as well as additional benchmark data. The benchmark data includes dose per MU determined for 17 points for SSD between 80 and 110 cm, depth between 5 and 20 cm, and lateral offset of up to 16.5 cm. Relative comparisons were made in a heterogeneous phantom made of cork and solid water. Results: Compared to the commissioning beam data, the agreement are generally better than 2% with large errors (up to 13%) observed in the buildup regions of the FDD and penumbra regions of the OAR profiles. The overall mean standard deviation is 0.04% when all data are taken into account. Compared to the benchmark data, the agreements are generally better than 2%. Relative comparison in heterogeneous phantom is in general better than 4%. Conclusion: A commercial deterministic algorithm was commissioned for megavoltage photon beams. In a homogeneous medium, the agreement between the algorithm and measurement at the benchmark points is generally better than 2%. The dose accuracy for a deterministic algorithm is better than a convolution algorithm in heterogeneous medium.« less

SU-F-J-179: Commissioning Dosimetric Data of a New 2.5 Megavoltage Imaging Beam from a TrueBeam Linear

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

Ding, G

2016-06-15

Purpose: Recently a new 2.5 megavoltage imaging beam has become available in a TrueBeam linear accelerator for image guidance. There is limited information available related to the beam characteristics. Commissioning dosimetric data of the new imaging is necessary for configuration of the beam in a treatment planning system in order to calculate imaging doses to patients resulting from this new imaging beam. The purpose of this study is to provide measured commissioning data recommended for a beam configuration in a treatment planning system. Methods: A recently installed TrueBeam linear accelerator is equipped with a new low energy photon beam withmore » a nominal energy of 2.5 MV which provides better image quality in addition to other therapeutic megavoltage beams. Dosimetric characteristics of the 2.5 MV are measured for commissioning. An ionization chamber was used to measure dosimetric data including depth-dose curves and dose profiles at different depths for field sizes ranging from 5×5 cm{sup 2} to 40×40 cm{sup 2}. Results: Although the new 2.5 MV beam is a flattening-filter-free (FFF) beam, its dose profiles are much flatter compared to a 6 MV FFF beam. The dose decrease at 20 cm away from the central axis is less than 30% for a 40×40 cm{sup 2} field. This moderately lower dose at off-axis distances benefits the imaging quality. The values of percentage depth-dose (PDD) curves are 53% and 63% for 10×10 cm{sup 2} and 40×40 cm{sup 2} fields respectively. The measured beam output is 0.85 cGy/MU for a reference field size at depth 5 cm obtained according to the AAPM TG-51 protocol. Conclusion: This systematically measured commissioning data is useful for configuring the new imaging beam in a treatment planning system for patient imaging dose calculations resulting from the application of this 2.5 MV beam which is commonly set as a default in imaging procedures.« less

Lesion Formation and Antibody Response Induced by Papillomatous Digital Dermatitis-Associated Spirochetes in a Murine Abscess Model▿

PubMed Central

Elliott, Margaret K.; Alt, David P.; Zuerner, Richard L.

2007-01-01

Papillomatous digital dermatitis (PDD), also known as hairy heel wart, is a growing cause of lameness of cows in the U.S. dairy industry. Farms with PDD-afflicted cows experience economic loss due to treatment costs, decreased milk production, lower reproductive efficiency, and premature culling. While the exact cause of PDD is unknown, lesion development is associated with the presence of anaerobic spirochetes. This study was undertaken to investigate the virulence and antigenic relatedness of four previously isolated Treponema phagedenis-like spirochetes (1A, 3A, 4A, and 5B) by using a mouse abscess model with subcutaneous inoculation of 109, 1010, and 1011 spirochetes. Each of the PDD isolates induced abscess formation, with strain 3A causing cutaneous ulceration. Lesion development and antibody responses were dose dependent and differed significantly from those seen with the nonpathogenic human T. phagedenis strain. Strains 3A, 4A, and 5B showed two-way cross-reactivity with each other and a one-way cross-reaction with T. phagedenis. Strain 5B showed one-way cross-reactivity with 1A. None of the isolates showed cross-reactivity with T. denticola. In addition, distinct differences in immunoglobulin G subclass elicitation occurred between the PDD strains and T. phagedenis. From these data, we conclude that spirochetes isolated from PDD lesions have differential virulence and antigenic traits in vivo. Continuing investigation of these properties is important for the elucidation of virulence mechanisms and antigenic targets for vaccine development. PMID:17591787

Feasibility study of proton-based quality assurance of proton range compensator

NASA Astrophysics Data System (ADS)

Park, S.; Jeong, C.; Min, B. J.; Kwak, J.; Lee, J.; Cho, S.; Shin, D.; Lim, Y. K.; Park, S. Y.; Lee, S. B.

2013-06-01

All patient specific range compensators (RCs) are customized for achieving distal dose conformity of target volume in passively scattered proton therapy. Compensators are milled precisely using a computerized machine. In proton therapy, precision of the compensator is critical and quality assurance (QA) is required to protect normal tissues and organs from radiation damage. This study aims to evaluate the precision of proton-based quality assurance of range compensator. First, the geometry information of two compensators was extracted from the DICOM Radiotherapy (RT) plan. Next, RCs were irradiated on the EBT film individually by proton beam which is modulated to have a photon-like percent depth dose (PDD). Step phantoms were also irradiated on the EBT film to generate calibration curve which indicates relationship between optical density of irradiated film and perpendicular depth of compensator. Comparisons were made using the mean absolute difference (MAD) between coordinate information from DICOM RT and converted depth information from the EBT film. MAD over the whole region was 1.7, and 2.0 mm. However, MAD over the relatively flat regions on each compensator selected for comparison was within 1 mm. These results shows that proton-based quality assurance of range compensator is feasible and it is expected to achieve MAD over the whole region less than 1 mm with further correction about scattering effect of proton imaging.

Potentiation of the photodynamic action of hypericin.

PubMed

Saw, Constance Lay Lay; Heng, Paul Wan Sia; Olivo, Malini

2008-01-01

Hypericin (HY) is an interesting photosensitizer with dark activity and photodynamic therapy (PDT) effects via p53-independent pathway. In photodynamic diagnosis (PDD) of bladder cancer using HY, very high sensitivity and specificity were reported, in comparison with its counterpart, 5-aminolevulinic acid (5-ALA). HY was tested for the detection of human gastric cancer. It was also studied for treating some cancers and age-related macular degeneration and showed some promising findings. Several strategies to enhance the efficacy of HY-PDD and HY-PDT are reviewed. Using fractionated light dosing, fractionated drug dosing, hyperthermia, adjuvants such as oxygen carrier/antiangiogenesis, chemical modifications, and formulation approaches to enhance the PDT effects of HY are topics of this review. Despite cutting-edge technology approach such as preparing transferring-mediated targeting HY liposomes and nanoparticles of HY, such preparations did not always offer the desired enhanced treatment effects. It turns out that simple solutions of HY, especially those prepared without using plasma protein, were more successful in enhancing the delivery of HY for in vitro and in vivo systems. Thus, the HY-PDT with these formulations performed better. It is anticipated that HY-PDD and HY-PDT can be enhanced and optimized with the right combination of light dosimetry and drug dose in an effective formulation containing a suitable adjuvant. Hyperoxygenation and hyperthermia can also be used to further enhance the efficacy of HY-PDT.

SU-E-T-118: Analysis of Variability and Stability Between Two Water Tank Phantoms Utilizing Water Tank Commissioning Procedures

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

Roring, J; Saenz, D; Cruz, W

2015-06-15

Purpose: The commissioning criteria of water tank phantoms are essential for proper accuracy and reproducibility in a clinical setting. This study outlines the results of mechanical and dosimetric testing between PTW MP3-M water tank system and the Standard Imaging Doseview 3D water tank system. Methods: Measurements were taken of each axis of movement on the tank using 30 cm calipers at 1, 5, 10, 50, 100, and 200 mm for accuracy and reproducibility of tank movement. Dosimetric quantities such as percent depth dose and dose profiles were compared between tanks using a 6 MV beam from a Varian 23EX LINAC.more » Properties such as scanning speed effects, central axis depth dose agreement with static measurements, reproducibility of measurements, symmetry and flatness, and scan time between tanks were also investigated. Results: Results showed high geometric accuracy within 0.2 mm. Central axis PDD and in-field profiles agreed within 0.75% between the tanks. These outcomes test many possible discrepancies in dose measurements across the two tanks and form a basis for comparison on a broader range of tanks in the future. Conclusion: Both 3D water scanning phantoms possess a high degree of spatial accuracy, allowing for equivalence in measurements regardless of the phantom used. A commissioning procedure when changing water tanks or upon receipt of a new tank is nevertheless critical to ensure consistent operation before and after the arrival of new hardware.« less

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

Reynoso, F; Cho, S

Purpose: To develop and validate a Monte Carlo (MC) model of a Phillips RT-250 orthovoltage unit to test various beam spectrum modulation strategies for in vitro/vivo studies. A model of this type would enable the production of unconventional beams from a typical orthovoltage unit for novel therapeutic applications such as gold nanoparticle-aided radiotherapy. Methods: The MCNP5 code system was used to create a MC model of the head of RT-250 and a 30 × 30 × 30 cm{sup 3} water phantom. For the x-ray machine head, the current model includes the vacuum region, beryllium window, collimators, inherent filters and exteriormore » steel housing. For increased computational efficiency, the primary x-ray spectrum from the target was calculated from a well-validated analytical software package. Calculated percentage-depth-dose (PDD) values and photon spectra were validated against experimental data from film and Compton-scatter spectrum measurements. Results: The model was validated for three common settings of the machine namely, 250 kVp (0.25 mm Cu), 125 kVp (2 mm Al), and 75 kVp (2 mm Al). The MC results for the PDD curves were compared with film measurements and showed good agreement for all depths with a maximum difference of 4 % around dmax and under 2.5 % for all other depths. The primary photon spectra were also measured and compared with the MC results showing reasonable agreement between the two, validating the input spectra and the final spectra as predicted by the current MC model. Conclusion: The current MC model accurately predicted the dosimetric and spectral characteristics of each beam from the RT-250 orthovoltage unit, demonstrating its applicability and reliability for beam spectrum modulation tasks. It accomplished this without the need to model the bremsstrahlung xray production from the target, while significantly improved on computational efficiency by at least two orders of magnitude. Supported by DOD/PCRP grant W81XWH-12-1-0198.« less

Comparison between proton boron fusion therapy (PBFT) and boron neutron capture therapy (BNCT): a monte carlo study.

PubMed

Jung, Joo-Young; Yoon, Do-Kun; Barraclough, Brendan; Lee, Heui Chang; Suh, Tae Suk; Lu, Bo

2017-06-13

The aim of this study is to compare between proton boron fusion therapy (PBFT) and boron neutron capture therapy (BNCT) and to analyze dose escalation using a Monte Carlo simulation. We simulated a proton beam passing through the water with a boron uptake region (BUR) in MCNPX. To estimate the interaction between neutrons/protons and borons by the alpha particle, the simulation yielded with a variation of the center of the BUR location and proton energies. The variation and influence about the alpha particle were observed from the percent depth dose (PDD) and cross-plane dose profile of both the neutron and proton beams. The peak value of the maximum dose level when the boron particle was accurately labeled at the region was 192.4% among the energies. In all, we confirmed that prompt gamma rays of 478 keV and 719 keV were generated by the nuclear reactions in PBFT and BNCT, respectively. We validated the dramatic effectiveness of the alpha particle, especially in PBFT. The utility of PBFT was verified using the simulation and it has a potential for application in radiotherapy.

Comparison between proton boron fusion therapy (PBFT) and boron neutron capture therapy (BNCT): a Monte Carlo study

PubMed Central

Barraclough, Brendan; Lee, Heui Chang; Suh, Tae Suk; Lu, Bo

2017-01-01

The aim of this study is to compare between proton boron fusion therapy (PBFT) and boron neutron capture therapy (BNCT) and to analyze dose escalation using a Monte Carlo simulation. We simulated a proton beam passing through the water with a boron uptake region (BUR) in MCNPX. To estimate the interaction between neutrons/protons and borons by the alpha particle, the simulation yielded with a variation of the center of the BUR location and proton energies. The variation and influence about the alpha particle were observed from the percent depth dose (PDD) and cross-plane dose profile of both the neutron and proton beams. The peak value of the maximum dose level when the boron particle was accurately labeled at the region was 192.4% among the energies. In all, we confirmed that prompt gamma rays of 478 keV and 719 keV were generated by the nuclear reactions in PBFT and BNCT, respectively. We validated the dramatic effectiveness of the alpha particle, especially in PBFT. The utility of PBFT was verified using the simulation and it has a potential for application in radiotherapy. PMID:28427153

Commissioning results of an automated treatment planning verification system

PubMed Central

Mason, Bryan E.; Robinson, Ronald C.; Kisling, Kelly D.; Kirsner, Steven M.

2014-01-01

A dose calculation verification system (VS) was acquired and commissioned as a second check on the treatment planning system (TPS). This system reads DICOM CT datasets, RT plans, RT structures, and RT dose from the TPS and automatically, using its own collapsed cone superposition/convolution algorithm, computes dose on the same CT dataset. The system was commissioned by extracting basic beam parameters for simple field geometries and dose verification for complex treatments. Percent depth doses (PDD) and profiles were extracted for field sizes using jaw settings 3 × 3 cm2 ‐ 40 × 40 cm2 and compared to measured data, as well as our TPS model. Smaller fields of 1 × 1 cm2 and 2 × 2 cm2 generated using the multileaf collimator (MLC) were analyzed in the same fashion as the open fields. In addition, 40 patient plans consisting of both IMRT and VMAT were computed and the following comparisons were made: 1) TPS to the VS, 2) VS to measured data, and 3) TPS to measured data where measured data is both ion chamber (IC) and film measurements. Our results indicated for all field sizes using jaw settings PDD errors for the VS on average were less than 0.87%, 1.38%, and 1.07% for 6x, 15x, and 18x, respectively, relative to measured data. PDD errors for MLC field sizes were less than 2.28%, 1.02%, and 2.23% for 6x, 15x, and 18x, respectively. The infield profile analysis yielded results less than 0.58% for 6x, 0.61% for 15x, and 0.77% for 18x for the VS relative to measured data. Analysis of the penumbra region yields results ranging from 66.5% points, meeting the DTA criteria to 100% of the points for smaller field sizes for all energies. Analysis of profile data for field sizes generated using the MLC saw agreement with infield DTA analysis ranging from 68.8%–100% points passing the 1.5%/1.5 mm criteria. Results from the dose verification for IMRT and VMAT beams indicated that, on average, the ratio of TPS to IC and VS to IC measurements was 100.5 ± 1.9% and 100.4 ± 1.3%, respectively, while our TPS to VS was 100.1 ± 1.0%. When comparing the TPS and VS to film measurements, the average percentage pixels passing a 3%/3 mm criteria based gamma analysis were 96.6 ± 4.2% and 97 ± 5.6%, respectively. When the VS was compared to the TPS, on average 98.1 ± 5.3% of pixels passed the gamma analysis. Based upon these preliminary results, the VS system should be able to calculate dose adequately as a verification tool of our TPS. PACS number: 87.55.km PMID:25207567

Tolerability and safety of weekly primaquine against relapse of Plasmodium vivax in Cambodians with glucose-6-phosphate dehydrogenase deficiency.

PubMed

Kheng, Sim; Muth, Sinoun; Taylor, Walter R J; Tops, Narann; Kosal, Khem; Sothea, Khon; Souy, Phum; Kim, Saorin; Char, Chuor Meng; Vanna, Chan; Ly, Po; Ringwald, Pascal; Khieu, Virak; Kerleguer, Alexandra; Tor, Pety; Baird, John K; Bjorge, Steven; Menard, Didier; Christophel, Eva

2015-08-25

Primaquine is used to prevent Plasmodium vivax relapse; however, it is not implemented in many malaria-endemic countries, including Cambodia, for fear of precipitating primaquine-induced acute haemolytic anaemia in patients with glucose-6-phosphate dehydrogenase deficiency (G6PDd). Reluctance to use primaquine is reinforced by a lack of quality safety data. This study was conducted to assess the tolerability of a primaquine regimen in Cambodian severely deficient G6PD variants to ascertain whether a weekly primaquine could be given without testing for G6PDd. From January 2013 to January 2014, Cambodians with acute vivax malaria were treated with dihydroartemisinin/piperaquine on days (D) 0, 1 and 2 with weekly doses of primaquine 0.75 mg/kg for 8 weeks (starting on D0, last dose on D49), and followed until D56. Participants' G6PD status was confirmed by G6PD genotype and measured G6PD activity. The primary outcome was treatment completion without primaquine toxicity defined as any one of: (1) severe anaemia (haemoglobin [Hb] <7 g/dL), (2) a >25 % fractional fall in Hb from D0, (3) the need for a blood transfusion, (4) haemoglobinuria, (5) acute kidney injury (an increase in baseline serum creatinine >50 %) or (6) methaemoglobinaemia >20 %. We enrolled 75 patients with a median age of 24 years (range 5-63); 63 patients (84 %) were male. Eighteen patients were G6PDd (17/18 had the Viangchan variant) and had D0 G6PD activity ranging from 0.1 to 1.5 U/g Hb (median 0.85 U/g Hb). In the 57 patients with normal G6PD (G6PDn), D0 G6PD activity ranged from 6.9 to 18.5 U/g Hb (median 12 U/g Hb). Median D0 Hb concentrations were similar (P = 0.46) between G6PDd (13 g/dL, range 9.6-16) and G6PDn (13.5 g/dL, range 9-16.3) and reached a nadir on D2 in both groups: 10.8 g/dL (8.2-15.3) versus 12.4 g/dL (8.8-15.2) (P = 0.006), respectively. By D7, five G6PDd patients (27.7 %) had a >25 % fall in Hb, compared to 0 G6PDn patients (P = 0.00049). One of these G6PDd patients required a blood transfusion (D0-D5 Hb, 10.0-7.2 g/dL). No patients developed severe anaemia, haemoglobinuria, a methaemoglobin concentration >4.9 %, or acute kidney injury. Vivax-infected G6PDd Cambodian patients demonstrated significant, mostly transient, falls in Hb and one received a blood transfusion. Weekly primaquine in G6PDd patients mandates medical supervision and pre-treatment screening for G6PD status. The feasibility of implementing a package of G6PDd testing and supervised primaquine should be explored. The trial was registered on 3/1/2013 and the registration number is ACTRN12613000003774.

Memantine improves attention and episodic memory in Parkinson's disease dementia and dementia with Lewy bodies.

PubMed

Wesnes, Keith A; Aarsland, Dag; Ballard, Clive; Londos, Elisabet

2015-01-01

In both dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), attentional dysfunction is a core clinical feature together with disrupted episodic memory. This study evaluated the cognitive effects of memantine in DLB and PDD using automated tests of attention and episodic memory. A randomised double-blind, placebo-controlled, 24-week three centre trial of memantine (20 mg/day) was conducted in which tests of attention (simple and choice reaction time) and word recognition (immediate and delayed) from the CDR System were administered prior to dosing and again at 12 and 24 weeks. Although other results from this study have been published, the data from the CDR System tests were not included and are presented here for the first time. Data were available for 51 patients (21 DLB and 30 PDD). In both populations, memantine produced statistically significant medium to large effect sized improvements to choice reaction time, immediate and delayed word recognition. These are the first substantial improvements on cognitive tests of attention and episodic recognition memory identified with memantine in either DLB or PDD. Copyright © 2014 John Wiley & Sons, Ltd.

Automation of a Linear Accelerator Dosimetric Quality Assurance Program

NASA Astrophysics Data System (ADS)

Lebron Gonzalez, Sharon H.

According to the American Society of Radiation Oncology, two-thirds of all cancer patients will receive radiation therapy during their illness with the majority of the treatments been delivered by a linear accelerator (linac). Therefore, quality assurance (QA) procedures must be enforced in order to deliver treatments with a machine in proper conditions. The overall goal of this project is to automate the linac's dosimetric QA procedures by analyzing and accomplishing various tasks. First, the photon beam dosimetry (i.e. total scatter correction factor, infinite percentage depth dose (PDD) and profiles) were parameterized. Parameterization consists of defining the parameters necessary for the specification of a dosimetric quantity model creating a data set that is portable and easy to implement for different applications including: beam modeling data input into a treatment planning system (TPS), comparing measured and TPS modelled data, the QA of a linac's beam characteristics, and the establishment of a standard data set for comparison with other data, etcetera. Second, this parameterization model was used to develop a universal method to determine the radiation field size of flattened (FF), flattening-filter-free (FFF) and wedge beams which we termed the parameterized gradient method (PGM). Third, the parameterized model was also used to develop a profile-based method for assessing the beam quality of photon FF and FFF beams using an ionization chamber array. The PDD and PDD change was also predicted from the measured profile. Lastly, methods were created to automate the multileaf collimator (MLC) calibration and QA procedures as well as the acquisition of the parameters included in monthly and annual photon dosimetric QA. A two field technique was used for the calculation of the MLC leaf relative offsets using an electronic portal imaging device (EPID). A step-and-shoot technique was used to accurately acquire the radiation field size, flatness, symmetry, output and beam quality specifiers in a single delivery to an ionization chamber array for FF and FFF beams.

SU-E-T-279: A Novel Electron-Beam Combined with Magnetic Field Application for Radiotherapy.

PubMed

Alezra, D; Nardi, E; Koren, S; Bragilovski, D; Orion, I

2012-06-01

The new beam and delivery system consists of an electron accelerator and a system of magnets (one or more). Introducing a transverse magnetic field in and near the tumor, causes the electrons to spiral in this region, thereby producing an effective peak in the depth dose distribution, within the tumor volume. Although the basic idea is not new, we suggest here for the first time, a viable as well as a workable, magnetic field configuration, which in addition to focusing the beam does not interfere with its propagation to the target. The electron accelerator: can be a linear accelerator or any other type electron accelerator, capable of producing different electron energies for different depths and dose absorption accumulation. The Field size can be as small as a pencil beam and as big as any of the other standard field sizes that are used in radiotherapy. The scatter filter can be used or removed. The dose rate accumulation can be as higher as possible.The magnets are able to produce magnetic fields. The order, direction, width, place, shape and number of the magnetic fields define the shape and the Percentage Depth Dose (PDD) curve of the electron beam. Prototypes were successfully tested by means of computer simulation, using:COMSOL-Multiphsics for magnetic fields calculations. FLUKA package, for electron beam MC simulation. Our results suggest that by using an electron beam at different energies, combined with magnetic fields, we could modify the delivered dose. This is caused by manipulating the electron motion via the Lorentz force. The applied magnetic field, will focus the electron beam at a given depth and deposit the energy in a given volume and depth, where otherwise the electron energy will have spread deeper. The direction and magnitude of the magnetic fields will prevent the scattering of the electron beam and its absorption in remote volumes. In practice, we get a pseudo Bragg peak depth dose distribution, applying a relatively low cost system. The therapeutic efficiency induced by the system is of similar efficiency as the ion beam therapy techniques. Our novel concept demonstrates treatment that is almost similar to proton therapy and in some parameters even better performance.Unlike the current high-energy electron therapy, our system's beam deposit almost all of its energy on its target, with a low amount of radiation deposited in tissues from the surface of the skin to the front of tumor, and almost no "exit dose" beyond the tumor. This property will enables to hit tumors with higher, potentially more effective radiation doses, while being considerably less expensive. © 2012 American Association of Physicists in Medicine.

SU-F-J-146: Experimental Validation of 6 MV Photon PDD in Parallel Magnetic Field Calculated by EGSnrc

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

Ghila, A; Steciw, S; Fallone, B

Purpose: Integrated linac-MR systems are uniquely suited for real time tumor tracking during radiation treatment. Understanding the magnetic field dose effects and incorporating them in treatment planning is paramount for linac-MR clinical implementation. We experimentally validated the EGSnrc dose calculations in the presence of a magnetic field parallel to the radiation beam travel. Methods: Two cylindrical bore electromagnets produced a 0.21 T magnetic field parallel to the central axis of a 6 MV photon beam. A parallel plate ion chamber was used to measure the PDD in a polystyrene phantom, placed inside the bore in two setups: phantom top surfacemore » coinciding with the magnet bore center (183 cm SSD), and with the magnet bore’s top surface (170 cm SSD). We measured the field of the magnet at several points and included the exact dimensions of the coils to generate a 3D magnetic field map in a finite element model. BEAMnrc and DOSXYZnrc simulated the PDD experiments in parallel magnetic field (i.e. 3D magnetic field included) and with no magnetic field. Results: With the phantom surface at the top of the electromagnet, the surface dose increased by 10% (compared to no-magnetic field), due to electrons being focused by the smaller fringe fields of the electromagnet. With the phantom surface at the bore center, the surface dose increased by 30% since extra 13 cm of air column was in relatively higher magnetic field (>0.13T) in the magnet bore. EGSnrc Monte Carlo code correctly calculated the radiation dose with and without the magnetic field, and all points passed the 2%, 2 mm Gamma criterion when the ion chamber’s entrance window and air cavity were included in the simulated phantom. Conclusion: A parallel magnetic field increases the surface and buildup dose during irradiation. The EGSnrc package can model these magnetic field dose effects accurately. Dr. Fallone is a co-founder and CEO of MagnetTx Oncology Solutions (under discussions to license Alberta bi-planar linac MR for commercialization).« less

Surface integrity on grinding of gamma titanium aluminide intermetallic compounds

NASA Astrophysics Data System (ADS)

Murtagian, Gregorio Roberto

Gamma-TiAl is an ordered intermetallic compound characterized by high strength to density ratio, good oxidation resistance, and good creep properties at elevated temperatures. However, it is intrinsically brittle at room temperature. This thesis investigates the potential for the use of grinding to process TiAl into useful shapes. Grinding is far from completely understood, and many aspects of the individual mechanical interactions of the abrasive grit with the material and their effect on surface integrity are unknown. The development of new synthetic diamond superabrasives in which shape and size can be controlled raises the question of the influence of those variables on the surface integrity. The goal of this work is to better understand the fundamentals of the abrasive grit/material interaction in grinding operations. Experimental, analytical, and numerical work was done to characterize and predict the resultant deformation and surface integrity on ground lamellar gamma-TiAl. Grinding tests were carried out, by analyzing the effects of grit size and shape, workpiece speed, wheel depth of cut, and wear on the subsurface plastic deformation depth (PDD). A practical method to assess the PDD is introduced based on the measurement of the lateral material flow by 3D non-contact surface profilometry. This method combines the quantitative capabilities of the microhardness measurement with the sensitivity of Nomarski microscopy. The scope and limitations of this technique are analyzed. Mechanical properties were obtained by quasi-static and split Hopkinson bar compression tests. Residual stress plots were obtained by x-ray, and surface roughness and cracking were evaluated. The abrasive grit/material interaction was accounted by modeling the force per abrasive grit for different grinding conditions, and studying its correlation to the PDD. Numerical models of this interaction were used to analyze boundary conditions, and abrasive size effects on the PDD. An explicit 2D triple planar slip crystal plasticity model of single point scratching was used to analyze the effects of lamellae orientation, material anisotropy, and grain boundaries on the deformation.

An Open-Label Trial of Escitalopram in Pervasive Developmental Disorders.

ERIC Educational Resources Information Center

Owley, Thomas; Walton, Laura; Salt, Jeff; Guter, Stephen J., Jr.; Winnega, Marrea; Leventhal, Bennett L.; Cook, Edwin H., Jr.

2005-01-01

Objective: To assess the effect of escitalopram in the treatment of pervasive developmental disorders (PDDs). Method: This 10-week study had a forced titration, open-label design. Twenty-eight subjects (mean age 125.1 [+ or -] 33.5 months) with a PDD received escitalopram at a dose that increased weekly to a maximum dose of 20 mg as tolerated. The…

Lens of the eye dose calculation for neuro-interventional procedures and CBCT scans of the head

NASA Astrophysics Data System (ADS)

Xiong, Zhenyu; Vijayan, Sarath; Rana, Vijay; Jain, Amit; Rudin, Stephen; Bednarek, Daniel R.

2016-03-01

The aim of this work is to develop a method to calculate lens dose for fluoroscopically-guided neuro-interventional procedures and for CBCT scans of the head. EGSnrc Monte Carlo software is used to determine the dose to the lens of the eye for the projection geometry and exposure parameters used in these procedures. This information is provided by a digital CAN bus on the Toshiba Infinix C-Arm system which is saved in a log file by the real-time skin-dose tracking system (DTS) we previously developed. The x-ray beam spectra on this machine were simulated using BEAMnrc. These spectra were compared to those determined by SpekCalc and validated through measured percent-depth-dose (PDD) curves and half-value-layer (HVL) measurements. We simulated CBCT procedures in DOSXYZnrc for a CTDI head phantom and compared the surface dose distribution with that measured with Gafchromic film, and also for an SK150 head phantom and compared the lens dose with that measured with an ionization chamber. Both methods demonstrated good agreement. Organ dose calculated for a simulated neuro-interventional-procedure using DOSXYZnrc with the Zubal CT voxel phantom agreed within 10% with that calculated by PCXMC code for most organs. To calculate the lens dose in a neuro-interventional procedure, we developed a library of normalized lens dose values for different projection angles and kVp's. The total lens dose is then calculated by summing the values over all beam projections and can be included on the DTS report at the end of the procedure.

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

Koren, S; Kindler, J; Reich, E

Purpose: We propose the use of a HDR X-ray source collimator to apply a conformal, relatively small, radiation suitable for a single fraction with short delivery time. In addition, this technique can be applied using a radioactive source. Methods: We have built a stainless steel 1.5 mm thick applicator, to accommodate the needle applicator of the Intra-Beam X-ray source. Additional cavity is created in the applicator to allow the hosting/nesting/positioning of a LED diode. This LED is allowing a pre-irradiation beam marking on the tissue. The visible light emitted from the opening of the collimated applicator will delineate/verify the aperturemore » of the kV beam to be applied, as well as serve as distance indicator and will assist in the determination of dose to be delivered. For the evaluation of the collimated spatial dose distribution we have performed water tank measurements using (IBA Dosimetry) with a 0.4 cc ion chamber (IBA Dosimetry). We have scanned a two dimensional array with 1mm pitch in depth and 0.3 mm step size laterally. Additional verifications were conducted using Gaf-Chromic film for PDD measurements and Optical Stimulated Luminescence Dosimetry (OSLD, Landauer inc.) for absolute dosimetry. Results: The collimated applicator enables a conformal irradiated cross-section of about 3 mm square at the applicator surface was used in this study. A 180 seconds of 50 kVp delivery yielded 29 Gy, 20.6 Gy and 14.5 Gy at 5, 10 and 15 mm depths respectively. These results are in good agreement with the needle applicator depth dose curve published data. Conclusion: We have demonstrated the feasibility of focal HDR brachytherapy for conjunctival and ocular tumors, using the Intra-Beam needle applicator with in-house developed collimator. The delivery time was found to be several minutes- suitable for an intra-operative procedure and will allow dose fractionation deliveries.« less

A 3D correction method for predicting the readings of a PinPoint chamber on the CyberKnife® M6™ machine

NASA Astrophysics Data System (ADS)

Zhang, Yongqian; Brandner, Edward; Ozhasoglu, Cihat; Lalonde, Ron; Heron, Dwight E.; Saiful Huq, M.

2018-02-01

The use of small fields in radiation therapy techniques has increased substantially in particular in stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT). However, as field size reduces further still, the response of the detector changes more rapidly with field size, and the effects of measurement uncertainties become increasingly significant due to the lack of lateral charged particle equilibrium, spectral changes as a function of field size, detector choice, and subsequent perturbations of the charged particle fluence. This work presents a novel 3D dose volume-to-point correction method to predict the readings of a 0.015 cc PinPoint chamber (PTW 31014) for both small static-fields and composite-field dosimetry formed by fixed cones on the CyberKnife® M6™ machine. A 3D correction matrix is introduced to link the 3D dose distribution to the response of the PinPoint chamber in water. The parameters of the correction matrix are determined by modeling its 3D dose response in circular fields created using the 12 fixed cones (5 mm-60 mm) on a CyberKnife® M6™ machine. A penalized least-square optimization problem is defined by fitting the calculated detector reading to the experimental measurement data to generate the optimal correction matrix; the simulated annealing algorithm is used to solve the inverse optimization problem. All the experimental measurements are acquired for every 2 mm chamber shift in the horizontal planes for each field size. The 3D dose distributions for the measurements are calculated using the Monte Carlo calculation with the MultiPlan® treatment planning system (Accuray Inc., Sunnyvale, CA, USA). The performance evaluation of the 3D conversion matrix is carried out by comparing the predictions of the output factors (OFs), off-axis ratios (OARs) and percentage depth dose (PDD) data to the experimental measurement data. The discrepancy of the measurement and the prediction data for composite fields is also performed for clinical SRS plans. The optimization algorithm used for generating the optimal correction factors is stable, and the resulting correction factors were smooth in the spatial domain. The measurement and prediction of OFs agree closely with percentage differences of less than 1.9% for all the 12 cones. The discrepancies between the prediction and the measurement PDD readings at 50 mm and 80 mm depth are 1.7% and 1.9%, respectively. The percentage differences of OARs between measurement and prediction data are less than 2% in the low dose gradient region, and 2%/1 mm discrepancies are observed within the high dose gradient regions. The differences between the measurement and prediction data for all the CyberKnife based SRS plans are less than 1%. These results demonstrate the existence and efficiency of the novel 3D correction method for small field dosimetry. The 3D correction matrix links the 3D dose distribution and the reading of the PinPoint chamber. The comparison between the predicted reading and the measurement data for static small fields (OFs, OARs and PDDs) yield discrepancies within 2% for low dose gradient regions and 2%/1 mm for high dose gradient regions; the discrepancies between the predicted and the measurement data are less than 1% for all the SRS plans. The 3D correction method provides an access to evaluate the clinical measurement data and can be applied to non-standard composite fields intensity modulated radiation therapy point dose verification.

Optimization of GATE and PHITS Monte Carlo code parameters for uniform scanning proton beam based on simulation with FLUKA general-purpose code

NASA Astrophysics Data System (ADS)

Kurosu, Keita; Takashina, Masaaki; Koizumi, Masahiko; Das, Indra J.; Moskvin, Vadim P.

2014-10-01

Although three general-purpose Monte Carlo (MC) simulation tools: Geant4, FLUKA and PHITS have been used extensively, differences in calculation results have been reported. The major causes are the implementation of the physical model, preset value of the ionization potential or definition of the maximum step size. In order to achieve artifact free MC simulation, an optimized parameters list for each simulation system is required. Several authors have already proposed the optimized lists, but those studies were performed with a simple system such as only a water phantom. Since particle beams have a transport, interaction and electromagnetic processes during beam delivery, establishment of an optimized parameters-list for whole beam delivery system is therefore of major importance. The purpose of this study was to determine the optimized parameters list for GATE and PHITS using proton treatment nozzle computational model. The simulation was performed with the broad scanning proton beam. The influences of the customizing parameters on the percentage depth dose (PDD) profile and the proton range were investigated by comparison with the result of FLUKA, and then the optimal parameters were determined. The PDD profile and the proton range obtained from our optimized parameters list showed different characteristics from the results obtained with simple system. This led to the conclusion that the physical model, particle transport mechanics and different geometry-based descriptions need accurate customization in planning computational experiments for artifact-free MC simulation.

Beneficial effects of curcumin nano-emulsion on spermatogenesis and reproductive performance in male rats under protein deficient diet model: enhancement of sperm motility, conservancy of testicular tissue integrity, cell energy and seminal plasma amino acids content.

PubMed

Ahmed-Farid, Omar A H; Nasr, Maha; Ahmed, Rania F; Bakeer, Rofanda M

2017-09-02

Malnutrition resulting from protein and calorie deficiency continues to be a major concern worldwide especially in developing countries. Specific deficiencies in the protein intake can adversely influence reproductive performance. The present study aimed to evaluate the effects of curcumin and curcumin nano-emulsion on protein deficient diet (PDD)-induced testicular atrophy, troubled spermatogenesis and decreased reproductive performance in male rats. Juvenile rats were fed the protein deficient diet (PDD) for 75 days. Starting from day 60 the rats were divided into 4 groups and given the corresponding treatments for the last 15 days orally and daily as follows: 1st group; curcumin group (C) received 50 mg/kg curcumin p.o. 2 nd group; curcumin nano-form low dose group (NCL) received 2.5 mg/kg nano-curcumin. 3rd group; curcumin nano-form high dose group (NCH) received 5 mg/kg nano-curcumin. 4th group served as malnutrition group (PDD group) receiving the protein deficient diet daily for 75 days and received distilled water ingestions (5 ml/kg p.o) daily for the last 15 days of the experiment. A normal control group was kept under the same conditions for the whole experiment and received normal diet according to nutrition requirement center daily for 75 days and received distilled water ingestions (5 ml/kg p.o) daily for the last 15 days of the experiment. PDD induced significant (P < 0.05) reduction in serum testosterone level, sperm motility, testicular GSH, CAT, SOD, testicular cell energy (ATP, ADP and AMP), essential and non-essential amino acids in seminal plasma, an increase in testicular MDA, NOx, GSSG and 8-OHDG. Data was confirmed by histological examination and revealed pathological alteration in the PDD group. Ingestion of curcumin (50 mg/kg) and curcumin nano-emulsion (2.5 and 5 mg/kg) showed significant (P< 0.05) amelioration effects against PDD-induced disrupted reproductive performance as well as biochemical and pathological alterations and the overall results of the nano-emulsion (5 mg/kg) were comparable to curcumin (50 mg/kg). The present study suggests that administration of curcumin nano-emulsion as a daily supplement would be beneficial in malnutrition- induced troubled male reproductive performance and spermatogenesis cases.

Technical Note: Direct measurement of continuous TMR data with a 1D tank and automated couch movements.

PubMed

Knutson, Nels C; Schmidt, Matthew C; Belley, Matthew D; Nguyen, Ngoc B; Li, H Harold; Sajo, Erno; Price, Michael J

2017-07-01

Real-time dynamic control of the linear accelerator, couch, and imaging parameters during radiation delivery was investigated as a novel technique for acquiring tissue maximum ratio (TMR) data. TrueBeam Developer Mode (Varian Medical Systems, Palo Alto, CA, USA) was used to control the linear accelerator using the Extensible Markup Language (XML). A single XML file was used to dynamically manipulate the machine, couch, and imaging parameters during radiation delivery. A TG-51 compliant 1D water tank was placed on the treatment couch, and used to position a detector at isocenter at a depth of 24.5 cm. A depth scan was performed towards the water surface. Via XML control, the treatment couch vertical position was simultaneously lowered at the same rate, maintaining the detector position at isocenter, allowing for the collection of TMR data. To ensure the detector remained at isocenter during the delivery, the in-room camera was used to monitor the detector. Continuous kV fluoroscopic images during 10 test runs further confirmed this result. TMR data at multiple Source to Detector Distances (SDD) and scan speeds were acquired to investigate their impact on the TMR data. Percentage depth dose (PDD) scans (for conversion to TMR) along with traditional discrete TMR data were acquired as a standard for comparison. More than 99.8% of the measured points had a gamma value (1%/1 mm) < 1 when compared with discrete or PDD converted TMR data. Fluoroscopic images showed that the concurrent couch and tank movements resulted in SDD errors < 1 mm. TMRs acquired at SDDs of 99, 100, and 101 cm showed differences less than 0.004. TrueBeam Developer Mode was used to collect continuous TMR data with the same accuracy as traditionally collected discrete data, but yielded higher sampled resolution and reduced acquisition time. This novel method does not require the modification of any equipment and does not use a 3D tank or reservoir. © 2017 American Association of Physicists in Medicine.

4α-phorbol 12,13-didecanoate activates cultured mouse dorsal root ganglia neurons independently of TRPV4

PubMed Central

Alexander, R; Kerby, A; Aubdool, AA; Power, AR; Grover, S; Gentry, C; Grant, AD

2013-01-01

Background and Purpose The Ca2+-permeable cation channel TRPV4 is activated by mechanical disturbance of the cell membrane and is implicated in mechanical hyperalgesia. Nerve growth factor (NGF) is increased during inflammation and causes mechanical hyperalgesia. 4α-phorbol 12,13-didecanoate (4αPDD) has been described as a selective TRPV4 agonist. We investigated NGF-induced hyperalgesia in TRPV4 wild-type (+/+) and knockout (–/–) mice, and the increases in [Ca2+]i produced by 4αPDD in cultured mouse dorsal root ganglia neurons following exposure to NGF. Experimental Approach Withdrawal thresholds to heat, von Frey hairs and pressure were measured in mice before and after systemic administration of NGF. Changes in intracellular Ca2+ concentration were measured by ratiometric imaging with Fura-2 in cultured DRG and trigeminal ganglia (TG) neurons during perfusion of TRPV4 agonists. Key Results Administration of NGF caused a significant sensitization to heat and von Frey stimuli in TRPV4 +/+ and –/– mice, but only TRPV4 +/+ mice showed sensitization to noxious pressure. 4αPDD stimulated a dose-dependent increase in [Ca2+]i in neurons from +/+ and –/– mice, with the proportion of responding neurons and magnitude of increase unaffected by the genotype. In contrast, the selective TRPV4 agonist GSK1016790A failed to stimulate an increase in intracellular Ca2+ in cultured neurons. Responses to 4αPDD were unaffected by pretreatment with NGF. Conclusions and Implications TRPV4 contributes to mechanosensation in vivo, but there is little evidence for functional TRPV4 in cultured DRG and TG neurons. We conclude that 4αPDD activates these neurons independently of TRPV4, so it is not appropriate to refer to 4αPDD as a selective TRPV4 agonist. PMID:22928864

Dosimetric investigation of dual energy photon beams with assymmetric collimator jaws

NASA Astrophysics Data System (ADS)

Varatharaj, C.; Ravikumar, M.; Supe, Sanjay S.; Sathiyan, S.; Ganesh, K. M.; Arunkumar, T.

2008-01-01

Many modern linear accelerators are equipped with asymmetric collimators or jaws that can be moved independently. Asymmetric jaws have got many clinical applications in radiation therapy. In the present study, the dosimetric characteristics of asymmetric collimators from our linear accelerator with 6 and 18 MV X-rays were carried out. The field size factors (FSF) and half value layer (HVL) were measured in a water phantom using 0.6 cc Farmer chamber for symmetric and asymmetric fields for both 6 and 18 MV X-rays. Measurements of beam penumbra, percentage depth dose (PDD), cross beam profiles and calculated isodose curves were measured by RFA 300 for both asymmetric and symmetric fields. The FSF were found to agree with in 3% for symmetric and asymmetric fields. The HVL in water was found to be 15.8 cm and 14.4 cm for 6 MV photons and 26 cm and 22.9 cm for 18 MV photons at the central axis and at 20 cm off the central axis. At 30 cm depth the percentage depth dose for symmetric and asymmetric fields were found to differ as high as 6% for 6 MV and 4% for 18 MV fields. No observable difference in penumbra was noticed for symmetric and asymmetric fields of same dimensions. The constrictions of isodose curves at the edge nearer to central axis were noticed for asymmetrically placed fields. The observed differences could be due to the passage of primary beam through differential thickness of the flattening filter which alters the beam quality.

Prescription patterns of diuretics in Dutch community-dwelling elderly patients

PubMed Central

Van Kraaij, Dave J W; Jansen, René W M M; De Gier, Johan J; Gribnau, Frank W J; Hoefnagels, Willibrord H L

1998-01-01

Aims To describe age-and gender-related prescription patterns of diuretics in community-dwelling elderly, and to compare diuretics to other cardiovascular (CV) medications. Methods Cross-sectional study of patient-specific prescription data derived from a panel of 10 Dutch community pharmacies. Determination of proportional prescription rates and prescribed daily dose (PDD) of diuretics, cardiac glycosides, nitrates, angiotensin converting enzyme (ACE) inhibitors, β-adrenoceptor blockers, and calcium channel blockers in all 5326 patients aged 65 years or older dispensed CV medications between August 1st, 1995 and February 1st, 1996. Results Diuretics were prescribed to 2677 of 5326 patients (50.3%), 1325 patients (24.9%) using thiazides and 1198 patients (22.5%) using loop diuretics. Prescription rates of loop diuretics increased from 15.1% in patients aged 65–74 years to 37.2% in patients aged 85 years or older. Rates also increased for digoxin and nitrates. Rates for thiazide diuretics remained unchanged with age; rates for β-adrenoceptor blockers, ACE inhibitors and calcium channel blockers declined with age. Thiazides were prescribed to 30.1% of women compared with 16% of men (P<0.001). Average PDD was 135±117% of defined daily dose (DDD) for loop diuretics, and highest for bumetanide (245±2.01% of DDD, equivalent to 2.5±2.0 mg). Average PDD was 74±40% of DDD for thiazides, and highest for chlorthalidone (100±49% of DDD, equivalent to 25±12 mg). Conclusions Important characteristics of diuretic usage patterns in this elderly population were a steep increase in loop diuretic use in the oldest old, a large gender difference for thiazide use, and high prescribed doses for thiazides. PMID:9803990

Screening for Glucose-6-Phosphate Dehydrogenase Deficiency Using Three Detection Methods: A Cross-Sectional Survey in Southwestern Uganda

PubMed Central

Roh, Michelle E.; Oyet, Caesar; Orikiriza, Patrick; Wade, Martina; Mwanga-Amumpaire, Juliet; Boum, Yap; Kiwanuka, Gertrude N.; Parikh, Sunil

2016-01-01

Despite the potential benefit of primaquine in reducing Plasmodium falciparum transmission and radical cure of Plasmodium vivax and Plasmodium ovale infections, concerns over risk of hemolytic toxicity in individuals with glucose-6-phosphate dehydrogenase deficiency (G6PDd) have hampered its deployment. A cross-sectional survey was conducted in 2014 to assess the G6PDd prevalence among 631 children between 6 and 59 months of age in southwestern Uganda, an area where primaquine may be a promising control measure. G6PDd prevalence was determined using three detection methods: a quantitative G6PD enzyme activity assay (Trinity Biotech® G-6-PDH kit), a qualitative point-of-care test (CareStart™ G6PD rapid diagnostic test [RDT]), and molecular detection of the G6PD A− G202A allele. Qualitative tests were compared with the gold standard quantitative assay. G6PDd prevalence was higher by RDT (8.6%) than by quantitative assay (6.8%), using a < 60% activity threshold. The RDT performed optimally at a < 60% threshold and demonstrated high sensitivity (≥ 90%) and negative predictive values (100%) across three activity thresholds (below 60%, 30%, and 40%). G202A allele frequency was 6.4%, 7.9%, and 6.8% among females, males, and overall, respectively. Notably, over half of the G202A homo-/hemizygous children expressed ≥ 60% enzyme activity. Overall, the CareStart™ G6PD RDT appears to be a viable screening test to accurately identify individuals with enzyme activities below 60%. The low prevalence of G6PDd across all three diagnostic modalities and absence of severe deficiency in our study suggests that there is little barrier to the use of single-dose primaquine in this region. PMID:27672207

Development and characterization of a three-dimensional radiochromic film stack dosimeter for megavoltage photon beam dosimetry.

PubMed

McCaw, Travis J; Micka, John A; DeWerd, Larry A

2014-05-01

Three-dimensional (3D) dosimeters are particularly useful for verifying the commissioning of treatment planning and delivery systems, especially with the ever-increasing implementation of complex and conformal radiotherapy techniques such as volumetric modulated arc therapy. However, currently available 3D dosimeters require extensive experience to prepare and analyze, and are subject to large measurement uncertainties. This work aims to provide a more readily implementable 3D dosimeter with the development and characterization of a radiochromic film stack dosimeter for megavoltage photon beam dosimetry. A film stack dosimeter was developed using Gafchromic(®) EBT2 films. The dosimeter consists of 22 films separated by 1 mm-thick spacers. A Virtual Water™ phantom was created that maintains the radial film alignment within a maximum uncertainty of 0.3 mm. The film stack dosimeter was characterized using simulations and measurements of 6 MV fields. The absorbed-dose energy dependence and orientation dependence of the film stack dosimeter were investigated using Monte Carlo simulations. The water equivalence of the dosimeter was determined by comparing percentage-depth-dose (PDD) profiles measured with the film stack dosimeter and simulated using Monte Carlo methods. Film stack dosimeter measurements were verified with thermoluminescent dosimeter (TLD) microcube measurements. The film stack dosimeter was also used to verify the delivery of an intensity-modulated radiation therapy (IMRT) procedure. The absorbed-dose energy response of EBT2 film differs less than 1.5% between the calibration and film stack dosimeter geometries for a 6 MV spectrum. Over a series of beam angles ranging from normal incidence to parallel incidence, the overall variation in the response of the film stack dosimeter is within a range of 2.5%. Relative to the response to a normally incident beam, the film stack dosimeter exhibits a 1% under-response when the beam axis is parallel to the film planes. Measured and simulated PDD profiles agree within a root-mean-square difference of 1.3%. In-field film stack dosimeter and TLD measurements agree within 5%, and measurements in the field penumbra agree within 0.5 mm. Film stack dosimeter and TLD measurements have expanded (k = 2) overall measurement uncertainties of 6.2% and 5.8%, respectively. Film stack dosimeter measurements of an IMRT dose distribution have 98% agreement with the treatment planning system dose calculation, using gamma criteria of 3% and 2 mm. The film stack dosimeter is capable of high-resolution, low-uncertainty 3D dose measurements, and can be readily incorporated into an existing film dosimetry program.

A Fast parallel tridiagonal algorithm for a class of CFD applications

NASA Technical Reports Server (NTRS)

Moitra, Stuti; Sun, Xian-He

1996-01-01

The parallel diagonal dominant (PDD) algorithm is an efficient tridiagonal solver. This paper presents for study a variation of the PDD algorithm, the reduced PDD algorithm. The new algorithm maintains the minimum communication provided by the PDD algorithm, but has a reduced operation count. The PDD algorithm also has a smaller operation count than the conventional sequential algorithm for many applications. Accuracy analysis is provided for the reduced PDD algorithm for symmetric Toeplitz tridiagonal (STT) systems. Implementation results on Langley's Intel Paragon and IBM SP2 show that both the PDD and reduced PDD algorithms are efficient and scalable.

Comparison of measured electron energy spectra for six matched, radiotherapy accelerators.

PubMed

McLaughlin, David J; Hogstrom, Kenneth R; Neck, Daniel W; Gibbons, John P

2018-05-01

This study compares energy spectra of the multiple electron beams of individual radiotherapy machines, as well as the sets of spectra across multiple matched machines. Also, energy spectrum metrics are compared with central-axis percent depth-dose (PDD) metrics. A lightweight, permanent magnet spectrometer was used to measure energy spectra for seven electron beams (7-20 MeV) on six matched Elekta Infinity accelerators with the MLCi2 treatment head. PDD measurements in the distal falloff region provided R 50 and R 80-20 metrics in Plastic Water ® , which correlated with energy spectrum metrics, peak mean energy (PME) and full-width at half maximum (FWHM). Visual inspection of energy spectra and their metrics showed whether beams on single machines were properly tuned, i.e., FWHM is expected to increase and peak height decrease monotonically with increased PME. Also, PME spacings are expected to be approximately equal for 7-13 MeV beams (0.5-cm R 90 spacing) and for 13-16 MeV beams (1.0-cm R 90 spacing). Most machines failed these expectations, presumably due to tolerances for initial beam matching (0.05 cm in R 90 ; 0.10 cm in R 80-20 ) and ongoing quality assurance (0.2 cm in R 50 ). Also, comparison of energy spectra or metrics for a single beam energy (six machines) showed outlying spectra. These variations in energy spectra provided ample data spread for correlating PME and FWHM with PDD metrics. Least-squares fits showed that R 50 and R 80-20 varied linearly and supralinearly with PME, respectively; however, both suggested a secondary dependence on FWHM. Hence, PME and FWHM could serve as surrogates for R 50 and R 80-20 for beam tuning by the accelerator engineer, possibly being more sensitive (e.g., 0.1 cm in R 80-20 corresponded to 2.0 MeV in FWHM). Results of this study suggest a lightweight, permanent magnet spectrometer could be a useful beam-tuning instrument for the accelerator engineer to (a) match electron beams prior to beam commissioning, (b) tune electron beams for the duration of their clinical use, and (c) provide estimates of PDD metrics following machine maintenance. However, a real-time version of the spectrometer is needed to be practical. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

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

Cardenas, C; The University of Texas Graduate School of Biomedical Sciences, Houston, TX; Nitsch, P

Purpose: To investigate out-of-field electron doses and neutron production from electron beams from modern Varian and Elekta linear accelerators. Methods: Electron dose measurements were made using 10×10cm{sup 2} applicators on two Varian 21iXs, a Varian TrueBeam, and an Elekta Versa HD operating at energies from 6 to 20 MeV. Out-of-field dose profiles and PDD curves were measured in a Wellhofer water phantom using a Farmer chamber. Neutron measurements were made with a combination of moderator buckets and gold activation-foils placed on the treatment couch at various locations in the patient plane on both the 21iX and Versa HD linear accelerators.more » Results: Electron doses were highest for the highest electron energies. Dose profile curves for the Varian units were found to be lower than those from the Versa HD unit, and were lower than photon beams. Elekta’s dose profiles were higher and exhibited a second dose peak around 20–30 cm from central-axis. Electron doses in this region (0.8–1.3% of dmax at central-axis) were close to 5 times (2.5–4.8) greater than doses from photon beams with similar energies. Electron doses decreased sharply with depth before becoming nearly constant; the dose was found to decrease to a depth of approximately E(MeV)/4 in cm. Q-values and neutron dose equivalent increased with energy and were typically higher on central-axis. 18 MV photon beam neutron dose equivalents were greater than any electron beam, being approximately 40 times greater than for the 20 MeV electron beam (21iX). Conclusion: The Versa HD exhibited higher than expected out-of-field electron doses in comparison to typical radiotherapy photon beams. Fortunately, out-of-field electron doses can be substantially reduced by applying a water-equivalent bolus with thickness of E(MeV)/4 in cm. Neutron contamination from clinical electron beams can be considered negligible in relation to photon beams but may need to be considered for special cases. This work was supported by Public Health Service Grant CA180803 awarded by the National Cancer Institute, United States Department of Health and Human Services.« less

Validation of GPU-accelerated superposition-convolution dose computations for the Small Animal Radiation Research Platform.

PubMed

Cho, Nathan; Tsiamas, Panagiotis; Velarde, Esteban; Tryggestad, Erik; Jacques, Robert; Berbeco, Ross; McNutt, Todd; Kazanzides, Peter; Wong, John

2018-05-01

The Small Animal Radiation Research Platform (SARRP) has been developed for conformal microirradiation with on-board cone beam CT (CBCT) guidance. The graphics processing unit (GPU)-accelerated Superposition-Convolution (SC) method for dose computation has been integrated into the treatment planning system (TPS) for SARRP. This paper describes the validation of the SC method for the kilovoltage energy by comparing with EBT2 film measurements and Monte Carlo (MC) simulations. MC data were simulated by EGSnrc code with 3 × 10 8 -1.5 × 10 9 histories, while 21 photon energy bins were used to model the 220 kVp x-rays in the SC method. Various types of phantoms including plastic water, cork, graphite, and aluminum were used to encompass the range of densities of mouse organs. For the comparison, percentage depth dose (PDD) of SC, MC, and film measurements were analyzed. Cross beam (x,y) dosimetric profiles of SC and film measurements are also presented. Correction factors (CFz) to convert SC to MC dose-to-medium are derived from the SC and MC simulations in homogeneous phantoms of aluminum and graphite to improve the estimation. The SC method produces dose values that are within 5% of film measurements and MC simulations in the flat regions of the profile. The dose is less accurate at the edges, due to factors such as geometric uncertainties of film placement and difference in dose calculation grids. The GPU-accelerated Superposition-Convolution dose computation method was successfully validated with EBT2 film measurements and MC calculations. The SC method offers much faster computation speed than MC and provides calculations of both dose-to-water in medium and dose-to-medium in medium. © 2018 American Association of Physicists in Medicine.

Comprehensive quality assurance phantom for the small animal radiation research platform (SARRP)

PubMed Central

Jermoumi, M.; Korideck, H.; Bhagwat, M.; Zygmanski, P.; Makrigiogos, G.M.; Berbeco, R.I.; Cormack, R.C.; Ngwa, W.

2016-01-01

Purpose To develop and test the suitability and performance of a comprehensive quality assurance (QA) phantom for the Small Animal Radiation Research Platform (SARRP). Methods and materials A QA phantom was developed for carrying out daily, monthly and annual QA tasks including: imaging, dosimetry and treatment planning system (TPS) performance evaluation of the SARRP. The QA phantom consists of 15 (60 × 60 × 5 mm3) kV-energy tissue equivalent solid water slabs. The phantom can incorporate optically stimulated luminescence dosimeters (OSLD), Mosfet or film. One slab, with inserts and another slab with hole patterns are particularly designed for image QA. Results Output constancy measurement results showed daily variations within 3%. Using the Mosfet in phantom as target, results showed that the difference between TPS calculations and measurements was within 5%. Annual QA results for the Percentage depth dose (PDD) curves, lateral beam profiles, beam flatness and beam profile symmetry were found consistent with results obtained at commissioning. PDD curves obtained using film and OSLDs showed good agreement. Image QA was performed monthly, with image-quality parameters assessed in terms of CBCT image geometric accuracy, CT number accuracy, image spatial resolution, noise and image uniformity. Conclusions The results show that the developed QA phantom can be employed as a tool for comprehensive performance evaluation of the SARRP. The study provides a useful reference for development of a comprehensive quality assurance program for the SARRP and other similar small animal irradiators, with proposed tolerances and frequency of required tests. PMID:25964129

Comprehensive quality assurance phantom for the small animal radiation research platform (SARRP).

PubMed

Jermoumi, M; Korideck, H; Bhagwat, M; Zygmanski, P; Makrigiogos, G M; Berbeco, R I; Cormack, R C; Ngwa, W

2015-07-01

To develop and test the suitability and performance of a comprehensive quality assurance (QA) phantom for the Small Animal Radiation Research Platform (SARRP). A QA phantom was developed for carrying out daily, monthly and annual QA tasks including: imaging, dosimetry and treatment planning system (TPS) performance evaluation of the SARRP. The QA phantom consists of 15 (60 × 60 × 5 mm(3)) kV-energy tissue equivalent solid water slabs. The phantom can incorporate optically stimulated luminescence dosimeters (OSLD), Mosfet or film. One slab, with inserts and another slab with hole patterns are particularly designed for image QA. Output constancy measurement results showed daily variations within 3%. Using the Mosfet in phantom as target, results showed that the difference between TPS calculations and measurements was within 5%. Annual QA results for the Percentage depth dose (PDD) curves, lateral beam profiles, beam flatness and beam profile symmetry were found consistent with results obtained at commissioning. PDD curves obtained using film and OSLDs showed good agreement. Image QA was performed monthly, with image-quality parameters assessed in terms of CBCT image geometric accuracy, CT number accuracy, image spatial resolution, noise and image uniformity. The results show that the developed QA phantom can be employed as a tool for comprehensive performance evaluation of the SARRP. The study provides a useful reference for development of a comprehensive quality assurance program for the SARRP and other similar small animal irradiators, with proposed tolerances and frequency of required tests. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Prompt gamma ray imaging for verification of proton boron fusion therapy: A Monte Carlo study.

PubMed

Shin, Han-Back; Yoon, Do-Kun; Jung, Joo-Young; Kim, Moo-Sub; Suh, Tae Suk

2016-10-01

The purpose of this study was to verify acquisition feasibility of a single photon emission computed tomography image using prompt gamma rays for proton boron fusion therapy (PBFT) and to confirm an enhanced therapeutic effect of PBFT by comparison with conventional proton therapy without use of boron. Monte Carlo simulation was performed to acquire reconstructed image during PBFT. We acquired percentage depth dose (PDD) of the proton beams in a water phantom, energy spectrum of the prompt gamma rays, and tomographic images, including the boron uptake region (BUR; target). The prompt gamma ray image was reconstructed using maximum likelihood expectation maximisation (MLEM) with 64 projection raw data. To verify the reconstructed image, both an image profile and contrast analysis according to the iteration number were conducted. In addition, the physical distance between two BURs in the region of interest of each BUR was measured. The PDD of the proton beam from the water phantom including the BURs shows more efficient than that of conventional proton therapy on tumour region. A 719keV prompt gamma ray peak was clearly observed in the prompt gamma ray energy spectrum. The prompt gamma ray image was reconstructed successfully using 64 projections. Different image profiles including two BURs were acquired from the reconstructed image according to the iteration number. We confirmed successful acquisition of a prompt gamma ray image during PBFT. In addition, the quantitative image analysis results showed relatively good performance for further study. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

SU-E-T-191: Commissioning and Dosimetric Characteristics of Elekta Agility for Total Skin Electron Beam (TSEB) Therapy

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

Sayler, E; Charpentier, P; Micaily, B

2015-06-15

Purpose The purpose of this work is to publish beam data from Elekta Synergy(R) linear accelerators with Agility(TM) MLC for total skin electron beam (TSEB) therapy using the HDRE1 (High Dose Rate Electron 6MeV) energy. Method & Materials The optimal gantry angles for TSEB were determined using ion chamber measurements along a vertical profile at 450cm SSD. After gantry angles were chosen, field uniformity was measured over the entire treatment area. Uniformity was measured with and without the patient support device, allowing the dosimetric effect of the support device to be determined. Beam output and PDD were measured at themore » calibration point (450cm SSD) for a dual beam using a parallel plate chamber in solid water. These measurements were repeated with the chamber and phantom rotated about the patient isocenter at various angles, in order to measure the contribution from oblique beams. This technique provides a precise measurement of the treatment skin dose (TSD). Lastly, ion chamber measurements were verified by film and diodes. Results The optimal gantry angle for 450 cm SSD was determined to be 90±16°. This achieved uniformity better than 96% on the vertical axis, and 92% along the horizontal axis. HDRE1 was calibrated to deliver 10 cGy/MU at standard geometry (100 cm SSD, 1.2 cm depth). Thus at TSEB geometry (450 cm SSD, 0.1 cm depth) the output of the AP dual field was measured to be 0.35 cGy/MU. The TSD of a 20 cm radius cylinder for six (equally, 60° spaced) dual fields was measured to be 1.19 cGy/MU. Percent Depth Dose data for the AP dual field and TSD are shown in Figure 2. Conclusion This paper provides a modern procedure for commissioning TSEB therapy on a linear accelerator, and clinical beam data for the Elekta Synergy(R) with Agility(TM) MLC.« less

Development of a Web-Based Clinical Decision Support System for Drug Prescription: Non-Interventional Naturalistic Description of the Antipsychotic Prescription Patterns in 4345 Outpatients and Future Applications.

PubMed

Berrouiguet, Sofian; Barrigón, Maria Luisa; Brandt, Sara A; Ovejero-García, Santiago; Álvarez-García, Raquel; Carballo, Juan Jose; Lenca, Philippe; Courtet, Philippe; Baca-García, Enrique

2016-01-01

The emergence of electronic prescribing devices with clinical decision support systems (CDSS) is able to significantly improve management pharmacological treatments. We developed a web application available on smartphones in order to help clinicians monitor prescription and further propose CDSS. A web application (www.MEmind.net) was developed to assess patients and collect data regarding gender, age, diagnosis and treatment. We analyzed antipsychotic prescriptions in 4345 patients attended in five Psychiatric Community Mental Health Centers from June 2014 to October 2014. The web-application reported average daily dose prescribed for antipsychotics, prescribed daily dose (PDD), and the PDD to defined daily dose (DDD) ratio. The MEmind web-application reported that antipsychotics were used in 1116 patients out of the total sample, mostly in 486 (44%) patients with schizophrenia related disorders but also in other diagnoses. Second generation antipsychotics (quetiapine, aripiprazole and long-acting paliperidone) were preferably employed. Low doses were more frequently used than high doses. Long acting paliperidone and ziprasidone however, were the only two antipsychotics used at excessive dosing. Antipsychotic polypharmacy was used in 287 (26%) patients with classic depot drugs, clotiapine, amisulpride and clozapine. In this study we describe the first step of the development of a web application that is able to make polypharmacy, high dose usage and off label usage of antipsychotics visible to clinicians. Current development of the MEmind web application may help to improve prescription security via momentary feedback of prescription and clinical decision support system.

Development of a Web-Based Clinical Decision Support System for Drug Prescription: Non-Interventional Naturalistic Description of the Antipsychotic Prescription Patterns in 4345 Outpatients and Future Applications

PubMed Central

Berrouiguet, Sofian; Barrigón, Maria Luisa; Brandt, Sara A.; Ovejero-García, Santiago; Álvarez-García, Raquel; Carballo, Juan Jose; Lenca, Philippe; Courtet, Philippe; Baca-García, Enrique

2016-01-01

Purpose The emergence of electronic prescribing devices with clinical decision support systems (CDSS) is able to significantly improve management pharmacological treatments. We developed a web application available on smartphones in order to help clinicians monitor prescription and further propose CDSS. Method A web application (www.MEmind.net) was developed to assess patients and collect data regarding gender, age, diagnosis and treatment. We analyzed antipsychotic prescriptions in 4345 patients attended in five Psychiatric Community Mental Health Centers from June 2014 to October 2014. The web-application reported average daily dose prescribed for antipsychotics, prescribed daily dose (PDD), and the PDD to defined daily dose (DDD) ratio. Results The MEmind web-application reported that antipsychotics were used in 1116 patients out of the total sample, mostly in 486 (44%) patients with schizophrenia related disorders but also in other diagnoses. Second generation antipsychotics (quetiapine, aripiprazole and long-acting paliperidone) were preferably employed. Low doses were more frequently used than high doses. Long acting paliperidone and ziprasidone however, were the only two antipsychotics used at excessive dosing. Antipsychotic polypharmacy was used in 287 (26%) patients with classic depot drugs, clotiapine, amisulpride and clozapine. Conclusions In this study we describe the first step of the development of a web application that is able to make polypharmacy, high dose usage and off label usage of antipsychotics visible to clinicians. Current development of the MEmind web application may help to improve prescription security via momentary feedback of prescription and clinical decision support system. PMID:27764107

Pervasive developmental disorders among children and adolescents attending psychiatric day treatment.

PubMed

Sverd, Jeffrey; Dubey, Dennis R; Schweitzer, Robert; Ninan, Remani

2003-11-01

This study sought to determine the prevalence of pervasive developmental disorders (PDD) among children admitted to a state hospital day treatment service and to characterize the psychiatric disturbance of patients with PDD. A total of 146 consecutively admitted patients were evaluated for PDD. Patients who had PDD were compared with a sample of age- and sex-matched patients in day treatment who did not have PDD. Psychiatric symptoms, family history, and developmental and educational histories were examined. Of the 146 patients, 20 (14 percent) met criteria for PDD. An additional five patients who had PDD were included, yielding a final sample of 25. Only two of an array of psychiatric symptoms were more prevalent among patients with PDD: engaging in unusual fantasy and talking to themselves, animals, or inanimate objects. Significantly more patients with PDD had a history of speech delay, language abnormalities, and inexplicable or lengthy episodes of crying or screaming. The groups did not differ significantly in IQ or global functioning. Seven patients with PDD (28 percent) met criteria for childhood-onset schizophrenia, and 19 (76 percent) had symptoms of a tic disorder. The study found that PDD is not rare and that children with PDD represent a significant subgroup of children with serious emotional disturbance referred for psychiatric treatment. The findings support the view that PDD may be easily missed because it may be mild and associated with psychiatric disturbances that are present among other severely ill youngsters.

Effect of scattered electrons on the ‘Magic Plate’ transmission array detector response

NASA Astrophysics Data System (ADS)

Alrowaili, Z. A.; Lerch, M.; Petasecca, M.; Carolan, M.; Rosenfeld, A.

2017-02-01

Transmission type detectors can provide a measure of the energy fluence and if they are real-time systems that do not significantly attenuate the radiation beam have a distinct advantage over the current method as Quality Assurance (QA) could in principle be done during the actual patient treatment. The use of diode arrays in QA holds much promise due to real-time operation and feedback when compared to other methods e.g. films which are not real-time. The goal of this work is to describe the characterization of the radiation response of a silicon diode array called the Magic Plate (MP) when operated in transmission mode (MPTM). The response linearity of MPTM was excellent (R2=1). When the MP was placed in linac block tray position; the change in PDD at phantom surface (SSD 100 cm) for a 10 × 10 cm2 was -0.037 %, -0.178 % and -0.949 % for 6 MV, 10 MV and 18 MV beams. Therefore, MP does not provide a significant increase in skin dose to the patient and the percentage depth doses showed an excellent agreement with and without MPTM for 6 MV, 10 MV and 18 MV beams.

Photodynamic application in neurosurgery: present and future

NASA Astrophysics Data System (ADS)

Kostron, Herwig

2009-06-01

Photodynamic techniques such as photodynamic diagnosis (PDD), fluorescence guided tumor resection (FGR) and photodynamic therapy (PDT) are currently undergoing intensive clinical investigations as adjunctive treatment for malignant brain tumours. This review provides an overview on the current clinical data and trials as well as on photosensitisers, technical developments and indications for photodynamic application in Neurosurgery. Furthermore new developments and clinical significance of FGR for neurosurgery will be discussed. Over 1000 patients were enrolled in various clinical phase I/II trials for PDT for malignant brain tumours. Despite various treatment protocols, variation of photosensitisers and light dose there is a clear trend towards prolonging median survival after one single PDT as compared to conventional therapeutic modalities. The median survival after PDT for primary glioblastoma multiforme WHO IV was 19 months and for recurrent GBM 9 months as compared to standard convential treatment which is 15 months and 3 months, respectively. FGR in combination with adjunctive radiation was significantly superior to standard surgical resection followed by radiation. The combination of FGR/PDD and intraoperative PDT increased significantly survival in recurrent glioblastoma patients. The combination of PDD/ FGR and PDT offers an exciting approach to the treatment of malignant brain tumours "to see and to treat." PDT was generally well tolerated and side effects consisted of occasionally increased intracranial pressure and prolonged skin sensitivity against direct sunlight. This review covers the current available data and draws the future potential of PDD and PDT for its application in neurosurgery.

The Neurobiological Basis of Cognitive Impairment in Parkinson'S Disease

PubMed Central

Halliday, Glenda M.; Leverenz, James B.; Schneider, Jay S.; Adler, Charles H.

2014-01-01

The recent formalization of clinical criteria for PD with dementia (PD-D) codifies many studies on this topic, including those assessing biological correlates. These studies show that the emergence of PD-D occurs on the background of severe dopamine deficits with the main pathological drivers of cognitive decline being a synergistic effect between α -synuclein and Alzheimer's disease pathology. The presence of these pathologies correlates with a marked loss of limbic and cortically projecting dopamine, noradrenaline, serotonin and acetylcholine neurons, although the exact timing of these relationships remains to be determined. Genetic factors, such as triplications in the α-synuclein gene, lead to a clear increased risk of PD-D, while others, such as parkin mutations, are associated with a reduced risk of PD-D. The very recent formalization of clinical criteria for PD with mild cognitive impairment (PD-MCI) allows only speculation on its biological and genetic bases. Critical assessment of animal models shows that chronic low dose MPTP treatment in primates recapitulates PD-MCI over time, enhancing the current biological concept of PD-MCI as having enhanced dopamine deficiency in frontostriatal pathways as well as involvement of other neurotransmitter systems. Data from other animal models support multiple transmitter involvement in cognitive impairment in PD. While dopamine dysfunction has been highlighted because of its obvious role in PD, the role of the other neurotransmitter systems, neurodegenerative pathologies and genetic factors in PD-MCI remain to be fully elucidated. PMID:24757112

Pervasive Developmental Disorders: PDD-NOS, Asperger's Disorder and Autism. Parent Information Booklet.

ERIC Educational Resources Information Center

Levine, Karen

This information booklet is designed for parents who have a child who has been diagnosed with Pervasive Developmental Disorder (PDD) or Asperger's Disorder. It provides information on: (1) the definition of PDD; (2) the five subtypes of PDD, including PDD "not otherwise specified," Asperger's disorder, autistic disorder, childhood…

SU-F-T-467: A Cross-Checking Approach for Dosimetric Verification of Beam- Matched Elekta Linear Accelerators

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

Zheng, Y; Yuan, J; Geis, P

2016-06-15

Purpose: To verify the similarity of the dosimetric characteristics between two Elekta linear accelerators (linacs) in order to treat patients interchangeably on these two machines without re-planning. Methods: To investigate the viability of matching the 6 MV flattened beam on an existing linac (Elekta Synergy with Agility head) with a recently installed new linca (Elekta Versa HD), percent depth doses (PDD), flatness and symmetry output factors were compared for both machines. To validate the beam matching among machines, we carried out two approaches to cross-check the dosimetrical equivalence: 1) the prior treatment plans were re-computed based on the newly builtmore » Versa HD treatment planning system (TPS) model without changing the beam control points; 2) The same plans were delivered on both machines and the radiation dose measurements on a MapCheck2 were compared with TPS calculations. Three VMAT plans (Head and neck, lung, and prostate) were used in the study. Results: The difference between the PDDs for 10×10 cm{sup 2} field at all depths was less than 0.8%. The difference of flatness and symmetry for 30×30 cm{sup 2} field was less than 0.8%, and the measured output factors varies by less than 1% for each field size ranging from 2×2 cm2 to 40×40 cm{sup 2}. For the same plans, the maximum difference of the two calculated dose distributions is 2% of prescription. For the QA measurements, the gamma index passing rates were above 99% for 3%/3mm criteria with 10% threshold for all three clinical plans. Conclusion: A beam modality matching between two Elekta linacs is demonstrated with a cross-checking approach.« less

SU-E-T-607: Performance Quantification of the Nine Detectors Used for Dosimetry Measurements in Advanced Radiation Therapy Treatments

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

Markovic, M; Stathakis, S; Jurkovic, I

2015-06-15

Purpose: The purpose of this study was to quantify performance of the nine detectors used for dosimetry measurements in advanced radiation therapy treatments. Methods: The 6 MV beam was utilized for measurements of the field sizes with the lack of lateral charge particle equilibrium. For dose fidelity aspect, energy dependence was studied by measuring PDD and profiles at different depths. The volume effect and its influence on the measured dose profiles have been observed by measuring detector’s response function. Output factor measurements with respect to change in energy spectrum have been performed and collected data has been analyzed. The linearitymore » of the measurements with the dose delivered has been evaluated and relevant comparisons were done. Results: The measured values of the output factors with respect to change in energy spectrum indicated presence of the energy dependence. The detectors with active volume size ≤ 0.3 mm3 maximum deviation from the mean is 5.6% for the field size 0.5 x 0.5 cm2 while detectors with active volume size > 0.3 mm3 have maximum deviation from the mean 7.1%. Linearity with dose at highest dose rate examined for diode detectors showed maximum deviation of 4% while ion chambers showed maximum deviation of 2.2%. Dose profiles showed energy dependence at shallow depths (surface to dmax) influenced by low energy particles with 12 % maximum deviation from the mean for 5 mm2 field size. In relation to Monte Carlo calculation, the detector’s response function σ values were between (0.42±0.25) mm and (1.2±0.25) mm. Conclusion: All the detectors are appropriate for the dosimetry measurements in advanced radiation therapy treatments. The choice of the detectors has to be determined by the application and the scope of the measurements in respect to energy dependence and ability to accurately resolve dose profiles as well as to it’s intrinsic characteristics.« less

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

Oyewale, S; Pokharel, S; Rana, S

Purpose: To compare the percentage depth dose (PDD) computational accuracy of Adaptive Convolution (AC) and Collapsed Cone Convolution (CCC) algorithms in the presence of air gaps. Methods: A 30×30×30 cm{sup 3} solid water phantom with two 5cm air gaps was scanned with a CT simulator unit and exported into the Phillips Pinnacle™ treatment planning system. PDDs were computed using the AC and CCC algorithms. Photon energy of 6 MV was used with field sizes of 3×3 cm{sup 2}, 5×5 cm{sup 2}, 10×10 cm{sup 2}, 15×15 cm{sup 2}, and 20×20 cm{sup 2}. Ionization chamber readings were taken at different depths inmore » water for all the field sizes. The percentage differences in the PDDs were computed with normalization to the depth of maximum dose (dmax). The calculated PDDs were then compared with measured PDDs. Results: In the first buildup region, both algorithms overpredicted the dose for all field sizes and under-predicted for all other subsequent buildup regions. After dmax in the three water media, AC under-predicted the dose for field sizes 3×3 and 5×5 cm{sup 2} and overpredicted for larger field sizes, whereas CCC under-predicted for all field sizes. Upon traversing the first air gap, AC showed maximum differences of –3.9%, −1.4%, 2.0%, 2.5%, 2.9% and CCC had maximum differences of −3.9%, −3.0%,–3.1%, −2.7%, −1.8% for field sizes 3×3, 5×5, 10×10, 15×15, and 20×20 cm{sup 2} respectively. Conclusion: The effect of air gaps causes a significant difference in the PDDs computed by both the AC and CCC algorithms in secondary build-up regions. AC computed larger values for the PDDs except at smaller field sizes. For CCC, the size of the errors in prediction of the PDDs has an inverse relationship with respect to field size. These effects should be considered in treatment planning where significant air gaps are encountered.« less

Regression-based adaptive sparse polynomial dimensional decomposition for sensitivity analysis

NASA Astrophysics Data System (ADS)

Tang, Kunkun; Congedo, Pietro; Abgrall, Remi

2014-11-01

Polynomial dimensional decomposition (PDD) is employed in this work for global sensitivity analysis and uncertainty quantification of stochastic systems subject to a large number of random input variables. Due to the intimate structure between PDD and Analysis-of-Variance, PDD is able to provide simpler and more direct evaluation of the Sobol' sensitivity indices, when compared to polynomial chaos (PC). Unfortunately, the number of PDD terms grows exponentially with respect to the size of the input random vector, which makes the computational cost of the standard method unaffordable for real engineering applications. In order to address this problem of curse of dimensionality, this work proposes a variance-based adaptive strategy aiming to build a cheap meta-model by sparse-PDD with PDD coefficients computed by regression. During this adaptive procedure, the model representation by PDD only contains few terms, so that the cost to resolve repeatedly the linear system of the least-square regression problem is negligible. The size of the final sparse-PDD representation is much smaller than the full PDD, since only significant terms are eventually retained. Consequently, a much less number of calls to the deterministic model is required to compute the final PDD coefficients.

Screening for Glucose-6-Phosphate Dehydrogenase Deficiency Using Three Detection Methods: A Cross-Sectional Survey in Southwestern Uganda.

PubMed

Roh, Michelle E; Oyet, Caesar; Orikiriza, Patrick; Wade, Martina; Mwanga-Amumpaire, Juliet; Boum, Yap; Kiwanuka, Gertrude N; Parikh, Sunil

2016-11-02

Despite the potential benefit of primaquine in reducing Plasmodium falciparum transmission and radical cure of Plasmodium vivax and Plasmodium ovale infections, concerns over risk of hemolytic toxicity in individuals with glucose-6-phosphate dehydrogenase deficiency (G6PDd) have hampered its deployment. A cross-sectional survey was conducted in 2014 to assess the G6PDd prevalence among 631 children between 6 and 59 months of age in southwestern Uganda, an area where primaquine may be a promising control measure. G6PDd prevalence was determined using three detection methods: a quantitative G6PD enzyme activity assay (Trinity Biotech ® G-6-PDH kit), a qualitative point-of-care test (CareStart ™ G6PD rapid diagnostic test [RDT]), and molecular detection of the G6PD A- G202A allele. Qualitative tests were compared with the gold standard quantitative assay. G6PDd prevalence was higher by RDT (8.6%) than by quantitative assay (6.8%), using a < 60% activity threshold. The RDT performed optimally at a < 60% threshold and demonstrated high sensitivity (≥ 90%) and negative predictive values (100%) across three activity thresholds (below 60%, 30%, and 40%). G202A allele frequency was 6.4%, 7.9%, and 6.8% among females, males, and overall, respectively. Notably, over half of the G202A homo-/hemizygous children expressed ≥ 60% enzyme activity. Overall, the CareStart ™ G6PD RDT appears to be a viable screening test to accurately identify individuals with enzyme activities below 60%. The low prevalence of G6PDd across all three diagnostic modalities and absence of severe deficiency in our study suggests that there is little barrier to the use of single-dose primaquine in this region. © The American Society of Tropical Medicine and Hygiene.

SU-E-T-296: Dosimetric Analysis of Small Animal Image-Guided Irradiator Using High Resolution Optical CT Imaging of 3D Dosimeters

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

Na, Y; Qian, X; Wuu, C

Purpose: To verify the dosimetric characteristics of a small animal image-guided irradiator using a high-resolution of optical CT imaging of 3D dosimeters. Methods: PRESAEGE 3D dosimeters were used to determine dosimetric characteristics of a small animal image-guided irradiator and compared with EBT2 films. Cylindrical PRESAGE dosimeters with 7cm height and 6cm diameter were placed along the central axis of the beam. The films were positioned between 6×6cm{sup 2} cubed plastic water phantoms perpendicular to the beam direction with multiple depths. PRESAGE dosimeters and EBT2 films were then irradiated with the irradiator beams at 220kVp and 13mA. Each of irradiated PRESAGEmore » dosimeters named PA1, PA2, PB1, and PB2, was independently scanned using a high-resolution single laser beam optical CT scanner. The transverse images were reconstructed with a 0.1mm high-resolution pixel. A commercial Epson Expression 10000XL flatbed scanner was used for readout of irradiated EBT2 films at a 0.4mm pixel resolution. PDD curves and beam profiles were measured for the irradiated PRESAGE dosimeters and EBT2 films. Results: The PDD agreements between the irradiated PRESAGE dosimeter PA1, PA2, PB1, PB2 and the EB2 films were 1.7, 2.3, 1.9, and 1.9% for the multiple depths at 1, 5, 10, 15, 20, 30, 40 and 50mm, respectively. The FWHM measurements for each PRESAEGE dosimeter and film agreed with 0.5, 1.1, 0.4, and 1.7%, respectively, at 30mm depth. Both PDD and FWHM measurements for the PRESAGE dosimeters and the films agreed overall within 2%. The 20%–80% penumbral widths of each PRESAGE dosimeter and the film at a given depth were respectively found to be 0.97, 0.91, 0.79, 0.88, and 0.37mm. Conclusion: Dosimetric characteristics of a small animal image-guided irradiator have been demonstrated with the measurements of PRESAGE dosimeter and EB2 film. With the high resolution and accuracy obtained from this 3D dosimetry system, precise targeting small animal irradiation can be achieved.« less

Defect-induced mix experiment for NIF

NASA Astrophysics Data System (ADS)

Schmitt, M. J.; Bradley, P. A.; Cobble, J. A.; Hsu, S. C.; Krasheninnikova, N. S.; Kyrala, G. A.; Magelssen, G. R.; Murphy, T. J.; Obrey, K. A.; Tregillis, I. L.; Wysocki, F. J.; Finnegan, S. M.

2013-11-01

The Defect Induced Mix Experiment (DIME-II) will measure the implosion and mix characteristics of CH capsules filled with 5 atmospheres of DT by incorporating mid-Z dopant layers of Ge and Ga. This polar direct drive (PDD) experiment also will demonstrate the filling of a CH capsule at target chamber center using a fill tube. Diagnostics for these experiments include areal x-ray backlighting to obtain early time images of the implosion trajectory and a multiple-monochromatic imager (MMI) to collect spectrally-resolved images of the capsule dopant line emission near bangtime. The inclusion of two (or more) thin dopant layers at separate depths within the capsule shell facilitates spatial correlation of mix between the layers and the hot gas core on a single shot. The dopant layers are typically 2 μm thick and contain dopant concentrations of 1.5%. Three dimensional Hydra simulations have been performed to assess the effects of PDD asymmetry on capsule performance.

Pluridirectional High-Energy Agile Scanning Electron Radiotherapy (PHASER): Extremely Rapid Treatment for Early Lung Cancer

DTIC Science & Technology

2015-09-01

used to simulate 50- 150MeV VHEE beam dose deposition and its effects on steel and titanium (Ti) heterogeneities in a water phantom. Heterogeneities of...and water with segmented prostheses ( steel and Ti) geometries with 100MeV and 150MeV beams. Results: 100MeV PDD 5cm behind steel /Ti heterogeneity...in steel and 18% in Ti heterogeneities. The dose immediately behind steel heterogeneity decreased by an average of 6%, although for 150MeV, the

Ethylene-vinyl acetate foam as a new lung substitute in radiotherapy.

PubMed

Marqués, Enrique; Mancha, Pedro J

2018-04-01

The purpose of this study was to evaluate ethylene-vinyl acetate (EVA) foam as a new lung substitute in radiotherapy and to study its physical and dosimetric characteristics. We calculated the ideal vinyl acetate (VA) content of EVA foam sheets to mimic the physical and dosimetric characteristics of the ICRU lung tissue. We also computed the water-to-medium mass collision stopping power ratios, mass attenuation coefficients, CT numbers, effective atomic numbers and electron densities for: ICRU lung tissue, the RANDO commercial phantom, scaled WATER and EVA foam sheets with varying VA contents in a range between the minimum and maximum values supplied by the manufacturer. For all these substitutes, we simulated percent depth-dose curves with EGSnrc Monte Carlo (MC PDDs) in a water-lung substitute-water slab phantom expressed as dose-to-medium and dose-to-water for 3 × 3- and 10 × 10-cm 2 field sizes. PDD for the 10 × 10-cm 2 field size was also calculated with the MultiGrid Superposition algorithm (MGS PDD) for a relative electron density to water ratio of 0.26. The latter was compared with the MC PDDs in dose-to-water for scaled WATER and EVA foam sheets with the VA content that was most similar to the calculated ideal content that is physically achievable in practice. We calculated an ideal VA content of 55%; however, the maximum physically achievable content with current manufacturing techniques is 40%. The physical characteristics of the EVA foam sheets with a VA content of 40% (EVA40) are very close to those of the ICRU lung reference. The physical densities of the EVA40 foam sheets ranged from 0.030 to 0.965 g/cm 3 , almost covering the entire physical density range of the inflated/deflated lung (0.260-1.050 g/cm 3 ). Its mass attenuation coefficient at the effective energy of a 6-MV photon beam agrees within 0.8% of the ICRU reference value, and its CT number agrees within 6 HU. The effective atomic number for EVA40 varies by less than 0.42 of the ICRU value, and its effective electron density is within 0.9%. PDDs expressed in dose-to-medium and dose-to-water agree with the ICRU curve within 2% in all regions. PDDs calculated with both MC and MGS were within 1.5%. The EVA40 is an excellent cork-like lung substitute for radiotherapy applications. From a sole material used in footwear, it is possible to obtain a lung substitute that mimics the physical and dosimetric characteristics of ICRU lung tissue even better than the RANDO commercial phantom. © 2018 American Association of Physicists in Medicine.

Development and characterization of a three-dimensional radiochromic film stack dosimeter for megavoltage photon beam dosimetry

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

McCaw, Travis J., E-mail: mccaw@wisc.edu; Micka, John A.; DeWerd, Larry A.

Purpose: Three-dimensional (3D) dosimeters are particularly useful for verifying the commissioning of treatment planning and delivery systems, especially with the ever-increasing implementation of complex and conformal radiotherapy techniques such as volumetric modulated arc therapy. However, currently available 3D dosimeters require extensive experience to prepare and analyze, and are subject to large measurement uncertainties. This work aims to provide a more readily implementable 3D dosimeter with the development and characterization of a radiochromic film stack dosimeter for megavoltage photon beam dosimetry. Methods: A film stack dosimeter was developed using Gafchromic{sup ®} EBT2 films. The dosimeter consists of 22 films separated bymore » 1 mm-thick spacers. A Virtual Water™ phantom was created that maintains the radial film alignment within a maximum uncertainty of 0.3 mm. The film stack dosimeter was characterized using simulations and measurements of 6 MV fields. The absorbed-dose energy dependence and orientation dependence of the film stack dosimeter were investigated using Monte Carlo simulations. The water equivalence of the dosimeter was determined by comparing percentage-depth-dose (PDD) profiles measured with the film stack dosimeter and simulated using Monte Carlo methods. Film stack dosimeter measurements were verified with thermoluminescent dosimeter (TLD) microcube measurements. The film stack dosimeter was also used to verify the delivery of an intensity-modulated radiation therapy (IMRT) procedure. Results: The absorbed-dose energy response of EBT2 film differs less than 1.5% between the calibration and film stack dosimeter geometries for a 6 MV spectrum. Over a series of beam angles ranging from normal incidence to parallel incidence, the overall variation in the response of the film stack dosimeter is within a range of 2.5%. Relative to the response to a normally incident beam, the film stack dosimeter exhibits a 1% under-response when the beam axis is parallel to the film planes. Measured and simulated PDD profiles agree within a root-mean-square difference of 1.3%. In-field film stack dosimeter and TLD measurements agree within 5%, and measurements in the field penumbra agree within 0.5 mm. Film stack dosimeter and TLD measurements have expanded (k = 2) overall measurement uncertainties of 6.2% and 5.8%, respectively. Film stack dosimeter measurements of an IMRT dose distribution have 98% agreement with the treatment planning system dose calculation, using gamma criteria of 3% and 2 mm. Conclusions: The film stack dosimeter is capable of high-resolution, low-uncertainty 3D dose measurements, and can be readily incorporated into an existing film dosimetry program.« less

Peacekeeping/Stabilization and Conflict Transitions: Background and Congressional Action on the Civilian Response/Reserve Corps and Other Civilian Stabilization and Reconstruction Capabilities

DTIC Science & Technology

2009-02-05

Peace Operations. February 24, 2000 http://www.fas.org/irp/ offdocs/pdd/pdd-71-4.htm, hereafter referred to as PDD-71 White Paper; and U.S. Text ... Summary of Presidential Decision Directive 71, http://www.fas.org/irp/offdocs/pdd/pdd-71-1.htm. 8 See CRS Report RL32321, Policing in Peacekeeping and

A simplified approach for exit dose in vivo measurements in radiotherapy and its clinical application.

PubMed

Banjade, D P; Shrestha, S L; Shukri, A; Tajuddin, A A; Bhat, M

2002-09-01

This is a study using LiF:Mg;Ti thermoluminescent dosimeter (TLD) rods in phantoms to investigate the effect of lack of backscatter on exit dose. Comparing the measured dose with anticipated dose calculated using tissue maximum ratio (TMR) or percentage depth dose (PDD) gives rise to a correction factor. This correction factor may be applied to in-vivo dosimetry results to derive true dose to a point within the patient. Measurements in a specially designed humanoid breast phantom as well as patients undergoing radiotherapy treatment were also been done. TLDs with reproducibility of within +/- 3% (1 SD) are irradiated in a series of measurements for 6 and 10 MV photon beams from a medical linear accelerator. The measured exit doses for the different phantom thickness for 6 MV beams are found to be lowered by 10.9 to 14.0% compared to the dose derived from theoretical estimation (normalized dose at dmax). The same measurements for 10 MV beams are lowered by 9.0 to 13.5%. The variations of measured exit dose for different field sizes are found to be within 2.5%. The exit doses with added backscatter material from 2 mm up to 15 cm, shows gradual increase and the saturated values agreed within 1.5% with the expected results for both beams. The measured exit doses in humanoid breast phantom as well as in the clinical trial on patients undergoing radiotherapy also agreed with the predicted results based on phantom measurements. The authors' viewpoint is that this technique provides sufficient information to design exit surface bolus to restore build down effect in cases where part of the exit surface is being considered as a target volume. It indicates that the technique could be translated for in vivo dose measurements, which may be a conspicuous step of quality assurance in clinical practice.

Estimation of extremely small field radiation dose for brain stereotactic radiotherapy using the Vero4DRT system.

PubMed

Nakayama, Shinichi; Monzen, Hajime; Onishi, Yuichi; Kaneshige, Soichiro; Kanno, Ikuo

2018-06-01

The purpose of this study was a dosimetric validation of the Vero4DRT for brain stereotactic radiotherapy (SRT) with extremely small fields calculated by the treatment planning system (TPS) iPlan (Ver.4.5.1; algorithm XVMC). Measured and calculated data (e.g. percentage depth dose [PDD], dose profile, and point dose) were compared for small square fields of 30 × 30, 20 × 20, 10 × 10 and 5 × 5 mm 2 using ionization chambers of 0.01 or 0.04 cm 3 and a diamond detector. Dose verifications were performed using an ionization chamber and radiochromic film (EBT3; the equivalent field sizes used were 8.2, 8.7, 8.9, 9.5, and 12.9 mm 2 ) for five brain SRT cases irradiated with dynamic conformal arcs. The PDDs and dose profiles for the measured and calculated data were in good agreement for fields larger than or equal to 10 × 10 mm 2 when an appropriate detector was chosen. The dose differences for point doses in fields of 30 × 30, 20 × 20, 10 × 10 and 5 × 5 mm 2 were +0.48%, +0.56%, -0.52%, and +11.2% respectively. In the dose verifications for the brain SRT plans, the mean dose difference between the calculated and measured doses were -0.35% (range, -0.94% to +0.47%), with the average pass rates for the gamma index under the 3%/2 mm criterion being 96.71%, 93.37%, and 97.58% for coronal, sagittal, and axial planes respectively. The Vero4DRT system provides accurate delivery of radiation dose for small fields larger than or equal to 10 × 10 mm 2 . Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Can i have a second child? dilemmas of mothers of children with pervasive developmental disorder: a qualitative study

PubMed Central

2010-01-01

Background Pervasive developmental disorder (PDD) has an uncertain etiology, no method of treatment, and results in communication deficiencies and other behavioral problems. As the reported recurrence risk is 5%-10% and there are no methods of either prevention or prenatal testing, mothers of PDD children may face unique challenges when contemplating second pregnancies. The purpose of this study was to explore the mothers' lived experiences of second child-related decision-making after the birth of a child with PDD. Methods The participants for this study were restricted to mothers living within the greater Tokyo metropolitan area who had given birth to a first child with PDD within the past 18 years. The ten participants were encouraged to describe their experiences of second-child related decision-making after the birth of a child with PDD on the basis of semi-structured interviews. Data analysis was performed by using Interpretive Phenomenological Analysis (IPA), which is concerned with understanding what the participant thinks or believes about the topic under discussion. Results We identified two superordinate themes. The first was balancing hopes and fears, in which hope was the potential joy to be gained by the birth of a new child without PDD and fears were characterized as uncertainty of PDD and perception of recurrence risk, burden on later-born children, and negative effects on a child with PDD. The second superordinate theme was assessing the manageability of the situation, which was affected by factors as diverse as severity of PDD, relationship between mother and father, and social support and acceptance for PDD. Our 10 participants suffered from extreme psychological conflict, and lack of social support and acceptance for PDD created numerous practical difficulties in having second children. Conclusions Our participants faced various difficulties when considering second pregnancies after the birth of children with PDD in the Japanese society. As lack of social support and acceptance for PDD also played a large role in second child-related decision-making, creating a social environment that more fully accepts those disabled and providing flexible support systems for families of children with PDD are crucial. PMID:20977702

TU-AB-BRC-05: Creation of a Monte Carlo TrueBeam Model by Reproducing Varian Phase Space Data

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

O’Grady, K; Davis, S; Seuntjens, J

Purpose: To create a Varian TrueBeam 6 MV FFF Monte Carlo model using BEAMnrc/EGSnrc that accurately reproduces the Varian representative dataset, followed by tuning the model’s source parameters to accurately reproduce in-house measurements. Methods: A BEAMnrc TrueBeam model for 6 MV FFF has been created by modifying a validated 6 MV Varian CL21EX model. Geometric dimensions and materials were adjusted in a trial and error approach to match the fluence and spectra of TrueBeam phase spaces output by the Varian VirtuaLinac. Once the model’s phase space matched Varian’s counterpart using the default source parameters, it was validated to match 10more » × 10 cm{sup 2} Varian representative data obtained with the IBA CC13. The source parameters were then tuned to match in-house 5 × 5 cm{sup 2} PTW microDiamond measurements. All dose to water simulations included detector models to include the effects of volume averaging and the non-water equivalence of the chamber materials, allowing for more accurate source parameter selection. Results: The Varian phase space spectra and fluence were matched with excellent agreement. The in-house model’s PDD agreement with CC13 TrueBeam representative data was within 0.9% local percent difference beyond the first 3 mm. Profile agreement at 10 cm depth was within 0.9% local percent difference and 1.3 mm distance-to-agreement in the central axis and penumbra regions, respectively. Once the source parameters were tuned, PDD agreement with microDiamond measurements was within 0.9% local percent difference beyond 2 mm. The microDiamond profile agreement at 10 cm depth was within 0.6% local percent difference and 0.4 mm distance-to-agreement in the central axis and penumbra regions, respectively. Conclusion: An accurate in-house Monte Carlo model of the Varian TrueBeam was achieved independently of the Varian phase space solution and was tuned to in-house measurements. KO acknowledges partial support by the CREATE Medical Physics Research Training Network grant of the Natural Sciences and Engineering Research Council (Grant number: 432290).« less

Remote Cherenkov imaging-based quality assurance of a magnetic resonance image-guided radiotherapy system.

PubMed

Andreozzi, Jacqueline M; Mooney, Karen E; Brůža, Petr; Curcuru, Austen; Gladstone, David J; Pogue, Brian W; Green, Olga

2018-06-01

Tools to perform regular quality assurance of magnetic resonance image-guided radiotherapy (MRIgRT) systems should ideally be independent of interference from the magnetic fields. Remotely acquired optical Cherenkov imaging-based dosimetry measurements in water were investigated for this purpose, comparing measures of dose accuracy, temporal dynamics, and overall integrated IMRT delivery. A 40 × 30.5 × 37.5 cm 3 water tank doped with 1 g/L of quinine sulfate was imaged using an intensified charge-coupled device (ICCD) to capture the Cherenkov emission while being irradiated by a commercial MRIgRT system (ViewRay™). The ICCD was placed down-bore at the end of the couch, 4 m from treatment isocenter and behind the 5-Gauss line of the 0.35-T MRI. After establishing optimal camera acquisition settings, square beams of increasing size (4.2 × 4.2 cm 2 , 10.5 × 10.5 cm 2 , and 14.7 × 14.7 cm 2 ) were imaged at 0.93 frames per second, from an individual cobalt-60 treatment head, to develop projection measures related to percent depth dose (PDD) curves and cross beam profiles (CPB). These Cherenkov-derived measurements were compared to ionization chamber (IC) and radiographic film dosimetry data, as well as simulation data from the treatment planning system (TPS). An intensity-modulated radiotherapy (IMRT) commissioning plan from AAPM TG-119 (C4:C-Shape) was also imaged at 2.1 frames per second, and the single linear sum image from 509 s of plan delivery was compared to the dose volume prediction generated by the TPS using gamma index analysis. Analysis of standardized test target images (1024 × 1024 pixels) yielded a pixel resolution of 0.37 mm/pixel. The beam width measured from the Cherenkov image-generated projection CBPs was within 1 mm accuracy when compared to film measurements for all beams. The 502 point measurements (i.e., pixels) of the Cherenkov image-based projection percent depth dose curves (pPDDs) were compared to pPDDs simulated by the treatment planning system (TPS), with an overall average error of 0.60%, 0.56%, and 0.65% for the 4.2, 10.5, and 14.7 cm square beams, respectively. The relationships between pPDDs and central axis PDDs derived from the TPS were used to apply a weighting factor to the Cherenkov pPDD, so that the Cherenkov data could be directly compared to IC PDDs (average error of -0.07%, 0.10%, and -0.01% for the same sized beams, respectively). Finally, the composite image of the TG-119 C4 treatment plan achieved a 95.1% passing rate using 4%/4 mm gamma index agreement criteria between Cherenkov intensity and TPS dose volume data. This is the first examination of Cherenkov-generated pPDDs and pCBPs in an MR-IGRT system. Cherenkov imaging measurements were fast to acquire, and minimal error was observed overall. Cherenkov imaging also provided novel real-time data for IMRT QA. The strengths of this imaging are the rapid data capture ability providing real-time, high spatial resolution data, combined with the remote, noncontact nature of imaging. The biggest limitation of this method is the two-dimensional (2D) projection-based imaging of three-dimensional (3D) dose distributions through the transparent water tank. © 2018 American Association of Physicists in Medicine.

Validation of OSLD and a treatment planning system for surface dose determination in IMRT treatments

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

Zhuang, Audrey H., E-mail: hzhuang@usc.edu; Olch, Arthur J.

2014-08-15

Purpose: To evaluate the accuracy of skin dose determination for composite multibeam 3D conformal radiation therapy (3DCRT) and intensity modulated radiation therapy (IMRT) treatments using optically stimulated luminescent dosimeters (OSLDs) and Eclipse treatment planning system. Methods: Surface doses measured by OSLDs in the buildup region for open field 6 MV beams, either perpendicular or oblique to the surface, were evaluated by comparing against dose measured by Markus Parallel Plate (PP) chamber, surface diodes, and calculated by Monte Carlo simulations. The accuracy of percent depth dose (PDD) calculation in the buildup region from the authors’ Eclipse system (Version 10), which wasmore » precisely commissioned in the buildup region and was used with 1 mm calculation grid, was also evaluated by comparing to PP chamber measurements and Monte Carlo simulations. Finally, an anthropomorphic pelvic phantom was CT scanned with OSLDs in place at three locations. A planning target volume (PTV) was defined that extended close to the surface. Both an 8 beam 3DCRT and IMRT plan were generated in Eclipse. OSLDs were placed at the CT scanned reference locations to measure the skin doses and were compared to diode measurements and Eclipse calculations. Efforts were made to ensure that the dose comparison was done at the effective measurement points of each detector and corresponding locations in CT images. Results: The depth of the effective measurement point is 0.8 mm for OSLD when used in the buildup region in a 6 MV beam and is 0.7 mm for the authors’ surface diode. OSLDs and Eclipse system both agree well with Monte Carlo and/or Markus PP ion chamber and/or diode in buildup regions in 6 MV beams with normal or oblique incidence and across different field sizes. For the multiple beam 3DCRT plan and IMRT plans, the differences between OSLDs and Eclipse calculations on the surface of the anthropomorphic phantom were within 3% and distance-to-agreement less than 0.3 mm. Conclusions: The authors’ experiment showed that OSLD is an accurate dosimeter for skin dose measurements in complex 3DCRT or IMRT plans. It also showed that an Eclipse system with accurate commissioning of the data in the buildup region and 1 mm calculation grid can calculate surface doses with high accuracy and has a potential to replacein vivo measurements.« less

Small field measurements with a novel silicon position sensitive diode array.

PubMed

Manolopoulos, S; Wojnecki, C; Hugtenburg, R; Jaafar Sidek, M A; Chalmers, G; Heyes, G; Green, S

2009-02-07

DOSI, a novel dosimeter based on position sensitive detectors for particle physics experiments, was used for relative clinical dosimetry measurements in small radiotherapy fields. The device is capable of dynamic measurements in real time and provides sub-millimetre spatial resolution. The basic beam data for a stereotactic radiotherapy collimator system (BrainLAB) using 6 MV photons were measured and compared with the corresponding data acquired with a small diamond detector and a PinPoint ionization chamber. All measurements showed an excellent agreement between DOSI and the diamond detector. There was an increasing discrepancy between the relative output factors (ROF) measured with DOSI and those measured with the ionization chamber with decreasing field size, specifically for collimators with a diameter smaller than 15 mm. The percentage depth doses (PDD) were in agreement to better than 1% for all depths. The agreement on off-axis ratios (OAR) was better than 3% for all collimators, whereas the agreement on relative output factors (ROF) was at the 1% level. DOSI's fast read-out electronics made it possible for all measurements to be recorded within 45 min including time to change collimators. This should reduce the overall time for commissioning and QA measurements, an important factor especially for busy radiotherapy departments.

Cell and small animal models for phenotypic drug discovery.

PubMed

Szabo, Mihaly; Svensson Akusjärvi, Sara; Saxena, Ankur; Liu, Jianping; Chandrasekar, Gayathri; Kitambi, Satish S

2017-01-01

The phenotype-based drug discovery (PDD) approach is re-emerging as an alternative platform for drug discovery. This review provides an overview of the various model systems and technical advances in imaging and image analyses that strengthen the PDD platform. In PDD screens, compounds of therapeutic value are identified based on the phenotypic perturbations produced irrespective of target(s) or mechanism of action. In this article, examples of phenotypic changes that can be detected and quantified with relative ease in a cell-based setup are discussed. In addition, a higher order of PDD screening setup using small animal models is also explored. As PDD screens integrate physiology and multiple signaling mechanisms during the screening process, the identified hits have higher biomedical applicability. Taken together, this review highlights the advantages gained by adopting a PDD approach in drug discovery. Such a PDD platform can complement target-based systems that are currently in practice to accelerate drug discovery.

Research and Design on a Product Data Definition System of Semiconductor Packaging Industry

NASA Astrophysics Data System (ADS)

Shi, Jinfei; Ma, Qingyao; Zhou, Yifan; Chen, Ruwen

2017-12-01

This paper develops a product data definition (PDD) system for a semiconductor packaging and testing company with independent intellectual property rights. The new PDD system can solve the problems such as, the effective control of production plans, the timely feedback of production processes, and the efficient schedule of resources. Firstly, this paper introduces the general requirements of the PDD system and depicts the operation flow and the data flow of the PDD system. Secondly, the overall design scheme of the PDD system is put forward. After that, the physical data model is developed using the Power Designer15.0 tool, and the database system is built. Finally, the function realization and running effects of the PDD system are analysed. The successful operation of the PDD system can realize the information flow among various production departments of the enterprise to meet the standard of the enterprise manufacturing integration and improve the efficiency of production management.

Pervasive Developmental Disorder: Client-Centered Approach. A Guide for Parents and Teachers.

ERIC Educational Resources Information Center

Stewart, Bonnie C.

This guide to pervasive developmental disorder (PDD) or autistic spectrum disorder (ASD) first provides a review of the literature on defining characteristics of PDD/ASD, causes of PDD, and diagnosis of PDD. Review of intervention and treatment comprises the major portion of the paper. After briefly considering parent education, this section…

[Gender dysphoria in pervasive developmental disorders].

PubMed

Tateno, Masaru; Ikeda, Hiroshi; Saito, Toshikazu

2011-01-01

Pervasive developmental disorders (PDD) are characterized by two essential symptoms: impairment in social interaction, and restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. PDD include autistic disorder, Asperger's disorder, and PDD-Not Otherwise Specified (PDD-NOS). These three disorders are sometimes termed autism spectrum disorders. A recent epidemiological survey demonstrated that the rate of PDD may be almost 1% and that many PDD cases might not be diagnosed properly in childhood. Erik Erikson described eight stages of psychosocial development through which a normally developing human should pass from infancy to adulthood. In the theory, an adolescent shows 'Identity vs. Role Confusion'. It has been reported that individuals with PDD often have identity crises which sometimes include gender dysphoria. This phenomenon might be related to the so-called identity diffusion in youth. When they reach their young youth, it has been said that subjects with PDD realize their uniqueness and differences compared to others, and, as a result, they may develop confusion of identity which could be exhibited as gender identity disorder. A recent study demonstrated that, amongst 204 children and adolescents who visited a GID clinic in the Netherlands, 7.8% were diagnosed with autism spectrum disorders after a careful diagnostic procedure by a multi-disciplinary team. Taken together, PDD and GID seem closely related to each other. In this paper, we present four PDD cases with gender dysphoria and related symptoms: 1) a girl with PDD who repeatedly asserted gender identity disorder (GID) symptoms in response to social isolation at school, 2) a junior high school boy with PDD and transvestism, 3) a boy diagnosed with Asperger's disorder who developed a disturbance of sexual orientation, and 4) a boy with Asperger's disorder and comorbid childhood GID. Many of the clinical symptoms related to gender dysphoria might be explained by the cognitive characteristics and psychopathology of PDD. The Japanese Society of Psychiatry and Neurology published guidelines for the assessment and treatment of GID in 1997, and revised them in 2006. As a result, GID has become well known as a clinical entity in Japan, and there have been an increasing number of Japanese patients complaining of gender dysphoria. It is important to consider an underlying diagnosis of PDD when encountering patients with gender dysphoria.

A measurement-based generalized source model for Monte Carlo dose simulations of CT scans

PubMed Central

Ming, Xin; Feng, Yuanming; Liu, Ransheng; Yang, Chengwen; Zhou, Li; Zhai, Hezheng; Deng, Jun

2018-01-01

The goal of this study is to develop a generalized source model (GSM) for accurate Monte Carlo dose simulations of CT scans based solely on the measurement data without a priori knowledge of scanner specifications. The proposed generalized source model consists of an extended circular source located at x-ray target level with its energy spectrum, source distribution and fluence distribution derived from a set of measurement data conveniently available in the clinic. Specifically, the central axis percent depth dose (PDD) curves measured in water and the cone output factors measured in air were used to derive the energy spectrum and the source distribution respectively with a Levenberg-Marquardt algorithm. The in-air film measurement of fan-beam dose profiles at fixed gantry was back-projected to generate the fluence distribution of the source model. A benchmarked Monte Carlo user code was used to simulate the dose distributions in water with the developed source model as beam input. The feasibility and accuracy of the proposed source model was tested on a GE LightSpeed and a Philips Brilliance Big Bore multi-detector CT (MDCT) scanners available in our clinic. In general, the Monte Carlo simulations of the PDDs in water and dose profiles along lateral and longitudinal directions agreed with the measurements within 4%/1mm for both CT scanners. The absolute dose comparison using two CTDI phantoms (16 cm and 32 cm in diameters) indicated a better than 5% agreement between the Monte Carlo-simulated and the ion chamber-measured doses at a variety of locations for the two scanners. Overall, this study demonstrated that a generalized source model can be constructed based only on a set of measurement data and used for accurate Monte Carlo dose simulations of patients’ CT scans, which would facilitate patient-specific CT organ dose estimation and cancer risk management in the diagnostic and therapeutic radiology. PMID:28079526

A measurement-based generalized source model for Monte Carlo dose simulations of CT scans

NASA Astrophysics Data System (ADS)

Ming, Xin; Feng, Yuanming; Liu, Ransheng; Yang, Chengwen; Zhou, Li; Zhai, Hezheng; Deng, Jun

2017-03-01

The goal of this study is to develop a generalized source model for accurate Monte Carlo dose simulations of CT scans based solely on the measurement data without a priori knowledge of scanner specifications. The proposed generalized source model consists of an extended circular source located at x-ray target level with its energy spectrum, source distribution and fluence distribution derived from a set of measurement data conveniently available in the clinic. Specifically, the central axis percent depth dose (PDD) curves measured in water and the cone output factors measured in air were used to derive the energy spectrum and the source distribution respectively with a Levenberg-Marquardt algorithm. The in-air film measurement of fan-beam dose profiles at fixed gantry was back-projected to generate the fluence distribution of the source model. A benchmarked Monte Carlo user code was used to simulate the dose distributions in water with the developed source model as beam input. The feasibility and accuracy of the proposed source model was tested on a GE LightSpeed and a Philips Brilliance Big Bore multi-detector CT (MDCT) scanners available in our clinic. In general, the Monte Carlo simulations of the PDDs in water and dose profiles along lateral and longitudinal directions agreed with the measurements within 4%/1 mm for both CT scanners. The absolute dose comparison using two CTDI phantoms (16 cm and 32 cm in diameters) indicated a better than 5% agreement between the Monte Carlo-simulated and the ion chamber-measured doses at a variety of locations for the two scanners. Overall, this study demonstrated that a generalized source model can be constructed based only on a set of measurement data and used for accurate Monte Carlo dose simulations of patients’ CT scans, which would facilitate patient-specific CT organ dose estimation and cancer risk management in the diagnostic and therapeutic radiology.

Interaction of Social and Play Behaviors in Preschoolers With and Without Pervasive Developmental Disorder

ERIC Educational Resources Information Center

Pierce-Jordan, Sandra; Lifter, Karin

2005-01-01

This study investigated the relationship between the social and play behaviors of young children with pervasive developmental disorder (PDD) and without PDD. Videotaped observations of 21 preschool children (12 with PDD and 9 without PDD) were examined independently for (a) social complexity and (b) play complexity that was assessed on an…

Hemispheric Processing of Idioms and Irony in Adults With and Without Pervasive Developmental Disorder.

PubMed

Saban-Bezalel, Ronit; Mashal, Nira

2015-11-01

Previous studies on individuals with pervasive developmental disorders (PDD) have pointed to difficulties in comprehension of figurative language. Using the divided visual field paradigm, the present study examined hemispheric processing of idioms and irony in 23 adults with PDD and in 24 typically developing (TD) adults. The results show that adults with PDD were relatively unimpaired in understanding figurative language. While the TD group demonstrated a right hemisphere advantage in processing the non-salient meanings of idioms as well as the ironic endings of paragraphs, the PDD group processed these stimuli bilaterally. Our findings suggest that brain lateralization is atypical in adults with PDD. Successful performance along with bilateral brain activation suggests that the PDD group uses a compensation mechanism.

Comparing cerebral perfusion in Alzheimer's disease and Parkinson's disease dementia: an ASL-MRI study.

PubMed

Le Heron, Campbell J; Wright, Sarah L; Melzer, Tracy R; Myall, Daniel J; MacAskill, Michael R; Livingston, Leslie; Keenan, Ross J; Watts, Richard; Dalrymple-Alford, John C; Anderson, Tim J

2014-06-01

Emerging evidence suggests that Alzheimer's disease (AD) and Parkinson's disease dementia (PDD) share neurodegenerative mechanisms. We sought to directly compare cerebral perfusion in these two conditions using arterial spin labeling magnetic resonance imaging (ASL-MRI). In total, 17 AD, 20 PDD, and 37 matched healthy controls completed ASL and structural MRI, and comprehensive neuropsychological testing. Alzheimer's disease and PDD perfusion was analyzed by whole-brain voxel-based analysis (to assess absolute blood flow), a priori specified region of interest analysis, and principal component analysis (to generate a network differentiating the two groups). Corrections were made for cerebral atrophy, age, sex, education, and MRI scanner software version. Analysis of absolute blood flow showed no significant differences between AD and PDD. Comparing each group with controls revealed an overlapping, posterior pattern of hypoperfusion, including posterior cingulate gyrus, precuneus, and occipital regions. The perfusion network that differentiated AD and PDD groups identified relative differences in medial temporal lobes (AD

Efficacy of patient-specific bolus created using three-dimensional printing technique in photon radiotherapy.

PubMed

Fujimoto, Koya; Shiinoki, Takehiro; Yuasa, Yuki; Hanazawa, Hideki; Shibuya, Keiko

2017-06-01

A commercially available bolus ("commercial-bolus") does not make complete contact with the irregularly shaped patient skin. This study aims to customise a patient-specific three-dimensional (3D) bolus using a 3D printing technique ("3D-bolus") and to evaluate its clinical feasibility for photon radiotherapy. The 3D-bolus was designed using a treatment planning system (TPS) in Digital Imaging and Communications in Medicine-Radiotherapy (DICOM-RT) format, and converted to stereolithographic format for printing. To evaluate its physical characteristics, treatment plans were created for water-equivalent phantoms that were bolus-free, or had a flat-form printed 3D-bolus, a TPS-designed bolus ("virtual-bolus"), or a commercial-bolus. These plans were compared based on the percentage depth dose (PDD) and target-volume dose volume histogram (DVH) measurements. To evaluate the clinical feasibility, treatment plans were created for head phantoms that were bolus-free or had a 3D-bolus, a virtual-bolus, or a commercial-bolus. These plans were compared based on the target volume DVH. In the physical evaluation, the 3D-bolus provided effective dose coverage in the build-up region, which was equivalent to the commercial-bolus. With regard to the clinical feasibility, the air gaps were lesser with the 3D-bolus when compared to the commercial-bolus. Furthermore, the prescription dose could be delivered appropriately to the target volume. The 3D-bolus has potential use for air-gap reduction compared to the commercial-bolus and facilitates target-volume dose coverage and homogeneity improvement. A 3D-bolus produced using a 3D printing technique is comparable to a commercial-bolus applied to an irregular-shaped skin surface. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Comparison of DSM-IV Symptoms in Elementary School-Age Children with PDD versus Clinic and Community Samples

ERIC Educational Resources Information Center

Gadow, Kenneth D.; Devincent, Carla J.; Pomeroy, John; Azizian, Allen

2005-01-01

This study compares DSM-IV symptoms in children (ages 6 to 12 years) with pervasive developmental disorder (PDD), clinic controls, and community-based samples. Parents/teachers completed the Child Symptom Inventory-4 for four samples: PDD (N= 284/284) and non-PDD psychiatric clinic referrals (N= 189/181) and pupils in regular (N= 385/404) and…

Poster - Thur Eve - 45: Commissioning of the Varian ECLIPSE eMC algorithm for clinical electron treatment planning.

PubMed

Serban, M; Ruo, R; Sarfehnia, A; Parker, W; Evans, M

2012-07-01

Fast electron Monte Carlo systems have been developed commercially, and implemented for clinical practice in radiation therapy clinics. In this work the Varian eMC (electron Monte Carlo) algorithm was commissioned for clinical electron beams of energies between 6 MeV and 20 MeV. Beam outputs, PDDs and profiles were measured for 29 regular and irregular cutouts using the IC-10 (Wellhöfer) ionization chamber. Detailed percentage depth dose comparisons showed that the agreement between measurement and eMC for different characteristic points on the PDD are generally less than 1 mm and always less than 2 mm, with the eMC calculated values being lower than the measured values. Of the 145 measured output factors, 19 cases fail a ±2% agreement but only 8 cases fail a ±3% agreement between calculation and measurement. Comparison of central axis dose distributions for two electron energies (9, and 20 MeV) for a 10 × 10 cm 2 field, centrally shielded with Pb of width 0 cm (open), 1, 2 and 3 cm, shows agreement to within 3% except near the surface. Comparison of central axis dose distributions for 9 MeV in heterogeneous phantoms including bone and lung inserts showed agreement of 1 mm and 3 mm respectively with measured TLD data. The overall agreement between measurement and eMC calculation has enabled us to begin implementing this calculation model for clinical use. © 2012 American Association of Physicists in Medicine.

SU-E-T-110: Development of An Independent, Monte Carlo, Dose Calculation, Quality Assurance Tool for Clinical Trials

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

Faught, A; University of Texas Health Science Center Houston, Graduate School of Biomedical Sciences, Houston, TX; Davidson, S

2014-06-01

Purpose: To develop a comprehensive end-to-end test for Varian's TrueBeam linear accelerator for head and neck IMRT using a custom phantom designed to utilize multiple dosimetry devices. Purpose: To commission a multiple-source Monte Carlo model of Elekta linear accelerator beams of nominal energies 6MV and 10MV. Methods: A three source, Monte Carlo model of Elekta 6 and 10MV therapeutic x-ray beams was developed. Energy spectra of two photon sources corresponding to primary photons created in the target and scattered photons originating in the linear accelerator head were determined by an optimization process that fit the relative fluence of 0.25 MeVmore » energy bins to the product of Fatigue-Life and Fermi functions to match calculated percent depth dose (PDD) data with that measured in a water tank for a 10x10cm2 field. Off-axis effects were modeled by a 3rd degree polynomial used to describe the off-axis half-value layer as a function of off-axis angle and fitting the off-axis fluence to a piecewise linear function to match calculated dose profiles with measured dose profiles for a 40×40cm2 field. The model was validated by comparing calculated PDDs and dose profiles for field sizes ranging from 3×3cm2 to 30×30cm2 to those obtained from measurements. A benchmarking study compared calculated data to measurements for IMRT plans delivered to anthropomorphic phantoms. Results: Along the central axis of the beam 99.6% and 99.7% of all data passed the 2%/2mm gamma criterion for 6 and 10MV models, respectively. Dose profiles at depths of dmax, through 25cm agreed with measured data for 99.4% and 99.6% of data tested for 6 and 10MV models, respectively. A comparison of calculated dose to film measurement in a head and neck phantom showed an average of 85.3% and 90.5% of pixels passing a 3%/2mm gamma criterion for 6 and 10MV models respectively. Conclusion: A Monte Carlo multiple-source model for Elekta 6 and 10MV therapeutic x-ray beams has been developed as a quality assurance tool for clinical trials.« less

Diagnosis of upper urinary tract tumours: is photodynamic diagnosis assisted ureterorenoscopy required as an addition to modern imaging and ureterorenoscopy?

PubMed

Aboumarzouk, Omar M; Mains, Edward; Moseley, Harry; Kata, Sławomir G

2013-05-01

We aimed to assess the diagnostic accuracy of photodynamic diagnostic ureterorenoscopy (PDD-FURS) in detection of UUT-TCC in comparison with CT Urogram (CTU) and WL-FURS. Between June 2009 and August 2011, 30 patients underwent PDD-FURS after CTU for suspicion of UUT-TCC. Ureterorenoscopy was performed for abnormal upper urinary tract on imaging. Oral 5-Aminolevulinic Acid (5-ALA) was used as a photosensitizer. All procedures were performed by single endourologist experienced in photodynamic diagnosis. The sensitivity, specificity, and detection rate of WL-FURS, PDD-FURS and CTU were calculated using the Meta-DiSc v1.4 programme. P values <0.05 were considered significant. PDD-FURS detected more UUT-TCCs than CTU or WL-FURS (94% (16/17) vs. 76.5% (13/17) vs. 82% (14/17) respectively). PDD-FURS was not significantly more sensitive than CTU and WL-FURS to detect UUT-TCC (0.94 (95% CI: 0.71-0.99) vs. 0.82 (95% CI: 0.57-0.96) vs. 0.81 (95% CI: 0.54-0.96) respectively; PDD-FURS vs. CTU: P=0.249; PDD-FURS vs. WL-FURS: P=0.277). There was no difference in the specificity between PDD-FURS and WL-FURS (1.0 (95% CI: 0.75-1.0) and 1.0 (95% CI: 0.75-1.0) respectively) (P=1), while PDD-FURS was significantly more specific than CTU (CTU: 0.21 (95% CI: 0.05-0.51) (P<0.001). PDD-FURS picked up 3 cases of CIS, which was not seen on WL-FURL and CTU. Oral 5-ALA induced PDD-FURS has a high sensitivity and specificity to detect lesions and a higher detection rate to diagnose UUT-TCC than WL-FURS and CTU. It appears to be the only tool to visualise UUT CIS lesions. Copyright © 2012 Elsevier B.V. All rights reserved.

Safety of Live Liver Donation by Individuals With G6PD Deficiency: Initial Results and Comparative Study.

PubMed

Reddy, Mettu S; Shrivastav, Manoj; Kaliamoorthy, Ilankumaran; Kota, Venugopal; Dabora, Abderrhaim; Govil, Sanjay; Rela, Mohamed

2016-04-01

G6PD deficiency (G6PDd) is the commonest genetic enzyme defect in the world. However, baring a single case report, there is no published literature regarding the safety of donor hepatectomy in G6PDd individuals. Potential donors with World Health Organization class III or class IV G6PDd without evidence of hemolysis were evaluated for donation, if there was no other suitable donor. Postoperatively, donors were closely monitored for hemolysis and medications, which can induce hemolysis, were avoided. Outcomes of our first 14 G6PDd donors are presented. Postoperative course of these donors was also compared with a matched cohort of 30 non-G6PDd donors. There were 9 left lateral segment, 2 left lobe, and 3 right lobe donors. Two G6PDd donors had biochemical evidence of postoperative hemolysis not needing any specific treatment. Postoperative liver function tests, intensive care unit stay, hospital stay, and morbidity (greater than Clavien II) were similar in the G6PDd and non-G6PDd donor cohorts. Donors in the G6PDd group had lower trough hemoglobin in postoperative period (P = 0.006), greater drop in postoperative hemoglobin (P = 0.007), and a higher need for postoperative blood transfusion (4/14 vs 2/30, P = 0.071). This is the first case series reporting the safety of liver resection in G6PDd individuals. Hepatectomy in G6PD-deficient donors is associated with a greater drop in postoperative hemoglobin and a marginally increased need for postoperative transfusion. Use of these donors can be considered with caution, and it should not be an absolute contraindication for live liver donation.

WE-G-BRB-08: TG-51 Calibration of First Commercial MRI-Guided IMRT System in the Presence of 0.35 Tesla Magnetic Field.

PubMed

Goddu, S; Green, O Pechenaya; Mutic, S

2012-06-01

The first real-time-MRI-guided radiotherapy system has been installed in a clinic and it is being evaluated. Presence of magnetic field (MF) during radiation output calibration may have implications on ionization measurements and there is a possibility that standard calibration protocols may not be suitable for dose measurements for such devices. In this study, we evaluated whether a standard calibration protocol (AAPM- TG-51) is appropriate for absolute dose measurement in presence of MF. Treatment delivery of the ViewRay (VR) system is via three 15,000Ci Cobalt-60 heads positioned 120-degrees apart and all calibration measurements were done in the presence of 0.35T MF. Two ADCL- calibrated ionization-chambers (Exradin A12, A16) were used for TG-51 calibration. Chambers were positioned at 5-cm depth, (SSD=105cm: VR's isocenter), and the MLC leaves were shaped to a 10.5cm × 10.5 cm field size. Percent-depth-dose (PDD) measurements were performed for 5 and 10 cm depths. Individual output of each head was measured using the AAPM- TG51 protocol. Calibration accuracy for each head was subsequently verified by Radiological Physics Center (RPC) TLD measurements. Measured ion-recombination (Pion) and polarity (Ppol) correction factors were less-than 1.002 and 1.006, respectively. Measured PDDs agreed with BJR-25 within ±0.2%. Maximum dose rates for the reference field size at VR's isocenter for heads 1, 2 and 3 were 1.445±0.005, 1.446±0.107, 1.431±0.006 Gy/minute, respectively. Our calibrations agreed with RPC- TLD measurements within ±1.3%, ±2.6% and ±2.0% for treatment-heads 1, 2 and 3, respectively. At the time of calibration, mean activity of the Co-60 sources was 10,800Ci±0.1%. This study shows that the TG- 51 calibration is feasible in the presence of 0.35T MF and the measurement agreement is within the range of results obtainable for conventional treatment machines. Drs. Green, Goddu, and Mutic served as scientific consultants for ViewRay, Inc. Dr. Mutic is on the clinical focus group for ViewRay, Inc., and his spouse holds shares in ViewRay, Inc. © 2012 American Association of Physicists in Medicine.

[Pervasive developmental disorder in adults; importance of diagnosis in concern to the type of ego structure with PDD].

PubMed

Hirosawa, Masataka

2011-01-01

Most adult patients with pervasive developmental disorder (PDD) who consult with psychiatrists for the first time may have normal intelligence. In diagnosing high-functioning PDD to adult patients, we should pay much attention to psychological consistency which exists between developmental problems in childhood, developed personality, recent problems in social adjustment, and manifested psychiatric symptoms. In order to understand these relationships, considering the patients' type of ego structure ("PDD ego type") seems to be useful. "PDD ego type" is characterized by their unique self-universe image which takes form of grid one (just like a touch panel), which is decisively different from the form of a radial or concentric circle held by most people (Jung, C.G). This self-universe image characterizes adult PDD patients' psychiatric symptoms, unsuitable social performance, and their "personality."

Is pervasive developmental disorder not otherwise specified less stable than autistic disorder? A meta-analysis.

PubMed

Rondeau, Emélie; Klein, Leslie S; Masse, André; Bodeau, Nicolas; Cohen, David; Guilé, Jean-Marc

2011-09-01

We reviewed the stability of the diagnosis of pervasive developmental disorder not otherwise specified (PDD-NOS). A Medline search found eight studies reiterating a diagnostic assessment for PDD-NOS. The pooled group included 322 autistic disorder (AD) and 122 PDD-NOS cases. We used percentage of individuals with same diagnose at Times 1 and 2 as response criterion. The pooled Relative Risk was 1.95 (p < 0.001) showing that AD diagnostic stability was higher than PDD-NOS. When diagnosed before 36 months PDD-NOS bore a 3-year stability rate of 35%. Examining the developmental trajectories showed that PDD-NOS corresponded to a group of heterogeneous pathological conditions including prodromic forms of later AD, remitted or less severe forms of AD, and developmental delays in interaction and communication.

Determination of recombination and polarity correction factors, kS and kP, for small cylindrical ionization chambers PTW 31021 and PTW 31022 in pulsed filtered and unfiltered beams.

PubMed

Bruggmoser, Gregor; Saum, Rainer; Kranzer, Rafael

2018-01-12

The aim of this technical communication is to provide correction factors for recombination and polarity effect for two new ionization chambers PTW PinPoint 3D (type 31022) and PTW Semiflex 3D (type 31021). The correction factors provided are for the (based on the) German DIN 6800-2 dosimetry protocol and the AAPM TG51 protocol. The measurements were made in filtered and unfiltered high-energy photon beams in a water equivalent phantom at maximum depth of the PDD and a field size on the surface of 10cm×10cm. The design of the new chamber types leads to an ion collection efficiency and a polarity effect that are well within the specifications requested by pertinent dosimetry protocols including the addendum of TG-51. It was confirmed that the recombination effect of both chambers mainly depends on dose per pulse and is independent of the filtration of the photon beam. Copyright © 2018. Published by Elsevier GmbH.

Early diagnosis of Alzheimer's disease and Parkinson's disease associated with dementia using cerebral perfusion SPECT.

PubMed

Song, In-Uk; Chung, Yong-An; Chung, Sung-Woo; Jeong, Jaeseung

2014-01-01

Since patterns of cognitive dysfunction in mild Parkinson's disease associated with dementia (PDD) are similar to those in mild Alzheimer's disease (AD), it is difficult to accurately differentiate between these two types of dementia in their early phases using neuropsychological tests. The purpose of the current study was to investigate differences in cerebral perfusion patterns of patients with AD and PDD at the earliest stages using single photon emission computed tomography (SPECT). We consecutively recruited 31 patients with mild PDD, 32 patients with mild probable AD and 33 age-matched healthy subjects. All subjects underwent (99m)Tc-hexamethylpropyleneamine oxime perfusion SPECT and completed general neuropsychological tests. We found that both mild PDD and AD patients showed distinct hypoperfusion in frontal, parietal and temporal regions, compared with healthy subjects. More importantly, hypoperfusion in occipital and cerebellar regions was observed only in mild PDD. The observation of a significant decrease in cerebral perfusion in occipital and cerebellar regions in patients with mild PDD is likely useful to differentiate between PDD and AD at the earliest stages. © 2013 S. Karger AG, Basel.

"Characterization of ELEKTA SRS cone collimator using high spatial resolution monolithic silicon detector array".

PubMed

Shukaili, Khalsa Al; Corde, Stéphanie; Petasecca, Marco; Pereveratylo, Vladimir; Lerch, Michael; Jackson, Michael; Rosenfeld, Anatoly

2018-05-22

To investigate the accuracy of the dosimetry of radiation fields produced by small ELEKTA cone collimators used for stereotactic radiosurgery treatments (SRS) using commercially available detectors EBT3 Gafchromic TM film, IBA Stereotactic diode (SFD), and the recently developed detector DUO, which is a monolithic silicon orthogonal linear diode array detector. These three detectors were used for the measurement of beam profiles, output factors, and percentage depth dose for SRS cone collimators with cone sizes ranging from 5 to 50 mm diameter. The measurements were performed at 10 cm depth and 90 cm SSD. The SRS cone beam profiles measured with DUO, EBT3 film, and IBA SFD agreed well, results being in agreement within ±0.5 mm in the FWHM, and ±0.7 mm in the penumbra region. The output factor measured by DUO with 0.5 mm air gap above agrees within ±1% with EBT3. The OF measured by IBA SFD (corrected for the over-response) agreed with both EBT3 and DUO within ±2%. All three detectors agree within ±2% for PDD measurements for all SRS cones. The characteristics of the ELEKTA SRS cone collimator have been evaluated by using a monolithic silicon high spatial resolution detector DUO, EBT3, and IBA SFD diode. The DUO detector is suitable for fast real-time quality assurance dosimetry in small radiation fields typical for SRS/SRT. This has been demonstrated by its good agreement of measured doses with EBT 3 films. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

A quantification method for peroxyacetyl nitrate (PAN) using gas chromatography (GC) with a non-radioactive pulsed discharge detector (PDD)

NASA Astrophysics Data System (ADS)

Zhang, Lei; Jaffe, Daniel A.; Gao, Xin; McClure, Crystal D.

2018-04-01

In this study, we developed a method for continuous PAN measurements by gas chromatography (GC) with a non-radioactive pulsed discharge detector (PDD). Operational parameters were optimized based on the ratio of peak height over baseline noise (P/N ratio). The GC/PDD system was compared with a traditional radioactive electron-capture detector (ECD). In the lab, the method detection limit (MDL) of the new GC/PDD method (9 pptv) was lower than the radioactive GC/ECD method (15 pptv), demonstrating its excellent potential. The MDL of GC/PDD in the field campaign at the Mt. Bachelor Observatory (MBO) was 23 pptv, higher than in the lab. This was caused in part by the decreased slope of the calibration curve resulting from the low air pressure level at MBO. However, the MDL level of GC/PDD at MBO is still low enough for accurate PAN measurements, although special attention should be paid to its application at high-elevation sites. Observations of PAN were conducted at MBO in the summer of 2016 with the GC/PDD system, and provided more evidence of the performance of the system. PAN was found to be highly correlated with CO. The promising performance of GC/PDD which does not require a radioactive source makes it a useful approach for accurate PAN measurements in the field.

Characterization of a 2.5 MV inline portal imaging beam

PubMed Central

Owen, Jennifer; Eduardo Villarreal‐Barajas, J.; Khan, Rao F.H.

2016-01-01

A new megavoltage (MV) energy was recently introduced on Varian TrueBeam linear accelerators for imaging applications. This work describes the experimental characterization of a 2.5 MV inline portal imaging beam for commissioning, routine clinical use, and quality assurance purposes. The beam quality of the 2.5 MV beam was determined by measuring a percent depth dose, PDD, in water phantom for 10×10 cm2 field at source‐to‐surface distance 100 cm with a CC13 ion chamber, plane parallel Markus chamber, and GafChromic EBT3 film. Absolute dosimetric output calibration of the beam was performed using a traceable calibrated ionization chamber, following the AAPM Task Group 51 procedure. EBT3 film measurements were also performed to measure entrance dose. The output stability of the imaging beam was monitored for five months. Coincidence of 2.5 MV imaging beam with 6 MV therapy beam was verified with hidden‐target cubic phantom. Image quality was studied using the Leeds and QC3 phantom. The depth of maximum dose, dmax, and percent dose at 10 cm depth were, respectively, 5.7 mm and 51.7% for CC13, 6.1 mm and 51.9% for Markus chamber, and 5.1 mm and 51.9% for EBT3 film. The 2.5 MV beam quality is slightly inferior to that of a  60Co teletherapy beam; however, an estimated kQ of 1.00 was used for output calibration purposes. The beam output was found to be stable to within 1% over a five‐month period. The relative entrance dose as measured with EBT3 films was 63%, compared to 23% for a clinical 6 MV beam for a 10×10 cm2 field. Overall coincidence of the 2.5 MV imaging beam with the 6 MV clinical therapy beam was within 0.2 mm. Image quality results for two commonly used imaging phantoms were superior for the 2.5 MV beam when compared to the conventional 6 MV beam. The results from measurements on two TrueBeam accelerators show that 2.5 MV imaging beam is slightly softer than a therapeutic  60Co beam, it provides superior image quality than a 6 MV therapy beam, and has excellent output stability. These 2.5 MV beam characterization results can serve as reference for clinics planning to commission and use this novel energy‐image modality. PACS number(s): 87.57.‐s, 87.59.‐e, 06.20.fb, 87.53.Bn PMID:27685135

The association between congenital anomalies and autism spectrum disorders in a Finnish national birth cohort.

PubMed

Timonen-Soivio, Laura; Vanhala, Raija; Malm, Heli; Leivonen, Susanna; Jokiranta, Elina; Hinkka-Yli-Salomäki, Susanna; Gissler, Mika; Brown, Alan S; Sourander, Andre

2015-01-01

The first aim of this study was to evaluate the association between different subgroups of autism spectrum disorders (ASDs) (childhood autism, Asperger syndrome, and pervasive developmental disorder/pervasive developmental disorder - not otherwise specified [PDD/PDD-NOS]) and congenital anomalies. Second, we assessed the association among intellectually disabled children with ASDs in the subgroups of childhood autism and PDD/PDD-NOS. Nationwide population-based register data for children with a diagnosis of ASD (n=4449; 3548 males, 901 females) were collected during years 1987-2000 from the Finnish Hospital Discharge Register. Data on congenital anomalies were derived from the National Register of Congenital Malformations. Conditional logistic regression models were used as a statistical method. The association between ASD subgroups and congenital anomalies was stratified by the presence or absence of intellectual disability. Congenital anomalies occurred more frequently in all subgroups of ASD than in comparison participants (adjusted odds ratio [OR] for major congenital anomalies 1.8, 95% confidence interval [CI] 1.5-2.2, p<0.001). The association between congenital anomalies and childhood autism (OR 2.4, 95% CI 1.6-3.6, p<0.001) and between congenital anomalies and PDD/PDD-NOS (OR 3.7, 95% CI 2.4-5.7, p<0.001) among children with an intellectual disability was strong but remained significant also without intellectual disability (childhood autism: OR 1.7, 95% CI 1.3-2.3, p<0.001; PDD/PDD-NOS: OR 2.3, 95% CI 1.9-2.8, p<0.001). The results suggest a significant association between ASDs and congenital anomalies regardless of the ASD subgroup. The association between childhood autism and PDD/PDD-NOS and congenital anomalies is stronger among children with intellectual disability is stronger than among those without intellectual disability. These results may have relevance in examining early risk factors in autism during fetal neurodevelopment. © 2014 Mac Keith Press.

An international multicenter study comparing EUS-guided pancreatic duct drainage with enteroscopy-assisted endoscopic retrograde pancreatography after Whipple surgery.

PubMed

Chen, Yen-I; Levy, Michael J; Moreels, Tom G; Hajijeva, Gulara; Will, Uwe; Artifon, Everson L; Hara, Kazuo; Kitano, Masayuki; Topazian, Mark; Abu Dayyeh, Barham; Reichel, Andreas; Vilela, Tiago; Ngamruengphong, Saowanee; Haito-Chavez, Yamile; Bukhari, Majidah; Okolo, Patrick; Kumbhari, Vivek; Ismail, Amr; Khashab, Mouen A

2017-01-01

Endoscopic management of post-Whipple pancreatic adverse events (AEs) with enteroscopy-assisted endoscopic retrograde pancreatography (e-ERP) is associated with high failure rates. EUS-guided pancreatic duct drainage (EUS-PDD) has shown promising results; however, no comparative data have been done for these 2 modalities. The goal of this study is to compare EUS-PDD with e-ERP in terms of technical success (PDD through dilation/stent), clinical success (improvement/resolution of pancreatic-type symptoms), and AE rates in patients with post-Whipple anatomy. This is an international multicenter comparative retrospective study at 7 tertiary centers (2 United States, 2 European, 2 Asian, and 1 South American). All consecutive patients who underwent EUS-PDD or e-ERP between January 2010 and August 2015 were included. In total, 66 patients (mean age, 57 years; 48% women) and 75 procedures were identified with 40 in EUS-PDD and 35 in e-ERP. Technical success was achieved in 92.5% of procedures in the EUS-PDD group compared with 20% of procedures in the e-ERP group (OR, 49.3; P < .001). Clinical success (per patient) was attained in 87.5% of procedures in the EUS-PDD group compared with 23.1% in the e-ERP group (OR, 23.3; P < .001). AEs occurred more commonly in the EUS-PDD group (35% vs 2.9%, P < .001). However, all AEs were rated as mild or moderate. Procedure time and length of stay were not significantly different between the 2 groups. EUS-PDD is superior to e-ERP in post-Whipple anatomy in terms of efficacy with acceptable safety. As such, EUS-PDD should be considered as a potential first-line treatment in post-pancreaticoduodenectomy anatomy when necessary expertise is available. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Design and dosimetric characteristics of a new endocavitary contact radiotherapy system using an electronic brachytherapy source.

PubMed

Richardson, Susan; Garcia-Ramirez, Jose; Lu, Wei; Myerson, Robert J; Parikh, Parag

2012-11-01

To present design aspects and acceptance tests performed for clinical implementation of electronic brachytherapy treatment of early stage rectal adenocarcinoma. A dosimetric comparison is made between the historically used Philips RT-50 unit and the newly developed Axxent(®) Model S700 electronic brachytherapy source manufactured by Xoft (iCad, Inc.). Two proctoscope cones were manufactured by ElectroSurgical Instruments (ESI). Two custom surface applicators were manufactured by Xoft and were designed to fit and interlock with the proctoscope cones from ESI. Dose rates, half value layers (HVL), and percentage depth dose (PDD) measurements were made with the Xoft system and compared to historical RT-50 data. A description of the patient treatment approach and exposure rates during the procedure is also provided. The electronic brachytherapy system has a lower surface dose rate than the RT-50. The dose rate to water on the surface from the Xoft system is approximately 2.1 Gy∕min while the RT-50 is 10-12 Gy∕min. However, treatment times with Xoft are still reasonable. The HVLs and PDDs between the two systems were comparable resulting in similar doses to the target and to regions beyond the target. The exposure rate levels around a patient treatment were acceptable. The standard uncertainty in the dose rate to water on the surface is approximately ±5.2%. The Philips RT-50 unit is an out-of-date radiotherapy machine that is no longer manufactured with limited replacement parts. The use of a custom-designed proctoscope and Xoft surface applicators allows delivery of a well-established treatment with the ease of a modern radiotherapy device. While the dose rate is lower with the use of Xoft, the treatment times are still reasonable. Additionally, personnel may stand farther away from the Xoft radiation source, thus potentially reducing radiation exposure to the operator and other personnel.

Monitored Geologic Repository Project Description Document

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

P. M. Curry

2001-01-30

The primary objective of the Monitored Geologic Repository Project Description Document (PDD) is to allocate the functions, requirements, and assumptions to the systems at Level 5 of the Civilian Radioactive Waste Management System (CRWMS) architecture identified in Section 4. It provides traceability of the requirements to those contained in Section 3 of the ''Monitored Geologic Repository Requirements Document'' (MGR RD) (YMP 2000a) and other higher-level requirements documents. In addition, the PDD allocates design related assumptions to work products of non-design organizations. The document provides Monitored Geologic Repository (MGR) technical requirements in support of design and performance assessment in preparing formore » the Site Recommendation (SR) and License Application (LA) milestones. The technical requirements documented in the PDD are to be captured in the System Description Documents (SDDs) which address each of the systems at Level 5 of the CRWMS architecture. The design engineers obtain the technical requirements from the SDDs and by reference from the SDDs to the PDD. The design organizations and other organizations will obtain design related assumptions directly from the PDD. These organizations may establish additional assumptions for their individual activities, but such assumptions are not to conflict with the assumptions in the PDD. The PDD will serve as the primary link between the technical requirements captured in the SDDs and the design requirements captured in US Department of Energy (DOE) documents. The approved PDD is placed under Level 3 baseline control by the CRWMS Management and Operating Contractor (M and O) and the following portions of the PDD constitute the Technical Design Baseline for the MGR: the design characteristics listed in Table 1-1, the MGR Architecture (Section 4.1), the Technical Requirements (Section 5), and the Controlled Project Assumptions (Section 6).« less

SU-F-T-533: Study of Dosimetric Properties of Cadmium Free Alloy Used in Compensator Based IMRT

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

Tyagi, A; Kaushik, S; Guru Jambheshwar University of Science & Technology, Hisar, Haryana

Purpose: To study the dosimetric properties of cadmium free alloy which is used in compensator based IMRT. Methods: A mixture of 30% of lead,52% of bismuth and 18% of tin was used to prepare alloy. We prepared slabs of different thicknesses ranging from 0.71 cm to 6.14 cm. Density of alloy was measured by Archimedes’ principle using SI-234 Denver instrument and water as buoyant liquid. Transmission, linear attenuation coefficient (µ), tissue phantom ration (TPR), beam hardening, surface dose (Ds), percentage depth dose (PDD) and effect of scatter were measured and analyze for different field size and different thickness of compensatormore » for 6 MV photon beam. Measurements were carried out at 100 cm SSD and 160 cm SSD. Results: Density of alloy was found to be 9.5456 gm/cm3. Melting point of alloy is 90–95 °C. For a field size of 10×10 cm2 µ was 0.4253 cm-1 at 100 cm SSD. Calculated TPR was found to be within 3 % of measured TPR. Ds was found to be decreasing with increasing thickness of compensator. 1cm, 1.98 cm and 4.16 cm thick compensator slab decreased surface dose by 4.2%, 6.1% and 9.5% respectively for a field size of 10×10cm2 at 100 cm SSD. As field size increases Ds increases for a given compensator thickness. This is due to increase in amount of scattered dose from wider collimator opening. For smaller field size, PDDs are increased from 3.0% to 5.5% of open beam PDDs as compensator thickness increases from 1 cm to 6.14 cm at a depth of 10 cm in water. For larger field size variation in PDDs is not significant. Conclusion: High degree of modulation can be achieved from this compensator material, which is essential in compensator based IMRT. Dosimetric properties analyzed in this study establish this alloy as a reliable, cost effective, reusable compensator material.« less

Block copolymer nanoassemblies for photodynamic therapy and diagnosis.

PubMed

Dickerson, Matthew; Bae, Younsoo

2013-11-01

Light can be a powerful therapeutic and diagnostic tool. Light-sensitive molecules can be used to develop locally targeted cancer therapeutics. This approach is known as photodynamic therapy (PDT). Similarly, it is possible to diagnose diseases and track the course of treatment in vivo using ligh-sensitive molecules. This methodology is referred to as photodynamic diagnosis (PDD). Despite the potential, many PDT and PDD agents have imperfect physiochemical properties for their successful clinical application. Nanotechnology may solve these issues by improving the viability of PDT and PDD. This review summarizes the current state of PDT and PDD development, the integration of nanotechnology in the field, and the prospective future applications, demonstrating the potential of PDT and PDD for improved cancer treatment and diagnosis.

SU-F-T-574: MLC Based SRS Beam Commissioning - Minimum Target Size Investigation

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

Zakikhani, R; Able, C

2016-06-15

Purpose: To implement a MLC accelerator based SRS program using small fields down to 1 cm × 1 cm and to determine the smallest target size safe for clinical treatment. Methods: Computerized beam scanning was performed in water using a diode detector and a linac-head attached transmission ion chamber to characterize the small field dosimetric aspects of a 6 MV photon beam (Trilogy-Varian Medical Systems, Inc.). The output factors, PDD and profiles of field sizes 1, 2, 3, 4, and 10 cm{sup 2} were measured and utilized to create a new treatment planning system (TPS) model (AAA ver 11021). Staticmore » MLC SRS treatment plans were created and delivered to a homogeneous phantom (Cube 20, CIRS, Inc.) for a 1.0 cm and 1.5 cm “PTV” target. A 12 field DMLC plan was created for a 2.1 cm target. Radiochromic film (EBT3, Ashland Inc.) was used to measure the planar dose in the axial, coronal and sagittal planes. A micro ion chamber (0.007 cc) was used to measure the dose at isocenter for each treatment delivery. Results: The new TPS model was validated by using a tolerance criteria of 2% dose and 2 mm distance to agreement. For fields ≤ 3 cm{sup 2}, the max PDD, Profile and OF difference was 0.9%, 2%/2mm and 1.4% respectively. The measured radiochromic film planar dose distributions had gamma scores of 95.3% or higher using a 3%/2mm criteria. Ion chamber measurements for all 3 test plans effectively met our goal of delivering the dose accurately to within 5% when compared to the expected dose reported by the TPS (1 cm plan Δ= −5.2%, 1.5 cm plan Δ= −2.0%, 2 cm plan Δ= 1.5%). Conclusion: End to end testing confirmed that MLC defined SRS for target sizes ≥ 1.0 cm can be safely planned and delivered.« less

SU-E-T-423: Fast Photon Convolution Calculation with a 3D-Ideal Kernel On the GPU

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

Moriya, S; Sato, M; Tachibana, H

Purpose: The calculation time is a trade-off for improving the accuracy of convolution dose calculation with fine calculation spacing of the KERMA kernel. We investigated to accelerate the convolution calculation using an ideal kernel on the Graphic Processing Units (GPU). Methods: The calculation was performed on the AMD graphics hardware of Dual FirePro D700 and our algorithm was implemented using the Aparapi that convert Java bytecode to OpenCL. The process of dose calculation was separated with the TERMA and KERMA steps. The dose deposited at the coordinate (x, y, z) was determined in the process. In the dose calculation runningmore » on the central processing unit (CPU) of Intel Xeon E5, the calculation loops were performed for all calculation points. On the GPU computation, all of the calculation processes for the points were sent to the GPU and the multi-thread computation was done. In this study, the dose calculation was performed in a water equivalent homogeneous phantom with 150{sup 3} voxels (2 mm calculation grid) and the calculation speed on the GPU to that on the CPU and the accuracy of PDD were compared. Results: The calculation time for the GPU and the CPU were 3.3 sec and 4.4 hour, respectively. The calculation speed for the GPU was 4800 times faster than that for the CPU. The PDD curve for the GPU was perfectly matched to that for the CPU. Conclusion: The convolution calculation with the ideal kernel on the GPU was clinically acceptable for time and may be more accurate in an inhomogeneous region. Intensity modulated arc therapy needs dose calculations for different gantry angles at many control points. Thus, it would be more practical that the kernel uses a coarse spacing technique if the calculation is faster while keeping the similar accuracy to a current treatment planning system.« less

TH-C-12A-04: Dosimetric Evaluation of a Modulated Arc Technique for Total Body Irradiation

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

Tsiamas, P; Czerminska, M; Makrigiorgos, G

2014-06-15

Purpose: A simplified Total Body Irradiation (TBI) was developed to work with minimal requirements in a compact linac room without custom motorized TBI couch. Results were compared to our existing fixed-gantry double 4 MV linac TBI system with prone patient and simultaneous AP/PA irradiation. Methods: Modulated arc irradiates patient positioned in prone/supine positions along the craniocaudal axis. A simplified inverse planning method developed to optimize dose rate as a function of gantry angle for various patient sizes without the need of graphical 3D treatment planning system. This method can be easily adapted and used with minimal resources. Fixed maximum fieldmore » size (40×40 cm2) is used to decrease radiation delivery time. Dose rate as a function of gantry angle is optimized to result in uniform dose inside rectangular phantoms of various sizes and a custom VMAT DICOM plans were generated using a DICOM editor tool. Monte Carlo simulations, film and ionization chamber dosimetry for various setups were used to derive and test an extended SSD beam model based on PDD/OAR profiles for Varian 6EX/ TX. Measurements were obtained using solid water phantoms. Dose rate modulation function was determined for various size patients (100cm − 200cm). Depending on the size of the patient arc range varied from 100° to 120°. Results: A PDD/OAR based beam model for modulated arc TBI therapy was developed. Lateral dose profiles produced were similar to profiles of our existing TBI facility. Calculated delivery time and full arc depended on the size of the patient (∼8min/ 100° − 10min/ 120°, 100 cGy). Dose heterogeneity varied by about ±5% − ±10% depending on the patient size and distance to the surface (buildup region). Conclusion: TBI using simplified modulated arc along craniocaudal axis of different size patients positioned on the floor can be achieved without graphical / inverse 3D planning.« less

SU-E-T-274: Radiation Therapy with Very High-Energy Electron (VHEE) Beams in the Presence of Metal Implants

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

Jensen, C; Palma, B; Qu, B

2014-06-01

Purpose: To evaluate the effect of metal implants on treatment plans for radiation therapy with very high-energy electron (VHEE) beams. Methods: The DOSXYZnrc/BEAMnrc Monte Carlo (MC) codes were used to simulate 50–150MeV VHEE beam dose deposition and its effects on steel and titanium (Ti) heterogeneities in a water phantom. Heterogeneities of thicknesses ranging from 0.5cm to 2cm were placed at 10cm depth. MC was also used to calculate electron and photon spectra generated by the VHEE beams' interaction with metal heterogeneities. The original VMAT patient dose calculation was planned in Eclipse. Patient dose calculations with MC-generated beamlets were planned usingmore » a Matlab GUI and research version of RayStation. VHEE MC treatment planning was performed on water-only geometry and water with segmented prostheses (steel and Ti) geometries with 100MeV and 150MeV beams. Results: 100MeV PDD 5cm behind steel/Ti heterogeneity was 51% less than in the water-only phantom. For some cases, dose enhancement lateral to the borders of the phantom increased the dose by up to 22% in steel and 18% in Ti heterogeneities. The dose immediately behind steel heterogeneity decreased by an average of 6%, although for 150MeV, the steel heterogeneity created a 23% increase in dose directly behind it. The average dose immediately behind Ti heterogeneities increased 10%. The prostate VHEE plans resulted in mean dose decrease to the bowel (20%), bladder (7%), and the urethra (5%) compared to the 15MV VMAT plan. The average dose to the body with prosthetic implants was 5% higher than to the body without implants. Conclusion: Based on MC simulations, metallic implants introduce dose perturbations to VHEE beams from lateral scatter and backscatter. However, when performing clinical planning on a prostate case, the use of multiple beams and inverse planning still produces VHEE plans that are dosimetrically superior to photon VMAT plans. BW Loo and P Maxim received research support from RaySearch laboratories; B Hardemark and E Hynning are employees of RaySearch.« less

Brief Report: Pervasive Developmental Disorder Can Evolve into ADHD--Case Illustrations

ERIC Educational Resources Information Center

Fein, Deborah; Dixon, Pamela; Paul, Jennifer; Levin, Harriet

2005-01-01

Despite prominent attentional symptoms in Pervasive Developmental Disorders (PDD) the relationship between PDD and Attention Deficit Hyperactivity Disorder (ADHD) has received little direct examination. In addition, outcome studies of children with PDD often focus on language, educational placement, or adaptive skills, but seldom on loss of the…

Face and Emotion Recognition in MCDD versus PDD-NOS

ERIC Educational Resources Information Center

Herba, Catherine M.; de Bruin, Esther; Althaus, Monika; Verheij, Fop; Ferdinand, Robert F.

2008-01-01

Previous studies indicate that Multiple Complex Developmental Disorder (MCDD) children differ from PDD-NOS and autistic children on a symptom level and on psychophysiological functioning. Children with MCDD (n = 21) and PDD-NOS (n = 62) were compared on two facets of social-cognitive functioning: identification of neutral faces and facial…

G6PD deficiency alleles in a malaria-endemic region in the Western Brazilian Amazon.

PubMed

Dombrowski, Jamille G; Souza, Rodrigo M; Curry, Jonathan; Hinton, Laura; Silva, Natercia R M; Grignard, Lynn; Gonçalves, Ligia A; Gomes, Ana Rita; Epiphanio, Sabrina; Drakeley, Chris; Huggett, Jim; Clark, Taane G; Campino, Susana; Marinho, Claudio R F

2017-06-15

Plasmodium vivax parasites are the predominant cause of malaria infections in the Brazilian Amazon. Infected individuals are treated with primaquine, which can induce haemolytic anaemia in glucose-6-phosphate dehydrogenase (G6PD)-deficient individuals and may lead to severe and fatal complications. This X-linked disorder is distributed globally and is caused by allelic variants with a geographical distribution that closely reflects populations exposed historically to endemic malaria. In Brazil, few studies have reported the frequency of G6PD deficiency (G6PDd) present in malaria-endemic areas. This is particularly important, as G6PDd screening is not currently performed before primaquine treatment. The aim of this study was to determine the prevalence of G6PDd in the region of Alto do Juruá, in the Western Brazilian Amazon, an area characterized by a high prevalence of P. vivax infection. Five-hundred and sixteen male volunteers were screened for G6PDd using the fluorescence spot test (Beutler test) and CareStart™ G6PD Biosensor system. Demographic and clinical-epidemiological data were acquired through an individual interview. To assess the genetic basis of G6PDd, 24 SNPs were genotyped using the Kompetitive Allele Specific PCR assay. Twenty-three (4.5%) individuals were G6PDd. No association was found between G6PDd and the number of malaria cases. An increased risk of reported haemolysis symptoms and blood transfusions was evident among the G6PDd individuals. Twenty-two individuals had the G6PDd A(-) variant and one the G6PD A(+) variant. The Mediterranean variant was not present. Apart from one polymorphism, almost all SNPs were monomorphic or with low frequencies (0-0.04%). No differences were detected among ethnic groups. The data indicates that ~1/23 males from the Alto do Juruá could be G6PD deficient and at risk of haemolytic anaemia if treated with primaquine. G6PD A(-) is the most frequent deficiency allele in this population. These results concur with reported G6PDd in other regions in Brazil. Routine G6PDd screening to personalize primaquine administration should be considered, particularly as complete treatment of patients with vivax malaria using chloroquine and primaquine, is crucial for malaria elimination.

Survey of preventable disaster death at medical institutions in areas affected by the Great East Japan Earthquake: a retrospective preliminary investigation of medical institutions in Miyagi Prefecture.

PubMed

Yamanouchi, Satoshi; Sasaki, Hiroyuki; Tsuruwa, Miho; Ueki, Yuzuru; Kohayagawa, Yoshitaka; Kondo, Hisayoshi; Otomo, Yasuhiro; Koido, Yuichi; Kushimoto, Shigeki

2015-04-01

The 2011, magnitude (M) 9, Great East Japan Earthquake and massive tsunami caused widespread devastation and left approximately 18,500 people dead or missing. The incidence of preventable disaster death (PDD) during the Great East Japan Earthquake remains to be clarified; the present study investigated PDD at medical institutions in areas affected by the Great East Japan Earthquake in order to improve disaster medical systems. A total of 25 hospitals in Miyagi Prefecture (Japan) that were disaster base hospitals (DBHs), or had at least 20 patient deaths between March 11, 2011 and April 1, 2011, were selected to participate based on the results of a previous study. A database was created using the medical records of all patient deaths (n=868), and PDD was determined from discussion with 10 disaster health care professionals. A total of 102 cases of PDD were identified at the participating hospitals. The rate of PDD was higher at coastal hospitals compared to inland hospitals (62/327, 19.0% vs 40/541, 7.4%; P<.01). No difference was observed in overall PDD rates between DBHs and general hospitals (GHs); however, when analysis was limited to cases with an in-hospital cause of PDD, the PDD rate was higher at GHs compared to DBHs (24/316, 7.6% vs 21/552, 3.8%; P<.05). The most common causes of PDD were: insufficient medical resources, delayed medical intervention, disrupted lifelines, deteriorated environmental conditions in homes and emergency shelters at coastal hospitals, and delayed medical intervention at inland hospitals. Meanwhile, investigation of PDD causes based on type of medical institution demonstrated that, while delayed medical intervention and deteriorated environmental conditions in homes and emergency shelters were the most common causes at DBHs, insufficient medical resources and disrupted lifelines were prevalent causes at GHs. Preventable disaster death at medical institutions in areas affected by the Great East Japan Earthquake occurred mainly at coastal hospitals. Insufficient resources (at GHs), environmental factors (at coastal hospitals), and delayed medical intervention (at all hospitals) constituted the major potential contributing factors. Further investigation of all medical institutions in Miyagi Prefecture, including those with fewer than 20 patient deaths, is required in order to obtain a complete picture of the details of PDD at medical institutions in the disaster area.

The prevalence of glucose-6-phosphate dehydrogenase deficiency in Gambian school children.

PubMed

Okebe, Joseph; Amambua-Ngwa, Alfred; Parr, Jason; Nishimura, Sei; Daswani, Melissa; Takem, Ebako N; Affara, Muna; Ceesay, Serign J; Nwakanma, Davis; D'Alessandro, Umberto

2014-04-17

Primaquine, the only available drug effective against Plasmodium falciparum sexual stages, induces also a dose-dependent haemolysis, especially in glucose-6-phosphate dehydrogenase deficient (G6PDd) individuals. Therefore, it is important to determine the prevalence of this deficiency in areas that would potentially benefit from its use. The prevalence of G6PD deficiency by genotype and enzyme activity was determined in healthy school children in The Gambia. Blood samples from primary school children collected during a dry season malaria survey were screened for G6PDd and malaria infection. Genotypes for allele mutations reported in the country; 376, 202A-, 968A- and 542 were analysed while enzyme activity (phenotype) was assayed using a semi-quantitative commercial test kit. Enzyme activity values were fitted in a finite mixture model to determine the distribution and calculate a cut-off for deficiency. The association between genotype and phenotype for boys and girls as well as the association between mutant genotype and deficient phenotype was analysed. Samples from 1,437 children; 51% boys were analysed. The prevalence of P. falciparum malaria infection was 14%. The prevalence of the 202A-, 968 and 542 mutations was 1.8%, 2.1% and 1.0%, respectively, and higher in boys than in girls. The prevalence of G6PDd phenotype was 6.4% (92/1,437), 7.8% (57/728) in boys and 4.9% (35/709) in girls with significantly higher odds in the former (OR 1.64, 95% CI 1.05, 2.53, p = 0.026). The deficient phenotype was associated with reduced odds of malaria infection (OR 0.77, 95% CI 0.36, 1.62, p = 0.49). There is a weak association between genotype and phenotype estimates of G6PDd prevalence. The phenotype expression of deficiency represents combinations of mutant alleles rather than specific mutations. Genotype studies in individuals with a deficient phenotype would help identify alleles responsible for haemolysis.

Viral vector vaccines protect cockatiels from inflammatory lesions after heterologous parrot bornavirus 2 challenge infection.

PubMed

Runge, Solveig; Olbert, Marita; Herden, Christiane; Malberg, Sara; Römer-Oberdörfer, Angela; Staeheli, Peter; Rubbenstroth, Dennis

2017-01-23

Avian bornaviruses are causative agents of proventricular dilatation disease (PDD), a chronic neurologic and often fatal disorder of psittacines including endangered species. To date no causative therapy or immunoprophylaxis is available. Our previous work has shown that viral vector vaccines can delay the course of homologous bornavirus challenge infections but failed to protect against PDD when persistent infection was not prevented. The goal of this study was to refine our avian bornavirus vaccination and infection model to better represent natural bornavirus infections in order to achieve full protection against a heterologous challenge infection. We observed that parrot bornavirus 2 (PaBV-2) readily infected cockatiels (Nymphicus hollandicus) by combined intramuscular and subcutaneous injection with as little as 10 2.7 foci-forming units (ffu) per bird, whereas a 500-fold higher dose of the same virus administered via peroral and oculonasal route did not result in persistent infection. These results indicated that experimental bornavirus challenge infections with this virus should be performed via the parenteral route. Prime-boost vaccination of cockatiels with Newcastle disease virus (NDV) and modified vaccinia virus Ankara (MVA) vectors expressing the nucleoprotein and phosphoprotein genes of PaBV-4 substantially blocked bornavirus replication following parenteral challenge infection with 10 3.5 ffu of heterologous PaBV-2. Only two out of six vaccinated birds had very low viral levels detectable in a few organs. As a consequence, only one vaccinated bird developed mild PDD-associated microscopic lesions, while mock-vaccinated controls were not protected against PaBV-2 infection and inflammation. Our results demonstrate that NDV and MVA vector vaccines can protect against invasive heterologous bornavirus challenge infections and subsequent PDD. These vector vaccines represent a promising tool to combat avian bornaviruses in psittacine populations. Copyright © 2016 Elsevier Ltd. All rights reserved.

SU-F-T-376: The Efficiency of Calculating Photonuclear Reaction On High-Energy Photon Therapy by Monte Carlo Method

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

Hirayama, S; Fujibuchi, T

Purpose: Secondary-neutrons having harmful influences to a human body are generated by photonuclear reaction on high-energy photon therapy. Their characteristics are not known in detail since the calculation to evaluate them takes very long time. PHITS(Particle and Heavy Ion Transport code System) Monte Carlo code since versions 2.80 has the new parameter “pnimul” raising the probability of occurring photonuclear reaction forcibly to make the efficiency of calculation. We investigated the optimum value of “pnimul” on high-energy photon therapy. Methods: The geometry of accelerator head based on the specification of a Varian Clinac 21EX was used for PHITS ver. 2.80. Themore » phantom (30 cm * 30 cm * 30 cm) filled the composition defined by ICRU(International Commission on Radiation Units) was placed at source-surface distance 100 cm. We calculated the neutron energy spectra in the surface of ICRU phantom with “pnimal” setting 1, 10, 100, 1000, 10000 and compared the total calculation time and the behavior of photon using PDD(Percentage Depth Dose) and OCR(Off-Center Ratio). Next, the cutoff energy of photon, electron and positron were investigated for the calculation efficiency with 4, 5, 6 and 7 MeV. Results: The calculation total time until the errors of neutron fluence become within 1% decreased as increasing “pnimul”. PDD and OCR showed no differences by the parameter. The calculation time setting the cutoff energy like 4, 5, 6 and 7 MeV decreased as increasing the cutoff energy. However, the errors of photon become within 1% did not decrease by the cutoff energy. Conclusion: The optimum values of “pnimul” and the cutoff energy were investigated on high-energy photon therapy. It is suggest that using the optimum “pnimul” makes the calculation efficiency. The study of the cutoff energy need more investigation.« less

Prevalence and molecular characterization of G6PD deficiency in two Plasmodium vivax endemic areas in Venezuela: predominance of the African A-(202A/376G) variant.

PubMed

Vizzi, Esmeralda; Bastidas, Gilberto; Hidalgo, Mariana; Colman, Laura; Pérez, Hilda A

2016-01-11

Glucose-6-phosphate dehydrogenase (G6PD) deficiency causes acute haemolytic anaemia triggered by oxidative drugs such as primaquine (PQ), used for Plasmodium vivax malaria radical cure. However, in many endemic areas of vivax malaria, patients are treated with PQ without any evaluation of their G6PD status. G6PD deficiency and its genetic heterogeneity were evaluated in northeastern and southeastern areas from Venezuela, Cajigal (Sucre state) and Sifontes (Bolívar state) municipalities, respectively. Blood samples from 664 randomly recruited unrelated individuals were screened for G6PD activity by a quantitative method. Mutation analysis for exons 4-8 of G6PD gen was performed on DNA isolated from G6PD-deficient (G6PDd) subjects through PCR-RFLP and direct DNA sequencing. Quantitative biochemical characterization revealed that overall 24 (3.6%) subjects were G6PDd (average G6PD enzyme activity 4.5 ± 1.2 U/g Hb, moderately deficient, class III), while DNA analysis showed one or two mutated alleles in 19 of them (79.2%). The G6PD A-(202A/376G) variant was the only detected in 17 (70.8%) individuals, 13 of them hemizygous males and four heterozygous females. Two males carried only the 376A → G mutation. No other mutation was found in the analysed exons. The G6PDd prevalence was as low as that one shown by nearby countries. This study contributes to the knowledge of the genetic background of Venezuelan population, especially of those living in malaria-endemic areas. Despite the high degree of genetic mixing described for Venezuelan population, a net predominance of the mild African G6PD A-(202A/376G) variant was observed among G6PDd subjects, suggesting a significant flow of G6PD genes from Africa to Americas, almost certainly introduced through African and/or Spanish immigrants during and after the colonization. The data suggest that 1:27 individuals of the studied population could be G6PDd and therefore at risk of haemolysis under precipitating factors. Information about PQ effect on G6PDd individuals carrying mild variant is limited, but since the regimen of 45 mg weekly dose for prevention of malaria relapse does not seem to be causing clinically significant haemolysis in people having the G6PD A-variant, a reasoned weighing of risk-benefit for its use in Venezuela should be done, when implementing public health strategies of control and elimination.

Penile Dysmorphic Disorder: Development of a Screening Scale.

PubMed

Veale, David; Miles, Sarah; Read, Julie; Troglia, Andrea; Carmona, Lina; Fiorito, Chiara; Wells, Hannah; Wylie, Kevan; Muir, Gordon

2015-11-01

Penile dysmorphic disorder (PDD) is shorthand for men diagnosed with body dysmorphic disorder, in whom the size or shape of the penis is their main, if not their exclusive, preoccupation causing significant shame or handicap. There are no specific measures for identifying men with PDD compared to men who are anxious about the size of their penis but do not have PDD. Such a measure might be helpful for treatment planning, reducing unrealistic expectations, and measuring outcome after any psychological or physical intervention. Our aim was, therefore, to validate a specific measure, termed the Cosmetic Procedure Screening Scale for PDD (COPS-P). Eighty-one male participants were divided into three groups: a PDD group (n = 21), a small penis anxiety group (n = 37), and a control group (n = 23). All participants completed the COPS-P as well as standardized measures of depression, anxiety, social phobia, body image, quality of life, and erectile function. Penis size was also measured. The final COPS-P was based on nine items. The scale had good internal reliability and significant convergent validity with measures of related constructs. It discriminated between the PDD group, the small penis anxiety group, and the control group. This is the first study to develop a scale able to discriminate between those with PDD and men anxious about their size who did not have PDD. Clinicians and researchers may use the scale as part of an assessment for men presenting with anxiety about penis size and as an audit or outcome measure after any intervention for this population.

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

Tang, Kunkun, E-mail: ktg@illinois.edu; Inria Bordeaux – Sud-Ouest, Team Cardamom, 200 avenue de la Vieille Tour, 33405 Talence; Congedo, Pietro M.

The Polynomial Dimensional Decomposition (PDD) is employed in this work for the global sensitivity analysis and uncertainty quantification (UQ) of stochastic systems subject to a moderate to large number of input random variables. Due to the intimate connection between the PDD and the Analysis of Variance (ANOVA) approaches, PDD is able to provide a simpler and more direct evaluation of the Sobol' sensitivity indices, when compared to the Polynomial Chaos expansion (PC). Unfortunately, the number of PDD terms grows exponentially with respect to the size of the input random vector, which makes the computational cost of standard methods unaffordable formore » real engineering applications. In order to address the problem of the curse of dimensionality, this work proposes essentially variance-based adaptive strategies aiming to build a cheap meta-model (i.e. surrogate model) by employing the sparse PDD approach with its coefficients computed by regression. Three levels of adaptivity are carried out in this paper: 1) the truncated dimensionality for ANOVA component functions, 2) the active dimension technique especially for second- and higher-order parameter interactions, and 3) the stepwise regression approach designed to retain only the most influential polynomials in the PDD expansion. During this adaptive procedure featuring stepwise regressions, the surrogate model representation keeps containing few terms, so that the cost to resolve repeatedly the linear systems of the least-squares regression problem is negligible. The size of the finally obtained sparse PDD representation is much smaller than the one of the full expansion, since only significant terms are eventually retained. Consequently, a much smaller number of calls to the deterministic model is required to compute the final PDD coefficients.« less

SU-F-E-06: Dosimetric Characterization of Small Photons Beams of a Novel Linear Accelerator

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

Almonte, A; Polanco, G; Sanchez, E

2016-06-15

Purpose: The aim of the present contribution was to measure the main dosimetric quantities of small fields produced by UNIQUE and evaluate its matching with the corresponding dosimetric data of one 21EX conventional linear accelerator (Varian) in operation at the same center. The second step was to evaluate comparative performance of the EDGE diode detector and the PinPoint micro-ionization chamber for dosimetry of small fields. Methods: UNIQUE is configured with MLC (120 leaves with 0.5 cm leaf width) and a single low photon energy of 6 MV. Beam data were measured with scanning EDGE diode detector (volume of 0.019 mm{supmore » 3}), a PinPoint micro-ionization chamber (PTW) and for larger fields (≥ 4×4cm{sup 2}) a PTW Semi flex chamber (0.125 cm{sup 3}) was used. The scanning system used was the 3D cylindrical tank manufactured by Sun Nuclear, Inc. The measurement of PDD and profiles were done at 100 cm SSD and 1.5 depth; the relative output factors were measured at 10 cm depth. Results: PDD and the profile data showed less than 1% variation between the two linear accelerators for fields size between 2×2 cm{sup 2} and 5×5cm{sup 2}. Output factor differences was less than 1% for field sizes between 3×3 cm{sup 2} and 10×10 cm{sup 2} and less of 1.5 % for fields of 1.5×1.5 cm{sup 2} and 2×2 cm{sup 2} respectively. The dmax value of the EDGE diode detector, measured from the PDD, was 8.347 mm for 0.5×0,5cm{sup 2} for UNIQUE. The performance of EDGE diode detector was comparable for all measurements in small fields. Conclusion: UNIQUE linear accelerator show similar dosimetrics characteristics as conventional 21EX Varian linear accelerator for small, medium and large field sizes.EDGE detector show good performance by measuring dosimetrics quantities in small fields typically used in IMRT and radiosurgery treatments.« less

Abnormal Selective Attention Normalizes P3 Amplitudes in PDD

ERIC Educational Resources Information Center

Hoeksma, Marco R.; Kemner, Chantal; Kenemans, J. Leon; van Engeland, Herman

2006-01-01

This paper studied whether abnormal P3 amplitudes in PDD are a corollary of abnormalities in ERP components related to selective attention in visual and auditory tasks. Furthermore, this study sought to clarify possible age differences in such abnormalities. Children with PDD showed smaller P3 amplitudes than controls, but no abnormalities in…

Phosphorylation of an HP1-like protein is a prerequisite for heterochromatin body formation in Tetrahymena DNA elimination.

PubMed

Kataoka, Kensuke; Noto, Tomoko; Mochizuki, Kazufumi

2016-08-09

Multiple heterochromatic loci are often clustered into a higher order nuclear architecture called a heterochromatin body in diverse eukaryotes. Although phosphorylation of Heterochromatin Protein 1 (HP1) family proteins regulates heterochromatin dynamics, its role in heterochromatin bodies remains unknown. We previously reported that dephosphorylation of the HP1-like protein Pdd1p is required for the formation of heterochromatin bodies during the process of programmed DNA elimination in the ciliated protozoan Tetrahymena Here, we show that the heterochromatin body component Jub4p is required for Pdd1p phosphorylation, heterochromatin body formation, and DNA elimination. Moreover, our analyses of unphosphorylatable Pdd1p mutants demonstrate that Pdd1p phosphorylation is required for heterochromatin body formation and DNA elimination, whereas it is dispensable for local heterochromatin assembly. Therefore, both phosphorylation and the following dephosphorylation of Pdd1p are necessary to facilitate the formation of heterochromatin bodies. We suggest that Jub4p-mediated phosphorylation of Pdd1p creates a chromatin environment that is a prerequisite for subsequent heterochromatin body assembly and DNA elimination.

[Delinquency by a juvenile with pervasive developmental disorder: a case in which interaction between disorder and family dysfunction played a key role].

PubMed

Kurumatani, Takahiro; Yamashita, Mahoko

2003-01-01

Pervasive Developmental Disorder (PDD) is characterized by peculiar psycho-behavioral patterns. Youths with PDD who commit delinquent acts often exhibit strange behavior beyond ordinary comprehension. In order to fully understand and identify PDD it is important to take a comprehensive psychosocial history. Here we report on a 19-year-old delinquent male from a juvenile detention home who was exhibiting PDD. Both the psycho-behavioral patterns of the subject and the dysfunctional family background were key factors in this case. The subject persistently stalked and harassed an elementary school girl despite repeated intervention by police and the girl's parents to stop doing so. This behavior culminated in the subject being arrested and put on probation. While on probation his behavior continued, leading to his arrest and confinement to a correctional facility for juveniles with medical needs. Several features that included sustained impairment in social interaction and repetitive patterns of behavior that are often identified in delinquents with PDD were found to exist in the subject and he was diagnosed with PDD (probably Asperger's disease). The subject presented with a superficial understanding of the consequences his behavior had on others and for himself. Also, impaired family function was found to be a major contributing factor to his delinquency. Together theses factors hindered the subject from acquiring appropriate social skills. The major responsibility for providing care and support of an individual with PDD is within the family. Failure of the family to undertake such responsibilities can lead to ineffective treatment even after a specialist has identified the disorder. Given the slow decline of the nuclear family in Japan, it is important to understand the role of the family in caring for a child with PDD. Also, public recognition of PDD and social support for individuals with the disorder is important.

Applications and accuracy of the parallel diagonal dominant algorithm

NASA Technical Reports Server (NTRS)

Sun, Xian-He

1993-01-01

The Parallel Diagonal Dominant (PDD) algorithm is a highly efficient, ideally scalable tridiagonal solver. In this paper, a detailed study of the PDD algorithm is given. First the PDD algorithm is introduced. Then the algorithm is extended to solve periodic tridiagonal systems. A variant, the reduced PDD algorithm, is also proposed. Accuracy analysis is provided for a class of tridiagonal systems, the symmetric, and anti-symmetric Toeplitz tridiagonal systems. Implementation results show that the analysis gives a good bound on the relative error, and the algorithm is a good candidate for the emerging massively parallel machines.

Feasibility study of a photoconductor based dosimeter for quality assurance in radiotherapy

NASA Astrophysics Data System (ADS)

Lee, Y. K.; Kim, S. W.; Kim, J. N.; Kang, Y. N.; Kim, J. Y.; Lee, D. S.; Kim, K. T.; Han, M. J.; Ahn, K. J.; Park, S. K.

2017-09-01

With the recent market entries of new types of linear accelerators (LINACs) with a multi leaf collimator (MLC) mounted on them, high-precision radiosurgery applying a LINAC to measure high-dose radiation on the target region has been gaining popularity. Systematic and accurate quality assurance (QA) is of vital important for high-precision radiosurgery because of its increased risk of side effects including life-threatening ones such as overexposure of healthy tissues to high-dose radiation beams concentrated on small areas. Therefore, accurate dose and dose-distribution measurements are crucial in the treatment procedure. The accurate measurement of the properties of beams concentrated on small areas requires high-precision dosimeters capable of high-resolution output and dose mapping as well as accurate dosimetry in penumbra regions. In general, the properties of beams concentrated on small areas are measured using thermos luminescent dosimeters (TLD), diode detectors, ion chambers, diamond detectors, or films, and many papers have presented the advantages and disadvantages of each of these detectors for dosimetry. In this study, a solid-state photoconductor dosimeter was developed, and its clinical usability was tested by comparing its relative dosimetric performance with that of a conventional ion chamber. As materials best-suited for radiation dosimeters, four candidates namely lead (II) iodide (PbI2), lead (II) oxide (PbO), mercury (II) iodide (HgI2), and HgI2/ titanium dioxide (TiO2) composite, the performances of which were proved in previous studies, were used. The electrical properties of each candidate material were examined using the sedimentation method, one of the particle-in-binder (PIB) methods, and unit-cell-type prototypes were fabricated. The unit-cell samples thus prepared were cut into specimens of area 1 × 1 cm2 with 400-μ m thickness. The electrical properties of each sample, such as sensitivity, dark current, output current, rising time, falling time, and response delay, were then measured, in addition to the consistency, reproducibility and linearity of each unit-cell. According to the measurement results, HgI2/TiO2 composite outperformed the other candidate materials. A radiation dosimeter with a chamber-type structure was fabricated in this study using a LINAC under accelerating voltages of 6, and 15 MV and compared with a commercial ion chamber. Percent depth dose (PDD) and beam profile were measured on a water phantom at a fixed area of 10 × 10 cm2 by using the fabricated chamber-type dosimeter, and the values were compared with those measured by a commercial ion chamber. Additionally, a homogeneous phantom was fabricated, and the exposure doses of the center points were measured according to a real treatment plan, followed by a comparison of the measured values as relative values. In this paper, we report that the manufactured dosimeter shows similar characteristics in terms of PDD and beam profile and results for the conventional ion chamber. Based on these results, it is demonstrated that the HgI2/TiO2-based dosimeter complies with radiotherapy QA requirements, namely Superior detection characteristics, consistency, dose linearity, reproducibility. Thus, we expect the HgI2/TiO2-based dosimeter to be used commercially in the future.

Photodynamic diagnosis in upper urinary tract urothelial carcinoma: A systematic review.

PubMed

Osman, Elsawi; Alnaib, Ziad; Kumar, Nitya

2017-06-01

To assess the diagnostic accuracy and safety of photodynamic diagnosis (PDD) in upper urinary tract urothelial carcinoma (UUTUC). A systematic literature search was conducted. Included studies were assessed for the risks of bias and quality using appropriate tools. Dedicated data extraction forms were used. Diagnostic accuracy in terms of sensitivity and specificity were quoted whenever provided by individual studies. A combined toxicity profile of 5-aminolevulinic acid (5ALA) was given after reviewing individual studies. In all, 17 studies were identified. After screening seven studies were included involving a total of 194 patients. None of the studies were randomised. All the available studies were of low-to-moderate quality. The largest available study, with 106 patients, reported a sensitivity of 95.8% and 53.5% for PDD and white-light (WL) ureterorenoscopy (URS) respectively, with a statistically significant difference. The specificity was 96.6% for PDD and 95.2% for WL-URS with no statistical significance. PDD showed better ability in detecting carcinoma in situ and dysplasia. One study compared PDD to computed tomography urogram (CTU) and found PDD to have better sensitivity and statistically significantly better specificity. 5ALA-associated toxicity was minor in nature and hypotension was the most common adverse event. PDD in UUTUC appears to be more accurate than WL-URS and CTU, with no significant toxicity. Larger scale randomised trials are needed.

Brief Report: Eye Movements during Visual Search Tasks Indicate Enhanced Stimulus Discriminability in Subjects with PDD

ERIC Educational Resources Information Center

Kemner, Chantal; van Ewijk, Lizet; van Engeland, Herman; Hooge, Ignace

2008-01-01

Subjects with PDD excel on certain visuo-spatial tasks, amongst which visual search tasks, and this has been attributed to enhanced perceptual discrimination. However, an alternative explanation is that subjects with PDD show a different, more effective search strategy. The present study aimed to test both hypotheses, by measuring eye movements…

PDD Symptoms in ADHD, an Independent Familial Trait?

ERIC Educational Resources Information Center

Nijmeijer, J. S.; Hoekstra, P. J.; Minderaa, R. B.; Buitelaar, J. K.; Altink, M. E.; Buschgens, C. J. M.; Fliers, E. A.; Rommelse, N. N. J.; Sergeant, J. A.; Hartman, C. A.

2009-01-01

The aims of this study were to investigate whether subtle PDD symptoms in the context of ADHD are transmitted in families independent of ADHD, and whether PDD symptom familiality is influenced by gender and age. The sample consisted of 256 sibling pairs with at least one child with ADHD and 147 healthy controls, aged 5-19 years. Children who…

Bovine Immune Response to Papillomatous Digital Dermatitis (PDD)-associated Spirochetes is Skewed in Isolate Reactivity and Subclass Elicitation

USDA-ARS?s Scientific Manuscript database

Papillomatous digital dermatitis (PDD), also known as hairy heel wart, is a growing cause of lameness of cows in the U.S. dairy industry. Farms with PDD-afflicted cows experience economic loss due to treatment costs, decreased milk production, lower reproductive efficiency and premature culling. Cow...

G6PD Deficiency Prevalence and Estimates of Affected Populations in Malaria Endemic Countries: A Geostatistical Model-Based Map

PubMed Central

Howes, Rosalind E.; Piel, Frédéric B.; Patil, Anand P.; Nyangiri, Oscar A.; Gething, Peter W.; Dewi, Mewahyu; Hogg, Mariana M.; Battle, Katherine E.; Padilla, Carmencita D.; Baird, J. Kevin; Hay, Simon I.

2012-01-01

Background Primaquine is a key drug for malaria elimination. In addition to being the only drug active against the dormant relapsing forms of Plasmodium vivax, primaquine is the sole effective treatment of infectious P. falciparum gametocytes, and may interrupt transmission and help contain the spread of artemisinin resistance. However, primaquine can trigger haemolysis in patients with a deficiency in glucose-6-phosphate dehydrogenase (G6PDd). Poor information is available about the distribution of individuals at risk of primaquine-induced haemolysis. We present a continuous evidence-based prevalence map of G6PDd and estimates of affected populations, together with a national index of relative haemolytic risk. Methods and Findings Representative community surveys of phenotypic G6PDd prevalence were identified for 1,734 spatially unique sites. These surveys formed the evidence-base for a Bayesian geostatistical model adapted to the gene's X-linked inheritance, which predicted a G6PDd allele frequency map across malaria endemic countries (MECs) and generated population-weighted estimates of affected populations. Highest median prevalence (peaking at 32.5%) was predicted across sub-Saharan Africa and the Arabian Peninsula. Although G6PDd prevalence was generally lower across central and southeast Asia, rarely exceeding 20%, the majority of G6PDd individuals (67.5% median estimate) were from Asian countries. We estimated a G6PDd allele frequency of 8.0% (interquartile range: 7.4–8.8) across MECs, and 5.3% (4.4–6.7) within malaria-eliminating countries. The reliability of the map is contingent on the underlying data informing the model; population heterogeneity can only be represented by the available surveys, and important weaknesses exist in the map across data-sparse regions. Uncertainty metrics are used to quantify some aspects of these limitations in the map. Finally, we assembled a database of G6PDd variant occurrences to inform a national-level index of relative G6PDd haemolytic risk. Asian countries, where variants were most severe, had the highest relative risks from G6PDd. Conclusions G6PDd is widespread and spatially heterogeneous across most MECs where primaquine would be valuable for malaria control and elimination. The maps and population estimates presented here reflect potential risk of primaquine-associated harm. In the absence of non-toxic alternatives to primaquine, these results represent additional evidence to help inform safe use of this valuable, yet dangerous, component of the malaria-elimination toolkit. Please see later in the article for the Editors' Summary PMID:23152723

G6PD deficiency prevalence and estimates of affected populations in malaria endemic countries: a geostatistical model-based map.

PubMed

Howes, Rosalind E; Piel, Frédéric B; Patil, Anand P; Nyangiri, Oscar A; Gething, Peter W; Dewi, Mewahyu; Hogg, Mariana M; Battle, Katherine E; Padilla, Carmencita D; Baird, J Kevin; Hay, Simon I

2012-01-01

Primaquine is a key drug for malaria elimination. In addition to being the only drug active against the dormant relapsing forms of Plasmodium vivax, primaquine is the sole effective treatment of infectious P. falciparum gametocytes, and may interrupt transmission and help contain the spread of artemisinin resistance. However, primaquine can trigger haemolysis in patients with a deficiency in glucose-6-phosphate dehydrogenase (G6PDd). Poor information is available about the distribution of individuals at risk of primaquine-induced haemolysis. We present a continuous evidence-based prevalence map of G6PDd and estimates of affected populations, together with a national index of relative haemolytic risk. Representative community surveys of phenotypic G6PDd prevalence were identified for 1,734 spatially unique sites. These surveys formed the evidence-base for a Bayesian geostatistical model adapted to the gene's X-linked inheritance, which predicted a G6PDd allele frequency map across malaria endemic countries (MECs) and generated population-weighted estimates of affected populations. Highest median prevalence (peaking at 32.5%) was predicted across sub-Saharan Africa and the Arabian Peninsula. Although G6PDd prevalence was generally lower across central and southeast Asia, rarely exceeding 20%, the majority of G6PDd individuals (67.5% median estimate) were from Asian countries. We estimated a G6PDd allele frequency of 8.0% (interquartile range: 7.4-8.8) across MECs, and 5.3% (4.4-6.7) within malaria-eliminating countries. The reliability of the map is contingent on the underlying data informing the model; population heterogeneity can only be represented by the available surveys, and important weaknesses exist in the map across data-sparse regions. Uncertainty metrics are used to quantify some aspects of these limitations in the map. Finally, we assembled a database of G6PDd variant occurrences to inform a national-level index of relative G6PDd haemolytic risk. Asian countries, where variants were most severe, had the highest relative risks from G6PDd. G6PDd is widespread and spatially heterogeneous across most MECs where primaquine would be valuable for malaria control and elimination. The maps and population estimates presented here reflect potential risk of primaquine-associated harm. In the absence of non-toxic alternatives to primaquine, these results represent additional evidence to help inform safe use of this valuable, yet dangerous, component of the malaria-elimination toolkit. Please see later in the article for the Editors' Summary.

A Comparison of DSM-IV PDD and DSM-5 ASD Prevalence in an Epidemiologic Sample

PubMed Central

Kim, Young Shin; Fombonne, Eric; Koh, Yun-Joo; Kim, Soo-Jeong; Cheon, Keun-Ah; Leventhal, Bennett

2014-01-01

Objective Changes in autism diagnostic criteria found in DSM5 may affect Autism Spectrum Disorder (ASD) prevalence, research findings, diagnostic processes and eligibility for clinical and other services. Utilizing our published, total-population Korean prevalence data, we compute DSM5 ASD and Social Communication Disorder (SCD) prevalence and compare them to DSMIV Pervasive Developmental Disorder (PDD) prevalence estimates. We also describe individuals previously diagnosed with DSMIV PDD when diagnoses change with DSM-5 criteria. Method The target population was all 7-12-year-old children in a South Korean community (N= 55,266), those in regular and special education schools and a disability registry. We utilized the Autism Spectrum Screening Questionnaire for systematic, multi-informant screening. Parents of screen-positive children were offered comprehensive assessments using standardized diagnostic procedures, including the Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule. Best estimate clinical diagnoses were made using DSMIV PDD and DSM5 ASD and SCD criteria. Results DSM5 ASD estimated prevalence is 2.20% (CI: 1.77-3.64). Combined DSM-5 ASD and SCD prevalence is virtually same as DSM-IV PDD prevalence (2.64%). Most children with Autistic Disorder (99%), Asperger Disorder (92%), and PDD NOS (63%) met DSM-5 ASD criteria, whereas 1%, 8% and 32%, respectively, met SCD criteria. All remaining children (2% ) had other psychopathology, principally Attention Deficit Hyperactivity Disorder and anxiety disorder. Conclusion Our findings suggest that most individuals with a prior DSMIV PDD meet DSM5 diagnostic criteria for ASD and SCD. PDD, ASD or SCD, extant diagnostic criteria identify a large, clinically meaningful group of individuals and families who require evidence-based services. PMID:24745950

Adaptive surrogate modeling by ANOVA and sparse polynomial dimensional decomposition for global sensitivity analysis in fluid simulation

NASA Astrophysics Data System (ADS)

Tang, Kunkun; Congedo, Pietro M.; Abgrall, Rémi

2016-06-01

The Polynomial Dimensional Decomposition (PDD) is employed in this work for the global sensitivity analysis and uncertainty quantification (UQ) of stochastic systems subject to a moderate to large number of input random variables. Due to the intimate connection between the PDD and the Analysis of Variance (ANOVA) approaches, PDD is able to provide a simpler and more direct evaluation of the Sobol' sensitivity indices, when compared to the Polynomial Chaos expansion (PC). Unfortunately, the number of PDD terms grows exponentially with respect to the size of the input random vector, which makes the computational cost of standard methods unaffordable for real engineering applications. In order to address the problem of the curse of dimensionality, this work proposes essentially variance-based adaptive strategies aiming to build a cheap meta-model (i.e. surrogate model) by employing the sparse PDD approach with its coefficients computed by regression. Three levels of adaptivity are carried out in this paper: 1) the truncated dimensionality for ANOVA component functions, 2) the active dimension technique especially for second- and higher-order parameter interactions, and 3) the stepwise regression approach designed to retain only the most influential polynomials in the PDD expansion. During this adaptive procedure featuring stepwise regressions, the surrogate model representation keeps containing few terms, so that the cost to resolve repeatedly the linear systems of the least-squares regression problem is negligible. The size of the finally obtained sparse PDD representation is much smaller than the one of the full expansion, since only significant terms are eventually retained. Consequently, a much smaller number of calls to the deterministic model is required to compute the final PDD coefficients.

Recovery of divergent avian bornaviruses from cases of proventricular dilatation disease: Identification of a candidate etiologic agent

PubMed Central

Kistler, Amy L; Gancz, Ady; Clubb, Susan; Skewes-Cox, Peter; Fischer, Kael; Sorber, Katherine; Chiu, Charles Y; Lublin, Avishai; Mechani, Sara; Farnoushi, Yigal; Greninger, Alexander; Wen, Christopher C; Karlene, Scott B; Ganem, Don; DeRisi, Joseph L

2008-01-01

Background Proventricular dilatation disease (PDD) is a fatal disorder threatening domesticated and wild psittacine birds worldwide. It is characterized by lymphoplasmacytic infiltration of the ganglia of the central and peripheral nervous system, leading to central nervous system disorders as well as disordered enteric motility and associated wasting. For almost 40 years, a viral etiology for PDD has been suspected, but to date no candidate etiologic agent has been reproducibly linked to the disease. Results Analysis of 2 PDD case-control series collected independently on different continents using a pan-viral microarray revealed a bornavirus hybridization signature in 62.5% of the PDD cases (5/8) and none of the controls (0/8). Ultra high throughput sequencing was utilized to recover the complete viral genome sequence from one of the virus-positive PDD cases. This revealed a bornavirus-like genome organization for this agent with a high degree of sequence divergence from all prior bornavirus isolates. We propose the name avian bornavirus (ABV) for this agent. Further specific ABV PCR analysis of an additional set of independently collected PDD cases and controls yielded a significant difference in ABV detection rate among PDD cases (71%, n = 7) compared to controls (0%, n = 14) (P = 0.01; Fisher's Exact Test). Partial sequence analysis of a total of 16 ABV isolates we have now recovered from these and an additional set of cases reveals at least 5 distinct ABV genetic subgroups. Conclusion These studies clearly demonstrate the existence of an avian reservoir of remarkably diverse bornaviruses and provide a compelling candidate in the search for an etiologic agent of PDD. PMID:18671869

Pluridirectional High-Energy Agile Scanning Electron Radiotherapy (PHASER): Extremely Rapid Treatment for Early Lung Cancer

DTIC Science & Technology

2014-06-01

BEAMnrc Monte Carlo (MC) codes were used to simulate 50- 150MeV VHEE beam dose deposition and its effects on steel and titanium (Ti) heterogeneities in a...performed on water-only geometry and water with segmented prostheses ( steel and Ti) geometries with 100MeV and 150MeV beams...8 Results: 100MeV PDD 5cm behind steel /Ti heterogeneity was 51% less than in the

A Comparison of DSM-IV-TR and DSM-5 Diagnostic Classifications in the Clinical Diagnosis of Autistic Spectrum Disorder.

PubMed

Yaylaci, Ferhat; Miral, Suha

2017-01-01

Aim of this study was to compare children diagnosed with Pervasive Developmental Disorder (PDD) according to DSM-IV-TR and DSM-5 diagnostic systems. One hundred fifty children aged between 3 and 15 years diagnosed with PDD by DSM-IV-TR were included. PDD symptoms were reviewed through psychiatric assessment based on DSM-IV-TR and DSM-5 criteria. Clinical severity was determined using Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC). A statistically significant decrease (19.3 %) was detected in the diagnostic ratio with DSM-5. Age and symptom severity differed significantly between those who were and were not diagnosed with PDD using DSM-5. B4 criteria in DSM-5 was most common criterion. Results indicate that individuals diagnosed with PDD by DSM-IV-TR criteria may not be diagnosed using DSM-5 criteria.

"Parkinson-dementia" diseases: a comparison by double tracer SPECT studies.

PubMed

Rossi, Carlo; Volterrani, Duccio; Nicoletti, Valentina; Manca, Gianpiero; Frosini, Daniela; Kiferle, Lorenzo; Unti, Elisa; De Feo, Paola; Bonuccelli, Ubaldo; Ceravolo, Roberto

2009-12-01

We performed 123I-FP-CIT/SPECT and ECD/SPECT in 30 patients with Parkinson's disease with dementia (PDD) and 30 patients with dementia with Lewy bodies (DLB) to evaluate whether presynaptic nigro-striatal function and/or cerebral perfusional pattern is different in these diseases. The striatal uptake of DAT tracer was statistically significantly lower in PDD and DLB with respect to control data (p < 0.0005), however no significant difference was found between PDD and DLB. Patients with PDD and DLB showed a significant reduction of rCBF (p < 0.001) in parieto-occipital and frontal areas, with respect to controls, but the comparison between the two groups did not result in any significant difference by SPM analysis. Finally no correlation was found between any regional perfusional changes and nigro-striatal dysfunction. We conclude that neither studies with 123I-FP-CIT nor ECD/SPECT were able to discriminate between DLB and PDD in vivo.

Using cluster ensemble and validation to identify subtypes of pervasive developmental disorders.

PubMed

Shen, Jess J; Lee, Phil-Hyoun; Holden, Jeanette J A; Shatkay, Hagit

2007-10-11

Pervasive Developmental Disorders (PDD) are neurodevelopmental disorders characterized by impairments in social interaction, communication and behavior. Given the diversity and varying severity of PDD, diagnostic tools attempt to identify homogeneous subtypes within PDD. Identifying subtypes can lead to targeted etiology studies and to effective type-specific intervention. Cluster analysis can suggest coherent subsets in data; however, different methods and assumptions lead to different results. Several previous studies applied clustering to PDD data, varying in number and characteristics of the produced subtypes. Most studies used a relatively small dataset (fewer than 150 subjects), and all applied only a single clustering method. Here we study a relatively large dataset (358 PDD patients), using an ensemble of three clustering methods. The results are evaluated using several validation methods, and consolidated through an integration step. Four clusters are identified, analyzed and compared to subtypes previously defined by the widely used diagnostic tool DSM-IV.

Using Cluster Ensemble and Validation to Identify Subtypes of Pervasive Developmental Disorders

PubMed Central

Shen, Jess J.; Lee, Phil Hyoun; Holden, Jeanette J.A.; Shatkay, Hagit

2007-01-01

Pervasive Developmental Disorders (PDD) are neurodevelopmental disorders characterized by impairments in social interaction, communication and behavior.1 Given the diversity and varying severity of PDD, diagnostic tools attempt to identify homogeneous subtypes within PDD. Identifying subtypes can lead to targeted etiology studies and to effective type-specific intervention. Cluster analysis can suggest coherent subsets in data; however, different methods and assumptions lead to different results. Several previous studies applied clustering to PDD data, varying in number and characteristics of the produced subtypes19. Most studies used a relatively small dataset (fewer than 150 subjects), and all applied only a single clustering method. Here we study a relatively large dataset (358 PDD patients), using an ensemble of three clustering methods. The results are evaluated using several validation methods, and consolidated through an integration step. Four clusters are identified, analyzed and compared to subtypes previously defined by the widely used diagnostic tool DSM-IV.2 PMID:18693920

Platelet Serotonin Levels in Pervasive Developmental Disorders and Mental Retardation: Diagnostic Group Differences, Within-Group Distribution, and Behavioral Correlates.

ERIC Educational Resources Information Center

Mulder, Erik J.; Anderson, George M.; Kema, Ido P.; De Bildt, Annelies; Van Lang, Natasja D.J.; Den Boer, Johan A.; Minderaa Ruud B.

2004-01-01

Objective: To investigate group differences, the within-group distributions, and the clinical correlates of platelet serotonin (5-HT) levels in pervasive developmental disorders (PDD). Method: Platelet 5-HT levels were measured in Dutch children and young adults, recruited from 2001 through 2003, with PDD (autism, Asperger's and PDD-not otherwise…

Comparing clinical profiles in Alzheimer's disease and Parkinson's disease dementia.

PubMed

Farlow, Martin R; Schmitt, Frederick; Aarsland, Dag; Grossberg, George T; Somogyi, Monique; Meng, Xiangyi

2013-01-01

Greater understanding of differences in baseline impairment and disease progression in patients with Alzheimer's disease (AD) and Parkinson's disease dementia (PDD) may improve the interpretation of drug effects and the design of future studies. This was a retrospective analysis of three randomized, double-blind rivastigmine databases (one in PDD, two in AD). Impairment on the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog), Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scale, 10-item Neuropsychiatric Inventory (NPI-10) and the ADCS-Clinical Global Impression of Change (CGIC) was compared [standardized difference (Cohen's d), similar if <0.1]. Patients with AD or PDD had similar levels of impairment on the ADAS-cog and NPI-10. Scores on the ADCS-ADL scale (standardized difference = 0.47) and the ADAS-cog memory domain (total, 0.33; items, 0.10-0.58) were higher in AD; PDD patients were more impaired in the language (0.23) and praxis (0.34) domains. AD patients receiving placebo showed greater deterioration on the ADAS-cog (0.14) and improvement on the NPI-10 (0.11) compared with patients with PDD. Differing patterns of impairment occur in AD and PDD.

Beam perturbation characteristics of a 2D transmission silicon diode array, Magic Plate

PubMed Central

Alrowaili, Ziyad A.; Lerch, Michael L.F.; Petasecca, Marco; Carolan, Martin G.; Metcalfe, Peter E.

2016-01-01

The main objective of this study is to demonstrate the performance characteristics of the Magic Plate (MP) system when operated upstream of the patient in transmission mode (MPTM). The MPTM is an essential component of a real‐time QA system designed for operation during radiotherapy treatment. Of particular interest is a quantitative study into the influence of the MP on the radiation beam quality at several field sizes and linear accelerator potential differences. The impact is measured through beam perturbation effects such as changes in the skin dose and/or percentage depth dose (PDD) (both in and out of field). The MP was placed in the block tray of a Varian linac head operated at 6, 10 and 18 MV beam energy. To optimize the MPTM operational setup, two conditions were investigated and each setup was compared to the case where no MP is positioned in place (i.e., open field): (i) MPTM alone and (ii) MPTM with a thin passive contamination electron filter. The in‐field and out‐of‐field surface doses of a solid water phantom were investigated for both setups using a Markus plane parallel (Model N23343) and Attix parallel‐plate, MRI model 449 ionization chambers. In addition, the effect on the 2D dose distribution measured by the Delta4 QA system was also investigated. The transmission factor for both of these MPTM setups in the central axis was also investigated using a Farmer ionization chamber (Model 2571A) and an Attix ionization chamber. Measurements were performed for different irradiation field sizes of 5×5 cm2 and 10×10 cm2. The change in the surface dose relative to dmax was measured to be less than 0.5% for the 6 MV, 10 MV, and 18 MV energy beams. Transmission factors measured for both set ups (i & ii above) with 6 MV, 10 MV, and 18 MV at a depth of dmax and a depth of 10 cm were all within 1.6% of open field. The impact of both the bare MPTM and the MPTM with 1 mm buildup on 3D dose distribution in comparison to the open field investigated using the Delta4 system and both the MPTM versions passed standard clinical gamma analysis criteria. Two MPTM operational setups were studied and presented in this article. The results indicate that both versions may be suitable for the new real‐time megavoltage photon treatment delivery QA system under development. However, the bare MPTM appears to be slightly better suited of the two MP versions, as it minimally perturbs the radiation field and does not lead to any significant increase in skin dose to the patient. PACS number(s): 87.50.up, 87.53.Bn, 87.55.N, 87.55.Qr, 87.56.Fc. PMID:27074475

Psychiatric diagnostic screening of social maladaptive behaviour in children with mild intellectual disability: differentiating disordered attachment and pervasive developmental disorder behaviour.

PubMed

Giltaij, H P; Sterkenburg, P S; Schuengel, C

2015-02-01

Children with intellectual disability (ID) are at risk for maladaptive development of social relatedness. Controversy exists whether Pervasive Developmental Disorder (PDD) takes precedence over disordered attachment for describing maladaptive social behaviour. The aim of this study was to assess the prevalence of disordered attachment symptoms in children with ID referred for mental health diagnosis, and to study the potential diagnostic overlap between symptoms of disordered attachment and PDD symptoms. Children (n = 102) in the age of 5-11 with IDs (borderline or mild; IQ 50-85) referred for psychiatric consultation were recruited. Parents were administered a screening interview for disturbances of attachment and teachers were administered a screening questionnaire for PDD. Behavioural symptoms of disordered attachment were reported for 42%* of the children, with 16%* showing symptoms of inhibited and 37%* showing symptoms of disinhibited attachment disorder. In 11% both types of symptoms were noted. Attachment disorder symptoms were not significantly associated with gender, ethnic background or age. Positive screening for PDD occurred for 27%. Positive screening for PDD was not significantly associated with symptoms of attachment disorder. Among children with ID referred for psychiatric consultation, Reactive Attachment Disorder (RAD) and PDD symptoms were both highly prevalent. RAD and PDD symptoms appear as distinct, but sometimes comorbid, forms of aberrant social relatedness. MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Study of Variation in Dose Calculation Accuracy Between kV Cone-Beam Computed Tomography and kV fan-Beam Computed Tomography

PubMed Central

Kaliyaperumal, Venkatesan; Raphael, C. Jomon; Varghese, K. Mathew; Gopu, Paul; Sivakumar, S.; Boban, Minu; Raj, N. Arunai Nambi; Senthilnathan, K.; Babu, P. Ramesh

2017-01-01

Cone-beam computed tomography (CBCT) images are presently used for geometric verification for daily patient positioning. In this work, we have compared the images of CBCT with the images of conventional fan beam CT (FBCT) in terms of image quality and Hounsfield units (HUs). We also compared the dose calculated using CBCT with that of FBCT. Homogenous RW3 plates and Catphan phantom were scanned by FBCT and CBCT. In RW3 and Catphan phantom, percentage depth dose (PDD), profiles, isodose distributions (for intensity modulated radiotherapy plans), and calculated dose volume histograms were compared. The HU difference was within ± 20 HU (central region) and ± 30 HU (peripheral region) for homogeneous RW3 plates. In the Catphan phantom, the difference in HU was ± 20 HU in the central area and peripheral areas. The HU differences were within ± 30 HU for all HU ranges starting from −1000 to 990 in phantom and patient images. In treatment plans done with simple symmetric and asymmetric fields, dose difference (DD) between CBCT plan and FBCT plan was within 1.2% for both phantoms. In intensity modulated radiotherapy (IMRT) treatment plans, for different target volumes, the difference was <2%. This feasibility study investigated HU variation and dose calculation accuracy between FBCT and CBCT based planning and has validated inverse planning algorithms with CBCT. In our study, we observed a larger deviation of HU values in the peripheral region compared to the central region. This is due to the ring artifact and scatter contribution which may prevent the use of CBCT as the primary imaging modality for radiotherapy treatment planning. The reconstruction algorithm needs to be modified further for improving the image quality and accuracy in HU values. However, our study with TG-119 and intensity modulated radiotherapy test targets shows that CBCT can be used for adaptive replanning as the recalculation of dose with the anisotropic analytical algorithm is in full accord with conventional planning CT except in the build-up regions. Patient images with CBCT have to be carefully analyzed for any artifacts before using them for such dose calculations. PMID:28974864

SU-F-T-83: Infant Total Skin Electron Therapy Using Five Fields Technique

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

Saleh, H; Howlin, T; Massey, V

Purpose: We were presented with a 9 month old boy with Relapsed Acute Myeloid Leukemia (AML) involving the skin. The plan was to treat the entire skin using 6 MeV electrons with the infant under complete anesthesia. The purpose of this work is to commission the 6 MeV electron beam and to develop a technique that can be used to deliver total skin dose to infants with minimal patient immobilization. Methods: A baby mannequin phantom that mimics the child’s length was used to determine the best technique to treat the infant. The 76 cm long phantom was placed on themore » floor. The phantom was placed in four unique immobilization devices to simulate four different treatment positions (anterior, posterior, left lateral and right lateral). Radiochromic films were used to determine beam profile in both axial and radial directions, and percent depth dose (PDD). Absolute calibration of the machine output at 214 cm distance was measured using an Exradin A11 parallel-plate ion chamber. A 1.0 cm plexiglass scatter plate was inserted in the collimator. Mosfet dosimeters were used for dose verification for phantom and and patient. Results: At 214 cm source to surface distance (SSD) using gantry angle of + 20o from vertical beam flatness is + 10% in the radial direction over a region of 70 cm and + 4% in the axial direction over 60 cm. A five field arrangement was determined to optimally deliver the desired dose with > 90% uniformity. The fifth field was used to boost the head vertex. Conclusion: It is possible to treat sedated infants with total skin dose using five positions. Four positions were enough to cover the body and the fifth position boosts the vertex of the head. All fractions can be reproduced accurately daily because of the patient’s stable immobilization.« less

Autism and Intellectual Disability: A Study of Prevalence on a Sample of the Italian Population

ERIC Educational Resources Information Center

La Malfa, G.; Lassi, S.; Bertelli, M.; Salvini, R.; Placidi, G. F.

2004-01-01

In 1994, the American Association on Mental Retardation with the DSM-IV has come to a final definition of pervasive developmental disorders (PDD), in agreement with the ICD-10. Prevalence of PDD in the general population is 0.10.15% according to the DSM-IV. PDD are more frequent in people with severe intellectual disability (ID). There is a strict…

Glucose-6-phosphate dehydrogenase deficiency among malaria suspects attending Gambella hospital, southwest Ethiopia.

PubMed

Tsegaye, Arega; Golassa, Lemu; Mamo, Hassen; Erko, Berhanu

2014-11-18

Glucose-6-phosphate dehydrogenase deficiency (G6PDd) is widespread across malaria endemic regions. G6PD-deficient individuals are at risk of haemolysis when exposed, among other agents, to primaquine and tafenoquine, which are capable of blocking malaria transmission by killing Plasmodium falciparum gametocytes and preventing Plasmodium vivax relapses by targeting hypnozoites. It is evident that no measures are currently in place to ensure safe delivery of these drugs within the context of G6PDd risk. Thus, determining G6PDd prevalence in malarious areas would contribute towards avoiding possible complications in malaria elimination using the drugs. This study, therefore, was aimed at determining G6PDd prevalence in Gambella hospital, southwest Ethiopia, using CareStart™ G6PDd fluorescence spot test. Venous blood samples were collected from febrile patients (n = 449) attending Gambella hospital in November-December 2013. Malaria was diagnosed using blood films and G6PDd was screened using CareStart™ G6PDd screening test (Access Bio, New Jersey, USA). Haematological parameters were also measured. The association of G6PD phenotype with sex, ethnic group and malaria smear positivity was tested. Malaria prevalence was 59.2% (96.6% of the cases being P. falciparum mono infections). Totally 33 participants (7.3%) were G6PD-deficient with no significant difference between the sexes. The chance of being G6PD-deficient was significantly higher for the native ethnic groups (Anuak and Nuer) compared to the 'highlanders'/settlers (odds ratio (OD) = 3.9, 95% confidence interval (CI) 0.481-31.418 for Anuak vs 'highlanders'; OD = 4.9, 95% CI 0.635-38.00 for Nuer vs 'highlanders'). G6PDd prevalence among the Nuer (14.3%) was significantly higher than that for the Anuak (12.0%). G6PDd prevalence in the area is substantial with 30 (90.9%) of the 33 deficient individuals having malaria suggesting the non-protective role of the disorder at least from clinical malaria. The indigenous Nilotic people tend to have a higher chance of being G6PD-deficient as 32 (96.9%) of the total 33 cases occurred among them.

Utility of Autonomic Function Tests to Differentiate Dementia with Lewy Bodies and Parkinson Disease with Dementia from Alzheimer Disease.

PubMed

Toru, Shuta; Kanouchi, Tadashi; Yokota, Takanori; Yagi, Yosuke; Machida, Akira; Kobayashi, Takayoshi

2018-01-01

We studied autonomic disturbance in patients with dementia with Lewy bodies (DLB), Parkinson disease with dementia (PDD), Alzheimer disease (AD), to determine whether autonomic function tests can be used to distinguish these disorders. Autonomic function was tested in 56 patients with DLB, 37 patients with PDD, and 59 patients with AD by using the sympathetic skin response, coefficient of variation in R-R interval, the head-up tilt test, serum norepinephrine concentration, and 123I-meta-iodobenzylguanidine cardiac scintigraphy. Symptoms of autonomic dysfunction, such as constipation, urinary symptoms, and orthostatic hypotension, were also noted. The groups did not differ on baseline characteristics other than those associated with Parkinsonism and dementia. All patients with DLB and PDD had some dysautonomia, whereas rates were much lower for patients with AD (19%). Significantly more DLB and PDD patients than AD patients showed abnormalities on autonomic function tests. Autonomic function tests might be quite useful to distinguish DLB and PDD from AD. © 2017 S. Karger AG, Basel.

The natural history of the anterior knee instability by stress radiography

PubMed Central

de Rezende, Márcia Uchôa; Hernandez, Arnaldo José; Camanho, Gilberto Luis

2014-01-01

OBJECTIVE: To analyze the anteroposterior displacement of the knee by means of stress radiography in individuals with unilateral anterior knee instability and relate to time of instability. METHODS: Sixty individuals with intact knees (control group) and 125 patients with unilateral anterior instability (AI group) agreed to participate in the study. Gender, age, weight, height, age at injury, time between injury and testing, and surgical findings are studied. Both groups are submitted to anterior and posterior stress radiographies of both knees. Anterior (ADD) and posterior displacement difference (PDD) were calculated between sides. RESULTS: In the control group ADD and PDD are in average, zero, whereas in the AI group ADD averaged 9.8mm and PDD, 1.92mm. Gender, age, weight, height, age at trauma and presence of menisci's lesions do not intervene in the values of ADD and PDD. Meniscal injuries increase with time. ADD and PDD do not relate with the presence or absence of associated menisci's lesions. The ADD and the PDD are related to each other and increase with time. CONCLUSION: There is a permanent anterior subluxation of the injured knee that is related to the amount of anterior displacement that increases with time. Level of Evidence III, Study Types Case-control study. PMID:25246846

G6PD deficiency in Latin America: systematic review on prevalence and variants

PubMed Central

Monteiro, Wuelton M; Val, Fernando FA; Siqueira, André M; Franca, Gabriel P; Sampaio, Vanderson S; Melo, Gisely C; Almeida, Anne CG; Brito, Marcelo AM; Peixoto, Henry M; Fuller, Douglas; Bassat, Quique; Romero, Gustavo AS; Maria Regina F, Oliveira; Marcus Vinícius G, Lacerda

2014-01-01

Plasmodium vivax radical cure requires the use of primaquine (PQ), a drug that induces haemolysis in glucose-6-phosphate dehydrogenase deficient (G6PDd) individuals, which further hampers malaria control efforts. The aim of this work was to study the G6PDd prevalence and variants in Latin America (LA) and the Caribbean region. A systematic search of the published literature was undertaken in August 2013. Bibliographies of manuscripts were also searched and additional references were identified. Low prevalence rates of G6PDd were documented in Argentina, Bolivia, Mexico, Peru and Uruguay, but studies from Curaçao, Ecuador, Jamaica, Saint Lucia, Suriname and Trinidad, as well as some surveys carried out in areas of Brazil, Colombia and Cuba, have shown a high prevalence (> 10%) of G6PDd. The G6PD A-202A mutation was the variant most broadly distributed across LA and was identified in 81.1% of the deficient individuals surveyed. G6PDd is a frequent phenomenon in LA, although certain Amerindian populations may not be affected, suggesting that PQ could be safely used in these specific populations. Population-wide use of PQ as part of malaria elimination strategies in LA cannot be supported unless a rapid, accurate and field-deployable G6PDd diagnostic test is made available. PMID:25141282

A biomechanical study of artificial cervical discs using computer simulation.

PubMed

Ahn, Hyung Soo; DiAngelo, Denis J

2008-04-15

A virtual simulation model of the subaxial cervical spine was used to study the biomechanical effects of various disc prosthesis designs. To study the biomechanics of different design features of cervical disc arthroplasty devices. Disc arthroplasty is an alternative approach to cervical fusion surgery for restoring and maintaining motion at a diseased spinal segment. Different types of cervical disc arthroplasty devices exist and vary based on their placement and degrees of motion offered. A virtual dynamic model of the subaxial cervical spine was used to study 3 different prosthetic disc designs (PDD): (1) PDD-I: The center of rotation of a spherical joint located at the mid C5-C6 disc, (2) PDD-II: The center of rotation of a spherical joint located 6.5 mm below the mid C5-C6 disc, and (3) PDD-III: The center of rotation of a spherical joint in a plane located at the C5-C6 disc level. A constrained spherical joint placed at the disc level (PDD-I) significantly increased facet loads during extension. Lowering the rotational axis of the spherical joint towards the subjacent body (PDD-II) caused a marginal increase in facet loading during flexion, extension, and lateral bending. Lastly, unconstraining the spherical joint to move freely in a plane (PDD-III) minimized facet load build up during all loading modes. The simulation model showed the impact simple design changes may have on cervical disc dynamics. The predicted facet loads calculated from computer model have to be validated in the experimental study.

New technical tip for anterior cervical plating : make hole first and choose the proper plate size later.

PubMed

Park, Jeong Yoon; Zhang, Ho Yeol; Oh, Min Chul

2011-04-01

It is well known that plate-to-disc distance (PDD) is closely related to adjacent-level ossification following anterior cervical plate placement. The study was undertaken to compare the outcomes of two different anterior cervical plating methods for degenerative cervical condition. Specifically, the new method involves making holes for plate screws first with an air drill and then choosing a plate size. The other method was standard, that is, decide on the plate size first, locate the plate on the anterior vertebral body, and then drilling the screw holes. Our null hypothesis was that the new technical tip may increase PDD as compared with the standard anterior cervical plating procedure. We retrospectively reviewed 49 patients who had a solid fusion after anterior cervical arthrodesis with a plate for the treatment of cervical disc degeneration. Twenty-three patients underwent the new anterior cervical plating technique (Group A) and 26 patients underwent the standard technique (Group B). PDD and ratios between PDD to anterior body heights (ABH) were measured using postoperative lateral radiographs. In addition, operating times and clinical results were reviewed in all cases. The mean durations of follow-up were 16.42±5.99 (Group A) and 19.83±6.71 (Group B) months, range 12 to 35 months. Of these parameters mentioned above, cephalad PDD (5.43 versus 3.46 mm, p=0.005) and cephalad PDD/ABH (0.36 versus 0.23, p=0.004) were significantly greater in the Group A, whereas operation time for two segment arthrodesis (141.9 versus 170.6 minutes, p=0.047) was significantly lower in the Group A. There were no significant difference between the two groups in caudal PDD (5.92 versus 5.06 mm), caudal PDD/ABH (0.37 versus 0.32) and clinical results. The new anterior cervical plating method represents an improvement over the standard method in terms of cephalad plate-to-disc distance and operating time.

Systematic review of the clinical manifestations of glucose-6-phosphate dehydrogenase deficiency in the Greater Mekong Subregion: implications for malaria elimination and beyond.

PubMed

Ong, Ken Ing Cherng; Kosugi, Hodaka; Thoeun, Sophea; Araki, Hitomi; Thandar, Moe Moe; Iwagami, Moritoshi; Hongvanthong, Bouasy; Brey, Paul T; Kano, Shigeyuki; Jimba, Masamine

2017-01-01

To achieve malaria elimination in the Greater Mekong Subregion (GMS) by 2030, proper case management is necessary. 8-aminoquinolines, such as primaquine, are the only available medicines effective in preventing relapse of the hypnozoite stage of Plasmodium vivax , as well as the onward transmission of Plasmodium falciparum . However, primaquine can cause haemolysis in individuals who have glucose-6-phosphate dehydrogenase deficiency (G6PDd). We conducted a systematic review on the reported clinical manifestations of G6PDd to provide a comprehensive overview of the situation in the GMS. The protocol for this systematic review was registered on PROSPERO: International prospective register of systematic reviews (CRD42016043146). We searched the PubMed/MEDLINE, CINAHL, and Web of Science databases for published articles describing the clinical manifestations of G6PDd in the GMS. We included articles of all study designs from inception until 31 July 2016, reporting the clinical manifestations of G6PDd. We then performed a narrative synthesis of these articles. We included 56 articles in this review, 45 of which were from Thailand. Haemolysis in G6PD-deficient individuals was caused not only by primaquine but also by other medicines and infections. Other clinical manifestations of G6PDd that were found were favism, neonatal jaundice and chronic non-spherocytic haemolytic anaemia. G6PDd also influenced the clinical presentations of genetic disorders and infections, such as thalassemia and typhoid fever. As G6PDd also affects the clinical presentations of other infections, the benefits of G6PD testing and proper record keeping transcend those of malaria case management. Therefore, healthcare workers at the community level should be made familiar with complications resulting from G6PDd as these complications extend beyond the scope of malaria.

Systematic review of the clinical manifestations of glucose-6-phosphate dehydrogenase deficiency in the Greater Mekong Subregion: implications for malaria elimination and beyond

PubMed Central

Ong, Ken Ing Cherng; Kosugi, Hodaka; Thoeun, Sophea; Araki, Hitomi; Thandar, Moe Moe; Iwagami, Moritoshi; Hongvanthong, Bouasy; Brey, Paul T; Kano, Shigeyuki; Jimba, Masamine

2017-01-01

Introduction To achieve malaria elimination in the Greater Mekong Subregion (GMS) by 2030, proper case management is necessary. 8-aminoquinolines, such as primaquine, are the only available medicines effective in preventing relapse of the hypnozoite stage of Plasmodium vivax, as well as the onward transmission of Plasmodium falciparum. However, primaquine can cause haemolysis in individuals who have glucose-6-phosphate dehydrogenase deficiency (G6PDd). We conducted a systematic review on the reported clinical manifestations of G6PDd to provide a comprehensive overview of the situation in the GMS. Methods The protocol for this systematic review was registered on PROSPERO: International prospective register of systematic reviews (CRD42016043146). We searched the PubMed/MEDLINE, CINAHL, and Web of Science databases for published articles describing the clinical manifestations of G6PDd in the GMS. We included articles of all study designs from inception until 31 July 2016, reporting the clinical manifestations of G6PDd. We then performed a narrative synthesis of these articles. Results We included 56 articles in this review, 45 of which were from Thailand. Haemolysis in G6PD-deficient individuals was caused not only by primaquine but also by other medicines and infections. Other clinical manifestations of G6PDd that were found were favism, neonatal jaundice and chronic non-spherocytic haemolytic anaemia. G6PDd also influenced the clinical presentations of genetic disorders and infections, such as thalassemia and typhoid fever. Conclusion As G6PDd also affects the clinical presentations of other infections, the benefits of G6PD testing and proper record keeping transcend those of malaria case management. Therefore, healthcare workers at the community level should be made familiar with complications resulting from G6PDd as these complications extend beyond the scope of malaria. PMID:29082022

sA Comparison of DSM-IV-TR and DSM-5 Diagnostic Classifications in the Clinical Diagnosis of Autistic Spectrum Disorder

ERIC Educational Resources Information Center

Yaylaci, Ferhat; Miral, Suha

2017-01-01

Aim of this study was to compare children diagnosed with Pervasive Developmental Disorder (PDD) according to DSM-IV-TR and DSM-5 diagnostic systems. One hundred fifty children aged between 3 and 15 years diagnosed with PDD by DSM-IV-TR were included. PDD symptoms were reviewed through psychiatric assessment based on DSM-IV-TR and DSM-5 criteria.…

Glucose-6-phosphate dehydrogenase deficiency prevalence and genetic variants in malaria endemic areas of Colombia.

PubMed

Valencia, Sócrates Herrera; Ocampo, Iván Darío; Arce-Plata, María Isabel; Recht, Judith; Arévalo-Herrera, Myriam

2016-05-26

Glucose 6-phosphate dehydrogenase (G6PD) is an enzyme involved in prevention of cellular oxidative damage, particularly protecting erythrocytes from haemolysis. An estimated 400 million people present variable degrees of inherited G6PD deficiency (G6PDd) which puts them at risk for developing haemolysis triggered by several risk factors including multiple drugs and certain foods. Primaquine (PQ) is a widely used anti-malarial drug that can trigger haemolysis in individuals with G6PDd. Intensification of malaria control programmes worldwide and particularly malaria elimination planning in some regions recommend a more extensive use of PQ and related drugs in populations with different G6PDd prevalence. This a preliminary study to assess the prevalence of G6PDd in representative malaria endemic areas of Colombia by measuring G6PD phonotype and genotypes. Volunteers (n = 426) from four malaria endemic areas in Colombia (Buenaventura, Tumaco, Tierralta and Quibdo) were enrolled. Blood samples were drawn to evaluate G6PD enzymatic activity by using a quantitative G6PD test and a subset of samples was analysed by PCR-RFLP to determine the frequency of the three most common G6PD genotypic variants: A-, A+ and Mediterranean. A total of 28 individuals (6.56 %) displayed either severe or intermediate G6PDd. The highest prevalence (3.51 %) was in Buenaventura, whereas G6PDd prevalence was lower (<1 %) in Tierralta and Quibdo. G6PD A alleles were the most frequent (15.23 %) particularly in Buenaventura and Tumaco. Overall, a high frequency of G6PD A- genotype, followed by A+ genotype was found in the analysed population. G6PDd based on enzymatic activity as well as G6PD A allelic variants were found in malaria-endemic populations on the Pacific coast of Colombia, where most of malaria cases are caused by Plasmodium vivax infections. These infections are treated for 14 days with PQ, however there are no official reports of PQ-induced haemolytic crises. Further assessment of G6PDd prevalence in malaria endemic areas in Colombia is crucial in view of possible mass drug administration for malaria elimination in these regions, as well as implementation of appropriate G6PDd diagnostic methods.

SU-F-T-582: Small Field Dosimetry in Radiosurgery Collimators with a Stealth Chamber

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

Azcona, J; Barbes, B

2016-06-15

Purpose: The extraction of a reference signal for measuring small fields in scanning mode can be problematic. In this work we describe the use of a transmission chamber in small field dosimetry for radiosurgery collimators and compare TMR curves obtained with stereotactic diode and microionization chamber. Methods: Four radiosurgery cones of diameters 5, 10, 12.5, and 15mm supplied by Elekta Medical were commissioned in a 6MV FFF beam from an Elekta Versa linac. A transmission chamber manufactured by IBA (Stealth chamber) was attached to the lower part of the collimators and used for PDD and profile measurements in scanning modemore » with a Scanditronix stereotactic diode. It was also used for centering the stereotactic diode in the water tank to measure TMR and output factors, by integrating the signal. TMR measurements for all collimators and the OF for the largest collimator were also acquired on a polystyrene PTW 29672 phantom with a PTW PinPoint 3D chamber 0.016 cm3 volume. Results: Measured TMR with diode and microionization chamber agreed very well with differences larger than 1% only for depths above 15cm, except the smaller collimator, for which differences were always smaller than 2%. Calculated TMR were significantly different (up to 7%) from measured TMR. The differences are attributed to the change in response of the diode with depth, because the effective field aperture varies with depth. Furthermore, neglecting the ratio of phantom-scatter factors in the conversion formula also contributes to this difference. OF measured with diode and chamber showed a difference of 3.5%. Conclusion: The transmission chamber overcomes the problem of extracting a reference signal and is of great help for small field commissioning. Calculating TMR from PDD is strongly discouraged. Good agreement was found when comparing measurements of TMR with stereotactic diode in water with measurements with microionization chamber in polystyrene.« less

Information Warfare and Cyber Defense

DTIC Science & Technology

2002-04-22

Information Technology Trends Power Is Up 1980 1982 1986 1989 1992 1996 1998 2000 286 386 486 Pentium P6 Pentium 4 286k 1MB 4MB 16MB 64MB 256 MB...384 MBDRAM CPU (Source: EIA, CNET, Gartner, Dell -- 2000) 2002 512 MB Pentium 4/ Celeron 5 Information Technology Trends Price Is Down Cost per MIPS...Operations Architecture Technology Info Assurance PDD-56 PDD-63 PDD-68 Information Operations Focus Areas Elements • PSYOP • Deception • EW •

Emotional distress and its correlates among parents of children with pervasive developmental disorders.

PubMed

Yamada, Atsurou; Suzuki, Miyoshi; Kato, Misuzu; Suzuki, Mie; Tanaka, Sayumi; Shindo, Takuo; Taketani, Kazuo; Akechi, Tatsuo; Furukawa, Toshi A

2007-12-01

A number of studies have reported that parents of autistic children face higher levels of stress, but few studies examined the stress associated with the home care of children with pervasive developmental disorders (PDD) other than autistic disorder. The aims of the present study were therefore to (i) evaluate the emotional stress level of parents caring for their children with PDD; and (ii) explore the correlates of their emotional stress. Participants were 147 families (147 mothers and 122 fathers) of 158 children with PDD (42 with autistic disorder, 35 with Asperger's disorder and 81 with PDD not otherwise specified). K6 was used to measure the stress level of the parents. Marital relationships and personality were assessed with the Intimate Bond Measure and the NEO Five-Factor Inventory, respectively. The parents also rated the characteristics of their children with PDD through the Pervasive Developmental Disorder-Autism Society Japan Rating Scale (PARS). The mean K6 score of the mothers was significantly higher than that of the women in the general population in Japan. Stepwise multiple regression indicated that the emotional stress of the mothers was correlated with the personality traits of Neuroticism and Agreeableness, perceived Control by the husband, and the children's PARS score. Clinicians can deliver better service by paying appropriate attention to the emotional distress of mothers of children with not only autistic disorder but also other PDD.

Pervasive developmental disorders in Prader-Willi syndrome: the Leuven experience in 59 subjects and controls.

PubMed

Descheemaeker, Mie-Jef; Govers, Veerle; Vermeulen, Peter; Fryns, Jean-Pierre

2006-06-01

In the present study we investigated the co-morbidity of pervasive developmental disorder (PDD) in 59 Prader-Willi syndrome (PWS) individuals and in 59 non-specific mentally retarded controls, matched for IQ, gender, and age. The 'Pervasive Developmental Disorder Mentally Retardation Scale' (PDD-MRScale), a screening questionnaire based on the DSM-III-R criteria for PDD, has been applied in the PWS group and in the control group. Results of the present study revealed a striking autistic-like behavioral phenotype in the majority of the PWS individuals, particularly deficits in the quality of language and communication and of imagination and interests. This intersection with autistic symptomatology is an important addition to the behavioral phenotype in PWS persons. A first approach to delineate subtypes of autistic symptomalogy among PWS persons was performed. Nineteen percent of the PWS group did meet the full diagnostic DSM-III-R criteria for PDD in comparison with 15% in the control group. Results revealed that a higher IQ in PWS does not protect to develop genuine PDD and that uniparental disomy/imprinting mutation as genetic origin seems to be an additional risk factor for developing genuine PDD. The results of the present study suggest the importance of reconsidering the commonly recognized obsessive-compulsive like behavior in PWS persons within the broader spectrum of autism disorders. Copyright 2006 Wiley-Liss, Inc.

Control quantum evolution speed of a single dephasing qubit for arbitrary initial states via periodic dynamical decoupling pulses.

PubMed

Song, Ya-Ju; Tan, Qing-Shou; Kuang, Le-Man

2017-03-08

We investigate the possibility to control quantum evolution speed of a single dephasing qubit for arbitrary initial states by the use of periodic dynamical decoupling (PDD) pulses. It is indicated that the quantum speed limit time (QSLT) is determined by initial and final quantum coherence of the qubit, as well as the non-Markovianity of the system under consideration during the evolution when the qubit is subjected to a zero-temperature Ohmic-like dephasing reservoir. It is shown that final quantum coherence of the qubit and the non-Markovianity of the system can be modulated by PDD pulses. Our results show that for arbitrary initial states of the dephasing qubit with non-vanishing quantum coherence, PDD pulses can be used to induce potential acceleration of the quantum evolution in the short-time regime, while PDD pulses can lead to potential speedup and slow down in the long-time regime. We demonstrate that the effect of PDD on the QSLT for the Ohmic or sub-Ohmic spectrum (Markovian reservoir) is much different from that for the super-Ohmic spectrum (non-Markovian reservoir).

SU-E-T-111: Development of Proton Dosimetry System Using Fiber-Optic Cerenkov Radiation Sensor Array

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

Son, J; Kim, M; Shin, D

2014-06-01

Purpose: We had developed and evaluated a new dosimetric system for proton therapy using array of fiber-optic Cerenkov radiation sensor (FOCRS) which can measure a percent depth dose (PDD) instantly. In this study, the Bragg peaks and spread out Bragg peak (SOBP) of the proton beams measured by FOCRS array were compared with those measured by an ion chamber. Methods and Method: We fabricated an optical fiber array of FOCRS in a handmade phantom which is composed of poly-methyl methacrylate (PMMA). There are 75 holes of 1mm diameter inside the phantom which is designed to be exposed in direction ofmore » beam when it is emerged in water phantom. The proton beam irradiation was carried out using IBA cyclotron PROTEUS 235 at national cancer center in Korea and a commercial data acquisition system was used to digitize the analog signal. Results: The measured Bragg peak and SOBP for the proton ranges of 7∼ 20 cm were well matched with the result from ion chamber. The comparison results show that the depth of proton beam ranges and the width of SOBP measured by array of FOCRS are comparable with the measurement from multi-layer ion chamber (MLIC) although there are some uncertainty in the measurement of FOCRS array for some specific beam ranges. Conclusion: The newly developed FOCRS array based dosimetric system for proton therapy can efficiently reduce the time and effort needed for proton beam range measurement compared to the conventional method and has the potential to be used for the proton pencil beam application.« less

Poster - 38: On the physical and dosimetric properties of 3D printed electron bolus fabricated using polylactic acid

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

Sasaki, David; Jensen, Martin; Rickey, Daniel W

Purpose: 3D printing technology could simplify and improve electron bolus fabrication. The purpose of this study was to characterize the density, dimensional accuracy, uniformity, and attenuation of PLA boluses fabricated with a low-cost 3D printer. Methods: Several solid square slabs were printed with specific requested dimensions and 100% infill using different fill patterns. These pieces were imaged using an x-ray flat panel imager in order to check for uniformity of the prints. Percentage depth doses (PDDs) were measured downstream of the slabs in solid water using a parallel plate chamber and compared to measurements in water in order to characterizemore » attenuation. The dimensions of the PLA slabs were measured using digital calipers. The slabs were also weighed to find their density. Results: The fill pattern used to create boluses can affect the attenuation of the bolus. Fill patterns should be chosen carefully and quality assurance should be done for each printed piece. PLA causes the electron PDD to shift towards shallower depths, compared to water, by 1.7 mm for each centimeter of PLA. Agreement with design dimensions was within 1 mm in the plane of the printer bed, and within 1/3 of a millimeter (roughly the thickness of a single layer), perpendicular to the printer bed. Average density was in the range 1.20 – 1.22. Conclusions: 3D printing shows great promise for use in fabricating electron bolus. This work indicates that printed PLA can be a suitable material provided the increased attenuation is properly accounted for.« less

Total skin electron therapy in the lying‐on‐the‐floor position using a customized flattening filter to accommodate frail patients

PubMed Central

Antolak, John A.

2013-01-01

A total skin electron (TSE) floor technique is presented for treating patients who are unable to safely stand for extended durations. A customized flattening filter is used to eliminate the need for field junctioning, improve field uniformity, and reduce setup time. The flattening filter is constructed from copper and polycarbonate, fits into the linac's accessory slot, and is optimized to extend the useful height and width of the beam such that no field junctions are needed during treatment. A TSE floor with flattening filter (TSE FF) treatment course consisted of six patient positions: three supine and three prone. For all treatment fields, electron beam energy was 6 MeV; collimator settings were an x of 30 cm, y of 40 cm, and θcoll of 0°; and a 0.4 cm thick polycarbonate spoiler was positioned in front of the patient. Percent depth dose (PDD) and photon contamination for the TSE FF technique were compared with our standard technique, which is similar to the Stanford technique. Beam profiles were measured using radiochromic film, and dose uniformity was verified using an anthropomorphic radiological phantom. The TSE FF technique met field uniformity requirements specified by the American Association of Physicists in Medicine Task Group 30. TSE FF R80 ranges from 4 to 4.8 mm. TSE FF photon contamination was ~ 3%. Anthropomorphic radiological phantom verification demonstrated that dose to the entire skin surface was expected to be within about ±15% of the prescription dose, except for the perineum, scalp vertex, top of shoulder, and soles of the feet. The TSE floor technique presented herein eliminates field junctioning, is suitable for patients who cannot safely stand during treatment, and provides comparable quality and uniformity to the Stanford technique. PACS number: 87 PMID:24036864

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

Devic, Slobodan; Tomic, Nada; Aldelaijan, Saad

Purpose: Despite numerous advantages of radiochromic film dosimeter (high spatial resolution, near tissue equivalence, low energy dependence) to measure a relative dose distribution with film, one needs to first measure an absolute dose (following previously established reference dosimetry protocol) and then convert measured absolute dose values into relative doses. In this work, we present result of our efforts to obtain a functional form that would linearize the inherently nonlinear dose-response curve of the radiochromic film dosimetry system. Methods: Functional form [{zeta}= (-1){center_dot}netOD{sup (2/3)}/ln(netOD)] was derived from calibration curves of various previously established radiochromic film dosimetry systems. In order to testmore » the invariance of the proposed functional form with respect to the film model used we tested it with three different GAFCHROMIC Trade-Mark-Sign film models (EBT, EBT2, and EBT3) irradiated to various doses and scanned on a same scanner. For one of the film models (EBT2), we tested the invariance of the functional form to the scanner model used by scanning irradiated film pieces with three different flatbed scanner models (Epson V700, 1680, and 10000XL). To test our hypothesis that the proposed functional argument linearizes the response of the radiochromic film dosimetry system, verification tests have been performed in clinical applications: percent depth dose measurements, IMRT quality assurance (QA), and brachytherapy QA. Results: Obtained R{sup 2} values indicate that the choice of the functional form of the new argument appropriately linearizes the dose response of the radiochromic film dosimetry system we used. The linear behavior was insensitive to both film model and flatbed scanner model used. Measured PDD values using the green channel response of the GAFCHROMIC Trade-Mark-Sign EBT3 film model are well within {+-}2% window of the local relative dose value when compared to the tabulated Cobalt-60 data. It was also found that criteria of 3%/3 mm for an IMRT QA plan and 3%/2 mm for a brachytherapy QA plan are passing 95% gamma function points. Conclusions: In this paper, we demonstrate the use of functional argument to linearize the inherently nonlinear response of a radiochromic film based reference dosimetry system. In this way, relative dosimetry can be conveniently performed using radiochromic film dosimetry system without the need of establishing calibration curve.« less

SU-F-T-491: Photon Beam Matching Analysis at Multiple Sites Up to Twelve Years Post Installation

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

Able, C; Zakikhani, R; Yan, K

Purpose: To determine if the photon beams associated with several models of accelerators are matched with ‘Golden Beam’ data (VGBD) to assess treatment planning modeling and delivery. Methods: Six accelerators’ photon beams were evaluated to determine if they matched the manufacturer’s (Varian Medical Systems, Inc.) VGBD. Additional direct comparisons of the 6X and 18X beams using the manufacturer’s specification of Basic and Fine beam matching were also performed. The Cseries accelerator models were 21 EX (3), IX (2), and a IX Trilogy, ranging from three to twelve years post installation. Computerized beam scanning was performed (IBA Blue Phantom 2) withmore » 2 CC13 ion chambers in water at 100 cm SSD. Dmax (10 cm2 field size), percentage depth dose (6 cm2, 10 cm2, 20 cm2, and 30 cm2 field sizes) and beam uniformity (10 cm2, 30 cm2 and 40 cm2 field sizes) were evaluated. Results: When comparing the beams with VGBD using the ‘Basic’ matching criteria, all beams were within the specifications ( 1.5mm at dmax, 1% PDD, and 2% Profiles). When considering the “Fine” matching criteria ( 1.5mm at dmax, 0.5% PDD, and 2% Profiles), only three of six 6MV beams and two of six high energy (five 18MV & one 15MV) beams passed. Direct comparisons between accelerators using the Clinac IX (installed 2012) as the reference beam datasets resulted in all 6 MV and 18MV beams meeting both the “Basic” and “Fine” criterion with the exception of two accelerators. Conclusion: Linear accelerators installed up to nine years apart are capable of meeting the manufacturers beam matching criteria for “Basic” matching. Without any adjustments most beams, when evaluated, may meet the “Fine” match criteria. The use of a single dataset (VGBD or designated accelerator reference data) for treatment planning commissioning is acceptable and can provide quality treatment delivery.« less

SU-E-T-254: Optimization of GATE and PHITS Monte Carlo Code Parameters for Uniform Scanning Proton Beam Based On Simulation with FLUKA General-Purpose Code

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

Kurosu, K; Department of Medical Physics ' Engineering, Osaka University Graduate School of Medicine, Osaka; Takashina, M

Purpose: Monte Carlo codes are becoming important tools for proton beam dosimetry. However, the relationships between the customizing parameters and percentage depth dose (PDD) of GATE and PHITS codes have not been reported which are studied for PDD and proton range compared to the FLUKA code and the experimental data. Methods: The beam delivery system of the Indiana University Health Proton Therapy Center was modeled for the uniform scanning beam in FLUKA and transferred identically into GATE and PHITS. This computational model was built from the blue print and validated with the commissioning data. Three parameters evaluated are the maximummore » step size, cut off energy and physical and transport model. The dependence of the PDDs on the customizing parameters was compared with the published results of previous studies. Results: The optimal parameters for the simulation of the whole beam delivery system were defined by referring to the calculation results obtained with each parameter. Although the PDDs from FLUKA and the experimental data show a good agreement, those of GATE and PHITS obtained with our optimal parameters show a minor discrepancy. The measured proton range R90 was 269.37 mm, compared to the calculated range of 269.63 mm, 268.96 mm, and 270.85 mm with FLUKA, GATE and PHITS, respectively. Conclusion: We evaluated the dependence of the results for PDDs obtained with GATE and PHITS Monte Carlo generalpurpose codes on the customizing parameters by using the whole computational model of the treatment nozzle. The optimal parameters for the simulation were then defined by referring to the calculation results. The physical model, particle transport mechanics and the different geometrybased descriptions need accurate customization in three simulation codes to agree with experimental data for artifact-free Monte Carlo simulation. This study was supported by Grants-in Aid for Cancer Research (H22-3rd Term Cancer Control-General-043) from the Ministry of Health, Labor and Welfare of Japan, Grants-in-Aid for Scientific Research (No. 23791419), and JSPS Core-to-Core program (No. 23003). The authors have no conflict of interest.« less

Polar-Direct-Drive Defect Implosions at OMEGA inPreparation for Experiments at NIF

NASA Astrophysics Data System (ADS)

Cobble, J. A.; Schmitt, M. J.; Murphy, T. J.; Tregillis, I. L.; Wysocki, F. J.; Obrey, K. D.; Magelssen, G. R.; Glebov, V.; Bradley, P. A.; Hsu, S. C.; Krasheninnikova, N. V.; Batha, S. H.

2011-10-01

The Defect-Implosion (DIME) campaign involves compressing perturbed spherical capsules with polar direct drive (PDD). For direct-drive implosions at NIF, PDD will be used. We have done simulations and experiments at OMEGA to test our modeling capability for equatorial-plane defects in fusion capsules and for PDD at NIF. Since PDD is anisotropic, we show the results of 0th hydrodynamics of implosions and perturbation-driven features near stagnation. Later presentations discuss defect-induced mix and neutronics, and laser pointing for NIF experiments. Prototype OMEGA shots used 865- μm diameter CH shells filled with 5 atm of D2. Machined channels 30- μm wide and up to 9- μm deep formed the defects. This work has been performed under the auspices of the US DOE, contract number DE-AC52-06NA25396.

Downward finger displacement distinguishes Parkinson disease dementia from Alzheimer disease.

PubMed

Lieberman, Abraham; Deep, Aman; Shi, Jiong; Dhall, Rohit; Shafer, Saulena; Moguel-Cobos, Guillermo; Dhillon, Ravneet; Frames, Christopher W; McCauley, Margaret

2018-02-01

Purpose/Aim of the study: To study finger displacement in patients with Parkinson disease dementia (PDD) and in patients with Alzheimer disease (AD). We examined 56 patients with PDD and 35 with AD. Patients were examined during their regular outpatient clinic visit. Finger displacement was measured by observers not actively involved in the study using a creative grid ruler for all PDD and AD patients. Finger displacement was examined by asking patients to point their index fingers toward the grid ruler with the nails facing upward. Patients were asked to maintain the pointing position for 15 s. After 15 s, patients were asked to close their eyes for another 15 s while maintaining the same position. A positive result was downward index finger displacement of ≥5 cm within the 15-second time window with eyes closed. Of the 56 PDD patients, 53 had bilateral finger displacement of >5 cm. In comparison, of the 35 AD patients, only 1 patient had minimal displacement. Results of the non-invasive finger displacement test may provide insight, on an outpatient basis, of the integrity of subcortical-cortical circuits. Downward finger displacement, especially bilateral downward displacement, may signal the extensive disruption of subcortical-cortical circuits that occurs in PDD patients. AChE: acetylcholinesterase; AD: Alzheimer disease; DLB: dementia with Lewy bodies; ET: essential tremor; MDS-UPDRS: Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale; MMSE: Mini-Mental State Examination; PD: Parkinson disease; PDD: Parkinson disease dementia.

Antigen tissue distribution of Avian bornavirus (ABV) in psittacine birds with natural spontaneous proventricular dilatation disease and ABV genotype 1 infection.

PubMed

Wünschmann, Arno; Honkavuori, Kirsi; Briese, Thomas; Lipkin, W Ian; Shivers, Jan; Armien, Aníbal G

2011-07-01

Tissues of 10 psittacines from aviary 1 ("case birds") and 5 psittacines from different aviaries were investigated for the presence of Avian bornavirus (ABV) antigen by immunohistochemistry using a polyclonal serum specific for the viral nucleocapsid (N) protein. Seven of 10 case birds had clinical signs, and necropsy findings consistent with proventricular dilatation disease (PDD) while 3 case birds and the 5 birds from other aviaries did not exhibit signs and lesions of this disease. In birds with clinical signs of PDD, ABV antigen was largely limited to neuroectodermal cells including neurons, astroglia, and ependymal cells of the central nervous system, neurons of the peripheral nervous system, and adrenal cells. ABV antigen was present in the nuclei and cytoplasm of infected cells. In 2 case birds that lacked signs and lesions of PDD, viral antigen had a more widespread distribution and was present in nuclei and cytoplasm of epithelial cells of the alimentary and urogenital tract, retina, heart, skeletal muscle, and skin in addition to the mentioned neuroectodermal cells. ABV RNA was identified by reverse transcription polymerase chain reaction (RT-PCR) in tissues of all 7 case birds available for testing from aviary 1, including 4 birds with PDD lesions and the 3 birds without PDD lesions. Sequencing and phylogenetic analysis indicated the presence of ABV genotype 1 in all cases. Findings further substantiate a role of ABV in PDD of psittacine bird species.

Antigen tissue distribution of Avian bornavirus (ABV) in psittacine birds with natural spontaneous proventricular dilatation disease and ABV genotype 1 infection

PubMed Central

Wünschmann, Arno; Honkavuori, Kirsi; Briese, Thomas; Lipkin, W. Ian; Shivers, Jan; Armien, Aníbal G.

2014-01-01

Tissues of 10 psittacines from aviary 1 (“case birds”) and 5 psittacines from different aviaries were investigated for the presence of Avian bornavirus (ABV) antigen by immunohistochemistry using a polyclonal serum specific for the viral nucleocapsid (N) protein. Seven of 10 case birds had clinical signs, and necropsy findings consistent with proventricular dilatation disease (PDD) while 3 case birds and the 5 birds from other aviaries did not exhibit signs and lesions of this disease. In birds with clinical signs of PDD, ABV antigen was largely limited to neuroectodermal cells including neurons, astroglia, and ependymal cells of the central nervous system, neurons of the peripheral nervous system, and adrenal cells. ABV antigen was present in the nuclei and cytoplasm of infected cells. In 2 case birds that lacked signs and lesions of PDD, viral antigen had a more widespread distribution and was present in nuclei and cytoplasm of epithelial cells of the alimentary and urogenital tract, retina, heart, skeletal muscle, and skin in addition to the mentioned neuroectodermal cells. ABV RNA was identified by reverse transcription polymerase chain reaction (RT-PCR) in tissues of all 7 case birds available for testing from aviary 1, including 4 birds with PDD lesions and the 3 birds without PDD lesions. Sequencing and phylogenetic analysis indicated the presence of ABV genotype 1 in all cases. Findings further substantiate a role of ABV in PDD of psittacine bird species. PMID:21908314

Study of false positives in 5-ALA induced photodynamic diagnosis of bladder carcinoma

NASA Astrophysics Data System (ADS)

Draga, Ronald O. P.; Grimbergen, Matthijs C. M.; Kok, Esther T.; Jonges, Trudy G. N.; Bosch, J. L. H. R.

2009-02-01

Photodynamic diagnosis (PDD) is a technique that enhances the detection of tumors during cystoscopy using a photosensitizer which accumulates primarily in cancerous cells and will fluoresce when illuminated by violetblue light. A disadvantage of PDD is the relatively low specificity. In this retrospective study we aimed to identify predictors for false positive findings in PDD. Factors such as gender, age, recent transurethral resection of bladder tumors (TURBT), previous intravesical therapy (IVT) and urinary tract infections (UTIs) were examined for association with the false positive rates in a multivariate analysis. Data of 366 procedures and 200 patients were collected. Patients were instilled with 5-aminolevulinic acid (5-ALA) intravesically and 1253 biopsies were taken from tumors and suspicious lesions. Female gender and TURBT are independent predictors of false positives in PDD. However, previous intravesical therapy with Bacille Calmette-Guérin is also an important predictor of false positives. The false positive rate decreases during the first 9-12 weeks after the latest TURBT and the latest intravesical chemotherapy. Although shortly after IVT and TURBT false positives increase, PDD improves the diagnostic sensitivity and results in more adequate treatment strategies in a significant number of patients.

Hexyl aminolevulinate-guided fluorescence cystoscopy in the diagnosis and follow-up of patients with non-muscle-invasive bladder cancer: a critical review of the current literature.

PubMed

Rink, Michael; Babjuk, Marko; Catto, James W F; Jichlinski, Patrice; Shariat, Shahrokh F; Stenzl, Arnulf; Stepp, Herbert; Zaak, Dirk; Witjes, J Alfred

2013-10-01

Controversy exists regarding the therapeutic benefit and cost effectiveness of photodynamic diagnosis (PDD) with 5-aminolevulinic acid (5-ALA) or hexyl aminolevulinate (HAL) in addition to white-light cystoscopy (WLC) in the management of non-muscle-invasive bladder cancer (NMIBC). To systematically evaluate evidence regarding the therapeutic benefits and economic considerations of PDD in NMIBC detection and treatment. We performed a critical review of PubMed/Medline, Embase, and the Cochrane Library in October 2012 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Identified reports were reviewed according to the Consolidated Standards of Reporting Trials (CONSORT) and Standards for the Reporting of Diagnostic Accuracy Studies (STARD) criteria. Forty-four publications were selected for inclusion in this analysis. Included reports used 5-ALA (in 26 studies), HAL (15 studies), or both (three studies) as photosensitising agents. PDD increased the detection of both papillary tumours (by 7-29%) and flat carcinoma in situ (CIS; by 25-30%) and reduced the rate of residual tumours after transurethral resection of bladder tumour (TURBT; by an average of 20%) compared to WLC alone. Superior recurrence-free survival (RFS) rates and prolonged RFS intervals were reported for PDD, compared to WLC in most studies. PDD did not appear to reduce disease progression. Our findings are limited by tumour heterogeneity and a lack of NMIBC risk stratification in many reports or adjustment for intravesical therapy use in most studies. Although cost effectiveness has been demonstrated for 5-ALA, it has not been studied for HAL. Moderately strong evidence exists that PDD improves tumour detection and reduces residual disease after TURBT compared with WLC. This has been shown to improve RFS but not progression to more advanced disease. Further work to evaluate cost effectiveness of PDD is required. Copyright © 2013 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Risks of Hemolysis in Glucose-6-Phosphate Dehydrogenase Deficient Infants Exposed to Chlorproguanil-Dapsone, Mefloquine and Sulfadoxine-Pyrimethamine as Part of Intermittent Presumptive Treatment of Malaria in Infants.

PubMed

Poirot, Eugenie; Vittinghoff, Eric; Ishengoma, Deus; Alifrangis, Michael; Carneiro, Ilona; Hashim, Ramadhan; Baraka, Vito; Mosha, Jacklin; Gesase, Samwel; Chandramohan, Daniel; Gosling, Roland

2015-01-01

Chlorproguanil-dapsone (CD) has been linked to hemolysis in symptomatic glucose-6-phosphate dehydrogenase deficient (G6PDd) children. Few studies have explored the effects of G6PD status on hemolysis in children treated with Intermittent Preventive Treatment in infants (IPTi) antimalarial regimens. We sought to examine the joint effects of G6PD status and IPTi antimalarial treatment on incidence of hemolysis in asymptomatic children treated with CD, sulfadoxine-pyrimethamine (SP), and mefloquine (MQ). A secondary analysis of data from a double-blind, placebo-controlled trial of IPTi was conducted. Hemoglobin (Hb) measurements were made at IPTi doses, regular follow-up and emergency visits. G6PD genotype was determined at 9 months looking for SNPs for the A- genotype at coding position 202. Multivariable linear and logistic regression models were used to examine hemolysis among children with valid G6PD genotyping results. Hemolysis was defined as the absolute change in Hb or as any post-dose Hb <8 g/dL. These outcomes were assessed using either a single follow-up Hb on day 7 after an IPTi dose or Hb obtained 1 to 14 or 28 days after each IPTi dose. Relative to placebo, CD reduced Hb by approximately 0.5 g/dL at day 7 and within 14 days of an IPTi dose, and by 0.2 g/dL within 28 days. Adjusted declines in the CD group were larger than in the MQ and SP groups. At day 7, homo-/hemizygous genotype was associated with higher odds of Hb <8 g/dL (adjusted odds ratio = 6.7, 95% CI 1.7 to 27.0) and greater absolute reductions in Hb (-0.6 g/dL, 95% CI -1.1 to 0.003). There was no evidence to suggest increased reductions in Hb among homo-/hemizygous children treated with CD compared to placebo, SP or MQ. While treatment with CD demonstrated greater reductions in Hb at 7 and 14 days after an IPTi dose compared to both SP and MQ, there was no evidence that G6PD deficiency exacerbated the adverse effects of CD, despite evidence for higher hemolysis risk among G6PDd infants.

Fluorescence detection of malignant liver tumors using 5-aminolevulinic acid-mediated photodynamic diagnosis: principles, technique, and clinical experience.

PubMed

Inoue, Yoshihiro; Tanaka, Ryo; Komeda, Koji; Hirokawa, Fumitoshi; Hayashi, Michihiro; Uchiyama, Kazuhisa

2014-07-01

Photoactive drugs selectively accumulate in malignant tissue specimens and cause drug-induced fluorescence. Photodynamic diagnosis (PDD) and fluorescence can distinguish normal from malignant tissue. From May 2012 to September 2013, a total of 70 patients underwent hepatic resections using 5-ALA-mediated PDD for liver tumors at our hospital. 5-ALA fluorescence was detected in all hepatocellular carcinoma cases with serosa invasion. In liver metastasis from colorectal cancer cases with serosa invasion, 18 patients (85.7 %) were detected, and three patients (14.2 %) whose tumors showed complete response to neoadjuvant chemotherapy showed no fluorescence. Both superficial and deep malignant liver tumors were detected with 92.5 % sensitivity. Using 5-ALA-mediated PDD, tumors remaining at the cut surface and postoperative bile leakage were less frequent than in our previous hepatic resections using conventional white-light observation. Moreover, all malignant liver tumors were completely removed with a clear microscopic margin using 5-ALA, with a significant difference in resection margin width between 5-ALA-mediated PDD (6.7 ± 6.9 mm) and white-light observation (9.2 ± 7.0 mm; p = 0.0083). With the detection of malignant liver tumors, residual tumor and bile leakage at the cut surface of the remnant liver were improved by PDD with 5-ALA. This procedure may provide greater sensitivity than the conventional procedure. Furthermore, 5-ALA-mediated PDD can ensure histological clearance regardless of the resection margin and preserve as much liver parenchyma as possible in patients with impaired liver function.

Altered spontaneous brain activity in MRI-negative refractory temporal lobe epilepsy patients with major depressive disorder: A resting-state fMRI study.

PubMed

Zhu, Xi; He, Zhongqiong; Luo, Cheng; Qiu, Xiangmiao; He, Shixu; Peng, Anjiao; Zhang, Lin; Chen, Lei

2018-03-15

To investigate alterations in spontaneous brain activity in MRI-negative refractory temporal lobe epilepsy patients with major depressive disorder using resting-state functional magnetic resonance imaging (RS-fMRI). Eighteen MRI-negative refractory temporal lobe epilepsy patients with major depressive disorder (PDD), 17 MRI-negative refractory temporal lobe epilepsy patients without major depressive disorder (nPDD), and 21 matched healthy controls (HC) were recruited from West China Hospital of SiChuan University from April 2016 to June 2017. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and 17-item Hamilton Depression Rating Scale were employed to confirm the diagnosis of major depressive disorder and assess the severity of depression. All participants underwent RS-fMRI scans using a 3.0T MRI system. MRI data were compared and analyzed using the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) to measure spontaneous brain activity. These two methods were both used to evaluate spontaneous cerebral activity. The PDD group showed significantly altered spontaneous brain activity in the bilateral mesial prefrontal cortex, precuneus, angular gyrus, right parahippocampal gyrus, and right temporal pole. Meanwhile, compared with HC, the nPDD group demonstrated altered spontaneous brain activity in the temporal neocortex but no changes in mesial temporal structures. The PDD group showed regional brain activity alterations in the prefrontal-limbic system and dysfunction of the default mode network. The underlying pathophysiology of PDD may be provided for further studies. Copyright © 2018 Elsevier B.V. All rights reserved.

Calibration of EBT2 film using a red-channel PDD method in combination with a modified three-channel technique

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

Chang, Liyun, E-mail: liyunc@isu.edu.tw; Ho, Sheng-Yow; Lee, Tsair-Fwu

Purpose: Ashland Inc. EBT2 and EBT3 films are widely used in quality assurance for radiation therapy; however, there remains a relatively high degree of uncertainty [B. Hartmann, M. Martisikova, and O. Jakel, “Homogeneity of Gafchromic EBT2 film,” Med. Phys. 37, 1753–1756 (2010)]. Micke et al. (2011) recently improved the spatial homogeneity using all color channels of a flatbed scanner; however, van Hoof et al. (2012) pointed out that the corrected nonuniformity still requires further investigation for larger fields. To reduce the calibration errors and the uncertainty, the authors propose a new red-channel percentage-depth-dose method in combination with a modified three-channelmore » technique. Methods: For the ease of comparison, the EBT2 film image used in the authors’ previous study (2012) was reanalyzed using different approaches. Photon beams of 6-MV were delivered to two different films at two different beam on times, resulting in the absorption doses of ranging from approximately 30 to 300 cGy at the vertical midline of the film, which was set to be coincident with the central axis of the beam. The film was tightly sandwiched in a 30{sup 3}-cm{sup 3} polystyrene phantom, and the pixel values for red, green, and blue channels were extracted from 234 points on the central axis of the beam and compared with the corresponding depth doses. The film was first calibrated using the multichannel method proposed by Micke et al. (2010), accounting for nonuniformities in the scanner. After eliminating the scanner and dose-independent nonuniformities, the film was recalibrated via the dose-dependent optical density of the red channel and fitted to a power function. This calibration was verified via comparisons of the dose profiles extracted from the films, where three were exposed to a 60° physical wedge field and three were exposed to composite fields, and all of which were measured in a water phantom. A correction for optical attenuation was implemented, and treatment plans of intensity modulated radiation therapy and volumetric modulated arc therapy were evaluated. Results: The method described here demonstrated improved accuracy with reduced uncertainty. The relative error compared with the measurements of a water phantom was less than 1%, and the overall calibration uncertainty was less than 2%. Verification tests revealed that the results were close to those of the authors’ previous study, and all differences were within 3%, except those with a high-dose gradient. The gamma pass rates (2%/2 mm) of the treatment plan evaluated using the method described here were greater than 99%, and no obvious stripe patterns were observed in the dose-difference maps. Conclusions: Spatial homogeneity was significantly improved via the calibration method described here. This technique is both convenient and time-efficient because it does not require cutting the film, and only two exposures are necessary.« less

Calibration of EBT2 film using a red-channel PDD method in combination with a modified three-channel technique.

PubMed

Chang, Liyun; Ho, Sheng-Yow; Lee, Tsair-Fwu; Yeh, Shyh-An; Ding, Hueisch-Jy; Chen, Pang-Yu

2015-10-01

Ashland Inc. EBT2 and EBT3 films are widely used in quality assurance for radiation therapy; however, there remains a relatively high degree of uncertainty [B. Hartmann, M. Martisikova, and O. Jakel, "Homogeneity of Gafchromic EBT2 film," Med. Phys. 37, 1753-1756 (2010)]. Micke et al. (2011) recently improved the spatial homogeneity using all color channels of a flatbed scanner; however, van Hoof et al. (2012) pointed out that the corrected nonuniformity still requires further investigation for larger fields. To reduce the calibration errors and the uncertainty, the authors propose a new red-channel percentage-depth-dose method in combination with a modified three-channel technique. For the ease of comparison, the EBT2 film image used in the authors' previous study (2012) was reanalyzed using different approaches. Photon beams of 6-MV were delivered to two different films at two different beam on times, resulting in the absorption doses of ranging from approximately 30 to 300 cGy at the vertical midline of the film, which was set to be coincident with the central axis of the beam. The film was tightly sandwiched in a 30(3)-cm(3) polystyrene phantom, and the pixel values for red, green, and blue channels were extracted from 234 points on the central axis of the beam and compared with the corresponding depth doses. The film was first calibrated using the multichannel method proposed by Micke et al. (2010), accounting for nonuniformities in the scanner. After eliminating the scanner and dose-independent nonuniformities, the film was recalibrated via the dose-dependent optical density of the red channel and fitted to a power function. This calibration was verified via comparisons of the dose profiles extracted from the films, where three were exposed to a 60° physical wedge field and three were exposed to composite fields, and all of which were measured in a water phantom. A correction for optical attenuation was implemented, and treatment plans of intensity modulated radiation therapy and volumetric modulated arc therapy were evaluated. The method described here demonstrated improved accuracy with reduced uncertainty. The relative error compared with the measurements of a water phantom was less than 1%, and the overall calibration uncertainty was less than 2%. Verification tests revealed that the results were close to those of the authors' previous study, and all differences were within 3%, except those with a high-dose gradient. The gamma pass rates (2%/2 mm) of the treatment plan evaluated using the method described here were greater than 99%, and no obvious stripe patterns were observed in the dose-difference maps. Spatial homogeneity was significantly improved via the calibration method described here. This technique is both convenient and time-efficient because it does not require cutting the film, and only two exposures are necessary.

Optimization of GATE and PHITS Monte Carlo code parameters for spot scanning proton beam based on simulation with FLUKA general-purpose code

NASA Astrophysics Data System (ADS)

Kurosu, Keita; Das, Indra J.; Moskvin, Vadim P.

2016-01-01

Spot scanning, owing to its superior dose-shaping capability, provides unsurpassed dose conformity, in particular for complex targets. However, the robustness of the delivered dose distribution and prescription has to be verified. Monte Carlo (MC) simulation has the potential to generate significant advantages for high-precise particle therapy, especially for medium containing inhomogeneities. However, the inherent choice of computational parameters in MC simulation codes of GATE, PHITS and FLUKA that is observed for uniform scanning proton beam needs to be evaluated. This means that the relationship between the effect of input parameters and the calculation results should be carefully scrutinized. The objective of this study was, therefore, to determine the optimal parameters for the spot scanning proton beam for both GATE and PHITS codes by using data from FLUKA simulation as a reference. The proton beam scanning system of the Indiana University Health Proton Therapy Center was modeled in FLUKA, and the geometry was subsequently and identically transferred to GATE and PHITS. Although the beam transport is managed by spot scanning system, the spot location is always set at the center of a water phantom of 600 × 600 × 300 mm3, which is placed after the treatment nozzle. The percentage depth dose (PDD) is computed along the central axis using 0.5 × 0.5 × 0.5 mm3 voxels in the water phantom. The PDDs and the proton ranges obtained with several computational parameters are then compared to those of FLUKA, and optimal parameters are determined from the accuracy of the proton range, suppressed dose deviation, and computational time minimization. Our results indicate that the optimized parameters are different from those for uniform scanning, suggesting that the gold standard for setting computational parameters for any proton therapy application cannot be determined consistently since the impact of setting parameters depends on the proton irradiation technique. We therefore conclude that customization parameters must be set with reference to the optimized parameters of the corresponding irradiation technique in order to render them useful for achieving artifact-free MC simulation for use in computational experiments and clinical treatments.

Neoclassic drug discovery: the case for lead generation using phenotypic and functional approaches.

PubMed

Lee, Jonathan A; Berg, Ellen L

2013-12-01

Innovation and new molecular entity production by the pharmaceutical industry has been below expectations. Surprisingly, more first-in-class small-molecule drugs approved by the U.S. Food and Drug Administration (FDA) between 1999 and 2008 were identified by functional phenotypic lead generation strategies reminiscent of pre-genomics pharmacology than contemporary molecular targeted strategies that encompass the vast majority of lead generation efforts. This observation, in conjunction with the difficulty in validating molecular targets for drug discovery, has diminished the impact of the "genomics revolution" and has led to a growing grassroots movement and now broader trend in pharma to reconsider the use of modern physiology-based or phenotypic drug discovery (PDD) strategies. This "From the Guest Editors" column provides an introduction and overview of the two-part special issues of Journal of Biomolecular Screening on PDD. Terminology and the business case for use of PDD are defined. Key issues such as assay performance, chemical optimization, target identification, and challenges to the organization and implementation of PDD are discussed. Possible solutions for these challenges and a new neoclassic vision for PDD that combines phenotypic and functional approaches with technology innovations resulting from the genomics-driven era of target-based drug discovery (TDD) are also described. Finally, an overview of the manuscripts in this special edition is provided.

Neonatal factors among subjects diagnosed with a pervasive developmental disorder in the US.

PubMed

Geier, David; Kern, Janet; Geier, Mark

2018-07-01

Contradictory studies suggest that some neonatal factors may be associated with a pervasive developmental disorder (PDD) diagnosis, but limited data is available from longitudinal, prospective medical record assessments. The present hypothesis-testing longitudinal, case-control study evaluated birth characteristics among cases diagnosed with a PDD in comparison to controls by examining prospectively collected automated medical records within the Vaccine Safety Datalink (VSD) database. Cases were Health Maintenance Organization (HMO)-enrolled from birth until diagnosed with International Classification of Disease, 9th revision (ICD-9) PDD (299.xx) and controls were HMO-enrolled from birth for at least 4.75 years without a PDD diagnosis. The birth characteristics examined included: gender, gestational age in weeks at birth, mean birth weight in grams, Appearance-Pulse-Grimace-Activity-Respiration (APGAR) scores at 1 minute and 5 minutes, and maternal age in years at birth. Cases had a significantly increased male/female ratio relative to controls. By contrast, mean gestational age at birth, mean birth weight, mean maternal age at birth, and mean APGAR scores at 1 minute and 5 minutes were not statistically different among cases compared to controls. This study indicates that cases diagnosed with a PDD as compared to controls do not have significant differences in neonatal factors.

Stereotypic behaviors in degenerative dementias.

PubMed

Prioni, S; Fetoni, V; Barocco, F; Redaelli, V; Falcone, C; Soliveri, P; Tagliavini, F; Scaglioni, A; Caffarra, P; Concari, L; Gardini, S; Girotti, F

2012-11-01

Stereotypies are simple or complex involuntary/unvoluntary behaviors, common in fronto-temporal dementia (FTD), but not studied in other types of degenerative dementias. The aim was to investigate stereotypy frequency and type in patients with FTD, Alzheimer's disease (AD), progressive supranuclear palsy (PSP) and Parkinson's disease with dementia (PDD) in a multicenter observational study; and to investigate the relation of stereotypies to cognitive, behavioral and motor impairment. One hundred fifty-five consecutive outpatients (45 AD, 40 FTD, 35 PSP and 35 PDD) were studied in four hospitals in northern Italy. Stereotypies were examined by the five-domain Stereotypy Rating Inventory. Cognition was examined by the Mini Mental State and Frontal Assessment Battery, neuropsychiatric symptoms by the Neuropsychiatric Inventory, and motor impairment and invalidity by the Unified Parkinson's Disease Rating Scale part III, and activities of daily living. Stereotypies were present in all groups. FTD and PDD had the greatest frequency of one-domain stereotypies; FTD also had the greatest frequency of two-or-more domain stereotypies; movement stereotypies were the most common stereotypies in all groups. AD patients had fewer stereotypies than the other groups. Stereotypies are not exclusive to FTD, but are also fairly common in PSP and PDD, though less so in AD. Stereotypies may be underpinned by dysfunctional striato-frontal circuits, known to be damaged in PSP and PDD, as well as FTD.

Economic impacts of reduced milk production associated with papillomatous digital dermatitis in dairy cows in the USA.

PubMed

Losinger, Willard C

2006-05-01

The goal of this study was to measure the economic impacts of reduced milk production associated with papillomatous digital dermatitis (PDD) in dairy cows in the USA, and of specific risk factors for PDD, in 1996. The method applied was an economic-welfare analysis of producer and consumer surplus, with the GUM Workbench used to analyse uncertainties in the measurements. Reduced milk production associated with PDD was found to reduce consumer surplus by Dollars 750 million +/- Dollars 580 million, and to increase the economic surplus of producers by Dollars 560 million +/- Dollars 470 million, with a net economic loss of Dollars 190 million +/- Dollars 130 million. An examination of the economic effects of specific epidemiologic risk factors for PDD showed that having dairy cows that were not born on the operation had important economic consequences associated with the disease, as did the type of land to which dairy cows had access during the winter months and the type of flooring on which cows walked. Washing hoof-trimming equipment between cows was an important biosecurity measure that was associated with reduced PDD. The epidemiologic model used also implicated hoof trimmers who trimmed cattle hooves on other operations as having an important economic impact associated with this disease, although this finding may have been erroneous.

Glucose-6-phosphate dehydrogenase deficiency in people living in malaria endemic districts of Nepal.

PubMed

Ghimire, Prakash; Singh, Nihal; Ortega, Leonard; Rijal, Komal Raj; Adhikari, Bipin; Thakur, Garib Das; Marasini, Baburam

2017-05-23

Glucose-6-phosphate dehydrogenase (G6PD) is a rate limiting enzyme of the pentose phosphate pathway and is closely associated with the haemolytic disorders among patients receiving anti-malarial drugs, such as primaquine. G6PD deficiency (G6PDd) is an impending factor for radical treatment of malaria which affects the clearance of gametocytes from the blood and subsequent delay in the achievement of malaria elimination. The main objective of this study was to assess the prevalence of G6PD deficiency in six malaria endemic districts in Southern Nepal. A cross-sectional population based prevalence survey was conducted in six malaria endemic districts of Nepal, during April-Dec 2013. A total of 1341 blood samples were tested for G6PDd using two different rapid diagnostic test kits (Binax-Now ® and Care Start™). Equal proportions of participants from each district (n ≥ 200) were enrolled considering ethnic and demographic representation of the population groups. Out of total 1341 blood specimens collected from six districts, the overall prevalence of G6PDd was 97/1341; 7.23% on Binax Now and 81/1341; 6.0% on Care Start test. Higher prevalence was observed in male than females [Binax Now: male 10.2%; 53/521 versus female 5.4%; 44/820 (p = 0.003) and Care Start: male 8.4%; 44/521 versus female 4.5%; 37/820 (p = 0.003)]. G6PDd was higher in ethnic groups Rajbanshi (11.7%; 19/162) and Tharu (5.6%; 56/1005) (p = 0.006), major inhabitant of the endemic districts. Higher prevalence of G6PDd was found in Jhapa (22/224; 9.8%) and Morang districts (18/225; 8%) (p = 0.031). In a multivariate analysis, male were found at more risk for G6PDd than females, on Binax test (aOR = 1.97; CI 1.28-3.03; p = 0.002) and Care Start test (aOR = 1.86; CI 1.16-2.97; p = 0.009). The higher prevalence of G6PDd in certain ethnic group, gender and geographical region clearly demonstrates clustering of the cases and ascertained the risk groups within the population. This is the first study in Nepal which identified the vulnerable population groups for G6PDd in malaria endemic districts. The finding of this study warrants the need for G6PDd testing in vulnerable population groups in endemic districts, and also facilitates use of primaquine in mass supporting timely progress for malaria elimination.

SU-E-T-245: Detection of the Photon Target Damage in Varian Linac Based On Periodical Quality Assurance Measurements

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

Gao, S; Balter, P; Wang, X

2015-06-15

Purpose: To determine the best dosimetric metric measured by our routine QA devices for diagnosing photon target failure on a Varian C-series linac. Methods: We have retrospectively reviewed and analyzed the dosimetry data from a Varian linac with a target degradation that was undiagnosed for one year. A failure in the daily QA symmetry tests was the first indication of an issue. The beam was steered back to a symmetric shape and water scans indicated the beam energy had changed but stayed within the manufacturer’s specifications and agreed reasonably with our treatment planning system data. After the problem was identifiedmore » and the target was replaced, we retrospectively analyzed our QA data including diagonals normalized flatness (F-DN) from the daily device (DQA3), profiles from an ionization chamber array (IC Profiler), as well as profiles and PDDs from a 3D water Scanner (3DS). These metrics were cross-compared to determine which was the best early indicator of target degradation. Results: A 3% change in FDN measured by the DQA3 was found to be an early indicator of target degradation. It is more sensitive than changes in output, symmetry, flatness or PDD. All beam shape metrics (flatness at dmax and 10 cm depth, and F-DN) indicated an energy increase while the PDD indicated an energy decrease. This disagreement between the beam-shape based energy metrics (F-DN and flatness) and PDD based energy metric may indicate target failure as opposed to an energy change resulting from changes in the incident electron energy. Conclusion: Photon target degradation has been identified as a failure mode for linacs. The manufacturer’s test for this condition is highly invasive and requires machine down time. We have demonstrated that the condition could be caught early based upon data acquired during routine QA activities, such as the F-DN.« less

A new structured interview for children with autism spectrum disorder based on the DSM-IV.

PubMed

Hansakunachai, Tippawan; Roongpraiwan, Rawiwan; Sombuntham, Tasnawat; Limprasert, Pornprot; Ruangdaraganon, Nichara

2014-08-01

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder in children. The clinical spectrum of ASD includes autism, childhood disintegrative disorder Asperger syndrome and pervasive developmental disorder not otherwise specified (PDD-NOS). Although the DSM-IVcriteria are well acceptedforASD diagnosis, there are some known limitations for clinicians. The most important issue is lack'ofspecific age-appropriate items in each domain. Thus, the DSM-IVneeds some modifications in order to be appropriate for clinical use. To develop a structured interview for children based on the DSM-IVdiagnostic criteria ofautism and PDD-NOS. MATERIAL ANDMETHOD: From June 2006 to December 2008, 140 Thai children, 121 boys and 19 girls, already diagnosed with ASD, were recruited through the child development clinics of Ramathibodi and Thammasat University Hospitals in Thailand. A 26-item structured interview was developed with scoring according to the DSM-IVdiagnostic criteria for autism andPDD- NOS. To test the accuracy of the structured interview and its reliability, 32 children with ASD were selected and interviewed by four clinicians using the new instrument. One clinician interviewed the parents or caregivers, while three others independently took notes and observed the play behavior of the children. All items from the structured interview as scored by each clinician were compared using inter-rater agreement statistics (Kappa). All of the original 140 patients were then clinically diagnosed again using the structured interview and the results were compared with the initial diagnoses. Ofthe 140patients originally diagnosed with ASD, 110 and 30patients were finally diagnosed with the new interview as having autism and PDD-NOS, respectively. The initial diagnoses from 15 cases (10.7%) were changed according to the structured interview Inter-rater reliability among the four clinicians showed a good level ofagreement (Kappa = 0.897) with statistical significance (p<0.001). The authors only compared the items in the structured interview between the autism and PDD-NOSgroups from 105 cases aged 2-5 years (79 cases with autism and 26 cases with PDD-NOS) because there were only 4 cases with PDD-NOS in the other age groups. Highly significant differences (p<0.001) in clinical items between patients with autism and patients with PDD-NOS from the final diagnoses were noted in 6 of 8 items in the category of restricted, repetitive and stereotyped patterns ofbehavior, interests and activities, which were more common in the autism group than the PDD-NOS group. In addition, the autism group had higher frequencies of using finger-pointing to indicate interest rather than verbalization, and idiosyncratic language, than the PDD-NOS group. The newly developed structured interview for Thai children with ASD had a high level ofinterrater reliability between four clinicians. However, most children tested using this structured interview were 2-5years ofage, and the study did not include non-autistic groups. The application ofthis structured interview needs further study with a wider variety ofcases, such as ASD cases from different age groups, children with delayed development and normal children.

Concerns Expressed by Parents of Children with Pervasive Developmental Disorders for Different Time Periods of the Day: A Case–Control Study

PubMed Central

Sasaki, Yoshinori; Usami, Masahide; Sasayama, Daimei; Okada, Takashi; Iwadare, Yoshitaka; Watanabe, Kyota; Ushijima, Hirokage; Tanaka, Tetsuya; Harada, Maiko; Tanaka, Hiromi; Kodaira, Masaki; Sugiyama, Nobuhiro; Sawa, Tetsuji; Saito, Kazuhiko

2015-01-01

Background/Aim The Questionnaire: Children with Difficulties (QCD) is a parent-assessed questionnaire designed to evaluate child’s difficulties in functioning during specific periods of the day. This study aimed to evaluate difficulties in daily functioning of children and adolescents with pervasive developmental disorder (PDD) using the QCD. Results were compared with those for a community sample. Methods A case–control design was used. The cases comprised elementary school students (182 males, 51 females) and junior high school students (100 males, 39 females) with PDD, whereas a community sample of elementary school students (568 males, 579 females) and junior high school students (180 males, 183 females) was enrolled as controls. Their behavior was assessed using the QCD, the Tokyo Autistic Behavior Scale (TABS), the ADHD-rating scale (ADHD-RS), and the Oppositional Defiant Behavior Inventory (ODBI) for elementary and junior high school students, respectively. Effects of gender and diagnosis on the QCD scores were analyzed. Correlation coefficients between QCD and TABS, ADHD-RS, and ODBI scores were analyzed. Results The QCD scores for the children with PDD were significantly lower compared with those from the community sample (P < 0.001). Significantly strong correlations were observed in more areas of the ADHD-RS and ODBI scores compared with the TABS scores. Conclusions Children with PDD experienced greater difficulties in completing basic daily activities; moreover, their QCD scores revealed stronger associations with their ADHD-RS and ODBI scores in comparison with their TABS scores. The difficulties of PDD, ADHD and OBDI symptoms combined in children makes it necessary to assess all diagnoses before any therapy for PDD is initiated in order to be able to evaluate its results properly. PMID:25898260

Efficacy of rivastigmine for cognitive symptoms in Parkinson disease with dementia.

PubMed

Almaraz, Amy C; Driver-Dunckley, Erika D; Woodruff, Bryan K; Wellik, Kay E; Caselli, Richard J; Demaerschalk, Bart M; Adler, Charles H; Caviness, John N; Wingerchuk, Dean M

2009-07-01

Impairment of multiple neurotransmitter networks, including acetylcholine, may contribute to the cognitive impairment in patients with Parkinson disease with dementia (PDD). Therefore, cholinesterase inhibitors might improve cognitive function in PDD. On the other hand, enhancing cholinergic function could plausibly worsen features of parkinsonism. To determine if oral cholinesterase inhibitors improve measures of cognitive outcome and are tolerated by people with PDD. We addressed the question through the development of a critically appraised topic. Participants included consultant and resident neurologists, clinical epidemiologists, a medical librarian, and behavioral neurology and movement disorder specialists. Participants began with a structured clinical question, devised search strategies, compiled the best evidence, performed a critical appraisal, summarized the evidence, provided commentary, and declared bottom-line conclusions. A randomized controlled trial (n = 541) showed that, compared with placebo, rivastigmine (mean, 8.6 mg/d) significantly improved scores on 2 coprimary cognitive outcome scales in PDD, including the Alzheimer disease Cooperative Study-Clinician's Global Impression of Change. When dichotomized to evaluate clinically significant benefit (moderate or marked improvement), this outcome was not significant (risk difference = 5.3%; 95% confidence interval (CI) = -1.6 to 12.1). The number needed to treat (NNT) to avoid clinically significant worsening of cognition was 10 (95% CI = 6-28). The NNT for the combined outcome of either achieving clinically significant benefit or avoiding significant worsening was 7. The numbers needed to harm for cholinergic side effects were 9 (95% CI = 5-24) for parkinsonian symptoms and 11 (95% CI = 6-32) for rivastigmine discontinuation due to any side effect. Rivastigmine therapy for PDD is associated with significant tradeoffs in efficacy and adverse effects. Carefully monitored trials of rivastigmine may provide meaningful benefits for a minority of PDD patients.

G6PD deficiency in Plasmodium falciparum and Plasmodium vivax malaria-infected Cambodian patients.

PubMed

Khim, Nimol; Benedet, Christophe; Kim, Saorin; Kheng, Sim; Siv, Sovannaroth; Leang, Rithea; Lek, Soley; Muth, Sinuon; Chea, Nguon; Chuor, Char Meng; Duong, Socheat; Kerleguer, Alexandra; Tor, Pety; Chim, Pheaktra; Canier, Lydie; Witkowski, Benoit; Taylor, Walter R J; Ménard, Didier

2013-05-28

Glucose-6-phosphate-dehydrogenase deficiency (G6PDd) rates are unknown in malaria-infected Cambodian patients. These data are key to a rational drug policy for malaria elimination of Plasmodium falciparum and Plasmodium vivax. From September 2010-2012, a two-year survey of G6PDd and haemoglobinopathies assessed by quantitative enzyme activity assay and haemoglobin electrophoresis, respectively, was conducted in malaria-infected patients presenting to 19 health centres throughout Cambodia. A total of 2,408 confirmed malaria patients of mean age 26.7 (range 2-81) years were recruited from mostly western Cambodia (n = 1,732, 71.9%); males outnumbered females by 3.9:1. Plasmodium falciparum was present in 1,443 (59.9%) and P. vivax in 965 (40.1%) patients. Mean G6PD activity was 11.6 (CI 95%: 11.4-11.8) U/g Hb, G6PDd was present in 13.9% of all patients (335/2,408) and severe G6PDd (including WHO Class I and II variants) was more common in western (158/1,732, 9.1%) versus eastern (21/414, 5.1%) Cambodia (P = 0.01). Of 997/2,408 (41.4%) had a haemoglobinopathy. Mean haemoglobin concentrations were inversely related to age: 8.1 g/dL < five years, 8.7 g/dL five to 14 years, and 10.4 g/dL >15 years (P <0.001). G6PDd prevalence, anaemia and haemoglobinopathies were common in malaria-infected patients. The deployment of primaquine in Cambodia should be preceded by primaquine safety studies paralleled with evaluations of easy to use tests to detect G6PDd.

G6PD deficiency in Plasmodium falciparum and Plasmodium vivax malaria-infected Cambodian patients

PubMed Central

2013-01-01

Background Glucose-6-phosphate-dehydrogenase deficiency (G6PDd) rates are unknown in malaria-infected Cambodian patients. These data are key to a rational drug policy for malaria elimination of Plasmodium falciparum and Plasmodium vivax. Methods From September 2010–2012, a two-year survey of G6PDd and haemoglobinopathies assessed by quantitative enzyme activity assay and haemoglobin electrophoresis, respectively, was conducted in malaria-infected patients presenting to 19 health centres throughout Cambodia. Results A total of 2,408 confirmed malaria patients of mean age 26.7 (range 2–81) years were recruited from mostly western Cambodia (n = 1,732, 71.9%); males outnumbered females by 3.9:1. Plasmodium falciparum was present in 1,443 (59.9%) and P. vivax in 965 (40.1%) patients. Mean G6PD activity was 11.6 (CI 95%: 11.4-11.8) U/g Hb, G6PDd was present in 13.9% of all patients (335/2,408) and severe G6PDd (including WHO Class I and II variants) was more common in western (158/1,732, 9.1%) versus eastern (21/414, 5.1%) Cambodia (P = 0.01). Of 997/2,408 (41.4%) had a haemoglobinopathy. Mean haemoglobin concentrations were inversely related to age: 8.1 g/dL < five years, 8.7 g/dL five to 14 years, and 10.4 g/dL >15 years (P <0.001). Conclusions G6PDd prevalence, anaemia and haemoglobinopathies were common in malaria-infected patients. The deployment of primaquine in Cambodia should be preceded by primaquine safety studies paralleled with evaluations of easy to use tests to detect G6PDd. PMID:23714236

Lewy Body Dementias: Dementia With Lewy Bodies and Parkinson Disease Dementia

PubMed Central

Gomperts, Stephen N.

2016-01-01

ABSTRACT Purpose of Review: This article provides an overview of the clinical features, neuropathologic findings, diagnostic criteria, and management of dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD), together known as the Lewy body dementias. Recent Findings: DLB and PDD are common, clinically similar syndromes that share characteristic neuropathologic changes, including deposition of α-synuclein in Lewy bodies and neurites and loss of tegmental dopamine cell populations and basal forebrain cholinergic populations, often with a variable degree of coexisting Alzheimer pathology. The clinical constellations of DLB and PDD include progressive cognitive impairment associated with parkinsonism, visual hallucinations, and fluctuations of attention and wakefulness. Current clinical diagnostic criteria emphasize these features and also weigh evidence for dopamine cell loss measured with single-photon emission computed tomography (SPECT) imaging and for rapid eye movement (REM) sleep behavior disorder, a risk factor for the synucleinopathies. The timing of dementia relative to parkinsonism is the major clinical distinction between DLB and PDD, with dementia arising in the setting of well-established idiopathic Parkinson disease (after at least 1 year of motor symptoms) denoting PDD, while earlier cognitive impairment relative to parkinsonism denotes DLB. The distinction between these syndromes continues to be an active research question. Treatment for these illnesses remains symptomatic and relies on both pharmacologic and nonpharmacologic strategies. Summary: DLB and PDD are important and common dementia syndromes that overlap in their clinical features, neuropathology, and management. They are believed to exist on a spectrum of Lewy body disease, and some controversy persists in their differentiation. Given the need to optimize cognition, extrapyramidal function, and psychiatric health, management can be complex and should be systematic. PMID:27042903

Persistent Depression as a Novel Diagnostic Category: Results from the Menderes Depression Study

PubMed Central

ILDIRLI, Saliha; ŞAİR, Yaşan Bilge; DEREBOY, Ferhan

2015-01-01

Introduction Persistent depressive disorder (PDD) introduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 as a novel diagnostic category represents a consolidation of two separate DSM-IV categories, chronic major depressive disorder (MDD) and dysthymic disorder. The present study aims to investigate the frequency and clinical as well as socio-demographic correlates of PDD in comparison with those of episodic MDD among patients seeking treatment for depressive symptoms. Methods Participants were 140 depressive out-and in-patients under treatment at the psychiatry clinic of the Adnan Menderes University Research Hospital. Each patient was assessed by means of a structured clinical interview (SCID-I) and relevant psychometric instruments including the Hamilton Depression Inventory and Eskin Suicidal Behavior Inventory. Results Among the depressive patients, 61% fulfilled the criteria for PDD and 39% for episodic MDD. As compared with patients with episodic MDD, the PDD patients were older (d=.54), lower in educational attainment (d=.55), more likely to have comorbid generalized anxiety disorder (OR=3.7), and more prone to report symptoms of anxiety, hopelessness, pessimism, and somatic complaints. Nevertheless, the PDD patients displayed heterogeneous characteristics with respect to clinical severity and suicidal behavior. Conclusion Our findings suggest that majority of depressive patients, including those fulfilling the criteria for MDD, have been suffering from a persistent ailment rather than an episodic disorder. Clinicians with a cross-sectional perspective are more likely to diagnose MDD, whereas those with a longitudinal perspective are more likely to identify PDD in the majority of depressive patients. The incorporation of both of these perspectives into DSM-5 in a complementary manner will possibly enhance our insight into depressive disorders and improve our treatment results. PMID:28360740

Molecular Imaging and Updated Diagnostic Criteria in Lewy Body Dementias.

PubMed

Bohnen, Nicolaas I; Müller, Martijn L T M; Frey, Kirk A

2017-08-14

The aims of the study were to review recent advances in molecular imaging in the Lewy body dementias (LBD) and determine if these may support the clinical but contested temporal profile distinction between Parkinson disease (PD) with dementia (PDD) versus dementia with Lewy bodies (DLB). There do not appear to be major regional cerebral metabolic or neurotransmitter distinctions between PDD and DLB. However, recent studies highlight the relative discriminating roles of Alzheimer proteinopathies. PDD patients have lower cortical β-amyloid deposition than DLB. Preliminary tau PET studies suggest a gradient of increasing tau binding from cognitively normal PD (absent to lowest) to cognitively impaired PD (low) to DLB (intermediate) to Alzheimer disease (AD; highest). However, tau binding in DLB, including the medial temporal lobe, is substantially lower than in AD. Alzheimer-type proteinopathies appear to be more common in DLB compared to PDD with relative but no absolute differences. Given the spectrum of overlapping pathologies, future α-synuclein ligands are expected to have the best potential to distinguish the LBD from pure AD.

Posterior hypoperfusion in Parkinson's disease with and without dementia measured with arterial spin labeling MRI.

PubMed

Kamagata, Koji; Motoi, Yumiko; Hori, Masaaki; Suzuki, Michimasa; Nakanishi, Atsushi; Shimoji, Keigo; Kyougoku, Shinsuke; Kuwatsuru, Ryohei; Sasai, Keisuke; Abe, Osamu; Mizuno, Yoshikuni; Aoki, Shigeki; Hattori, Nobutaka

2011-04-01

To determine whether quantitative arterial spin labeling (ASL) can be used to evaluate regional cerebral blood flow in Parkinson's disease with dementia (PDD) and without dementia (PD). Thirty-five PD patients, 11 PDD patients, and 35 normal controls were scanned by using a quantitative ASL method with a 3 Tesla MRI unit. Regional cerebral blood flow was compared in the posterior cortex using region-of-interest analysis. PD and PDD patients showed lower regional cerebral blood flow in the posterior cortex than normal controls (P = 0.002 and P = 0.001, respectively, analysis of variance with a Bonferroni post hoc test). This is the first study to detect hypoperfusion in the posterior cortex in PD and PDD patients using ASL perfusion MRI. Because ASL perfusion MRI is completely noninvasive and can, therefore, safely be used for repeated assessments, this method can be used to monitor treatment effects or disease progression in PD. Copyright © 2011 Wiley-Liss, Inc.

Parkinson Disease and Dementia.

PubMed

Garcia-Ptacek, Sara; Kramberger, Milica G

2016-09-01

Dementia is a frequent complication of Parkinson disease (PD) with a yearly incidence of around 10% of patients with PD. Lewy body pathology is the most important factor in the development of Parkinson disease dementia (PDD) and there is evidence for a synergistic effect with β-amyloid. The clinical phenotype in PDD extends beyond the dysexecutive syndrome that is often present in early PD and encompasses deficits in recognition memory, attention, and visual perception. Sleep disturbances, hallucinations, neuroleptic sensitivity, and fluctuations are often present. This review provides an update on current knowledge of PDD including aspects of epidemiology, pathology, clinical presentation, management, and prognosis. © The Author(s) 2016.

Clinical radiation therapy measurements with a new commercial synthetic single crystal diamond detector

PubMed Central

Crilly, Richard

2014-01-01

A commercial version of a synthetic single crystal diamond detector (SCDD) in a Schottky diode configuration was recently released as the new type 60019 microDiamond detector (PTW‐Freiburg, Germany). In this study we investigate the dosimetric properties of this detector to independently confirm that findings from the developing group of the SCDDs still hold true for the commercial version of the SCDDs. We further explore if the use of the microDiamond detector can be expanded to high‐energy photon beams of up to 15 MV and to large field measurements. Measurements were performed with an Elekta Synergy linear accelerator delivering 6, 10, and 15 MV X‐rays, as well as 6, 9, 12, 15, and 20 MeV electron beams. The dependence of the microdiamond detector response on absorbed dose after connecting the detector was investigated. Furthermore, the dark current of the diamond detector was observed after irradiation. Results are compared to similar results from measurements with a diamond detector type 60003. Energy dependency was investigated, as well. Photon depth‐dose curves were measured for field sizes 3×3,10×10, and 30×30cm2. PDDs were measured with the Semiflex type 31010 detector, microLion type 31018 detector, P Diode type 60016, SRS Diode type 60018, and the microDiamond type 60019 detector (all PTW‐Freiburg). Photon profiles were measured at a depth of 10 cm. Electron depth‐dose curves normalized to the dose maximum were measured with the 14×14cm2 electron cone. PDDs were measured with a Markus chamber type 23343, an E Diode type 60017 and the microDiamond type 60019 detector (all PTW‐Freiburg). Profiles were measured with the E Diode and microDiamond at half of D90,D90,D70, and D50 depths and for electron cone sizes of 6×6cm2, 14×14cm2, and 20×20cm2. Within a tolerance of 0.5% detector response of the investigated detector was stable without any preirradiation. After preirradition with approximately 250 cGy the detector response was stable within 0.1%. A dark current after irradiation was not observed. The microDiamond detector shows no energy dependence in high energy photon or electron dosimetry. Electron PDD measurements with the E Diode and microDiamond are in good agreement. However, compared to E Diode measurements, dose values in the bremsstrahlungs region are about 0.5% lower when measured with the microDiamond detector. Markus detector measurements agree with E Diode measurements in the bremsstrahlungs region. For depths larger than dmax, depth‐dose curves of photon beams measured with the microDiamond detector are in close agreement to those measured with the microLion detector for small fields and with those measured with a Semiflex 0.125 cc ionization chamber for large fields. Differences are in the range of 0.25% and less. For profile measurements, microDiamond detector measurements agree well with microLion and P Diode measurements in the high‐dose region of the profile and the penumbra region. For areas outside the open field, P Diode measurements are about 0.5%–1.0% higher than microDiamond and microLion measurements. Thus it becomes evident that the investigated diamond detector (type 60019) is suitable for a wide range of applications in high‐energy photon and electron dosimetry and is interesting for relative, as well as absolute, dosimetry. PACS numbers: 00.06, 80.87 PMID:25493512

Trends in Autism Spectrum Disorder Diagnoses: 1994-2007

ERIC Educational Resources Information Center

Rosenberg, Rebecca E.; Daniels, Amy M.; Law, J. Kiely; Law, Paul A.; Kaufmann, Walter E.

2009-01-01

We analyzed predictors of parent-reported initial diagnosis (autistic disorder [AD], pervasive developmental disorder-not otherwise specified [PDD-NOS], pervasive developmental disorder ["PDD"] and autism spectrum disorder ["ASD"], and Asperger syndrome [AS]), among 6,176 individuals with autism spectrum disorders diagnosed from 1994 through 2007.…

Utilization of legacy P in soils, a strategic approach meeting the 40% loading reduction goal while sustaining agricultural production in the Lake Erie basin?

NASA Astrophysics Data System (ADS)

Zhang, Tiequan; Tan, Chin, S.; Wang, Yutao; Welacky, Tom

2017-04-01

Legacy phosphorus (P) in agricultural lands has been deemed the major source contributing to eutrophication of the Lake Erie. Canada and USA bilateral governments have set up a goal of 40% P loading reduction by 2025. Soil P draw-down (PDD) is a potential beneficial management practice for high P soils to overcome legacy P effect and mitigate soil P loss. A field experiment was conducted to assess the effects of PDD on crop yields, soil test P change, and soil P losses in both surface runoff and tile drainage under a corn-soybean rotation in a Brookston clay loam soil in a 9-year period from 2008 to 2016. Both yields of corn and soybean with PDD were highly identical to those with continuous P addition (CPA). Soil Olsen P with PDD declined with time at about 2.3 mg P kg-1 year-1, while with CPA it remained unchanged. Relative to CPA, PDD significantly decreased dissolved P and particular P losses, eventually the total P loss by 36%. In addition, farmers' production profitability increased by 15% through savings in investment for P fertilizer. The results indicate that utilization of soil legacy P can be an effective approach that enables us to reach the agri-P loading reduction goal, while improving production profitability and conserving world P resource.

[Clinical usefulness of IDEA and CARS: concordance with DSM-IV-TR in children and adolescents with suspicion of PDD].

PubMed

García-López, C; Narbona, J

2014-02-01

Observational scales are useful to estimate the severity of symptoms in PDD as well as to monitor their evolution. a) To analyze the concordance between diagnoses based on the Autism Spectrum Inventory (Inventario del Espectro Autista, IDEA)) and the Childhood Autism Rating Scale (CARS), compared to DSM-IV-TR criteria, in subjects with a suspicion of pervasive developmental disorders (PDD), and b) to study the discrimination power of both scales to differentiate between a clinical diagnosis situated in the autism spectrum. Fifty-six children and adolescents, between 2 and 20 years-old, who attended our Neuropediatric Unit due to suspicion of PDD. Independently, two clinicians evaluated the presence of PDD symptoms; one of them according to DSM-IV-TR criteria and the other one based on the application of IDEA and CARS. The concordance of IDEA and CARS when compared to DSM-IV-TR classification was 73 and 82%, respectively, with a sensitivity of 1 and 0,83 and a specificity of 0,61 and 0,82, respectively. Both scales correctly discriminated between autistic disorder and other clinical diagnoses. Both IDEA and CARS are useful instruments to detect and monitor autism symptoms in the context of routine clinical practice. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Development of a Multi-Dimensional Scale for PDD and ADHD

ERIC Educational Resources Information Center

Funabiki, Yasuko; Kawagishi, Hisaya; Uwatoko, Teruhisa; Yoshimura, Sayaka; Murai, Toshiya

2011-01-01

A novel assessment scale, the multi-dimensional scale for pervasive developmental disorder (PDD) and attention-deficit/hyperactivity disorder (ADHD) (MSPA), is reported. Existing assessment scales are intended to establish each diagnosis. However, the diagnosis by itself does not always capture individual characteristics or indicate the level of…

Quality of Life of Adults with Pervasive Developmental Disorders and Intellectual Disabilities

ERIC Educational Resources Information Center

Gerber, F.; Baud, M. A.; Giroud, M.; Carminati, G. Galli

2008-01-01

The purpose of this study was to observe quality of life (QoL) and global evolution of persons with Pervasive Developmental Disorders (PDD) in three different groups. Individualized programs for PDD were compared to traditional programs for intellectual disabilities. Behavioural disorders were repeatedly evaluated using the Aberrant Behaviour…

Processing Capacity in Children and Adolescents with Pervasive Developmental Disorders

ERIC Educational Resources Information Center

Hoeksma, Marco R.; Kemner, Chantal; Verbaten, Marinus N.; van Engeland, Herman

2004-01-01

This study sought to investigate whether the abnormally small P3 amplitudes observed in pervasive developmental disorder (PDD) are related to differences in processing capacity. PDD children and adolescents and their control groups participated in the study. Visual probe stimuli were presented during an auditory task with two levels of difficulty.…

A Normed Study of Face Recognition in Autism and Related Disorders.

ERIC Educational Resources Information Center

Klin, Ami; Sparrow, Sara S.; de Bildt, Annelies; Cicchetti, Domenic V.; Cohen, Donald J.; Volkmar, Fred R.

1999-01-01

This study used a well-normed task of face recognition with 102 young children with autism, pervasive developmental disorder (PDD) not otherwise specified, and non-PDD disorders (mental retardation and language disorders) matched for chronological age and either verbal or nonverbal mental age. Autistic subjects exhibited pronounced deficits in…

Brief Report: Prevalence of Pervasive Developmental Disorder in Brazil--A Pilot Study

ERIC Educational Resources Information Center

Paula, Cristiane S.; Ribeiro, Sabrina H.; Fombonne, Eric; Mercadante, Marcos T.

2011-01-01

This pilot study presents preliminary results concerning the prevalence of Pervasive Developmental Disorder (PDD) in South America. It was a three-phase study conducted in a typical town in Southeast Brazil. Case definition was based in a combination of standardized instruments and clinical evaluations by experts. The prevalence of PDD was…

Injury Treatment among Children with Autism or Pervasive Developmental Disorder

ERIC Educational Resources Information Center

McDermott, Suzanne; Zhou, Li; Mann, Joshua

2008-01-01

This study examined the differences in the frequency and type of injury for children with autism and pervasive developmental disorder (PDD) compared with typically developing peers, when both groups are insured by Medicaid. The relative rate (RR) of emergency/hospital treatment of injury for children with autism or PDD compared to controls was…

Donepezil in the Treatment of ADHD-Like Symptoms in Youths with Pervasive Developmental Disorder: A Case Series

ERIC Educational Resources Information Center

Doyle, Robert L.; Frazier, Jean; Spencer, Thomas J.; Geller, Daniel; Biederman, Joseph; Wilens, Timothy

2006-01-01

Background: Recent studies reported ADHD-like symptoms and cognitive deficits in pervasive developmental disorder (PDD). Because work in dementia documents improvement in executive function deficits with the acetylcholinesterase inhibitor donepezil, the authors reason that similar benefits could be obtained in PDD. Method: The authors describe…

Targeting Social Skills Deficits in an Adolescent with Pervasive Developmental Disorder

ERIC Educational Resources Information Center

Hagopian, Louis P.; Kuhn, David E.; Strother, Geri E.

2009-01-01

Social skills deficits are a defining feature of individuals diagnosed with autism and other pervasive developmental disorders (PDD), which can impair functioning and put the individual at higher risk for developing problem behavior (e.g., self-injury, aggression). In the current study, an adolescent with PDD displayed inappropriate social…

Antibiotic residues in milk samples obtained from cows after treatment for papillomatous digital dermatitis.

PubMed

Britt, J S; Carson, M C; von Bredow, J D; Condon, R J

1999-09-15

To determine whether there would be detectable antibiotic residues in milk obtained from dairy cattle with papillomatous digital dermatitis (PDD) after topical treatment with oxytetracycline. Randomized controlled clinical trial. 28 lactating Holstein cows with PDD. Cows were assigned to 2 treatment groups. Treatment 1 (n = 16) consisted of spraying of PDD lesions with 15 ml of a solution containing 100 mg of oxytetracycline/ml; lesions were sprayed twice daily for 7 days, using a garden sprayer. Treatment 2 (n = 12) consisted of a one-time application of a bandage that consisted of cotton soaked with 20 ml of a solution containing 100 mg of oxytetracycline/ml. Milk samples were obtained before and after treatment and assayed for tetracycline content by use of high-performance liquid chromatography and a commercially available tetracycline screening test. None of the cows in either treatment group had violative residues of oxytetracycline in milk samples. Producers treating lactating cows that have PDD, via topical application of oxytetracycline solution at the concentrations reported in this study, have a low risk of causing violative antibiotic residues in milk.

Using virtual reality environment to improve joint attention associated with pervasive developmental disorder.

PubMed

Cheng, Yufang; Huang, Ruowen

2012-01-01

The focus of this study is using data glove to practice Joint attention skill in virtual reality environment for people with pervasive developmental disorder (PDD). The virtual reality environment provides a safe environment for PDD people. Especially, when they made errors during practice in virtual reality environment, there is no suffering or dangerous consequences to deal with. Joint attention is a critical skill in the disorder characteristics of children with PDD. The absence of joint attention is a deficit frequently affects their social relationship in daily life. Therefore, this study designed the Joint Attention Skills Learning (JASL) systems with data glove tool to help children with PDD to practice joint attention behavior skills. The JASL specifically focus the skills of pointing, showing, sharing things and behavior interaction with other children with PDD. The system is designed in playroom-scene and presented in the first-person perspectives for users. The functions contain pointing and showing, moving virtual objects, 3D animation, text, speaking sounds, and feedback. The method was employed single subject multiple-probe design across subjects' designs, and analysis of visual inspection in this study. It took 3 months to finish the experimental section. Surprisingly, the experiment results reveal that the participants have further extension in improving the joint attention skills in their daily life after using the JASL system. The significant potential in this particular treatment of joint attention for each participant will be discussed in details in this paper. Copyright © 2012 Elsevier Ltd. All rights reserved.

SU-F-T-500: The Effectiveness of a Patient Specific Bolus Made by Using Three-Dimensional Printing Technique in Photon Radiotherapy

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

Fujimoto, K; Yuasa, Y; Shiinoki, T

Purpose: A commercially available bolus (commercial-bolus) would not completely contact with the irregular shape of a patient’s skin. The purposes of this study were to customize a patient specific three-dimensional (3D) bolus using a 3D printer (3D-bolus) and to evaluate its clinical feasibility for photon radiotherapy. Methods: The 3D-bolus was designed using a treatment planning system (TPS) in DICOM-RT format. To print the 3D bolus, the file was converted into stereolithography format. To evaluate its physical characteristics, plans were created for water equivalent phantoms without the bolus, with the 3D-bolus printed in a flat form, and with the virtual bolusmore » which supposed a commercial-bolus. These plans were compared with the percent depth dose (PDD) measured from the TPS. Furthermore, to evaluate its clinical feasibility, the treatment plans were created for RANDO phantoms without the bolus and with the 3D-bolus which was customized for contacting with the surface of the phantom. Both plans were compared with the dose volume histogram (DVH) of the target volume. Results: In the physical evaluation, dmax of the plan without the bolus, with the 3D-bolus, and with the virtual bolus were 2.2 cm, 1.6 cm, and 1.7 cm, respectively. In the evaluation of clinical feasibility, for the plan without the bolus, Dmax, Dmin, Dmean, D90%, and V90% of the target volume were 102.6 %, 1.6 %, 88.8 %, 57.2 %, and 69.3 %, respectively. By using the 3D-bolus, the prescription dose could be delivered to at least 90 % of the target volume, Dmax, Dmin, Dmean, D90%, and V90% of the target volume were 104.3 %, 91.6 %, 92.1 %, 91.7 %, and 98.0 %, respectively. The 3D-bolus has the potential to be useful for providing effective dose coverage in the buildup region. Conclusion: A 3D-bolus produced using 3D printing technique is comparable to a commercially available bolus.« less

Molecular cloning and characterization of a type 3 iodothyronine deiodinase in the pine snake Pituophis deppei.

PubMed

Villalobos, Patricia; Orozco, Aurea; Valverde-R, Carlos

2010-11-01

The three distinct but related isotypes of the iodothyronine deiodinase family: D1, D2, and D3, have been amply studied in vertebrate homeotherms and to a lesser extent in ectotherms, particularly in reptiles. Here, we report the molecular and kinetic characteristics of both the native and the recombinant hepatic D3 from the pine snake Pituophis deppei (PdD3). The complete PdD3 cDNA (1680 bp) encodes a protein of 287 amino acids (aa), which is the longest type 3 deiodinase so far cloned. PdD3 shares 78% identity with chicken and 71% with its other orthologs. Interestingly, the hinge domain in D3s, including PdD3, is rich in proline. This structural feature is shared with D1s, the other inner-ring deiodinases, and deserves further study. The kinetic characteristics of both native and recombinant PdD3 were similar to those reported for D3 in other vertebrates. True K(m) values for T(3) IRD were 9 and 11 nM for native and recombinant PdD3, respectively. Both exhibited a requirement for a high concentration of cofactor (40 mM DTT), insensitivity to inhibition by PTU (>2 mM), and bisubstrate, sequential-type reaction kinetics. In summary, the present data demonstrate that the liver of the adult pine snake P. deppei expresses D3. Furthermore, this is the first report of the cloning and expression of a reptilian D3 cDNA. The finding of hepatic D3 expression in the adult pine snake P. deppei is consistent with results in adult piscine species in which the dietary T(3) content seems to regulate liver deiodinase expression. Thus, our present results support the proposal that hepatic D3 in adult vertebrates plays a sentinel role in avoiding an inappropriate overload of exogenous T(3) secondary to feeding in those species that devour the whole prey. Copyright © 2010 Elsevier Inc. All rights reserved.

[Pervasive developmental disorders screening program in the health areas of Salamanca and Zamora in Spain].

PubMed

García Primo, P; Santos Borbujo, J; Martín Cilleros, M V; Martínez Velarte, M; Lleras Muñoz, S; Posada de la Paz, M; Canal Bedia, R

2014-05-01

To evaluate the results of the Pervasive Developmental Disorders (PDD) screening program currently ongoing in the public health services in the health area of Salamanca and Zamora, Spain, in terms of feasibility, reliability and costs, with the purpose of extending the program at regional and national levels. A total of 54 paediatric teams (nurses and paediatricians) from the provinces of Salamanca and Zamora participated in the training sessions for the PDD Screening Programme in September 2005, and agreed to administer the questionnaire M-CHAT(1) to all parents attending their clinics in any of these two visits: 18 months and/or 24 months within the Well-baby Check-up Program. A total of 9,524 children have participated up to December 2012. Additionally, we evaluated the participation and opinions of the paediatric teams using questionnaires, and costs per positive case have estimated. Out of a total of 852 (8.9%) children determined as PDD high-risk with the M-CHAT questionnaire results, 61 (7.1%) were confirmed as positive with the M-CHAT follow-up interview. Of these, 22 were diagnosed with a PDD and 31 other disorders of childhood onset according to DSM-IV-TR(2). Almost three-quarters (74%) of respondents felt the program was totally feasible, and 22% viable, but with reservations (n=54). This study has been able to show for the first time in Spain, the feasibility of a population-based PDD screening program within the public health system. Training in social and communicative development, and dissemination of the early signs of PDD among paediatricians, as well as the use of the M-CHAT, is essential for progress in the early detection of these disorders. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Autism and Classical Eyeblink Conditioning: Performance Changes of the Conditioned Response Related to Autism Spectrum Disorder Diagnosis

PubMed Central

Welsh, John P.; Oristaglio, Jeffrey T.

2016-01-01

Changes in the timing performance of conditioned responses (CRs) acquired during trace and delay eyeblink conditioning (EBC) are presented for diagnostic subgroups of children having autism spectrum disorder (ASD) aged 6–15 years. Children diagnosed with autistic disorder (AD) were analyzed separately from children diagnosed with either Asperger’s syndrome or Pervasive developmental disorder (Asp/PDD) not otherwise specified and compared to an age- and IQ-matched group of children who were typically developing (TD). Within-subject and between-groups contrasts in CR performance on sequential exposure to trace and delay EBC were analyzed to determine whether any differences would expose underlying functional heterogeneities of the cerebral and cerebellar systems, in ASD subgroups. The EBC parameters measured were percentage CRs, CR onset latency, and CR peak latency. Neither AD nor Asp/PDD groups were impaired in CR acquisition during trace or delay EBC. Both AD and Asp/PDD altered CR timing, but not always in the same way. Although the AD group showed normal CR timing during trace EBC, the Asp/PDD group showed a significant 27 and 28 ms increase in CR onset and peak latency, respectively, during trace EBC. In contrast, the direction of the timing change was opposite during delay EBC, during which the Asp/PDD group showed a significant 29 ms decrease in CR onset latency and the AD group showed a larger 77 ms decrease in CR onset latency. Only the AD group showed a decrease in CR peak latency during delay EBC, demonstrating another difference between AD and Asp/PDD. The difference in CR onset latency during delay EBC for both AD and Asp/PDD was due to an abnormal prevalence of early onset CRs that were intermixed with CRs having normal timing, as observed both in CR onset histograms and mean CR waveforms. In conclusion, significant heterogeneity in EBC performance was apparent between diagnostic groups, and this may indicate that EBC performance can report the heterogeneity in the neurobiological predispositions for ASD. The findings will inform further explorations with larger cohorts, different sensory modalities, and different EBC paradigms and provide a reference set for future EBC studies of children having ASD and non-human models. PMID:27563293

Clinical complications of G6PD deficiency in Latin American and Caribbean populations: systematic review and implications for malaria elimination programmes

PubMed Central

2014-01-01

Background Although G6PDd individuals are generally asymptomatic throughout their life, the clinical burden of this genetic condition includes a range of haematological conditions, including acute haemolytic anaemia (AHA), neonatal jaundice (NNJ) and chronic non-sphaerocytic anaemia (CNSA). In Latin America (LA), the huge knowledge gap regarding G6PDd is related to the scarce understanding of the burden of clinical manifestation underlying G6PDd carriage. The aim of this work was to study the clinical significance of G6PDd in LA and the Caribbean region through a systematic review. Methods A systematic search of the published literature was undertaken in August 2013. Bibliographies of manuscripts were also searched and additional references were identified. Only original research was included. All study designs were included, as long as any clinical information was present. Studies were eligible for inclusion if they reported clinical information from populations living in LA or Caribbean countries or about migrants from these countries living in countries outside this continent. Results The Medline search generated 487 papers, and the LILACS search identified 140 papers. After applying the inclusion criteria, 100 original papers with any clinical information on G6PDd in LA were retrieved. Additionally, 16 articles were included after reading the references from these papers. These 116 articles reported data from 18 LA and Caribbean countries. The major clinical manifestations reported from LA countries were those related to AHA, namely drug-induced haemolysis. Most of the published works regarding drug-induced haemolysis in LA referred to haemolytic crises in P. vivax malaria patients during the course of the treatment with primaquine (PQ). Favism, infection-induced haemolysis, NNJ and CNSA appear to play only a minor public health role in this continent. Conclusion Haemolysis in patients using PQ seems to be the major clinical manifestation of G6PDd in LA and contributes to the morbidity of P. vivax infection in this continent, although the low number of reported cases, which could be linked to under-reporting of complications. These results support the need for better strategies to diagnose and manage G6PDd in malaria field conditions. Additionally, Malaria Control Programmes in LA should not overlook this condition in their national guidelines. PMID:24568147

Characterization of a new transmission detector for patient individualized online plan verification and its influence on 6MV X-ray beam characteristics.

PubMed

Thoelking, Johannes; Sekar, Yuvaraj; Fleckenstein, Jens; Lohr, Frank; Wenz, Frederik; Wertz, Hansjoerg

2016-09-01

Online verification and 3D dose reconstruction on daily patient anatomy have the potential to improve treatment delivery, accuracy and safety. One possible implementation is to recalculate dose based on online fluence measurements with a transmission detector (TD) attached to the linac. This study provides a detailed analysis of the influence of a new TD on treatment beam characteristics. The influence of the new TD on surface dose was evaluated by measurements with an Advanced Markus Chamber (Adv-MC) in the build-up region. Based on Monte Carlo simulations, correction factors were determined to scale down the over-response of the Adv-MC close to the surface. To analyze the effects beyond dmax percentage depth dose (PDD), lateral profiles and transmission measurements were performed. All measurements were carried out for various field sizes and different SSDs. Additionally, 5 IMRT-plans (head & neck, prostate, thorax) and 2 manually created test cases (3×3cm(2) fields with different dose levels, sweeping gap) were measured to investigate the influence of the TD on clinical treatment plans. To investigate the performance of the TD, dose linearity as well as dose rate dependency measurements were performed. With the TD inside the beam an increase in surface dose was observed depending on SSD and field size (maximum of +11%, SSD = 80cm, field size = 30×30cm(2)). Beyond dmax the influence of the TD on PDDs was below 1%. The measurements showed that the transmission factor depends slightly on the field size (0.893-0.921 for 5×5cm(2) to 30×30cm(2)). However, the evaluation of clinical IMRT-plans measured with and without the TD showed good agreement after using a single transmission factor (γ(2%/2mm) > 97%, δ±3% >95%). Furthermore, the response of TD was found to be linear and dose rate independent (maximum difference <0.5% compared to reference measurements). When placed in the path of the beam, the TD introduced a slight, clinically acceptable increase of the skin dose even for larger field sizes and smaller SSDs and the influence of the detector on the dose beyond dmax as well as on clinical IMRT-plans was negligible. Since there was no dose rate dependency and the response was linear, the device is therefore suitable for clinical use. Only its absorption has to be compensated during treatment planning, either by the use of a single transmission factor or by including the TD in the incident beam model. Copyright © 2015. Published by Elsevier GmbH.

SU-E-P-32: Adapting An MMLC to a Conventional Linac to Perform Stereotactic Applications

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

Emam, I; Hosini, M

2015-06-15

Purpose: Micro-MLCs minimizes beam scalloping effects caused by conventional-MLCs and facilitates conformal dynamic treatment delivery. But their effect on dosimetric parameters require careful investigations. Physical and dosimetric parameters and Linac mechanical stability with mMLC (net weight 30 Kg) attached to the gantry are to be investigated. Moreover, output study along with recommended jaws offsets are studied. Adaptation of an mMLC to our 16-years old conventional Linac is investigated in this work Methods: BrainLab mMLC (m3) mounted in a detachable chassis to the Philips SL-15 Linac (30kg). Gantry and collimator spoke shots measurements are made using a calibrated film in amore » solid phantom and compared with pin-point measurements. Leaf penumbra, transmission, leakage between the leaves, percentage depth dose (PDD) are measured using IBA pin-point ion chamber at 6 and 10 MV. For output measurements (using brass build-up cap), jaws are modified continuously regarding to m3-fields while output factor are compared with fixed jaws situation, while the mMLC leaf configuration is modified for different m3-fields Results: Mean transmission through leaves is 1.9±0.1% and mean leakage between leaves is 2.8±0.15%. Between opposing leaves abutting along the central beam-axis mean transmission is 15±3%, but it is reduced to 4.5±0.6% by moving the abutment position 4.5cm off-axis. The penumbra was sharper for m3 -fields than jaws-fields (maximum difference is 1.51±0.2%). m3-fields PDD show ∼3% variation from those of jaws-fields. m3-fields output factors show large variations (<4%) from Jaws defined fields. Output for m3-rectangular fields show slight variation in case of leaf-end&leaf-side as well as X-jaw&Y-jaw exchange. Circular m3-fields output factors shows close agreement with their corresponding square jaws-defined fields using 2mm Jaws offsets, If jaws are retracted to m3 limits, differences become <5%. Conclusion: BrainLab m3 is successfully adapted to our 16 old Philips-SL-15 Linac. Dosimetric properties should be taken into account for treatment planning considerations.« less

Level 2 Screening with the PDD Behavior Inventory: Subgroup Profiles and Implications for Differential Diagnosis

ERIC Educational Resources Information Center

Cohen, Ira L.; Liu, Xudong; Hudson, Melissa; Gillis, Jennifer; Cavalari, Rachel N. S.; Romanczyk, Raymond G.; Karmel, Bernard Z.; Gardner, Judith M.

2017-01-01

The PDD Behavior Inventory (PDDBI) has recently been shown, in a large multisite study, to discriminate well between autism spectrum disorder (ASD) and other groups when its scores were examined using a machine learning tool, Classification and Regression Trees (CART). Discrimination was good for toddlers, preschoolers, and school-age children;…

Common and Unique Impairments in Facial-Expression Recognition in Pervasive Developmental Disorder-Not Otherwise Specified and Asperger's Disorder

ERIC Educational Resources Information Center

Uono, Shota; Sato, Wataru; Toichi, Motomi

2013-01-01

This study was designed to identify specific difficulties and associated features related to the problems with social interaction experienced by individuals with pervasive developmental disorder-not otherwise specified (PDD-NOS) using an emotion-recognition task. We compared individuals with PDD-NOS or Asperger's disorder (ASP) and typically…

Using Video Modeling to Teach Children with PDD-NOS to Respond to Facial Expressions

ERIC Educational Resources Information Center

Axe, Judah B.; Evans, Christine J.

2012-01-01

Children with autism spectrum disorders often exhibit delays in responding to facial expressions, and few studies have examined teaching responding to subtle facial expressions to this population. We used video modeling to train 3 participants with PDD-NOS (age 5) to respond to eight facial expressions: approval, bored, calming, disapproval,…

A Descriptive Study of Hyperlexia in a Clinically Referred Sample of Children with Developmental Delays.

ERIC Educational Resources Information Center

Grigorenok, Elena L.; Klin, Ami; Pauls, David L.; Senft, Riley; Hooper, Catalina; Volkmar, Fred

2002-01-01

This study of hyperlexia in 80 children with developmental delays found no significant differences in the frequency of hyperlexia in girls compared with boys; a significantly elevated frequency of hyperlexia in children diagnosed with pervasive developmental disorders (PDD) compared with children with non-PDD diagnoses; and a similar range of IQ…

Using Virtual Reality Environment to Improve Joint Attention Associated with Pervasive Developmental Disorder

ERIC Educational Resources Information Center

Cheng, Yufang; Huang, Ruowen

2012-01-01

The focus of this study is using data glove to practice Joint attention skill in virtual reality environment for people with pervasive developmental disorder (PDD). The virtual reality environment provides a safe environment for PDD people. Especially, when they made errors during practice in virtual reality environment, there is no suffering or…

Hemispheric Processing of Idioms and Irony in Adults with and without Pervasive Developmental Disorder

ERIC Educational Resources Information Center

Saban-Bezalel, Ronit; Mashal, Nira

2015-01-01

Previous studies on individuals with pervasive developmental disorders (PDD) have pointed to difficulties in comprehension of figurative language. Using the divided visual field paradigm, the present study examined hemispheric processing of idioms and irony in 23 adults with PDD and in 24 typically developing (TD) adults. The results show that…

Using the PDD Behavior Inventory as a Level 2 Screener: A Classification and Regression Trees Analysis

ERIC Educational Resources Information Center

Cohen, Ira L.; Liu, Xudong; Hudson, Melissa; Gillis, Jennifer; Cavalari, Rachel N. S.; Romanczyk, Raymond G.; Karmel, Bernard Z.; Gardner, Judith M.

2016-01-01

In order to improve discrimination accuracy between Autism Spectrum Disorder (ASD) and similar neurodevelopmental disorders, a data mining procedure, Classification and Regression Trees (CART), was used on a large multi-site sample of PDD Behavior Inventory (PDDBI) forms on children with and without ASD. Discrimination accuracy exceeded 80%,…

Is long-term prognosis for pervasive developmental disorder not otherwise specified different from prognosis for autistic disorder? Findings from a 30-year follow-up study.

PubMed

Mordre, Marianne; Groholt, Berit; Knudsen, Ann Kristin; Sponheim, Eili; Mykletun, Arnstein; Myhre, Anne Margrethe

2012-06-01

We followed 74 children with autistic disorder (AD) and 39 children with pervasive developmental disorder not otherwise specified (PDD NOS) for 17-38 years in a record linkage study. Rates of disability pension award, marital status, criminality and mortality were compared between groups. Disability pension award was the only outcome measure that differed significantly between the AD and PDD NOS groups (89% vs. 72%, p < 0.05). The lower rate of disability pension award in the PDD NOS group was predicted by better psychosocial functioning. The lack of substantial differences in prognosis between the groups supports a dimensional description of autism spectrum disorder, in line with proposed DSM-V revision.

The effect of donepezil on increased regional cerebral blood flow in the posterior cingulate cortex of a patient with Parkinson's disease dementia.

PubMed

Imamura, Keiko; Wada-Isoe, Kenji; Kowa, Hisanori; Tanabe, Yoshio; Nakashima, Kenji

2008-01-01

It has been reported that the cholinesterase inhibitor, donepezil, improves cognitive decline in patients with Parkinson's disease dementia (PDD). However, this improvement was dominant for frontal lobe dysfunction, and the increase in the Mini-Mental State Examination (MMSE) score was minimal. We report a PDD patient with a decline of regional cerebral blood flow (rCBF) in the posterior cingulate cortex, precunei, and bilateral parietotemporal association cortex, as determined by single-photon emission computed tomography (SPECT) using the easy Z-scores imaging system (e-ZIS). Upon administration of donepezil, both the rCBF and MMSE score increased. The effectiveness of donepezil may vary based on the rCBF pattern in PDD.

Brief report: Representational momentum for dynamic facial expressions in pervasive developmental disorder.

PubMed

Uono, Shota; Sato, Wataru; Toichi, Motomi

2010-03-01

Individuals with pervasive developmental disorder (PDD) have difficulty with social communication via emotional facial expressions, but behavioral studies involving static images have reported inconsistent findings about emotion recognition. We investigated whether dynamic presentation of facial expression would enhance subjective perception of expressed emotion in 13 individuals with PDD and 13 typically developing controls. We presented dynamic and static emotional (fearful and happy) expressions. Participants were asked to match a changeable emotional face display with the last presented image. The results showed that both groups perceived the last image of dynamic facial expression to be more emotionally exaggerated than the static facial expression. This finding suggests that individuals with PDD have an intact perceptual mechanism for processing dynamic information in another individual's face.

Predicting children with pervasive developmental disorders using the Wechsler Intelligence Scale for Children-Third Edition.

PubMed

Koyama, Tomonori; Inada, Naoko; Tsujii, Hiromi; Kurita, Hiroshi

2008-08-01

An original combination score (i.e. the sum of Vocabulary and Comprehension subtracted from the sum of Block Design and Digit Span) was created from the four Wechsler Intelligence Scale for Children-Third Edition (WISC-III) subtests identified by discriminant analysis on WISC-III data from 139/129 children with/without pervasive developmental disorders (PDD; mean, 8.3/8.1 years) and its utility examined for predicting PDD. Its best cut-off was 2/3, with sensitivity, specificity, positive and negative predictive values of 0.68, 0.61, 0.65 and 0.64, respectively. The score seems useful, so long as clinicians are aware of its limitations and use it only as a supplemental measure in PDD diagnosis.

Concordance of DSM-5 and DSM-IV-TR classifications for autism spectrum disorder.

PubMed

Ohashi, Kei; Mizuno, Yoshifumi; Miyachi, Taishi; Asai, Tomoko; Imaeda, Masayuki; Saitoh, Shinji

2015-12-01

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in May 2013. Autism spectrum disorder (ASD) has been structured for the three subtypes of pervasive developmental disorder (PDD), but the number of impairment in social and communication dimension is not stated. The subjects were 68 children who visited the Department of Psychology and Development at Nagoya City University Hospital for the first time between the ages of 6 and 15 years old. We retrospectively re-examined the subjects using DSM-IV-TR criteria and DSM-5 criteria with two rules (two of three and one of three on the social and communication dimension) and examined the concordance rate. Forty subjects were diagnosed with PDD, and 28 were not. The mean PDD subject age was 9.4 years, and mean IQ was 84.0 on the Wechsler Intelligence Scale for Children III or 62.7 on the Tanaka-Binet test. Twenty-seven (68%) of the PDD subjects were classified with ASD using DSM-5 criteria when the two of three rule was applied, while 32 (80%) were classified with ASD when the one of three rule was applied. All subjects without PDD were not diagnosed with ASD on DSM-5 criteria. DSM-5 criteria may exclude high functioning and older subjects from ASD because they tend to be atypical. The diagnostic procedure for DSM-5 criteria is ambiguous, especially in high functioning subjects and those diagnosed at an older age. © 2015 Japan Pediatric Society.

Analysis of the Substantia Innominata Volume in Patients with Parkinson’s Disease with Dementia, Dementia with Lewy Bodies, and Alzheimer’s Disease

PubMed Central

Kim, Hee Jin; Lee, Ji Eun; Shin, Soo Jeong; Sohn, Young Ho; Lee, Phil Hyu

2011-01-01

Background and Purpose The substantia innominata (SI) contains the nucleus basalis of Meynert, which is the major source of cholinergic input to the cerebral cortex. We hypothesized that degeneration of the SI and its relationship to general cognitive performance differs in amyloidopathy and synucleinopathy. Methods We used magnetic resonance imaging (MRI)-based volumetric analysis to evaluate the SI volume in patients with amnestic mild cognitive impairment (aMCI), Alzheimer’s disease (AD), Parkinson’s disease-mild cognitive impairment (PD-MCI), PD with dementia (PDD), dementia with Lewy bodies (DLB), and healthy elderly controls. The correlation between SI volume and general cognitive performance, measured using the Korean version of the Mini-Mental State Examination (K-MMSE), was examined. Results Compared to control subjects, the mean normalized SI volume was significantly decreased in all of the other groups. The normalized SI volume did not differ between the subjects with PDD and DLB, whereas it was significantly smaller in subjects with PDD (p = 0.029) and DLB (p = 0.011) compared with AD. In subjects with PD-related cognitive impairment (PD-MCI, PDD, or DLB), there was a significant positive correlation between the SI volume and K-MMSE score (r = 0.366, p < 0.001), whereas no correlation was seen in subjects with AD-related cognitive impairment (aMCI or AD). Conclusions Our data suggest that the SI loss is greater in synucleinopathy-related dementia (PDD or DLB) than in AD and that the contribution of the SI to cognitive performance is greater in synucleinopathy than in amyloidopathy. PMID:24868398

A new paper-based analytical device for detection of Glucose-6-phosphate dehydrogenase deficiency.

PubMed

Kaewarsa, Phuritat; Laiwattanapaisal, Wanida; Palasuwan, Attakorn; Palasuwan, Duangdao

2017-03-01

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a genetic haemolytic disorder. Most persons with G6PD deficiency are asymptomatic, but exposure to oxidant drugs, such as the anti-malarial drug primaquine, may induce haemolysis, which is commonly found in Asian countries. A reliable test is necessary for diagnosing the deficiency to prevent an acute haemolytic crisis. This study proposes a novel quantitative method to detect G6PD deficiency using paper-based analytical devices (G6PDD-PAD). Wax printing was utilized for fabricating circular reaction zone patterns in paper. The colorimetric assay is based on the formation of formazan via a reduction of tetra-nitro blue tetrazolium (TNBT) by the G6PD enzyme on G6PDD-PAD. Detection was achieved by capturing the colour using a desktop scanner and the colour intensity was analysed with Adobe Photoshop C56. The results showed that the G6PD activity analysed by G6PDD-PAD was highly correlated with the standard biochemical assay (SBA) (r 2 =0.87, p<0.01). Moreover, good agreement by Bland-Altman bias plot was demonstrated between G6PDD-PAD and the SBA (mean bias 1.4 IU/gHb). The detection limit was 0 IU/gHb of G6PD activity. This study demonstrates the feasibility of using G6PDD-PAD. This simple, low-cost test ($0.1/test) should be useful for diagnosing G6PD deficiency in resource-limited settings. Copyright © 2016 Elsevier B.V. All rights reserved.

Pervasive Developmental Disorders in Individuals with Cerebral Palsy

ERIC Educational Resources Information Center

Kilincaslan, Ayse; Mukaddes, Nahit Motavalli

2009-01-01

The aim of the present study was to describe the prevalence and associated factors of pervasive developmental disorders (PDD), including autistic disorder and PDD not otherwise specified (NOS), in a clinical sample of 126 children and adolescents (75 males, 51 females; age range 4-18y, mean 8y 8mo, SD 3y 8mo) with tetraplegic, hemiplegic,…

Pervasive Developmental Disorder Behavior in Adolescents with Intellectual Disability and Co-Occurring Somatic Chronic Diseases

ERIC Educational Resources Information Center

Oeseburg, B.; Groothoff, J. W.; Dijkstra, G. J.; Reijneveld, S. A.; Jansen, D. E. M. C.

2010-01-01

Evidence on the association between somatic chronic diseases in ID-adolescents and the full range of pervasive developmental disorder behavior (PDD behavior) is scarce. The aim of the present study is to assess the association between somatic chronic diseases in ID-adolescents and mild PDD behavior. We obtained data on 1044 ID-adolescents, aged…

Determining Differences in Social Cognition between High-Functioning Autistic Disorder and Other Pervasive Developmental Disorders Using New Advanced "Mind-Reading" Tasks

ERIC Educational Resources Information Center

Kuroda, Miho; Wakabayashi, Akio; Uchiyama, Tokio; Yoshida, Yuko; Koyama, Tomonori; Kamio, Yoko

2011-01-01

Deficits in understanding the mental state of others ("mind-reading") have been well documented in individuals with pervasive developmental disorders (PDD). However, it is unclear whether this deficit in social cognition differs between the subgroups of PDD defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text…

Detecting Subgroups in Children Diagnosed with Pervasive Developmental Disorder--Not Otherwise Specified

ERIC Educational Resources Information Center

Brennan, Laura; Barton, Marianne; Chen, Chi-Ming; Green, James; Fein, Deborah

2015-01-01

Hierarchical cluster analyses were used to detect three subgroups in a sample of children with pervasive developmental disorder--not otherwise specified (PDD-NOS) evaluated at ages 2 and 4. At age 2, Cluster 1 demonstrated few autism symptoms and high cognitive scores; 60% no longer met criteria for PDD at 4. Cluster 2 exhibited more autism…

Reliability and Diagnostic Efficiency of the Diagnostic Inventory for Disharmony (DID) in Youths with Pervasive Developmental Disorder and Multiple Complex Developmental Disorder

ERIC Educational Resources Information Center

Xavier, Jean; Vannetzel, Leonard; Viaux, Sylvie; Leroy, Arthur; Plaza, Monique; Tordjman, Sylvie; Mille, Christian; Bursztejn, Claude; Cohen, David; Guile, Jean-Marc

2011-01-01

The Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) category is a psychopathological entity few have described and is poorly, and mainly negatively, defined by autism exclusion. In order to limit PDD-NOS heterogeneity, alternative clinical constructs have been developed. This study explored the reliability and the diagnostic…

Systematic Review and Meta-Analysis of Pharmacological Treatment of the Symptoms of Attention-Deficit/Hyperactivity Disorder in Children with Pervasive Developmental Disorders

ERIC Educational Resources Information Center

Reichow, Brian; Volkmar, Fred R.; Bloch, Michael H.

2013-01-01

Many children with pervasive developmental disorders (PDD) exhibit behaviors and symptoms of attention-deficit/hyperactivity disorder (ADHD). We sought to determine the relative efficacy of medications for treating ADHD symptoms in children with PDD by identifying all double-blind, randomized, placebo-controlled trials examining the efficacy of…

Larger Brains in Medication Naive High-Functioning Subjects with Pervasive Developmental Disorder

ERIC Educational Resources Information Center

Palmen, Saskia J. M. C.; Pol, Hilleke E. Hulshoff; Kemner, Chantal; Schnack, Hugo G.; Janssen, Joost; Kahn, Rene S.; van Engeland, Herman

2004-01-01

Background: Are brain volumes of individuals with Pervasive Developmental Disorder (PDD) still enlarged in adolescence and adulthood, and if so, is this enlargement confined to the gray and/or the white matter and is it global or more prominent in specific brain regions. Methods: Brain MRI scans were made of 21 adolescents with PDD and 21 closely…

The pedunculopontine nucleus is related to visual hallucinations in Parkinson's disease: preliminary results of a voxel-based morphometry study.

PubMed

Janzen, J; van 't Ent, D; Lemstra, A W; Berendse, H W; Barkhof, F; Foncke, E M J

2012-01-01

Visual hallucinations (VH) are common in Parkinson's disease (PD) and lead to a poor quality of life. For a long time, dopaminergic therapy was considered to be the most important risk factor for the development of VH in PD. Recently, the cholinergic system, including the pedunculopontine nucleus (PPN), has been implicated in the pathophysiology of VH. The aim of the present study was to investigate grey matter density of the PPN region and one of its projection areas, the thalamus. Thirteen non-demented PD patients with VH were compared to 16 non-demented PD patients without VH, 13 demented PD patients (PDD) with VH and 11 patients with dementia with Lewy bodies (DLB). Isotropic 3-D T1-weighted MRI images (3T) were analysed using voxel-based morphometry (VBM) with the PPN region and thalamus as ROIs. PD and PDD patients with VH showed grey matter reductions of the PPN region and the thalamus compared to PD patients without VH. VH in PD(D) patients are associated with atrophy of the PPN region and its thalamic target area, suggesting that a cholinergic deficit may be involved in the development of VH in PD(D).

Single low-dose primaquine for blocking transmission of Plasmodium falciparum malaria - a proposed model-derived age-based regimen for sub-Saharan Africa.

PubMed

Taylor, W Robert; Naw, Htee Khu; Maitland, Kathryn; Williams, Thomas N; Kapulu, Melissa; D'Alessandro, Umberto; Berkley, James A; Bejon, Philip; Okebe, Joseph; Achan, Jane; Amambua, Alfred Ngwa; Affara, Muna; Nwakanma, Davis; van Geertruyden, Jean-Pierre; Mavoko, Muhindo; Lutumba, Pascal; Matangila, Junior; Brasseur, Philipe; Piola, Patrice; Randremanana, Rindra; Lasry, Estrella; Fanello, Caterina; Onyamboko, Marie; Schramm, Birgit; Yah, Zolia; Jones, Joel; Fairhurst, Rick M; Diakite, Mahamadou; Malenga, Grace; Molyneux, Malcolm; Rwagacondo, Claude; Obonyo, Charles; Gadisa, Endalamaw; Aseffa, Abraham; Loolpapit, Mores; Henry, Marie-Claire; Dorsey, Grant; John, Chandy; Sirima, Sodiomon B; Barnes, Karen I; Kremsner, Peter; Day, Nicholas P; White, Nicholas J; Mukaka, Mavuto

2018-01-18

In 2012, the World Health Organization recommended blocking the transmission of Plasmodium falciparum with single low-dose primaquine (SLDPQ, target dose 0.25 mg base/kg body weight), without testing for glucose-6-phosphate dehydrogenase deficiency (G6PDd), when treating patients with uncomplicated falciparum malaria. We sought to develop an age-based SLDPQ regimen that would be suitable for sub-Saharan Africa. Using data on the anti-infectivity efficacy and tolerability of primaquine (PQ), the epidemiology of anaemia, and the risks of PQ-induced acute haemolytic anaemia (AHA) and clinically significant anaemia (CSA), we prospectively defined therapeutic-dose ranges of 0.15-0.4 mg PQ base/kg for children aged 1-5 years and 0.15-0.5 mg PQ base/kg for individuals aged ≥6 years (therapeutic indices 2.7 and 3.3, respectively). We chose 1.25 mg PQ base for infants aged 6-11 months because they have the highest rate of baseline anaemia and the highest risks of AHA and CSA. We modelled an anthropometric database of 661,979 African individuals aged ≥6 months (549,127 healthy individuals, 28,466 malaria patients and 84,386 individuals with other infections/illnesses) by the Box-Cox transformation power exponential and tested PQ doses of 1-15 mg base, selecting dosing groups based on calculated mg/kg PQ doses. From the Box-Cox transformation power exponential model, five age categories were selected: (i) 6-11 months (n = 39,886, 6.03%), (ii) 1-5 years (n = 261,036, 45.46%), (iii) 6-9 years (n = 20,770, 3.14%), (iv) 10-14 years (n = 12,155, 1.84%) and (v) ≥15 years (n = 328,132, 49.57%) to receive 1.25, 2.5, 5, 7.5 and 15 mg PQ base for corresponding median (1st and 99th centiles) mg/kg PQ base of: (i) 0.16 (0.12-0.25), (ii) 0.21 (0.13-0.37), (iii) 0.25 (0.16-0.38), (iv) 0.26 (0.15-0.38) and (v) 0.27 (0.17-0.40). The proportions of individuals predicted to receive optimal therapeutic PQ doses were: 73.2 (29,180/39,886), 93.7 (244,537/261,036), 99.6 (20,690/20,770), 99.4 (12,086/12,155) and 99.8% (327,620/328,132), respectively. We plan to test the safety of this age-based dosing regimen in a large randomised placebo-controlled trial (ISRCTN11594437) of uncomplicated falciparum malaria in G6PDd African children aged 0.5 - 11 years. If the regimen is safe and demonstrates adequate pharmacokinetics, it should be used to support malaria elimination.

Is glucose-6-phosphate dehydrogenase deficiency more prevalent in Carrion's disease endemic areas in Latin America?

PubMed

Mazulis, Fernando; Weilg, Claudia; Alva-Urcia, Carlos; Pons, Maria J; Del Valle Mendoza, Juana

2015-12-01

Glucose-6-phosphate dehydrogenase (G6PD) is a cytoplasmic enzyme with an important function in cell oxidative damage prevention. Erythrocytes have a predisposition towards oxidized environments due to their lack of mitochondria, giving G6PD a major role in its stability. G6PD deficiency (G6PDd) is the most common enzyme deficiency in humans; it affects approximately 400 million individuals worldwide. The overall G6PDd allele frequency across malaria endemic countries is estimated to be 8%, corresponding to approximately 220 million males and 133 million females. However, there are no reports on the prevalence of G6PDd in Andean communities where bartonellosis is prevalent. Copyright © 2015 Hainan Medical College. Production and hosting by Elsevier B.V. All rights reserved.

The first evaluation of glucose-6-phosphate dehydrogenase deficiency (G6PD) gene mutation in malaria-endemic region at South Central Timor (SCT) district, Eastern Indonesia 2015-2016

NASA Astrophysics Data System (ADS)

Hutagalung, J.; Kusnanto, H.; Supargiyono; Sadewa, A. H.; Satyagraha, A. W.

2018-03-01

Primaquine (PQ) is the only licensed drug effective against P. vivax for specific hypnozoites and as a key drug in the malaria elimination stage. However, PQ can cause severe hemolysis in G6PD deficient individuals. Unfortunately, few epidemiological data of these disorders was in Indonesia. This study aimed to assesses the prevalence and genotyping variant of G6PDd among the people on malaria-endemic. Blood samples from 555 unrelated subjects in eastern Indonesia were for G6PDd by quantitative test and PCR-RFLP-DNA sequencing. All protocols followed by Promega, Madison, USA. The prevalence of malaria and anemia was 32.6% (181/555) and 16% (89/555) with P. vivaxdominant species 52.5% (95/181), respectively. Overall, 16.6% (92/555) subjects were G6PD deficient, including 58.7% (54/92) females and 41.3% (38/92). Among the 92 cases G6PD deficient molecularly studied, the genotype variant Vanua Lava (T10883C) were detected dominant and unknown G6PD deficient (T-13.154-C) in 3 cases. It was high G6PD deficient in eastern Indonesia indicate that diagnosis and management of G6PD deficient are necessary. Obligatory anti-malaria doses for G6PD deficient individuals, population screening, are needed on endemic malaria in eastern Indonesia.

Ecological Assessment of Clinicians' Antipsychotic Prescription Habits in Psychiatric Inpatients: A Novel Web- and Mobile Phone-Based Prototype for a Dynamic Clinical Decision Support System.

PubMed

Berrouiguet, Sofian; Barrigón, Maria Luisa; Brandt, Sara A; Nitzburg, George C; Ovejero, Santiago; Alvarez-Garcia, Raquel; Carballo, Juan; Walter, Michel; Billot, Romain; Lenca, Philippe; Delgado-Gomez, David; Ropars, Juliette; de la Calle Gonzalez, Ivan; Courtet, Philippe; Baca-García, Enrique

2017-01-26

Electronic prescribing devices with clinical decision support systems (CDSSs) hold the potential to significantly improve pharmacological treatment management. The aim of our study was to develop a novel Web- and mobile phone-based application to provide a dynamic CDSS by monitoring and analyzing practitioners' antipsychotic prescription habits and simultaneously linking these data to inpatients' symptom changes. We recruited 353 psychiatric inpatients whose symptom levels and prescribed medications were inputted into the MEmind application. We standardized all medications in the MEmind database using the Anatomical Therapeutic Chemical (ATC) classification system and the defined daily dose (DDD). For each patient, MEmind calculated an average for the daily dose prescribed for antipsychotics (using the N05A ATC code), prescribed daily dose (PDD), and the PDD to DDD ratio. MEmind results found that antipsychotics were used by 61.5% (217/353) of inpatients, with the largest proportion being patients with schizophrenia spectrum disorders (33.4%, 118/353). Of the 217 patients, 137 (63.2%, 137/217) were administered pharmacological monotherapy and 80 (36.8%, 80/217) were administered polytherapy. Antipsychotics were used mostly in schizophrenia spectrum and related psychotic disorders, but they were also prescribed in other nonpsychotic diagnoses. Notably, we observed polypharmacy going against current antipsychotics guidelines. MEmind data indicated that antipsychotic polypharmacy and off-label use in inpatient units is commonly practiced. MEmind holds the potential to create a dynamic CDSS that provides real-time tracking of prescription practices and symptom change. Such feedback can help practitioners determine a maximally therapeutic drug treatment while avoiding unproductive overprescription and off-label use. ©Sofian Berrouiguet, Maria Luisa Barrigón, Sara A Brandt, George C Nitzburg, Santiago Ovejero, Raquel Alvarez-Garcia, Juan Carballo, Michel Walter, Romain Billot, Philippe Lenca, David Delgado-Gomez, Juliette Ropars, Ivan de la Calle Gonzalez, Philippe Courtet, Enrique Baca-García. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.01.2017.

Psychometric Properties of Spanish Adaptation of the PDD-MRS Scale in Adults with Intellectual Developmental Disorders: The EVTEA-DI Scale

ERIC Educational Resources Information Center

Cortés, Maria José; Orejuela, Carmen; Castellví, Gemma; Folch, Annabel; Rovira, Lluís; Salvador-Carulla, Luis; Irazábal, Marcia; Muñoz, Silvia; Haro, Josep Maria; Vilella, Elisabet; Martínez-Leal, Rafael

2018-01-01

Strategies for the early detection of autism spectrum disorders (ASD) in people with intellectual developmental disorder (IDD) are urgently needed, but few specific tools have been developed. The present study examines the psychometric properties of the EVTEA-DI, a Spanish adaptation of the PDD-MRS, in a large randomized sample of 979 adults with…

Metabolite ratios in the posterior cingulate cortex do not track cognitive decline in Parkinson's disease in a clinical setting.

PubMed

Almuqbel, Mustafa; Melzer, Tracy R; Myall, Daniel J; MacAskill, Michael R; Pitcher, Toni L; Livingston, Leslie; Wood, Kyla-Louise; Keenan, Ross J; Dalrymple-Alford, John C; Anderson, Tim J

2016-01-01

Parkinson's Disease (PD) is classified as a motor disorder, but most patients develop cognitive impairment, and eventual dementia (PDD). Predictive neurobiomarkers may be useful in the identification of those patients at imminent risk of PDD. Given the compromised cerebral integrity in PDD, we investigated whether brain metabolites track disease progression over time. Proton Magnetic Resonance Spectroscopy (MRS) was used to identify brain metabolic changes associated with cognitive impairment and dementia in PD. Forty-nine healthy participants and 130 PD patients underwent serial single voxel proton MRS and neuropsychological testing. At baseline patients were classified as either having normal cognitive status (PDN, n = 77), mild cognitive impairment (PDMCI, n = 33), or dementia (PDD, n = 20). Posterior cingulate cortex (PCC) was examined to quantify N-acetylaspartate (NAA), choline (Cho), creatine (Cr), and myo-inositol (mI). A hierarchical Bayesian model was used to assess whether cognitive ability and other covariates were related to baseline MRS values and changes in MRS over time. At baseline, relative to controls, PDD had significantly decreased NAA/Cr and increased Cho/Cr. However, these differences did not remain significant after accounting for age, sex, and MDS-UPDRS III. At follow-up, no significant changes in MRS metabolite ratios were detected, with no relationship found between MRS measures and change in cognitive status. Unlike Alzheimer's disease, single voxel MR spectroscopy of the PCC failed to show any significant association with cognitive status at baseline or over time. This suggests that MRS of PCC is not a clinically useful biomarker for tracking or predicting cognitive impairment in Parkinson's disease. Copyright © 2015 Elsevier Ltd. All rights reserved.

Development of excitation light source for photodynamic diagnosis

NASA Astrophysics Data System (ADS)

Lim, Hyun Soo

2008-02-01

Photodynamic diagnosis (PDD) is a method to diagnose the possibility of cancer, both by the principle that if a photosensitizer is injected into an organic tissue, it is accumulated in the tissue of a malignant tumor selectively after a specific period, and by a comparison of the intensity of the fluorescence of normal tissue with abnormal tissue after investigating the excitation light of a tissue with accumulated photosensitizer. Currently, there are two methods of PDD: The first is a way to acquire incitement fluorescence by using a photosensitizer, and the second is a way to use auto-fluorescence by green fluorescence protein (GFP) and red fluorescence protein (RFP) such as NADH+ active factors within the organic body. Since the selection of the wavelength band of excitation light has an interrelation with fluorescence generation according to the selection of a photosensitizer, it plays an important role in PDD. This study aims at designing and evaluating light source devices that can stably generate light with various kinds of wavelengths in order to make possible PDD using a photosensitizer and diagnosis using auto-fluorescence. The light source was a Xenon lamp and filter wheel, composed of an optical output control through Iris and filters with several wavelength bands. It also makes the inducement of auto-fluorescence possible because it is designed to generate a wavelength band of 380-420nm, 430-480nm, 480-560nm. The transmission part of the light source was developed to enhance the efficiency of light transmission. To evaluate this light source, the characteristics of light output and wavelength band were verified. To validate the capability of this device as PDD, the detection of auto-fluorescence using mouse models was performed.

Sudomotor, skin vasomotor, and cardiovascular reflexes in 3 clinical forms of Lewy body disease.

PubMed

Akaogi, Y; Asahina, M; Yamanaka, Y; Koyama, Y; Hattori, T

2009-07-07

To elucidate the differences among dementia with Lewy bodies (DLB), Parkinson disease with dementia (PDD), and Parkinson disease without dementia (PD), with respect to the involvement of the autonomic nervous system, we clinically investigated the cutaneous and cardiovascular autonomic functions in patients with Lewy body disease. We studied 36 patients with Lewy body disorders, including 12 patients with DLB (age, 75.4 +/- 5.9 years), 12 patients with PDD (71.0 +/- 6.8 years), and 12 patients with PD (70.9 +/- 4.2 years), and 12 healthy control subjects (69.9 +/- 5.3 years). Sympathetic sweat response (SSwR) and skin vasomotor reflex (SkVR) on the palm were recorded to estimate the cutaneous sympathetic function, and the head-up tilt test was performed and coefficient of variation of R-R intervals (CV(R-R)) was studied to estimate the cardiovascular function. The patients with DLB, patients with PDD, and patients with PD showed severely reduced SSwR amplitudes, significantly lower than that in the controls. The mean SkVR amplitudes in the patients with DLB and patients with PDD were significantly lower than that in the controls, but not in the patients with PD. The mean decreases in the systolic blood pressure during the head-up tilt test in the patients with DLB and patients with PDD were less than that in the controls. The mean CV(R-R) value was significantly lower in the patients with DLB. Sudomotor function on the palm may be severely affected in Lewy body disorders, while skin vasomotor function and the cardiovascular system may be more severely affected in dementia with Lewy bodies and Parkinson disease with dementia than in Parkinson disease.

Sex differences in progression to mild cognitive impairment and dementia in Parkinson's disease.

PubMed

Cholerton, Brenna; Johnson, Catherine O; Fish, Brian; Quinn, Joseph F; Chung, Kathryn A; Peterson-Hiller, Amie L; Rosenthal, Liana S; Dawson, Ted M; Albert, Marilyn S; Hu, Shu-Ching; Mata, Ignacio F; Leverenz, James B; Poston, Kathleen L; Montine, Thomas J; Zabetian, Cyrus P; Edwards, Karen L

2018-05-01

Identification of factors associated with progression of cognitive symptoms in Parkinson's disease (PD) is important for treatment planning, clinical care, and design of future clinical trials. The current study sought to identify whether prediction of cognitive progression is aided by examining baseline cognitive features, and whether this differs according to stage of cognitive disease. Participants with PD in the Pacific Udall Center Clinical Consortium who had longitudinal data available and were nondemented at baseline were included in the study (n = 418). Logistic and Cox regression models were utilized to examine the relationship between cognitive, demographic, and clinical variables with risk and time to progression from no cognitive impairment to mild cognitive impairment (PD-MCI) or dementia (PDD), and from PD-MCI to PDD. Processing speed (OR = 1.05, p = 0.009) and working memory (OR = 1.01, p = 0.03) were associated with conversion to PDD among those with PD-MCI at baseline, over and above demographic variables. Conversely, the primary predictive factor in the transition from no cognitive impairment to PD-MCI or PDD was male sex (OR = 4.47, p = 0.004), and males progressed more rapidly than females (p = 0.01). Further, among females with shorter disease duration, progression was slower than for their male counterparts, and poor baseline performance on semantic verbal fluency was associated with shorter time to cognitive impairment in females but not in males. This study provides evidence for sex differences in the progression to cognitive impairment in PD, while specific cognitive features become more important indicators of progression with impending conversion to PDD. Copyright © 2018 Elsevier Ltd. All rights reserved.

Event-related potentials of self-face recognition in children with pervasive developmental disorders.

PubMed

Gunji, Atsuko; Inagaki, Masumi; Inoue, Yuki; Takeshima, Yasuyuki; Kaga, Makiko

2009-02-01

Patients with pervasive developmental disorders (PDD) often have difficulty reading facial expressions and deciphering their implied meaning. We focused on semantic encoding related to face cognition to investigate event-related potentials (ERPs) to the subject's own face and familiar faces in children with and without PDD. Eight children with PDD (seven boys and one girl; aged 10.8+/-2.9 years; one left-handed) and nine age-matched typically developing children (four boys and five girls; aged 11.3+/-2.3 years; one left-handed) participated in this study. The stimuli consisted of three face images (self, familiar, and unfamiliar faces), one scrambled face image, and one object image (e.g., cup) with gray scale. We confirmed three major components: N170 and early posterior negativity (EPN) in the occipito-temporal regions (T5 and T6) and P300 in the parietal region (Pz). An enhanced N170 was observed as a face-specific response in all subjects. However, semantic encoding of each face might be unrelated to N170 because the amplitude and latency were not significantly different among the face conditions. On the other hand, an additional component after N170, EPN which was calculated in each subtracted waveform (self vs. familiar and familiar vs. unfamiliar), indicated self-awareness and familiarity with respect to face cognition in the control adults and children. Furthermore, the P300 amplitude in the control adults was significantly greater in the self-face condition than in the familiar-face condition. However, no significant differences in the EPN and P300 components were observed among the self-, familiar-, and unfamiliar-face conditions in the PDD children. The results suggest a deficit of semantic encoding of faces in children with PDD, which may be implicated in their delay in social communication.

Autism Spectrum Disorder in the DSM-5: Diagnostic Sensitivity and Specificity in Early Childhood.

PubMed

Christiansz, Jessica A; Gray, Kylie M; Taffe, John; Tonge, Bruce J

2016-06-01

Changes to the DSM-5 Autism Spectrum Disorder (ASD) criteria raised concerns among parents and practitioners that the criteria may exclude some children with Pervasive Developmental Disorder (PDD). Few studies have examined DSM-5 sensitivity and specificity in children less than 5 years of age. This study evaluated 185 children aged 20-55 months with DSM-IV PDD or developmental delay. Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) data was assigned to DSM-5 subdomains. Children displaying the required symptomatology were classified with DSM-5 ASD. DSM-IV clinical diagnoses were compared to DSM-5 classifications. Using combined ADI-R/ADOS information, sensitivity was .84 and specificity was .54. Comorbid behaviour and emotional problems were significantly lower in children with PDD that did not meet DSM-5 criteria.

Parameterization of photon beam dosimetry for a linear accelerator

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

Lebron, Sharon; Barraclough, Brendan; Lu, Bo

2016-02-15

Purpose: In radiation therapy, accurate data acquisition of photon beam dosimetric quantities is important for (1) beam modeling data input into a treatment planning system (TPS), (2) comparing measured and TPS modeled data, (3) the quality assurance process of a linear accelerator’s (Linac) beam characteristics, (4) the establishment of a standard data set for comparison with other data, etcetera. Parameterization of the photon beam dosimetry creates a data set that is portable and easy to implement for different applications such as those previously mentioned. The aim of this study is to develop methods to parameterize photon beam dosimetric quantities, includingmore » percentage depth doses (PDDs), profiles, and total scatter output factors (S{sub cp}). Methods: S{sub cp}, PDDs, and profiles for different field sizes, depths, and energies were measured for a Linac using a cylindrical 3D water scanning system. All data were smoothed for the analysis and profile data were also centered, symmetrized, and geometrically scaled. The S{sub cp} data were analyzed using an exponential function. The inverse square factor was removed from the PDD data before modeling and the data were subsequently analyzed using exponential functions. For profile modeling, one halfside of the profile was divided into three regions described by exponential, sigmoid, and Gaussian equations. All of the analytical functions are field size, energy, depth, and, in the case of profiles, scan direction specific. The model’s parameters were determined using the minimal amount of measured data necessary. The model’s accuracy was evaluated via the calculation of absolute differences between the measured (processed) and calculated data in low gradient regions and distance-to-agreement analysis in high gradient regions. Finally, the results of dosimetric quantities obtained by the fitted models for a different machine were also assessed. Results: All of the differences in the PDDs’ buildup and the profiles’ penumbra regions were less than 2 and 0.5 mm, respectively. The differences in the low gradient regions were 0.20% ± 0.20% (<1% for all) and 0.50% ± 0.35% (<1% for all) for PDDs and profiles, respectively. For S{sub cp} data, all of the absolute differences were less than 0.5%. Conclusions: This novel analytical model with minimum measurement requirements was proved to accurately calculate PDDs, profiles, and S{sub cp} for different field sizes, depths, and energies.« less

Development of a Screening Scale for High-Functioning Pervasive Developmental Disorders Using the Tokyo Child Development Schedule and Tokyo Autistic Behavior Scale

ERIC Educational Resources Information Center

Suzuki, Mayo; Tachimori, Hisateru; Saito, Mari; Koyama, Tomonori; Kurita, Hiroshi

2011-01-01

This study aimed to compile a screening scale for high-functioning pervasive developmental disorders (PDD), using the Tokyo Child Development Schedule (TCDS) and Tokyo Autistic Behavior Scale (TABS). The 72 participants (IQ greater than or equal to 70) were divided into 3 groups after IQ matching depending on their diagnoses: i.e., PDD,…

Dysphagia in Lewy body dementia - a clinical observational study of swallowing function by videofluoroscopic examination.

PubMed

Londos, Elisabet; Hanxsson, Oskar; Alm Hirsch, Ingrid; Janneskog, Anna; Bülow, Margareta; Palmqvist, Sebastian

2013-10-07

Dysphagia, which can result in aspiration pneumonia and death, is a well-known problem in patients with dementia and Parkinson's disease. There are few studies on dysphagia in patients with dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), especially studies objectively documenting the type of swallowing dysfunction. The aim of this study was therefore to investigate the prevalence, and define the actual swallowing dysfunction according to a videofluoroscopic swallowing examination (VFSE) in patients with DLB and PDD. Eighty-two consecutive patients with DLB or PDD in a clinical follow-up program were asked about symptoms of dysphagia. Those experiencing dysphagia were examined with VFSE. Prevalence and type of swallowing dysfunction was recorded. Twenty-six patients (32%) reported symptoms of dysphagia such as swallowing difficulties or coughing. Twenty-four (92%) of these had a documented swallowing dysfunction on VFSE. Eighty-eight percent suffered from pharyngeal dysfunction. Almost all DLB or PDD patients with subjective signs of dysphagia had pathologic results on VFSE, the majority of pharyngeal type. This type of dysphagia has not been reported in DLB before. The results have clinical implications and highlight the importance of asking for and examining swallowing function to prevent complications such as aspiration.

Brief Report: Normal Intestinal Permeability at Elevated Platelet Serotonin Levels in a Subgroup of Children with Pervasive Developmental Disorders in Curacao (The Netherlands Antilles)

ERIC Educational Resources Information Center

Kemperman, Ramses F. J.; Muskiet, Fred D.; Boutier, A. Inge; Kema, Ido P.; Muskiet, Frits A. J.

2008-01-01

This study investigated the relationship between platelet (PLT) serotonin (5-HT) and intestinal permeability in children with pervasive developmental disorders (PDD). Differential sugar absorption and PLT 5-HT were determined in 23 children with PDD. PLT 5-HT (2.0-7.1 nmol/10[to the ninth power] PLT) was elevated in 4/23 patients. None exhibited…

Social Skills Groups for Asperger’s Disorder and Pervasive Developmental Disorder Not Otherwise Specified

PubMed Central

2008-01-01

Pervasive developmental disorders (PDD) including Asperger’s disorder are relatively rare conditions that can be very disabling for individuals affected. This article focuses on social skills therapy, looking at research that has been completed in a group therapy format and then using composite case examples to review basic techniques that have been used to teach social skills to children with a diagnosis of PDD. PMID:19727303

Redefining autism spectrum disorder using DSM-5: the implications of the proposed DSM-5 criteria for autism spectrum disorders.

PubMed

Young, Robyn L; Rodi, Melissa L

2014-04-01

A number of changes were made to pervasive developmental disorders (PDDs) in the recently released diagnostic and statistical manual of mental disorders (APA, Diagnostic and statistical manual of mental disorders, American Psychiatric Publishing, Arlington, VA, 2013). Of the 210 participants in the present study who met DSM-IV-TR criteria for a PDD [i.e., autistic disorder, Asperger's disorder and pervasive developmental disorder-not otherwise specified (PDD-NOS)], only 57.1% met DSM-5 criteria (specificity = 1.0) for autism spectrum disorder when criteria were applied concurrently during diagnostic assessment. High-functioning individuals (i.e., Asperger's disorder and PDD-NOS) were less likely to meet DSM-5 criteria than those with autistic disorder. A failure to satisfy all three criteria in the social-communication domain was the most common reason for exclusion (39%). The implications of these results are discussed.

Conversational Behaviors in Youth with High-functioning ASD and Asperger Syndrome

PubMed Central

Orlovski, Stephanie Miles; Marcinko, Hillary Chuba; Volkmar, Fred

2010-01-01

Twenty-nine youth with autism spectrum disorders and 26 with typical development between 12 and 18 years of age were engaged in structured interviews (ADOS). The interviews were videotaped and rated for atypical conversational behaviors by trained raters, using the Pragmatic Rating Scale (Landa et al. Psychol Med 22:245–254, 1992). The ASD group was divided into AS and HFA/PDD-NOS subgroups. Significant differences were found among groups on approximately one-third of the PRS items. These items involved primarily the management of topics and information, reciprocity, intonation, and gaze management. The only differences to reach significance between the AS and HFA/PDD-NOS group were a greater tendency for overly formal speech on the part of the AS group, and more difficulty with gaze management on the part of the group with HFA/PDD-NOS. The implications of these findings for understanding and treating conversational deficits in ASD are discussed. PMID:18607708

Modeling data for pancreatitis in presence of a duodenal diverticula using logistic regression

NASA Astrophysics Data System (ADS)

Dineva, S.; Prodanova, K.; Mlachkova, D.

2013-12-01

The presence of a periampullary duodenal diverticulum (PDD) is often observed during upper digestive tract barium meal studies and endoscopic retrograde cholangiopancreatography (ERCP). A few papers reported that the diverticulum had something to do with the incidence of pancreatitis. The aim of this study is to investigate if the presence of duodenal diverticula predisposes to the development of a pancreatic disease. A total 3966 patients who had undergone ERCP were studied retrospectively. They were divided into 2 groups-with and without PDD. Patients with a duodenal diverticula had a higher rate of acute pancreatitis. The duodenal diverticula is a risk factor for acute idiopathic pancreatitis. A multiple logistic regression to obtain adjusted estimate of odds and to identify if a PDD is a predictor of acute or chronic pancreatitis was performed. The software package STATISTICA 10.0 was used for analyzing the real data.

Policy Driven Development: Flexible Policy Insertion for Large Scale Systems.

PubMed

Demchak, Barry; Krüger, Ingolf

2012-07-01

The success of a software system depends critically on how well it reflects and adapts to stakeholder requirements. Traditional development methods often frustrate stakeholders by creating long latencies between requirement articulation and system deployment, especially in large scale systems. One source of latency is the maintenance of policy decisions encoded directly into system workflows at development time, including those involving access control and feature set selection. We created the Policy Driven Development (PDD) methodology to address these development latencies by enabling the flexible injection of decision points into existing workflows at runtime , thus enabling policy composition that integrates requirements furnished by multiple, oblivious stakeholder groups. Using PDD, we designed and implemented a production cyberinfrastructure that demonstrates policy and workflow injection that quickly implements stakeholder requirements, including features not contemplated in the original system design. PDD provides a path to quickly and cost effectively evolve such applications over a long lifetime.

[Left temporal arachnoid cyst and specific learning disorders associated with Pervasive Developmental Disorders - Not Otherwise Specified (PDD-NOS): contributions of an integrative neuropsychomotor, neuropsychological, psychopathological and neurosurgical approach about a case report in a child (François)].

PubMed

Vaivre-Douret, L; Boschi, A; Cuny, M L; Clouard, C; Mosser, A; Golse, B; Philippe, A; Bourgeois, M; Boddaert, N; Puget, S

2016-12-01

Left temporal arachnoid cyst and specific learning disorders associated with pervasive developmental disorders - not otherwise specified (PDD-NOS): contributions of an integrative neuro-psychomotor, neuropsychological, psychopathological and neurosurgical approach about a case report in a child (François). With DSM-IV and DSM-IV-TR, the terminology of pervasive developmental disorders (PDD) covers two main categories of infantile disorders: disorders of "strictly" autistic nature and pervasive developmental disorders - not otherwise specified (PDD-NOS). Under the terminology of multiple complex developmental disorder (MCDD), it is proposed to classify children presenting symptoms approaching the psychotic disharmonies and usually diagnosed as PDD-NOS. Such a category of developmental disorders is now included without nosographic distinction in the autistic spectrum in the Diagnostic and Statistical Manual of mental disorders (DSM-V). We are reporting a case report of a 6-year-old boy which shows a PDD-NoS/MCDD complex symptomatology type. This child presents multiple disorders: minor neurological signs (soft signs), neuro-psychomotor disorders, developmental coordination disorder (DCD), communication, thought, and regulation of emotions disorders, attention deficit disorders (ADD); in the presence of a high verbal intellectual potential, which makes it difficult to establish a clear diagnosis. A cerebral magnetic resonance imaging (MRI) was carried out due to the presence of minor neurological signs (soft signs) and of neurodevelopmental multiple disorders. The MRI revealed a voluminous arachnoid temporo-polar left cyst with a marked mass effect on the left temporal lobe. A neurosurgical intervention allowed to observe the gradual disappearance of the specific symptomatology (in particular soft signs, neuro-psychomotor functions and autistic symptoms) secondary to the interference of the cyst's pressure with intracranial areas involving neurological and psychopathological abnormalities, underlying at the same time the reversibility of the disorders after decompression as demonstrated in some studies. There are always, with a quantitative and qualitative decrease, an emotional dysregulation, a DCD, an ADD as well as impairments in the executive functions. This clinical case underlines the necessity of an evaluation in a transdisciplinary way and to follow the developmental evolution of the child in order to focus adapted therapeutics. Furthermore, with neurodevelopmental disorders not specified, it is important to examine the presence of soft signs with standardized neuro-psychomotor assessment, and then, to propose an MRI investigation. To our knowledge, this is the first report in the literature with a school age child of an unusual association between a temporal arachnoid cyst associated with PDD-NOS/MCDD. Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

High resolution (1 km) positive degree-day modelling of Greenland ice sheet surface mass balance, 1870–2012 using reanalysis data

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

Wilton, David J.; Jowett, Amy; Hanna, Edward

Here, we show results from a positive degree-day (PDD) model of Greenland ice sheet (GrIS) surface mass balance (SMB), 1870–2012, forced with reanalysis data. The model includes an improved daily temperature parameterization as compared with a previous version and is run at 1 km rather than 5 km resolution. The improvements lead overall to higher SMB with the same forcing data. We also compare our model with results from two regional climate models (RCMs). While there is good qualitative agreement between our PDD model and the RCMs, it usually results in lower precipitation and lower runoff but approximately equivalent SMB:more » mean 1979–2012 SMB (± standard deviation), in Gt a –1, is 382 ± 78 in the PDD model, compared with 379 ± 101 and 425 ± 90 for the RCMs. Comparison with in situ SMB observations suggests that the RCMs may be more accurate than PDD at local level, in some areas, although the latter generally compares well. Dividing the GrIS into seven drainage basins we show that SMB has decreased sharply in all regions since 2000. Finally we show correlation between runoff close to two calving glaciers and either calving front retreat or calving flux, this being most noticeable from the mid-1990s.« less

High resolution (1 km) positive degree-day modelling of Greenland ice sheet surface mass balance, 1870–2012 using reanalysis data

DOE PAGES

Wilton, David J.; Jowett, Amy; Hanna, Edward; ...

2016-12-15

Here, we show results from a positive degree-day (PDD) model of Greenland ice sheet (GrIS) surface mass balance (SMB), 1870–2012, forced with reanalysis data. The model includes an improved daily temperature parameterization as compared with a previous version and is run at 1 km rather than 5 km resolution. The improvements lead overall to higher SMB with the same forcing data. We also compare our model with results from two regional climate models (RCMs). While there is good qualitative agreement between our PDD model and the RCMs, it usually results in lower precipitation and lower runoff but approximately equivalent SMB:more » mean 1979–2012 SMB (± standard deviation), in Gt a –1, is 382 ± 78 in the PDD model, compared with 379 ± 101 and 425 ± 90 for the RCMs. Comparison with in situ SMB observations suggests that the RCMs may be more accurate than PDD at local level, in some areas, although the latter generally compares well. Dividing the GrIS into seven drainage basins we show that SMB has decreased sharply in all regions since 2000. Finally we show correlation between runoff close to two calving glaciers and either calving front retreat or calving flux, this being most noticeable from the mid-1990s.« less

Measurement of relative depth-dose distribution in radiochromic film dosimeters irradiated with 43-70 keV electron beam for industrial application

NASA Astrophysics Data System (ADS)

Matsui, Shinjiro; Hattori, Takeaki; Nonaka, Takashi; Watanabe, Yuki; Morita, Ippei; Kondo, Junichi; Ishikawa, Masayoshi; Mori, Yoshitaka

2018-05-01

The relative dose in a layer, which is thinner than the thickness of the dosimeter is evaluated using simulated depth-dose distributions, and the measured responses of dosimeters with acceleration voltages from 43 to 70 kV, via ultra-low-energy electron beam (ULEB) irradiation. By stacking thin film dosimeters, we confirmed that the simulated depth-dose distributions coincided with the measured depth-dose curve within the measurement uncertainty (k = 2). Using the measurement dose of the 47 μm dosimeter and the simulated depth-dose distribution, the dose of 11 μm dosimeters in the surface was evaluated within the measurement uncertainty (k = 2). We also verified the effectiveness of this method for a thinner layer by changing the acceleration voltage of the irradiation source. We evaluated the relative dose for an adjusted depth of energy deposition from 4.4 μm to 22.8 μm. As a result, this method was found to be effective for a thickness, which is less than the thickness of the dosimeter. When irradiation conditions are well known with accuracy, using the confirmed relative depth-dose distributions across any dosimeter thickness range, a dose evaluation, in several μm steps will possibly improve the design of industrial ULEB processes.

Increased systemic elastase and C-reactive protein in aggressive periodontitis (CLOI-D-00160R2).

PubMed

Wohlfeil, Martin; Scharf, Susanne; Siegelin, Yasemin; Schacher, Beate; Oremek, Gerhard M; Sauer-Eppel, Hildegund; Schubert, Ralf; Eickholz, Peter

2012-08-01

The inflammatory mediators, serum elastase and C-reactive protein (CRP), are associated with an increased risk for coronary heart disease. Thus, the aim of this study is to compare systemic inflammatory mediators in periodontally healthy controls (C), patients with untreated aggressive (AgP) and chronic (ChP) periodontitis. C [periodontal pocket probing depth (PPD)  <3.6 or <5 mm without bleeding (BOP), BOP < 10%], ChP (PDD ≥ 3.6 mm and probing attachment loss ≥5 mm at >30% of sites; age >35 years), and AgP (clinically healthy; PDD ≥ 3.6 mm at >30% of sites, bone loss ≥50% at ≥2 teeth; age ≤35 years) were examined clinically, and the body mass index was assessed. Blood was sampled for assessment of serum levels of elastase, CRP, lipopolysaccharide binding protein (LBP), interleukin (IL) 6, 8, and leukocyte counts. Thirty C, 31 ChP, and 29 AgP were analyzed. Elastase, CRP, LBP, and IL-6 levels were elevated in AgP compared to C (p < 0.013), whereas leukocyte counts and IL-8 were similar. Multiple regression analysis identified AgP (p < 0.001) and education level (p < 0.001) to explain 47% of the variation of elastase. AgP (p = 0.003), African origin (p = 0.006), female sex (p = 0.002), and BMI (p < 0.001) explained 39% of the variation of CRP. Serum elastase and CRP are significantly elevated in AgP compared to C. AgP patients exhibit a stronger systemic inflammatory burden than C patients.

Anosognosia for cognitive and behavioral symptoms in Parkinson's disease with mild dementia and mild cognitive impairment: Frequency and neuropsychological/neuropsychiatric correlates.

PubMed

Orfei, Maria Donata; Assogna, Francesca; Pellicano, Clelia; Pontieri, Francesco Ernesto; Caltagirone, Carlo; Pierantozzi, Mariangela; Stefani, Alessandro; Spalletta, Gianfranco

2018-04-17

Anosognosia is a multidimensional phenomenon with detrimental effects on patients' illness course, therapy compliance and quality of life. We aimed at investigating anosognosia for cognitive and behavioral symptoms in Parkinson's Disease (PD) with dementia (PDD) and, for the first time, in PD with Mild Cognitive Impairment (MCI-PD). Community dwelling subjects (47 mild PDD, 136 multidomain MCI-PD (mdMCI-PD), 5 single domain MCI-PD (sdMCI-PD), and 197 PD without cognitive impairment (noCI-PD) were enrolled in a cross-sectional design study. All the subjects were administered the Anosognosia Questionnaire for Dementia, the Mental Deterioration Battery and a number of neuropsychiatric inventories. A diagnosis of anosognosia was made in 36% of patients with mild PDD and 16% with mdMCI-PD, whether it was negligible in sdMCI-PD and noCI-PD. Higher severity of anosognosia for cognitive impairment was also found in PDD and in mdMCI-PD. SdMCI-PD had the lower severity of anosognosia for cognitive impairment. Higher anosognosia for cognitive impairment was associated to lower depression in noCI-PD (r = -0.227, p = 0.0013) and mdMCI-PD (r = -0.266, p = 0.0016), and to reduced hedonic tone in noCI-PD (r = -0.191, p = 0.0071). Greater anosognosia was associated to lower executive performances in PDD (r = 0.424, p = 0.0074). Anosognosia for non-motor symptoms is frequent in PD patients with mild dementia or mdMCI. Results confirm the role of neuropsychiatric characteristics in anosognosia also in PD, the high prevalence of anosognosia in neurodegenerative illnesses and suggest a common pathogenic path for anosognosia in different neurodegenerative and psychiatric disorders. Copyright © 2018 Elsevier Ltd. All rights reserved.

Implication of the ryanodine receptor in TRPV4-induced calcium response in pulmonary arterial smooth muscle cells from normoxic and chronically hypoxic rats.

PubMed

Dahan, Diana; Ducret, Thomas; Quignard, Jean-François; Marthan, Roger; Savineau, Jean-Pierre; Estève, Eric

2012-11-01

There is a growing body of evidence indicating that transient receptor potential (TRP) channels are implicated in calcium signaling and various cellular functions in the pulmonary vasculature. The aim of this study was to investigate the expression, functional role, and coupling to reticulum calcium channels of the type 4 vanilloid TRP subfamily (TRPV4) in the pulmonary artery from both normoxic (Nx) and chronically hypoxic (CH) rats. Activation of TRPV4 with the specific agonist 4α-phorbol-12,13-didecanoate (4α-PDD, 5 μM) increased the intracellular calcium concentration ([Ca(2+)](i)). This effect was significantly reduced by a high concentration of ryanodine (100 μM) or chronic caffeine (5 mM) that blocked ryanodine receptor (RyR) but was insensitive to xestospongin C (10 μM), an inositol trisphosphate receptor antagonist. Inhibition of RyR1 and RyR3 only with 10 μM of dantrolene did not attenuate the 4α-PDD-induced [Ca(2+)](i) increase. Western blotting experiments revealed the expression of TRPV4 and RyR2 with an increase in both receptors in pulmonary arteries from CH rats vs. Nx rats. Accordingly, the 4α-PDD-activated current, measured with patch-clamp technique, was increased in pulmonary artery smooth muscle cells (PASMC) from CH rats vs. Nx rats. 4α-PDD increased isometric tension in artery rings, and this response was also potentiated under chronic hypoxia conditions. 4α-PDD-induced calcium response, current, and contraction were all inhibited by the selective TRPV4 blocker HC-067047. Collectively, our findings provide evidence of the interplay between TRPV4 and RyR2 in the Ca(2+) release mechanism and contraction in PASMC. This study provides new insights onto the complex calcium signaling in PASMC and point out the importance of the TRPV4-RyR2 signaling pathway under hypoxic conditions that may lead to pulmonary hypertension.

SU-F-T-551: Beam Hardening and Attenuation of Photon Beams Using Integral Quality Monitor in Radiotherapy

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

Casar, B; Carot, I Mendez; Peterlin, P

2016-06-15

Purpose: Aim of the multi-centre study was to analyse beam hardening effect of the Integral Quality Monitor (IQM) for high energy photon beams used in radiotherapy with linear accelerators. Generic values for attenuation coefficient k(IQM) of IQM system were additionally investigated. Methods: Beam hardening effect of the IQM system was studied for a set of standard nominal photon energies (6 MV–18 MV) and two flattening filter free (FFF) energies (6 MV FFF and 10 MV FFF). PDD curves were measured and analysed for various square radiation fields, with and without IQM in place. Differences between PDD curves were statistically analysedmore » through comparison of respective PDD-20,10 values. Attenuation coefficients k(IQM) were determined for the same range of photon energies. Results: Statistically significant differences in beam qualities for all evaluated high energy photon beams were found, comparing PDD-20,10 values derived from PDD curves with and without IQM in place. Significance of beam hardening effect was statistically proven with high confidence (p < 0,01) for all analysed photon beams except for 15 MV (p = 0,078), although relative differences in beam qualities were minimal, ranging from 0,1 % to 0,5 %. Attenuation of the IQM system showed negligible dependence on radiation field size. However, clinically important dependence of kIQM versus TPRs20,10 was found: 0,941 for 6 MV photon beams, to 0,959 for 18 MV photon beams, with highest uncertainty below 0,006. k(IQM) versus TPRs were tabulated and polynomial equation for the determination of k(IQM) is suggested for clinical use. Conclusion: There was no clinically relevant beam hardening, when IQM system was on linear accelerators. Consequently, no additional commissioning is needed for the IQM system regarding the determination of beam qualities. Generic values for k(IQM) are proposed and can be used as tray factors for complete range of examined photon beam energies.« less

The Interagency and Counterinsurgency Warfare: Stability, Security, Transition, and Reconstruction Roles

DTIC Science & Technology

2007-12-01

The final post-Somalia, but pre-PDD-56, interagency planning effort that had an impact on the publication of PDD-56 was never executed but proved...understanding of who produced the specific outcomes achieved, there would clearly be no impact on the perceptions of the intended audience. Ibid. p. IV-27...armed forces and helped end the early 20th-century military operations there. However, the media’s daily impact on today’s operations has no precedent

Density characterization of radiochromic film through source axis distance (SAD) technique in linac with slab phantom for radiotherapy applications

NASA Astrophysics Data System (ADS)

Hariani, Yousida; Haris, Bambang

2017-05-01

Characterization of radiochromic film density is accomplished through Source Axis Distance (SAD) technique in a slab phantom Linac with various depths and breadths of field. Type of the film used is gafchromic RTQA2. The dose of radiation exposure of the film may cause changes in the film density. This research aims to determine the relation between the density and the dose depth through the characteristic of curves to identify the depth of the dose and particular breadth of the field as a reference for the dose of radiotherapy patients. The result shows that the higher the dose is absorbed, the darker the film will be, yet the lower the density is obtained. The dose depth is determined by measuring the amount of dose received at various depths and breadths of field using film that is placed on the slab phantom with 6 MV linac radiation and dose of 300 cGy. The variation of the depth at 1.5 cm; 4 cm; 6 cm; 8 cm; 10 cm, the field size at 4 × 4 cm2, and the dose depth at 359.7 cGy; 315.3 cGy; 281.4 cGy; 241.2 cGy; 220.5 cGy were settled. The field size 6 × 6 cm2 takes the dose depth 354.6 cGy; 314.1 cGy; 282.6 cGy; 244.5 cGy; 224.7 cGy. The field size 8 × 8 cm2 takes the dose depth 351.6 cGy; 313 cGy; 283.8 cGy; 247.2 cGy; 228 cGy. The field size 10 × 10 cm2 takes the dose depth 348.9 cGy; 342.6 cGy; 248.4 cGy; 249.6 cGy; 231 cGy.

[Application of high-frequency ultrasound in dermabrasion of patients with deep partial-thickness burns].

PubMed

Zang, C Y; Cao, Y Q; Xue, W J; Zhao, R; Zhang, M; Zhang, Y H; Feng, Z; Wang, Y B

2017-02-20

Objective: To investigate the application of high-frequency ultrasound in dermabrasion of patients with deep partial-thickness burns. Methods: Twenty-six patients with deep partial-thickness burns conforming to the study criteria were hospitalized in our unit from March 2015 to March 2016. Patients were all performed with dermabrasion. The structure of skin tissue and blood flow signals of uninjured side and wounds before dermabrasion, and those of wounds immediately post dermabrasion and on post dermabrasion day (PDD) 1, 3, 5, 7, 10, 14, and 21 were detected with high-frequency ultrasound, and the percentage of blood flow signals was calculated. According to the results of comparison between percentage of blood flow signals of wounds and that of normal skin before dermabrasion, patients were divided into no significant decrease group (NSD, n =19) and significant decrease group (SD, n =7). Wound healing time of patients in two groups was recorded. Data were processed with analysis of variance of repeated measurement, LSD test, t test and Chi-square test. The correlation between the percentage of blood flow signals of wounds before dermabrasion and wound healing time of 26 patients were analyzed by Spearman correlation analysis. Results: (1) Epidermis of normal skin of patients in two groups before dermabrasion showed continuous smooth linear hyperecho, which was stronger than that of dermis, and boundary of dermis and subcutaneous tissue showed stronger discontinuous linear echo than that of dermis, which gradually transited to subcutaneous tissue. In group NSD, epidermis of wound of patients before dermabrasion showed intermittent rough linear echo, which was weaker than that of normal skin epidermis, and there was no obvious abnormity of boundary between dermis and subcutaneous tissue. Immediately post dermabrasion and on PDD 1, no linear hyperecho of epidermis was observed, showing complete attrition of epidermis, and the echo of dermis and subcutaneous tissue had no obvious change as compared with that before dermabrasion, with flat surface of dermis and partly abraded superficial-dermis but relatively well preserved dermal tissue in whole. The epidermis showed discontinuous linear hyperecho, and epidermis was discontinuously regenerated on PDD 3 and 5. Partial continuous linear hyperecho was detected in the epidermis, showing partial continuous regeneration of epidermis on PDD 7 and 10. The regenerated epidermis was thicker than normal skin epidermis and showed rough linear hyperecho with non-uniform thickness on PDD 14. The regenerated epidermis was thicker than normal skin epidermis and showed rather smooth linear hyperecho with uniform thickness on PDD 21. In group SD, the structure of epidermis and dermis of wound of patients before dermabrasion, immediately post dermabrasion, and on PDD 1 was similar to that in group NSD, but the echo of boundary of dermis and subcutaneous tissue was weakened in different degrees. There was no linear hyperecho of epidermis, showing no epidermis was regenerated on PDD 3 and 5. Intermittent regeneration of epidermis appeared on PDD 7 and 10 with intermittent linear hyperecho. Partial continuous linear hyperecho was detected in the epidermis, showing partial continuous regeneration of epidermis on PDD 14 and 21. (2) The percentages of blood flow signals of wounds of patients in group NSD before dermabrasion, immediately post dermabrasion, and on PDD 1 were (3.1±1.3)%, (6.5±2.0)%, and (5.3±1.9)% respectively, higher than those in group SD [(0.9±1.1)%, (3.5±1.3)%, and (3.6±0.9)% respectively, P <0.05 or P <0.01]. The percentages of blood flow signals of wounds of patients in two groups were similar at the other time points (with P values above 0.05). Compared with the percentage of normal skin in the same group [(3.2±0.7)%], the percentages of blood flow signals of wounds of patients in group NSD were significantly increased immediately post dermabrasion and on PDD 1 (with P values below 0.01) but had no significant change at the other time points (with P values above 0.05). The percentage of blood flow signals of wounds of patients before dermabrasion in group SD was significantly lower than that of normal skin in the same group [(2.8±0.6)%, P <0.01]. The percentage of blood flow signals of wounds of patients in group SD was close to that of normal skin in the same group at each time point post dermabrasion (with P values above 0.05). (3) The wound healing time of patients in group NSD was (16.2±2.5) d, lower than that in group SD [(30.9±2.9) d, t =12.67, P <0.01]. There was obvious negative correlation between the percentage of blood flow signals of wounds before dermabrasion and wound healing time of 26 patients ( r =-0.77, P <0.01). Conclusions: High-frequency ultrasound is a good way to observe the imaging features of wounds in patients with deep partial-thickness burns before and after dermabrasion, and it can provide objective imaging evidence for the performance of dermabrasion in patients with deep partial-thickness burns.

Dementia with Lewy bodies: a comprehensive review for nurses.

PubMed

Ajon Gealogo, Gretchel

2013-12-01

Much of the current nursing literature on dementia focuses on Alzheimer disease (AD), the dementia subtype most commonly diagnosed in the older adults. There is a paucity of nursing literature on dementia with Lewy bodies (DLB), the second most common subtype of dementia, which is closely associated with Parkinson disease with dementia (PDD), considered the third most common dementia subtype. Both are aging-related disorders attributed to Lewy bodies, abnormal protein aggregates or "clumps" found to cause cumulative neurodegeneration over time. DLB is defined as dementia onset that is preceded by Parkinsonian symptoms for 1 year or less, whereas in PDD, 2 or more years of Parkinsonian symptoms precede dementia onset. Although basic science knowledge of DLB has increased exponentially, the lack of nursing research on DLB indicates that this knowledge excludes the nursing perspective and its implications for nursing practice. The purpose of this article is to provide nurses with a comprehensive overview of DLB as it compares with PDD and Alzheimer disease and to propose key nursing interventions for clinical practice.

Evaluation of the Revolver Ignition Design at the National Ignition Facility Using Polar-Direct-Drive Illumination

NASA Astrophysics Data System (ADS)

McKenty, P. W.; Collins, T. J. B.; Marozas, J. A.; Campbell, E. M.; Molvig, K.; Schmitt, M.

2017-10-01

The direct-drive ignition design Revolver employs a triple-shell target using a beryllium ablator, a copper driver, and an eventual gold pusher. Symmetric numerical calculations indicate that each of the three shells exhibit low convergence ( 3to 5) resulting in a modest gain (G 4) for 1.7 MJ of incident laser energy. Studies are now underway to evaluate the robustness of this design employing polar direct drive (PDD) at the National Ignition Facility. Integral to these calculations is the leveraging of illumination conditioning afforded by research done to demonstrate ignition for a traditional PDD hot-spot target design. Two-dimensional simulation results, employing nonlocal electron-thermal transport and cross-beam energy transport, will be presented that indicate ignition using PDD. A study of the allowed levels of long-wavelength perturbations (target offset and power imbalance) not precluding ignition will also be examined. This material is based upon work supported by the Department of Energy National Nuclear Security Administration under Award Number DE-NA0001944.

An Exploratory Investigation of the Role of Parenting Stress in Relationship Focused Intervention.

PubMed

Alquraini, Turki; Mahoney, Gerald

2015-11-01

Mothers of young children with Pervasive Developmental Disorders (PDD) and other disabilities (DD) have been reported to experience high levels of stress. This investigation examined the effects of parental stress on mothers' participation in a Relationship Focused intervention (RFI). Mothers and young children who had either PDD (n = 18) or DD (n = 26) received weekly RF intervention for one year. Pre-post comparisons indicated significant increases in mothers' responsiveness and children's development and social emotional functioning. Intervention effects were greater for mothers of children with PDD than for mothers of children with DD. There were three findings related to the role parenting stress. First, high levels of parenting stress did not interfere with mothers' ability to learn RFI strategies; second, there were non-significant decreases in parenting stress during intervention; third, parenting stress enhanced the effects of mothers' responsiveness on children. High levels of parenting stress does not appear to interfere with parent participation in RFI. © 2015 John Wiley & Sons Ltd.

Patterns of Early Skill Attainment and Loss in Young Children with Autism

PubMed Central

Thurm, Audrey; Manwaring, Stacy S.; Luckenbaugh, David A.; Lord, Catherine; Swedo, Susan E.

2015-01-01

The purpose of this study was to extend the literature on the ontogeny of autism spectrum disorder (ASD) by examining early attainment and loss of specific sociocommunicative skills in children with autism (AUT; n = 125), pervasive developmental disorder not otherwise specified (PDD-NOS; n = 42), nonspectrum developmental delays (n = 46), and typical development (n = 31). The ages of skill attainment and loss were obtained from a caregiver interview. The findings indicated that children with AUT, PDD-NOS, and developmental delays diverged from typically developing children in attainment of sociocommunicative skills early in the first year of life. Loss of at least one skill was reported in a majority of children with AUT and PDD-NOS. Significant delays in attainment of skills were also reported in children who lost skills. The wide variation in skill attainment and loss reported across children indicates that symptom onset and regression may be best represented continuously, with at least some early delay and loss present for a great majority of children with ASD. PMID:24274034

Patterns of skill attainment and loss in young children with autism.

PubMed

Thurm, Audrey; Manwaring, Stacy S; Luckenbaugh, David A; Lord, Catherine; Swedo, Susan E

2014-02-01

The purpose of this study was to extend the literature on the ontogeny of autism spectrum disorder (ASD) by examining early attainment and loss of specific sociocommunicative skills in children with autism (AUT; n = 125), pervasive developmental disorder not otherwise specified (PDD-NOS; n = 42), nonspectrum developmental delays (n = 46), and typical development (n = 31). The ages of skill attainment and loss were obtained from a caregiver interview. The findings indicated that children with AUT, PDD-NOS, and developmental delays diverged from typically developing children in attainment of sociocommunicative skills early in the first year of life. Loss of at least one skill was reported in a majority of children with AUT and PDD-NOS. Significant delays in attainment of skills were also reported in children who lost skills. The wide variation in skill attainment and loss reported across children indicates that symptom onset and regression may be best represented continuously, with at least some early delay and loss present for a great majority of children with ASD.

Potential role of photodynamic techniques combined with new generation flexible ureterorenoscopes and molecular markers for the management of urothelial carcinoma of the upper urinary tract.

PubMed

Audenet, François; Traxer, Olivier; Yates, David R; Cussenot, Olivier; Rouprêt, Morgan

2012-02-01

•  To discuss how the development of new generation flexible ureterorenoscopes in combination with photodynamic diagnosis (PDD) improves the assessment of urothelial cell carcinoma of the upper urinary tract (UUT-UCC). •  Ultimately, this may allow accurate tumour classification and the ability to select which patients would benefit from conservative treatment as opposed to radical surgery. •  We conducted an exhaustive Pubmed literature search using a combination of keywords including: ureterorenoscopy, UUT-UCC diagnosis, PDD, narrow band imaging, conservative treatment UUT-UCC and molecular urinalysis. •  We then selected salient high calibre articles relevant to our objective. •  We give specific consideration to anatomical aspects of UUT-UCC investigation, PDD in UCC, aminolevulinic acid and its derivatives, autofluorescence, narrow band imaging, molecular marker analysis and the recent advances in ureterorenoscopic technology. •  The traditional pitfalls of UUT-UCC diagnosis, namely poor visualisation and difficulty in obtaining representative histological samples, are being circumvented by the introduction of modern digital flexible ureteroscopes that can be combined with PDD and molecular analysis to improve tumour classification, deferring to conservative treatment accordingly. •  The accuracy of the diagnostic work-up of UUT-UCC is improving due to advances in technology, pharmaceutical agents and incorporation of molecular markers, all factors allowing us to characterise tumours of the UUT more definitively. © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

Cholinergic and perfusion brain networks in Parkinson disease dementia.

PubMed

Colloby, Sean J; McKeith, Ian G; Burn, David J; Wyper, David J; O'Brien, John T; Taylor, John-Paul

2016-07-12

To investigate muscarinic M1/M4 cholinergic networks in Parkinson disease dementia (PDD) and their association with changes in Mini-Mental State Examination (MMSE) after 12 weeks of treatment with donepezil. Forty-nine participants (25 PDD and 24 elderly controls) underwent (123)I-QNB and (99m)Tc-exametazime SPECT scanning. We implemented voxel principal components (PC) analysis, producing a series of PC images of patterns of interrelated voxels across individuals. Linear regression analyses derived specific M1/M4 and perfusion spatial covariance patterns (SCPs). We found an M1/M4 SCP of relative decreased binding in basal forebrain, temporal, striatum, insula, and anterior cingulate (F1,47 = 31.9, p < 0.001) in cholinesterase inhibitor-naive patients with PDD, implicating limbic-paralimbic and salience cholinergic networks. The corresponding regional cerebral blood flow SCP showed relative decreased uptake in temporoparietal and prefrontal areas (F1,47 = 177.5, p < 0.001) and nodes of the frontoparietal and default mode networks (DMN). The M1/M4 pattern that correlated with an improvement in MMSE (r = 0.58, p = 0.005) revealed relatively preserved/increased pre/medial/orbitofrontal, parietal, and posterior cingulate areas coinciding with the DMN and frontoparietal networks. Dysfunctional limbic-paralimbic and salience cholinergic networks were associated with PDD. Established cholinergic maintenance of the DMN and frontoparietal networks may be prerequisite for cognitive remediation following cholinergic treatment in this condition. © 2016 American Academy of Neurology.

Cholinergic and perfusion brain networks in Parkinson disease dementia

PubMed Central

McKeith, Ian G.; Burn, David J.; Wyper, David J.; O'Brien, John T.; Taylor, John-Paul

2016-01-01

Objective: To investigate muscarinic M1/M4 cholinergic networks in Parkinson disease dementia (PDD) and their association with changes in Mini-Mental State Examination (MMSE) after 12 weeks of treatment with donepezil. Methods: Forty-nine participants (25 PDD and 24 elderly controls) underwent 123I-QNB and 99mTc-exametazime SPECT scanning. We implemented voxel principal components (PC) analysis, producing a series of PC images of patterns of interrelated voxels across individuals. Linear regression analyses derived specific M1/M4 and perfusion spatial covariance patterns (SCPs). Results: We found an M1/M4 SCP of relative decreased binding in basal forebrain, temporal, striatum, insula, and anterior cingulate (F1,47 = 31.9, p < 0.001) in cholinesterase inhibitor–naive patients with PDD, implicating limbic-paralimbic and salience cholinergic networks. The corresponding regional cerebral blood flow SCP showed relative decreased uptake in temporoparietal and prefrontal areas (F1,47 = 177.5, p < 0.001) and nodes of the frontoparietal and default mode networks (DMN). The M1/M4 pattern that correlated with an improvement in MMSE (r = 0.58, p = 0.005) revealed relatively preserved/increased pre/medial/orbitofrontal, parietal, and posterior cingulate areas coinciding with the DMN and frontoparietal networks. Conclusion: Dysfunctional limbic-paralimbic and salience cholinergic networks were associated with PDD. Established cholinergic maintenance of the DMN and frontoparietal networks may be prerequisite for cognitive remediation following cholinergic treatment in this condition. PMID:27306636

Current Treatment Options for Alzheimer's Disease and Parkinson's Disease Dementia.

PubMed

Szeto, Jennifer Y Y; Lewis, Simon J G

2016-01-01

Alzheimer's disease (AD) and Parkinson's disease (PD) are the two most common neurodegenerative disorders encountered in clinical practice. Whilst dementia has long been synonymous with AD, it is becoming more widely accepted as part of the clinical spectrum in PD (PDD). Neuropsychiatric complications, including psychosis, mood and anxiety disorders, and sleep disorders also frequently co-exist with cognitive dysfunctions in AD and PDD patients. The incidence of such symptoms is often a significant source of disability, and may aggravate pre-existing cognitive deficits. Management of AD and PDD involves both pharmacological and non-pharmacological measures. Although research on pharmacological therapies for AD and PDD has so far had some success in terms of developing symptomatic treatments, the benefits are often marginal and non-sustained. These shortcomings have led to the investigation of non-pharmacological and novel treatments for both AD and PD. Furthermore, in light of the diverse constellation of other neuropsychiatric, physical, and behavioural symptoms that often occur in AD and PD, consideration needs to be given to the potential side effects of pharmacological treatments where improving one symptom may lead to the worsening of another, rendering the clinical management of these patients challenging. Therefore, the present article will critically review the evidence for both pharmacological and non-pharmacological treatments for cognitive impairment in AD and PD patients. Treatment options for other concomitant neuropsychiatric and behavioural symptoms, as well as novel treatment strategies will also be discussed.

Autism occurrence by MMR vaccine status among US children with older siblings with and without autism.

PubMed

Jain, Anjali; Marshall, Jaclyn; Buikema, Ami; Bancroft, Tim; Kelly, Jonathan P; Newschaffer, Craig J

2015-04-21

Despite research showing no link between the measles-mumps-rubella (MMR) vaccine and autism spectrum disorders (ASD), beliefs that the vaccine causes autism persist, leading to lower vaccination levels. Parents who already have a child with ASD may be especially wary of vaccinations. To report ASD occurrence by MMR vaccine status in a large sample of US children who have older siblings with and without ASD. A retrospective cohort study using an administrative claims database associated with a large commercial health plan. Participants included children continuously enrolled in the health plan from birth to at least 5 years of age during 2001-2012 who also had an older sibling continuously enrolled for at least 6 months between 1997 and 2012. MMR vaccine receipt (0, 1, 2 doses) between birth and 5 years of age. ASD status defined as 2 claims with a diagnosis code in any position for autistic disorder or other specified pervasive developmental disorder (PDD) including Asperger syndrome, or unspecified PDD (International Classification of Diseases, Ninth Revision, Clinical Modification 299.0x, 299.8x, 299.9x). Of 95,727 children with older siblings, 994 (1.04%) were diagnosed with ASD and 1929 (2.01%) had an older sibling with ASD. Of those with older siblings with ASD, 134 (6.9%) had ASD, vs 860 (0.9%) children with unaffected siblings (P < .001). MMR vaccination rates (≥1 dose) were 84% (n = 78,564) at age 2 years and 92% (n = 86,063) at age 5 years for children with unaffected older siblings, vs 73% (n = 1409) at age 2 years and 86% (n = 1660) at age 5 years for children with affected siblings. MMR vaccine receipt was not associated with an increased risk of ASD at any age. For children with older siblings with ASD, at age 2, the adjusted relative risk (RR) of ASD for 1 dose of MMR vaccine vs no vaccine was 0.76 (95% CI, 0.49-1.18; P = .22), and at age 5, the RR of ASD for 2 doses compared with no vaccine was 0.56 (95% CI, 0.31-1.01; P = .052). For children whose older siblings did not have ASD, at age 2, the adjusted RR of ASD for 1 dose was 0.91 (95% CI, 0.67-1.20; P = .50) and at age 5, the RR of ASD for 2 doses was 1.12 (95% CI, 0.78-1.59; P = .55). In this large sample of privately insured children with older siblings, receipt of the MMR vaccine was not associated with increased risk of ASD, regardless of whether older siblings had ASD. These findings indicate no harmful association between MMR vaccine receipt and ASD even among children already at higher risk for ASD.

Monte Carlo simulation and film dosimetry for electron therapy in vicinity of a titanium mesh

PubMed Central

Rostampour, Masoumeh; Roayaei, Mahnaz

2014-01-01

Titanium (Ti) mesh plates are used as a bone replacement in brain tumor surgeries. In the case of radiotherapy, these plates might interfere with the beam path. The purpose of this study is to evaluate the effect of titanium mesh on the dose distribution of electron fields. Simulations were performed using Monte Carlo BEAMnrc and DOSXYZnrc codes for 6 and 10 MeV electron beams. In Monte Carlo simulation, the shape of the titanium mesh was simulated. The simulated titanium mesh was considered as the one which is used in head and neck surgery with a thickness of 0.055 cm. First, by simulation, the percentage depth dose was obtained while the titanium mesh was present, and these values were then compared with the depth dose of homogeneous phantom with no titanium mesh. In the experimental measurements, the values of depth dose with titanium mesh and without titanium mesh in various depths were measured. The experiments were performed using a RW3 phantom with GAFCHROMIC EBT2 film. The results of experimental measurements were compared with values of depth dose obtained by simulation. In Monte Carlo simulation, as well as experimental measurements, for the voxels immediately beyond the titanium mesh, the change of the dose were evaluated. For this purpose the ratio of the dose for the case with titanium to the case without titanium was calculated as a function of titanium depth. For the voxels before the titanium mesh there was always an increase of the dose up to 13% with respect to the same voxel with no titanium mesh. This is because of the increased back scattering effect of the titanium mesh. The results also showed that for the voxel right beyond the titanium mesh, there is an increased or decreased dose to soft tissues, depending on the depth of the titanium mesh. For the regions before the depth of maximum dose, there is an increase of the dose up to 10% compared to the dose of the same depth in homogeneous phantom. Beyond the depth of maximum dose, there was a 16% decrease in dose. For both 6 and 10 MeV, before the titanium mesh, there was always an increase in dose. If titanium mesh is placed in buildup region, it causes an increase of the dose and could lead to overdose of the adjacent tissue, whereas if titanium mesh is placed beyond the buildup region, it would lead to a decrease in dose compared to the homogenous tissue. PACS number: 87.53.Bn PMID:25207397

Experimental Evidence for LENR in a Polarized Pd/D Lattice

NASA Astrophysics Data System (ADS)

Szpak, S.

2005-03-01

Experimental evidence in support of claims that excess enthalpy production in a polarized Pd/D lattice is of a nuclear origin is questioned on various grounds, eg marginal intensity and difficulty in reproducing. Here, evidence is presented that is 100% reproducible and of sufficient intensity to be well outside of experimental errors. In addition to the thermal behavior, the nuclear manifestations include: X-ray emission; tritium production; and, when an operating cell is placed in an external electric field, fusion to create heavier metals such as Ca, Al, Mg, and Zn.

Composite depth dose measurement for total skin electron (TSE) treatments using radiochromic film

NASA Astrophysics Data System (ADS)

Gamble, Lisa M.; Farrell, Thomas J.; Jones, Glenn W.; Hayward, Joseph E.

2003-04-01

Total skin electron (TSE) radiotherapy is routinely used to treat cutaneous T-cell lymphomas and can be implemented using a modified Stanford technique. In our centre, the composite depth dose for this technique is achieved by a combination of two patient positions per day over a three-day cycle, and two gantry angles per patient position. Due to patient morphology, underdosed regions typically occur and have historically been measured using multiple thermoluminescent dosimeters (TLDs). We show that radiochromic film can be used as a two-dimensional relative dosimeter to measure the percent depth dose in TSE radiotherapy. Composite depth dose curves were measured in a cylindrical, polystyrene phantom and compared with TLD data. Both multiple films (1 film per day) and a single film were used in order to reproduce a realistic clinical scenario. First, three individual films were used to measure the depth dose, one per treatment day, and then compared with TLD data; this comparison showed a reasonable agreement. Secondly, a single film was used to measure the dose delivered over three daily treatments and then compared with TLD data; this comparison showed good agreement throughout the depth dose, which includes doses well below 1 Gy. It will be shown that one piece of radiochromic film is sufficient to measure the composite percent depth dose for a TSE beam, hence making radiochromic film a suitable candidate for monitoring underdosed patient regions.

Composite depth dose measurement for total skin electron (TSE) treatments using radiochromic film.

PubMed

Gamble, Lisa M; Farrell, Thomas J; Jones, Glenn W; Hayward, Joseph E

2003-04-07

Total skin electron (TSE) radiotherapy is routinely used to treat cutaneous T-cell lymphomas and can be implemented using a modified Stanford technique. In our centre, the composite depth dose for this technique is achieved by a combination of two patient positions per day over a three-day cycle, and two gantry angles per patient position. Due to patient morphology, underdosed regions typically occur and have historically been measured using multiple thermoluminescent dosimeters (TLDs). We show that radiochromic film can be used as a two-dimensional relative dosimeter to measure the percent depth dose in TSE radiotherapy. Composite depth dose curves were measured in a cylindrical, polystyrene phantom and compared with TLD data. Both multiple films (1 film per day) and a single film were used in order to reproduce a realistic clinical scenario. First, three individual films were used to measure the depth dose, one per treatment day, and then compared with TLD data; this comparison showed a reasonable agreement. Secondly, a single film was used to measure the dose delivered over three daily treatments and then compared with TLD data; this comparison showed good agreement throughout the depth dose, which includes doses well below 1 Gy. It will be shown that one piece of radiochromic film is sufficient to measure the composite percent depth dose for a TSE beam, hence making radiochromic film a suitable candidate for monitoring underdosed patient regions.

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

Xu, Z; Baker, J; Hsia, A

Purpose: The commercially available Leipzig-style Cone for High Dose Rate (HDR) Brachytherapy has a steep depth dose curve and a non-uniform dose distribution. This work shows the performance of a Ring Surface Applicator created using a 3D printer that can generate a better dose distribution. Calculated doses were verified with film measurement. Methods: The water equivalent red-ABS plastic was used to print the Ring Surface Applicator which hosts three catheters: a center piece with a straight catheter and two concentric rings with diameters of 3.5 and 5.5 cm. Gafchromic EBT2 film, Epson Expression 10000 flatbed scanner, and the online softwaremore » at radiochromic.com were used to analyze the measured data. 10cm×10cm piece of film was sandwiched between two 15×10×5cm3 polystyrene phantoms. The applicator was positioned directly on top of the phantom. Measurement was done using dwell time and positions calculated by Eclipse BrachyVision treatment planning system (RTP). Results: Depth dose curve was generated from the plan and measurement. The results show that the measured and calculated depth dose were in agreement (<3%) from surface to 4mm depth. A discrepancy of 6% was observed at 5 mm depth, where the dose is typically prescribed to. For depths deeper than 5 mm, the measured doses were lower than those calculated by Eclipse BrachyVision. This can be attributed to a combination of simple calculation algorithm using TG-43 and the lack of inhomogeneity correction. Dose profiles at 5 mm depth were also generated from TPS calculation and measured with film. The measured and calculated profiles are similar. Consistent with the depth dose curve, the measured dose is lower than the calculated. Conclusion: Our results showed that the Ring Surface Applicator, printed using 3D printer, can generate more uniform dose distribution within the target volume and can be safely used in the clinic.« less

Multileaf collimator tongue-and-groove effect on depth and off-axis doses: A comparison of treatment planning data with measurements and Monte Carlo calculations

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

Kim, Hee Jung; Department of Biomedical Engineering, Seoul National University, Seoul; Department of Radiation Oncology, Soonchunhyang University Hospital, Seoul

2015-01-01

To investigate how accurately treatment planning systems (TPSs) account for the tongue-and-groove (TG) effect, Monte Carlo (MC) simulations and radiochromic film (RCF) measurements were performed for comparison with TPS results. Two commercial TPSs computed the TG effect for Varian Millennium 120 multileaf collimator (MLC). The TG effect on off-axis dose profile at 3 depths of solid water was estimated as the maximum depth and the full width at half maximum (FWHM) of the dose dip at an interleaf position. When compared with the off-axis dose of open field, the maximum depth of the dose dip for MC and RCF rangedmore » from 10.1% to 20.6%; the maximum depth of the dose dip gradually decreased by up to 8.7% with increasing depths of 1.5 to 10 cm and also by up to 4.1% with increasing off-axis distances of 0 to 13 cm. However, TPS results showed at most a 2.7% decrease for the same depth range and a negligible variation for the same off-axis distances. The FWHM of the dose dip was approximately 0.19 cm for MC and 0.17 cm for RCF, but 0.30 cm for Eclipse TPS and 0.45 cm for Pinnacle TPS. Accordingly, the integrated value of TG dose dip for TPS was larger than that for MC and RCF and almost invariant along the depths and off-axis distances. We concluded that the TG dependence on depth and off-axis doses shown in the MC and RCF results could not be appropriately modeled by the TPS versions in this study.« less

SU-F-T-142: An Analytical Model to Correct the Aperture Scattered Dose in Clinical Proton Beams

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

Sun, B; Liu, S; Zhang, T

2016-06-15

Purpose: Apertures or collimators are used to laterally shape proton beams in double scattering (DS) delivery and to sharpen the penumbra in pencil beam (PB) delivery. However, aperture-scattered dose is not included in the current dose calculations of treatment planning system (TPS). The purpose of this study is to provide a method to correct the aperture-scattered dose based on an analytical model. Methods: A DS beam with a non-divergent aperture was delivered using a single-room proton machine. Dose profiles were measured with an ion-chamber scanning in water and a 2-D ion chamber matrix with solid-water buildup at various depths. Themore » measured doses were considered as the sum of the non-contaminated dose and the aperture-scattered dose. The non-contaminated dose was calculated by TPS and subtracted from the measured dose. Aperture scattered-dose was modeled as a 1D Gaussian distribution. For 2-D fields, to calculate the scatter-dose from all the edges of aperture, a sum of weighted distance was used in the model based on the distance from calculation point to aperture edge. The gamma index was calculated between the measured and calculated dose with and without scatter correction. Results: For a beam with range of 23 cm and aperture size of 20 cm, the contribution of the scatter horn was ∼8% of the total dose at 4 cm depth and diminished to 0 at 15 cm depth. The amplitude of scatter-dose decreased linearly with the depth increase. The 1D gamma index (2%/2 mm) between the calculated and measured profiles increased from 63% to 98% for 4 cm depth and from 83% to 98% at 13 cm depth. The 2D gamma index (2%/2 mm) at 4 cm depth has improved from 78% to 94%. Conclusion: Using the simple analytical method the discrepancy between the measured and calculated dose has significantly improved.« less

SU-E-T-149: Electron Beam Profile Differences Between Elekta MLCi2 and Elekta Agility Treatment Heads

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

Wu, C; Hatcher, C

2014-06-01

Purpose: To report and investigate observed differences in electron beam profiles at various energies/applicators between Elekta MLCi2 and Agility treatment head on Elekta Infinity LINAC Methods: When we upgraded from MLCi2 to Agility on one of our Elekta Infinity LINAC's, electron beam PDDs and profiles were acquired for comparison purpose. All clinical electron energies (6/9/12/15/12/18 MeV) and electron applicators (6/10/14/20/25 square) were included in measurement. PDDs were acquired at 100 SSD in water (PTW MP3 water tank) with a plane-parallel ion chamber (PTW Roos). X and Y Profiles were acquired using IC Profiler (Sun Nuclear Corp.) at 1cm and maximummore » PDD depths (water equivalent). Results: All PDD curves match very well between MLCi2 and Agility treatment head. However, some significant differences on electron profiles were found. On Agility, even after increasing the default auto-tracking offset values for backup diaphragms in Y and MLC in X by 2.8 cm (the maximum allowed change is 3.0 cm), electron profiles still have rounder shoulders comparing to corresponding MLCi2 profiles. This difference is significantly more pronounced at larger applicators (20 and 25 square), for all electron energies. Conclusion: The significant design change between MLCi2 and Agility beam limiting device seems to affect exit electron beam profiles. In IEC1217 X direction, the main change on Agility is the removal of the original MLCi2 X backup diaphragms and replacing it with MLC leaves; In Y direction, the main change is the radius and materials on Y backup diaphragms.« less

Depth dose measurements with the Liulin-5 experiment inside the spherical phantom of the MATROSHKA-R project onboard the International Space Station

NASA Astrophysics Data System (ADS)

Semkova, J.; Koleva, R.; Maltchev, St.; Bankov, N.; Benghin, V.; Chernykh, I.; Shurshakov, V.; Petrov, V.; Drobyshev, S.; Nikolaev, I.

2012-02-01

The Liulin-5 experiment is a part of the international project MATROSHKA-R on the Russian segment of the ISS, which uses a tissue-equivalent spherical phantom equipped with a set of radiation detectors. The objective of the MATROSHKA-R project is to provide depth dose distribution of the radiation field inside the sphere in order to get more information on the distribution of dose in a human body. Liulin-5 is a charged particle telescope using three silicon detectors. It measures time resolved energy deposition spectra, linear energy transfer (LET) spectra, particle flux, and absorbed doses of electrons, protons and heavy ions, simultaneously at three depths along the radius of the phantom. Measurements during the minimum of the solar activity in cycle 23 show that the average absorbed daily doses at 40 mm depth in the phantom are between 180 μGy/day and 220 μGy/day. The absorbed doses at 165 mm depth in the phantom decrease by a factor of 1.6-1.8 compared to the doses at 40 mm depth due to the self-shielding of the phantom from trapped protons. The average dose equivalent at 40 mm depth is 590 ± 32 μSV/day and the galactic cosmic rays (GCR) contribute at least 70% of the total dose equivalent at that depth. Shown is that due to the South Atlantic Anomaly (SAA) trapped protons asymmetry and the direction of Liulin-5 lowest shielding zone the dose rates on ascending and descending nodes in SAA are different. The data obtained are compared to data from other radiation detectors on ISS.

The impacts of dental filling materials on RapidArc treatment planning and dose delivery: Challenges and solution

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

Mail, Noor; Al-Ghamdi, S.; Saoudi, A.

Purpose: The presence of high-density material in the oral cavity creates dose perturbation in both downstream and upstream directions at the surfaces of dental filling materials (DFM). In this study, the authors have investigated the effect of DFM on head and neck RapidArc treatment plans and delivery. Solutions are proposed to address (1) the issue of downstream dose perturbation, which might cause target under dosage, and (2) to reduce the upstream dose from DFM which may be the primary source of mucositis. In addition, an investigation of the clinical role of a custom-made plastic dental mold/gutter (PDM) in sparing themore » oral mucosa and tongue reaction is outlined.Methods: The influence of the dental filling artifacts on dose distribution was investigated using a geometrically well-defined head and neck intensity modulated radiation therapy (IMRT) verification phantom (PTW, Freiberg, Germany) with DFM inserts called amalgam, which contained 50% mercury, 25% silver, 14% tin, 8% copper, and 3% other trace metals. Three RapidArc plans were generated in the Varian Eclipse System to treat the oral cavity using the same computer tomography (CT) dataset, including (1) a raw CT image, (2) a streaking artifacts region, which was replaced with a mask of 10 HU, and (3) a 2 cm-thick 6000 HU virtual filter [a volume created in treatment planning system to compensate for beam attenuation, where the thickness of this virtual filter is based on the measured percent depth dose (PDD) data and Eclipse calculation]. The dose delivery for the three plans was verified using Gafchromic-EBT2 film measurements. The custom-made PDM technique to reduce backscatter dose was clinically tested on four head and neck cancer patients (T3, N1, M0) with DFM, two patients with PDM and the other two patients without PDM. The thickness calculation of the PDM toward the mucosa and tongue was purely based on the measured upstream dose. Patients’ with oral mucosal reaction was clinically examined initially and weekly during the course of radiotherapy.Results: For a RapidArc treatment technique, the backscatter dose from the DFM insert was measured to be 9.25 ± 2.17 in the IMRT-verification-phantom. The measured backscatter upstream dose from DFM for a single-field was 22% higher than without the DFM, whereas the downstream dose was lower by 14%. The values of homogeneity index for the plans with and without the application of mask were 0.09 and 0.14, respectively. The calculated mean treatment planning volume (PTV) dose differed from the delivered dose by 13% and was reduced to 2% when using the mask and virtual filter together. A grade 3 mucosa reaction was observed in the control group after 22–24 fractions (44–48 Gy). In contrast, no grade 3 mucositis was observed in the patients wearing the PDM after 25–26 fractions (50–52 Gy).Conclusions: The backscatter from the DFM for a single, parallel-opposed fields, and RapidArc treatment technique was found significant. The application of mask in replacing streaking artifacts can be useful in improving dose homogeneity in the PTV. The use of a virtual filter around the teeth during the planning phase reduces the target underdosage issue in the phantom. Furthermore, a reduction in mucositis is observed in the head and neck patients with the use of PDM.« less

SU-F-T-370: A Fast Monte Carlo Dose Engine for Gamma Knife

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

Song, T; Zhou, L; Li, Y

2016-06-15

Purpose: To develop a fast Monte Carlo dose calculation algorithm for Gamma Knife. Methods: To make the simulation more efficient, we implemented the track repeating technique on GPU. We first use EGSnrc to pre-calculate the photon and secondary electron tracks in water from two mono-energy photons of 60Co. The total photon mean free paths for different materials and energies are obtained from NIST. During simulation, each entire photon track was first loaded to shared memory for each block, the incident original photon was then splitted to Nthread sub-photons, each thread transport one sub-photon, the Russian roulette technique was applied formore » scattered and bremsstrahlung photons. The resultant electrons from photon interactions are simulated by repeating the recorded electron tracks. The electron step length is stretched/shrunk proportionally based on the local density and stopping power ratios of the local material. Energy deposition in a voxel is proportional to the fraction of the equivalent step length in that voxel. To evaluate its accuracy, dose deposition in a 300mm*300mm*300mm water phantom is calculated, and compared to EGSnrc results. Results: Both PDD and OAR showed great agreements (within 0.5%) between our dose engine result and the EGSnrc result. It only takes less than 1 min for every simulation, being reduced up to ∼40 times compared to EGSnrc simulations. Conclusion: We have successfully developed a fast Monte Carlo dose engine for Gamma Knife.« less

Proposed changes to the American Psychiatric Association diagnostic criteria for autism spectrum disorder: implications for young children and their families.

PubMed

Grant, Roy; Nozyce, Molly

2013-05-01

The American Psychiatric Association has revised the diagnostic criteria for their DSM-5 manual. Important changes have been made to the diagnosis of the current (DSM-IV) category of Pervasive Developmental Disorders. This category includes Autistic Disorder (autism), Asperger's Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). The DSM-5 deletes Asperger's Disorder and PDD-NOS as diagnostic entities. This change may have unintended consequences, including the possibility that the new diagnostic framework will adversely affect access to developmental interventions under Individuals with Disabilities Education Act (IDEA) programs, Early Intervention (for birth to 2 years olds) and preschool special education (for 3 and 4 years olds). Changing the current diagnosis of PDD-NOS to a "Social Communication Disorder" focused on language pragmatics in the DSM-5 may restrict eligibility for IDEA programs and limit the scope of services for affected children. Young children who meet current criteria for PDD-NOS require more intensive and multi-disciplinary services than would be available with a communication domain diagnosis and possible service authorization limited to speech-language therapy. Intensive behavioral interventions, inclusive group setting placements, and family support services are typically more available for children with an autism spectrum disorder than with diagnoses reflecting speech-language delay. The diagnostic distinction reflective of the higher language and social functioning between Asperger's Disorder and autism is also undermined by eliminating the former as a categorical diagnosis and subsuming it under autism. This change may adversely affect treatment planning and misinform parents about prognosis for children who meet current criteria for Asperger's Disorder.

Sensitivity and specificity of Addenbrooke's Cognitive Examination, Mattis Dementia Rating Scale, Frontal Assessment Battery and Mini Mental State Examination for diagnosing dementia in Parkinson's disease.

PubMed

Kaszás, B; Kovács, N; Balás, I; Kállai, J; Aschermann, Z; Kerekes, Z; Komoly, S; Nagy, F; Janszky, J; Lucza, T; Karádi, K

2012-06-01

Among the non-motor features of Parkinson's disease (PD), cognitive impairment is one of the most troublesome problems. Highly sensitive and specific screening instruments for detecting dementia in PD (PDD) are required in the clinical practice. In our study we evaluated the sensitivity and specificity of different neuropsychological tests (Addenbrooke's Cognitive Examination, ACE; Frontal Assessment Battery, FAB and Mattis Dementia Rating Scale, MDRS) in 73 Parkinson's disease patients without depression. By receiver operating characteristic curve analysis, these screening instruments were tested against the recently established clinical diagnostic criteria of PDD. Best cut-off score for ACE to identify PDD was 80 points (sensitivity = 74.0%, specificity = 78.1%). For FAB the most optimal cut-off value was 12 points (sensitivity = 66.3%, specificity = 72.2%); whereas for MDRS it was 125 points (sensitivity = 89.8%, specificity = 98.3%). Among the examined test batteries, MDRS had the best clinicometric profile for detecting PDD. Although the types of applied screening instruments might differ from movement disorder clinic to clinic within a country, determination of the most specific and sensitive test for the given population remains to be an important task. Our results demonstrated that the specificity and sensitivity of MDRS was better than those of ACE, FAB and MMSE in Hungary. However, further studies with larger sample size and more uniform criteria for participation are required to determine the most suitable screening instrument for cognitive impairment. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effects of a weighted vest on attention to task and self-stimulatory behaviors in preschoolers with pervasive developmental disorders.

PubMed

Fertel-Daly, D; Bedell, G; Hinojosa, J

2001-01-01

This study examined the effectiveness of using a weighted vest for increasing attention to a fine motor task and decreasing self-stimulatory behaviors in preschool children with pervasive developmental disorders (PDD). Using an ABA single-subject design, the duration of attention to task and self-stimulatory behaviors and the number of distractions were measured in five preschool children with PDD over a period of 6 weeks. During the intervention phase, all participants displayed a decrease in the number of distractions and an increase in the duration of focused attention while wearing the weighted vest. All but 1 participant demonstrated a decrease in the duration of self-stimulatory behaviors while wearing a weighted vest; however, the type of self-stimulatory behaviors changed and became less self-abusive for this child while she wore the vest. During the intervention withdrawal phase, 3 participants experienced an increase in the duration of self-stimulatory behaviors, and all participants experienced an increase in the number of distractions and a decrease in the duration of focused attention. The increase or decrease, however, never returned to baseline levels for these behaviors. The findings suggest that for these 5 children with PDD, the use of a weighted vest resulted in an increase in attention to task and decrease in self-stimulatory behaviors. The most consistent improvement observed was the decreased number of distractions. Additional research is necessary to build consensus about the effectiveness of wearing a weighted vest to increase attention to task and decrease self-stimulatory behaviors for children with PDD.

Dopaminergic Therapy Modulates Cortical Perfusion in Parkinson Disease With and Without Dementia According to Arterial Spin Labeled Perfusion Magnetic Resonance Imaging

PubMed Central

Lin, Wei-Che; Chen, Pei-Chin; Huang, Yung-Cheng; Tsai, Nai-Wen; Chen, Hsiu-Ling; Wang, Hung-Chen; Lin, Tsu-Kung; Chou, Kun-Hsien; Chen, Meng-Hsiang; Chen, Yi-Wen; Lu, Cheng-Hsien

2016-01-01

Abstract Arterial spin labeling (ASL) magnetic resonance imaging analyses allow for the quantification of altered cerebral blood flow, and provide a novel means of examining the impact of dopaminergic treatments. The authors examined the cerebral perfusion differences among 17 Parkinson disease (PD) patients, 17 PD with dementia (PDD) patients, and 17 healthy controls and used ASL-MRI to assess the effects of dopaminergic therapies on perfusion in the patients. The authors demonstrated progressive widespread cortical hypoperfusion in PD and PDD and robust effects for the dopaminergic therapies. Specifically, dopaminergic medications further decreased frontal lobe and cerebellum perfusion in the PD and PDD groups, respectively. These patterns of hypoperfusion could be related to cognitive dysfunctions and disease severity. Furthermore, desensitization to dopaminergic therapies in terms of cortical perfusion was found as the disease progressed, supporting the concept that long-term therapies are associated with the therapeutic window narrowing. The highly sensitive pharmaceutical response of ASL allows clinicians and researchers to easily and effectively quantify the absolute perfusion status, which might prove helpful for therapeutic planning. PMID:26844450

Dopaminergic Therapy Modulates Cortical Perfusion in Parkinson Disease With and Without Dementia According to Arterial Spin Labeled Perfusion Magnetic Resonance Imaging.

PubMed

Lin, Wei-Che; Chen, Pei-Chin; Huang, Yung-Cheng; Tsai, Nai-Wen; Chen, Hsiu-Ling; Wang, Hung-Chen; Lin, Tsu-Kung; Chou, Kun-Hsien; Chen, Meng-Hsiang; Chen, Yi-Wen; Lu, Cheng-Hsien

2016-02-01

Arterial spin labeling (ASL) magnetic resonance imaging analyses allow for the quantification of altered cerebral blood flow, and provide a novel means of examining the impact of dopaminergic treatments. The authors examined the cerebral perfusion differences among 17 Parkinson disease (PD) patients, 17 PD with dementia (PDD) patients, and 17 healthy controls and used ASL-MRI to assess the effects of dopaminergic therapies on perfusion in the patients. The authors demonstrated progressive widespread cortical hypoperfusion in PD and PDD and robust effects for the dopaminergic therapies. Specifically, dopaminergic medications further decreased frontal lobe and cerebellum perfusion in the PD and PDD groups, respectively. These patterns of hypoperfusion could be related to cognitive dysfunctions and disease severity. Furthermore, desensitization to dopaminergic therapies in terms of cortical perfusion was found as the disease progressed, supporting the concept that long-term therapies are associated with the therapeutic window narrowing. The highly sensitive pharmaceutical response of ASL allows clinicians and researchers to easily and effectively quantify the absolute perfusion status, which might prove helpful for therapeutic planning.

Autism and Related Disorders

PubMed Central

McPartland, James; Volkmar, Fred R.

2012-01-01

The Pervasive Developmental Disorders are a group of neurodevelopmental disorders that include Autistic Disorder, Asperger’s Disorder, Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS), Childhood Disintegrative Disorder (CDD), and Rett’s Disorder. All feature childhood onset with a constellation of symptoms spanning social interaction and communication and including atypical behavior patterns. The first three disorders (Autistic Disorder, Asperger’s Disorder, and PDD-NOS) are currently referred to as Autism Spectrum Disorders, reflecting divergent phenotypic and etiologic characteristics compared to Rett’s Disorder and CDD. This chapter reviews relevant research and clinical information relevant to appropriate medical diagnosis and treatment. PMID:22608634

Comparison of EGS4 and MCNP Monte Carlo codes when calculating radiotherapy depth doses.

PubMed

Love, P A; Lewis, D G; Al-Affan, I A; Smith, C W

1998-05-01

The Monte Carlo codes EGS4 and MCNP have been compared when calculating radiotherapy depth doses in water. The aims of the work were to study (i) the differences between calculated depth doses in water for a range of monoenergetic photon energies and (ii) the relative efficiency of the two codes for different electron transport energy cut-offs. The depth doses from the two codes agree with each other within the statistical uncertainties of the calculations (1-2%). The relative depth doses also agree with data tabulated in the British Journal of Radiology Supplement 25. A discrepancy in the dose build-up region may by attributed to the different electron transport algorithims used by EGS4 and MCNP. This discrepancy is considerably reduced when the improved electron transport routines are used in the latest (4B) version of MCNP. Timing calculations show that EGS4 is at least 50% faster than MCNP for the geometries used in the simulations.

Purification and characteristics of an inducible by polycyclic aromatic hydrocarbons NADP(+)-dependent naphthalenediol dehydrogenase (NDD) in Mucor circinelloides YR-1.

PubMed

Camacho-Morales, Reyna Lucero; Zazueta-Novoa, Vanesa; Casillas, Juana Lizbeth González; Ballesteros, Elizabeth Aranda; Bote, Juan Antonio Ocampo; Zazueta-Sandoval, Roberto

2014-05-01

We detected NADP(+)-dependent dihydrodiol dehydrogenase (DD) activity in a cell-free extract from Mucor circinelloides YR-1, after high-speed centrifugation. We analyzed the enzymatic activity in the cytosolic fraction by zymograms, as described previously, and eight different DD activity bands were revealed. Five constitutive DD activities (DD1-5) were present when glucose was used as carbon source and three inducible activities (NDD, PDD1 and PDD2) when aromatic hydrocarbon compounds were used. NDD activity was induced all of the aromatic hydrocarbon compounds. The highest DD activity inducer was naphthalene and the lowest was pyrene. One of the enzymes showed higher activity with cis-naphthalene-diol rather than with trans-nahthalenediol as a substrate. We purified this particular enzyme to homogeneity and found that it had an isoelectric point of 4.6. The molecular weight for the native protein was 197.4kDa and 49.03±0.5kDa for the monomer that conforms it, suggesting a homotetrameric structure for the complete enzyme. Polyclonal antibodies were raised against it and obtained. NDD activity was almost totally inhibited when antibodies were used at low concentrations, and in native immunoblots only one band, which corresponds to the activity band detected in the zymograms, could be detected. In denaturing PAGE immunoblots only one band was detected. This band corresponds to the purified protein band of 49kDa detected in SDS-PAGE gels. The other two inducible enzymes PDD1 and PDD2 were present only when phenanthrene was used as sole carbon source in the culture media. Copyright © 2014 Elsevier Inc. All rights reserved.

Motor performance differentiates individuals with Lewy body dementia, Parkinson's and Alzheimer's disease.

PubMed

Fritz, Nora E; Kegelmeyer, Deborah A; Kloos, Anne D; Linder, Shannon; Park, Ariane; Kataki, Maria; Adeli, Anahita; Agrawal, Punit; Scharre, Douglas W; Kostyk, Sandra K

2016-10-01

Differential diagnosis of dementia with Lewy bodies (DLB), Parkinson's disease with dementia (PDD), Parkinson's disease (PD) and Alzheimer's disease (AD) is challenging. Comparative motor profiles of these neurodegenerative disorders may aid in earlier diagnosis but have not been extensively studied. Groups were rigorously matched by age, education, and sex. DLB/PDD participants were matched by Mini-Mental State Examination Score to individuals with AD and by Unified Parkinson's Disease Rating Scale motor scores to individuals with PD. Gait, balance, dual task walking and hand dexterity measures were compared between a combined group (n=21) of individuals with Lewy body dementia (LBD) consisting of those with DLB (n=11) and PDD (n=10) to individuals with PD (n=21) or AD (n=21). Individuals at the same disease stage with LBD walked significantly slower with shorter stride lengths (p<0.05), demonstrated poorer balance on both the Tinetti and Berg Balance Scale, and poorer performance on dual-task and figure-of-eight walking compared to PD and AD (p<0.05 for all) groups. Upper extremity coordination on the 9-hole peg test differentiated LBD from both PD and AD and was the only motor test in which individuals with AD performed worse than those with PD. Tinetti balance subscores were significantly lower in PDD compared to DLB participants (10.4±2.3 versus 12.8±2.3; p=0.027). Motor features distinguish individuals with LBD from those with AD and PD. Measures of gait, balance and finger dexterity provide an additional means of differentiating individuals with LBD from those with AD and PD. Copyright © 2016 Elsevier B.V. All rights reserved.

Rivastigmine: the advantages of dual inhibition of acetylcholinesterase and butyrylcholinesterase and its role in subcortical vascular dementia and Parkinson’s disease dementia

PubMed Central

Kandiah, Nagaendran; Pai, Ming-Chyi; Senanarong, Vorapun; Looi, Irene; Ampil, Encarnita; Park, Kyung Won; Karanam, Ananda Krishna; Christopher, Stephen

2017-01-01

Several studies have demonstrated clinical benefits of sustained cholinesterase inhibition with rivastigmine in Alzheimer’s disease (AD) and Parkinson’s disease dementia (PDD). Unlike donepezil and galantamine that selectively inhibit acetylcholinesterase (AChE; EC 3.1.1.7), rivastigmine is a unique cholinesterase inhibitor with both AChE and butyrylcholinesterase (BuChE; EC 3.1.1.8) inhibitory activity. Rivastigmine is also available as transdermal patch that has been approved by the US Food and Drug Administration for the treatment of mild, moderate, and severe AD as well as mild-to-moderate PDD. In this review, we explore the role of BuChE inhibition in addition to AChE inhibition with rivastigmine in the outcomes of cognition, global function, behavioral symptoms, and activities of daily living. Additionally, we review the evidence supporting the use of dual AChE−BuChE inhibitory activity of rivastigmine as a therapeutic strategy in the treatment of neurological disorders, with a focus on the role of rivastigmine in subcortical dementias such as vascular dementia (VaD) and PDD. Toward this objective, we performed a literature search in PubMed and Ovid with limits to articles published in the English language before June 2016. The available evidence from the literature suggests that the dual inhibition of AChE and BuChE may afford additional therapeutic potential of rivastigmine in subcortical dementias (subcortical VaD and PDD) with benefits on cognition and behavioral symptoms. Rivastigmine was found to specifically benefit executive dysfunction frequently observed in subcortical dementias; however, large randomized clinical studies are warranted to support these observations. PMID:28458525

Rivastigmine: the advantages of dual inhibition of acetylcholinesterase and butyrylcholinesterase and its role in subcortical vascular dementia and Parkinson's disease dementia.

PubMed

Kandiah, Nagaendran; Pai, Ming-Chyi; Senanarong, Vorapun; Looi, Irene; Ampil, Encarnita; Park, Kyung Won; Karanam, Ananda Krishna; Christopher, Stephen

2017-01-01

Several studies have demonstrated clinical benefits of sustained cholinesterase inhibition with rivastigmine in Alzheimer's disease (AD) and Parkinson's disease dementia (PDD). Unlike donepezil and galantamine that selectively inhibit acetylcholinesterase (AChE; EC 3.1.1.7), rivastigmine is a unique cholinesterase inhibitor with both AChE and butyrylcholinesterase (BuChE; EC 3.1.1.8) inhibitory activity. Rivastigmine is also available as transdermal patch that has been approved by the US Food and Drug Administration for the treatment of mild, moderate, and severe AD as well as mild-to-moderate PDD. In this review, we explore the role of BuChE inhibition in addition to AChE inhibition with rivastigmine in the outcomes of cognition, global function, behavioral symptoms, and activities of daily living. Additionally, we review the evidence supporting the use of dual AChE-BuChE inhibitory activity of rivastigmine as a therapeutic strategy in the treatment of neurological disorders, with a focus on the role of rivastigmine in subcortical dementias such as vascular dementia (VaD) and PDD. Toward this objective, we performed a literature search in PubMed and Ovid with limits to articles published in the English language before June 2016. The available evidence from the literature suggests that the dual inhibition of AChE and BuChE may afford additional therapeutic potential of rivastigmine in subcortical dementias (subcortical VaD and PDD) with benefits on cognition and behavioral symptoms. Rivastigmine was found to specifically benefit executive dysfunction frequently observed in subcortical dementias; however, large randomized clinical studies are warranted to support these observations.

Psychiatric disorders in Danish children aged 5-7 years: A general population study of prevalence and risk factors from the Copenhagen Child Cohort (CCC 2000).

PubMed

Elberling, Hanne; Linneberg, Allan; Rask, Charlotte Ulrikka; Houman, Tine; Goodman, Robert; Mette Skovgaard, Anne

2016-01-01

Knowledge about the presentation of psychopathology in preschool age and associated risk factors is fundamental to preventive intervention before schooling. To investigate the full spectrum of psychiatric diagnoses in general population children at the period of transition from preschool to school. A sample of 1585 children from the Copenhagen Child Cohort, CCC2000 aged 5-7 years was assessed using the Development and Well-Being Assessment (DAWBA) with diagnostic classification by experienced clinicians. Perinatal, sociodemographic and socio-economic data was obtained from Danish national registries. The prevalence of any ICD-10 psychiatric disorder was 5.7% (95%CI: 4.4-7.1). Pervasive developmental disorders (PDD) were found in 1.3% (95%CI: 0.8-1.8) and behavioural and hyperkinetic disorders were found in 1.5% (95%CI: 0.9-2.1) and 1.0% (95%CI: 0.4-1.6), respectively. Emotional disorders were found in 2.9% (95%CI: 1.9-40). More boys were diagnosed with PDD, behavioural disorders and tics. No gender differences were found in hyperactivity disorders (HD) and emotional disorders. Co-morbidity was frequent, in particular between HD and PDD, but also between HD and emotional disorder and behavioural disorder. Teenage mothers, single parents and low household income the first two years after the child's birth were associated with a three-to fourfold increased risk of psychiatric disorder in the child at age 5-7 years. The study results point to two "windows of opportunity" for prevention. In the earliest postnatal years, prevention should target families at socio-economic risk; and in the years before schooling, intervention should focus on children with symptoms of PDD, HD, and behavioural disorders.

Electron fluence correction factors for various materials in clinical electron beams.

PubMed

Olivares, M; DeBlois, F; Podgorsak, E B; Seuntjens, J P

2001-08-01

Relative to solid water, electron fluence correction factors at the depth of dose maximum in bone, lung, aluminum, and copper for nominal electron beam energies of 9 MeV and 15 MeV of the Clinac 18 accelerator have been determined experimentally and by Monte Carlo calculation. Thermoluminescent dosimeters were used to measure depth doses in these materials. The measured relative dose at dmax in the various materials versus that of solid water, when irradiated with the same number of monitor units, has been used to calculate the ratio of electron fluence for the various materials to that of solid water. The beams of the Clinac 18 were fully characterized using the EGS4/BEAM system. EGSnrc with the relativistic spin option turned on was used to optimize the primary electron energy at the exit window, and to calculate depth doses in the five phantom materials using the optimized phase-space data. Normalizing all depth doses to the dose maximum in solid water stopping power ratio corrected, measured depth doses and calculated depth doses differ by less than +/- 1% at the depth of dose maximum and by less than 4% elsewhere. Monte Carlo calculated ratios of doses in each material to dose in LiF were used to convert the TLD measurements at the dose maximum into dose at the center of the TLD in the phantom material. Fluence perturbation correction factors for a LiF TLD at the depth of dose maximum deduced from these calculations amount to less than 1% for 0.15 mm thick TLDs in low Z materials and are between 1% and 3% for TLDs in Al and Cu phantoms. Electron fluence ratios of the studied materials relative to solid water vary between 0.83+/-0.01 and 1.55+/-0.02 for materials varying in density from 0.27 g/cm3 (lung) to 8.96 g/cm3 (Cu). The difference in electron fluence ratios derived from measurements and calculations ranges from -1.6% to +0.2% at 9 MeV and from -1.9% to +0.2% at 15 MeV and is not significant at the 1sigma level. Excluding the data for Cu, electron fluence correction factors for open electron beams are approximately proportional to the electron density of the phantom material and only weakly dependent on electron beam energy.

SU-C-304-06: Determination of Intermediate Correction Factors for Three Dosimeters in Small Composite Photon Fields Used in Robotic Radiosurgery

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

Christiansen, E; Belec, J; Vandervoort, E

2015-06-15

Purpose: To calculate using Monte-Carlo the intermediate and total correction factors (CFs) for two microchambers and a plastic scintillator for composite fields delivered by the CyberKnife system. Methods: A linac model was created in BEAMnrc by matching percentage depth dose (PDD) curves and output factors (OFs) measured using an A16 microchamber with Monte Carlo calculations performed in egs-chamber to explicitly model detector response. Intermediate CFs were determined for the A16 and A26 microchambers and the W1 plastic scintillator in fourteen different composite fields inside a solid water phantom. Seven of these fields used a 5 mm diameter collimator; the remainingmore » fields employed a 7.5 mm collimator but were otherwise identical to the first seven. Intermediate CFs are reported relative to the respective CF for a 60 mm collimator (800 mm source to detector distance and 100 mm depth in water). Results: For microchambers in composite fields, the intermediate CFs that account for detector density and volume were the largest contributors to total CFs. The total CFs for the A26 were larger than those for the A16, especially for the 5 mm cone (1.227±0.003 to 1.144±0.004 versus 1.142±0.003 to 1.099±0.004), due to the A26’s larger active volume (0.015 cc) relative to the A16 (0.007 cc), despite the A26 using similar wall and electrode material. The W1 total and intermediate CFs are closer to unity, due to its smaller active volume and near water-equivalent composition, however, 3–4% detector volume corrections are required for 5 mm collimator fields. In fields using the 7.5 mm collimator, the correction is nearly eliminated for the W1 except for a non-isocentric field. Conclusion: Large and variable CFs are required for microchambers in small composite fields primarily due to density and volume effects. Corrections are reduced but not eliminated for a plastic scintillator in the same fields.« less

Limitations of silicon diodes for clinical electron dosimetry.

PubMed

Song, Haijun; Ahmad, Munir; Deng, Jun; Chen, Zhe; Yue, Ning J; Nath, Ravinder

2006-01-01

This work investigates the relevance of several factors affecting the response of silicon diode dosemeters in depth-dose scans of electron beams. These factors are electron energy, instantaneous dose rate, dose per pulse, photon/electron dose ratio and electron scattering angle (directional response). Data from the literature and our own experiments indicate that the impact of these factors may be up to +/-15%. Thus, the different factors would have to cancel out perfectly at all depths in order to produce true depth-dose curves. There are reports of good agreement between depth-doses measured with diodes and ionisation chambers. However, our measurements with a Scantronix electron field detector (EFD) diode and with a plane-parallel ionisation chamber show discrepancies both in the build-up and in the low-dose regions, with a ratio up to 1.4. Moreover, the absolute sensitivity of two diodes of the same EFD model was found to differ by a factor of 3, and this ratio was not constant but changed with depth between 5 and 15% in the low-dose regions of some clinical electron beams. Owing to these inhomogeneities among diodes even of the same model, corrections for each factor would have to be diode-specific and beam-specific. All these corrections would have to be determined using parallel plane chambers, as recommended by AAPM TG-25, which would be unrealistic in clinical practice. Our conclusion is that in general diodes are not reliable in the measurement of depth-dose curves of clinical electron beams.

Validation of Monte Carlo simulation of mammography with TLD measurement and depth dose calculation with a detailed breast model

NASA Astrophysics Data System (ADS)

Wang, Wenjing; Qiu, Rui; Ren, Li; Liu, Huan; Wu, Zhen; Li, Chunyan; Li, Junli

2017-09-01

Mean glandular dose (MGD) is not only determined by the compressed breast thickness (CBT) and the glandular content, but also by the distribution of glandular tissues in breast. Depth dose inside the breast in mammography has been widely concerned as glandular dose decreases rapidly with increasing depth. In this study, an experiment using thermo luminescent dosimeters (TLDs) was carried out to validate Monte Carlo simulations of mammography. Percent depth doses (PDDs) at different depth values were measured inside simple breast phantoms of different thicknesses. The experimental values were well consistent with the values calculated by Geant4. Then a detailed breast model with a CBT of 4 cm and a glandular content of 50%, which has been constructed in previous work, was used to study the effects of the distribution of glandular tissues in breast with Geant4. The breast model was reversed in direction of compression to get a reverse model with a different distribution of glandular tissues. Depth dose distributions and glandular tissue dose conversion coefficients were calculated. It revealed that the conversion coefficients were about 10% larger when the breast model was reversed, for glandular tissues in the reverse model are concentrated in the upper part of the model.

Evaluation of surface and shallow depth dose reductions using a Superflab bolus during conventional and advanced external beam radiotherapy.

PubMed

Yoon, Jihyung; Xie, Yibo; Zhang, Rui

2018-03-01

The purpose of this study was to evaluate a methodology to reduce scatter and leakage radiations to patients' surface and shallow depths during conventional and advanced external beam radiotherapy. Superflab boluses of different thicknesses were placed on top of a stack of solid water phantoms, and the bolus effect on surface and shallow depth doses for both open and intensity-modulated radiotherapy (IMRT) beams was evaluated using thermoluminescent dosimeters and ion chamber measurements. Contralateral breast dose reduction caused by the bolus was evaluated by delivering clinical postmastectomy radiotherapy (PMRT) plans to an anthropomorphic phantom. For the solid water phantom measurements, surface dose reduction caused by the Superflab bolus was achieved only in out-of-field area and on the incident side of the beam, and the dose reduction increased with bolus thickness. The dose reduction caused by the bolus was more significant at closer distances from the beam. Most of the dose reductions occurred in the first 2-cm depth and stopped at 4-cm depth. For clinical PMRT treatment plans, surface dose reductions using a 1-cm Superflab bolus were up to 31% and 62% for volumetric-modulated arc therapy and 4-field IMRT, respectively, but there was no dose reduction for Tomotherapy. A Superflab bolus can be used to reduce surface and shallow depth doses during external beam radiotherapy when it is placed out of the beam and on the incident side of the beam. Although we only validated this dose reduction strategy for PMRT treatments, it is applicable to any external beam radiotherapy and can potentially reduce patients' risk of developing radiation-induced side effects. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Molecular epidemiology of avian bornavirus from pet birds in Japan.

PubMed

Sassa, Yukiko; Horie, Masayuki; Fujino, Kan; Nishiura, Naomi; Okazaki, Sachiko; Furuya, Tetsuya; Nagai, Makoto; Omatsu, Tsutomu; Kojima, Atsushi; Mizugami, Masaya; Ueda, Kengo; Iki, Haruko; Ebisawa, Kazumasa; Tomonaga, Keizo; Mizutani, Tetsuya

2013-08-01

Recently, Avian bornavirus (ABV) was detected in proventricular dilatation disease (PDD) affected-birds and feather picking diseases affected-birds. However, the pathogenicity of ABV has not been thoroughly investigated. In this study, we surveyed ABV in pet birds in Japan. We found four ABV-infected birds among 93 pet birds using RT-PCR, and genotypes of the ABV were determined as ABV-2 and -4. Two of the birds positive for ABV-4 showed proventricular dilatation typically found in PDD, and chronic stomach disturbance, whereas two of the birds positive for ABV-2 showed unexplained behavioral problems that are tapping, autophagia, and cloaca prolapse.

Global Prevalence of Autism and Other Pervasive Developmental Disorders

PubMed Central

Elsabbagh, Mayada; Divan, Gauri; Koh, Yun-Joo; Kim, Young Shin; Kauchali, Shuaib; Marcín, Carlos; Montiel-Nava, Cecilia; Patel, Vikram; Paula, Cristiane S; Wang, Chongying; Yasamy, Mohammad Taghi; Fombonne, Eric

2012-01-01

We provide a systematic review of epidemiological surveys of autistic disorder and pervasive developmental disorders (PDDs) worldwide. A secondary aim was to consider the possible impact of geographic, cultural/ethnic, and socioeconomic factors on prevalence estimates and on clinical presentation of PDD. Based on the evidence reviewed, the median of prevalence estimates of autism spectrum disorders was 62/10 000. While existing estimates are variable, the evidence reviewed does not support differences in PDD prevalence by geographic region nor of a strong impact of ethnic/cultural or socioeconomic factors. However, power to detect such effects is seriously limited in existing data sets, particularly in low-income countries. While it is clear that prevalence estimates have increased over time and these vary in different neighboring and distant regions, these findings most likely represent broadening of the diagnostic concets, diagnostic switching from other developmental disabilities to PDD, service availability, and awareness of autistic spectrum disorders in both the lay and professional public. The lack of evidence from the majority of the world's population suggests a critical need for further research and capacity building in low- and middle-income countries. Autism Res 2012, 5: 160–179. © 2012 International Society for Autism Research, Wiley Periodicals, Inc. PMID:22495912

New frontier in hypericin-mediated diagnosis of cancer with current optical technologies.

PubMed

Olivo, Malini; Fu, Chit Yaw; Raghavan, Vijaya; Lau, Weber Kam On

2012-02-01

Photosensitizers (PSs) have shown great potentials as molecular contrast agents in photodynamic diagnosis (PDD) of cancer. While the diagnostic values of PSs have been proven previously, little efforts have been put into developing optical imaging and diagnostic algorithms. In this article, we review the recent development of optical probes that have been used in conjunction with a potent PS, hypericin (HY). Various fluorescence techniques such as laser confocal microscopy, fluorescence urine cytology, endoscopy and endomicroscopy are covered. We will also discuss about image processing and classification approaches employed for accurate PDD. We anticipate that continual efforts in these developments could lead to an objective PDD and complete surgical clearance of tumors. Recent advancements in nanotechnology have also opened new horizons for PSs. The use of biocompatible gold nanoparticles as carrier for enhanced targeted delivery of HY has been attained. In addition, plasmonic properties of nanoparticles were harnessed to induce localized hyperthermia and to manage the release of PS molecules, enabling a better therapeutic outcome of a combined photodynamic and photothermal therapy. Finally, we discuss how nanoparticles can be used as contrast agents for other optical techniques such as optical coherence tomography and surface-enhanced Raman scattering imaging.

Photodynamic detection in visualisation of cutaneous and oral mucosa premalignant and malignant lesions: two clinical cases

NASA Astrophysics Data System (ADS)

Jurczyszyn, Kamil; Ziólkowski, Piotr; Osiecka, Beata; Gerber, Hanna; Dziedzic, Magdalena

2008-11-01

Photodynamic diagnosis (PDD) is promising method of visualisation of premalignant and malignant lesions. PDD is consisted of two main agents: special chemical compound which is called photosensitizer and light. Photosensitizer has affinity to fast proliferating cells such as pre- or malignant. During light irradiation (with proper wavelength - corresponding to absorption peak of photosensitizer) photosensitizer gains energy and passes into excited singlet state S1. Returning to basic singlet state Sn, leads to fluorescence. Due to difference between concentration of photosensitizer in lesion and normal tissue it is possible to obtain high contrast image of lesion. Case #1: 53 years old woman with basal cell carcinoma (BCC) in nasal region; 20% delta-aminolevulinic acid as a precursor of photosensitizer on eucerin base was used. Case #2: 57 years old woman with multifocal oral leukoplakia on cheek mucosa and tongue; 2% chlorophyll gel as photosesitizer was used. All photographs were taken in white light without any filter and in blue and UV light with orange filter: in both cases the total area of the lesions appeared to be larger than it has been clinically observed. Thus, the PDD might be helpful in evaluation of margins of surgical excision of such lesions.

SU-E-T-804: Verification of the BJR-25 Method of KQ Determination for CyberKnife Absolute Dosimetry

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

Gersh, J; Spectrum Medical Physics, LLC - Greenville, SC; Willett, B

2015-06-15

Purpose: Absolute calibration of the CyberKnife is performed using a 6cm-diameter cone defined at 80cm SAD. Since kQ is defined using PDD values determined using 10×10 cm fields at 100cm SSD, the PDD must be corrected in order to correctly apply the quality conversion factor. The accepted method is based on equivalent field-size conversions of PDD values using BJR25. Using the new InCise MLC system, the CK is capable of generating a rectangular field equivalent to 10×10 cm square field. In this study, a comparison is made between kQ values determined using the traditional BJR25 method and the MLC methodmore » introduced herein. Methods: First, kQ(BJR) is determined: a PDD is acquired using a 6cm circular field at 100cm SSD, its field size converted to an equivalent square, and PDD converted to a 10×10cm field using the appropriate BJR25 table. Maintaining a consistent setup, the collimator is changed, and the MLC method is used. Finally, kQ is determined using PDDs acquired with a 9.71×10.31cm at 100cm SSD. This field is produced by setting the field to a size of 7.77×8.25cm (since it is defined at 80cm SAD). An exact 10×10cm field since field size is relegated to increments of its leaf width (0.25cm). This comparison is made using an Exradin A1SL, IBA CC08, IBA CC13, and an Exradin A19. For each detector and collimator type, the beam injector was adjusted to give 5 different beam qualities; representing a range of clinical systems. Results: Averaging across all beam qualities, kQ(MLC) differed from kQ(BJR) by less than 0.15%. The difference between the values increased with detector volume. Conclusion: For CK users with standard cone collimators, the BJR25 method has been verified. For CK users the MLC system, a technique is described to determine kQ. Primary author is the President/Owner of Spectrum Medical Physics, LLC, a company which maintains contracts with Siemens Healthcare and Standard Imaging, Inc.« less

Heterogeneity in pathways to abstinence among women in treatment for alcohol use disorder.

PubMed

Holzhauer, Cathryn Glanton; Epstein, Elizabeth E; Cohn, Amy M; McCrady, Barbara S; Graff, Fiona S; Cook, Sharon

2017-04-01

Although many providers recommend alcohol abstinence as an initial step in the treatment of alcohol use disorders (AUD), there is a scarcity of research on specific behavioral strategies to achieve this step. The current study examined efficacy of a unique abstinence planning intervention for alcohol in a cognitive behavioral therapy (CBT) outpatient protocol. 128 women enrolled in a randomized controlled trial of CBT for AUD at a university-based clinic comprised the sample. Session 1 manual-guided interventions included an abstinence planning discussion in which each woman chose a specific plan for achieving initial abstinence in collaboration with her therapist. Drinking data were collected via participant logs during the 16week within-treatment period and via Timeline Follow-Back interview at 12month follow-up. For 32.8% (n=42) of women who stopped drinking during the pre-treatment assessment period, their abstinence plan was to maintain abstinence (MA). 18.0% (n=23) of women chose a "cold turkey" approach (CT, abrupt cessation without medical assistance), and 46.1% (n=59) chose a "winding down" approach (WD, systematic reduction of drinking toward a specified quit date). Generalized Estimating Equations (GEE) analyses showed that type of abstinence plan chosen was differentially associated with percent days drinking (PDD) in later treatment (weeks 7-16) (p<0.01) and during 12month follow-up (p<0.01). Women in the WD group had the highest PDD for both time frames and women in the CT group drank more frequently during later treatment compared to those in the MA group. The association between plan and PDD during follow-up was moderated by early treatment PDD (weeks 1-7; p<0.01), such that women in the MA and WD groups had lower follow-up PDD if they were able to decrease their drinking during early treatment. Women who were maintaining abstinence at treatment entry or had planned to stop using alcohol abruptly (i.e., "cold turkey") after starting treatment had better overall drinking outcomes than those who chose to wind down. A plan to wind-down drinking appeared to be the most appealing option to women in the study and, among those who were able to successfully execute this winding down approach, was related to positive long-term drinking outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Investigation of Kodak extended dose range (EDR) film for megavoltage photon beam dosimetry.

PubMed

Chetty, Indrin J; Charland, Paule M

2002-10-21

We have investigated the dependence of the measured optical density on the incident beam energy, field size and depth for a new type of film, Kodak extended dose range (Kodak EDR). Film measurements have been conducted over a range of field sizes (3 x 3 cm2 to 25 x 25 cm2) and depths (d(max) to 15 cm), for 6 MV and 15 MV photons within a solid water phantom, and the variation in sensitometric response (net optical density versus dose) has been reported. Kodak EDR film is found to have a linear response with dose, from 0 to 350 cGy, which is much higher than that typically seen for Kodak XV film (0-50 cGy). The variation in sensitometric response for Kodak EDR film as a function of field size and depth is observed to be similar to that of Kodak XV film; the optical density varied in the order of 2-3% for field sizes of 3 x 3 cm2 and 10 x 10 cm2 at depths of d(max), 5 cm and 15 cm in the phantom. Measurements for a 25 x 25 cm2 field size showed consistently higher optical densities at depths of d(max), 5 cm and 15 cm, relative to a 10 x 10 cm2 field size at 5 cm depth, with 4-5% differences noted at a depth of 15 cm. Fractional depth dose and profiles conducted with Kodak EDR film showed good agreement (2%/2 mm) with ion chamber measurements for all field sizes except for the 25 x 25 cm2 at depths greater than 15 cm, where differences in the order of 3-5% were observed. In addition, Kodak EDR film measurements were found to be consistent with those of Kodak XV film for all fractional depth doses and profiles. The results of this study indicate that Kodak EDR film may be a useful tool for relative dosimetry at higher dose ranges.

Energetic properties' investigation of removing flattening filter at phantom surface: Monte Carlo study using BEAMnrc code, DOSXYZnrc code and BEAMDP code

NASA Astrophysics Data System (ADS)

Bencheikh, Mohamed; Maghnouj, Abdelmajid; Tajmouati, Jaouad

2017-11-01

The Monte Carlo calculation method is considered to be the most accurate method for dose calculation in radiotherapy and beam characterization investigation, in this study, the Varian Clinac 2100 medical linear accelerator with and without flattening filter (FF) was modelled. The objective of this study was to determine flattening filter impact on particles' energy properties at phantom surface in terms of energy fluence, mean energy, and energy fluence distribution. The Monte Carlo codes used in this study were BEAMnrc code for simulating linac head, DOSXYZnrc code for simulating the absorbed dose in a water phantom, and BEAMDP for extracting energy properties. Field size was 10 × 10 cm2, simulated photon beam energy was 6 MV and SSD was 100 cm. The Monte Carlo geometry was validated by a gamma index acceptance rate of 99% in PDD and 98% in dose profiles, gamma criteria was 3% for dose difference and 3mm for distance to agreement. In without-FF, the energetic properties was as following: electron contribution was increased by more than 300% in energy fluence, almost 14% in mean energy and 1900% in energy fluence distribution, however, photon contribution was increased 50% in energy fluence, and almost 18% in mean energy and almost 35% in energy fluence distribution. The removing flattening filter promotes the increasing of electron contamination energy versus photon energy; our study can contribute in the evolution of removing flattening filter configuration in future linac.

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

Xu, H; Guerrero, M; Chen, S

Purpose: The TG-71 report was published in 2014 to present standardized methodologies for MU calculations and determination of dosimetric quantities. This work explores the clinical implementation of a TG71-based electron MU calculation algorithm and compares it with a recently released commercial secondary calculation program–Mobius3D (Mobius Medical System, LP). Methods: TG-71 electron dosimetry data were acquired, and MU calculations were performed based on the recently published TG-71 report. The formalism in the report for extended SSD using air-gap corrections was used. The dosimetric quantities, such PDD, output factor, and f-air factors were incorporated into an organized databook that facilitates data accessmore » and subsequent computation. The Mobius3D program utilizes a pencil beam redefinition algorithm. To verify the accuracy of calculations, five customized rectangular cutouts of different sizes–6×12, 4×12, 6×8, 4×8, 3×6 cm{sup 2}–were made. Calculations were compared to each other and to point dose measurements for electron beams of energy 6, 9, 12, 16, 20 MeV. Each calculation / measurement point was at the depth of maximum dose for each cutout in a 10×10 cm{sup 2} or 15×15cm{sup 2} applicator with SSDs 100cm and 110cm. Validation measurements were made with a CC04 ion chamber in a solid water phantom for electron beams of energy 9 and 16 MeV. Results: Differences between the TG-71 and the commercial system relative to measurements were within 3% for most combinations of electron energy, cutout size, and SSD. A 5.6% difference between the two calculation methods was found only for the 6MeV electron beam with 3×6 cm{sup 2}cutout in the 10×10{sup 2}cm applicator at 110cm SSD. Both the TG-71 and the commercial calculations show good consistency with chamber measurements: for 5 cutouts, <1% difference for 100cm SSD, and 0.5–2.7% for 110cm SSD. Conclusions: Based on comparisons with measurements, a TG71-based computation method and a Mobius3D program produce reasonably accurate MU calculations for electron-beam therapy.« less

Concept of proton radiography using energy resolved dose measurement.

PubMed

Bentefour, El H; Schnuerer, Roland; Lu, Hsiao-Ming

2016-08-21

Energy resolved dosimetry offers a potential path to single detector based proton imaging using scanned proton beams. This is because energy resolved dose functions encrypt the radiological depth at which the measurements are made. When a set of predetermined proton beams 'proton imaging field' are used to deliver a well determined dose distribution in a specific volume, then, at any given depth x of this volume, the behavior of the dose against the energies of the proton imaging field is unique and characterizes the depth x. This concept applies directly to proton therapy scanning delivery methods (pencil beam scanning and uniform scanning) and it can be extended to the proton therapy passive delivery methods (single and double scattering) if the delivery of the irradiation is time-controlled with a known time-energy relationship. To derive the water equivalent path length (WEPL) from the energy resolved dose measurement, one may proceed in two different ways. A first method is by matching the measured energy resolved dose function to a pre-established calibration database of the behavior of the energy resolved dose in water, measured over the entire range of radiological depths with at least 1 mm spatial resolution. This calibration database can also be made specific to the patient if computed using the patient x-CT data. A second method to determine the WEPL is by using the empirical relationships between the WEPL and the integral dose or the depth at 80% of the proximal fall off of the energy resolved dose functions in water. In this note, we establish the evidence of the fundamental relationship between the energy resolved dose and the WEPL at the depth of the measurement. Then, we illustrate this relationship with experimental data and discuss its imaging dynamic range for 230 MeV protons.

Quantifying the effect of air gap, depth, and range shifter thickness on TPS dosimetric accuracy in superficial PBS proton therapy.

PubMed

Shirey, Robert J; Wu, Hsinshun Terry

2018-01-01

This study quantifies the dosimetric accuracy of a commercial treatment planning system as functions of treatment depth, air gap, and range shifter thickness for superficial pencil beam scanning proton therapy treatments. The RayStation 6 pencil beam and Monte Carlo dose engines were each used to calculate the dose distributions for a single treatment plan with varying range shifter air gaps. Central axis dose values extracted from each of the calculated plans were compared to dose values measured with a calibrated PTW Markus chamber at various depths in RW3 solid water. Dose was measured at 12 depths, ranging from the surface to 5 cm, for each of the 18 different air gaps, which ranged from 0.5 to 28 cm. TPS dosimetric accuracy, defined as the ratio of calculated dose relative to the measured dose, was plotted as functions of depth and air gap for the pencil beam and Monte Carlo dose algorithms. The accuracy of the TPS pencil beam dose algorithm was found to be clinically unacceptable at depths shallower than 3 cm with air gaps wider than 10 cm, and increased range shifter thickness only added to the dosimetric inaccuracy of the pencil beam algorithm. Each configuration calculated with Monte Carlo was determined to be clinically acceptable. Further comparisons of the Monte Carlo dose algorithm to the measured spread-out Bragg Peaks of multiple fields used during machine commissioning verified the dosimetric accuracy of Monte Carlo in a variety of beam energies and field sizes. Discrepancies between measured and TPS calculated dose values can mainly be attributed to the ability (or lack thereof) of the TPS pencil beam dose algorithm to properly model secondary proton scatter generated in the range shifter. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Monte Carlo study of si diode response in electron beams.

PubMed

Wang, Lilie L W; Rogers, David W O

2007-05-01

Silicon semiconductor diodes measure almost the same depth-dose distributions in both photon and electron beams as those measured by ion chambers. A recent study in ion chamber dosimetry has suggested that the wall correction factor for a parallel-plate ion chamber in electron beams changes with depth by as much as 6%. To investigate diode detector response with respect to depth, a silicon diode model is constructed and the water/silicon dose ratio at various depths in electron beams is calculated using EGSnrc. The results indicate that, for this particular diode model, the diode response per unit water dose (or water/diode dose ratio) in both 6 and 18 MeV electron beams is flat within 2% versus depth, from near the phantom surface to the depth of R50 (with calculation uncertainty <0.3%). This suggests that there must be some other correction factors for ion chambers that counter-balance the large wall correction factor at depth in electron beams. In addition, the beam quality and field-size dependence of the diode model are also calculated. The results show that the water/diode dose ratio remains constant within 2% over the electron energy range from 6 to 18 MeV. The water/diode dose ratio does not depend on field size as long as the incident electron beam is broad and the electron energy is high. However, for a very small beam size (1 X 1 cm(2)) and low electron energy (6 MeV), the water/diode dose ratio may decrease by more than 2% compared to that of a broad beam.

SU-E-T-439: An Improved Formula of Scatter-To-Primary Ratio for Photon Dose Calculation

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

Zhu, T

2014-06-01

Purpose: Scatter-to-primary ratio (SPR) is an important dosimetric quantity that describes the contribution from the scatter photons in an external photon beam. The purpose of this study is to develop an improved analytical formula to describe SPR as a function of circular field size (r) and depth (d) using Monte Carlo (MC) simulation. Methods: MC simulation was performed for Mohan photon spectra (Co-60, 4, 6, 10, 15, 23 MV) using EGSNRC code. Point-spread scatter dose kernels in water are generated. The scatter-to-primary ratio (SPR) is also calculated using MC simulation as a function of field size for circular field sizemore » with radius r and depth d. The doses from forward scatter and backscatter photons are calculated using a convolution of the point-spread scatter dose kernel and by accounting for scatter photons contributing to dose before (z'd) reaching the depth of interest, d, where z' is the location of scatter photons, respectively. The depth dependence of the ratio of the forward scatter and backscatter doses is determined as a function of depth and field size. Results: We are able to improve the existing 3-parameter (a, w, d0) empirical formula for SPR by introducing depth dependence for one of the parameter d0, which becomes 0 for deeper depths. The depth dependence of d0 can be directly calculated as a ratio of backscatter-to-forward scatter doses for otherwise the same field and depth. With the improved empirical formula, we can fit SPR for all megavoltage photon beams to within 2%. Existing 3-parameter formula cannot fit SPR data for Co-60 to better than 3.1%. Conclusion: An improved empirical formula is developed to fit SPR for all megavoltage photon energies to within 2%.« less

Protoporphyrin IX fluorescence for enhanced photodynamic diagnosis and photodynamic therapy in murine models of skin and breast cancer

NASA Astrophysics Data System (ADS)

Rollakanti, Kishore Reddy

Protoporphyrin IX (PpIX) is a photosensitizing agent derived from aminolevulinic acid. PpIX accumulates specifically within target cancer cells, where it fluoresces and produces cytotoxic reactive oxygen species. Our aims were to employ PpIX fluorescence to detect squamous cell carcinoma (SCC) of the skin (Photodynamic diagnosis, PDD), and to improve treatment efficacy (Photodynamic therapy, PDT) for basal cell carcinoma (BCC) and cutaneous breast cancer. Hyperspectral imaging and a spectrometer based dosimeter system were used to detect very early SCC in UVB-irradiated murine skin, using PpIX fluorescence. Regarding PDT, we showed that low non-toxic doses of vitamin D, given before ALA application, increase tumor specific PpIX accumulation and sensitize BCC and breast cancer cells to ALA-PDT. These optical imaging methods and the combination therapy regimen (vitamin D and ALA-PDT) are promising tools for effective management of skin and breast cancer.

Optimal sensitometric curves of Kodak EDR2 film for dynamic intensity modulated radiation therapy verification

PubMed Central

Suriyapee, S; Pitaxtarnin, N; Oonsiri, S; Jumpangern, C; Israngkul Na Ayuthaya, I

2008-01-01

Purpose: To investigate the optimal sensitometric curves of extended dose range (EDR2) radiographic film in terms of depth, field size, dose range and processing conditions for dynamic intensity modulated radiation therapy (IMRT) dosimetry verification with 6 MV X-ray beams. Materials and methods: A Varian Clinac 23 EX linear accelerator with 6 MV X-ray beam was used to study the response of Kodak EDR2 film. Measurements were performed at depths of 5, 10 and 15 cm in MedTec virtual water phantom and with field sizes of 2x2, 3x3, 10x10 and 15x15 cm2. Doses ranging from 20 to 450 cGy were used. The film was developed with the Kodak RP X-OMAT Model M6B automatic film processor. Film response was measured with the Vidar model VXR-16 scanner. Sensitometric curves were applied to the dose profiles measured with film at 5 cm in the virtual water phantom with field sizes of 2x2 and 10x10 cm2 and compared with ion chamber data. Scanditronix/Wellhofer OmniProTM IMRT software was used for the evaluation of the IMRT plan calculated by Eclipse treatment planning. Results: Investigation of the reproducibility and accuracy of the film responses, which depend mainly on the film processor, was carried out by irradiating one film nine times with doses of 20 to 450 cGy. A maximum standard deviation of 4.9% was found which decreased to 1.9% for doses between 20 and 200 cGy. The sensitometric curves for various field sizes at fixed depth showed a maximum difference of 4.2% between 2x2 and 15x15 cm2 at 5 cm depth with a dose of 450 cGy. The shallow depth tended to show a greater effect of field size responses than the deeper depths. The sensitometric curves for various depths at fixed field size showed slightly different film responses; the difference due to depth was within 1.8% for all field sizes studied. Both field size and depth effect were reduced when the doses were lower than 450 cGy. The difference was within 2.5% in the dose range from 20 to 300 cGy for all field sizes and depths studied. Dose profiles measured with EDR2 film were consistent with those measured with an ion chamber. The optimal sensitometric curve was acquired by irradiating film at a depth of 5 cm with doses ranging from 20 to 450 cGy with a 3×3 cm2 multileaf collimator. The optimal sensitometric curve allowed accurate determination of the absolute dose distribution. In almost 200 cases of dynamic IMRT plan verification with EDR2 film, the difference between measured and calculated dose was generally less than 3% and with 3 mm distance to agreement when using gamma value verification. Conclusion: EDR2 film can be used for accurate verification of composite isodose distributions of dynamic IMRT when the optimal sensitometric curve has been established. PMID:21614315

Optimal sensitometric curves of Kodak EDR2 film for dynamic intensity modulated radiation therapy verification.

PubMed

Suriyapee, S; Pitaxtarnin, N; Oonsiri, S; Jumpangern, C; Israngkul Na Ayuthaya, I

2008-01-01

To investigate the optimal sensitometric curves of extended dose range (EDR2) radiographic film in terms of depth, field size, dose range and processing conditions for dynamic intensity modulated radiation therapy (IMRT) dosimetry verification with 6 MV X-ray beams. A Varian Clinac 23 EX linear accelerator with 6 MV X-ray beam was used to study the response of Kodak EDR2 film. Measurements were performed at depths of 5, 10 and 15 cm in MedTec virtual water phantom and with field sizes of 2x2, 3x3, 10x10 and 15x15 cm(2). Doses ranging from 20 to 450 cGy were used. The film was developed with the Kodak RP X-OMAT Model M6B automatic film processor. Film response was measured with the Vidar model VXR-16 scanner. Sensitometric curves were applied to the dose profiles measured with film at 5 cm in the virtual water phantom with field sizes of 2x2 and 10x10 cm(2) and compared with ion chamber data. Scanditronix/Wellhofer OmniPro(TM) IMRT software was used for the evaluation of the IMRT plan calculated by Eclipse treatment planning. Investigation of the reproducibility and accuracy of the film responses, which depend mainly on the film processor, was carried out by irradiating one film nine times with doses of 20 to 450 cGy. A maximum standard deviation of 4.9% was found which decreased to 1.9% for doses between 20 and 200 cGy. The sensitometric curves for various field sizes at fixed depth showed a maximum difference of 4.2% between 2x2 and 15x15 cm(2) at 5 cm depth with a dose of 450 cGy. The shallow depth tended to show a greater effect of field size responses than the deeper depths. The sensitometric curves for various depths at fixed field size showed slightly different film responses; the difference due to depth was within 1.8% for all field sizes studied. Both field size and depth effect were reduced when the doses were lower than 450 cGy. The difference was within 2.5% in the dose range from 20 to 300 cGy for all field sizes and depths studied. Dose profiles measured with EDR2 film were consistent with those measured with an ion chamber. The optimal sensitometric curve was acquired by irradiating film at a depth of 5 cm with doses ranging from 20 to 450 cGy with a 3×3 cm(2) multileaf collimator. The optimal sensitometric curve allowed accurate determination of the absolute dose distribution. In almost 200 cases of dynamic IMRT plan verification with EDR2 film, the difference between measured and calculated dose was generally less than 3% and with 3 mm distance to agreement when using gamma value verification. EDR2 film can be used for accurate verification of composite isodose distributions of dynamic IMRT when the optimal sensitometric curve has been established.

Global optical lightning flash rates determined with the Forte satellite

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

Light, T.; Davis, S. M.; Boeck, W. L.

2003-01-01

Using FORTE photodiode detector (PDD) observations of lightning, we have determined the geographic distribution of nighttime flash rate density. We estimate the PDD flash detection efficiency to be 62% for total lightning through comparison to lightning observations by the TRMM satellite's Lightning Imaging Sensor (LIS), using cases in which FORTE and TRMM viewed the same storm. We present here both seasonal and l,ot,al flash rate maps. We examine some characteristics of the optical emissions of lightning in both high and low flash rate environments, and find that while lightning occurs less frequently over ocean, oceanic lightning flashes are somewhat moremore » powerful, on average, than those over land.« less

Can autism be diagnosed accurately in children under 3 years?

PubMed

Stone, W L; Lee, E B; Ashford, L; Brissie, J; Hepburn, S L; Coonrod, E E; Weiss, B H

1999-02-01

This study investigated the reliability and stability of an autism diagnosis in children under 3 years of age who received independent diagnostic evaluations from two clinicians during two consecutive yearly evaluations. Strong evidence for the reliability and stability of the diagnosis was obtained. Diagnostic agreement between clinicians was higher for the broader discrimination of autism spectrum vs. no autism spectrum than for the more specific discrimination of autism vs. PDD-NOS. The diagnosis of autism at age 2 was more stable than the diagnosis of PDD-NOS at the same age. Social deficits and delays in spoken language were the most prominent DSM-IV characteristics evidenced by very young children with autism.

Otitis and autism spectrum disorders

PubMed Central

Tajima-Pozo, Kazuhiro; Zambrano-Enriquez, Diana; De Anta, Laura; Zelmanova, Julie; De Dios Vega, Jose Luis; Lopez-Ibor, Juan Jose

2010-01-01

The case of a 5-year-old child diagnosed as having pervasive developmental disorder (PDD), autistic type, from age 1 is reported. After surgery of vegetation in middle ear for repetitive otitis, the child presented an improvement in autistic behaviours, previously expressed as impaired social interactions, qualitative abnormalities in communication, a marked delay in language development, echolalia, stereotypies and self-aggressive behaviours. The aim of this paper is to bring attention to occurrences of misdiagnosis of PDD, which can occur when an adequate screening of the autistic syndrome is not realised. The result of the surgery was an improvement in autistic behaviours, despite the persistence of less severe autistic traits that may be more closely related to Asperger’s syndrome. PMID:22736729

Monte Carlo simulation of depth-dose distributions in TLD-100 under 90Sr-90Y irradiation.

PubMed

Rodríguez-Villafuerte, M; Gamboa-deBuen, I; Brandan, M E

1997-04-01

In this work the depth-dose distribution in TLD-100 dosimeters under beta irradiation from a 90Sr-90Y source was investigated using the Monte Carlo method. Comparisons between the simulated data and experimental results showed that the depth-dose distribution is strongly affected by the different components of both the source and dosimeter holders due to the large number of electron scattering events.

Polynomial expressions of electron depth dose as a function of energy in various materials: application to thermoluminescence (TL) dosimetry

NASA Astrophysics Data System (ADS)

Deogracias, E. C.; Wood, J. L.; Wagner, E. C.; Kearfott, K. J.

1999-02-01

The CEPXS/ONEDANT code package was used to produce a library of depth-dose profiles for monoenergetic electrons in various materials for energies ranging from 500 keV to 5 MeV in 10 keV increments. The various materials for which depth-dose functions were derived include: lithium fluoride (LiF), aluminum oxide (Al 2O 3), beryllium oxide (BeO), calcium sulfate (CaSO 4), calcium fluoride (CaF 2), lithium boron oxide (LiBO), soft tissue, lens of the eye, adiopose, muscle, skin, glass and water. All materials data sets were fit to five polynomials, each covering a different range of electron energies, using a least squares method. The resultant three dimensional, fifth-order polynomials give the dose as a function of depth and energy for the monoenergetic electrons in each material. The polynomials can be used to describe an energy spectrum by summing the doses at a given depth for each energy, weighted by the spectral intensity for that energy. An application of the polynomial is demonstrated by explaining the energy dependence of thermoluminescent detectors (TLDs) and illustrating the relationship between TLD signal and actual shallow dose due to beta particles.

SU-E-T-145: Effects of Temporary Tachytherapy Inhibition Magnet On MOSFET Dose Measurements of Cardiovascular Implantable Electronic Devices (CIED) in Radiation Therapy Patients

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

P, Joshi; Salomons, G; Kerr, A

2014-06-01

Purpose: To determine the effects of temporary tachytherapy inhibition magnet on MOSFET dose measurements of cardiovascular implantable electronic devices (CIED) in radiation therapy patients. Methods: Infield and peripheral MOSFET dose measurements with 6MV photon beams were performed to evaluate dose to a CIED in the presence of a doughnut shaped temporary tachytherapy inhibition magnet. Infield measurements were done to quantify the effects of the magnetic field alone and shielding by the magnet. MOSFETs were placed inside a 20×20cm{sup 2} field at a depth of 3cm in the isocentre plane in the presence and absence of the magnet. Peripheral dose measurementsmore » were done to determine the impact of the magnet on dose to the CIED in a clinical setting. These measurements were performed at the centre, under the rim and half way between a 10×10cm{sup 2} field edge and the magnet with MOSFETS placed at the surface, 0.5cm and 1cm depths in the presence and absence of the magnet. Results: Infield measurements showed that effects of magnetic field on the MOSFET readings were within the 2% MOSFET dose measurement uncertainty; a 20% attenuation of dose under the magnet rim was observed. Peripheral dose measurements at the centre of the magnet show an 8% increase in surface dose and a 6% decrease in dose at 1cm depth. Dose under the magnet rim was reduced by approximately 68%, 45% and 25% for MOSFET placed at 0.0, 0.5 and 1.0cm bolus depths, respectively. Conclusions: The magnetic field has an insignificant effect on MOSFET dose measurements. Dose to the central region of CIED represented by centre of the magnet doughnut increases at the surface, and decreases at depths due to low energy scattering contributions from the magnet. Dose under the magnet rim, representing CIED edges, decreased significantly due to shielding.« less

Episodic Memory in Alzheimer Disease, Frontotemporal Dementia, and Dementia With Lewy Bodies/Parkinson Disease Dementia: Disentangling Retrieval From Consolidation.

PubMed

Economou, Alexandra; Routsis, Christopher; Papageorgiou, Sokratis G

2016-01-01

Differences in episodic memory performance in patients with Alzheimer disease (AD), frontotemporal dementia (FTD), dementia with Lewy bodies (DLB)/Parkinson disease with dementia (PDD) are inconsistent and task dependent. The inconsistencies may be attributed to the different tasks drawing on different memory processes. Few studies have examined episodic memory impairment in the above groups using memory tests that facilitate encoding, to distinguish memory deficits due to impairment of specific processes. We examined the memory performance of 106 AD patients, 51 FTD patients, 26 DLB/PDD patients, and 37 controls using the Five-Words Test, a 5-item memory test that facilitates encoding. The patient groups did not differ in modified Mini Mental State Examination scores. AD patients scored lowest on the Five-Words Test overall, and showed the greatest reduction from immediate total recall to delayed free recall relative to the other 2 groups, consistent with a predominantly consolidation deficit. DLB/PDD patients showed the largest improvement from delayed free to delayed total recall relative to the other 2 groups, consistent with a predominantly retrieval deficit. Deficits in both consolidation and retrieval underlie the memory impairment of the patients, to different extents, and contribute to the theoretical understanding of the nature of the memory impairment of the patient groups.

Graph theory network function in Parkinson's disease assessed with electroencephalography.

PubMed

Utianski, Rene L; Caviness, John N; van Straaten, Elisabeth C W; Beach, Thomas G; Dugger, Brittany N; Shill, Holly A; Driver-Dunckley, Erika D; Sabbagh, Marwan N; Mehta, Shyamal; Adler, Charles H; Hentz, Joseph G

2016-05-01

To determine what differences exist in graph theory network measures derived from electroencephalography (EEG), between Parkinson's disease (PD) patients who are cognitively normal (PD-CN) and matched healthy controls; and between PD-CN and PD dementia (PD-D). EEG recordings were analyzed via graph theory network analysis to quantify changes in global efficiency and local integration. This included minimal spanning tree analysis. T-tests and correlations were used to assess differences between groups and assess the relationship with cognitive performance. Network measures showed increased local integration across all frequency bands between control and PD-CN; in contrast, decreased local integration occurred in PD-D when compared to PD-CN in the alpha1 frequency band. Differences found in PD-MCI mirrored PD-D. Correlations were found between network measures and assessments of global cognitive performance in PD. Our results reveal distinct patterns of band and network measure type alteration and breakdown for PD, as well as with cognitive decline in PD. These patterns suggest specific ways that interaction between cortical areas becomes abnormal and contributes to PD symptoms at various stages. Graph theory analysis by EEG suggests that network alteration and breakdown are robust attributes of PD cortical dysfunction pathophysiology. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Clinical application of photodynamic medicine technology using light-emitting fluorescence imaging based on a specialized luminous source.

PubMed

Namikawa, Tsutomu; Fujisawa, Kazune; Munekage, Eri; Iwabu, Jun; Uemura, Sunao; Tsujii, Shigehiro; Maeda, Hiromichi; Kitagawa, Hiroyuki; Fukuhara, Hideo; Inoue, Keiji; Sato, Takayuki; Kobayashi, Michiya; Hanazaki, Kazuhiro

2018-04-04

The natural amino acid 5-aminolevulinic acid (ALA) is a protoporphyrin IX (PpIX) precursor and a new-generation photosensitive substance that accumulates specifically in cancer cells. When indocyanine green (ICG) is irradiated with near-infrared (NIR) light, it shifts to a higher energy state and emits infrared light with a longer wavelength than the irradiated NIR light. Photodynamic diagnosis (PDD) using ALA and ICG-based NIR fluorescence imaging has emerged as a new diagnostic technique. Specifically, in laparoscopic examinations for serosa-invading advanced gastric cancer, peritoneal metastases could be detected by ALA-PDD, but not by conventional visible-light imaging. The HyperEye Medical System (HEMS) can visualize ICG fluorescence as color images simultaneously projected with visible light in real time. This ICG fluorescence method is widely applicable, including for intraoperative identification of sentinel lymph nodes, visualization of blood vessels in organ resection, and blood flow evaluation during surgery. Fluorescence navigation by ALA-PDD and NIR using ICG imaging provides good visualization and detection of the target lesions that is not possible with the naked eye. We propose that this technique should be used in fundamental research on the relationship among cellular dynamics, metabolic enzymes, and tumor tissues, and to evaluate clinical efficacy and safety in multicenter cooperative clinical trials.

Quality of life: a key variable to consider in the evaluation of adjustment in parents of children with autism spectrum disorders and in the development of relevant support and assistance programmes.

PubMed

Cappe, Emilie; Wolff, Marion; Bobet, René; Adrien, Jean-Louis

2011-10-01

Our primary objective was to identify cognitive and behavioural profiles that affect adjustment, in order to make relevant recommendations about support and assistance for parents of autistic children. One hundred and sixty French parents completed a battery of questionnaires and self-report measures developed or adapted to assess (1) the child and family situations; (2) perceived stress; (3) perceived social support; (4) perceived control; (5) coping strategies; and (6) quality of life. The psychometric properties of the instruments we used proved to be adequate. Our results support the pre-existing data and our findings may prove to be of interest to clinicians. Our primary finding was that emotion-focused coping strategies seem to be less effective. Parents who employed emotion-focused strategies were more stressed and more disturbed in most parts of their life. They also experienced more guilt and reported more false beliefs about PDD. Our data underscore the need for psychoeducation programmes for parents, focused on handling stress and emotions, modifying false beliefs and solving the daily problems that arise from PDD. We propose a 5-axis intervention model for parents of children with PDD, based on cognitive-behavioural therapies and on a stress management programme.

The phonatory deviation diagram: a novel objective measurement of vocal function.

PubMed

Madazio, Glaucya; Leão, Sylvia; Behlau, Mara

2011-01-01

To identify the discriminative characteristics of the phonatory deviation diagram (PDD) in rough, breathy and tense voices. One hundred and ninety-six samples of normal and dysphonic voices from adults were submitted to perceptual auditory evaluation, focusing on the predominant vocal quality and the degree of deviation. Acoustic analysis was performed with the VoxMetria (CTS Informatica). Significant differences were observed between the dysphonic and normal groups (p < 0.001), and also between the breathy and rough samples (p = 0.044) and the breathy and tense samples (p < 0.001). All normal voices were positioned in the inferior left quadrant, 45% of the rough voices in the inferior right quadrant, 52.6% of the breathy voices in the superior right quadrant and 54.3% of the tense voices in the inferior left quadrant of the PDD. In the inferior left quadrant, 93.8% of voices with no deviation were located and 72.7% of voices with mild deviation; voices with moderate deviation were distributed in the inferior and superior right quadrants, the latter ones containing the most deviant voices and 80% of voices with severe deviation. The PDD was able to discriminate normal from dysphonic voices, and the distribution was related to the type and degree of voice alteration. Copyright © 2011 S. Karger AG, Basel.

Biliary Stenosis and Gastric Outlet Obstruction: Late Complications After Acute Pancreatitis With Pancreatic Duct Disruption.

PubMed

Sugimoto, Motokazu; Sonntag, David P; Flint, Greggory S; Boyce, Cody J; Kirkham, John C; Harris, Tyler J; Carr, Sean M; Nelson, Brent D; Bell, Don A; Barton, Joshua G; Traverso, L William

2018-07-01

Pancreatic duct disruption (PDD) after acute pancreatitis can cause pancreatic collections in the early phase and biliary stenosis (BS) or gastric outlet obstruction (GOO) in the late phase. We aimed to document those late complications after moderate or severe acute pancreatitis. Between September 2010 and August 2014, 141 patients showed pancreatic collections on computed tomography. Percutaneous drainage was primarily performed for patients with signs or symptoms of uncontrolled pancreatic juice leakage. Pancreatic duct disruption was defined as persistent amylase-rich drain fluid or a pancreatic duct cut-off on imaging. Clinical course of the patients who developed BS or GOO was investigated. Among the 141 patients with collections, 33 patients showed PDD in the pancreatic head/neck area. Among them, 9 patients (27%) developed BS 65 days after onset and required stenting for 150 days, and 5 patients (15%) developed GOO 92 days after onset and required gastric decompression and jejunal tube feeding for 147 days (days shown in median). All 33 patients recovered successfully without requiring surgical intervention. Anatomic proximity of the bile duct or duodenum to the site of PDD and severe inflammation seemed to contribute to the late onset of BS or GOO. Conservative management successfully reversed these complications.

Triple tracks in CR-39 as the result of Pd-D Co-deposition: evidence of energetic neutrons.

PubMed

Mosier-Boss, Pamela A; Szpak, Stanislaw; Gordon, Frank E; Forsley, Lawrence P G

2009-01-01

Since the announcement by Fleischmann and Pons that the excess enthalpy generated in the negatively polarized Pd-D-D(2)O system was attributable to nuclear reactions occurring inside the Pd lattice, there have been reports of other manifestations of nuclear activities in this system. In particular, there have been reports of tritium and helium-4 production; emission of energetic particles, gamma or X-rays, and neutrons; as well as the transmutation of elements. In this communication, the results of Pd-D co-deposition experiments conducted with the cathode in close contact with CR-39, a solid-state nuclear etch detector, are reported. Among the solitary tracks due to individual energetic particles, triple tracks are observed. Microscopic examination of the bottom of the triple track pit shows that the three lobes of the track are splitting apart from a center point. The presence of three alpha-particle tracks outgoing from a single point is diagnostic of the (12)C(n,n')3alpha carbon breakup reaction and suggests that DT reactions that produce > or = 9.6 MeV neutrons are occurring inside the Pd lattice. To our knowledge, this is the first report of the production of energetic (> or = 9.6 MeV) neutrons in the Pd-D system.

SU-F-T-53: Treatment Planning with Inhomogeneity Correction for Intraoperative Radiotherapy Using KV X-Ray Beams

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

Chen, Y; Ghaly, M; Souri, S

Purpose: The current standard in dose calculation for intraoperative radiotherapy (IORT) using the ZEISS Intrabeam 50 kV x-ray system is based on depth dose measurements in water and no heterogeneous tissue effect has been taken into account. We propose an algorithm for pre-treatment planning including inhomogeneity correction based on data of depth dose measurements in various tissue phantoms for kV x-rays. Methods: Direct depth dose measurements were made in air, water, inner bone and cortical bone phantoms for the Intrabeam 50 kV x-rays with a needle applicator. The data were modelled by a function of power law combining exponential withmore » different parameters. Those phantom slabs used in the measurements were scanned to obtain CT numbers. The x-ray beam initiated from the source isocenter is ray-traced through tissues. The corresponding doses will be deposited/assigned at different depths. On the boundary of tissue/organ changes, the x-ray beam will be re-traced in new tissue/organ starting at an equivalent depth with the same dose. In principle, a volumetric dose distribution can be generated if enough directional beams are traced. In practice, a several typical rays traced may be adequate in providing estimates of maximum dose to the organ at risk and minimum dose in the target volume. Results: Depth dose measurements and modeling are shown in Figure 1. The dose versus CT number is shown in Figure 2. A computer program has been written for Kypho-IORT planning using those data. A direct measurement through 2 mm solid water, 2 mm inner bone, and 1 mm solid water yields a dose rate of 7.7 Gy/min. Our calculation shows 8.1±0.4 Gy/min, consistent with the measurement within 5%. Conclusion: The proposed method can be used to more accurately calculate the dose by taking into account the heterogeneous effect. The further validation includes comparison with Monte Carlo simulation.« less

Sleep Behaviors and Sleep Quality in Children with Autism Spectrum Disorders

PubMed Central

Souders, Margaret C.; Mason, Thorton B. A.; Valladares, Otto; Bucan, Maja; Levy, Susan E.; Mandell, David S.; Weaver, Terri E.; Pinto-Martin, Jennifer

2009-01-01

Study Objectives: (1) Compare sleep behaviors of children with autism spectrum disorders (ASD) with sleep behaviors of typically developing (TD) children using the Children's Sleep Habits Questionnaire (CSHQ); (2) compare sleep quality—defined as mean activity, sleep latency, number of awakenings, sleep efficiency and total sleep time—of the cohort of children with ASD and TD, as measured by 10 nights of actigraphy; and (3) estimate the prevalence of sleep disturbances in the ASD and TD cohorts. Design: Descriptive cross-sectional study. Setting: The Children's Hospital of Philadelphia. Participants: Randomly selected children from the Regional Autism Center. The ASD cohort of 59 children, aged 4 to 10 years, (26 with autism, 21 with pervasive developmental disorder-not otherwise specified [PDD-NOS], and 12 with Asperger disorder) were compared with 40 TD control subjects. Measurements and Results: The CSHQ, sleep diaries, and 10 nights of actigraphy using the Sadeh algorithm of children with ASD and TD control subjects were compared. CSHQ showed 66.1% of parents of children with ASD (62.5% autism, 76.2% PDD-NOS, 58.3% Asperger disorder) and 45% of parents of the control subjects reported that their children had sleep problems. Actigraphic data showed that 66.7% of children with ASD (75% autism, 52.4% PDD-NOS, 75% Asperger disorder) and 45.9% of the control subjects had disturbed sleep. Conclusions: The prevalence estimate of 45% for mild sleep disturbances in the TD cohort highlights pediatric sleep debt as a public health problem of concern. The prevalence estimate of 66% for moderate sleep disturbances in the ASD cohort underscores the significant sleep problems that the families of these children face. The predominant sleep disorders in the ASD cohort were behavioral insomnia sleep-onset type and insomnia due to PDD. Citation: Souders MC; Mason TBA; Valladares O; Bucan M; Levy SE; Mandell DS; Weaver TE; Pinto-Martin D. Sleep behaviors and sleep quality in children with autism spectrum disorders. SLEEP 2009;32(12):1566-1578. PMID:20041592

Undisclosed conflicts of interest among biomedical textbook authors.

PubMed

Piper, Brian J; Lambert, Drew A; Keefe, Ryan C; Smukler, Phoebe U; Selemon, Nicolas A; Duperry, Zachary R

2018-02-05

Textbooks are a formative resource for health care providers during their education and are also an enduring reference for pathophysiology and treatment. Unlike the primary literature and clinical guidelines, biomedical textbook authors do not typically disclose potential financial conflicts of interest (pCoIs). The objective of this study was to evaluate whether the authors of textbooks used in the training of physicians, pharmacists, and dentists had appreciable undisclosed pCoIs in the form of patents or compensation received from pharmaceutical or biotechnology companies. The most recent editions of six medical textbooks, Harrison's Principles of Internal Medicine ( Har PIM), Katzung and Trevor's Basic and Clinical Pharmacology ( Kat BCP), the American Osteopathic Association's Foundations of Osteopathic Medicine ( AOA FOM), Remington: The Science and Practice of Pharmacy ( Rem SPP), Koda-Kimble and Young's Applied Therapeutics ( KKY AT), and Yagiela's Pharmacology and Therapeutics for Dentistry ( Yag PTD), were selected after consulting biomedical educators for evaluation. Author names (N = 1,152, 29.2% female) were submitted to databases to examine patents (Google Scholar) and compensation (ProPublica's Dollars for Docs [PDD]). Authors were listed as inventors on 677 patents (maximum/author = 23), with three-quarters (74.9%) to Har PIM authors. Females were significantly underrepresented among patent holders. The PDD 2009-2013 database revealed receipt of US$13.2 million, the majority to (83.9%) to Har PIM. The maximum compensation per author was $869,413. The PDD 2014 database identified receipt of $6.8 million, with 50.4% of eligible authors receiving compensation. The maximum compensation received by a single author was $560,021. Cardiovascular authors were most likely to have a PDD entry and neurologic disorders authors were least likely. An appreciable subset of biomedical authors have patents and have received remuneration from medical product companies and this information is not disclosed to readers. These findings indicate that full transparency of financial pCoI should become a standard practice among the authors of biomedical educational materials.

A simple lead dust fall method predicts children's blood lead level: New evidence from Australia.

PubMed

Gulson, Brian; Taylor, Alan

2017-11-01

We have measured dust fall accumulation in petri dishes (PDD) collected 6 monthly from inside residences in Sydney urban area, New South Wales, Australia as part of a 5-year longitudinal study to determine environmental associations, including soil. with blood lead (PbB) levels. The Pb loading in the dishes (n = 706) had geometric means (GM) of 24µg/m 2 /30d, a median value of 22µg/m 2 /30d with a range from 0.2 to 11,390µg/m 2 /30d. Observed geometric mean PbB was 2.4µg/dL at ages 2-3 years. Regression analyses showed a statistically significant relationship between predicted PbB and PDD. The predicted PbB values from dust in our study are consistent with similar analyses from the US in which floor dust was collected by wipes. Predicted PbB values from PDD indicate that an increase in PDD of about 100µg/m 2 /30d would increase PbB by about 1.5µg/dL or a doubling PbB at the low levels currently observed in many countries. Predicted PbB values from soil indicate that a change from 0 to 1000mg Pb/kg results in an increase of 1.7µg/dL in PbB, consistent with earlier investigations. Blood Pb levels can be predicted from dust fall accumulation (and soil) in cases where blood sampling is not always possible, especially in young children. Petri dish loading data could provide an alternative or complementary "action level" at about 100µg Pb/m 2 /30 days, similar to the suggested level of about 110µg Pb/m 2 for surface wipes, for use in monitoring activities such as housing rehabilitation, demolition or soil resuspension. Copyright © 2017 Elsevier Inc. All rights reserved.

Glucose-6-phosphate dehydrogenase deficient variants are associated with reduced susceptibility to malaria in the Brazilian Amazon.

PubMed

Santana, Marli S; Monteiro, Wuelton M; Siqueira, André M; Costa, Mônica F; Sampaio, Vanderson; Lacerda, Marcus V; Alecrim, Maria G

2013-05-01

Glucose-6-phosphate dehydrogenase deficiency (G6PDd) has been shown to protect against malaria infection and severe manifestations in African and Asia, but there is a scarcity of studies in the Americas. This study aimed to study the prevalence of G6PDd and its association with malaria occurrence in the Brazilian Amazon. A cross-sectional study was conducted in the male population to estimate the prevalence of G6PDd and malaria infection. G6PD deficient samples were genotyped to identify the deficient variant. Number of previous malaria episodes and need for blood transfusion during malaria episodes were recorded by applying a standardized questionary. From a sample of 1478 male individuals, 66 were detected as G6PD deficient, resulting in a prevalence of of 4.5% (95% CI = 3.44-5.56%). Fifty six G6PD deficient individuals (3.8%; 95% CI = 2.82-4.77) presented the G6PD A-variant mutation, while 10 individuals (0.7%; 95% CI = 0.42-0.97) severely deficient were genotyped as carriers of the G6PD Mediterranean variant. After adjusting for age, G6PD deficient individuals were less likely to report the occurrence of malaria episodes, and the protective effect was related to the enzyme activity, with carriers of the GG6PD A-variant presenting a 88% reduction (AOR: 0.119; 95% CI = 0.057-0.252; p < 0.001) and carriers of the Meditarrenean variant presenting 99% lower risk (AOR: 0.010; 95% CI = 0.002-0.252; p < 0.001) when compared to non-deficient individuals. On the other hand, G6PD deficient subjects reported higher need of transfusion during malaria episodes (p < 0.001). G6PD enzyme activity was directly related to susceptibility to malaria in the Brazilian Amazon, where P. vivax predominates. Severe G6PDd was associated with considerable higher risk of malaria-related transfusions.

Development of a pharmacovigilance safety monitoring tool for the rollout of single low-dose primaquine and artemether-lumefantrine to treat Plasmodium falciparum infections in Swaziland: a pilot study.

PubMed

Poirot, Eugenie; Soble, Adam; Ntshalintshali, Nyasatu; Mwandemele, Asen; Mkhonta, Nomcebo; Malambe, Calisile; Vilakati, Sibonakaliso; Pan, Sisi; Darteh, Sarah; Maphalala, Gugu; Brown, Joelle; Hwang, Jimee; Pace, Cheryl; Stergachis, Andy; Vittinghoff, Eric; Kunene, Simon; Gosling, Roland

2016-07-22

Countries remain reluctant to adopt the 2012 World Health Organization recommendation for single low-dose (0.25 mg/kg) primaquine (SLD PQ) for Plasmodium falciparum transmission-blocking due to concerns over drug-related haemolysis risk, especially among glucose-6-phosphate dehydrogenase-deficient (G6PDd) people, without evidence demonstrating that it can be safely deployed in their settings. Pharmacovigilance methods provide a systematic way of collecting safety data and supporting the rollout of SLD PQ. The Primaquine Roll Out Monitoring Pharmacovigilance Tool (PROMPT), comprising: (1) a standardized form to support the surveillance of possible adverse events following SLD PQ treatment; (2) a patient information card to enhance awareness of known adverse drug reactions of SLD PQ use; and (3) a database compiling recorded information, was developed and piloted. Data on patient characteristics, malaria diagnosis and treatment are collected. Blood samples are taken to measure haemoglobin (Hb) and test for G6PD deficiency. Active follow-up includes a repeat Hb measurement and adverse event monitoring on or near day 7. A 13-month prospective pilot study in two hospital facilities in Swaziland alongside the introduction of SLD PQ generated preliminary evidence on the feasibility and acceptability of PROMPT. PROMPT was well received by nurses as a simple, pragmatic approach to active surveillance of SLD PQ safety data. Of the 102 patients enrolled and administered SLD PQ, none were G6PDd. 93 (91.2 %) returned on or near day 7 for follow-up. Four (4.6 %) patients had falls in Hb ≥25 % from baseline, none of whom presented with signs or symptoms of anaemia. No patient's Hb fell below 7 g/dL and none required a blood transfusion. Of the 11 (11 %) patients who reported an adverse event over the study period, three were considered serious and included two deaths and one hospitalization; none were causally related to SLD PQ. Four non-serious adverse events were considered definitely, probably, or possibly related to SLD PQ. Improved pharmacovigilance to monitor and promote the safety of the WHO recommendation is needed. The successful application of PROMPT demonstrates its potential as an important tool to rapidly generate locally acquired safety data and support pharmacovigilance in resource-limited settings.

Yokukansan (TJ-54) for treatment of pervasive developmental disorder not otherwise specified and Asperger's disorder: a 12-week prospective, open-label study.

PubMed

Miyaoka, Tsuyoshi; Wake, Rei; Furuya, Motohide; Liaury, Kristian; Ieda, Masa; Kawakami, Kazunori; Tsuchie, Keiko; Inagaki, Takuji; Horiguchi, Jun

2012-11-29

Numerous medications have been tested on patients with pervasive developmental disorder not otherwise specified (PDD-NOS) and Asperger's disorder. Although many of these medications have been demonstrated to be useful, no clear primary treatment for PDD-NOS and Asperger's disorder has emerged. Despite the efficacy of some of the medicines, the acceptability and side effects have proven to be barriers to their use. Recent studies indicate that the traditional Japanese herbal medicine yokukansan (TJ-54) may be safe and useful in treating behavioral and psychological symptoms in dementia and some neuropsychiatric disorders. We aimed at evaluating both the efficacy and safety of TJ-54 in patients with well-defined PDD-NOS and Asperger's disorder. This was a 12-week prospective, open-label investigation of TJ-54 in 40 children, adolescents, and adults diagnosed with PDD-NOS or Asperger's disorder. Primary outcome measures included the Clinical Global Impressions-Severity of Illness Scale (CGI-S) and the Aberrant Behavior Checklist-Iritability subscale score (ABC-I). Forty subjects, ages 8-40 years (mean 22.7 ± 7.3 years) received a mean final TJ-54 dosage of 6.4 ± 1.3 g/day (range 2.5-7.5 g/day). Full-scale intelligence quotient (IQ) scores ranged from 70 to 110 (mean 88.9 ± 13.2). Thirty-six (90%) of 40 subjects showed fewer interfering symptoms of irritability, including aggression, self-injury, and tantrums, with a final CGI-S of 1 or 2 (normal, not at all ill or borderline mentally ill) and a 80% or greater improvement on the ABC-I. The mean CGI-S score at baseline was 6.8 ± 0.8 whereas scores at end point was 1.9 ± 0.1 (< 0.0001). ABC-I scores ranged from 11 to 29 (mean 17.4 ± 3.66) at baseline, whereas scores at week 12 ranged from 0 to 5 (mean 0.93 ± 0.97) (p <0.0001). TJ-54 was well tolerated. No subject exited the study due to a drug-related adverse event. These preliminary data suggest that TJ-54 may be effective and well tolerated for treatment of severe irritability, lethargy/withdrawal, stereotypic behavior, hyperactivity/noncompliance, and inappropriate speech in patients with PDD-NOS or Asperger's disorder. However, given the characteristics of this trial, the present findings should be taken cautiously, and larger-scale placebo-controlled studies are needed to elucidate the efficacy and tolerability of TJ-54 in this understudied population.

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

Xu, H; Guerrero, M; Prado, K

Purpose: Building up a TG-71 based electron monitor-unit (MU) calculation protocol usually involves massive measurements. This work investigates a minimum data set of measurements and its calculation accuracy and measurement time. Methods: For 6, 9, 12, 16, and 20 MeV of our Varian Clinac-Series linear accelerators, the complete measurements were performed at different depth using 5 square applicators (6, 10, 15, 20 and 25 cm) with different cutouts (2, 3, 4, 6, 10, 15 and 20 cm up to applicator size) for 5 different SSD’s. For each energy, there were 8 PDD scans and 150 point measurements for applicator factors,more » cutout factors and effective SSDs that were then converted to air-gap factors for SSD 99–110cm. The dependence of each dosimetric quantity on field size and SSD was examined to determine the minimum data set of measurements as a subset of the complete measurements. The “missing” data excluded in the minimum data set were approximated by linear or polynomial fitting functions based on the included data. The total measurement time and the calculated electron MU using the minimum and the complete data sets were compared. Results: The minimum data set includes 4 or 5 PDD’s and 51 to 66 point measurements for each electron energy, and more PDD’s and fewer point measurements are generally needed as energy increases. Using only <50% of complete measurement time, the minimum data set generates acceptable MU calculation results compared to those with the complete data set. The PDD difference is within 1 mm and the calculated MU difference is less than 1.5%. Conclusion: Data set measurement for TG-71 electron MU calculations can be minimized based on the knowledge of how each dosimetric quantity depends on various setup parameters. The suggested minimum data set allows acceptable MU calculation accuracy and shortens measurement time by a few hours.« less

Dependency of EBT2 film calibration curve on postirradiation time

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

Chang, Liyun, E-mail: liyunc@isu.edu.tw; Ding, Hueisch-Jy; Ho, Sheng-Yow

2014-02-15

Purpose: The Ashland Inc. product EBT2 film model is a widely used quality assurance tool, especially for verification of 2-dimensional dose distributions. In general, the calibration film and the dose measurement film are irradiated, scanned, and calibrated at the same postirradiation time (PIT), 1-2 days after the films are irradiated. However, for a busy clinic or in some special situations, the PIT for the dose measurement film may be different from that of the calibration film. In this case, the measured dose will be incorrect. This paper proposed a film calibration method that includes the effect of PIT. Methods: Themore » dose versus film optical density was fitted to a power function with three parameters. One of these parameters was PIT dependent, while the other two were found to be almost constant with a standard deviation of the mean less than 4%. The PIT-dependent parameter was fitted to another power function of PIT. The EBT2 film model was calibrated using the PDD method with 14 different PITs ranging from 1 h to 2 months. Ten of the fourteen PITs were used for finding the fitting parameters, and the other four were used for testing the model. Results: The verification test shows that the differences between the delivered doses and the film doses calculated with this modeling were mainly within 2% for delivered doses above 60 cGy, and the total uncertainties were generally under 5%. The errors and total uncertainties of film dose calculation were independent of the PIT using the proposed calibration procedure. However, the fitting uncertainty increased with decreasing dose or PIT, but stayed below 1.3% for this study. Conclusions: The EBT2 film dose can be modeled as a function of PIT. For the ease of routine calibration, five PITs were suggested to be used. It is recommended that two PITs be located in the fast developing period (1∼6 h), one in 1 ∼ 2 days, one around a week, and one around a month.« less

SU-F-T-124: Radiation Biological Equivalent Presentations OfLEM-1 and MKM Approaches in the Carbon-Ion Radiotherapy

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

Hsi, W; Jiang, G; Sheng, Y

Purpose: To study the correlations of the radiation biological equivalent doses (BED) along depth and lateral distance between LEM-1 and MKM approaches. Methods: In NIRS-MKM (Microdosimetric Kinetic Model) approach, the prescribed BED, referred as C-Eq, doses aims to present the relative biological effectiveness (RBE) for different energies of carbon-ions on a fixed 10% survival value of HCG cell with respect to convention X-ray. Instead of a fixed 10% survival, the BED doses of LEM-1 (Local Effect Model) approach, referred as X-Eq, aims to present the RBE over the whole survival curve of chordoma-like cell with alpha/beta ratio of 2.0. Themore » relationship of physical doses as a function of C-Eq and X-Eq doses were investigated along depth and lateral distance for various sizes of cubic targets in water irradiated by carbon-ions. Results: At the center of each cubic target, the trends between physical and C-Eq or X-Eq doses can be described by a linear and 2nd order polynomial functions, respectively. Using fit functions can then calculate a scaling factor between C-Eq and X-Eq doses to have similar physical doses. With equalized C-Eq and X-Eq doses at the depth of target center, over- and under-estimated X-Eq to C-Eq are seen for depths before and after the target center, respectively. Near the distal edge along depth, sharp rising of RBE value is observed for X-Eq, but sharp dropping of RBE value is observed for C-Eq. For lateral locations near and just outside 50% dose level, sharp raising of RBE value is also seen for X-Eq, while only minor increasing with fast dropping for C-Eq. Conclusion: An analytical function to model the differences between the CEq and X-Eq doses along depth and lateral distance need to further investigated to explain varied clinic outcome of specific cancers using two different approaches to calculated BED doses.« less

Evaluation on Geant4 Hadronic Models for Pion Minus, Pion Plus and Neutron Particles as Major Antiproton Annihilation Products

PubMed Central

Tavakoli, Mohammad Bagher; Mohammadi, Mohammad Mehdi; Reiazi, Reza; Jabbari, Keyvan

2015-01-01

Geant4 is an open source simulation toolkit based on C++, which its advantages progressively lead to applications in research domains especially modeling the biological effects of ionizing radiation at the sub-cellular scale. However, it was shown that Geant4 does not give a reasonable result in the prediction of antiproton dose especially in Bragg peak. One of the reasons could be lack of reliable physic model to predict the final states of annihilation products like pions. Considering the fact that most of the antiproton deposited dose is resulted from high-LET nuclear fragments following pion interaction in surrounding nucleons, we reproduced depth dose curves of most probable energy range of pions and neutron particle using Geant4. We consider this work one of the steps to understand the origin of the error and finally verification of Geant4 for antiproton tracking. Geant4 toolkit version 9.4.6.p01 and Fluka version 2006.3 were used to reproduce the depth dose curves of 220 MeV pions (both negative and positive) and 70 MeV neutrons. The geometry applied in the simulations consist a 20 × 20 × 20 cm3 water tank, similar to that used in CERN for antiproton relative dose measurements. Different physic lists including Quark-Gluon String Precompound (QGSP)_Binary Cascade (BIC)_HP, the recommended setting for hadron therapy, were used. In the case of pions, Geant4 resulted in at least 5% dose discrepancy between different physic lists at depth close to the entrance point. Even up to 15% discrepancy was found in some cases like QBBC compared to QGSP_BIC_HP. A significant difference was observed in dose profiles of different Geant4 physic list at small depths for a beam of pions. In the case of neutrons, large dose discrepancy was observed when LHEP or LHEP_EMV lists were applied. The magnitude of this dose discrepancy could be even 50% greater than the dose calculated by LHEP (or LHEP_EMV) at larger depths. We found that effect different Geant4 physic list in reproducing depth dose profile of the beam of pions was not negligible. Because the discrepancies were pronounced in smaller depth and also regarding the contribution of pions in deposited dose of a beam of antiproton, further investigation on choosing most suitable and accurate physic list for this purpose should be done. Furthermore, this study showed careful attention must be paid to choose the appropriate Geant4 physic list for neutron tracking depending to the applications criteria. We failed to find any agreement between results from Geant4 and Fluka to reproduce depth dose profile of pion with the energy range used in this study. PMID:26120569

Clinical evidence for individual animal therapy for papillomatous digital dermatitis (hairy heel wart) and infectious bovine pododermatitis (foot rot).

PubMed

Apley, Michael D

2015-03-01

Data supporting individual animal therapy for papillomatous digital dermatitis (PDD) and infectious pododermatitis (IP) in cattle are available for treatment with multiple drugs in the form of randomized, prospective clinical trials conducted in naturally occurring disease with negative controls and masked subjective evaluators. In the case of PDD, these trials support the use of topical tetracycline and oxytetracycline, lincomycin, a copper-containing preparation, and a nonantimicrobial cream. In individual therapy for IP, trial evidence is available to support systemic treatment with ceftiofur, florfenicol, tulathromycin, and oxytetracycline. However, it was not available for IP standards such as penicillin G, sulfadimethoxine, and tylosin. Copyright © 2015 Elsevier Inc. All rights reserved.

Characterization of a new unshielded diode for small field dosimetry under flattening filter free beams.

PubMed

Reggiori, Giacomo; Mancosu, Pietro; Suchowerska, Natalka; Lobefalo, Francesca; Stravato, Antonella; Tomatis, Stefano; Scorsetti, Marta

2016-02-01

To characterize the performance of a new unshielded silicon diode (Razor-IBA) for dose measurements in small flattening filter free beams. The Razor has an active volume of 0.6 mm in diameter and 20 µm in length. The detector response stability in measured dose, dose rate, dose per pulse, and dark current were evaluated. The detector response in square fields (0.6-5.0 cm) was determined using PDD curves, axial beam profiles and output ratios. The performances were compared to that of the previously available SFD-IBA and PFD-IBA diodes. The Razor short term stability relative to the SFD was much improved (<±0.1% after 1.2 kGy). The linearity was <±1% (0.05-30 Gy range) and the dose rate dependence was <±0.5% (4-24 Gy/min range). The dose per pulse dependence was <±0.7% (0.08-0.21 cGy/pulse range). The PDDs measured with Razor and PFD differed <1%. A larger dark current was observed with increase in dose (0.0025 pA/Gy) compared to the SFD (0.0002 pA/Gy). This characteristic is attributed to an increased concentration of recombination centers. The beam profile showed good agreement with the SFD. Penumbra differences were <±0.3 mm relative to PFD, with a slight overestimation of the tails (<1%), due to the absence of diode shielding. Output ratios were in good agreement for fields up to 5 × 5 cm(2) (<1%). The Razor diode has the same spatial resolution and performance reliability as its predecessor (SFD), but exhibits the additional advantage of improved stability. These features make the Razor diode detector a good candidate for small field dosimetry. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Gamma index evaluation of IMRT technique using gafchromic film EBT3 for homogeneous and inhomogeneous material

NASA Astrophysics Data System (ADS)

Nisauf, T. A.; Wibowo, W. E.; Pawiro, S. A.

2017-07-01

This study was done to evaluate the gamma index for registering between the planar of dose planning and the measurement of EBT film. The treatment plan was simulated for 5 patients using Fan Beam Computerized Tomography (FBCT) modality, Philips Pinnacle planning system, 6 MV photon energy, 50 segments IMRT technique, and calculation grid resolution (CGR) of 0.2 cm. Gamma Index (GI) evaluation was done with criteria of dose difference (DD) of 2 %, dose to agreement (DTA) of 2 mm and dose difference (DD) of 5 % DTA of 3 mm, SAD 100 cm, depth of 5 cm and 10 cm of the phantom. The result shows that GI for homogeneous material is greater than for inhomogeneous material with discrepancy to previous work is about 1.98 % for homogeneous material (depth 5 cm) and 2.05 % (depth 10 cm) while it was found of 2.98 % for inhomogeneous material (equivalent depth 5 cm) and 4.59 % (equivalent depth 10 cm).

SU-F-T-74: Experimental Validation of Monaco Electron Monte Carlo Dose Calculation for Small Fields

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

Varadhan; Way, S; Arentsen, L

2016-06-15

Purpose: To verify experimentally the accuracy of Monaco (Elekta) electron Monte Carlo (eMC) algorithm to calculate small field size depth doses, monitor units and isodose distributions. Methods: Beam modeling of eMC algorithm was performed for electron energies of 6, 9, 12 15 and 18 Mev for a Elekta Infinity Linac and all available ( 6, 10, 14 20 and 25 cone) applicator sizes. Electron cutouts of incrementally smaller field sizes (20, 40, 60 and 80% blocked from open cone) were fabricated. Dose calculation was performed using a grid size smaller than one-tenth of the R{sub 80–20} electron distal falloff distancemore » and number of particle histories was set at 500,000 per cm{sup 2}. Percent depth dose scans and beam profiles at dmax, d{sub 90} and d{sub 80} depths were measured for each cutout and energy with Wellhoffer (IBA) Blue Phantom{sup 2} scanning system and compared against eMC calculated doses. Results: The measured dose and output factors of incrementally reduced cutout sizes (to 3cm diameter) agreed with eMC calculated doses within ± 2.5%. The profile comparisons at dmax, d{sub 90} and d{sub 80} depths and percent depth doses at reduced field sizes agreed within 2.5% or 2mm. Conclusion: Our results indicate that the Monaco eMC algorithm can accurately predict depth doses, isodose distributions, and monitor units in homogeneous water phantom for field sizes as small as 3.0 cm diameter for energies in the 6 to 18 MeV range at 100 cm SSD. Consequently, the old rule of thumb to approximate limiting cutout size for an electron field determined by the lateral scatter equilibrium (E (MeV)/2.5 in centimeters of water) does not apply to Monaco eMC algorithm.« less

Changes in prescribed doses for the Seattle neutron therapy system

NASA Astrophysics Data System (ADS)

Popescu, A.

2008-06-01

From the beginning of the neutron therapy program at the University of Washington Medical Center, the neutron dose distribution in tissue has been calculated using an in-house treatment planning system called PRISM. In order to increase the accuracy of the absorbed dose calculations, two main improvements were made to the PRISM treatment planning system: (a) the algorithm was changed by the addition of an analytical expression of the central axis wedge factor dependence with field size and depth developed at UWMC. Older versions of the treatment-planning algorithm used a constant central axis wedge factor; (b) a complete newly commissioned set of measured data was introduced in the latest version of PRISM. The new version of the PRISM algorithm allowed for the use of the wedge profiles measured at different depths instead of one wedge profile measured at one depth. The comparison of the absorbed dose calculations using the old and the improved algorithm showed discrepancies mainly due to the missing central axis wedge factor dependence with field size and depth and due to the absence of the wedge profiles at depths different from 10 cm. This study concludes that the previously reported prescribed doses for neutron therapy should be changed.

A Measurement and Analysis of Buildup Region Dose for Open Field Photon Beams (Cobalt-60 through 24 MV)

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

McCullough, Edwin C.

2015-01-15

The central axis depth dose in the build-up region (surface to d{sub max}) of single open field photon beams (cobalt-60 through 24 MV) has been measured utilizing parallel plate and extrapolation chamber methodology. These data were used to derive, for a prescription dose of 100 cGy, values of surface dose, the maximum value of dose along the central axis (D{sub max}) and the depth (nearest the surface) at which 90% of the prescription dose occurs (d{sub 90}). For both single and parallel opposed pair (POP) open field configurations, data are presented at field sizes of 5 × 5, 15 ×more » 15 and 25 × 25 cm{sup 2} for prescription depths of 10, 15 and 20 cm (midplane for POP). For the treatment machines, field sizes, and prescription depths studied, it is possible to conclude that: for single open field irradiation, surface dose values (as a percentage of the prescription dose) can be either low (<10%) or comparable to the prescription dose itself; for POP open fields, surface dose values are relatively independent of photon energy and midplane depth, and range between 30% and 70% of prescription dose, being principally dependent on field size; the depth of the initial 90 cGy point for a prescription dose of 100 cGy, d{sub 90}, was larger for POP fields. For either single or POP open field treatments, d{sub 90} was always less than 22 mm, while for 6 MV or less, values of d{sub 90} were less than 4 mm; D{sub max} values can be very large (e.g., above 300 cGy) for certain treatment situations and are reduced significantly for POP treatments; for open field POP treatments, the percent reduction in D{sub max} with each increment in beam energy above 10 MV is reduced over that seen at 10 MV or less and, possibly, this further reduction may be clinically insignificant; for open field POP treatments, changes in surface dose, d{sub 90} and D{sub max} with beam energy above 10 MV do not suggest, with regard to these specific build-up curve parameters, any obvious advantage for treatment with beam energies greater than 10 MV for the specific machines and situations studied.« less

High-energy neutron depth-dose distribution experiment.

PubMed

Ferenci, M S; Hertel, N E

2003-01-01

A unique set of high-energy neutron depth-dose benchmark experiments were performed at the Los Alamos Neutron Science Center/Weapons Neutron Research (LANSCE/WNR) complex. The experiments consisted of filtered neutron beams with energies up to 800 MeV impinging on a 30 x 30 x 30 cm3 liquid, tissue-equivalent phantom. The absorbed dose was measured in the phantom at various depths with tissue-equivalent ion chambers. This experiment is intended to serve as a benchmark experiment for the testing of high-energy radiation transport codes for the international radiation protection community.

Commissioning dose computation models for spot scanning proton beams in water for a commercially available treatment planning system

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

Zhu, X. R.; Poenisch, F.; Lii, M.

2013-04-15

Purpose: To present our method and experience in commissioning dose models in water for spot scanning proton therapy in a commercial treatment planning system (TPS). Methods: The input data required by the TPS included in-air transverse profiles and integral depth doses (IDDs). All input data were obtained from Monte Carlo (MC) simulations that had been validated by measurements. MC-generated IDDs were converted to units of Gy mm{sup 2}/MU using the measured IDDs at a depth of 2 cm employing the largest commercially available parallel-plate ionization chamber. The sensitive area of the chamber was insufficient to fully encompass the entire lateralmore » dose deposited at depth by a pencil beam (spot). To correct for the detector size, correction factors as a function of proton energy were defined and determined using MC. The fluence of individual spots was initially modeled as a single Gaussian (SG) function and later as a double Gaussian (DG) function. The DG fluence model was introduced to account for the spot fluence due to contributions of large angle scattering from the devices within the scanning nozzle, especially from the spot profile monitor. To validate the DG fluence model, we compared calculations and measurements, including doses at the center of spread out Bragg peaks (SOBPs) as a function of nominal field size, range, and SOBP width, lateral dose profiles, and depth doses for different widths of SOBP. Dose models were validated extensively with patient treatment field-specific measurements. Results: We demonstrated that the DG fluence model is necessary for predicting the field size dependence of dose distributions. With this model, the calculated doses at the center of SOBPs as a function of nominal field size, range, and SOBP width, lateral dose profiles and depth doses for rectangular target volumes agreed well with respective measured values. With the DG fluence model for our scanning proton beam line, we successfully treated more than 500 patients from March 2010 through June 2012 with acceptable agreement between TPS calculated and measured dose distributions. However, the current dose model still has limitations in predicting field size dependence of doses at some intermediate depths of proton beams with high energies. Conclusions: We have commissioned a DG fluence model for clinical use. It is demonstrated that the DG fluence model is significantly more accurate than the SG fluence model. However, some deficiencies in modeling the low-dose envelope in the current dose algorithm still exist. Further improvements to the current dose algorithm are needed. The method presented here should be useful for commissioning pencil beam dose algorithms in new versions of TPS in the future.« less

Commissioning dose computation models for spot scanning proton beams in water for a commercially available treatment planning system

PubMed Central

Zhu, X. R.; Poenisch, F.; Lii, M.; Sawakuchi, G. O.; Titt, U.; Bues, M.; Song, X.; Zhang, X.; Li, Y.; Ciangaru, G.; Li, H.; Taylor, M. B.; Suzuki, K.; Mohan, R.; Gillin, M. T.; Sahoo, N.

2013-01-01

Purpose: To present our method and experience in commissioning dose models in water for spot scanning proton therapy in a commercial treatment planning system (TPS). Methods: The input data required by the TPS included in-air transverse profiles and integral depth doses (IDDs). All input data were obtained from Monte Carlo (MC) simulations that had been validated by measurements. MC-generated IDDs were converted to units of Gy mm2/MU using the measured IDDs at a depth of 2 cm employing the largest commercially available parallel-plate ionization chamber. The sensitive area of the chamber was insufficient to fully encompass the entire lateral dose deposited at depth by a pencil beam (spot). To correct for the detector size, correction factors as a function of proton energy were defined and determined using MC. The fluence of individual spots was initially modeled as a single Gaussian (SG) function and later as a double Gaussian (DG) function. The DG fluence model was introduced to account for the spot fluence due to contributions of large angle scattering from the devices within the scanning nozzle, especially from the spot profile monitor. To validate the DG fluence model, we compared calculations and measurements, including doses at the center of spread out Bragg peaks (SOBPs) as a function of nominal field size, range, and SOBP width, lateral dose profiles, and depth doses for different widths of SOBP. Dose models were validated extensively with patient treatment field-specific measurements. Results: We demonstrated that the DG fluence model is necessary for predicting the field size dependence of dose distributions. With this model, the calculated doses at the center of SOBPs as a function of nominal field size, range, and SOBP width, lateral dose profiles and depth doses for rectangular target volumes agreed well with respective measured values. With the DG fluence model for our scanning proton beam line, we successfully treated more than 500 patients from March 2010 through June 2012 with acceptable agreement between TPS calculated and measured dose distributions. However, the current dose model still has limitations in predicting field size dependence of doses at some intermediate depths of proton beams with high energies. Conclusions: We have commissioned a DG fluence model for clinical use. It is demonstrated that the DG fluence model is significantly more accurate than the SG fluence model. However, some deficiencies in modeling the low-dose envelope in the current dose algorithm still exist. Further improvements to the current dose algorithm are needed. The method presented here should be useful for commissioning pencil beam dose algorithms in new versions of TPS in the future. PMID:23556893

Commissioning dose computation models for spot scanning proton beams in water for a commercially available treatment planning system.

PubMed

Zhu, X R; Poenisch, F; Lii, M; Sawakuchi, G O; Titt, U; Bues, M; Song, X; Zhang, X; Li, Y; Ciangaru, G; Li, H; Taylor, M B; Suzuki, K; Mohan, R; Gillin, M T; Sahoo, N

2013-04-01

To present our method and experience in commissioning dose models in water for spot scanning proton therapy in a commercial treatment planning system (TPS). The input data required by the TPS included in-air transverse profiles and integral depth doses (IDDs). All input data were obtained from Monte Carlo (MC) simulations that had been validated by measurements. MC-generated IDDs were converted to units of Gy mm(2)/MU using the measured IDDs at a depth of 2 cm employing the largest commercially available parallel-plate ionization chamber. The sensitive area of the chamber was insufficient to fully encompass the entire lateral dose deposited at depth by a pencil beam (spot). To correct for the detector size, correction factors as a function of proton energy were defined and determined using MC. The fluence of individual spots was initially modeled as a single Gaussian (SG) function and later as a double Gaussian (DG) function. The DG fluence model was introduced to account for the spot fluence due to contributions of large angle scattering from the devices within the scanning nozzle, especially from the spot profile monitor. To validate the DG fluence model, we compared calculations and measurements, including doses at the center of spread out Bragg peaks (SOBPs) as a function of nominal field size, range, and SOBP width, lateral dose profiles, and depth doses for different widths of SOBP. Dose models were validated extensively with patient treatment field-specific measurements. We demonstrated that the DG fluence model is necessary for predicting the field size dependence of dose distributions. With this model, the calculated doses at the center of SOBPs as a function of nominal field size, range, and SOBP width, lateral dose profiles and depth doses for rectangular target volumes agreed well with respective measured values. With the DG fluence model for our scanning proton beam line, we successfully treated more than 500 patients from March 2010 through June 2012 with acceptable agreement between TPS calculated and measured dose distributions. However, the current dose model still has limitations in predicting field size dependence of doses at some intermediate depths of proton beams with high energies. We have commissioned a DG fluence model for clinical use. It is demonstrated that the DG fluence model is significantly more accurate than the SG fluence model. However, some deficiencies in modeling the low-dose envelope in the current dose algorithm still exist. Further improvements to the current dose algorithm are needed. The method presented here should be useful for commissioning pencil beam dose algorithms in new versions of TPS in the future.

Towards mapping the brain connectome in depression: functional connectivity by perfusion SPECT.

PubMed

Gardner, Ann; Åstrand, Disa; Öberg, Johanna; Jacobsson, Hans; Jonsson, Cathrine; Larsson, Stig; Pagani, Marco

2014-08-30

Several studies have demonstrated altered brain functional connectivity in the resting state in depression. However, no study has investigated interregional networking in patients with persistent depressive disorder (PDD). The aim of this study was to assess differences in brain perfusion distribution and connectivity between large groups of patients and healthy controls. Participants comprised 91 patients with PDD and 65 age- and sex-matched healthy controls. Resting state perfusion was investigated by single photon emission computed tomography, and group differences were assessed by Statistical Parametric Mapping. Brain connectivity was explored through a voxel-wise interregional correlation analysis using as covariate of interest the normalized values of clusters of voxels in which perfusion differences were found in group analysis. Significantly increased regional brain perfusion distribution covering a large part of the cerebellum was observed in patients as compared with controls. Patients showed a significant negative functional connectivity between the cerebellar cluster and caudate, bilaterally. This study demonstrated inverse relative perfusion between the cerebellum and the caudate in PDD. Functional uncoupling may be associated with a dysregulation between the role of the cerebellum in action control and of the caudate in action selection, initiation and decision making in the patients. The potential impact of the resting state condition and the possibility of mitochondrial impairment are discussed. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Nuts and Bolts of the Ion Band State Theory

NASA Astrophysics Data System (ADS)

Chubb, Scott R.

2005-12-01

The nuts and bolts of our ion band state theory of low energy nuclear reactions (LENR's) in palladium-deuteride (PdD) and palladium-hydride (PdH) are the electrons that hold together or tear apart the bonds (or lack of bonds) between deuterons (d's) or protons (p's) and the host material. In PdDx and PdHx, this bonding is strongly correlated with loading. In ambient loading conditions (x ≲ 0.6), bonding inhibits ion band state occupation. As x → 1, slight increases and decreases in loading can induce "vibrations" (which have conventionally been thought to occur from phonons) that can induce potential losses or increases of p/d. Naive assumptions about phonons fail to include these losses and increases. These effects can occur because neither H or D has core electrons and because in either PdD or PdH, the electrons near the Fermi energy have negligible overlap with the nucleus of either D or H. In the past, implicitly, we have used these facts to justify our ion band state theory. Here, we present a more formal justification, based on the relationship between H(D) ion band states (IBS's) and H(D) phonons that includes a microscopic picture that explains why occupation of IBS's can occur in PdD and PdH and how this can lead to nuclear reactions.

A Low-Noise X-ray Astronomical Silicon-On-Insulator Pixel Detector Using a Pinned Depleted Diode Structure

PubMed Central

Kamehama, Hiroki; Kawahito, Shoji; Shrestha, Sumeet; Nakanishi, Syunta; Yasutomi, Keita; Takeda, Ayaki; Tsuru, Takeshi Go

2017-01-01

This paper presents a novel full-depletion Si X-ray detector based on silicon-on-insulator pixel (SOIPIX) technology using a pinned depleted diode structure, named the SOIPIX-PDD. The SOIPIX-PDD greatly reduces stray capacitance at the charge sensing node, the dark current of the detector, and capacitive coupling between the sensing node and SOI circuits. These features of the SOIPIX-PDD lead to low read noise, resulting high X-ray energy resolution and stable operation of the pixel. The back-gate surface pinning structure using neutralized p-well at the back-gate surface and depleted n-well underneath the p-well for all the pixel area other than the charge sensing node is also essential for preventing hole injection from the p-well by making the potential barrier to hole, reducing dark current from the Si-SiO2 interface and creating lateral drift field to gather signal electrons in the pixel area into the small charge sensing node. A prototype chip using 0.2 μm SOI technology shows very low readout noise of 11.0 e−rms, low dark current density of 56 pA/cm2 at −35 °C and the energy resolution of 200 eV(FWHM) at 5.9 keV and 280 eV (FWHM) at 13.95 keV. PMID:29295523

Distinct brain metabolic patterns separately associated with cognition, motor function, and aging in Parkinson's disease dementia.

PubMed

Ko, Ji Hyun; Katako, Audrey; Aljuaid, Maram; Goertzen, Andrew L; Borys, Andrew; Hobson, Douglas E; Kim, Seok Min; Lee, Chong Sik

2017-12-01

We explored whether patients with Parkinson's disease dementia (PDD) show a distinct spatial metabolic pattern that characterizes cognitive deficits in addition to motor dysfunction. Eighteen patients with PDD underwent 3 separate positron emission tomography sessions with [ 18 F]fluorodeoxyglucose (for glucose metabolism), fluorinated N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) nortropane (for dopamine transporter density) and Pittsburgh compound-B (for beta-amyloid load). We confirmed in PDD versus normal controls, overall hypometabolism in the posterior and prefrontal brain regions accompanied with hypermetabolism in subcortical structures and the cerebellar vermis. A multivariate network analysis then revealed 3 metabolic patterns that are separately associated with cognitive performance (p = 0.042), age (p = 0.042), and motor symptom severity (p = 0.039). The age-related pattern's association with aging was replicated in healthy controls (p = 0.047) and patients with Alzheimer's disease (p = 0.002). The cognition-related pattern's association with cognitive performance was observed, with a trend-level of correlation, in patients with dementia with Lewy bodies (p = 0.084) but not in patients with Alzheimer's disease (p = 0.974). We found no association with fluorinated N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) nortropane and Pittsburgh compound-B positron emission tomography with patients' cognitive performance. Copyright © 2017 Elsevier Inc. All rights reserved.

A Low-Noise X-ray Astronomical Silicon-On-Insulator Pixel Detector Using a Pinned Depleted Diode Structure.

PubMed

Kamehama, Hiroki; Kawahito, Shoji; Shrestha, Sumeet; Nakanishi, Syunta; Yasutomi, Keita; Takeda, Ayaki; Tsuru, Takeshi Go; Arai, Yasuo

2017-12-23

This paper presents a novel full-depletion Si X-ray detector based on silicon-on-insulator pixel (SOIPIX) technology using a pinned depleted diode structure, named the SOIPIX-PDD. The SOIPIX-PDD greatly reduces stray capacitance at the charge sensing node, the dark current of the detector, and capacitive coupling between the sensing node and SOI circuits. These features of the SOIPIX-PDD lead to low read noise, resulting high X-ray energy resolution and stable operation of the pixel. The back-gate surface pinning structure using neutralized p-well at the back-gate surface and depleted n-well underneath the p-well for all the pixel area other than the charge sensing node is also essential for preventing hole injection from the p-well by making the potential barrier to hole, reducing dark current from the Si-SiO₂ interface and creating lateral drift field to gather signal electrons in the pixel area into the small charge sensing node. A prototype chip using 0.2 μm SOI technology shows very low readout noise of 11.0 e - rms , low dark current density of 56 pA/cm² at -35 °C and the energy resolution of 200 eV(FWHM) at 5.9 keV and 280 eV (FWHM) at 13.95 keV.

Determination of the depth dose distribution of proton beam using PRESAGE TM dosimeter

NASA Astrophysics Data System (ADS)

Zhao, L.; Das, I. J.; Zhao, Q.; Thomas, A.; Adamovics, J.; Oldman, M.

2010-11-01

PRESAGETM dosimeter dosimeter has been proved useful for 3D dosimetry in conventional photon therapy and IMRT [1-5]. Our objective is to examine the use of PRESAGETM dosimeter for verification of depth dose distribution in proton beam therapy. Three PRESAGETM samples were irradiated with a 79 MeV un-modulated proton beam. Percent depth dose profile measured from the PRESAGETM dosimeter is compared with data obtained in a water phantom using a parallel plate Advanced Markus chamber. The Bragg-peak position determined from the PRESAGETM is within 2 mm compared to measurements in water. PRESAGETM shows a highly linear response to proton dose. However, PRESAGETM also reveals an underdosage around the Bragg peak position due to LET effects. Depth scaling factor and quenching correction factor need further investigation. Our initial result shows that PRESAGETM has promising dosimetric characteristics that could be suitable for proton beam dosimetry.

Proton dose distribution measurements using a MOSFET detector with a simple dose-weighted correction method for LET effects.

PubMed

Kohno, Ryosuke; Hotta, Kenji; Matsuura, Taeko; Matsubara, Kana; Nishioka, Shie; Nishio, Teiji; Kawashima, Mitsuhiko; Ogino, Takashi

2011-04-04

We experimentally evaluated the proton beam dose reproducibility, sensitivity, angular dependence and depth-dose relationships for a new Metal Oxide Semiconductor Field Effect Transistor (MOSFET) detector. The detector was fabricated with a thinner oxide layer and was operated at high-bias voltages. In order to accurately measure dose distributions, we developed a practical method for correcting the MOSFET response to proton beams. The detector was tested by examining lateral dose profiles formed by protons passing through an L-shaped bolus. The dose reproducibility, angular dependence and depth-dose response were evaluated using a 190 MeV proton beam. Depth-output curves produced using the MOSFET detectors were compared with results obtained using an ionization chamber (IC). Since accurate measurements of proton dose distribution require correction for LET effects, we developed a simple dose-weighted correction method. The correction factors were determined as a function of proton penetration depth, or residual range. The residual proton range at each measurement point was calculated using the pencil beam algorithm. Lateral measurements in a phantom were obtained for pristine and SOBP beams. The reproducibility of the MOSFET detector was within 2%, and the angular dependence was less than 9%. The detector exhibited a good response at the Bragg peak (0.74 relative to the IC detector). For dose distributions resulting from protons passing through an L-shaped bolus, the corrected MOSFET dose agreed well with the IC results. Absolute proton dosimetry can be performed using MOSFET detectors to a precision of about 3% (1 sigma). A thinner oxide layer thickness improved the LET in proton dosimetry. By employing correction methods for LET dependence, it is possible to measure absolute proton dose using MOSFET detectors.

Analytical probabilistic proton dose calculation and range uncertainties

NASA Astrophysics Data System (ADS)

Bangert, M.; Hennig, P.; Oelfke, U.

2014-03-01

We introduce the concept of analytical probabilistic modeling (APM) to calculate the mean and the standard deviation of intensity-modulated proton dose distributions under the influence of range uncertainties in closed form. For APM, range uncertainties are modeled with a multivariate Normal distribution p(z) over the radiological depths z. A pencil beam algorithm that parameterizes the proton depth dose d(z) with a weighted superposition of ten Gaussians is used. Hence, the integrals ∫ dz p(z) d(z) and ∫ dz p(z) d(z)2 required for the calculation of the expected value and standard deviation of the dose remain analytically tractable and can be efficiently evaluated. The means μk, widths δk, and weights ωk of the Gaussian components parameterizing the depth dose curves are found with least squares fits for all available proton ranges. We observe less than 0.3% average deviation of the Gaussian parameterizations from the original proton depth dose curves. Consequently, APM yields high accuracy estimates for the expected value and standard deviation of intensity-modulated proton dose distributions for two dimensional test cases. APM can accommodate arbitrary correlation models and account for the different nature of random and systematic errors in fractionated radiation therapy. Beneficial applications of APM in robust planning are feasible.

Depth dose and off-axis characteristics of TLD in therapeutic pion beams.

PubMed

Hogstrom, K R; Irifune, T

1980-07-01

The thermoluminescent (TL) response of LiF (TLD-100, TLD-600, TLD-700) and Li2B4O7 (TLD-800) has been measured as a function of depth and off-axis position in a therapeutic negative-pion beam in order to evaluate their usefulness in pion radiotherapy. TLD-100, TLD-600, and TLD-800 have been shown to be of little use as in vivo dosemeters because the neutron kerma relative to that in tissue changes grossly with depth. The neutron source comes primarily from pion absorption in the lead-alloy collimator. The 200 degrees C TLD-700 response agrees well with the depth dose spectra, except for small changes due to the varying linear energy transfer (LET) distributions. This variation can be partially accounted for by incorporating the known LET response of LiF. The 260 degrees C peak of TLD-700 has been found to be approximately four times more sensitive than the 200 degrees C peak to high LET dose. Using a simple model of the LET responses, the measured 200 degrees C and 260 degrees C peaks predict total dose within +/- 4% and high LET dose within +/- 50%, therefore indicating TLD-700 to be a good in vivo dosemeter for total dose but only an indicator of high LET dose.

Understanding the autistic dental patient.

PubMed

Green, Danielle; Flanagan, Dennis

2008-01-01

Autism spectrum disorder (ASD) is one of many pervasive developmental disorders (PDD); others include Rett syndrome, childhood disintegrative disorder (also known as Heller's syndrome), pervasive developmental disorder not otherwise specified (PDD-NOS), and the higher functioning Asperger's syndrome. Because ASD is the most common of the developmental disabilities, it is not unusual for dentists to have ASD patients among their patient population. As the name indicates, ASD varies widely in its clinical manifestations; however, dentists are likely to encounter difficulties with communication and socialization. Although communication may be difficult, it is not impossible. A thorough understanding of this complex neurological disorder and displaying patience are vital for the dentist. This article seeks to familiarize readers with ASD characteristics and co-morbid conditions that may affect dental treatment and provide some management strategies for this unique population.

SU-F-T-325: On the Use of Bolus in Dosimetry and Dose Reduction for Pacemaker and Defibrillator

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

Liu, W; Kenneth, R; Higgins, S

Purpose: Special attention is required in planning and administering radiation therapy to patients with cardiac implantable electronic devices (CIEDs), such as pacemaker and defibrillator. The range of dose to CIEDs that can induce malfunction is very large among CIEDs. Significant defects have been reported at dose as low as 0.15Gy. Failures causing discomfort have been reported at dose as low as 0.05Gy. Therefore, accurate estimation of dose to CIED and dose reduction are both important even if the dose is expected to be less than the often-used 2Gy limit. We investigate the use of bolus in in vivo dosimetry formore » CIEDs. Methods: In our clinic, high-energy beams (>10MV) are not used for patients with CIED due to neutron production. Solid water phantom measurements of out-of-field dose for a 6MV beam were performed using parallel plate chamber at different depth with and without 2cm bolus covering the chamber. In vivo dosimetry at skin surface above the pacemaker was performed with and without bolus for 3 patients with pacemaker <5cm from the field edge. Results: Chamber measured dose at depth ∼1 to 1.5cm below the skin surface, where the CIED is normally located, was reduced by ∼6% – 20% with bolus. The dose reduction became smaller at deeper depth. In vivo dosimetry at skin surface also yielded ∼20% – 60% lower dose when using bolus for the 3 patients. In general, TPS calculation underestimated the dose. The dose measured with bolus is closer to the dose at the depth of the pacemaker and less affected by contaminant electrons and linac head leakage. Conclusion: In vivo CIED dose measurements should be performed with 1 to 2cm bolus covering the dosimeter on the skin above the CIED for more accurate CIED dose estimation. The use of bolus also reduces the dose delivered to CIED.« less

Impact energy and retained dose uniformity in enhanced glow discharge plasma immersion ion implantation

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

Lu, Q. Y.; Fu, Ricky K. Y.; Chu, Paul K.

2009-08-10

The implantation energy and retained dose uniformity in enhanced glow discharge plasma immersion ion implantation (EGD-PIII) is investigated numerically and experimentally. Depth profiles obtained from different samples processed by EGD-PIII and traditional PIII are compared. The retained doses under different pulse widths are calculated by integrating the area under the depth profiles. Our results indicate that the improvement in the impact energy and retained dose uniformity by this technique is remarkable.

Survey of Preventable Disaster Deaths at Medical Institutions in Areas Affected by the Great East Japan Earthquake: Retrospective Survey of Medical Institutions in Miyagi Prefecture.

PubMed

Yamanouchi, Satoshi; Sasaki, Hiroyuki; Kondo, Hisayoshi; Mase, Tomohiko; Otomo, Yasuhiro; Koido, Yuichi; Kushimoto, Shigeki

2017-10-01

Introduction In 2015, the authors reported the results of a preliminary investigation of preventable disaster deaths (PDDs) at medical institutions in areas affected by the Great East Japan Earthquake (2011). This initial survey considered only disaster base hospitals (DBHs) and hospitals that had experienced at least 20 patient deaths in Miyagi Prefecture (Japan); therefore, hospitals that experienced fewer than 20 patient deaths were not investigated. This was an additional study to the previous survey to better reflect PDD at hospitals across the entire prefecture. Of the 147 hospitals in Miyagi Prefecture, the 14 DBHs and 82 non-DBHs that agreed to participate were included in an on-site survey. A database was created based on the medical records of 1,243 patient deaths that occurred between March 11, 2011 and April 1, 2011, followed by determination of their status as PDDs. A total of 125 cases of PDD were identified among the patients surveyed. The rate of PDD was significantly higher at coastal hospitals than inland hospitals (17.3% versus 6.3%; P<.001). Preventable disaster deaths in non-DBHs were most numerous in facilities with few general beds, especially among patients hospitalized before the disaster in hospitals with fewer than 100 beds. Categorized by area, the most frequent causes of PDD were: insufficient medical resources, disrupted lifelines, delayed medical intervention, and deteriorated environmental conditions in homes and emergency shelters in coastal areas; and were delayed medical intervention and disrupted lifelines in inland areas. Categorized by hospital function, the most frequent causes were: delayed medical intervention, deteriorated environmental conditions in homes and emergency shelters, and insufficient medical resources at DBHs; while those at non-DBHs were disrupted lifelines, insufficient medical resources, delayed medical intervention, and lack of capacity for transport within the area. Preventable disaster death at medical institutions in areas affected by the Great East Japan Earthquake occurred mainly at coastal hospitals with insufficient medical resources, disrupted lifelines, delayed medical intervention, and deteriorated environmental conditions in homes and emergency shelters constituting the main contributing factors. Preventing PDD, in addition to strengthening organizational support and functional enhancement of DBHs, calls for the development of business continuity plans (BCPs) for medical facilities in directly affected areas, including non-DBHs. Yamanouchi S , Sasaki H , Kondo H , Mase T , Otomo Y , Koido Y , Kushimoto S . Survey of preventable disaster deaths at medical institutions in areas affected by the Great East Japan Earthquake: retrospective survey of medical institutions in Miyagi Prefecture. Prehosp Disaster Med. 2017;32(5):515-522.

Yokukansan (TJ-54) for treatment of pervasive developmental disorder not otherwise specified and Asperger’s disorder: a 12-week prospective, open-label study

PubMed Central

2012-01-01

Background Numerous medications have been tested on patients with pervasive developmental disorder not otherwise specified (PDD-NOS) and Asperger’s disorder. Although many of these medications have been demonstrated to be useful, no clear primary treatment for PDD-NOS and Asperger’s disorder has emerged. Despite the efficacy of some of the medicines, the acceptability and side effects have proven to be barriers to their use. Recent studies indicate that the traditional Japanese herbal medicine yokukansan (TJ-54) may be safe and useful in treating behavioral and psychological symptoms in dementia and some neuropsychiatric disorders. We aimed at evaluating both the efficacy and safety of TJ-54 in patients with well-defined PDD-NOS and Asperger’s disorder. Methods This was a 12-week prospective, open-label investigation of TJ-54 in 40 children, adolescents, and adults diagnosed with PDD-NOS or Asperger’s disorder. Primary outcome measures included the Clinical Global Impressions-Severity of Illness Scale (CGI-S) and the Aberrant Behavior Checklist-Iritability subscale score (ABC-I). Results Forty subjects, ages 8–40 years (mean 22.7 ± 7.3 years) received a mean final TJ-54 dosage of 6.4 ± 1.3 g/day (range 2.5-7.5 g/day). Full-scale intelligence quotient (IQ) scores ranged from 70 to 110 (mean 88.9 ± 13.2). Thirty-six (90%) of 40 subjects showed fewer interfering symptoms of irritability, including aggression, self-injury, and tantrums, with a final CGI-S of 1 or 2 (normal, not at all ill or borderline mentally ill) and a 80% or greater improvement on the ABC-I. The mean CGI-S score at baseline was 6.8 ± 0.8 whereas scores at end point was 1.9 ± 0.1 (< 0.0001). ABC-I scores ranged from 11 to 29 (mean 17.4 ± 3.66) at baseline, whereas scores at week 12 ranged from 0 to 5 (mean 0.93 ± 0.97) (p <0.0001). TJ-54 was well tolerated. No subject exited the study due to a drug-related adverse event. Conclusions These preliminary data suggest that TJ-54 may be effective and well tolerated for treatment of severe irritability, lethargy/withdrawal, stereotypic behavior, hyperactivity/noncompliance, and inappropriate speech in patients with PDD-NOS or Asperger’s disorder. However, given the characteristics of this trial, the present findings should be taken cautiously, and larger-scale placebo-controlled studies are needed to elucidate the efficacy and tolerability of TJ-54 in this understudied population. PMID:23194148

WE-EF-BRA-06: Feasibility of Spatially Modulated Proton Beams for Small Animal Research

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

Lee, E; Meyer, J

Purpose: To investigate the feasibility of proton minibeam radiotherapy (pMBRT) for small animal research. The motivation is to explore with protons the extraordinary normal tissue sparing effects to spatially modulated beams as observed on high flux synchrotron beam lines. We hypothesized that we can design a multi-slit collimator for our proton beam line to produce planar-parallel dose profiles with high modulation in the entrance region and homogenous dose coverage in the overlap of the Bragg peaks. Methods: The high dose rate 50 MeV research proton beamline at the University of Washington was modeled using the TOol for PArticle Simulation (TOPAS)more » Monte Carlo package. A brass collimator was implemented to generate proton minibeams. The collimator consists of an array of 2 cm long slits to cover an area of 2×2 cm{sup 2}. The slit widths (0.1–1 mm), center-to-center (ctc) distances (1–3 mm) and collimator thickness (1–7 cm) were varied to evaluate the effect on dose rate, the peak-to-valley dose ratios (PVDR) and the change of penumbra and peak width (FWHM) with depth. Results: The Bragg peak was at a depth of ∼21 mm. The penumbra and FWHM remained relatively constant to a depth of about 10–15 mm. The PVDR ranged from 1.6 to 26 and the dose rate dropped exponentially with collimator thickness. A uniform dose can be achieved at depth with slightly compromised PVDRs and dose rate. Conclusion: The technical realization of pMBRT is feasible. The simulations have shown that it is possible to obtain uniform dose at depth while modulation is maintained on the entrance side. While the simulated beam widths are larger than on synchrotron generated microbeams the dosimetric advantage could avoid having to interlace two microbeams to achieve uniform dose in the target. The next steps are to build a collimator and verify the simulations experimentally.« less

SU-E-T-283: Dose Perturbations Near Heterogeneity Junctions for Modulated-Scanning Protons

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

Deng, Y; Li, Y; Sheng, Y

2015-06-15

Purpose: To compare calculated and measured doses near heterogeneity junctions of tissue-substitute materials for modulated-scanning protons. Methods: Three heterogeneous phantoms were configured using slabs of various plastics to simulate lung, fat, soft-tissue (polystyrene), and bone with known relative linear stopping powers (RLSPs). Each phantom consisted of soft-tissue and a single heterogeneity of a 5 or 10 cm thickness of a non-soft-tissue material. CT images were loaded into a Syngo treatment planning system and each material contoured and assigned its RLSP. Planning target volumes (PTVs) were drawn such that a beam would partially traverse the heterogeneity and partially only soft-tissue. Lateralmore » profiles were measured using EDR2 films at a minimum of six depths between the phantom surface and the depth corresponding to the beam range. Absolute doses were measured inside and distal to the PTV in all phantoms using either a parallel plate or thimble chamber. Additional dose measurements were made between two lung slabs. Results: Profiles measured by film generally agreed with calculations except for depths distal to lung and fat junctions. Measured lateral penumbras for depths at the distal junction of lung were found to be wider than calculated ones. Compared with calculated doses, measured doses in the PTVs were 5.19% and 2.51% lower for lung and fat respectively but for bone were 0.2% higher. Measured doses for depths distal to the PTV were up to 29.65% and 10.58% higher for lung and fat, respectively but 6.30% lower for bone. Conclusion: The low measured doses in the PTVs for lung and fat might be due to underestimation of lateral scattering of protons. The higher measured doses distal to the PTV for the lung and fat are a Result of a shortened calculated beam range whereas the higher dose distal to the bone junction is within uncertainties.« less

Asperger syndrome in males over two decades: stability and predictors of diagnosis.

PubMed

Helles, Adam; Gillberg, Carina I; Gillberg, Christopher; Billstedt, Eva

2015-06-01

To examine the diagnostic stability of a childhood diagnosis of Asperger Syndrome (AS) into adulthood in a prospective longitudinal study, and identify the predictors of stability. One hundred males with AS diagnosed in childhood (T0) according to Gillberg's AS criteria, were followed up prospectively into adulthood over an average of 19 years (range 13-26 years). Fifty males (mean age 30 years) participated in this second follow-up (T2) of the cohort. Seventy-six had participated in a previous follow-up (T1) at mean age 22 years (47 participated in both follow-ups). Diagnosis at T2 was assessed using three sets of diagnostic criteria (Gillberg's AS criteria, DSM-IV Pervasive Developmental Disorder (PDD) and DSM-5 Autism Spectrum Disorder (ASD) criteria) and compared to previous assessments. Background predictors of diagnostic stability were analyzed. General functioning at T2 was assessed and compared to T1. There was a decline in the stability of AS diagnosis over time, the rate dropping from 82% at T1 to 44% at T2, when using the Gillberg criteria. There was also a significant decrease in the rate of cases fulfilling any PDD diagnosis according to the DSM-IV, from 91% at T1 to 76% at T2 in the 47 cases followed up twice. Severity of autism spectrum symptoms at T1 was the main predictor of diagnostic stability at T2. Twenty percent of those meeting criteria for a PDD diagnosis according to DSM-IV, did not meet DSM-5 ASD criteria although they had marked difficulties in everyday life. Asperger Syndrome, when considered as an ASD/PDD diagnosis, was fairly stable into adulthood, but there was a significant increase over time in cases no longer meeting criteria for an ASD diagnosis according to the DSM-IV, or AS according to the Gillberg criteria. Cases with a stable diagnosis showed significantly more core ASD symptoms in adolescence/young adulthood. © 2014 Association for Child and Adolescent Mental Health.

Sub-Saharan red cell antigen phenotypes and glucose-6-phosphate dehydrogenase deficiency variants in French Guiana.

PubMed

Petit, Florence; Bailly, Pascal; Chiaroni, Jacques; Mazières, Stéphane

2016-06-07

The treatment of Plasmodium vivax infections requires the use of primaquine, which can lead to severe haemolysis in glucose-6-phosphate dehydrogenase (G6PD)-deficient individuals. However, most of the Latin American countries, which are still endemic for vivax malaria, lack information on the distribution of G6PD deficiency (G6PDd). No survey has been performed so far in French Guiana. Herein, 80 individuals of the French Guianan Noir Marron population were scrutinized for red cell surface antigens of six blood group systems (ABO, Rh, Kell, Kidd, Duffy and MNS) and G6PD genetic polymorphisms. First, the sub-Saharan origin of the red cell phenotypes was assessed in relation with the literature. Then, given that the main sub-Saharan G6PDd variants are expected to be encountered, only the G6PD sequences of exons 4, 5, 6 and 9 were screened. This work aims at appraising the G6PD gene variation in this population, and thus, contributing to the G6PD piecemeal information in Latin America. Ninety-seven percent (97 %) of the red cells are Fy(a- b-), either D+ C- E- c+ e+ or D+ C+ E- c+ e+ and 44 % exhibited the Fya-/Jkb-/S- combined phenotype. Noteworthy is the detection of the G6PD(Val68Met) variant characterized by c.202G > A transition, G6PD(Asn126Asp) variant characterized by c.376A>G transition and G6PD(Asp181Val) variant characterized by c.542A>T transversion of the G6PD gene in 22.5 % of the sample, characteristic of the A(-(202)), A and Santamaria G6PDd variants, respectively. French Guianan Noir Marron population represents a pool of Rh-D antigen positive, Duffy-negative and G6PD-deficient erythrocytes, the latter accounting for one in every eight persons. The present study provides the first community-based estimation of the frequency of G6PDd polymorphisms in French Guiana. These results contribute to the G6PD genetic background information puzzle in Latin America.

SU-E-T-373: Evaluation and Reduction of Contralateral Skin /subcutaneous Dose for Tangential Breast Irradiation

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

Butson, M; Carroll, S; Whitaker, M

2015-06-15

Purpose: Tangential breast irradiation is a standard treatment technique for breast cancer therapy. One aspect of dose delivery includes dose delivered to the skin caused by electron contamination. This effect is especially important for highly oblique beams used on the medical tangent where the electron contamination deposits dose on the contralateral breast side. This work aims to investigate and predict as well as define a method to reduce this dose during tangential breast radiotherapy. Methods: Analysis and calculation of breast skin and subcutaneous dose is performed using a Varian Eclipse planning system, AAA algorithm for 6MV x-ray treatments. Measurements weremore » made using EBT3 Gafchromic film to verify the accuracy of planning data. Various materials were tested to assess their ability to remove electron contamination on the contralateral breast. Results: Results showed that the Varian Eclipse AAA algorithm could accurately estimate contralateral breast dose in the build-up region at depths of 2mm or deeper. Surface dose was underestimated by the AAA algorithm. Doses up to 12% of applied dose were seen on the contralateral breast surface and up to 9 % at 2mm depth. Due to the nature of this radiation, being mainly low energy electron contamination, a bolus material could be used to reduce this dose to less than 3%. This is accomplished by 10 mm of superflab bolus or by 1 mm of lead. Conclusion: Contralateral breast skin and subcutaneous dose is present for tangential breast treatment and has been measured to be up to 12% of applied dose from the medial tangent beam. This dose is deposited at shallow depths and is accurately calculated by the Eclipse AAA algorithm at depths of 2mm or greater. Bolus material placed over the contralateral can be used to effectively reduce this skin dose.« less

TLD extrapolation for skin dose determination in vivo.

PubMed

Kron, T; Butson, M; Hunt, F; Denham, J

1996-11-01

Prediction of skin reactions requires knowledge of the dose at various depths in the human skin. Using thermoluminescence dosimeters of three different thicknesses, the dose can be extrapolated to the surface and interpolated between the different depths. A TLD holder was designed for these TLD extrapolation measurements on patients during treatment which allowed measurements of entrance and exit skin dose with a day to day variability of +/-7% (S.D. of mean reading). In a pilot study on 18 patients undergoing breast irradiation, it was found that the angle of incidence of the radiation beam is the most significant factor influencing skin entrance dose. In most of these measurements the beam exit dose contributed 50% more to the surface dose than the entrance dose.

The photosensitizer talaporfinum caused microvascular embolization for photodynamic therapy

NASA Astrophysics Data System (ADS)

Li, Liming; Aizawa, Katsuo

2005-07-01

Photodynamic therapy (PDT) has been evolving rapidly in the recent years. A second-generation Photosensitizer mono-1-aspartyl chlorine 6 (Talaporfin / Npe6 / ME2906, Japan Meiji Seika, Ltd.) has been sanctified for the lung cancer clinical PDT by the Japan Ministry of Health, Labor and Welfare. In this paper, Talaporfin was injected to the implant cancer of a mouse a Talaporfin dose of 5mg/kg through intravenous. After 6 hours, the fluorescence images of the mouse were observed with a microscope and a 664 nm diode laser. Effects of therapy were clarified using the different irradiation energies of the laser (50, 100, 200 J/cm2). Both in plasma and in cancer, the concentrations of Talaporfin were analyzed using High Performance Liquid Chromatography (HPLC). Authors find that the higher concentrations of Talaporfin in plasma, the better PDD effect. It is experimentally verified that local microvascular embolisms in the cancer are formed for photodynamic therapy after the Talaporfin injection and the laser irradiation.

Persistent depressive disorder

MedlinePlus

... But, symptoms are not as severe as with major depression . Persistent depressive disorder used to be called dysthymia. ... with PDD will also have an episode of major depression at some point in their lives. Older people ...

Design of a modulated orthovoltage stereotactic radiosurgery system.

PubMed

Fagerstrom, Jessica M; Bender, Edward T; Lawless, Michael J; Culberson, Wesley S

2017-07-01

To achieve stereotactic radiosurgery (SRS) dose distributions with sharp gradients using orthovoltage energy fluence modulation with inverse planning optimization techniques. A pencil beam model was used to calculate dose distributions from an orthovoltage unit at 250 kVp. Kernels for the model were derived using Monte Carlo methods. A Genetic Algorithm search heuristic was used to optimize the spatial distribution of added tungsten filtration to achieve dose distributions with sharp dose gradients. Optimizations were performed for depths of 2.5, 5.0, and 7.5 cm, with cone sizes of 5, 6, 8, and 10 mm. In addition to the beam profiles, 4π isocentric irradiation geometries were modeled to examine dose at 0.07 mm depth, a representative skin depth, for the low energy beams. Profiles from 4π irradiations of a constant target volume, assuming maximally conformal coverage, were compared. Finally, dose deposition in bone compared to tissue in this energy range was examined. Based on the results of the optimization, circularly symmetric tungsten filters were designed to modulate the orthovoltage beam across the apertures of SRS cone collimators. For each depth and cone size combination examined, the beam flatness and 80-20% and 90-10% penumbrae were calculated for both standard, open cone-collimated beams as well as for optimized, filtered beams. For all configurations tested, the modulated beam profiles had decreased penumbra widths and flatness statistics at depth. Profiles for the optimized, filtered orthovoltage beams also offered decreases in these metrics compared to measured linear accelerator cone-based SRS profiles. The dose at 0.07 mm depth in the 4π isocentric irradiation geometries was higher for the modulated beams compared to unmodulated beams; however, the modulated dose at 0.07 mm depth remained <0.025% of the central, maximum dose. The 4π profiles irradiating a constant target volume showed improved statistics for the modulated, filtered distribution compared to the standard, open cone-collimated distribution. Simulations of tissue and bone confirmed previously published results that a higher energy beam (≥ 200 keV) would be preferable, but the 250 kVp beam was chosen for this work because it is available for future measurements. A methodology has been described that may be used to optimize the spatial distribution of added filtration material in an orthovoltage SRS beam to result in dose distributions with decreased flatness and penumbra statistics compared to standard open cones. This work provides the mathematical foundation for a novel, orthovoltage energy fluence-modulated SRS system. © 2017 American Association of Physicists in Medicine.

Brachytherapy treatment simulation of strontium-90 and ruthenium-106 plaques on small size posterior uveal melanoma using MCNPX code

NASA Astrophysics Data System (ADS)

Barbosa, N. A.; da Rosa, L. A. R.; Facure, A.; Braz, D.

2014-02-01

Concave eye applicators with 90Sr/90Y and 106Ru/106Rh beta-ray sources are usually used in brachytherapy for the treatment of superficial intraocular tumors as uveal melanoma with thickness up to 5 mm. The aim of this work consisted in using the Monte Carlo code MCNPX to calculate the 3D dose distribution on a mathematical model of the human eye, considering 90Sr/90Y and 160Ru/160Rh beta-ray eye applicators, in order to treat a posterior uveal melanoma with a thickness 3.8 mm from the choroid surface. Mathematical models were developed for the two ophthalmic applicators, CGD produced by BEBIG Company and SIA.6 produced by the Amersham Company, with activities 1 mCi and 4.23 mCi respectively. They have a concave form. These applicators' mathematical models were attached to the eye model and the dose distributions were calculated using the MCNPX *F8 tally. The average doses rates were determined in all regions of the eye model. The *F8 tally results showed that the deposited energy due to the applicator with the radionuclide 106Ru/106Rh is higher in all eye regions, including tumor. However the average dose rate in the tumor region is higher for the applicator with 90Sr/90Y, due to its high activity. Due to the dosimetric characteristics of these applicators, the PDD value for 3 mm water is 73% for the 106Ru/106Rh applicator and 60% for 90Sr/90Y applicator. For a better choice of the applicator type and radionuclide it is important to know the thickness of the tumor and its location.

Improving spot-scanning proton therapy patient specific quality assurance with HPlusQA, a second-check dose calculation engine.

PubMed

Mackin, Dennis; Li, Yupeng; Taylor, Michael B; Kerr, Matthew; Holmes, Charles; Sahoo, Narayan; Poenisch, Falk; Li, Heng; Lii, Jim; Amos, Richard; Wu, Richard; Suzuki, Kazumichi; Gillin, Michael T; Zhu, X Ronald; Zhang, Xiaodong

2013-12-01

The purpose of this study was to validate the use of HPlusQA, spot-scanning proton therapy (SSPT) dose calculation software developed at The University of Texas MD Anderson Cancer Center, as second-check dose calculation software for patient-specific quality assurance (PSQA). The authors also showed how HPlusQA can be used within the current PSQA framework. The authors compared the dose calculations of HPlusQA and the Eclipse treatment planning system with 106 planar dose measurements made as part of PSQA. To determine the relative performance and the degree of correlation between HPlusQA and Eclipse, the authors compared calculated with measured point doses. Then, to determine how well HPlusQA can predict when the comparisons between Eclipse calculations and the measured dose will exceed tolerance levels, the authors compared gamma index scores for HPlusQA versus Eclipse with those of measured doses versus Eclipse. The authors introduce the αβγ transformation as a way to more easily compare gamma scores. The authors compared measured and calculated dose planes using the relative depth, z∕R × 100%, where z is the depth of the measurement and R is the proton beam range. For relative depths than less than 80%, both Eclipse and HPlusQA calculations were within 2 cGy of dose measurements on average. When the relative depth was greater than 80%, the agreement between the calculations and measurements fell to 4 cGy. For relative depths less than 10%, the Eclipse and HPlusQA dose discrepancies showed a negative correlation, -0.21. Otherwise, the correlation between the dose discrepancies was positive and as large as 0.6. For the dose planes in this study, HPlusQA correctly predicted when Eclipse had and had not calculated the dose to within tolerance 92% and 79% of the time, respectively. In 4 of 106 cases, HPlusQA failed to predict when the comparison between measurement and Eclipse's calculation had exceeded the tolerance levels of 3% for dose and 3 mm for distance-to-agreement. The authors found HPlusQA to be reasonably effective (79% ± 10%) in determining when the comparison between measured dose planes and the dose planes calculated by the Eclipse treatment planning system had exceeded the acceptable tolerance levels. When used as described in this study, HPlusQA can reduce the need for patient specific quality assurance measurements by 64%. The authors believe that the use of HPlusQA as a dose calculation second check can increase the efficiency and effectiveness of the QA process.

TH-C-BRD-04: Beam Modeling and Validation with Triple and Double Gaussian Dose Kernel for Spot Scanning Proton Beams

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

Hirayama, S; Takayanagi, T; Fujii, Y

2014-06-15

Purpose: To present the validity of our beam modeling with double and triple Gaussian dose kernels for spot scanning proton beams in Nagoya Proton Therapy Center. This study investigates the conformance between the measurements and calculation results in absolute dose with two types of beam kernel. Methods: A dose kernel is one of the important input data required for the treatment planning software. The dose kernel is the 3D dose distribution of an infinitesimal pencil beam of protons in water and consists of integral depth doses and lateral distributions. We have adopted double and triple Gaussian model as lateral distributionmore » in order to take account of the large angle scattering due to nuclear reaction by fitting simulated inwater lateral dose profile for needle proton beam at various depths. The fitted parameters were interpolated as a function of depth in water and were stored as a separate look-up table for the each beam energy. The process of beam modeling is based on the method of MDACC [X.R.Zhu 2013]. Results: From the comparison results between the absolute doses calculated by double Gaussian model and those measured at the center of SOBP, the difference is increased up to 3.5% in the high-energy region because the large angle scattering due to nuclear reaction is not sufficiently considered at intermediate depths in the double Gaussian model. In case of employing triple Gaussian dose kernels, the measured absolute dose at the center of SOBP agrees with calculation within ±1% regardless of the SOBP width and maximum range. Conclusion: We have demonstrated the beam modeling results of dose distribution employing double and triple Gaussian dose kernel. Treatment planning system with the triple Gaussian dose kernel has been successfully verified and applied to the patient treatment with a spot scanning technique in Nagoya Proton Therapy Center.« less

High-precision dosimetry for radiotherapy using the optically stimulated luminescence technique and thin Al2O3:C dosimeters.

PubMed

Yukihara, E G; Yoshimura, E M; Lindstrom, T D; Ahmad, S; Taylor, K K; Mardirossian, G

2005-12-07

The potential of using the optically stimulated luminescence (OSL) technique with aluminium oxide (Al(2)O(3):C) dosimeters for a precise and accurate estimation of absorbed doses delivered by high-energy photon beams was investigated. This study demonstrates the high reproducibility of the OSL measurements and presents a preliminary determination of the depth-dose curve in water for a 6 MV photon beam from a linear accelerator. The uncertainty of a single OSL measurement, estimated from the variance of a large sample of dosimeters irradiated with the same dose, was 0.7%. In the depth-dose curve obtained using the OSL technique, the difference between the measured and expected doses was < or =0.7% for depths between 1.5 and 10 cm, and 1.1% for a depth of 15 cm. The readout procedure includes a normalization of the response of the dosimeter with respect to a reference dose in order to eliminate variations in the dosimeter mass, dosimeter sensitivity, and the reader's sensitivity. This may be relevant for quality assurance programmes, since it simplifies the requirements in terms of personnel training to achieve the precision and accuracy necessary for radiotherapy applications. We concluded that the OSL technique has the potential to be reliably incorporated in quality assurance programmes and dose verification.

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

Qu, H; Yu, N; Qi, P

Purpose: In commercial secondary dose calculation system, an average effective depth is used to calculate the Monitor Units for an arc beam from the volumetric modulated arc (VMAT) plans. Typically, an arithmetic mean of the effective depths (AMED) of a VMAT arc beam is used, which may result in large MU discrepancy from that of the primary treatment planning system. This study is to demonstrate the use of a dose weighted mean effective depth (DWED) can improve accuracy of MU calculation for the secondary MU verification. Methods: In-house scripts were written in the primary treatment planning system (TPS) to firstmore » convert a VMAT arc beam to a series of static step & shoot beams (every 4 degree). The computed dose and effective depth of each static beam were then used to obtain the dose weighted mean effective depth (DWED) for the VMAT beam. The DWED was used for the secondary MU calculation for VMAT plans. Six lung SBRT VMAT plans, eight head and neck VMAT plans and ten prostate VMAT plans that had > 5% MU deviations (failed MU verification) using the AMED method were recalculated with the DWED. For comparison, same number VMAT plans that had < 5% MU deviations (passed MU verification) using AMED method were also reevaluated with the dose weighted mean effective depth method. Results: For MU verification passed plans, the mean and standard deviation of MU differences between the TPS and the secondary calculation program were 2.2%±1.5% for the AMED and 2.1%±1.7% for the DMED method. For the failed plans, the mean and standard deviation of MU differences of TPS to the secondary calculation program were 9.9%±4.7% and 4.7%±2.6, respectively. Conclusion: The dose weighted mean effective depth improved MU calculation accuracy which can be used for the pre-treatment MU verification of VMAT plans.« less

The net fractional depth dose: a basis for a unified analytical description of FDD, TAR, TMR, and TPR.

PubMed

van de Geijn, J; Fraass, B A

1984-01-01

The net fractional depth dose (NFD) is defined as the fractional depth dose (FDD) corrected for inverse square law. Analysis of its behavior as a function of depth, field size, and source-surface distance has led to an analytical description with only seven model parameters related to straightforward physical properties. The determination of the characteristic parameter values requires only seven experimentally determined FDDs. The validity of the description has been tested for beam qualities ranging from 60Co gamma rays to 18-MV x rays, using published data from several different sources as well as locally measured data sets. The small number of model parameters is attractive for computer or hand-held calculator applications. The small amount of required measured data is important in view of practical data acquisition for implementation of a computer-based dose calculation system. The generating function allows easy and accurate generation of FDD, tissue-air ratio, tissue-maximum ratio, and tissue-phantom ratio tables.

Net fractional depth dose: a basis for a unified analytical description of FDD, TAR, TMR, and TPR

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

van de Geijn, J.; Fraass, B.A.

The net fractional depth dose (NFD) is defined as the fractional depth dose (FDD) corrected for inverse square law. Analysis of its behavior as a function of depth, field size, and source-surface distance has led to an analytical description with only seven model parameters related to straightforward physical properties. The determination of the characteristic parameter values requires only seven experimentally determined FDDs. The validity of the description has been tested for beam qualities ranging from /sup 60/Co gamma rays to 18-MV x rays, using published data from several different sources as well as locally measured data sets. The small numbermore » of model parameters is attractive for computer or hand-held calculator applications. The small amount of required measured data is important in view of practical data acquisition for implementation of a computer-based dose calculation system. The generating function allows easy and accurate generation of FDD, tissue-air ratio, tissue-maximum ratio, and tissue-phantom ratio tables.« less

Neuropsychological functioning of siblings of children with autism, siblings of children with developmental language delay, and siblings of children with mental retardation of unknown genetic etiology.

PubMed

Pilowsky, Tammy; Yirmiya, Nurit; Gross-Tsur, Varda; Shalev, Ruth S

2007-03-01

Neuropsychological functioning of 30 siblings of children with autism (AU-S), 28 siblings of children with mental retardation of (MR-S), and 30 siblings of children with developmental language delay (DLD-S) was compared. Two siblings, both AU-S, received diagnoses of pervasive developmental disorder (PDD). More siblings with cognitive disabilities were found in DLD-S than in AU-S. However, these differences disappeared after excluding diagnosed siblings or after accounting for family membership. In sum, despite the elevated incidence of PDD among AU-S, the neuropsychological functioning of the remaining siblings did not convey specific characteristics related to the genetic risk associated with autism, in contrast to the cognitive functioning of the DLD-S, which did reflect a genetic risk.

Design and evaluation of excitation light source device for fluorescence endoscope

NASA Astrophysics Data System (ADS)

Lim, Hyun Soo

2009-06-01

This study aims at designing and evaluating light source devices that can stably generate light with various wavelengths in order to make possible PDD using a photosensitizer and diagnosis using auto-fluorescence. The light source was a Xenon lamp and filter wheel, composed of an optical output control through Iris and filters with several wavelength bands. It also makes the inducement of auto-fluorescence possible because it is designed to generate a wavelength band of 380-420nm, 430-480nm, and 480-560nm. The transmission part of the light source was developed to enhance the efficiency of light transmission. To evaluate this light source, the characteristics of light output and wavelength band were verified. To validate the capability of this device as PDD, the detection of auto-fluorescence using mouse models was performed.

The detection of dissolved gases in transformer oil by gas chromatography with helium ionization detector

NASA Astrophysics Data System (ADS)

Deng, Xian-qin; Fang, Hua; Li, Min-xian

2017-07-01

The GC-PDD with the technology of valve cutting and helium ionization detector was used to analyze the dissolved gases in ultra-high voltage(UHV) and extra-high voltage(EHV) transformer oil. The detection limit(DL) reached ppb grade, especially for the featuring gas—C2H2 and H2, whose DL could reach 5ppb and 11ppb respectively. The test reproducibility of the instrument was about 1% and the correlation coefficient of standard curve-r is greater or equal to 0.99, which showed obvious advantage compared with normal GC. In addition, the auxiliary gas of H2 was not used in this instrument, which completely improved the safety performance. Thus, the application of GC-PDD has significant meaning in warning potential malfunction inside the ultra-high voltage transformer in advance.

Measuring the transportation needs of people with developmental disabilities: A means to social inclusion.

PubMed

Wasfi, Rania; Steinmetz-Wood, Madeleine; Levinson, David

2017-04-01

One of the major causes of social exclusion for people with developmental disability (PDD) is the inability to access different activities due to inadequate transportation services. This research paper identifies transportation needs, and reasons for unmet, but desired untaken trips of adults with developmental disabilities in Hennepin County, Minnesota. We hypothesize that PDD cannot make trips they want to make due to personal and neighborhood characteristics. A survey measuring existing travel behavior and unmet transportation needs of PDD (N = 114) was conducted. The survey included both demographic and attitudinal questions as well as a travel diary to record both actual and desired but untaken trips. Logistic regression analyses were conducted to determine reasons associated with their inability to make desired, but untaken trips. Most respondents did not live independently. More than half of the surveyed population worked every day and recreation trips occurred at least once a week for about two-thirds of the population. About 46% were unable to make trips they needed to make. Public transit posed physical and intellectual difficulties, however the presence of public transit in neighborhoods decreased odds of not making trips. Concerns about Paratransit services were also reported. Findings from this study can be of value to transportation engineers and planners interested in shedding light on the needs of a marginalized group that is rarely studied and have special transport needs that should be met to ensure their social inclusion in society. Copyright © 2016 Elsevier Inc. All rights reserved.

Long-term erythemal UV doses at Sodankylä estimated using total ozone, sunshine duration and snow depth

NASA Astrophysics Data System (ADS)

Lindfors, A. V.; Arola, A.; Kaurola, J.; Taalas, P.; Svenøe, T.

2003-04-01

A method for estimating daily erythemal UV doses using total ozone, sunshine duration and snow depth has been developed. The method consists of three steps: (1) daily clear-sky UV doses were simulated using the UVSPEC radiative transfer program, with daily values of total ozone as input data, (2) an empirical relationship was sought between the simulated clear-sky UV doses, the measured UV doses and the duration of bright sunshine, (3) daily erythemal UV doses were estimated using this relationship. The method accounts for the varying surface albedo by dividing the period of interest into winter and summer days, depending on the snow depth. Using this method, the daily erythemal UV doses at Sodankylä were estimated for the period 1950--99. This was done using Tromsø's total ozone together with Sodankylä's own sunshine duration and snow depth as input data. Although the method is fairly simple, the results are in good agreement, even on the daily scale, with the UV radiation measured with the Brewer spectrophotometer at Sodankylä. Statistically significant increasing trends in erythemal UV doses of a few percents per decade over the period 1950--99 were found for March and April, suggesting a connection to the stratospheric ozone depletion. For July, on the other hand, a significant decreasing trend of about 3% per decade, supported by the changes in both total ozone and sunshine duration, was found. The produced data set of erythemal UV doses is the longest time series of estimated UV known to the authors.

SU-E-T-614: Derivation of Equations to Define Inflection Points and Its Analysis in Flattening Filter Free Photon Beams Based On the Principle of Polynomial function

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

Muralidhar, K Raja; Komanduri, K

2014-06-01

Purpose: The objective of this work is to present a mechanism for calculating inflection points on profiles at various depths and field sizes and also a significant study on the percentage of doses at the inflection points for various field sizes and depths for 6XFFF and 10XFFF energy profiles. Methods: Graphical representation was done on Percentage of dose versus Inflection points. Also using the polynomial function, the authors formulated equations for calculating spot-on inflection point on the profiles for 6X FFF and 10X FFF energies for all field sizes and at various depths. Results: In a flattening filter free radiationmore » beam which is not like in Flattened beams, the dose at inflection point of the profile decreases as field size increases for 10XFFF. Whereas in 6XFFF, the dose at the inflection point initially increases up to 10x10cm2 and then decreases. The polynomial function was fitted for both FFF beams for all field sizes and depths. For small fields less than 5x5 cm2 the inflection point and FWHM are almost same and hence analysis can be done just like in FF beams. A change in 10% of dose can change the field width by 1mm. Conclusion: The present study, Derivative of equations based on the polynomial equation to define inflection point concept is precise and accurate way to derive the inflection point dose on any FFF beam profile at any depth with less than 1% accuracy. Corrections can be done in future studies based on the multiple number of machine data. Also a brief study was done to evaluate the inflection point positions with respect to dose in FFF energies for various field sizes and depths for 6XFFF and 10XFFF energy profiles.« less

125I eye plaque dose distribution including penumbra characteristics.

PubMed

de la Zerda, A; Chiu-Tsao, S T; Lin, J; Boulay, L L; Kanna, I; Kim, J H; Tsao, H S

1996-03-01

The two main purposes of this work are (1) to determine the penumbra characteristics for 125I eye plaque and the relative influence of the plaque and eye-air interface on the dose distribution, and (2) to initiate development of a treatment planning algorithm for clinical dose calculations. Dose was measured in a newly designed solid water eye phantom for an 125I (6711) seed at the center of a 20 mm COMS eye plaque using thermoluminescent dosimeter (TLD) "cubes" and "minichips" inside and outside the eye, in the longitudinal and transverse central planes. TLD cubes were used in most locations, except for short distances from the seed and in the penumbra region. In the presence of both the plaque and the eye-air interface, the dose along the central axis was found to be reduced by 10% at 1 cm and up to 20% at 2.5 cm, relative to the bulk homogeneous phantom case. In addition, the overall dose reduction was greater for larger off-axis coordinates at a given depth. The penumbra characteristics due to the lip collimation were quantified, particularly the dependence of penumbra center and width on depth. Only small differences were observed between the profiles in the transverse and longitudinal planes. In the bulk geometry (without the eye-air interface), the dose reduction due to the presence of the plaque alone was found to be 7% at a depth of 2.5 cm. The additional reduction of 13% observed, with the presence of eye-air interface (20% combined), can be attributed to the lack of backscattering from the air in front of the eye. The dose-reduction effect due to the anterior air interface alone became unnoticeable at a depth of 1.1 cm (1.5 cm from the eye-air interface). An analytic fit to measured data was developed for clinical dose calculations for a centrally loaded seed. The central axis values of the dose rates multiplied by distance squared, Dr2, were fitted with a double exponential function of depth. The off-axis profile of Dr2, at a given depth, was parametrized by a modified Fermi-Dirac function to model both the penumbra characteristics due the plaque lip collimation and the effect of oblique filtration by silastic.

TH-AB-BRA-06: MOSFET-Based Dosimetry in An MR Image-Guided Radiation Therapy System: Comparison with and Without a Static 0.3T Magnetic Field

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

Cammin, J; Curcuru, A; Li, H

Purpose: To compare depth-dose and surface-dose measurements without and with the magnetic field in a 0.3T MR image-guided Co-60 treatment unit using MOSFET dosimeters. Methods: MOSFET dosimeters (Best Medical Canada, model TN-502RDH-10) were placed in a solid water phantom at 5cm depth with 8cm backscatter (with the MOSFET wires in different orientations to the couch long axis) and also on the surface of an 8cm solid water phantom. The phantoms were placed in an MR image-guided Co-60 treatment machine at an SAD of 105cm to the MOSFETs. Dose measurements were performed between 50 and 200cGy at 5cm depth in amore » 10.5cm × 10.5cm radiation field without the magnetic field (during a machine maintenance period) and with the nominal magnetic field of 0.3T. The dose linearity was measured at 5cm depth with an orthogonal field and the angular dose dependence was measured on the surface with an orthogonal field and oblique fields at +60 degrees and −60 degrees. Results: The measured MOSFET readings at 5cm depth were linear with dose with slopes of (2.97 +/− 0.01) mV/cGy and (3.01 +/− 0.02) mV/cGy without and with the magnetic field, respectively. No statistically significant difference was found. The surface dose measurements, however, were lower by 6.4% for the AP field (2.3 σ) with magnetic field, 4.9% for the −60 degree field (1.4 σ), and 0.4% different for the +60 degree field (0.2 σ). Conclusion: There is no statistically significant difference in the dose at depth without and with the magnetic field and different orientations of the MOSFET wires. There is a statistically significant difference for the surface dose due to the influence of the magnetic field on secondary electrons from head-scatter and the build-up region in certain field orientations. Clinical surface-dose dosimetry in a magnetic field should apply asymmetric angle-dependent corrections.« less

SU-E-T-16: A Comparison of Expected Dwell Times and Dose Variations for NAMD Patients Treated with An Episcleral Brachytherapy Device

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

Hamilton, R; Patel, P; Balaggan, K

2015-06-15

Purpose: To evaluate the variations in dwell times and doses expected when using an episcleral brachytherapy device for treatment of neovascular agerelated macular degeneration (n-AMD) based on accurate imaging modalities Methods: Data from 40 eyes from 40 subjects with known n- AMD acquired through the Distance of Choroid Study (DOCS) conducted at Moorfields Eye Hospital was used to determine the target depth; the distance from the outer scleral surface of the eye, through the choroid, to the apex of the choroidal neovascularization (CNV). Each subject underwent, in triplicate, enhanced-depth Spectral Domain Optical Coherence Tomography (SD-OCT), Swept Source Optical Coherence Tomography,more » (SS-OCT) and Ocular Ultrasound (O-US). These data are the most comprehensive and accurate measurements of the dimensions of the CNV and adjacent layers of the eye for this cohort of patients. During treatment of n-AMD, patients receive a dose of 24Gy to the apex at the target depth. Using the percentage depth dose for a Sr-90 episcleral brachytherapy device, dwell times and doses to the apex were computed to determine the expected variations. Results: The mean target depth and the 95% confidence interval (CI) determined by combining O-US with SD-OCT were 1326 (956,1696)µm and with SS-OCT were 1332 (970,1693)µm. The calculated corresponding mean dwell times and 95% (CI) were 334 (223,445)s and 335 (226,445)s for SD-OCT and SS-OCT determined depths, respectively. The corresponding mean apex dose and 95% (CI) were 24 (35.9,18.0)Gy (SD-OCT) and 24 (35.6,18.1)Gy (SS-OCT). Conclusion: For episcleral brachytherapy treatment of n-AMD, using a patient population average target depth for treatment planning is inadequate, resulting in dose variations of a factor of approximately two over the 95% CI and larger variations for a nontrivial segment of the population. Each patient should have individualized imaging studies to determine the target depth for use in the dwell time calculation. Study was sponsored by Salutaris Medical Devices, Ltd., a subsidiary of Salutaris Medical Devices, Inc. Hamilton and Marsteller are founders of Salutaris Medical Devices, Inc. Drew, McGovern and Vitali are minor equity holders in Salutaris Medical Devices, Inc.« less

Energy spectrum and dose enhancement due to the depth of the Lipiodol position using flattened and unflattened beams.

PubMed

Kawahara, Daisuke; Ozawa, Shuichi; Saito, Akito; Kimura, Tomoki; Suzuki, Tatsuhiko; Tsuneda, Masato; Tanaka, Sodai; Hioki, Kazunari; Nakashima, Takeo; Ohno, Yoshimi; Murakami, Yuji; Nagata, Yasushi

2018-01-01

Lipiodol was used for stereotactic body radiotherapy combining trans arterial chemoembolization. Lipiodol used for tumour seeking in trans arterial chemoembolization remains in stereotactic body radiation therapy. In our previous study, we reported the dose enhancement effect in Lipiodol with 10× flattening-filter-free (FFF). The objective of our study was to evaluate the dose enhancement and energy spectrum of photons and electrons due to the Lipiodol depth with flattened (FF) and FFF beams. FF and FFF for 6 MV beams from TrueBeam were used in this study. The Lipiodol (3 × 3 × 3 cm 3 ) was located at depths of 1, 3, 5, 10, 20, and 30 cm in water. The dose enhancement factor (DEF) and the energy fluence were obtained by Monte Carlo calculations of the particle and heavy ion transport code system (PHITS). The DEFs at the centre of Lipiodol with the FF beam were 6.8, 7.3, 7.6, 7.2, 6.1, and 5.7% and those with the FFF beam were 20.6, 22.0, 21.9, 20.0, 12.3, and 12.1% at depths of 1, 3, 5, 10, 20, and 30 cm, respectively, where Lipiodol was located in water. Moreover, spectrum results showed that more low-energy photons and electrons were present at shallow depth where Lipiodol was located in water. The variation in the low-energy spectrum due to the depth of the Lipiodol position was more explicit with the FFF beam than that with the FF beam. The current study revealed variations in the DEF and energy spectrum due to the depth of the Lipiodol position with the FF and FFF beams. Although the FF beam could reduce the effect of energy dependence due to the depth of the Lipiodol position, the dose enhancement was overall small. To cause a large dose enhancement, the FFF beam with the distance of the patient surface to Lipiodol within 10 cm should be used.

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

Ferreira, C; Ahmad, S; Firestone, B

Purpose: To compare dosimetrically three plan calculation systems (Plato, Varian Brachytherapy, and in-house-made Excel) available for I-125 COMS eye plaque treatment with measurement. Methods: All systems assume homogeneous media and calculations are based on a three-dimensional Cartesian coordinates, Plato and Brachytherapy Planning are based on AAPM TG-43 and the in-house Excel program only on inverse square corrections. Doses at specific depths were measured with EBT3 Gafchromic film from a fully loaded and a partially loaded 16 mm plaque (13 and 8 seeds respectively, I-125, model 6711 GE, Oncura). Measurements took place in a water tank, utilizing solid water blocks andmore » a 3D-printed plaque holder. Taking advantage that gafchromic film has low energy dependence, a dose step wedge was delivered with 6 MV photon beam from a Varian 2100 EX linac for calibration. The gray-scale to dose in cGy was obtained with an Epson Expression 10000 XL scanner in the green channel. Treatment plans were generated for doses of 2200 cGy to a depth of 7 mm, and measurements were taken on a sagittal plane. Results: The calculated dose at the prescription point was 2242, 2344, and 2211 cGy with Excel, Brachyvision and Plato respectively for a fully loaded plaque, for the partially loaded plaque the doses were 2266, 2477, and 2193 cGy respectively. At 5 mm depth the doses for Brachyvision and Plato were comparable (3399 and 3267 cGy respectively), however, the measured dose in film was 3180 cGy which was lower by as much as 6.4% in the fully loaded plaque and 7.6% in the partially loaded plaque. Conclusion: Careful methodology and calibration are essential when measuring doses at specific depth due to the sensitivity and rapid dose fall off of I-125.« less

SU-E-T-50: Automatic Validation of Megavoltage Beams Modeled for Clinical Use in Radiation Therapy

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

Melchior, M; Salinas Aranda, F; 21st Century Oncology, Ft. Myers, FL

2014-06-01

Purpose: To automatically validate megavoltage beams modeled in XiO™ 4.50 (Elekta, Stockholm, Sweden) and Varian Eclipse™ Treatment Planning Systems (TPS) (Varian Associates, Palo Alto, CA, USA), reducing validation time before beam-on for clinical use. Methods: A software application that can automatically read and analyze DICOM RT Dose and W2CAD files was developed using MatLab integrated development environment.TPS calculated dose distributions, in DICOM RT Dose format, and dose values measured in different Varian Clinac beams, in W2CAD format, were compared. Experimental beam data used were those acquired for beam commissioning, collected on a water phantom with a 2D automatic beam scanningmore » system.Two methods were chosen to evaluate dose distributions fitting: gamma analysis and point tests described in Appendix E of IAEA TECDOC-1583. Depth dose curves and beam profiles were evaluated for both open and wedged beams. Tolerance parameters chosen for gamma analysis are 3% and 3 mm dose and distance, respectively.Absolute dose was measured independently at points proposed in Appendix E of TECDOC-1583 to validate software results. Results: TPS calculated depth dose distributions agree with measured beam data under fixed precision values at all depths analyzed. Measured beam dose profiles match TPS calculated doses with high accuracy in both open and wedged beams. Depth and profile dose distributions fitting analysis show gamma values < 1. Relative errors at points proposed in Appendix E of TECDOC-1583 meet therein recommended tolerances.Independent absolute dose measurements at points proposed in Appendix E of TECDOC-1583 confirm software results. Conclusion: Automatic validation of megavoltage beams modeled for their use in the clinic was accomplished. The software tool developed proved efficient, giving users a convenient and reliable environment to decide whether to accept or not a beam model for clinical use. Validation time before beam-on for clinical use was reduced to a few hours.« less

Dosimetric evaluation of internal shielding in a high dose rate skin applicator

PubMed Central

Granero, Domingo; Perez-Calatayud, Jose; Carmona, Vicente; Pujades, M Carmen; Ballester, Facundo

2011-01-01

Purpose The Valencia HDR applicators are accessories of the microSelectron HDR afterloading system (Nucletron) shaped as truncated cones. The base of the cone is either 2 or 3 cm diameter. They are intended to treat skin lesions, being the typical prescription depth 3 mm. In patients with eyelid lesions, an internal shielding is very useful to reduce the dose to the ocular globe. The purpose of this work was to evaluate the dose enhancement from potential backscatter and electron contamination due to the shielding. Material and methods Two methods were used: a) Monte Carlo simulation, performed with the GEANT4 code, 2 cm Valencia applicator was placed on the surface of a water phantom in which 2 mm lead slab was located at 3 mm depth; b) radiochromic EBT films, used to verify the Monte Carlo results, positioning the films at 1.5, 3, 5 and 7 mm depth, inside the phantom. Two irradiations, with and without the lead shielding slab, were carried out. Results The Monte Carlo results showed that due to the backscatter component from the lead, the dose level raised to about 200% with a depth range of 0.5 mm. Under the lead the dose level was enhanced to about 130% with a depth range of 1 mm. Two millimeters of lead reduce the dose under the slab with about 60%. These results agree with film measurements within uncertainties. Conclusions In conclusion, the use of 2 mm internal lead shielding in eyelid skin treatments with the Valencia applicators were evaluated using MC methods and EBT film dosimetry. The minimum bolus thickness that was needed above and below the shielding was 0.5 mm and 1 mm respectively, and the shielding reduced the absorbed dose delivered to the ocular globe by about 60%. PMID:27877198

Investigation of various energy deposition kernel refinements for the convolution/superposition method

PubMed Central

Huang, Jessie Y.; Eklund, David; Childress, Nathan L.; Howell, Rebecca M.; Mirkovic, Dragan; Followill, David S.; Kry, Stephen F.

2013-01-01

Purpose: Several simplifications used in clinical implementations of the convolution/superposition (C/S) method, specifically, density scaling of water kernels for heterogeneous media and use of a single polyenergetic kernel, lead to dose calculation inaccuracies. Although these weaknesses of the C/S method are known, it is not well known which of these simplifications has the largest effect on dose calculation accuracy in clinical situations. The purpose of this study was to generate and characterize high-resolution, polyenergetic, and material-specific energy deposition kernels (EDKs), as well as to investigate the dosimetric impact of implementing spatially variant polyenergetic and material-specific kernels in a collapsed cone C/S algorithm. Methods: High-resolution, monoenergetic water EDKs and various material-specific EDKs were simulated using the EGSnrc Monte Carlo code. Polyenergetic kernels, reflecting the primary spectrum of a clinical 6 MV photon beam at different locations in a water phantom, were calculated for different depths, field sizes, and off-axis distances. To investigate the dosimetric impact of implementing spatially variant polyenergetic kernels, depth dose curves in water were calculated using two different implementations of the collapsed cone C/S method. The first method uses a single polyenergetic kernel, while the second method fully takes into account spectral changes in the convolution calculation. To investigate the dosimetric impact of implementing material-specific kernels, depth dose curves were calculated for a simplified titanium implant geometry using both a traditional C/S implementation that performs density scaling of water kernels and a novel implementation using material-specific kernels. Results: For our high-resolution kernels, we found good agreement with the Mackie et al. kernels, with some differences near the interaction site for low photon energies (<500 keV). For our spatially variant polyenergetic kernels, we found that depth was the most dominant factor affecting the pattern of energy deposition; however, the effects of field size and off-axis distance were not negligible. For the material-specific kernels, we found that as the density of the material increased, more energy was deposited laterally by charged particles, as opposed to in the forward direction. Thus, density scaling of water kernels becomes a worse approximation as the density and the effective atomic number of the material differ more from water. Implementation of spatially variant, polyenergetic kernels increased the percent depth dose value at 25 cm depth by 2.1%–5.8% depending on the field size, while implementation of titanium kernels gave 4.9% higher dose upstream of the metal cavity (i.e., higher backscatter dose) and 8.2% lower dose downstream of the cavity. Conclusions: Of the various kernel refinements investigated, inclusion of depth-dependent and metal-specific kernels into the C/S method has the greatest potential to improve dose calculation accuracy. Implementation of spatially variant polyenergetic kernels resulted in a harder depth dose curve and thus has the potential to affect beam modeling parameters obtained in the commissioning process. For metal implants, the C/S algorithms generally underestimate the dose upstream and overestimate the dose downstream of the implant. Implementation of a metal-specific kernel mitigated both of these errors. PMID:24320507

Hemodynamic directed cardiopulmonary resuscitation improves short-term survival from ventricular fibrillation cardiac arrest.

PubMed

Friess, Stuart H; Sutton, Robert M; Bhalala, Utpal; Maltese, Matthew R; Naim, Maryam Y; Bratinov, George; Weiland, Theodore R; Garuccio, Mia; Nadkarni, Vinay M; Becker, Lance B; Berg, Robert A

2013-12-01

During cardiopulmonary resuscitation, adequate coronary perfusion pressure is essential for establishing return of spontaneous circulation. Current American Heart Association guidelines recommend standardized interval administration of epinephrine for patients in cardiac arrest. The objective of this study was to compare short-term survival using a hemodynamic directed resuscitation strategy versus chest compression depth-directed cardiopulmonary resuscitation in a porcine model of cardiac arrest. Randomized interventional study. Preclinical animal laboratory. Twenty-four 3-month-old female swine. After 7 minutes of ventricular fibrillation, pigs were randomized to receive one of three resuscitation strategies: 1) Hemodynamic directed care (coronary perfusion pressure-20): chest compressions with depth titrated to a target systolic blood pressure of 100 mm Hg and titration of vasopressors to maintain coronary perfusion pressure greater than 20 mm Hg; 2) Depth 33 mm: target chest compression depth of 33 mm with standard American Heart Association epinephrine dosing; or 3) Depth 51 mm: target chest compression depth of 51 mm with standard American Heart Association epinephrine dosing. All animals received manual cardiopulmonary resuscitation guided by audiovisual feedback for 10 minutes before first shock. Forty-five-minute survival was higher in the coronary perfusion pressure-20 group (8 of 8) compared to depth 33 mm (1 of 8) or depth 51 mm (3 of 8) groups; p equals to 0.002. Coronary perfusion pressures were higher in the coronary perfusion pressure-20 group compared to depth 33 mm (p = 0.004) and depth 51 mm (p = 0.006) and in survivors compared to nonsurvivors (p < 0.01). Total epinephrine dosing and defibrillation attempts were not different. Hemodynamic directed resuscitation targeting coronary perfusion pressures greater than 20 mm Hg during 10 minutes of cardiopulmonary resuscitation for ventricular fibrillation cardiac arrest improves short-term survival, when compared to resuscitation with depth of compressions guided to 33 mm or 51 mm and standard American Heart Association vasopressor dosing.

Analysis of variation in calibration curves for Kodak XV radiographic film using model-based parameters.

PubMed

Hsu, Shu-Hui; Kulasekere, Ravi; Roberson, Peter L

2010-08-05

Film calibration is time-consuming work when dose accuracy is essential while working in a range of photon scatter environments. This study uses the single-target single-hit model of film response to fit the calibration curves as a function of calibration method, processor condition, field size and depth. Kodak XV film was irradiated perpendicular to the beam axis in a solid water phantom. Standard calibration films (one dose point per film) were irradiated at 90 cm source-to-surface distance (SSD) for various doses (16-128 cGy), depths (0.2, 0.5, 1.5, 5, 10 cm) and field sizes (5 × 5, 10 × 10 and 20 × 20 cm²). The 8-field calibration method (eight dose points per film) was used as a reference for each experiment, taken at 95 cm SSD and 5 cm depth. The delivered doses were measured using an Attix parallel plate chamber for improved accuracy of dose estimation in the buildup region. Three fitting methods with one to three dose points per calibration curve were investigated for the field sizes of 5 × 5, 10 × 10 and 20 × 20 cm². The inter-day variation of model parameters (background, saturation and slope) were 1.8%, 5.7%, and 7.7% (1 σ) using the 8-field method. The saturation parameter ratio of standard to 8-field curves was 1.083 ± 0.005. The slope parameter ratio of standard to 8-field curves ranged from 0.99 to 1.05, depending on field size and depth. The slope parameter ratio decreases with increasing depth below 0.5 cm for the three field sizes. It increases with increasing depths above 0.5 cm. A calibration curve with one to three dose points fitted with the model is possible with 2% accuracy in film dosimetry for various irradiation conditions. The proposed fitting methods may reduce workload while providing energy dependence correction in radiographic film dosimetry. This study is limited to radiographic XV film with a Lumisys scanner.

GPS in ten years

DOT National Transportation Integrated Search

1997-09-16

What will GPS look like in ten years? This paper discusses improvements to the overall GPS system planned over the next ten years and examines their impact on system performance for several applications. The Presidential Decision Directive (PDD) rele...

Product Definition Data (PDD) Current Environment Report

DOT National Transportation Integrated Search

1989-05-01

The objective of the Air Force Computer-aided Acquisition and Logistics Support (CALS) Program is to improve weapon system reliability, supportability and maintainability, and to reduce the cost of weapon system acquisition and logistics support. As ...

Development of radiochromic film for spatially quantitative dosimetric analysis of indirect ionizing radiation fields

NASA Astrophysics Data System (ADS)

Brady, Samuel Loren

Two types of radiochromic films (RCF) were characterized for this work: EBT and XRQA film. Both films were investigated for: radiation interaction with film structure; light interaction with film structure for optimal film readout (densitometry) sensitivity; range of absorbed dose measurements; dependence of film dose measurement response as a function of changing radiation energy; fractionation and dose rate effects on film measurement response; film response sensitivity to ambient factors; and stability of measured film response with time. EBT film was shown to have the following properties: near water equivalent atomic weight (Zeff); dynamic dose range of 10 -1-102 Gy; 3% change in optical density (OD) response for a single exposure level when exposed to radiation energies from (75-18,000) kV; and best digitized using transmission densitometry. XRQA film was shown to have: a Zeff of ˜25; a 12 fold increase in sensitivity at lower photon energies for a dynamic dose range of 10-3-100 Gy, a difference of 25% in OD response when comparing 120 kV to 320 kV, and best digitized using reflective densitometry. Both XRQA and EBT films were shown to have: a temporal stability (DeltaOD) of ˜1% for t > 24 hr post film exposure for up to ˜20 days; a change in dose response of ˜0.03 mGy hr-1 when exposed to fluorescent room lighting at standard room temperature and humidity levels; a negligible dose rate and fractionation effect when operated within the optimal dose ranges; and a light wavelength dependence with dose for film readout. The flat bed scanner was chosen as the primary film digitizer due to its availability, cost, OD range, functionality (transmission and reflection scanning), and digitization speed. As a cost verses functionality comparison, the intrinsic and operational limitations were determined for two flat bed scanners. The EPSON V700 and 10000XL exhibited equal spatial and OD accuracy. The combined precision of both the scanner light sources and CCD sensors measured < 2% and < 7% deviation in pixel light intensities for 50 consecutive scans, respectively. Both scanner light sources were shown to be uniform in transmission and reflection scan modes along the center axis of light source translation. Additionally, RCFs demonstrated a larger dynamic range in pixel light intensities, and to be less sensitive to off axis light inhomogeneity, when scanned in landscape mode (long axis of film parallel with axis of light source translation). The EPSON 10000XL demonstrated slightly better light source/CCD temporal stability and provided a capacity to scan larger film formats at the center of the scanner in landscape mode. However, the EPSON V700 only measured an overall difference in accuracy and precision by 2%, and though smaller in size, at the time of this work, was one sixth the cost of the 10000XL. A scan protocol was developed to maximize RCF digitization accuracy and precision, and a calibration fitting function was developed for RCF absolute dosimetry. The fitting function demonstrated a superior goodness of fit for both RCF types over a large range of absorbed dose levels as compared to the currently accepted function found in literature. The RCF dosimetry system was applied to three novel areas from which a benefit could be derived for 2D or 3D dosimetric information. The first area was for a 3D dosimetry of a pendant breast in 3D-CT mammography. The novel method of developing a volumetric image of the breast from a CT acquisition technique was empirically measured for its dosimetry and compared to standard dual field digital mammography. The second area was dose reduction in CT for pediatric and adult scan protocols. In this application, novel methodologies were developed to measure 3D organ dosimetry and characterize a dose reduction scan protocol for pediatric and adult body habitus. The third area was in the field of small animal irradiation for radiobiology purposes and cancer patient treatment verification. In every case, the RCF dosimetry system was verified for accuracy using a traditional PDD as the golden standard. When considering all areas of radiation energy applications, the RCF dosimetry system agreed to better than 7% of the golden standard, and in some cases within better than 1%. In many instances, this work provided vital dosimetric information that otherwise was not captured using the PDD in similar geometry. This work demonstrates the need for RCF to more accurately measure volumetric dose. (Abstract shortened by UMI.)

Depth profiling of ion-induced damage in D9 alloy using X-ray diffraction

NASA Astrophysics Data System (ADS)

Dey, S.; Gayathri, N.; Mukherjee, P.

2018-04-01

The ion-induced depthwise damage profile in 35 MeV α-irradiated D9 alloy samples with doses of 5 × 1015 He2+/cm2, 6.4 × 1016 He2+/cm2 and 2 × 1017 He2+/cm2 has been assessed using X-ray diffraction technique. The microstructural characterisation has been done along the depth from beyond the stopping region (peak damage region) to the homogeneous damage region (surface) as simulated from SRIM. The parameters such as domain size and microstrain have been evaluated using two different X-ray diffraction line profile analysis techniques. The results indicate that at low dose the damage profile shows a prominent variation as a function of depth but, with increasing dose, it becomes more homogeneous along the depth. This suggests that enhanced defect diffusion and their annihilation in pre-existing and newly formed sinks play a significant role in deciding the final microstructure of the irradiated sample as a function of depth.

Comparative evaluation of Kodak EDR2 and XV2 films for verification of intensity modulated radiation therapy.

PubMed

Dogan, Nesrin; Leybovich, Leonid B; Sethi, Anil

2002-11-21

Film dosimetry provides a convenient tool to determine dose distributions, especially for verification of IMRT plans. However, the film response to radiation shows a significant dependence on depth, energy and field size that compromise the accuracy of measurements. Kodak's XV2 film has a low saturation dose (approximately 100 cGy) and, consequently, a relatively short region of linear dose-response. The recently introduced Kodak extended range EDR2 film was reported to have a linear dose-response region extending to 500 cGy. This increased dose range may be particularly useful in the verification of IMRT plans. In this work, the dependence of Kodak EDR2 film's response on the depth, field size and energy was evaluated and compared with Kodak XV2 film. Co-60, 6 MV, 10 MV and 18 MV beams were used. Field sizes were 2 x 2, 6 x 6, 10 x 10, 14 x 14, 18 x 18 and 24 x 24 cm2. Doses for XV2 and EDR2 films were 80 cGy and 300 cGy, respectively. Optical density was converted to dose using depth-corrected sensitometric (Hurter and Driffield, or H&D) curves. For each field size, XV2 and EDR2 depth-dose curves were compared with ion chamber depth-dose curves. Both films demonstrated similar (within 1%) field size dependence. The deviation from the ion chamber for both films was small forthe fields ranging from 2 x 2 to 10 x 10 cm2: < or =2% for 6, 10 and 18 MV beams. No deviation was observed for the Co-60 beam. As the field size increased to 24 x 24 cm2, the deviation became significant for both films: approximately 7.5% for Co-60, approximately 5% for 6 MV and 10 MV, and approximately 6% for 18 MV. During the verification of IMRT plans, EDR2 film showed a better agreement with the calculated dose distributions than the XV2 film.