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

Goke, Sarah Hayes; Elliott, Nathan Ryan

The Sandia National Laboratories’ Internal Dosimetry Technical Basis Manual is intended to provide extended technical discussion and justification of the internal dosimetry program at SNL. It serves to record the approach to evaluating internal doses from radiobioassay data, and where appropriate, from workplace monitoring data per the Department of Energy Internal Dosimetry Program Guide DOE G 441.1C. The discussion contained herein is directed primarily to current and future SNL internal dosimetrists. In an effort to conserve space in the TBM and avoid duplication, it contains numerous references providing an entry point into the internal dosimetry literature relevant to this program.more » The TBM is not intended to act as a policy or procedure statement, but will supplement the information normally found in procedures or policy documents. The internal dosimetry program outlined in this manual is intended to meet the requirements of Federal Rule 10CFR835 for monitoring the workplace and for assessing internal radiation doses to workers.« less

RECONSTRUCTING POPULATION EXPOSURES FROM DOSE BIOMARKERS: INHALATION OF TRICHLOROETHYLENE (TCE) AS A CASE STUDY

EPA Science Inventory

Physiologically based pharmacokinetic (PBPK) modeling is a well-established toxicological tool designed to relate exposure to a target tissue dose. The emergence of federal and state programs for environmental health tracking and the availability of exposure monitoring through bi...

1989 Environmental monitoring report, Sandia National Laboratories, Albuquerque, New Mexico

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

Hwang, S.; Chavez, G.; Phelan, J.

1990-05-01

This 1989 report contains monitoring data from routine radiological and nonradiological environmental surveillance activities. Summaries of significant environmental compliance programs in progress such as National Environmental Policy Act documentation, environmental permits, environmental restoration, and various waste management programs for Sandia National Laboratories in Albuquerque (SNL, Albuquerque) are included. The maximum offsite dose impact was calculated to be 8.8 {times} 10{sup {minus}4} mrem. The total Albuquerque population received a collective dose of 0.097 person-rem during 1989 from SNL, Albuquerque, operations. As in the previous year, SNL, Albuquerque, operations in 1989 had no adverse impact on the general public or on themore » environment. 46 refs., 20 figs., 31 tabs.« less

Maywood Interim Storage Site environmental report for calendar year 1992, 100 West Hunter Avenue, Maywood, New Jersey. Formerly Utilized Sites Remedial Action Program (FUSRAP)

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

Not Available

1993-05-01

This report describes the environmental surveillance program at the Maywood Interim Storage Site (MISS) and provides the results for 1992. Environmental monitoring of MISS began in 1984, when the site was assigned to DOE by Congress through the Energy and Water Development Appropriations Act and was placed under DOE`s Formerly Utilized Sites Remedial Action Program (FUSRAP). FUSRAP was established to identify and decontaminate or otherwise control sites where residual radioactive materials remain from the early years of the nation`s atomic energy program or from commercial operations causing conditions that Congress has authorized DOE to remedy. MISS is part of amore » National Priorities List (NPL) site. The environmental surveillance program at MISS includes sampling networks for radon and thoron in air; external gamma radiation exposure; and radium-226, radium-228, thorium-232, and total uranium in surface water, sediment, and groundwater. Additionally, chemical analysis includes metals and organic compounds in surface water and groundwater and metals in sediments. This program assists in fulfilling the DOE objective of measuring and monitoring effluents from DOE activities and calculating hypothetical doses to members of the general public. Monitoring results are compared with applicable Environmental Protection Agency (EPA) and state standards, DOE derived concentration guides (DCGs), dose limits, and other DOE requirements. Environmental standards are established to protect public health and the environment. The radiological data for all media sampled support the conclusion that doses to the public are not distinguishable from natural background radiation.« less

2007 Annual Health Physics Report for the HEU Transparency Program

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

Radev, R

2008-04-09

During the 2007 calendar year, Lawrence Livermore National Laboratory (LLNL) provided health physics support for the Highly Enriched Uranium (HEU) Transparency Program for external and internal radiation protection and technical expertise related to BDMS radioactive sources and Russian radiation safety regulatory compliance. For the calendar year 2007, there were 172 person-trips that required dose monitoring of the U.S. monitors. Of the 172 person-trips, 160 person-trips were SMVs and 12 person-trips were Transparency Monitoring Office (TMO) trips. There were 12 monitoring visits by TMO monitors to facilities other than UEIE and 10 to UEIE itself. There were two monitoring visits (sourcemore » changes) that were back to back with 14 monitors. LLNL's Hazard Control Division laboratories provided the dosimetry services for the HEU Transparency monitors.« less

St. Louis Airport Site. Annual site environmental report, calendar year 1985. Formerly Utilized Sites Remedial Action Program (FUSRAP). Revision 1

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

Not Available

1986-09-01

During 1985, the environmental monitoring program was continued at the St. Louis Airport Site (SLAPS) in St. Louis County, Missouri. The ditches north and south of the site have been designated for cleanup as part of the Formerly Utilized Sites Remedial Action Program (FUSRAP). The monitoring program at the SLAPS measures radon gas concentrations in air; external gamma radiation dose rates; and uranium, thorium, and radium concentrations in surface water, groundwater, and sediment. Potential radiation doses to the public are also calculated. Because the site is not controlled or regulated by the DOE, the DOE Derived Concentration Guides (DCGs) aremore » not applicable to SLAPS, but are included only as a basis for comparison. The DOE DCGs and the DOE radiation protection standard have been revised. (Appendix B). During 1985, annual average radon levels in air at the SLAPS were below the DCG for uncontrolled areas. External gamma monitoring in 1985 showed measured annual gamma dose rates ranging from 3 to 2087 mrem/y, with the highest value occurring in an area known to be contaminated. The calculated maximum dose at the site boundary, assuming limited occupancy, would be 6 mrem/y. Average annual concentrations of /sup 230/Th, /sup 226/Ra, and total uranium in surface waters remained below the DOE DCG. The on-site groundwater measurements showed that average annual concentrations of /sup 230/Th, /sup 226/Ra and total uranium were within the DOE DCGs. Although there are no DCGs for sediments, all concentrations of total uraniu, /sup 230/Th, and /sup 226/Ra were below the FUSRAP Guidelines.« less

AREA MONITORING OF AMBIENT DOSE RATES IN PARTS OF SOUTH-WESTERN NIGERIA USING A GPS-INTEGRATED RADIATION SURVEY METER.

PubMed

Okeyode, I C; Rabiu, J A; Alatise, O O; Makinde, V; Akinboro, F G; Al-Azmi, D; Mustapha, A O

2017-04-01

A radiation monitoring system comprising a Geiger-Muller counter connected to a smart phone via Bluetooth was used for a dose rate survey in some parts of south-western Nigeria. The smart phone has the Geographical Positioning System, which provides the navigation information and saves it along with the dose rate data. A large number of data points was obtained that shows the dose rate distribution within the region. The results show that the ambient dose rates in the region range from 60 to 520 nSv -1 and showed a bias that is attributable to the influence of geology on the ambient radiation dose in the region. The geology influence was demonstrated by superimposing the dose rate plot and the geological map of the area. The potential applications of the device in determining baseline information and in area monitoring, e.g. for lost or abandoned sources, radioactive materials stockpiles, etc., were discussed in the article, particularly against the background of Nigeria's plan to develop its nuclear power program. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

1992 Environmental monitoring report, Sandia National Laboratories, Albuquerque, New Mexico

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

Culp, T.; Cox, W.; Hwang, H.

1993-09-01

This 1992 report contains monitoring data from routine radiological and nonradiological environmental surveillance activities. summaries of significant environmental compliance programs in progress, such as National Environmental Policy Act documentation, environmental permits, envirorunental restoration, and various waste management programs for Sandia National Laboratories in Albuquerque, New Mexico, are included. The maximum offsite dose impact was calculated to be 0.0034 millirem. The total population within a 50-mile radius of Sandia National Laboratories/New Mexico received an estimated collective dose of 0.019 person-rem during 1992 from the laboratories` operations. As in the previous year, the 1992 operations at Sandia National Laboratories/New Mexico had nomore » discernible impact on the general public or on the environment.« less

1991 Environmental monitoring report Sandia National Laboratories, Albuquerque, New Mexico

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

Culp, T.; Cox, W.; Hwang, S.

1992-11-01

This 1991 report contains monitoring data from routine radiological and nonradiological environmental surveillance activities. Summaries of significant environmental compliance programs in progress such as National Environmental Policy Act (NEPA) documentation, environmental permits, environmental restoration (ER), and various waste management programs for Sandia National Laboratories in Albuquerque (SNL, Albuquerque) are included. The maximum offsite dose impact was calculated to be 1.3 {times} 10{sup {minus}3} mrem. The total population within a 50-mile radius of SNL, Albuquerque, received a collective dose of 0.53 person-rem during 1991 from SNL, Albuquerque, operations. As in the previous year, the 1991 operations at SNL, Albuquerque, had nomore » discernible impact on the general public or on the environment.« less

Niagara Falls Storage Site annual environmental report for calendar year 1991, Lewiston, New York. [Niagara Falls Storage Site

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

Not Available

1992-09-01

This document describes the environmental monitoring program at the Niagara Falls Storage Site (NFSS) and surrounding area, implementation of the program, and monitoring results for 1991. Environmental monitoring at NFSS began in 1981. The site is owned by the US Department of Energy (DOE) and is assigned to the DOE Formerly Utilized Sites Remedial Action Program (FUSRAP). FUSRAP is a program to decontaminate or otherwise control sites where residual radioactive materials remain from the early years of the nation's atomic energy program or from commercial operations causing conditions that Congress has authorized DOE to remedy. The environmental monitoring program atmore » NFSS includes sampling networks for radon concentrations in air; external gamma radiation exposure; and total uranium and radium-226 concentrations in surface water, sediments, and groundwater. Additionally, several nonradiological parameters including seven metals are routinely measured in groundwater. Monitoring results are compared with applicable Environmental Protection Agency (EPA) standards, DOE derived concentration guides (DCGs), dose limits, and other requirements in DOE orders. Environmental standards are established to protect public health and the environment.« less

Niagara Falls Storage Site annual environmental report for calendar year 1991, Lewiston, New York

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

Not Available

1992-09-01

This document describes the environmental monitoring program at the Niagara Falls Storage Site (NFSS) and surrounding area, implementation of the program, and monitoring results for 1991. Environmental monitoring at NFSS began in 1981. The site is owned by the US Department of Energy (DOE) and is assigned to the DOE Formerly Utilized Sites Remedial Action Program (FUSRAP). FUSRAP is a program to decontaminate or otherwise control sites where residual radioactive materials remain from the early years of the nation`s atomic energy program or from commercial operations causing conditions that Congress has authorized DOE to remedy. The environmental monitoring program atmore » NFSS includes sampling networks for radon concentrations in air; external gamma radiation exposure; and total uranium and radium-226 concentrations in surface water, sediments, and groundwater. Additionally, several nonradiological parameters including seven metals are routinely measured in groundwater. Monitoring results are compared with applicable Environmental Protection Agency (EPA) standards, DOE derived concentration guides (DCGs), dose limits, and other requirements in DOE orders. Environmental standards are established to protect public health and the environment.« less

Annual environmental monitoring report of the Lawrence Berkeley Laboratory

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

Schleimer, G.E.

1989-06-01

The Environmental Monitoring Program of the Lawrence Berkeley Laboratory (LBL) is described. Data for 1988 are presented and general trends are discussed. In order to establish whether LBL research activities produced any impact on the population surrounding the laboratory, a program of environmental air and water sampling and continuous radiation monitoring was carried on throughout the year. For 1988, as in the previous several years, dose equivalents attributable to LBL radiological operations were a small fraction of both the relevant radiation protection guidelines (RPG) and of the natural radiation background. 16 refs., 7 figs., 21 tabs.

St. Louis Airport Site annual site environmental report. Calendar year 1985

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

Not Available

1986-04-01

During 1985, the environmental monitoring program was continued at the St. Louis Airport Site (SLAPS) in St. Louis County, Missouri. The ditches north and south of the site have been designated for cleanup as part of the Formerly Utilized Sites Remedial Action Program (FUSRAP), a United States Department of Energy (DOE) program to identify, decontaminate, or otherwise control sites where low-level radioactive contamination remains from the early years of the nation's atomic energy program. The site is not currently controlled or regulated by DOE or NRC, although radiological monitoring of the site has been authorized by the DOE. The monitoringmore » program at the SLAPS measures radon gas concentrations in air; external gamma radiation dose rates; and uranium, thorium, and radium concentrations in surface water, groundwater, and sediment. Potential radiation doses to the public are also calculated. Because the site is not controlled or regulated by the DOE, the DOE Derived Concentration Guides (DCGs) are not applicable to SLAPS, but are included as a basis for comparison only. The DOE DCGs and the DOE radiation protection standard have been revised.« less

2004 Annual Health Physics Report for the HEU Transparency Program

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

Radev, R

2005-04-01

During the 2004 calendar year, LLNL provided health physics support for the Highly Enriched Uranium Transparency Implementation Program (HEU-TIP) in external and internal radiation protection and technical expertise into matters related to BDMS radioactive sources and Russian radiation safety regulatory compliance. For the calendar year 2004, there were 200 person-trips that required dose monitoring of the U.S. monitors. Of the 200 person-trips, 183 person-trips were SMVs and 17 person-trips were Transparency Monitoring Office (TMO) trips. Eight person-trips from the SMV trips were continuation trips of TMO monitors to facilities other than UEIP. The LLNL Safety Laboratories' Division provided the dosimetrymore » services for the HEU-TIP monitors.« less

Technical basis for internal dosimetry at Hanford

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

Sula, M.J.; Carbaugh, E.H.; Bihl, D.E.

1991-07-01

The Hanford Internal Dosimetry Program, administered by Pacific Northwest Laboratory for the US Department of Energy, provides routine bioassay monitoring for employees who are potentially exposed to radionuclides in the workplace. This report presents the technical basis for routine bioassay monitoring and the assessment of internal dose at Hanford. The radionuclides of concern include tritium, corrosion products ({sup 58}Co, {sup 60}Co, {sup 54}Mn, and {sup 59}Fe), strontium, cesium, iodine, europium, uranium, plutonium, and americium,. Sections on each of these radionuclides discuss the sources and characteristics; dosimetry; bioassay measurements and monitoring; dose measurement, assessment, and mitigation and bioassay follow-up treatment. 78more » refs., 35 figs., 115 tabs.« less

Technical basis for internal dosimetry at Hanford

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

Sula, M.J.; Carbaugh, E.H.; Bihl, D.E.

1989-04-01

The Hanford Internal Dosimetry Program, administered by Pacific Northwest Laboratory for the US Department of Energy, provides routine bioassay monitoring for employees who are potentially exposed to radionuclides in the workplace. This report presents the technical basis for routine bioassay monitoring and the assessment of internal dose at Hanford. The radionuclides of concern include tritium, corrosion products (/sup 58/Co, /sup 60/Co, /sup 54/Mn, and /sup 59/Fe), strontium, cesium, iodine, europium, uranium, plutonium, and americium. Sections on each of these radionuclides discuss the sources and characteristics; dosimetry; bioassay measurements and monitoring; dose measurement, assessment, and mitigation; and bioassay follow-up treatment. 64more » refs., 42 figs., 118 tabs.« less

2010 Annual Health Physics Report for the HEU Transparency Program

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

Radev, Radoslav

2011-05-16

During the 2010 calendar year, Lawrence Livermore National Laboratory (LLNL) provided health physics support for the Highly Enriched Uranium (HEU) Transparency Program for external and internal radiation protection. LLNL also provided technical expertise related to BDMS radioactive sources and Russian radiation safety regulatory compliance. For the calendar year 2010, there were 141 person-trips that required dose monitoring of the U.S. monitors. Of the 141 person-trips, 129 person-trips were Special Monitoring Visits (SMVs) and 12 person-trips were Transparency Monitoring Office (TMO) trips. In 8 of these TMO trips the TMO monitors participated also in the UEIE SMVs and in 2 TMOmore » trips the TMO monitors participated in UEIE and MPA SMVs. There were three monitoring visits (source changes) that were back-to-back SMVs with a total of 25 monitors. LLNL’s Hazard Control Department laboratories provided the dosimetry services for the HEU Transparency monitors.« less

Formerly Utilized Sites Remedial Action Program (FUSRAP) Hazelwood Interim Storage Site annual site environmental report. Calendar year 1985. [FUSRAP

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

Not Available

1986-04-01

The Hazelwood Interim Storage Site (HISS) is presently used for the storage of low-level radioactively contaminated soils. Monitoring results show that the HISS is in compliance with DOE concentration guides and radiation protection standards. Derived Concentration Guides (DCGs) represent the concentrations of radionuclides in air or water that would limit the radiation dose to 100 mrem/y. The applicable limits have been revised since the 1984 environmental monitoring report was published. The limits applied in 1984 were based on a radiation protection standard of 500 mrem/y; the limits applied for 1985 are based on a standard of 100 mrem/y. The HISSmore » is part of the Formerly Utilized Sites Remedial Action Program (FUSRAP), a DOE program to decontaminate or otherwise control sites where low-level radioactive contamination remains from the early years of the nation's atomic energy program. To determine whether the site is in compliance with DOE standards, environmental measurements are expressed as percentages of the applicable DCG, while the calculated doses to the public are expressed as percentages of the applicable radiation protection standard. The monitoring program at the HISS measures uranium, radium, and thorium concentrations in surface water, groundwater, and sediment; radon gas concentrations in air; and external gamma radiation exposure rates. Potential radiation doses to the public are also calculated. The HISS was designated for remedial action under FUSRAP because radioactivity above applicable limits was found to exist at the site and its vicinity. Elevated levels of radiation still exist in areas where remedial action has not yet been completed.« less

Maywood Interim Storage Site annual environmental report for calendar year 1991, Maywood, New Jersey. Formerly Utilized Sites Remedial Action Program (FUSRAP)

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

Not Available

1992-09-01

This document describes the environmental monitoring program at the Maywood Interim Storage Site (MISS) and surrounding area, implementation of the program, and monitoring results for 1991. Environmental monitoring of MISS began in 1984 when congress added the site to the US Department of Energy`s (DOE) Formerly Utilized Sites Remedial Action Program (FUSRAP). FUSRAP is a DOE program to identify and decontaminate or otherwise control sites where residual radioactive materials remain from the early years of the nation`s atomic energy program or from commercial operations causing conditions that Congress has authorized DOE to remedy. The environmental monitoring program at MISS includesmore » sampling networks for radon and thoron concentrations in air; external gamma radiation-exposure; and total uranium, radium-226, radium-228, thorium-232, and thorium-230 concentrations in surface water, sediment, and groundwater. Additionally, several nonradiological parameters are measured in surface water, sediment, and groundwater. Monitoring results are compared with applicable Environmental Protection Agency standards, DOE derived concentration guides (DCGs), dose limits, and other requirements in DOE orders. Environmental standards are established to protect public health and the environment.« less

2005 Annual Health Physics Report for HEU Transparency Program

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

Radev, R

2006-04-21

During the 2005 calendar year, LLNL provided health physics support for the Highly Enriched Uranium Transparency Program (HEU-TP) in external and internal radiation protection and technical expertise into matters related to BDMS radioactive sources and Russian radiation safety regulatory compliance. For the calendar year 2005, there were 161 person-trips that required dose monitoring of the U.S. monitors. Of the 161 person-trips, 149 person-trips were SMVs and 12 person-trips were Transparency Monitoring Office (TMO) trips. Additionally, there were 11 monitoring visits by TMO monitors to facilities other than UEIE and 3 to UEIE itself. There were two monitoring visits (source changes)more » that were back to back with 16 monitors. Each of these concurring visits were treated as single person-trips for dosimetry purposes. Counted individually, there were 191 individual person-visits in 2005. The LLNL Safety Laboratories Division provided the dosimetry services for the HEU-TP monitors.« less

Wayne Interim Storage Site environmental report for calendar year 1992, 868 Black Oak Ridge Road, Wayne, New Jersey. Formerly Utilized Sites Remedial Action Program (FUSRAP)

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

Not Available

1993-05-01

This report describes the environmental surveillance program at the Wayne Interim Storage Site (WISS) and provides the results for 1992. The fenced, site, 32 km (20 mi) northwest of Newark, New Jersey, was used between 1948 and 1971 for commercial processing of monazite sand to separate natural radioisotopes - predominantly thorium. Environmental surveillance of WISS began in 1984 in accordance with Department of Energy (DOE) Order 5400.1 when Congress added the site to DOE`s Formerly Utilized Sites Remedial Action Program (FUSRAP). The environmental surveillance program at WISS includes sampling networks for radon and thoron in air; external gamma radiation exposure;more » radium-226, radium-228, thorium-230, thorium-232, total uranium, and several chemicals in surface water and sediment; and total uranium, radium-226, radium-228, thorium-230, thorium-232, and organic and inorganic chemicals in groundwater. Monitoring results are compared with applicable Environmental Protection Agency (EPA) and state standards, DOE derived concentration guides (DCGs), dose limits, and other DOE requirements. This monitoring program assists in fulfilling the DOE policy of measuring and monitoring effluents from DOE activities and calculating hypothetical doses. Results for environmental surveillance in 1992 show that the concentrations of all radioactive and most chemical contaminants were below applicable standards.« less

WWW.NMDB.EU: The real-time Neutron Monitor database

NASA Astrophysics Data System (ADS)

Klein, Karl-Ludwig; Steigies, Christian T.; NMDB Consortium

2010-05-01

The Real time database for high-resolution neutron monitor measurements (NMDB), which was supported by the 7th framework program of the European Commission, hosts data on cosmic rays in the GeV range from European and some non-European neutron monitor stations. It offers a variety of applications ranging from the representation and retrieval of cosmic ray data over solar energetic particle alerts to the calculation of ionisation doses in the atmosphere and radiation dose rates at aircraft altitudes. Furthermore the web site comprises public outreach pages in several languages and offers training material on cosmic rays for university students and researchers and engineers who want to get familiar with cosmic rays and neutron monitor measurements. This contribution presents an overview of the provided services and indications on how to access the database. Operators of other neutron monitor stations are welcome to submit their data to NMDB.

SU-G-IeP3-12: Preliminary Report On the Experience of Patient Radiation Dose Monitoring and Tracking Systems; PEMNET, Radimetrics and DoseWatch

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

Lin, P; Corwin, F; Ghita, M

Purpose: Three patient radiation dose monitoring and tracking (PRDMT) systems have been in operation at this institution for the past 6 months. There are useful information that should be disseminated to those who are considering installation of PRDMT programs. In addition, there are “problems” uncovered in the process of estimating fluoroscopic “peak” skin dose (PSD), especially, for those patients who received interventional angiographic studies and in conjunction with surgical procedures. Methods: Upon exporting the PRDMT data to Microsoft Excel program, the peak skin dose can be estimated by applying various correction factors including; attenuation due to the tabletop and examinationmore » mattress, table height, tabletop translation, backscatter, etc. A procedure was established to screen and divide the PRDMT reported radiation dose and estimated PSD to three different levels of threshold to assess the potential skin injuries, to assist patient follow-up, risk management and provide radiation dosimetry information in case of “Sentinel Event”. Results: The Radiation Dose Structured Report (RDSR) was found to be the prerequisite for the PRDMT systems to work seamlessly. And, the geometrical parameters (gantry and table orientation) displayed by the equipment are not necessarily implemented in the “patient centric” manner which could result in a large error in the PSD estimation. Since, the PRDMT systems obtain their pertinent data from the DICOM tags including the polarity (+ and − signs), the geometrical parameters need to be verified. Conclusion: PRDMT systems provide a more accurate PSD estimation than previously possible as the air-kerma-area dose meter become widely implemented. However, care should be exercised to correctly apply the geometrical parameters in estimating the patient dose. In addition, further refinement is necessary for these software programs to account for all geometrical parameters such as the tabletop translation in the z-direction in particular.« less

Maywood Interim Storage Site annual environmental report for calendar year 1991, Maywood, New Jersey. [Maywood Interim Storage Site

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

None

1992-09-01

This document describes the environmental monitoring program at the Maywood Interim Storage Site (MISS) and surrounding area, implementation of the program, and monitoring results for 1991. Environmental monitoring of MISS began in 1984 when congress added the site to the US Department of Energy's (DOE) Formerly Utilized Sites Remedial Action Program (FUSRAP). FUSRAP is a DOE program to identify and decontaminate or otherwise control sites where residual radioactive materials remain from the early years of the nation's atomic energy program or from commercial operations causing conditions that Congress has authorized DOE to remedy. The environmental monitoring program at MISS includesmore » sampling networks for radon and thoron concentrations in air; external gamma radiation-exposure; and total uranium, radium-226, radium-228, thorium-232, and thorium-230 concentrations in surface water, sediment, and groundwater. Additionally, several nonradiological parameters are measured in surface water, sediment, and groundwater. Monitoring results are compared with applicable Environmental Protection Agency standards, DOE derived concentration guides (DCGs), dose limits, and other requirements in DOE orders. Environmental standards are established to protect public health and the environment.« less

Hazelwood Interim Storage Site annual environmental report for calendar year 1991, Hazelwood, Missouri

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

Not Available

1992-09-01

This document describes the environmental monitoring program at the Hazelwood Interim Storage Site (HISS) and surrounding area, implementation of the program, and monitoring results for 1991. Environmental monitoring of HISS began in 1984 when the site was assigned to the US Department of Energy (DOE) as part of the decontamination research and development project authorized by Congress under the 1984 Energy and Water Development Appropriations Act. DOE placed responsibility for HISS under the Formerly Utilized Sites Remedial Action Program (FUSRAP), a DOE program to decontaminate or otherwise control sites where residual radioactive materials remain from the early years of themore » nation`s atomic energy program or from commercial operations causing conditions that Congress has authorized DOE to remedy. The environmental monitoring program at HISS includes sampling networks for radon concentrations in air; external gamma radiation exposure; and radium-226, thorium-230, and total uranium concentrations in surface water, sediment, and groundwater. Additionally, several nonradiological parameters are measured in groundwater. Monitoring results are compared with applicable Environmental Protection Agency standards, DOE derived concentration guides (DCGs), dose limits, and other requirements in DOE orders. Environmental standards and DCGs are established to protect public health and the environment.« less

1990 Environmental Monitoring Report, Sandia National Laboratories, Albuquerque, New Mexico

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

Hwang, S.; Yeager, G.; Wolff, T.

1991-05-01

This 1990 report contains monitoring data from routine radiological and nonradiological environmental surveillance activities. Summaries of significant environmental compliance programs in progress such as National Environmental Policy Act (NEPA) documentation, environmental permits, environmental restoration, and various waste management programs for Sandia National Laboratories in Albuquerque (SNL, Albuquerque) are included. The maximum offsite dose impact was calculated to be 2.0 {times} 10{sup {minus}3} mrem. The total 50-mile population received a collective dose of 0.82 person-rem during 1990 from SNL, Albuquerque, operations. As in the previous year, the 1990 SNL operations had no adverse impact on the general public or on themore » environment. This report is prepared for the US Department of Energy in compliance with DOE Order 5400.1. 97 refs., 30 figs., 137 tabs.« less

Environmental monitoring in interventional radiology

NASA Astrophysics Data System (ADS)

Del Sol, S.; Garcia, R.; Sánchez-Guzmán, D.; Ramirez, G.; Chavarin, E. U.; Rivera, T.

2017-01-01

The procedures in Interventional Radiology involve long times of exposure and high number of radiographic images that bring higher radiation doses to patients, staff and environmental than those received in conventional Radiology. Currently for monitoring the dose, the thermoluminescent dosimetry use is recommended. The aim of this work was to carry out the monitoring of the environmental scattered radiation inside the IR room using two types of thermoluminescent dosimeters, TLD-100 (reference dosimeter), CaSO4:Dy (synthesized in our laboratory). The results indicate that the TLD-100 is not effective for the environmental monitoring of low-energy Rx rooms. The CaSO4:Dy presented good behaviour over the 6 months of study. The results will be specific to each room so it is recommended such studies as part of the program of quality control of each Rx room.

2009 Annual Health Physics Report for the HEU Transparency Program

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

Radev, R

2010-04-14

During the 2009 calendar year, Lawrence Livermore National Laboratory (LLNL) provided health physics support for the Highly Enriched Uranium (HEU) Transparency Program for external and internal radiation protection. LLNL also provided technical expertise related to BDMS radioactive sources and Russian radiation safety regulatory compliance. For the calendar year 2009, there were 159 person-trips that required dose monitoring of the U.S. monitors. Of the 159 person-trips, 149 person-trips were SMVs and 10 person-trips were Transparency Monitoring Office (TMO) trips. There were 4 monitoring visits by TMO monitors to facilities other than UEIE and 10 to UEIE itself. LLNL's Hazard Control Departmentmore » laboratories provided the dosimetry services for the HEU Transparency monitors. In 2009, the HEU Transparency activities in Russia were conducted in a radiologically safe manner for the HEU Transparency monitors in accordance with the expectations of the HEU Transparency staff, NNSA and DOE. The HEU Transparency Program now has over fifteen years of successful experience in developing and providing health and safety support in meeting its technical objectives.« less

TH-C-18A-06: Combined CT Image Quality and Radiation Dose Monitoring Program Based On Patient Data to Assess Consistency of Clinical Imaging Across Scanner Models

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

Christianson, O; Winslow, J; Samei, E

2014-06-15

Purpose: One of the principal challenges of clinical imaging is to achieve an ideal balance between image quality and radiation dose across multiple CT models. The number of scanners and protocols at large medical centers necessitates an automated quality assurance program to facilitate this objective. Therefore, the goal of this work was to implement an automated CT image quality and radiation dose monitoring program based on actual patient data and to use this program to assess consistency of protocols across CT scanner models. Methods: Patient CT scans are routed to a HIPPA compliant quality assurance server. CTDI, extracted using opticalmore » character recognition, and patient size, measured from the localizers, are used to calculate SSDE. A previously validated noise measurement algorithm determines the noise in uniform areas of the image across the scanned anatomy to generate a global noise level (GNL). Using this program, 2358 abdominopelvic scans acquired on three commercial CT scanners were analyzed. Median SSDE and GNL were compared across scanner models and trends in SSDE and GNL with patient size were used to determine the impact of differing automatic exposure control (AEC) algorithms. Results: There was a significant difference in both SSDE and GNL across scanner models (9–33% and 15–35% for SSDE and GNL, respectively). Adjusting all protocols to achieve the same image noise would reduce patient dose by 27–45% depending on scanner model. Additionally, differences in AEC methodologies across vendors resulted in disparate relationships of SSDE and GNL with patient size. Conclusion: The difference in noise across scanner models indicates that protocols are not optimally matched to achieve consistent image quality. Our results indicated substantial possibility for dose reduction while achieving more consistent image appearance. Finally, the difference in AEC methodologies suggests the need for size-specific CT protocols to minimize variability in image quality across CT vendors.« less

Methods and Models of the Hanford Internal Dosimetry Program, PNNL-MA-860

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

Carbaugh, Eugene H.; Bihl, Donald E.; Maclellan, Jay A.

2003-01-03

This manual describes the technical basis for the design of the routine radiobioassay monitoring program and assessments of internal dose. Its purpose is to provide a historical record of the methods, models, and assumptions used for internal dosimetry at Hanford, and serve as a technical reference for radiation protection and dosimetry staff.

2004 Environmental Report

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

Althouse, P E; Bertoldo, N A; Brown, R A

2005-09-28

The Lawrence Livermore National Laboratory (LLNL) annual Environmental Report, prepared for the Department of Energy (DOE) and made available to the public, presents summary environmental data that characterizes site environmental management performance, summarizes environmental occurrences and responses reported during the calendar year, confirms compliance with environmental standards and requirements, and highlights significant programs and efforts. By explaining the results of effluent and environmental monitoring, mentioning environmental performance indicators and performance measure programs, and assessing the impact of Laboratory operations on the environment and the public, the report also demonstrates LLNL's continuing commitment to minimize any potentially adverse impact of itsmore » operations. The combination of environmental and effluent monitoring, source characterization, and dose assessment showed that radiological doses to the public caused by LLNL operations in 2004 were less than 0.26% of regulatory standards and more than 11,000 times smaller than dose from natural background. Analytical results and evaluations generally showed continuing low levels of most contaminants; remediation efforts further reduced the concentrations of contaminants of concern in groundwater and soil vapor. In addition, LLNL's extensive environmental compliance activities related to water, air, endangered species, waste, wastewater, and waste reduction controlled or reduced LLNL's effects on the environment. LLNL's environmental program clearly demonstrates a commitment to protecting the environment from operational impacts.« less

Comparison between In-house developed and Diamond commercial software for patient specific independent monitor unit calculation and verification with heterogeneity corrections.

PubMed

Kuppusamy, Vijayalakshmi; Nagarajan, Vivekanandan; Jeevanandam, Prakash; Murugan, Lavanya

2016-02-01

The study was aimed to compare two different monitor unit (MU) or dose verification software in volumetric modulated arc therapy (VMAT) using modified Clarkson's integration technique for 6 MV photons beams. In-house Excel Spreadsheet based monitor unit verification calculation (MUVC) program and PTW's DIAMOND secondary check software (SCS), version-6 were used as a secondary check to verify the monitor unit (MU) or dose calculated by treatment planning system (TPS). In this study 180 patients were grouped into 61 head and neck, 39 thorax and 80 pelvic sites. Verification plans are created using PTW OCTAVIUS-4D phantom and also measured using 729 detector chamber and array with isocentre as the suitable point of measurement for each field. In the analysis of 154 clinically approved VMAT plans with isocentre at a region above -350 HU, using heterogeneity corrections, In-house Spreadsheet based MUVC program and Diamond SCS showed good agreement TPS. The overall percentage average deviations for all sites were (-0.93% + 1.59%) and (1.37% + 2.72%) for In-house Excel Spreadsheet based MUVC program and Diamond SCS respectively. For 26 clinically approved VMAT plans with isocentre at a region below -350 HU showed higher variations for both In-house Spreadsheet based MUVC program and Diamond SCS. It can be concluded that for patient specific quality assurance (QA), the In-house Excel Spreadsheet based MUVC program and Diamond SCS can be used as a simple and fast accompanying to measurement based verification for plans with isocentre at a region above -350 HU. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Assessment of medical occupational radiation doses in Costa Rica.

PubMed

Mora, P; Acuña, M

2011-09-01

Participation of the University of Costa Rica (UCR) in activities in an IAEA Regional Project RLA/9/066 through training, equipment and expert missions, has enabled to setting up of a national personal monitoring laboratory. Since 2007, the UCR has been in charge of monitoring around 1800 medical radiation workers of the Social Security System. Individual external doses are measured with thermoluminescent dosemeter using a Harshaw 6600 Plus reader. The service has accreditation with ISO/IEC 17025:2005. Distribution of monitored medical personnel is as follows: 83 % in diagnostic radiology, 6 % in nuclear medicine and 6 % in radiotherapy. Preliminary values for the 75 percentile of annual H(p)(10) in mSv are: radiology 0.37; interventional radiology 0.41; radiotherapy 0.53 and nuclear medicine 1.55. The service provided by the UCR in a steady and reliable way can help to implement actions to limit the doses received by the medical workers and optimise their radiation protection programs.

Meeting the Needs for Radiation Protection: Diagnostic Imaging.

PubMed

Frush, Donald P

2017-02-01

Radiation and potential risk during medical imaging is one of the foremost issues for the imaging community. Because of this, there are growing demands for accountability, including appropriate use of ionizing radiation in diagnostic and image-guided procedures. Factors contributing to this include increasing use of medical imaging; increased scrutiny (from awareness to alarm) by patients/caregivers and the public over radiation risk; and mounting calls for accountability from regulatory, accrediting, healthcare coverage (e.g., Centers for Medicare and Medicaid Services), and advisory agencies and organizations as well as industry (e.g., NEMA XR-29, Standard Attributes on CT Equipment Related to Dose Optimization and Management). Current challenges include debates over uncertainty with risks with low-level radiation; lack of fully developed and targeted products for diagnostic imaging and radiation dose monitoring; lack of resources for and clarity surrounding dose monitoring programs; inconsistencies across and between practices for design, implementation and audit of dose monitoring programs; lack of interdisciplinary programs for radiation protection of patients; potential shortages in personnel for these and other consensus efforts; and training concerns as well as inconsistencies for competencies throughout medical providers' careers for radiation protection of patients. Medical care providers are currently in a purgatory between quality- and value-based imaging paradigms, a state that has yet to mature to reward this move to quality-based performance. There are also deficits in radiation expertise personnel in medicine. For example, health physics academic programs and graduates have recently declined, and medical physics residency openings are currently at a third of the number of graduates. However, leveraging solutions to the medical needs will require money and resources, beyond personnel alone. Energy and capital will need to be directed to:• innovative and cooperative cross-disciplinary institutional/practice oversight of and guidance for the use of diagnostic imaging (e.g., radiology, surgical specialties, cardiologists, and intensivists);• initiatives providing practical benchmarks (e.g., dose index registries);• comprehensive (consisting of access, integrity, metrology, analytics, informatics) and effective and efficient dose monitoring programs;• collaboration with industry;• improved use of imaging, such as through decision support combined with evidence-based appropriateness for imaging use;• integration with e-health such as medical records;• education, including information extending beyond the medical imaging community that is relevant to patients, public, and providers and administration;• identification of opportunities for alignment with salient media and advocacy organizations to deliver balanced information regarding medical radiation and risk;• open lines of communication between medical radiation experts and appropriate bodies such as the U.S. Environmental Protection Agency, the U.S. Food and Drug Administration, and the Joint Commission to assure appropriate guidance on documents and actions originating from these organizations; and• increased grant funding to foster translational work that advances understanding of low-level radiation and biological effects.

Comparison of Body Weight Trend Algorithms for Prediction of Heart Failure Related Events in Home Care Setting.

PubMed

Eggerth, Alphons; Modre-Osprian, Robert; Hayn, Dieter; Kastner, Peter; Pölzl, Gerhard; Schreier, Günter

2017-01-01

Automatic event detection is used in telemedicine based heart failure disease management programs supporting physicians and nurses in monitoring of patients' health data. Analysis of the performance of automatic event detection algorithms for prediction of HF related hospitalisations or diuretic dose increases. Rule-Of-Thumb and Moving Average Convergence Divergence (MACD) algorithm were applied to body weight data from 106 heart failure patients of the HerzMobil-Tirol disease management program. The evaluation criteria were based on Youden index and ROC curves. Analysis of data from 1460 monitoring weeks with 54 events showed a maximum Youden index of 0.19 for MACD and RoT with a specificity > 0.90. Comparison of the two algorithms for real-world monitoring data showed similar results regarding total and limited AUC. An improvement of the sensitivity might be possible by including additional health data (e.g. vital signs and self-reported well-being) because body weight variations obviously are not the only cause of HF related hospitalisations or diuretic dose increases.

Hazelwood Interim Storage Site annual environmental report for calendar year 1991, Hazelwood, Missouri. [Hazelwood Interim Storage Site

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

Not Available

1992-09-01

This document describes the environmental monitoring program at the Hazelwood Interim Storage Site (HISS) and surrounding area, implementation of the program, and monitoring results for 1991. Environmental monitoring of HISS began in 1984 when the site was assigned to the US Department of Energy (DOE) as part of the decontamination research and development project authorized by Congress under the 1984 Energy and Water Development Appropriations Act. DOE placed responsibility for HISS under the Formerly Utilized Sites Remedial Action Program (FUSRAP), a DOE program to decontaminate or otherwise control sites where residual radioactive materials remain from the early years of themore » nation's atomic energy program or from commercial operations causing conditions that Congress has authorized DOE to remedy. The environmental monitoring program at HISS includes sampling networks for radon concentrations in air; external gamma radiation exposure; and radium-226, thorium-230, and total uranium concentrations in surface water, sediment, and groundwater. Additionally, several nonradiological parameters are measured in groundwater. Monitoring results are compared with applicable Environmental Protection Agency standards, DOE derived concentration guides (DCGs), dose limits, and other requirements in DOE orders. Environmental standards and DCGs are established to protect public health and the environment.« less

[A novel serial port auto trigger system for MOSFET dose acquisition].

PubMed

Luo, Guangwen; Qi, Zhenyu

2013-01-01

To synchronize the radiation of microSelectron-HDR (Nucletron afterloading machine) and measurement of MOSFET dose system, a trigger system based on interface circuit was designed and corresponding monitor and trigger program were developed on Qt platform. This interface and control system was tested and showed stable operate and reliable work. This adopted serial port detect technique may expand to trigger application of other medical devices.

Individual Radiation Protection Monitoring in the Marshall Islands: Rongelap Atoll (2002-2004)

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

Hamilton, T F; Kehl, S; Hickman, D

2006-01-17

The United States Department of Energy (U.S. DOE) has recently implemented a series of strategic initiatives to address long-term radiological surveillance needs at former U.S. nuclear test sites in the Marshall Islands. The plan is to engage local atoll communities in developing shared responsibilities for implementing radiation protection monitoring programs for resettled and resettling populations in the northern Marshall Islands. Using the pooled resources of the U.S. DOE and local atoll governments, individual radiological surveillance programs have been developed in whole body counting and plutonium urinalysis in order to accurately assess radiation doses resulting from the ingestion and uptake ofmore » fallout radionuclides contained in locally grown foods. Permanent whole body counting facilities have been established at three separate locations in the Marshall Islands including Rongelap Atoll (Figure 1). These facilities are operated and maintained by Marshallese technicians with scientists from the Lawrence Livermore National Laboratory (LLNL) providing on-going technical support services. Bioassay samples are collected under controlled conditions and analyzed for plutonium isotopes at the Center for Accelerator Mass Spectrometry at LLNL using state-of-the art measurement technologies. We also conduct an on-going environmental monitoring and characterization program at selected sites in the northern Marshall Islands. The aim of the environmental program is to determine the level and distribution of important fallout radionuclides in soil, water and local foods with a view towards providing more accurate and updated dose assessments, incorporating knowledge of the unique behaviors and exposure pathways of fallout radionuclides in coral atoll ecosystems. These scientific studies have also been essential in helping guide the development of remedial options used in support of island resettlement. Together, the individual and environmental radiological surveillance programs are helping meet the informational needs of the U.S. DOE and the Republic of the Marshall Islands. Our updated environmental assessments provide a strong scientific basis for predicting future change in exposure conditions especially in relation to changes in lifestyle, diet and/or land-use patterns. This information has important implications in addressing questions about existing (and future) radiological conditions on the islands, in determining as well as the implementation, cost and effectiveness of potential intervention options, and in general policy support considerations. Perhaps most importantly, the recently established individual radiological surveillance programs provide affected atoll communities with an unprecedented level of radiation protection monitoring where, for the first time, local resources are being made available to monitor resettled and resettling populations on a continuous basis. As a hard copy supplement to Marshall Islands Program website (http://eed.llnl.gov/mi/), this document provides an overview of the individual radiation protection monitoring program established for resettlement workers living on Rongelap Island along with a full disclosure of all verified measurement data (2002-2004). Readers are advised that an additional feature of the associated web site is a provision where users are able calculate and track doses delivered to volunteers (de-identified information only) participating the Marshall Islands Radiological Surveillance Program.« less

Individual Radiation Protection Monitoring in the Marshall Islands: Enewetak Atoll (2002-2004)

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

Hamilton, T F; Kehl, S; Hickman, D

2006-01-17

The United States Department of Energy (U.S. DOE) has recently implemented a series of strategic initiatives to address long-term radiological surveillance needs at former U.S. nuclear test sites in the Marshall Islands. The plan is to engage local atoll communities in developing shared responsibilities for implementing radiation protection monitoring programs for resettled and resettling populations in the northern Marshall Islands. Using the pooled resources of the U.S. DOE and local atoll governments, individual radiological surveillance programs have been developed in whole body counting and plutonium urinalysis in order to accurately assess radiation doses resulting from the ingestion and uptake ofmore » fallout radionuclides contained in locally grown foods. Permanent whole body counting facilities have been established at three separate locations in the Marshall Islands including Enewetak Island (Figure 1) (Bell et al., 2002). These facilities are operated and maintained by Marshallese technicians with scientists from the Lawrence Livermore National Laboratory (LLNL) providing on-going technical support services. Bioassay samples are collected under controlled conditions and analyzed for plutonium isotopes at the Center for Accelerator Mass Spectrometry at LLNL using state-of-the art measurement technologies. We also conduct an on-going environmental monitoring and characterization program at selected sites in the northern Marshall Islands. The aim of the environmental program is to determine the level and distribution of important fallout radionuclides in soil, water and local foods with a view towards providing more accurate and updated dose assessments, incorporating knowledge of the unique behaviors and exposure pathways of fallout radionuclides in coral atoll ecosystems. These scientific studies have also been essential in helping guide the development of remedial options used in support of island resettlement. Together, the individual and environmental radiological surveillance programs are helping meet the informational needs of the U.S. DOE and the Republic of the Marshall Islands. Our updated environmental assessments provide a strong scientific basis for predicting future change in exposure conditions especially in relation to changes in lifestyle, diet and/or land-use patterns. This information has important implications in addressing questions about existing (and future) radiological conditions on the islands, in determining the cost and estimating the effectiveness of potential remedial measures, and in general policy support considerations. Perhaps most importantly, the recently established individual radiological surveillance programs provide affected atoll communities with an unprecedented level of radiation protection monitoring where, for the first time, local resources are being made available to monitor resettled and resettling populations on a continuous basis. As a hard copy supplement to Marshall Islands Program website (http://eed.llnl.gov/mi/), this document provides an overview of the individual radiation protection monitoring program established for the Enewetak Atoll population group along with a full disclosure of all verified measurement data (2002-2004). Readers are advised that an additional feature of the associated web site is a provision where users are able calculate and track doses delivered to volunteers (de-identified information only) participating in the Marshall Islands Radiological Surveillance Program.« less

MO-E-18A-01: Imaging: Best Practices In Pediatric Imaging

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

Willis, C; Strauss, K; MacDougall, R

This imaging educational program will focus on solutions to common pediatric imaging challenges. The speakers will present collective knowledge on best practices in pediatric imaging from their experience at dedicated children's hospitals. Areas of focus will include general radiography, the use of manual and automatic dose management in computed tomography, and enterprise-wide radiation dose management in the pediatric practice. The educational program will begin with a discussion of the complexities of exposure factor control in pediatric projection radiography. Following this introduction will be two lectures addressing the challenges of computed tomography (CT) protocol optimization in the pediatric population. The firstmore » will address manual CT protocol design in order to establish a managed radiation dose for any pediatric exam on any CT scanner. The second CT lecture will focus on the intricacies of automatic dose modulation in pediatric imaging with an emphasis on getting reliable results in algorithmbased technique selection. The fourth and final lecture will address the key elements needed to developing a comprehensive radiation dose management program for the pediatric environment with particular attention paid to new regulations and obligations of practicing medical physicists. Learning Objectives: To understand how general radiographic techniques can be optimized using exposure indices in order to improve pediatric radiography. To learn how to establish diagnostic dose reference levels for pediatric patients as a function of the type of examination, patient size, and individual design characteristics of the CT scanner. To learn how to predict the patient's radiation dose prior to the exam and manually adjust technique factors if necessary to match the patient's dose to the department's established dose reference levels. To learn how to utilize manufacturer-provided automatic dose modulation technology to consistently achieve patient doses within the department's established size-based diagnostic reference range. To understand the key components of an enterprise-wide pediatric dose management program that integrates the expanding responsibilities of medial physicists in the new era of dose monitoring.« less

The development of remote wireless radiation dose monitoring system

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

Lee, Jin-woo; Chonbuk National University, Jeonjoo-Si; Jeong, Kyu-hwan

Internet of things (IoT) technology has recently shown a large flow of IT trends in human life. In particular, our lives are now becoming integrated with a lot of items around the 'smart-phone' with IoT, including Bluetooth, Near Field Communication (NFC), Beacons, WiFi, and Global Positioning System (GPS). Our project focuses on the interconnection of radiation dosimetry and IoT technology. The radiation workers at a nuclear facility should hold personal dosimeters such as a Thermo-Luminescence Dosimeter (TLD), an Optically Stimulated Luminescence Dosimeter (OSL), pocket ionization chamber dosimeters, an Electronic Personal Dosimeter (EPD), or an alarm dosimeter on their body. Somemore » of them have functions that generate audible or visible alarms to radiation workers in a real working area. However, such devices used in radiation fields these days have no functions for communicating with other areas or the responsible personnel in real time. In particular, when conducting a particular task in a high dose area, or a number of repair works within a radiation field, radiation dose monitoring is important for the health of the workers and the work efficiency. Our project aims at the development of a remote wireless radiation dose monitoring system (RWRD) that can be used to monitor the radiation dose in a nuclear facility for radiation workers and a radiation protection program In this project, a radiation dosimeter is the detection device for personal radiation dose, a smart phone is the mobile wireless communication tool, and, Beacon is the wireless starter for the detection, communication, and position of the worker using BLE (Bluetooth Low Energy). In this report, we report the design of the RWRD and a demonstration case in a real radiation field. (authors)« less

Dose Monitoring in Radiology Departments: Status Quo and Future Perspectives.

PubMed

Boos, J; Meineke, A; Bethge, O T; Antoch, G; Kröpil, P

2016-05-01

The number of computed tomography examinations has continuously increased over the last decades and accounts for a major part of the collective radiation dose from medical investigations. For purposes of quality assurance in modern radiology a systematic monitoring and analysis of dose related data from radiological examinations is mandatory. Various ways of collecting dose data are available today, for example the Digital Imaging and Communication in Medicine - Structured Report (DICOM-SR), optical character recognition and DICOM-modality performed procedure steps (MPPS). The DICOM-SR is part of the DICOM-standard and provides the DICOM-Radiation Dose Structured Report, which is an easily applicable and comprehensive solution to collect radiation dose parameters. This standard simplifies the process of data collection and enables comprehensive dose monitoring. Various commercial dose monitoring software devices with varying characteristics are available today. In this article, we discuss legal obligations, various ways to monitor dose data, current dose monitoring software solutions and future perspectives in regard to the EU Council Directive 2013/59/EURATOM. • Automated, systematic dose monitoring is an important element in quality assurance of radiology departments. • DICOM-RDSR-capable CT scanners facilitate the monitoring of dose data. • A variety of commercial and non-commercial dose monitoring software tools are available today. • Successful dose monitoring requires comprehensive infrastructure for monitoring, analysing and optimizing radiation exposure. Citation Format: • Boos J, Meineke A, Bethge OT et al. Dose Monitoring in Radiology Departments: Status Quo and Future Perspectives. Fortschr Röntgenstr 2016; 188: 443 - 450. © Georg Thieme Verlag KG Stuttgart · New York.

Frequency and quality of radiation monitoring of construction workers at two gaseous diffusion plants.

PubMed

Bingham, Eula; Ringen, Knut; Dement, John; Cameron, Wilfrid; McGowan, William; Welch, Laura; Quinn, Patricia

2006-09-01

Construction workers were and are considered temporary workers at many construction sites. Since World War II, large numbers of construction workers were employed at U.S. Department of Energy nuclear weapons sites for periods ranging from a few days to over 30 years. These workers performed tasks during new construction and maintenance, repair, renovation, and demolition of existing facilities. Such tasks may involve emergency situations, and may entail opportunities for significant radiation exposures. This paper provides data from interviews with more than 750 construction workers at two gaseous diffusion plants (GDPs) at Paducah, Kentucky, and Portsmouth, Ohio regarding radiation monitoring practices. The aim was to determine the extent to which workers believed they were monitored during tasks involving potential radiation exposures. The adequacy of monitoring practices is important for two reasons: (a) Protecting workers from exposures: Construction workers were employed by sub-contractors, and may frequently been excluded from safety and health programs provided to permanent employees; and (b) Supporting claims for compensation: The Energy Employees Occupational Illness Compensation Program Act (EEOICPA) requires dose reconstruction of radiation exposures for most workers who file a claim regarding cancer. The use of monitoring data for radiation to qualify a worker means that there should be valid and complete monitoring during the work time at the various nuclear plants or workers may be unfairly denied compensation. The worker interviews from Paducah and Portsmouth were considered especially useful because these sites were designated as Special Exposure Cohorts (SECs) and the workers did not have to have a dose reconstruction to qualify for compensation for most cancers. Therefore, their responses were less likely to be affected by compensation concerns. Interview questions included asking for information regarding whether monitoring was performed, how often, and the maintenance (calibration) of monitoring equipment (devices).

Colonie Interim Storage Site environmental report for calendar year 1992, 1130 Central Avenue, Colonie, New York. Formerly Utilized Sites Remedial Action Program (FUSRAP)

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

Not Available

1993-05-01

This report describes the environmental surveillance program at the Colonie Interim Storage Site (CISS) and provides the results for 1992. The site is located in eastern New York State, approximately 6.4 km (4.0 mi) northwest of downtown Albany. From 1958 to 1984, National Lead (NL) Industries used the facility to manufacture various components from depleted and enriched uranium natural thorium. Environmental monitoring of CISS began in 1984 when Congress added, the site to the US Department of Energy`s (DOE) Formerly Utilized Sites Remedial Action Program (FUSRAP). FUSRAP is a program established to identify and decontaminate or otherwise control sites wheremore » residual radioactive materials remain from the early years of the nation`s atomic energy program or from commercial operations causing conditions that Congress has authorized DOE to remedy. The environmental surveillance program at CISS includes sampling networks for external gamma radiation exposure and for thorium-232 and total uranium concentrations in surface water, sediment, and groundwater. Several chemical parameters are also measured in groundwater, including total metals, volatile organics, and water quality parameters. This surveillance program assists in fulfilling the DOE policy of measuring and monitoring effluents from DOE activities and calculating hypothetical doses. Results are compared with applicable Environmental Protection Agency (EPA) and New York State Department of Environmental Conservation (NYSDEC) standards, DOE derived concentration guides (DCGs), dose limits, and other DOE requirements.« less

Space Station Freedom Environmental Health Care Program

NASA Technical Reports Server (NTRS)

Richard, Elizabeth E.; Russo, Dane M.

1992-01-01

The paper discusses the environmental planning and monitoring aspects of the Space Station Freedom (SSF) Environmental Health Care Program, which encompasses all phases of the SSF assembly and operation from the first element entry at MB-6 through the Permanent Manned Capability and beyond. Environmental planning involves the definition of acceptability limits and monitoring requirements for the radiation dose barothermal parameters and potential contaminants in the SSF air and water and on internal surfaces. Inflight monitoring will be implemented through the Environmental Health System, which consists of five subsystems: Microbiology, Toxicology, Water Quality, Radiation, and Barothermal Physiology. In addition to the environmental data interpretation and analysis conducted after each mission, the new data will be compared to archived data for statistical and long-term trend analysis and determination of risk exposures. Results of these analyses will be used to modify the acceptability limits and monitoring requirements for the future.

Modelling the external radiation exposure from the Chernobyl fallout using data from the Swedish municipality measurement system.

PubMed

Jönsson, Mattias; Tondel, Martin; Isaksson, Mats; Finck, Robert; Wålinder, Robert; Mamour, Afrah; Rääf, Christopher

2017-11-01

In connection with the Chernobyl fallout and the subsequent deposition of radionuclides in Sweden, Swedish municipalities launched a measurement program to monitor the external radiation exposure. This program encompasses measurements of the ambient dose equivalent rate 1 m above ground at selected locations, and repeats those measurements at the same locations at 7-month intervals. Measurement data compiled from the seven locations with the highest deposition were combined with data from aerial surveys since May 1986 of ground deposition of 137 Cs, high-resolution gamma spectrometry performed at four locations in May 1986, and measurements from fixed continuous air gamma rate monitoring stations from 28 April to 15 May 1986. Based on these datasets, a model of the time pattern of the external dose rate in terms of ambient dose equivalent rate from the Chernobyl fallout was developed. The decrease in the ambient dose equivalent rate could, on average, be described by a four-component exponential decay function with effective half-times of 6.8 ± 0.3 d, 104 ± 26 d, 1.0 ± 0.02 y and 5.5 ± 0.09 y, respectively. The predominant contributions to the external dose rate in the first month were from short-lived fission products superseded by 134 Cs and then 137 Cs. Integrated over 70 y and using extrapolation of the curve fits, our model predicts that 137 Cs contributes about 60% and 134 Cs contributes about 30% of the external effective dose at these seven locations. The projected time-integrated 70 y external effective dose to an unshielded person from all nuclides per unit total activity deposition of 137 Cs is estimated to be 0.29 ± 0.0.08 mSv/(kBq m -2 ). These results are in agreement with those found in Chernobyl contaminated Russian forest areas, and emphasize the usefulness of maintaining a long-term and regular measurement program in contaminated areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

Vaccination Coverage Among Children Aged 2 Years - U.S. Affiliated Pacific Islands, April-October, 2016.

PubMed

Tippins, Ashley; Murthy, Neil; Meghani, Mehreen; Solsman, Amy; Apaisam, Carter; Basilius, Merlyn; Eckert, Maribeth; Judicpa, Peter; Masunu, Yolanda; Pistotnik, Kelsey; Pedro, Daisy; Sasamoto, Jeremy; Underwood, J Michael

2018-05-25

Vaccine-preventable diseases (VPDs) cause substantial morbidity and mortality in the United States Affiliated Pacific Islands (USAPI).* CDC collaborates with USAPI immunization programs to monitor vaccination coverage. In 2016, † USAPI immunization programs and CDC piloted a method for estimating up-to-date status among children aged 2 years using medical record abstraction to ascertain regional vaccination coverage. This was the first concurrent assessment of childhood vaccination coverage across five USAPI jurisdictions (American Samoa; Chuuk State, Federated States of Micronesia [FSM]; Commonwealth of the Northern Mariana Islands [CNMI]; Republic of the Marshall Islands [RMI]; and Republic of Palau). § Differences in vaccination coverage between main and outer islands ¶ were assessed for two jurisdictions where data were adequate.** Series coverage in this report includes the following doses of vaccines: ≥4 doses of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP); ≥3 doses of inactivated poliovirus vaccine (IPV); ≥1 dose of measles, mumps, and rubella vaccine (MMR); ≥3 doses of Haemophilus influenzae type B (Hib) vaccine; ≥3 doses of hepatitis B (HepB) vaccine; and ≥4 doses of pneumococcal conjugate vaccine (PCV); i.e., 4:3:1:3:3:4. Coverage with ≥3 doses of rotavirus vaccine was also assessed. Completion of the recommended series of each of these vaccines †† was <90% in all jurisdictions except Palau. Coverage with the full recommended six-vaccine series (4:3:1:3:3:4) ranged from 19.5% (Chuuk) to 69.1% (Palau). In RMI and Chuuk, coverage was lower in the outer islands than in the main islands for most vaccines, with differences ranging from 0.9 to 66.8 percentage points. Medical record abstraction enabled rapid vaccination coverage assessment and timely dissemination of results to guide programmatic decision-making. Effectively monitoring vaccination coverage, coupled with implementation of data-driven interventions, is essential to maintain protection from VPD outbreaks in the region and the mainland United States.

Niagara Falls Storage Site environmental report for calendar year 1992, 1397 Pletcher Road, Lewiston, New York. Formerly Utilized Sites Remedial Action Program (FUSRAP)

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

Not Available

1993-05-01

This report describes the environmental surveillance program at the Niagara Falls Storage Site (NFSS) and provides the results for 1992. From 1944 to the present, the primary use of NFSS has been storage of radioactive residues produced as a by-product of uranium production. All onsite areas of residual radioactivity above guidelines have been remediated. Materials generated during remediation are stored onsite in the 4-ha (10-acre) waste containment structure (WCS). The WCS is a clay-lined, clay-capped, and grass-covered storage pile. The environmental surveillance program at NFSS includes sampling networks for radon concentrations in air; external gamma radiation exposure; and total uraniummore » and radium-226 concentrations in surface water, sediments, and groundwater. Several chemical parameters, including seven metals, are also routinely measured in groundwater. This surveillance program assists in fulfilling the DOE policy of measuring and monitoring effluents from DOE activities and calculating hypothetical doses. Monitoring results are compared with applicable Environmental Protection Agency (EPA) and New York State Department of Environmental Conservation (NYSDEC) standards, DOE derived concentration guides (DCGs), dose limits, and other DOE requirements. Results of environmental monitoring during 1992 indicate that levels of the parameters measured were in compliance with all but one requirement: Concentrations of iron and manganese in groundwater were above NYSDEC groundwater quality standards. However, these elements occur naturally in the soils and groundwater associated with this region. In 1992 there were no environmental occurrences or reportable quantity releases.« less

Individual Radiation Protection Monitoring in the Marshall Islands: Utrok Atoll (2003-2004)

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

Hamilton, T F; Kehl, S; Hickman, D

2006-01-17

The United States Department of Energy (U.S. DOE) has recently implemented a series of strategic initiatives to address long-term radiological surveillance needs at former U.S. nuclear test sites in the Marshall Islands. The plan is to engage local atoll communities in developing shared responsibilities for implementing radiation protection monitoring programs for resettled and resettling populations in the northern Marshall Islands. Using the pooled resources of the U.S. DOE and local atoll governments, individual radiological surveillance programs have been developed in whole body counting and plutonium urinalysis in order to accurately assess radiation doses resulting from the ingestion and uptake ofmore » fallout radionuclides contained in locally grown foods. Permanent whole body counting facilities have been established at three separate locations in the Marshall Islands (Figure 1). These facilities are operated and maintained by Marshallese technicians with scientists from the Lawrence Livermore National Laboratory (LLNL) providing on-going technical support services. Bioassay samples are collected under controlled conditions and analyzed for plutonium isotopes at the Center for Accelerator Mass Spectrometry at LLNL using state-of-the art measurement technologies. We also conduct an on-going environmental monitoring and characterization program at selected sites in the northern Marshall Islands. The aim of the environmental program is to determine the level and distribution of important fallout radionuclides in soil, water and local foods with a view towards providing more accurate and updated dose assessments, incorporating knowledge of the unique behaviors and exposure pathways of fallout radionuclides in coral atoll ecosystems. These scientific studies have also been essential in helping guide the development of remedial options used in support of island resettlement. Together, the individual and environmental radiological surveillance programs are helping meet the informational needs of the U.S. DOE and the Republic of the Marshall Islands. Our updated environmental assessments provide a strong scientific basis for predicting future change in exposure conditions especially in relation to changes in life-style, diet and/or land-use patterns. This information has important implications in addressing questions about existing (and future) radiological conditions on the islands, in determining the cost and the effectiveness of potential remedial measures, and in general policy support considerations. Perhaps most importantly, the recently established individual radiological surveillance programs provide affected atoll communities with an unprecedented level of radiation protection monitoring where, for the first time, local resources are being made available to monitor resettled and resettling populations on a continuous basis. As a hard copy supplement to Marshall Islands Program website (http://eed.llnl.gov/mi/), this document provides an overview of the individual radiation surveillance monitoring program established for the Utrok Atoll population group along with a full disclosure of all verified measurement data (2003-2004). The Utrok whole body counting facility has been temporarily stationed on Majuro Atoll and, in cooperation with the Utrok Atoll Local Government, serves as a national facility open to the general public. Readers are advised that an additional feature of the associated website is a provision whereby users are able to calculate and track radiation doses delivered to volunteers (de-identified information only) participating in the Marshall Islands Radiological Surveillance Program.« less

Visual Indicators on Vaccine Boxes as Early Warning Tools to Identify Potential Freeze Damage.

PubMed

Angoff, Ronald; Wood, Jillian; Chernock, Maria C; Tipping, Diane

2015-07-01

The aim of this study was to determine whether the use of visual freeze indicators on vaccines would assist health care providers in identifying vaccines that may have been exposed to potentially damaging temperatures. Twenty-seven sites in Connecticut involved in the Vaccine for Children Program participated. In addition to standard procedures, visual freeze indicators (FREEZEmarker ® L; Temptime Corporation, Morris Plains, NJ) were affixed to each box of vaccine that required refrigeration but must not be frozen. Temperatures were monitored twice daily. During the 24 weeks, all 27 sites experienced triggered visual freeze indicator events in 40 of the 45 refrigerators. A total of 66 triggered freeze indicator events occurred in all 4 types of refrigerators used. Only 1 of the freeze events was identified by a temperature-monitoring device. Temperatures recorded on vaccine data logs before freeze indicator events were within the 35°F to 46°F (2°C to 8°C) range in all but 1 instance. A total of 46,954 doses of freeze-sensitive vaccine were stored at the time of a visual freeze indicator event. Triggered visual freeze indicators were found on boxes containing 6566 doses (14.0% of total doses). Of all doses stored, 14,323 doses (30.5%) were of highly freeze-sensitive vaccine; 1789 of these doses (12.5%) had triggered indicators on the boxes. Visual freeze indicators are useful in the early identification of freeze events involving vaccines. Consideration should be given to including these devices as a component of the temperature-monitoring system for vaccines.

2011 Annual Health Physics Report for the HEU transparency Program

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

Radev, R

2012-04-30

During the 2008 calendar year, Lawrence Livermore National Laboratory (LLNL) provided health physics support for the Highly Enriched Uranium (HEU) Transparency Program for external and internal radiation protection. They also provided technical expertise related to BDMS radioactive sources and Russian radiation safety regulatory compliance. For the calendar year 2008, there were 158 person-trips that required dose monitoring of the U.S. monitors. Of the 158 person-trips, 148 person-trips were SMVs and 10 person-trips were Transparency Monitoring Office (TMO) trips. There were 6 monitoring visits by TMO monitors to facilities other than UEIE and 8 to UEIE itself. There were three monitoringmore » visits (source changes) that were back-to-back with a total of 24 monitors. LLNL's Hazard Control Department laboratories provided the dosimetry services for the HEU Transparency monitors. In 2008, the HEU Transparency activities in Russia were conducted in a radiologically safe manner for the HEU Transparency monitors in accordance with the expectations of the HEU Transparency staff, NNSA and DOE. The HEU Transparency now has thirteen years of successful experience in developing and providing health and safety support in meeting its technical objectives.« less

2008 Annual Health Physics Report for the HEU Transparency Program

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

Radev, R.

2009-03-24

During the 2008 calendar year, Lawrence Livermore National Laboratory (LLNL) provided health physics support for the Highly Enriched Uranium (HEU) Transparency Program for external and internal radiation protection. They also provided technical expertise related to BDMS radioactive sources and Russian radiation safety regulatory compliance. For the calendar year 2008, there were 158 person-trips that required dose monitoring of the U.S. monitors. Of the 158 person-trips, 148 person-trips were SMVs and 10 person-trips were Transparency Monitoring Office (TMO) trips. There were 6 monitoring visits by TMO monitors to facilities other than UEIE and 8 to UEIE itself. There were three monitoringmore » visits (source changes) that were back-to-back with a total of 24 monitors. LLNL’s Hazard Control Department laboratories provided the dosimetry services for the HEU Transparency monitors. In 2008, the HEU Transparency activities in Russia were conducted in a radiologically safe manner for the HEU Transparency monitors in accordance with the expectations of the HEU Transparency staff, NNSA and DOE. The HEU Transparency now has thirteen years of successful experience in developing and providing health and safety support in meeting its technical objectives.« less

Hanford Site Environmental Report for calendar year 1992

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

Woodruff, R.K.; Hanf, R.W.; Lundgren, R.E.

1993-06-01

This report is prepared annually to summarize environmental data and information, describe environmental management performance, and demonstrate the status of compliance with environmental regulations at the Hanford Site. The following sections: describe the Hanford Site and its mission; summarize the status in 1992 of compliance with environmental regulations; describe the environmental programs at the Hanford Site; discuss public dose estimates from 1992 Hanford activities; present information on effluent monitoring and environmental surveillance, including ground-water protection and monitoring, and discuss activities to ensure quality.

Internal dosimetry monitoring equipment: Present and future

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

Selby, J.; Carbaugh, E.H.; Lynch, T.P.

1993-09-01

We have attempted to characterize the current and future status of in vivo and in vitro measurement programs coupled with the associated radioanalytical methods and workplace monitoring. Developments in these areas must be carefully integrated by internal dosimetrists, radiochemists and field health physicists. Their goal should be uniform improvement rather than to focus on one specific area (e.g., dose modeling) to the neglect of other areas where the measurement capabilities are substantially less sophisticated and, therefore, the potential source of error is greatest.

SU-C-BRD-07: The Radiological Physics Center (RPC): 45 Years of Improving Radiotherapy Dosimetry

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

Followill, D; Lowenstein, J; Molineu, A

Purpose: The RPC, established in 1968 has contributed to the development, conduct, and QA of NCI funded multi-institutional cooperative group clinical trials and institutions, primarily in the USA/Canada and 242 other countries, participating in trials. Methods: The RPC QA program components were designed to audit the radiation dose calculation chain from the NIST traceable reference beam calibration, to inclusion of dosimetry parameters used to calculate tumor doses, to the delivery of the radiation dose. The QA program included: 1) remote TLD/OSLD audit of machine output, 2) on-site dosimetry review visits, 3) credentialing for advanced technologies, and 4) review of patientmore » treatment records. The RPC presented and published their findings to the radiation oncology community. Results: The number of institutions monitored by the RPC increased from around 1200 in the late 90s, to ∼2000 in 2013. There were over 4000 megavoltage therapy machines and ∼28,000 therapy beams in the 1991 institutions monitored by the RPC by the end of 2013. Within the 14,000 photon, electron and proton beam outputs remotely monitored with TLD/OSLD annually, between 10-20% of the institutions have one or more beams outside the RPC 5% criterion. Dosimetry site visits to photon and proton centers continue to result in 2-4 recommendations affecting key dosimetry parameters that impact patient treatment times. One in four patient treatment records reviewed by the RPC have their dose data corrected by >5% before trial groups use them for outcomes analysis. Twelve of fourteen clinically active proton centers are approved to participate in NCI funded clinical trials. The RPC published 222 peer reviewed articles since 1972. Conclusion: Findings from the RPC suggest that human errors continue to play a role in radiotherapy discrepancies and without the RPC independent QA program, the number of undetected errors and time elapsed before their discovery would have been greater. Work supported by MGH C06 CA059267 and grants CA10953, CA081647 awarded by NCI, DHHS.« less

Colonie Interim Storage Site annual environmental report for calendar year 1991, Colonie, New York. Formerly Utilized Sites Remedial Action Program (FUSRAP)

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

Not Available

1992-09-01

This document describes the environmental monitoring program at the Colonie Interim Storage Site (CISS) and surrounding area, implementation of the program, and monitoring results for 1991. Environmental monitoring at CISS began in 1984 when Congress added the site to the US Department of Energy`s Formerly Utilized Sites Remedial Action Program. CISS property and surrounding areas were radioactively contaminated by operations conducted by National Lead Industries, which manufactured various components from uranium and thorium from 1958 to 1984. The environmental monitoring program at CISS includes sampling networks for external gamma radiation exposure and for radium-226, thorium-232, and total uranium concentrations inmore » surface water, sediment, and groundwater. Additionally, several nonradiological parameters are measured in groundwater. In 1992 the program will also include sampling networks for radioactive and chemical contaminants in stormwater to meet permit application requirements under the Clean Water Act. Monitoring results are compared with applicable Environmental Protection Agency (EPA) standards, DOE derived concentration guides (DCGs), dose limits, and other requirements in DOE.orders. Environmental standards are established to protect public health and the environment. Results of environmental monitoring during 1991 indicate that average concentrations of radioactive contaminants of concern were well below applicable standards and DCGS. Concentrations of some chemical contaminants in groundwater were above-the New York State Department of Environmental Conservation (Class GA) and EPA guidelines for drinking water. The potential annual radiation exposure (excluding background) calculated for a hypothetical maximally exposed individual is 0.23 mrem (milliroentgen equivalent man), which is less than an individual would receive while traveling in an airplane at 12,000 meters (39,000 feet) for one hour.« less

An educational program for insulin self-adjustment associated with structured self-monitoring of blood glucose significantly improves glycemic control in patients with type 2 diabetes mellitus after 12 weeks: a randomized, controlled pilot study.

PubMed

Silva, Daniel Dutra Romualdo; Bosco, Adriana Aparecida

2015-01-01

Self-monitoring of blood glucose (SMBG) has been recommended as a useful tool for improving glycemic control, but is still an underutilized strategy and most diabetic patients are not aware of the actions that must be taken in response to its results and do not adjust their treatment. The purpose of this study was to evaluate the effectiveness and safety of an educational program for insulin self-adjustment based on SMBG in poorly controlled patients with type 2 diabetes (T2DM). A prospective, randomized, controlled 12-week intervention study was conducted on poorly controlled insulin-requiring patients with T2DM. Twenty-three subjects were randomized to two educational programs: a 2-week basic program with guidance about SMBG and types and techniques of insulin administration (group A, n = 12) and a 6-week program including the basic one and additional instructions about self-titration of insulin doses according to a specific protocol (group B, n = 11). Patients were reviewed after 12 weeks and baseline to endpoint changes in glycated hemoglobin (A1C), insulin doses, body weight and incidence of hypoglycemia were compared by paired and independent Student t-tests. After 12 weeks, there was a significant reduction in A1C only in group B, but group comparison showed no significant difference (p = 0.051). A higher percentage of subjects in group B achieved an A1C near the treatment target (<7.5%) than in group A. Daily insulin dose increased non-significantly in the two groups and there was no significant difference in the incidence of hypoglycemia or body weight changes between groups. Training for self-titrating insulin doses combined with structured SMBG can safely improve glycemic control in poorly controlled insulin-treated T2DM patients. This strategy may facilitate effective insulin therapy in routine medical practice, compensating for any reluctance on the part of physicians to optimize insulin therapy and thus to improve the achievement of recommended targets of diabetes care.

An efficient inverse radiotherapy planning method for VMAT using quadratic programming optimization.

PubMed

Hoegele, W; Loeschel, R; Merkle, N; Zygmanski, P

2012-01-01

The purpose of this study is to investigate the feasibility of an inverse planning optimization approach for the Volumetric Modulated Arc Therapy (VMAT) based on quadratic programming and the projection method. The performance of this method is evaluated against a reference commercial planning system (eclipse(TM) for rapidarc(TM)) for clinically relevant cases. The inverse problem is posed in terms of a linear combination of basis functions representing arclet dose contributions and their respective linear coefficients as degrees of freedom. MLC motion is decomposed into basic motion patterns in an intuitive manner leading to a system of equations with a relatively small number of equations and unknowns. These equations are solved using quadratic programming under certain limiting physical conditions for the solution, such as the avoidance of negative dose during optimization and Monitor Unit reduction. The modeling by the projection method assures a unique treatment plan with beneficial properties, such as the explicit relation between organ weightings and the final dose distribution. Clinical cases studied include prostate and spine treatments. The optimized plans are evaluated by comparing isodose lines, DVH profiles for target and normal organs, and Monitor Units to those obtained by the clinical treatment planning system eclipse(TM). The resulting dose distributions for a prostate (with rectum and bladder as organs at risk), and for a spine case (with kidneys, liver, lung and heart as organs at risk) are presented. Overall, the results indicate that similar plan qualities for quadratic programming (QP) and rapidarc(TM) could be achieved at significantly more efficient computational and planning effort using QP. Additionally, results for the quasimodo phantom [Bohsung et al., "IMRT treatment planning: A comparative inter-system and inter-centre planning exercise of the estro quasimodo group," Radiother. Oncol. 76(3), 354-361 (2005)] are presented as an example for an extreme concave case. Quadratic programming is an alternative approach for inverse planning which generates clinically satisfying plans in comparison to the clinical system and constitutes an efficient optimization process characterized by uniqueness and reproducibility of the solution.

Executive summary: Weldon Spring Site Environmental Report for calendar year 1992. Weldon Spring Site Remedial Action Project, Weldon Spring, Missouri

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

Not Available

1993-06-01

This report has been prepared to provide information about the public safety and environmental protection programs conducted by the Weldon Spring Site Remedial Action Project. The Weldon Spring site is located in southern St. Charles County, Missouri, approximately 48 km (30 mi) west of St. Louis. The site consists of two main areas, the Weldon Spring Chemical Plant and raffinate pits and the Weldon Spring Quarry. The objectives of the Site Environmental Report are to present a summary of data from the environmental monitoring program, to characterize trends and environmental conditions at the site, and to confirm compliance with environmentalmore » and health protection standards and requirements. The report also presents the status of remedial activities and the results of monitoring these activities to assess their impacts on the public and environment. The scope of the environmental monitoring program at the Weldon Spring site has changed since it was initiated. Previously, the program focused on investigations of the extent and level of contaminants in the groundwater, surface waters, buildings, and air at the site. In 1992, the level of remedial activities required monitoring for potential impacts of those activities, particularly on surface water runoff and airborne effluents. This report includes monitoring data from routine radiological and nonradiological sampling activities. These data include estimates of dose to the public from the Weldon Spring site; estimates of effluent releases; and trends in groundwater contaminant levels. Also, applicable compliance requirements, quality assurance programs, and special studies conducted in 1992 to support environmental protection programs are reviewed.« less

Combined Use of a Patient Dose Monitoring System and a Real-Time Occupational Dose Monitoring System for Fluoroscopically Guided Interventions.

PubMed

Heilmaier, Christina; Kara, Levent; Zuber, Niklaus; Berthold, Christian; Weishaupt, Dominik

2016-04-01

To determine the effect on patient radiation exposure of the combined use of a patient dose monitoring system and real-time occupational dose monitoring during fluoroscopically guided interventions (FGIs). Patient radiation exposure, in terms of the kerma area product (KAP; Gy ∙ cm(2)), was measured in period 1 with a patient dose monitoring system, and a real-time occupational dose monitoring system was additionally applied in period 2. Mean/median KAP in 19 different types of FGIs was analyzed in both periods for two experienced interventional radiologists combined as well as individually. Patient dose and occupational dose were correlated, applying Pearson and Spearman correlation coefficients. Although FGIs were similar in numbers and types over both periods, a substantial decrease was found for period 2 in total mean ± SD/median KAP for both operators together (period 1, 47 Gy ∙ cm(2) ± 67/41 Gy ∙ cm(2); period 2, 37 Gy ∙ cm(2) ± 69/34 Gy ∙ cm(2)) as well as for each individual operator (for all, P < .05). Overall, KAP declined considerably in 15 of 19 types of FGIs in period 2. Mean accumulated dose per intervention was 4.6 µSv, and mean dose rate was 0.24 mSv/h. There was a strong positive correlation between patient and occupational dose (r = 0.88). Combined use of a patient dose monitoring system and a real-time occupational dose monitoring system in FGIs significantly lessens patient and operator doses. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

Proposed comprehensive ototoxicity monitoring program for VA healthcare (COMP-VA)

PubMed Central

Konrad-Martin, Dawn; Reavis, Kelly M.; McMillan, Garnett; Helt, Wendy J.; Dille, Marilyn

2015-01-01

Prevention and rehabilitation of hearing loss and tinnitus, the two most commonly awarded service-connected disabilities, are high priority initiatives in the Department of Veterans Affairs (VA). At least 4,000 Veterans, most with significant hearing loss, will receive cisplatin this year, with more than half sustaining permanent hearing shift and nearly 40% developing new tinnitus. With improved survivability following cancer treatment, Veterans treated with cisplatin are approached with the dual goals of effective treatment and preserved quality of life. This article describes COMP-VA, a comprehensive ototoxicity monitoring program developed for VA patients receiving cisplatin. The program includes an individualized pretreatment prediction model that identifies the likelihood of hearing shift given cisplatin dose and patient factors. It supports both manual and automated hearing testing with a newly developed portable audiometer capable of performing the recommended procedures on the chemotherapy unit during treatment. It also includes objective methods for identifying outer hair cell changes and predicting audiogram changes using distortion-product otoacoustic emissions. We describe this program of evidence-based ototoxicity monitoring protocols using a case example to give the reader an understanding of how this program would be applied, along with a plan for future work to accomplish the final stages of program development. PMID:24805896

File format for normalizing radiological concentration exposure rate and dose rate data for the effects of radioactive decay and weathering processes

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

Kraus, Terrence D.

2017-04-01

This report specifies the electronic file format that was agreed upon to be used as the file format for normalized radiological data produced by the software tool developed under this TI project. The NA-84 Technology Integration (TI) Program project (SNL17-CM-635, Normalizing Radiological Data for Analysis and Integration into Models) investigators held a teleconference on December 7, 2017 to discuss the tasks to be completed under the TI program project. During this teleconference, the TI project investigators determined that the comma-separated values (CSV) file format is the most suitable file format for the normalized radiological data that will be outputted frommore » the normalizing tool developed under this TI project. The CSV file format was selected because it provides the requisite flexibility to manage different types of radiological data (i.e., activity concentration, exposure rate, dose rate) from other sources [e.g., Radiological Assessment and Monitoring System (RAMS), Aerial Measuring System (AMS), Monitoring and Sampling). The CSV file format also is suitable for the file format of the normalized radiological data because this normalized data can then be ingested by other software [e.g., RAMS, Visual Sampling Plan (VSP)] used by the NA-84’s Consequence Management Program.« less

Real-time eye lens dose monitoring during cerebral angiography procedures.

PubMed

Safari, M J; Wong, J H D; Kadir, K A A; Thorpe, N K; Cutajar, D L; Petasecca, M; Lerch, M L F; Rosenfeld, A B; Ng, K H

2016-01-01

To develop a real-time dose-monitoring system to measure the patient's eye lens dose during neuro-interventional procedures. Radiation dose received at left outer canthus (LOC) and left eyelid (LE) were measured using Metal-Oxide-Semiconductor Field-Effect Transistor dosimeters on 35 patients who underwent diagnostic or cerebral embolization procedures. The radiation dose received at the LOC region was significantly higher than the dose received by the LE. The maximum eye lens dose of 1492 mGy was measured at LOC region for an AVM case, followed by 907 mGy for an aneurysm case and 665 mGy for a diagnostic angiography procedure. Strong correlations (shown as R(2)) were observed between kerma-area-product and measured eye doses (LOC: 0.78, LE: 0.68). Lateral and frontal air-kerma showed strong correlations with measured dose at LOC (AKL: 0.93, AKF: 0.78) and a weak correlation with measured dose at LE. A moderate correlation was observed between fluoroscopic time and dose measured at LE and LOC regions. The MOSkin dose-monitoring system represents a new tool enabling real-time monitoring of eye lens dose during neuro-interventional procedures. This system can provide interventionalists with information needed to adjust the clinical procedure to control the patient's dose. Real-time patient dose monitoring helps interventionalists to monitor doses. Strong correlation was observed between kerma-area-product and measured eye doses. Radiation dose at left outer canthus was higher than at left eyelid.

Determining the applicability of the Landauer nanoDot as a general public dosimeter in a research imaging facility.

PubMed

Charlton, Michael A; Thoreson, Kelly F; Cerecero, Jennifer A

2012-11-01

The Research Imaging Institute (RII) building at the University of Texas Health Science Center at San Antonio (UTHSCSA) houses two cyclotron particle accelerators, positron emission tomography (PET) machines, and a fluoroscopic unit. As part of the radiation protection program (RPP) and meeting the standard for achieving ALARA (as low as reasonably achievable), it is essential to minimize the ionizing radiation exposure to the general public through the use of controlled areas and area dose monitoring. Currently, thirty-four whole body Luxel+ dosimeters, manufactured by Landauer, are being used in various locations within the RII to monitor dose to the general public. The intent of this research was to determine if the nanoDot, a single point dosimeter, can be used as a general public dosimeter in a diagnostic facility. This was tested by first verifying characteristics of the nanoDot dosimeter including dose linearity, dose rate dependence, angular dependence, and energy dependence. Then, the response of the nanoDot dosimeter to the Luxel+ dosimeter when placed in a continuous, low dose environment was investigated. Finally, the nanoDot was checked for appropriate response in an acute, high dose environment. Based on the results, the current recommendation is that the nanoDot should not replace the Luxel+ dosimeter without further work to determine the energy spectra in the RII building and without considering the limitation of the microStar reader, portable on-site OSL reader, at doses below 0.1 mGy (10 mrad).

Colonie Interim Storage Site annual environmental report for calendar year 1991, Colonie, New York

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

Not Available

1992-09-01

This document describes the environmental monitoring program at the Colonie Interim Storage Site (CISS) and surrounding area, implementation of the program, and monitoring results for 1991. Environmental monitoring at CISS began in 1984 when Congress added the site to the US Department of Energy's Formerly Utilized Sites Remedial Action Program. CISS property and surrounding areas were radioactively contaminated by operations conducted by National Lead Industries, which manufactured various components from uranium and thorium from 1958 to 1984. The environmental monitoring program at CISS includes sampling networks for external gamma radiation exposure and for radium-226, thorium-232, and total uranium concentrations inmore » surface water, sediment, and groundwater. Additionally, several nonradiological parameters are measured in groundwater. In 1992 the program will also include sampling networks for radioactive and chemical contaminants in stormwater to meet permit application requirements under the Clean Water Act. Monitoring results are compared with applicable Environmental Protection Agency (EPA) standards, DOE derived concentration guides (DCGs), dose limits, and other requirements in DOE.orders. Environmental standards are established to protect public health and the environment. Results of environmental monitoring during 1991 indicate that average concentrations of radioactive contaminants of concern were well below applicable standards and DCGS. Concentrations of some chemical contaminants in groundwater were above-the New York State Department of Environmental Conservation (Class GA) and EPA guidelines for drinking water. The potential annual radiation exposure (excluding background) calculated for a hypothetical maximally exposed individual is 0.23 mrem (milliroentgen equivalent man), which is less than an individual would receive while traveling in an airplane at 12,000 meters (39,000 feet) for one hour.« less

SU-E-T-317: The Development of a DIBH Technique for Left Sided Breast Patients Undergoing Radiation Therapy Utilizing Varians RPM System in a Community Hospital

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

Hasson, B; Young, M; Workie, D

2014-06-01

Purpose: To develop and implement a Deep Inhalation Breath Hold program (DIBH) for treatment of patients with Left-sided breast cancer in a community hospital. Methods: All patients with left sided breast cancer underwent a screening free breathing CT. Evaluation of the conventional tangent treatment fields and the heart was conducted. If the heart would not be excluded using tangents, the patient then received DIBH breathe coaching. The patients returned for a 4D CT simulation. The patients breathing cycle was monitored using the Varian Real-Time position ManagementTM (RPM) system to assess duration of DIBH, amplitude, phase and recovery time to normalmore » breathing. Then a DIBH CT was obtained at the desired amplitude. Duplicate plans were developed for both free breathing and DIBH on the Eclipse planning system and comparison DVH's were created. The plan that provided the prescribed treatment coverage and the least doses to the OAR (heart, Lt. Lung) was determined. Those patients selected to receive treatment with DIBH were set up for treatment, and breathing was monitored using the RPM system. Practice trials were used to confirm that the amplitude, phase and recovery were consistent with findings from simulation. Results: 10 patients have been treated using the DIBH procedure in our clinic. The DIBH patients had an average increase of 80% lung volume on DIBH, decreased lung volume receiving 50% of the dose, and decreases in the V20 dose. Significant reduction in the maximum and mean dose to the heart, as well as the dose to 1CC of the volume for the DIBH plans. Conclusion: Using the RPM system already available in the clinic, staff training, and patient coaching a simple DIBH program was setup. The use of DIBH has shown promise in reducing doses to the critical organs while maintaining PTV coverage for left sided breast treatments.« less

A Monte Carlo program to calculate the exposure rate from airborne radioactive gases inside a nuclear reactor containment building.

PubMed

Sherbini, S; Tamasanis, D; Sykes, J; Porter, S W

1986-12-01

A program was developed to calculate the exposure rate resulting from airborne gases inside a reactor containment building. The calculations were performed at the location of a wall-mounted area radiation monitor. The program uses Monte Carlo techniques and accounts for both the direct and scattered components of the radiation field at the detector. The scattered component was found to contribute about 30% of the total exposure rate at 50 keV and dropped to about 7% at 2000 keV. The results of the calculations were normalized to unit activity per unit volume of air in the containment. This allows the exposure rate readings of the area monitor to be used to estimate the airborne activity in containment in the early phases of an accident. Such estimates, coupled with containment leak rates, provide a method to obtain a release rate for use in offsite dose projection calculations.

Monte Carlo simulations to replace film dosimetry in IMRT verification.

PubMed

Goetzfried, Thomas; Rickhey, Mark; Treutwein, Marius; Koelbl, Oliver; Bogner, Ludwig

2011-01-01

Patient-specific verification of intensity-modulated radiation therapy (IMRT) plans can be done by dosimetric measurements or by independent dose or monitor unit calculations. The aim of this study was the clinical evaluation of IMRT verification based on a fast Monte Carlo (MC) program with regard to possible benefits compared to commonly used film dosimetry. 25 head-and-neck IMRT plans were recalculated by a pencil beam based treatment planning system (TPS) using an appropriate quality assurance (QA) phantom. All plans were verified both by film and diode dosimetry and compared to MC simulations. The irradiated films, the results of diode measurements and the computed dose distributions were evaluated, and the data were compared on the basis of gamma maps and dose-difference histograms. Average deviations in the high-dose region between diode measurements and point dose calculations performed with the TPS and MC program were 0.7 ± 2.7% and 1.2 ± 3.1%, respectively. For film measurements, the mean gamma values with 3% dose difference and 3mm distance-to-agreement were 0.74 ± 0.28 (TPS as reference) with dose deviations up to 10%. Corresponding values were significantly reduced to 0.34 ± 0.09 for MC dose calculation. The total time needed for both verification procedures is comparable, however, by far less labor intensive in the case of MC simulations. The presented study showed that independent dose calculation verification of IMRT plans with a fast MC program has the potential to eclipse film dosimetry more and more in the near future. Thus, the linac-specific QA part will necessarily become more important. In combination with MC simulations and due to the simple set-up, point-dose measurements for dosimetric plausibility checks are recommended at least in the IMRT introduction phase. Copyright © 2010. Published by Elsevier GmbH.

The Idaho National Engineering Laboratory Site environmental report for calendar Year 1990

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

Hoff, D.L.; Mitchell, R.G.; Moore, R.

1991-06-01

The results of the various monitoring programs for 1990 indicate that most radioactivity from the Idaho National Engineering Laboratory (INEL) operations could not be distinguished from worldwide fallout and natural radioactivity in the region surrounding the INEL Site. Although some radioactive materials were discharged during Site operations, concentrations and doses to the surrounding population were of no health consequence and were far less than State of Idaho and Federal health protection guidelines. The first section of the report summarizes Calendar Year 1990 and January 1 through April 1, 1991, INEL activities related to compliance with environmental regulations and laws. Themore » balance of the report describes the surveillance program, the collection of foodstuffs at the INEL boundary and distant offsite locations, and the collection of air and water samples at onsite locations and offsite boundary and distant locations. The report also compares and evaluates the sample results and discusses implications, if any. Nonradioactive and radioactive effluent monitoring at the Site, and the US Geological Survey (USGS) ground-water monitoring program are also summarized. 33 refs., 18 figs., 29 tabs.« less

10 CFR 20.1502 - Conditions requiring individual monitoring of external and internal occupational dose.

Code of Federal Regulations, 2014 CFR

2014-01-01

... internal occupational dose. 20.1502 Section 20.1502 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Surveys and Monitoring § 20.1502 Conditions requiring individual monitoring of external and internal occupational dose. Each licensee shall monitor exposures to radiation and radioactive...

10 CFR 20.1502 - Conditions requiring individual monitoring of external and internal occupational dose.

Code of Federal Regulations, 2012 CFR

2012-01-01

... internal occupational dose. 20.1502 Section 20.1502 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Surveys and Monitoring § 20.1502 Conditions requiring individual monitoring of external and internal occupational dose. Each licensee shall monitor exposures to radiation and radioactive...

10 CFR 20.1502 - Conditions requiring individual monitoring of external and internal occupational dose.

Code of Federal Regulations, 2011 CFR

2011-01-01

... internal occupational dose. 20.1502 Section 20.1502 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Surveys and Monitoring § 20.1502 Conditions requiring individual monitoring of external and internal occupational dose. Each licensee shall monitor exposures to radiation and radioactive...

10 CFR 20.1502 - Conditions requiring individual monitoring of external and internal occupational dose.

Code of Federal Regulations, 2013 CFR

2013-01-01

... internal occupational dose. 20.1502 Section 20.1502 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Surveys and Monitoring § 20.1502 Conditions requiring individual monitoring of external and internal occupational dose. Each licensee shall monitor exposures to radiation and radioactive...

10 CFR 20.1502 - Conditions requiring individual monitoring of external and internal occupational dose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... internal occupational dose. 20.1502 Section 20.1502 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Surveys and Monitoring § 20.1502 Conditions requiring individual monitoring of external and internal occupational dose. Each licensee shall monitor exposures to radiation and radioactive...

Structuring a risk-based bioassay program for uranium usage in university laboratories

NASA Astrophysics Data System (ADS)

Dawson, Johnne Talia

Bioassay programs are integral in a radiation safety program. They are used as a method of determining whether individuals working with radioactive material have been exposed and have received a resulting dose. For radionuclides that are not found in nature, determining an exposure is straightforward. However, for a naturally occurring radionuclide like uranium, it is not as straightforward to determine whether a dose is the result of an occupational exposure. The purpose of this project is to address this issue within the University of Nevada, Las Vegas's (UNLV) bioassay program. This project consisted of two components that studied the effectiveness of a bioassay program in determining the dose for an acute inhalation of uranium. The first component of the plan addresses the creation of excretion curves, utilizing MATLAB that would allow UNLV to be able to determine at what time an inhalation dose can be attributed to. The excretion curves were based on the ICRP 30 lung model, as well as the Annual Limit Intake (ALI) values located in the Nuclear Regulatory Commission's 10CFR20 which is based on ICRP 30 (International Commission on Radiological Protection). The excretion curves would allow UNLV to be able to conduct in-house investigations of inhalation doses without solely depending on outside investigations and sources. The second component of the project focused on the creation of a risk based bioassay program to be utilized by UNLV that would take into account bioassay frequency that depended on the individual. Determining the risk based bioassay program required the use of baseline variance in order to minimize the investigation of false positives among those individuals who undergo bioassays for uranium work. The proposed program was compared against an evaluation limit of 10 mrem per quarter, an investigational limit of 125 mrem per quarter, and the federal/state requirement of 1.25 rem per quarter. It was determined that a bioassay program whose bioassay frequency varies per person, depending on the chemical class of material being worked with, in conjunction with continuous air monitoring can sufficiently meet ALARA standards.

TH-C-18A-08: A Management Tool for CT Dose Monitoring, Analysis, and Protocol Review

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

Wang, J; Chan, F; Newman, B

2014-06-15

Purpose: To develop a customizable tool for enterprise-wide managing of CT protocols and analyzing radiation dose information of CT exams for a variety of quality control applications Methods: All clinical CT protocols implemented on the 11 CT scanners at our institution were extracted in digital format. The original protocols had been preset by our CT management team. A commercial CT dose tracking software (DoseWatch,GE healthcare,WI) was used to collect exam information (exam date, patient age etc.), scanning parameters, and radiation doses for all CT exams. We developed a Matlab-based program (MathWorks,MA) with graphic user interface which allows to analyze themore » scanning protocols with the actual dose estimates, and compare the data to national (ACR,AAPM) and internal reference values for CT quality control. Results: The CT protocol review portion of our tool allows the user to look up the scanning and image reconstruction parameters of any protocol on any of the installed CT systems among about 120 protocols per scanner. In the dose analysis tool, dose information of all CT exams (from 05/2013 to 02/2014) was stratified on a protocol level, and within a protocol down to series level, i.e. each individual exposure event. This allows numerical and graphical review of dose information of any combination of scanner models, protocols and series. The key functions of the tool include: statistics of CTDI, DLP and SSDE, dose monitoring using user-set CTDI/DLP/SSDE thresholds, look-up of any CT exam dose data, and CT protocol review. Conclusion: our inhouse CT management tool provides radiologists, technologists and administration a first-hand near real-time enterprise-wide knowledge on CT dose levels of different exam types. Medical physicists use this tool to manage CT protocols, compare and optimize dose levels across different scanner models. It provides technologists feedback on CT scanning operation, and knowledge on important dose baselines and thresholds.« less

Use of Transportable Radiation Detection Instruments to Assess Internal Contamination from Intakes of Radionuclides Part II: Calibration Factors and ICAT Computer Program.

PubMed

Anigstein, Robert; Olsher, Richard H; Loomis, Donald A; Ansari, Armin

2016-12-01

The detonation of a radiological dispersion device or other radiological incidents could result in widespread releases of radioactive materials and intakes of radionuclides by affected individuals. Transportable radiation monitoring instruments could be used to measure radiation from gamma-emitting radionuclides in the body for triaging individuals and assigning priorities to their bioassay samples for in vitro assessments. The present study derived sets of calibration factors for four instruments: the Ludlum Model 44-2 gamma scintillator, a survey meter containing a 2.54 × 2.54-cm NaI(Tl) crystal; the Captus 3000 thyroid uptake probe, which contains a 5.08 × 5.08-cm NaI(Tl) crystal; the Transportable Portal Monitor Model TPM-903B, which contains two 3.81 × 7.62 × 182.9-cm polyvinyltoluene plastic scintillators; and a generic instrument, such as an ionization chamber, that measures exposure rates. The calibration factors enable these instruments to be used for assessing inhaled or ingested intakes of any of four radionuclides: Co, I, Cs, and Ir. The derivations used biokinetic models embodied in the DCAL computer software system developed by the Oak Ridge National Laboratory and Monte Carlo simulations using the MCNPX radiation transport code. The three physical instruments were represented by MCNP models that were developed previously. The affected individuals comprised children of five ages who were represented by the revised Oak Ridge National Laboratory pediatric phantoms, and adult men and adult women represented by the Adult Reference Computational Phantoms described in Publication 110 of the International Commission on Radiological Protection. These calibration factors can be used to calculate intakes; the intakes can be converted to committed doses by the use of tabulated dose coefficients. These calibration factors also constitute input data to the ICAT computer program, an interactive Microsoft Windows-based software package that estimates intakes of radionuclides and cumulative and committed effective doses, based on measurements made with these instruments. This program constitutes a convenient tool for assessing intakes and doses without consulting tabulated calibration factors and dose coefficients.

USE OF TRANSPORTABLE RADIATION DETECTION INSTRUMENTS TO ASSESS INTERNAL CONTAMINATION FROM INTAKES OF RADIONUCLIDES PART II: CALIBRATION FACTORS AND ICAT COMPUTER PROGRAM

PubMed Central

Anigstein, Robert; Olsher, Richard H.; Loomis, Donald A.; Ansari, Armin

2017-01-01

The detonation of a radiological dispersion device or other radiological incidents could result in widespread releases of radioactive materials and intakes of radionuclides by affected individuals. Transportable radiation monitoring instruments could be used to measure radiation from gamma-emitting radionuclides in the body for triaging individuals and assigning priorities to their bioassay samples for in vitro assessments. The present study derived sets of calibration factors for four instruments: the Ludlum Model 44-2 gamma scintillator, a survey meter containing a 2.54 × 2.54-cm NaI(Tl) crystal; the Captus 3000 thyroid uptake probe, which contains a 5.08 × 5.08-cm NaI(Tl) crystal; the Transportable Portal Monitor Model TPM-903B, which contains two 3.81 × 7.62 × 182.9-cm polyvinyltoluene plastic scintillators; and a generic instrument, such as an ionization chamber, that measures exposure rates. The calibration factors enable these instruments to be used for assessing inhaled or ingested intakes of any of four radionuclides: 60Co, 131I, 137Cs, and 192Ir. The derivations used biokinetic models embodied in the DCAL computer software system developed by the Oak Ridge National Laboratory and Monte Carlo simulations using the MCNPX radiation transport code. The three physical instruments were represented by MCNP models that were developed previously. The affected individuals comprised children of five ages who were represented by the revised Oak Ridge National Laboratory pediatric phantoms, and adult men and adult women represented by the Adult Reference Computational Phantoms described in Publication 110 of the International Commission on Radiological Protection. These calibration factors can be used to calculate intakes; the intakes can be converted to committed doses by the use of tabulated dose coefficients. These calibration factors also constitute input data to the ICAT computer program, an interactive Microsoft Windows-based software package that estimates intakes of radionuclides and cumulative and committed effective doses, based on measurements made with these instruments. This program constitutes a convenient tool for assessing intakes and doses without consulting tabulated calibration factors and dose coefficients. PMID:27798478

Upgrades of DARWIN, a dose and spectrum monitoring system applicable to various types of radiation over wide energy ranges

NASA Astrophysics Data System (ADS)

Sato, Tatsuhiko; Satoh, Daiki; Endo, Akira; Shigyo, Nobuhiro; Watanabe, Fusao; Sakurai, Hiroki; Arai, Yoichi

2011-05-01

A dose and spectrum monitoring system applicable to neutrons, photons and muons over wide ranges of energy, designated as DARWIN, has been developed for radiological protection in high-energy accelerator facilities. DARWIN consists of a phoswitch-type scintillation detector, a data-acquisition (DAQ) module for digital waveform analysis, and a personal computer equipped with a graphical-user-interface (GUI) program for controlling the system. The system was recently upgraded by introducing an original DAQ module based on a field programmable gate array, FPGA, and also by adding a function for estimating neutron and photon spectra based on an unfolding technique without requiring any specific scientific background of the user. The performance of the upgraded DARWIN was examined in various radiation fields, including an operational field in J-PARC. The experiments revealed that the dose rates and spectra measured by the upgraded DARWIN are quite reasonable, even in radiation fields with peak structures in terms of both spectrum and time variation. These results clearly demonstrate the usefulness of DARWIN for improving radiation safety in high-energy accelerator facilities.

Occupational radiation exposure experience: Paducah Gaseous Diffusion Plant

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

Baker, R.C.

1975-01-01

The potential for significant uranium exposure in gaseous diffusion plants is very low. The potential for significant radiation exposure in uranium hexafluoride manufacturing is very real. Exposures can be controlled to low levels only through the cooperation and commitment of facility management and operating personnel. Exposure control can be adequately monitored by a combination of air analyses, urinalyses, and measurements of internal deposition as obtained by the IVRML. A program based on control of air-borne uranium exposure has maintained the internal dose of the Paducah Gaseous Diffusion Plant workman to less than one-half the RPG dose to the lung (15more » rem/year) and probably to less than one-fourth that dose. (auth)« less

Racial disparities in access after regulatory surveillance of benzodiazepines.

PubMed

Pearson, Sallie-Anne; Soumerai, Stephen; Mah, Connie; Zhang, Fang; Simoni-Wastila, Linda; Salzman, Carl; Cosler, Leon E; Fanning, Thomas; Gallagher, Peter; Ross-Degnan, Dennis

2006-03-13

We examined the effects of a prescription-monitoring program on benzodiazepine access among Medicaid enrollees living in neighborhoods of different racial composition. We used interrupted time series and logistic regression to analyze data from noninstitutionalized persons aged 18 years or older (N = 124 867) enrolled continuously in New York Medicaid 12 months before and 24 months and 7 years after initiation of the program. We used census data to identify the racial composition of the neighborhoods. Outcome measures were nonproblematic use (short term, within dosing guidelines), potentially problematic use (>120 days' use or more than twice the recommended dose), and pharmacy hopping (filling prescriptions for the same benzodiazepine in different pharmacies within 7 days). There was a sudden, sustained reduction in benzodiazepine use in all the neighborhoods after the program's introduction. Despite the lowest rates of baseline use, enrollees in predominantly (> or = 75%) black neighborhoods experienced the highest rates of discontinuation after introduction of the program. This difference remained 7 years after policy initiation. Compared with white participants, black participants were more likely to discontinue nonproblematic (odds ratio, 1.78; 95% confidence interval, 1.47-2.17) and potentially problematic (odds ratio, 1.77; 95% confidence interval, 1.45-2.17) benzodiazepine use, after adjusting for sex, eligibility status, neighborhood poverty, and baseline use. The program almost completely eliminated pharmacy hopping in all racial groups, although less among white participants (82.6%) vs black participants (88.7%). A systematic benzodiazepine prescription-monitoring program reduced inappropriate prescribing, with a stronger effect in predominantly black neighborhoods despite lower baseline use. The policy may have resulted in an unintended decrease in nonproblematic use that disproportionately affects black populations.

Antifungal stewardship considerations for adults and pediatrics.

PubMed

Hamdy, Rana F; Zaoutis, Theoklis E; Seo, Susan K

2017-08-18

Antifungal stewardship refers to coordinated interventions to monitor and direct the appropriate use of antifungal agents in order to achieve the best clinical outcomes and minimize selective pressure and adverse events. Antifungal utilization has steadily risen over time in concert with the increase in number of immunocompromised adults and children at risk for invasive fungal infections (IFI). Challenges in diagnosing IFI often lead to delays in treatment and poorer outcomes. There are also emerging data linking prior antifungal exposure and suboptimal dosing to the emergence of antifungal resistance, particularly for Candida. Antimicrobial stewardship programs can take a multi-pronged bundle approach to ensure suitable prescribing of antifungals via post-prescription review and feedback and/or prior authorization. Institutional guidelines can also be developed to guide diagnostic testing in at-risk populations; appropriate choice, dose, and duration of antifungal agent; therapeutic drug monitoring; and opportunities for de-escalation and intravenous-to-oral conversion.

Comparison of Intervention Fidelity between COPE TEEN and an Attention-Control Program in a Randomized Controlled Trial

ERIC Educational Resources Information Center

Kelly, Stephanie A.; Oswalt, Krista; Melnyk, Bernadette Mazurek; Jacobson, Diana

2015-01-01

Fidelity in implementing an intervention is critical to accurately determine and interpret the effects of an intervention. It is important to monitor the manner in which the behavioral intervention is implemented (e.g. adaptations, delivery as intended and dose). Few interventions are implemented with 100% fidelity. In this study, high school…

Current methods of monitoring radiation exposure from CT.

PubMed

Talati, Ronak K; Dunkin, Jared; Parikh, Shrujal; Moore, William H

2013-09-01

Increased public and regulatory scrutiny of imaging-related radiation exposure requires familiarity with current dose-monitoring techniques and best practices. CT-related ionizing radiation exposure has been cited as the largest and fastest growing source of population-wide iatrogenic ionizing radiation exposure. Upcoming federal regulations require imaging centers to familiarize themselves with available dose-monitoring techniques and implement comprehensive strategies to track patient dose, with particular emphasis on CT. Because of institution-specific and vendor-specific technologies, there are significant barriers to adoption and implementation. In this article, the authors outline the core components of a universal dose-monitoring strategy and detail a few of the many available commercial platforms. In addition, the authors introduce a cloud-based hybrid model dose-tracking system with the goal of rapid implementation, multicenter scalability, real-time dose feedback for technologists, cumulative dose monitoring, and optional dose communication to patients and into the record; doing so results in improved patient loyalty, referring physician satisfaction, and opportunity for repeat business. Copyright © 2013 American College of Radiology. All rights reserved.

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

Chen, Q; Read, P

Purpose: Multiple error pathways can lead to delivery errors during the treatment course that cannot be caught with pre-treatment QA. While in vivo solutions are being developed for linacs, no such solution exists for tomotherapy. The purpose of this study is to develop a near real-time system for tomotherapy that can monitor the delivery and dose accumulation process during the treatment-delivery, which enable the user to assess the impact of delivery variations and/or errors and to interrupt the treatment if necessary. Methods: A program running on a tomotherapy planning station fetches the raw DAS data during treatment. Exit detector datamore » is extracted as well as output, gantry angle, and other machine parameters. For each sample, the MLC open-close state is determined. The delivered plan is compared with the original plan via a Monte Carlo dose engine which transports fluence deviations from a pre-treatment Monte Carlo run. A report containing the difference in fluence, dose and DVH statistics is created in html format. This process is repeated until the treatment is completed. Results: Since we only need to compute the dose for the difference in fluence for a few projections each time, dose with 2% statistical uncertainty can be computed in less than 1 second on a 4-core cpu. However, the current bottleneck in this near real-time system is the repeated fetching and processing the growing DAS data file throughout the delivery. The frame rate drops from 10Hz at the beginning of treatment to 5Hz after 3 minutes and to 2Hz after 10 minutes. Conclusion: A during-treatment delivery monitor system has been built to monitor tomotherapy treatments. The system improves patient safety by allowing operators to assess the delivery variations and errors during treatment delivery and adopt appropriate actions.« less

10 CFR 835.702 - Individual monitoring records.

Code of Federal Regulations, 2010 CFR

2010-01-01

... emergency exposures. (b) Recording of the non-uniform equivalent dose to the skin is not required if the... internal dose (committed effective dose or committed equivalent dose) is not required for any monitoring...: (i) The effective dose from external sources of radiation (equivalent dose to the whole body may be...

10 CFR 835.702 - Individual monitoring records.

Code of Federal Regulations, 2011 CFR

2011-01-01

... emergency exposures. (b) Recording of the non-uniform equivalent dose to the skin is not required if the... internal dose (committed effective dose or committed equivalent dose) is not required for any monitoring...: (i) The effective dose from external sources of radiation (equivalent dose to the whole body may be...

10 CFR 835.702 - Individual monitoring records.

Code of Federal Regulations, 2014 CFR

2014-01-01

... emergency exposures. (b) Recording of the non-uniform equivalent dose to the skin is not required if the... internal dose (committed effective dose or committed equivalent dose) is not required for any monitoring...: (i) The effective dose from external sources of radiation (equivalent dose to the whole body may be...

10 CFR 835.702 - Individual monitoring records.

Code of Federal Regulations, 2013 CFR

2013-01-01

... emergency exposures. (b) Recording of the non-uniform equivalent dose to the skin is not required if the... internal dose (committed effective dose or committed equivalent dose) is not required for any monitoring...: (i) The effective dose from external sources of radiation (equivalent dose to the whole body may be...

10 CFR 835.702 - Individual monitoring records.

Code of Federal Regulations, 2012 CFR

2012-01-01

... emergency exposures. (b) Recording of the non-uniform equivalent dose to the skin is not required if the... internal dose (committed effective dose or committed equivalent dose) is not required for any monitoring...: (i) The effective dose from external sources of radiation (equivalent dose to the whole body may be...

Changing tides: Adaptive monitoring, assessment, and management of pharmaceutical hazards in the environment through time.

PubMed

Gaw, Sally; Brooks, Bryan W

2016-04-01

Pharmaceuticals are ubiquitous contaminants in aquatic ecosystems. Adaptive monitoring, assessment, and management programs will be required to reduce the environmental hazards of pharmaceuticals of concern. Potentially underappreciated factors that drive the environmental dose of pharmaceuticals include regulatory approvals, marketing campaigns, pharmaceutical subsidies and reimbursement schemes, and societal acceptance. Sales data for 5 common antidepressants (duloxetine [Cymbalta], escitalopram [Lexapro], venlafaxine [Effexor], bupropion [Wellbutrin], and sertraline [Zoloft]) in the United States from 2004 to 2008 were modeled to explore how environmental hazards in aquatic ecosystems changed after patents were obtained or expired. Therapeutic hazard ratios for Effexor and Lexapro did not exceed 1; however, the therapeutic hazard ratio for Zoloft declined whereas the therapeutic hazard ratio for Cymbalta increased as a function of patent protection and sale patterns. These changes in therapeutic hazard ratios highlight the importance of considering current and future drivers of pharmaceutical use when prioritizing pharmaceuticals for water quality monitoring programs. When urban systems receiving discharges of environmental contaminants are examined, water quality efforts should identify, prioritize, and select target analytes presently in commerce for effluent monitoring and surveillance. © 2015 SETAC.

Dose assessment activities in the Republic of the Marshall Islands.

PubMed

Simon, S L; Graham, J C

1996-10-01

Dose assessments, both retrospective and prospective, comprise one important function of a radiological study commissioned by the Republic of the Marshall Islands (RMI) government in late 1989. Estimating past or future exposure requires the synthesis of information from historical data, results from a recently completed field monitoring program, laboratory measurements, and some experimental studies. Most of the activities in the RMI to date have emphasized a pragmatic rather than theoretical approach. In particular, most of the recent effort has been expended on conducting an independent radiological monitoring program to determine the degree of deposition and the geographical extent of weapons test fallout over the nation. Contamination levels on 70% of the land mass of the Marshall Islands were unknown prior to 1994. The environmental radioactivity data play an integral role in both retrospective and prospective assessments. One recent use of dose assessment has been to interpret environmental measurements of radioactivity into annual doses that might be expected at every atoll. A second use for dose assessment has been to determine compliance with a dose action level for the rehabilitation of Rongelap Island. Careful examination of exposure pathways relevant to the island lifestyle has been necessary to accommodate these purposes. Examples of specific issues studied include defining traditional island diets as well as current day variations, sources of drinking water, uses of tropical plants including those consumed for food and for medicinal purposes, the nature and microvariability of plutonium particles in the soil and unusual pathways of exposure, e.g., that which might be associated with cooking and washing outdoors and inadvertent soil ingestion. A study on the prevalence of thyroid disease is also being conducted and the geographic pattern of disease may be useful as a bioindicator of the geographic pattern of exposure to radioiodine. Finally, an examination is underway of gummed film, fixed-instrument, and aerial survey data accumulated during the 1950's by the Health and Safety Laboratory of the U.S. AEC. This article gives an overview of these many different activities and a summary of recent dose assessments.

Digoxin therapeutic drug monitoring practices. A College of American Pathologists Q-Probes study of 666 institutions and 18,679 toxic levels.

PubMed

Howanitz, P J; Steindel, S J

1993-07-01

We investigated digoxin therapeutic drug monitoring practices in 666 institutions participating in Q-Probes, a quality improvement program of the College of American Pathologists. Participants used 13 different lower and 16 different upper limits for their therapeutic range. More than 280,000 digoxin levels were studied, and 6.7% (n = 8679) of results were in the toxic range (> 2.6 nmol/L). For the 77% of patients with toxic levels, the last digoxin dose was given orally; for 23% of patients, it was given intravenously; and for less than 1%, it was given intramuscularly. Between 22% and 31% of specimens in the toxic range were obtained before steady state had occurred, depending on the criteria used. Small institutions (less than 150 beds), outpatients, stat specimens, and laboratory policies not requiring the time of the last dose before measurement were associated with higher percentages of specimens drawn before the recommended time had elapsed. We describe digoxin monitoring practice patterns and provide suggestions for improvement.

Therapeutic drug monitoring in pregnancy.

PubMed

Matsui, Doreen M

2012-10-01

Therapeutic drug monitoring (TDM) is commonly recommended to optimize drug dosing regimens of various medications. It has been proposed to guide therapy in pregnant women, in whom physiological changes may lead to altered pharmacokinetics resulting in difficulty in predicting the appropriate drug dosage. Ideally, TDM may play a role in enhancing the effectiveness of treatment while minimizing toxicity of both the mother and fetus. Monitoring of drug levels may also be helpful in assessing adherence to prescribed therapy in selected cases. Limitations exist as therapeutic ranges have only been defined for a limited number of drugs and are based on data obtained in nonpregnant patients. TDM has been suggested for anticonvulsants, antidepressants, and antiretroviral drugs, based on pharmacokinetic studies that have shown reduced drug concentrations. However, there is only relatively limited (and sometimes inconsistent) information regarding the clinical impact of these pharmacokinetic changes during pregnancy and the effect of subsequent dose adjustments. Further studies are required to determine whether implementation of TDM during pregnancy improves outcome and is associated with any benefit beyond that achieved by clinical judgment alone. The cost effectiveness of TDM programs during pregnancy also remains to be examined.

Annual radiological environmental operating report: Browns Ferry Nuclear Plant, 1992. Operations Services/Technical Programs

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

Not Available

1993-04-01

This report describes the environmental radiological monitoring program conducted by TVA in the vicinity of Browns Ferry Nuclear Plant (BFN) in 1992. The program includes the collection of samples from the environment and the determination of the concentrations of radioactive materials in the samples. Samples are taken from stations in the general area of the plant and from areas not influenced by plant operations. Station locations are selected after careful consideration of the weather patterns and projected radiation doses to the various areas around the plant. Material sampled includes air, water, milk, foods, vegetation, soil, fish, sediment, and direct radiationmore » levels. Results from stations near the plant are compared with concentrations from control stations and with preoperational measurements to determine potential impacts of plant operations. Small amounts of Co-60 and Cs-134 were found in sediment samples downstream from the plant. This activity in stream sediment would result in no measurable increase over background in the dose to the general public.« less

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

Willoner, T.; Turlington, R.; Koenig, R.

The U.S. Department of Energy (DOE) (Environmental Management [EM], Office of Packaging and Transportation [EM-45]) Packaging and Certification Program (DOE PCP) has developed a Radio Frequency Identification (RFID) tracking and monitoring system, called ARG-US, for the management of nuclear materials packages during transportation and storage. The performance of the ARG-US RFID equipment and system has been fully tested in two demonstration projects in April 2008 and August 2009. With the strong support of DOE-SR and DOE PCP, a field testing program was completed in Savannah River Site's K-Area Material Storage (KAMS) Facility, an active Category I Plutonium Storage Facility, inmore » 2010. As the next step (Phase II) of continued vault testing for the ARG-US system, the Savannah River Site K Area Material Storage facility has placed the ARG-US RFIDs into the 910B storage vault for operational testing. This latest version (Mark III) of the Argonne RFID system now has the capability to measure radiation dose and dose rate. This paper will report field testing progress of the ARG-US RFID equipment in KAMS, the operability and reliability trend results associated with the applications of the system, and discuss the potential benefits in enhancing safety, security and materials accountability. The purpose of this Phase II K Area test is to verify the accuracy of the radiation monitoring and proper functionality of the ARG-US RFID equipment and system under a realistic environment in the KAMS facility. Deploying the ARG-US RFID system leads to a reduced need for manned surveillance and increased inventory periods by providing real-time access to status and event history traceability, including environmental condition monitoring and radiation monitoring. The successful completion of the testing program will provide field data to support a future development and testing. This will increase Operation efficiency and cost effectiveness for vault operation. As the next step (Phase II) of continued vault testing for the ARG-US system, the Savannah River Site K Area Material Storage facility has placed the ARG-US RFIDs into the 910B storage vault. Deploying the ARG-US RFID system lends to a reduced need for manned surveillance and increased inventory periods by providing real-time access to status and event history traceability, including radiation and environmental monitoring. The successful completion of the testing program will provide field data to support future development and testing.« less

TH-E-209-00: Radiation Dose Monitoring and Protocol Management

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

NONE

Radiation dose monitoring solutions have opened up new opportunities for medical physicists to be more involved in modern clinical radiology practices. In particular, with the help of comprehensive radiation dose data, data-driven protocol management and informed case follow up are now feasible. Significant challenges remain however and the problems faced by medical physicists are highly heterogeneous. Imaging systems from multiple vendors and a wide range of vintages co-exist in the same department and employ data communication protocols that are not fully standardized or implemented making harmonization complex. Many different solutions for radiation dose monitoring have been implemented by imaging facilitiesmore » over the past few years. Such systems are based on commercial software, home-grown IT solutions, manual PACS data dumping, etc., and diverse pathways can be used to bring the data to impact clinical practice. The speakers will share their experiences with creating or tailoring radiation dose monitoring/management systems and procedures over the past few years, which vary significantly in design and scope. Topics to cover: (1) fluoroscopic dose monitoring and high radiation event handling from a large academic hospital; (2) dose monitoring and protocol optimization in pediatric radiology; and (3) development of a home-grown IT solution and dose data analysis framework. Learning Objectives: Describe the scope and range of radiation dose monitoring and protocol management in a modern radiology practice Review examples of data available from a variety of systems and how it managed and conveyed. Reflect on the role of the physicist in radiation dose awareness.« less

TH-E-209-02: Dose Monitoring and Protocol Optimization: The Pediatric Perspective

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

MacDougall, R.

Radiation dose monitoring solutions have opened up new opportunities for medical physicists to be more involved in modern clinical radiology practices. In particular, with the help of comprehensive radiation dose data, data-driven protocol management and informed case follow up are now feasible. Significant challenges remain however and the problems faced by medical physicists are highly heterogeneous. Imaging systems from multiple vendors and a wide range of vintages co-exist in the same department and employ data communication protocols that are not fully standardized or implemented making harmonization complex. Many different solutions for radiation dose monitoring have been implemented by imaging facilitiesmore » over the past few years. Such systems are based on commercial software, home-grown IT solutions, manual PACS data dumping, etc., and diverse pathways can be used to bring the data to impact clinical practice. The speakers will share their experiences with creating or tailoring radiation dose monitoring/management systems and procedures over the past few years, which vary significantly in design and scope. Topics to cover: (1) fluoroscopic dose monitoring and high radiation event handling from a large academic hospital; (2) dose monitoring and protocol optimization in pediatric radiology; and (3) development of a home-grown IT solution and dose data analysis framework. Learning Objectives: Describe the scope and range of radiation dose monitoring and protocol management in a modern radiology practice Review examples of data available from a variety of systems and how it managed and conveyed. Reflect on the role of the physicist in radiation dose awareness.« less

Improving the Accuracy of a Heliocentric Potential (HCP) Prediction Model for the Aviation Radiation Dose

NASA Astrophysics Data System (ADS)

Hwang, Junga; Yoon, Kyoung-Won; Jo, Gyeongbok; Noh, Sung-Jun

2016-12-01

The space radiation dose over air routes including polar routes should be carefully considered, especially when space weather shows sudden disturbances such as coronal mass ejections (CMEs), flares, and accompanying solar energetic particle events. We recently established a heliocentric potential (HCP) prediction model for real-time operation of the CARI-6 and CARI-6M programs. Specifically, the HCP value is used as a critical input value in the CARI-6/6M programs, which estimate the aviation route dose based on the effective dose rate. The CARI-6/6M approach is the most widely used technique, and the programs can be obtained from the U.S. Federal Aviation Administration (FAA). However, HCP values are given at a one month delay on the FAA official webpage, which makes it difficult to obtain real-time information on the aviation route dose. In order to overcome this critical limitation regarding the time delay for space weather customers, we developed a HCP prediction model based on sunspot number variations (Hwang et al. 2015). In this paper, we focus on improvements to our HCP prediction model and update it with neutron monitoring data. We found that the most accurate method to derive the HCP value involves (1) real-time daily sunspot assessments, (2) predictions of the daily HCP by our prediction algorithm, and (3) calculations of the resultant daily effective dose rate. Additionally, we also derived the HCP prediction algorithm in this paper by using ground neutron counts. With the compensation stemming from the use of ground neutron count data, the newly developed HCP prediction model was improved.

Development of UV-B screening compounds in response to variation in ambient levels of UV-B radiation

NASA Astrophysics Data System (ADS)

Sullivan, Joe H.; Xu, Chenping; Gao, Wei; Slusser, James R.

2005-08-01

The induction of UV-B screening compounds in response to exposure to UV-B radiation is a commonly reported response and is generally considered to be an adaptive response of plants for protection from UVinduced damage. However, a number of questions remain to be answered including the importance of qualitative and localization differences among species in providing protection, indirect consequences of changes in leaf secondary chemistry on ecological processes and the dose response of metabolite accumulation. In this study we utilized UV monitoring data provided on site by the USDA UV-B Monitoring and Research Program to monitor the changes in UV-screening compounds in soybeans under a range of UV-B levels due to natural variation in ambient UV-B radiation. Soybean cultivars Essex, Clark and Clark-magenta, an isoline of Clark that produces minimal levels of flavonols, were grown beneath shelters covered either with polyester to block most UV-B radiation or teflon which is nearly transparent in the UV range and harvested at regular intervals for pigment and protein analysis. Daily levels of weighted UV-B varied from <1 to >7 kJ m-2. Increases in UV-screening compounds showed a positive dose response to UV-B radiation in all cultivars with Essex showing the steepest dose response. UV-A also induced screening compounds in all species The hydroxycinnimates of the magenta isoline showed a steep dose response to UV-A and a rather constant (non dose specific) but small additional increment in response to UV-B. The Clark isoline, which produced primarily the flavonol quercetin, showed a dose response to UV-B intermediate between that of Clark-magenta and Essex. All three cultivars show similar tolerance to UV-B in field conditions indicating that UV-induced pigment production is adequate to protect them from excessive UV-B damage.

The Impact of AUC-Based Monitoring on Pharmacist-Directed Vancomycin Dose Adjustments in Complicated Methicillin-Resistant Staphylococcus aureus Infection.

PubMed

Stoessel, Andrew M; Hale, Cory M; Seabury, Robert W; Miller, Christopher D; Steele, Jeffrey M

2018-01-01

This study aimed to assess the impact of area under the curve (AUC)-based vancomycin monitoring on pharmacist-initiated dose adjustments after transitioning from a trough-only to an AUC-based monitoring method at our institution. A retrospective cohort study of patients treated with vancomycin for complicated methicillin-resistant Staphylococcus aureus (MRSA) infection between November 2013 and December 2016 was conducted. The frequency of pharmacist-initiated dose adjustments was assessed for patients monitored via trough-only and AUC-based approaches for trough ranges: 10 to 14.9 mg/L and 15 to 20 mg/L. Fifty patients were included: 36 in the trough-based monitoring and 14 in the AUC-based-monitoring group. The vancomycin dose was increased in 71.4% of patients when troughs were 10 to 14.9 mg/L when a trough-only approach was used and in only 25% of patients when using AUC estimation ( P = .048). In the AUC group, the dose was increased only when AUC/minimum inhibitory concentration (MIC) <400; unchanged regimens had an estimated AUC/MIC ≥400. The AUC-based monitoring did not significantly increase the frequency of dose reductions when trough concentrations were 15 to 20 mg/L (AUC: 33.3% vs trough: 4.6%; P = .107). The AUC-based monitoring resulted in fewer patients with dose adjustments when trough levels were 10 to 14.9 mg/L. The AUC-based monitoring has the potential to reduce unnecessary vancomycin exposure and warrants further investigation.

Is it useful to assess annual effective doses that are less than 100 mSv?

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

Strom, Daniel J.; Cameron, John R.

It is useful to assess annual effective doses less than 100 mSv. Beyond the''score-keeping'' needs of regulatory compliance, there are at least seven other valid reasons for performing personnel monitoring, many of which fall into the category of''no news is good news,'' or more aptly,''null news, as long as you can prove it, is good news.'' These are performance measures for contractual compliance, diagnosis of problems with radiation protection programs, health surveillance and occupational epidemiology, prevention of and support for litigation, demonstration of management commitment and safety, worker counseling, ensuring peace of mind. Furthermore, it is shown that there ismore » very reasonable expectation that detriment may be associated with doses smaller than 100 mSv per year.« less

ASSESSMENT OF INTAKE ACCORDING TO IDEAS GUIDANCE: CASE STUDY.

PubMed

Bitar, A; Maghrabi, M

2018-04-01

Estimation of radiation intake and internal dose can be carried out through direct or indirect measurements during routine or special monitoring program. In case of Iodine-131 contamination, direct measurements, such as thyroid counting, are fast and efficient to give quick results. Generally, the calculation method implements suitable values for known parameters whereas default values are used if no information is available. However, in view to avoid significant discrepancies, IDEAS guidelines put in route a comprehensive method to evaluate the monitoring data for one and different types of monitoring. This article deals with a case of internal contamination of a worker who inhaled aerosols containing 131I during the production of radiopharmaceuticals. The interpretation of data obtained was done by following IDEAS guidelines.

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

NASA Astrophysics Data System (ADS)

Johnson, Perry Barnett

Interventional fluoroscopy uses ionizing radiation to guide small instruments through blood vessels or other body pathways to sites of clinical interest. The technique represents a tremendous advantage over invasive surgical procedures, as it requires only a small incision, thus reducing the risk of infection and providing for shorter recovery times. The growing use and increasing complexity of interventional procedures, however, has resulted in public health concerns regarding radiation exposures, particularly with respect to localized skin dose. Tracking and documenting patient-specific skin and internal organ dose has been specifically identified for interventional fluoroscopy where extended irradiation times, multiple projections, and repeat procedures can lead to some of the largest doses encountered in radiology. Furthermore, inprocedure knowledge of localized skin doses can be of significant clinical importance to managing patient risk and in training radiology residents. In this dissertation, a framework is presented for monitoring the radiation dose delivered to patients undergoing interventional procedures. The framework is built around two key points, developing better anthropomorphic models, and designing clinically relevant software systems for dose estimation. To begin, a library of 50 hybrid patient-dependent computational phantoms was developed based on the UF hybrid male and female reference phantoms. These phantoms represent a different type of anthropomorphic model whereby anthropometric parameters from an individual patient are used during phantom selection. The patient-dependent library was first validated and then used in two patient-phantom matching studies focused on cumulative organ and local skin dose. In terms of organ dose, patient-phantom matching was shown most beneficial for estimating the dose to large patients where error associated with soft tissue attenuation differences could be minimized. For small patients, inherent difference in organ size and location limited the effectiveness of matching. For skin dose, patient-phantom matching was found most beneficial for estimating the dose during lateral and anterior-posterior projections. Patient-sculpting of the patient.s outer body contour was also investigated for use during skin dose estimation and highlighted as a substantial step towards better patient-specificity. In order to utilize the models for actual patient dosimetry, two programs were developed based on the newly released Radiation Dose Structured Report (RDSR). The first program allows for the visualization of skin dose by translating the reference point air kerma to the location of the patient.s skin characterized by a computational model. The program represents an innovative tool that can be used by the interventional physician to modify behavior when clinically appropriate. The second program operates by automatically generating an input file from the RDSR which can then be run within a Monte Carlo based radiation transport code. The program has great potential for initiating and promoting the concept of 'cloud dosimetry', where patient-specific radiation transport is performed off-site and returned via the internet. Both programs are non-proprietary and transferable, and also incorporate the most advanced computational phantoms developed to date. Using the tools developed in this work, there exist a tangible opportunity to improve patient care with the end goal being a better understanding of the risk/benefit relationship that accompanies the medical use of ionizing radiation.

An assessment of potential health impacts on Utrok Atoll from exposure to cesium-137 (137Cs) and plutonium

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

Hamilton, T

2007-07-24

Residual fallout contamination from the nuclear test program in the Marshall Islands is a concern to Marshall Islanders because of the potential health risks associated with exposure to residual fallout contamination in the environment. Scientists from Lawrence Livermore National Laboratory (LLNL) have been monitoring the amount of fallout radiation delivered to Utrok Atoll residents over the past 4 years. This briefing document gives an outline of our findings from the whole body counting and plutonium bioassay monitoring programs. Additional information can be found on the Marshall Islands web site (http://eed.lnl.gov/mi/). Cesium-137 is an important radioactive isotope produced in nuclear detonationsmore » and can be taken up from coral soils into locally grown food crop products that form an important part of the Marshallese diet. The Marshall Islands whole body counting program has clearly demonstrated that the majority of Utrok Atoll residents acquire a very small but measurable quantity of cesium-137 in their bodies (Hamilton et al., 2006; Hamilton et. al., 2007a; 2007b;). During 2006, a typical resident of Utrok Atoll received about 3 mrem of radiation from internally deposited cesium-137 (Hamilton et al., 2007a). The population-average dose contribution from cesium-137 is around 2% of the total radiation dose that people normally experience from naturally occurring radiation sources in the Marshall Islands and is thousands of times lower than the level where radiation exposure is known to produce measurable health effects. The existing dose estimates from the whole body counting and plutonium bioassay programs are also well below radiological protection standards for protection of the public as prescribed by U.S. regulators and international agencies including the Marshall Islands Nuclear Claim Tribunal (NCT). Similarly, the level of internally deposited plutonium found in Utrok Atoll residents is well within the range normally expected for people living in the Northern Hemisphere. In addition, the preliminary results of the bioassay program on Utrok Atoll (Hamilton et al., 2007b) provide clear evidence that residents of Utrok Atoll have never acquired a significant uptake of plutonium either through an acute exposure event or from long-term chronic exposure to plutonium in the environment. This information and data should provide a level of assurance to the Utrok Atoll population group and its leadership that the dose contribution from exposure to residual radioactive fallout contamination on Utrok Atoll is very low, and is not likely to have any discernible impact on human health. We also estimate that the dose contribution based on current radiological exposure conditions will not produce any additional cancer fatalities (or any other measurable health condition) above that normally expected to arise in a population group of similar size. The potential risks from any genetic illnesses caused by exposure to residual fallout contamination in the environment will be even lower still. In conclusion, the data and information developed from the radiological protection monitoring program on Utrok appear to support a consensus that it is safe to live on Utrok Atoll. The health risks from exposure to residual fallout contamination on the atoll are minimal when compared with other lifetime risks that people normally experience, and are very small when compared to the threshold where radiation health effects could be either medically diagnosed in an individual or epidemiologically discerned in a group of people.« less

Diagnostic Doses of Insecticides for Adult Aedes aegypti to Assess Insecticide Resistance in Cuba.

PubMed

Rodríguez, María Magdalena; Crespo, Ariel; Hurtado, Daymi; Fuentes, Ilario; Rey, Jorge; Bisset, Juan Andrés

2017-06-01

The objective of this study was to determine diagnostic doses (DDs) of 5 insecticides for the Rockefeller susceptible strain of Aedes aegypti , using the Centers for Disease Control and Prevention (CDC) bottle bioassay as a tool for monitoring insecticide resistance in the Cuban vector control program. The 30-min DD values determined in this study were 13.5 μg/ml, 6.5 μg/ml, 6 μg/ml, 90.0 μg/ml, and 15.0 μg/ml for cypermethrin, deltamethrin, lambda-cyhalothrin, chlorpyrifos, and propoxur, respectively. To compare the reliability of CDC bottle bioassay with the World Health Organization susceptible test, 3 insecticide-resistant strains were evaluated for deltamethrin and lambda-cyhalothrin. Results showed that the bottles can be used effectively from 21 to 25 days after treatment and reused up to 4 times, depending on the storage time. The CDC bottle bioassay is an effective tool to assess insecticide resistance in field populations of Ae. aegypti in Cuba and can be incorporated into vector management programs using the diagnostic doses determined in this study.

Lead poisoning in captive Andean condors (Vultur gryphus)

USGS Publications Warehouse

Pattee, O.H.; Carpenter, J.W.; Fritts, S.H.; Rattner, B.A.; Wiemeyer, Stanley N.; Royle, J. Andrew; Smith, M.R.

2006-01-01

Elevated lead in the tissues of raptors, especially those that scavenge, is a common occurrence, and lead poisoning appears to be a significant problem in the ongoing recovery effort for California condors (Gymnogyps californianus). Elevated blood lead levels have been found in released birds, and a number of birds have died of lead poisoning. In earlier work, we dosed turkey vultures (Cathartes aura) with lead shot but found them to be a poor model for lead poisoning. In this study, we dosed four Andean condors (Vultur gryphus) with lead shot and found them to be quite sensitive, as two of the birds died and the other two exhibit signs of lead poisoning within 50 days. All lead-responsive parameters were affected, and regurgitation of dosed shot occurred only once. The response of the Andean condors appeared to mimic California condors, suggesting that once exposed to lead, the possibility of survival is poor. This is consistent with observations in the wild, where otherwise healthy birds exposed to metallic lead quickly succumb. At the very least, the release program has to maintain constant surveillance and an active lead monitoring program.

TH-E-209-03: Development of An In-House CT Dose Monitoring and Management System Based On Open-Source Software Resources -- Pearls and Pitfalls

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

Zhang, D.

Radiation dose monitoring solutions have opened up new opportunities for medical physicists to be more involved in modern clinical radiology practices. In particular, with the help of comprehensive radiation dose data, data-driven protocol management and informed case follow up are now feasible. Significant challenges remain however and the problems faced by medical physicists are highly heterogeneous. Imaging systems from multiple vendors and a wide range of vintages co-exist in the same department and employ data communication protocols that are not fully standardized or implemented making harmonization complex. Many different solutions for radiation dose monitoring have been implemented by imaging facilitiesmore » over the past few years. Such systems are based on commercial software, home-grown IT solutions, manual PACS data dumping, etc., and diverse pathways can be used to bring the data to impact clinical practice. The speakers will share their experiences with creating or tailoring radiation dose monitoring/management systems and procedures over the past few years, which vary significantly in design and scope. Topics to cover: (1) fluoroscopic dose monitoring and high radiation event handling from a large academic hospital; (2) dose monitoring and protocol optimization in pediatric radiology; and (3) development of a home-grown IT solution and dose data analysis framework. Learning Objectives: Describe the scope and range of radiation dose monitoring and protocol management in a modern radiology practice Review examples of data available from a variety of systems and how it managed and conveyed. Reflect on the role of the physicist in radiation dose awareness.« less

Patient Dose Management: Focus on Practical Actions

PubMed Central

2016-01-01

Medical radiation is a very important part of modern medicine, and should be only used when needed and optimized. Justification and optimization of radiation examinations must be performed. The first step of reduction of medical exposure is to know the radiation dose in currently performed examinations. This review covers radiation units, how various imaging modalities report dose, and the current status of radiation dose reports and legislation. Also, practical tips that can be applied to clinical practice are introduced. Afterwards, the importance of radiology exposure related education is emphasized and the current status of education for medical personal and the public is explained, and appropriate education strategies are suggested. Commonly asked radiation dose related example questions and answers are provided in detail to allow medical personnel to answer patients. Lastly, we talk about computerized programs that can be used in medical facilities for managing patient dose. While patient dose monitoring and management should be used to decrease and optimize overall radiation dose, it should not be used to assess individual cancer risk. One must always remember that medically justified examinations should always be performed, and unneeded examinations should be avoided in the first place. PMID:26908988

[Estimation of effective doses derived from radon in selected SPA centers that use geothermal waters based on the information of radon concentrations].

PubMed

Walczak, Katarzyna; Zmyślony, Marek

2013-01-01

Geothermal waters contain, among other components, soluble radon gas. Alpha radioactive radon is a health hazard to humans, especially when it gets into the respiratory tract. SPA facilities that use geothermal water can be a source of an increased radiation dose to people who stay there. Based on the available literature concerning radon concentrations, we assessed exposure to radon among people - workers and visitors of Spa centers that use geothermal waters. Radon concentrations were analyzed in 17 geothermal centers: in Greece (3 centers), Iran (5), China (4) and India (5). Doses recived by people in the SPA were estimated using the formula that 1 hour exposure to 1 Bq/m3 of radon concentration and equilibrium factor F = 0.4 corresponds to an effective dose of 3.2 nSv. We have found that radon levels in SPAs are from a few to several times higher than those in confined spaces, where geothermal waters are not used (e.g., residential buildings). In 82% of the analyzed SPAs, workers may receive doses above 1 mSv/year. According to the relevant Polish regulations, people receiving doses higher than 1 mSv/year are included in category B of radiation exposure and require regular dosimetric monitoring. Doses received by SPA visitors are much lower because the time of their exposure to radon released from geothermal water is rather short. The analysis of radon concentration in SPA facilities shows that the radiological protection of people working with geothermal waters plays an important role. It seems reasonable to include SPA workers staying close to geotermal waters into a dosimetric monitoring program.

Air concentrations of /sup 239/Pu and /sup 240/Pu and potential radiation doses to persons living near Pu-contaminated areas in Palomares, Spain

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

Iranzo, E.; Salvador, S.; Iranzo, C.E.

1987-04-01

On 17 January 1966, an accident during a refueling operation resulted in the destruction of an air force KC-135 tanker and a B-52 bomber carrying four thermonuclear weapons. Two weapons, whose parachutes opened, were found intact. The others experienced non-nuclear explosion with some burning and release of the fissile fuel at impact. Joint efforts by the United States and Spain resulted in remedial action and a long-term program to monitor the effectiveness of the cleanup. Air concentrations of /sup 239/Pu and /sup 240/Pu have been continuously monitored since the accident. The average annual air concentration for each location was usedmore » to estimate committed dose equivalents for individuals living and working around the air sampling stations. The average annual /sup 239/Pu and /sup 240/Pu air concentrations during the 15-y period corresponding to 1966-1980 and the potential committed dose equivalents for various tissues due to the inhalation of the /sup 239/Pu and /sup 240/Pu average annual air concentration during this period are shown and discussed in the report.« less

Key Performance Indicators in the Evaluation of the Quality of Radiation Safety Programs.

PubMed

Schultz, Cheryl Culver; Shaffer, Sheila; Fink-Bennett, Darlene; Winokur, Kay

2016-08-01

Beaumont is a multiple hospital health care system with a centralized radiation safety department. The health system operates under a broad scope Nuclear Regulatory Commission license but also maintains several other limited use NRC licenses in off-site facilities and clinics. The hospital-based program is expansive including diagnostic radiology and nuclear medicine (molecular imaging), interventional radiology, a comprehensive cardiovascular program, multiple forms of radiation therapy (low dose rate brachytherapy, high dose rate brachytherapy, external beam radiotherapy, and gamma knife), and the Research Institute (including basic bench top, human and animal). Each year, in the annual report, data is analyzed and then tracked and trended. While any summary report will, by nature, include items such as the number of pieces of equipment, inspections performed, staff monitored and educated and other similar parameters, not all include an objective review of the quality and effectiveness of the program. Through objective numerical data Beaumont adopted seven key performance indicators. The assertion made is that key performance indicators can be used to establish benchmarks for evaluation and comparison of the effectiveness and quality of radiation safety programs. Based on over a decade of data collection, and adoption of key performance indicators, this paper demonstrates one way to establish objective benchmarking for radiation safety programs in the health care environment.

Radiation Internal Monitoring by In Vivo Scanning in Operation Tomodachi

DTIC Science & Technology

2013-08-01

2 cubic meter (m3) Mass /Density pound (lb) 4.535 924 × 10–1 kilogram (kg) atomic mass unit (AMU) 1.660 539 × 10–27 kilogram (kg) pound- mass per...40 2.2.5. Critical Level and Minimum Detectable Activity ............................... 42 ii Section 3. Radiological Properties...operation quality assurance program. x Operation Tomodachi Dose Assessment and Recording Working Group members, who provided critical information

International Program to Monitor Cat Flea Populations for Susceptibility to Imidacloprid.

PubMed

Rust, M K; Blagburn, B L; Denholm, I; Dryden, M W; Payne, P; Hinkle, N C; Kopp, S; Williamson, M

2018-06-20

An international team of scientists and veterinarians was assembled in 1999 to develop a monitoring program to determine the susceptibility of cat fleas, Ctenocephalides felis felis (Bouché) (Siphonaptera: Pulicidae), to imidacloprid. Cat flea eggs were collected, shipped to laboratories, and tested for their susceptibility to imidacloprid. Over 3,000 C. felis populations were collected from 2002 to 2017 from 10 different countries. Of these, 66.3% were collected from cats and 33.7% from dogs. C. f. felis populations (n = 2,200) were bioassayed by exposing cat flea eggs and the emerging larvae to a Diagnostic Dose (DD) of 3 ppm imidacloprid in larval rearing medium. Flea eggs hatched and developed in the untreated controls in 1,837 of the isolates (83.5%) bioassayed. Flea isolates (n = 61) that had ≥5% survival at the DD of 3 ppm were retested with a second DD of 3 ppm. None of them had ≥5% survival to the second dose of 3 ppm. Of the 1,837 valid C. felis isolates tested, there has been no evidence of a decreased susceptibility to imidacloprid over the past 17 yr. The methods outlined in this article should provide an acceptable protocol for testing many of the new active ingredients that have been registered for cat flea control.

Pharmacist-managed dose adjustment feedback using therapeutic drug monitoring of vancomycin was useful for patients with methicillin-resistant Staphylococcus aureus infections: a single institution experience

PubMed Central

Hirano, Ryuichi; Sakamoto, Yuichi; Kitazawa, Junichi; Yamamoto, Shoji; Tachibana, Naoki

2016-01-01

Background Vancomycin (VCM) requires dose adjustment based on therapeutic drug monitoring. At Aomori Prefectural Central Hospital, physicians carried out VCM therapeutic drug monitoring based on their experience, because pharmacists did not participate in the dose adjustment. We evaluated the impact of an Antimicrobial Stewardship Program (ASP) on attaining target VCM trough concentrations and pharmacokinetics (PK)/pharmacodynamics (PD) parameters in patients with methicillin-resistant Staphylococcus aureus (MRSA) infections. Materials and methods The ASP was introduced in April 2012. We implemented a prospective audit of prescribed VCM dosages and provided feedback based on measured VCM trough concentrations. In a retrospective pre- and postcomparison study from April 2007 to December 2011 (preimplementation) and from April 2012 to December 2014 (postimplementation), 79 patients were treated for MRSA infection with VCM, and trough concentrations were monitored (pre, n=28; post, n=51). In 65 patients (pre, n=15; post, n=50), 24-hour area under the concentration–time curve (AUC 0–24 h)/minimum inhibitory concentration (MIC) ratios were calculated. Results Pharmacist feedback, which included recommendations for changing dose or using alternative anti-MRSA antibiotics, was highly accepted during postimplementation (88%, 29/33). The number of patients with serum VCM concentrations within the therapeutic range (10–20 μg/mL) was significantly higher during postimplementation (84%, 43/51) than during preimplementation (39%, 11/28) (P<0.01). The percentage of patients who attained target PK/PD parameters (AUC 0–24 h/MIC >400) was significantly higher during postimplementation (84%, 42/50) than during preimplementation (53%, 8/15; P=0.013). There were no significant differences in nephrotoxicity or mortality rate. Conclusion Our ASP increased the percentage of patients that attained optimal VCM trough concentrations and PK/PD parameters, which contributed to the appropriate use of VCM in patients with MRSA infections. PMID:27789965

Environmental Radiation Measurements on the Mir Space Station. Program 1; Internal Experiment Program

NASA Technical Reports Server (NTRS)

Benton, E. V.; Frank, A. L.; Benton, E. R.

1998-01-01

As part of the NASA/Mir Phase 1B Science Program, the ionizing radiation environment inside and outside the Russian Mir's Space Station was monitored using a combination of Thermoluminescent Detectors (TLD) and CR-39 Plastic Nuclear Track Detectors (PNTD). Radiation measurements inside the Mir station were carried out using six Area Passive Dosimeters (APD), four located inside the Mir Base Block and two located inside the Kvant 2 module, during the NASA-2/Mir-21, NASA-3/Mir-22 and NASA-4/Mir-23 missions. The radiation environment under low shielding was measured using an External Dosimeter Array (EDA) mounted on the outer surface of the Kvant 2 module. The external radiation environment and a location inside the Kvant 2 roughly corresponding to the location of the EDA were monitored for 130 days during the NASA- 4/Mir-23 and NASA-5/Mir-24 missions. Dose rates measured by APD TLDs ranged from 271 to 407 microGy/d during the NASA-2/Mir-21 mission, from 265 to 378 microGy/d during the NASA-3/Mir-22 mission, and from 287 to 421 microGy/d during the NASA-4/Mir-23 mission. APD PNTDs have been analyzed and LET spectra have been Cenerated for the five APDs exposed on the NASA-2/Mir-21 mission and for two APD PNTDs exposed on the NASA-3/Mir-22 mission. Dose equivalent rates on the NASA-2/Mir-21 mission ranged from 513 microSv/d in the Kvant 2 module to 710 microSv/d on the floor of the Base Block. Dose as a function of shielding depth in TLDs has been measured in the thin TLD stacks including in the EDA. EDA dose range from 72.5 Gy under 0.0146 g/sq cm to 0.093 Gy under 3.25 g/sq cm of shielding. Readout and analysis of the reaming PNTDs form the NASA-3/Mir-22 mission and PNTDs from the NASA-4/Mir-23 mission (including those from the EDA) is ongoing and will be completed during the final year of this experiment. Dose equivalent rates for the NASA-3/Mir-22 and NASA-4/Mir-23 APDs will then be determined and comparisons will be made with both model calculations and with results from similar measurements.

Adherence to HAART therapy measured by electronic monitoring in newly diagnosed HIV patients in Botswana.

PubMed

Vriesendorp, Reinout; Cohen, Adam; Kristanto, Paulus; Vrijens, Bernard; Rakesh, Pande; Anand, Bene; Iwebor, Henry Uchechukwaka; Stiekema, Jacobus

2007-12-01

This pilot study was designed to evaluate the feasibility and benefits of electronic adherence monitoring of antiretroviral medications in HIV patients who recently started Highly Active Anti Retroviral Therapy (HAART) in Francistown, Botswana and to compare this with self-reporting. Dosing histories were compiled electronically using Micro Electro Mechanical Systems (MEMS) monitors to evaluate adherence to prescribed therapies. Thirty patients enrolled in the antiretroviral treatment program were monitored over 6 weeks. These patients were all antiretroviral (ARV) naïve. After each visit (mean three times) to the pharmacy, the data compiled by the monitors were downloaded. Electronic monitoring of adherence was compared to patient self-reports of adherence. The mean individual medication adherence level measured with the electronic device was 85% (range 21-100%). The mean adherence level measured by means of self-reporting was 98% (range 70-100%). Medication prescribed on a once-a-day dose base was associated with a higher adherence level (97.9% for efavirenz) compared with a twice-a-day regimen (88.4% for Lamivudine/Zidovudine). It is feasible to assess treatment adherence of patients living in a low resource setting on HAART by using electronic monitors. Adherence, even in the early stages of treatment, appears to be insufficient in some patients and may be below the level required for continuous inhibition of viral replication. This approach may lead to improved targeting of counselling about their medication intake of such patients in order to prevent occurrence of resistant viral strains due to inadequate inhibition of viral replication. In this pilot study a significant difference between the data recorded through the electronic monitors and those provided by self-reporting was observed.

Fast method for in-flight estimation of total dose from protons and electrons using RADE Minstrument on JUICE

NASA Astrophysics Data System (ADS)

Hajdas, Wojtek; Mrigakshi, Alankrita; Xiao, Hualin

2017-04-01

The primary concern of the ESA JUICE mission to Jupiter is the harsh particle radiation environment. Ionizing particles introduce radiation damage by total dose effects, displacement damages or single events effects. Therefore, both the total ionizing dose and the displacement damage equivalent fluence must be assessed to alert spacecraft and its payload as well as to quantify radiation levels for the entire mission lifetime. We present a concept and implementations steps for simplified method used to compute in flight a dose rate and total dose caused by protons. We also provide refinement of the method previously developed for electrons. The dose rates values are given for predefined active volumes located behind layers of materials with known thickness. Both methods are based on the electron and proton flux measurements provided by the Electron and Proton Detectors inside the Radiation Hard Electron Monitor (RADEM) located on-board of JUICE. The trade-off between method accuracy and programming limitations for in-flight computations are discussed. More comprehensive and precise dose rate computations based on detailed analysis of all stack detectors will be made during off-line data processing. It will utilize full spectral unfolding from all RADEM detector subsystems.

Evaluation of synergistic effects of resynchronization therapy and a β-blocker up-titration strategy based on a predefined patient-management program: the RESTORE study.

PubMed

Palmisano, Pietro; Ammendola, Ernesto; D'Onofrio, Antonio; Accogli, Michele; Calò, Leonardo; Ruocco, Antonio; Rapacciuolo, Antonio; Del Giorno, Giuseppe; Bianchi, Valter; Malacrida, Maurizio; Valsecchi, Sergio; Gronda, Edoardo

2015-01-01

Prior studies have suggested that a substantial number of eligible heart failure (HF) patients fail to receive β-blocker therapy, or receive it at a suboptimal dose. The aim of this study is to assess the benefit of a predefined management program designed for β-blocker up-titration, evaluating the synergistic effect of cardiac resynchronization therapy (CRT) and β-blockers in a HF population. The Resynchronization Therapy and β-Blocker Titration (RESTORE) study is a prospective, case-control, multicenter cohort study designed to test the hypothesis that a β-blocker up-titration strategy based on a predefined management program maximizes the beneficial effect of CRT, increasing the number of patients reaching the target dose of β-blockers and improving their clinical outcome. All study patients receive an implantable defibrillator for CRT delivery in accordance with current guidelines. Enrollments started in December 2011 and are scheduled to end in December 2014. Approximately 250 consecutive patients will be prospectively enrolled in 6 Italian centers and followed up for 24 months after implantation. The primary endpoint is to demonstrate that CRT may allow titration of β-blockers until the optimal dose, or at least to the effective dose, in patients with HF. This study might provide important information about the benefit of a predefined management program for β-blocker up-titration in patients receiving CRT. Moreover, assessment of health-care utilization and the consumption of resources will allow estimating the potential utility of remote monitoring by means of an automated telemedicine system in facilitating the titration of β-blockers in comparison with a standard in-hospital approach. © 2015 Wiley Periodicals, Inc.

Retention in medication-assisted treatment programs in Ukraine-Identifying factors contributing to a continuing HIV epidemic.

PubMed

Dumchev, Kostyantyn; Dvoryak, Sergii; Chernova, Olena; Morozova, Olga; Altice, Frederick L

2017-10-01

Opioid agonist treatments (OAT) are widely-used, evidence-based strategies for treating opioid dependence and reducing HIV transmission. The positive benefits of OAT are strongly correlated with time spent in treatment, making retention a key indicator for program quality. This study assessed patient retention and associated factors in Ukraine, where OAT was first introduced in 2004. Data from clinical records of 2916 patients enrolled in OAT at thirteen sites from 2005 to 2012 were entered into an electronic monitoring system. Survival analysis methods were used to determine the probability of retention and its correlates. Twelve-month retention was 65.8%, improving from 27.7% in 2005, to 70.9% in 2011. In multivariable analyses, the correlates of retention were receiving medium and high doses of medication (compared to low doses, dropout aHR=0.57 for both medium and high doses), having not been tested for HIV and tuberculosis (compared to not being tested, dropout aHR=4.44 and 3.34, respectively), and among those who were tested-a negative TB test result (compared to receiving a positive test result, dropout aHR=0.67). Retention in Ukrainian OAT programs, especially in recent years, is comparable to other countries. The results confirm the importance of adequate OAT dosing (≥60mg of methadone, ≥8mg of buprenorphine). Higher dosing, however, will require interventions that address negative attitudes toward OAT by patients and providers. Interruption of OAT, in the case developing tuberculosis, should incorporate continuity of OAT for TB patients through integrated care delivery systems. Copyright © 2017 Elsevier B.V. All rights reserved.

MO-FG-202-08: Real-Time Monte Carlo-Based Treatment Dose Reconstruction and Monitoring for Radiotherapy

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

Tian, Z; Shi, F; Gu, X

2016-06-15

Purpose: This proof-of-concept study is to develop a real-time Monte Carlo (MC) based treatment-dose reconstruction and monitoring system for radiotherapy, especially for the treatments with complicated delivery, to catch treatment delivery errors at the earliest possible opportunity and interrupt the treatment only when an unacceptable dosimetric deviation from our expectation occurs. Methods: First an offline scheme is launched to pre-calculate the expected dose from the treatment plan, used as ground truth for real-time monitoring later. Then an online scheme with three concurrent threads is launched while treatment delivering, to reconstruct and monitor the patient dose in a temporally resolved fashionmore » in real-time. Thread T1 acquires machine status every 20 ms to calculate and accumulate fluence map (FM). Once our accumulation threshold is reached, T1 transfers the FM to T2 for dose reconstruction ad starts to accumulate a new FM. A GPU-based MC dose calculation is performed on T2 when MC dose engine is ready and a new FM is available. The reconstructed instantaneous dose is directed to T3 for dose accumulation and real-time visualization. Multiple dose metrics (e.g. maximum and mean dose for targets and organs) are calculated from the current accumulated dose and compared with the pre-calculated expected values. Once the discrepancies go beyond our tolerance, an error message will be send to interrupt the treatment delivery. Results: A VMAT Head-and-neck patient case was used to test the performance of our system. Real-time machine status acquisition was simulated here. The differences between the actual dose metrics and the expected ones were 0.06%–0.36%, indicating an accurate delivery. ∼10Hz frequency of dose reconstruction and monitoring was achieved, with 287.94s online computation time compared to 287.84s treatment delivery time. Conclusion: Our study has demonstrated the feasibility of computing a dose distribution in a temporally resolved fashion in real-time and quantitatively and dosimetrically monitoring the treatment delivery.« less

A pilot study: dose adaptation of capecitabine using mobile phone toxicity monitoring - supporting patients in their homes.

PubMed

Weaver, Andrew; Love, Sharon B; Larsen, Mark; Shanyinde, Milensu; Waters, Rachel; Grainger, Lisa; Shearwood, Vanessa; Brooks, Claire; Gibson, Oliver; Young, Annie M; Tarassenko, Lionel

2014-10-01

Real-time symptom monitoring using a mobile phone is potentially advantageous for patients receiving oral chemotherapy. We therefore conducted a pilot study of patient dose adaptation using mobile phone monitoring of specific symptoms to investigate relative dose intensity of capecitabine, level of toxicity and perceived supportive care. Patients with breast or colorectal cancer receiving capecitabine completed a symptom, temperature and dose diary twice a day using a mobile phone application. This information was encrypted and automatically transmitted in real time to a secure server, with moderate levels of toxicity automatically prompting self-care symptom management messages on the screen of the patient's mobile phone or in severe cases, a call from a specialist nurse to advise on care according to an agreed protocol. Patients (n = 26) completed the mobile phone diary on 92.6 % of occasions. Twelve patients had a maximum toxicity grade of 3 (46.2 %). The average dose intensity for all patients as a percentage of standard dose was 90 %. In eight patients, the dose of capecitabine was reduced, and in eight patients, the dose of capecitabine was increased. Patients and healthcare professionals involved felt reassured by the novel monitoring system, in particular, during out of hours. It is possible to optimise the individual dose of oral chemotherapy safely including dose increase and to manage chemotherapy side effects effectively using real-time mobile phone monitoring of toxicity parameters entered by the patient.

Monitoring Compliance to Promote Quality Assurance: Development of a Mental Health Clinical Chart Audit Tool in Belize, 2013.

PubMed

Winer, Rachel A; Bennett, Eleanor; Murillo, Illouise; Schuetz-Mueller, Jan; Katz, Craig L

2015-09-01

Belize trained psychiatric nurse practitioners (PNPs) in the early 1990s to provide mental health services throughout the country. Despite overwhelming success, the program is limited by lack of monitoring, evaluation, and surveillance. To promote quality assurance, we developed a chart audit tool to monitor mental healthcare delivery compliance for initial psychiatric assessment notes completed by PNPs. After reviewing the Belize Health Information System electronic medical record system, we developed a clinical audit tool to capture 20 essential components for initial assessment clinical notes. The audit tool was then piloted for initial assessment notes completed during July through September of 2013. One hundred and thirty-four initial psychiatric interviews were audited. The average chart score among all PNPs was 9.57, ranging from 3 to 15. Twenty-three charts-or 17.2%-had a score of 14 or higher and met a 70% compliance benchmark goal. Among indicators most frequently omitted included labs ordered and named (15.7%) and psychiatric diagnosis (21.6%). Explicit statement of medications initiated with dose and frequency occurred in 47.0% of charts. Our findings provide direction for training and improvement, such as emphasizing the importance of naming labs ordered, medications and doses prescribed, and psychiatric diagnoses in initial assessment clinical notes. We hope this initial assessment helps enhance mental health delivery compliance by prompting creation of BHIS templates, development of audits tools for revisit follow-up visits, and establishment of corrective actions for low-scoring practitioners. These efforts may serve as a model for implementing quality assurance programming in other low resource settings.

Tritium recapture behavior at a nuclear power reactor due to airborne releases.

PubMed

Harris, Jason T; Miller, David W; Foster, Doug W

2008-08-01

This paper describes the initiatives taken by Cook Nuclear Plant to study the on-site behavior of recaptured tritium released in its airborne effluents. Recapture is the process where a released radioactive effluent, in this case tritium, is brought back on-site through some mechanism. Precipitation, shifts in wind direction, or anthropogenic structures that restrict or alter effluent movement can all lead to recapture. The investigation was started after tritium was detected in the north storm drain outfall. Recent inadvertent tritium releases by several other nuclear power plants, many of which entered the groundwater, have led to increased surveillance and scrutiny by regulatory authorities and the general public. To determine the source of tritium in the outfall, an on-site surface water, well water, rainwater and air-conditioning condensate monitoring program was begun. Washout coefficients were also determined to compare with results reported by other nuclear power plants. Program monitoring revealed detectable tritium concentrations in several precipitation sample locations downwind of the two monitored containment building release vents. Tritium was found in higher concentrations in air-conditioning condensate, with a mean value of 528 Bq L(-1) (14,300 pCi L(-1)). The condensate, and to a lesser extent rainwater, were contributing to the tritium found in the north storm drain outfall. Maximum concentration values for each sample type were used to estimate the most conservative dose. A maximum dose of 1.1 x 10(-10) mSv (1.1 x 10(-8) mrem) total body was calculated to determine the health impact of the tritium detected.

Reliability in individual monitoring service.

PubMed

Mod Ali, N

2011-03-01

As a laboratory certified to ISO 9001:2008 and accredited to ISO/IEC 17025, the Secondary Standard Dosimetry Laboratory (SSDL)-Nuclear Malaysia has incorporated an overall comprehensive system for technical and quality management in promoting a reliable individual monitoring service (IMS). Faster identification and resolution of issues regarding dosemeter preparation and issuing of reports, personnel enhancement, improved customer satisfaction and overall efficiency of laboratory activities are all results of the implementation of an effective quality system. Review of these measures and responses to observed trends provide continuous improvement of the system. By having these mechanisms, reliability of the IMS can be assured in the promotion of safe behaviour at all levels of the workforce utilising ionising radiation facilities. Upgradation of in the reporting program through a web-based e-SSDL marks a major improvement in Nuclear Malaysia's IMS reliability on the whole. The system is a vital step in providing a user friendly and effective occupational exposure evaluation program in the country. It provides a higher level of confidence in the results generated for occupational dose monitoring of the IMS, thus, enhances the status of the radiation protection framework of the country.

Human papillomavirus (HPV) vaccination coverage in young Australian women is higher than previously estimated: independent estimates from a nationally representative mobile phone survey.

PubMed

Brotherton, Julia M L; Liu, Bette; Donovan, Basil; Kaldor, John M; Saville, Marion

2014-01-23

Accurate estimates of coverage are essential for estimating the population effectiveness of human papillomavirus (HPV) vaccination. Australia has a purpose built National HPV Vaccination Program Register for monitoring coverage, however notification of doses administered to young women in the community during the national catch-up program (2007-2009) was not compulsory. In 2011, we undertook a population-based mobile phone survey of young women to independently estimate HPV vaccination coverage. Randomly generated mobile phone numbers were dialed to recruit women aged 22-30 (age eligible for HPV vaccination) to complete a computer assisted telephone interview. Consent was sought to validate self reported HPV vaccination status against the national register. Coverage rates were calculated based on self report and weighted to the age and state of residence structure of the Australian female population. These were compared with coverage estimates from the register using Australian Bureau of Statistics estimated resident populations as the denominator. Among the 1379 participants, the national estimate for self reported HPV vaccination coverage for doses 1/2/3, respectively, weighted for age and state of residence, was 64/59/53%. This compares with coverage of 55/45/32% and 49/40/28% based on register records, using 2007 and 2011 population data as the denominators respectively. Some significant differences in coverage between the states were identified. 20% (223) of women returned a consent form allowing validation of doses against the register and provider records: among these women 85.6% (538) of self reported doses were confirmed. We confirmed that coverage rates for young women vaccinated in the community (at age 18-26 years) are underestimated by the national register and that under-notification is greater for second and third doses. Using 2011 population estimates, rather than estimates contemporaneous with the program rollout, reduces register-based coverage estimates further because of large population increases due to immigration since the program. Copyright © 2013 Elsevier Ltd. All rights reserved.

Design and qualification of the SEU/TD Radiation Monitor chip

NASA Technical Reports Server (NTRS)

Buehler, Martin G.; Blaes, Brent R.; Soli, George A.; Zamani, Nasser; Hicks, Kenneth A.

1992-01-01

This report describes the design, fabrication, and testing of the Single-Event Upset/Total Dose (SEU/TD) Radiation Monitor chip. The Radiation Monitor is scheduled to fly on the Mid-Course Space Experiment Satellite (MSX). The Radiation Monitor chip consists of a custom-designed 4-bit SRAM for heavy ion detection and three MOSFET's for monitoring total dose. In addition the Radiation Monitor chip was tested along with three diagnostic chips: the processor monitor and the reliability and fault chips. These chips revealed the quality of the CMOS fabrication process. The SEU/TD Radiation Monitor chip had an initial functional yield of 94.6 percent. Forty-three (43) SEU SRAM's and 14 Total Dose MOSFET's passed the hermeticity and final electrical tests and were delivered to LL.

Observations on personnel dosimetry for radiotherapy personnel operating high-energy LINACs.

PubMed

Glasgow, G P; Eichling, J; Yoder, R C

1986-06-01

A series of measurements were conducted to determine the cause of a sudden increase in personnel radiation exposures. One objective of the measurements was to determine if the increases were related to changing from film dosimeters exchanged monthly to TLD-100 dosimeters exchanged quarterly. While small increases were observed in the dose equivalents of most employees, the dose equivalents of personnel operating medical electron linear accelerators with energies greater than 20 MV doubled coincidentally with the change in the personnel dosimeter program. The measurements indicated a small thermal neutron radiation component around the accelerators operated by these personnel. This component caused the doses measured with the TLD-100 dosimeters to be overstated. Therefore, the increase in these personnel dose equivalents was not due to changes in work habits or radiation environments. Either film or TLD-700 dosimeters would be suitable for personnel monitoring around high-energy linear accelerators. The final choice would depend on economics and personal preference.

Determination of in vitro lung solubility and intake-to-dose conversion factor for tritiated lanthanum nickel aluminum alloy.

PubMed

Farfán, Eduardo B; Labone, Thomas R; Staack, Gregory C; Cheng, Yung-Sung; Zhou, Yue; Varallo, Thomas P

2012-09-01

A sample of tritiated lanthanum nickel aluminum alloy (LaNi4.25Al0.75 or LANA.75) similar to that used at the Savannah River Site Tritium Facilities was analyzed to estimate the particle size distribution of this metal tritide powder and the rate at which this material dissolves in the human respiratory tract after it is inhaled. This information is used to calculate the committed effective dose received by a worker after inhaling the material. These doses, which were calculated using the same methodology given in the U.S. Department of Energy Tritium Handbook, are presented as inhalation intake-to-dose conversion factors (DCF). The DCF for this metal tritide was determined to be 9.4 × 10 Sv Bq, which is less than the DCF for tritiated water. Therefore, the radiation worker bioassay programs designed for tritiated water are adequate to monitor for intakes of this material.

A Dose-Response Study of Inactivated Low Pathogenic Avian Influenza H9N2 Virus in Specific-Pathogen-Free and Commercial Broiler Chickens.

PubMed

Kilany, Walid H; Ali, Ahmed; Bazid, Abdel-Hamid I; El-Deeb, Ayman H; El-Abideen, Mohamed A Zain; Sayed, Magdy El; El-Kady, Magdy F

2016-05-01

Since the first report of low pathogenic avian influenza (LPAI) H9N2 virus in Egypt in 2011, the Egyptian poultry industry has suffered from unexpected economic losses as a result of the wide spread of LPAI H9N2. Hence, inactivated H9N2 vaccines have been included in the vaccination programs of different poultry production sectors. The optimal antigen content of avian influenza virus vaccines is essential to reach protective antibody titers. In this study, the correlation between antigen content (based on hemagglutinating units [HAU]) and postvaccination (PV) antibody response of H9N2 inactivated vaccine was studied. Five different vaccine antigen loads (128, 200, 250, 300, and 350 HAU formulas/dose) were investigated in commercial broiler and specific-pathogen-free (SPF) chickens. Vaccine safety and PV antibody responses were monitored. At the fourth week PV only SPF vaccinated groups (128, 200, 250, and 300 HAU/dose) were challenged using LPAI H9N2 (A/Ck/EG/114940v/NLQP/11) virus with 10(6) EID50/bird. Oropharyngeal swabs were used to monitor virus shedding at 2, 4, 6, and 10 days postchallenge. Results showed that all vaccine formulations were well tolerated, and the highest antibody titers were observed in birds vaccinated with higher HAU. Vaccines containing 128 and 200 HAU/dose did not induce the required protective HI titers by 3 wk PV. Meanwhile, the challenge experiment in SPF chickens showed that 250 and 300 HAU vaccine doses were required to reduce the level and duration of virus shedding. Study results thus suggest that inactivated H9N2 vaccines containing at least 250 HAU/dose will induce the optimal protective titers and minimize virus shedding in SPF chickens.

Antipsychotic treatment dosing profile in patients with schizophrenia evaluated with electronic monitoring (MEMS®).

PubMed

Acosta, Francisco J; Ramallo-Fariña, Yolanda; Bosch, Esperanza; Mayans, Teresa; Rodríguez, Carlos J; Caravaca, Ana

2013-05-01

Although the Medication Event Monitoring System (MEMS®) device offers accurate information on treatment dosing profile, such profile has never been studied in patients with schizophrenia. Enhancing our knowledge on this issue would help in developing intervention strategies to improve adherence to antipsychotic treatment in these patients. 74 outpatients with schizophrenia were monitored with the MEMS device for a 3-month period, for evaluation of antipsychotic treatment dosing profile, possible influence of medication schedule-related variables, adherence to treatment--considering dose intake within prescribed timeframes--and possible Hawthorne's effect of using the MEMS device. Dose-omission gaps occurred in 18.7% of monitoring days, most frequently during weekends, almost significantly. Almost one-third of prescribed doses were taken out of prescribed time. Neither the prescribed number of daily doses nor the indicated time of the day for dose intake (breakfast, dinner), were associated with correct antipsychotic dosing. Excess-dose was rare in general, and more frequent out of prescribed dose timeframe. No Hawthorne's effect was found for the MEMS device. Adherence reached only 35% according to a definition that included dose intake within prescribed timeframes. Antipsychotic treatment dosing was considerably irregular among patients with schizophrenia. Strategies to reduce dose-omission gaps and increase dosing within prescribed timeframes seem to be necessary. Gaining knowledge on precise oral antipsychotic dosing profiles or the influence of schedule-related variables may be useful to design strategies towards enhancing adherence. There appears to be no Hawthorne's effect associated with the use of MEMS devices in outpatients with schizophrenia. Copyright © 2013 Elsevier B.V. All rights reserved.

SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT

PubMed Central

Halliburton, Sandra S.; Abbara, Suhny; Chen, Marcus Y.; Gentry, Ralph; Mahesh, Mahadevappa; Raff, Gilbert L.; Shaw, Leslee J.; Hausleiter, Jörg

2012-01-01

Over the last few years, computed tomography (CT) has developed into a standard clinical test for a variety of cardiovascular conditions. The emergence of cardiovascular CT during a period of dramatic increase in radiation exposure to the population from medical procedures and heightened concern about the subsequent potential cancer risk has led to intense scrutiny of the radiation burden of this new technique. This has hastened the development and implementation of dose reduction tools and prompted closer monitoring of patient dose. In an effort to aid the cardiovascular CT community in incorporating patient-centered radiation dose optimization and monitoring strategies into standard practice, the Society of Cardiovascular Computed Tomography has produced a guideline document to review available data and provide recommendations regarding interpretation of radiation dose indices and predictors of risk, appropriate use of scanner acquisition modes and settings, development of algorithms for dose optimization, and establishment of procedures for dose monitoring. PMID:21723512

Poster — Thur Eve — 38: Feasibility of a Table-Top Total Body Irradiation Technique using Robotic Couch Motion

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

Chin, Erika; Otto, Karl; Hoppe, Richard

Purpose: To develop and test the feasibility of a table-top implementation for total body irradiation (TBI) via robotic couch motion and coordinated monitor unit modulation on a standard C-arm linac geometry. Methods: To allow for collision free delivery and to maximize the effective field size, the couch was rotated to 270° IEC and dropped to 150 cm from the vertical radiation source. The robotic delivery was programmed using the TrueBeam STx Developer Mode using custom XML scripting. To assess the dosimetry of a sliding 30×20 cm{sup 2} field, irradiation on a solid water phantom of varying thickness was analyzed usingmore » EDR2 radiographic film and OSLDs. Beam modulation was achieved by dividing the couch path into multiple segments of varying dose rates and couch speeds in order to deliver 120 cGy to the midline. Results: The programmed irradiation in conjunction with coordinated couch motion was successfully delivered on a TrueBeam linac. When no beam modulation was employed, the dose difference between two different phantom sections was 17.0%. With simple beam modulation via changing dose rates and couch speeds, the desired prescription dose can be achieved at the centre of each phantom section within 1.9%. However, dose deviation at the junction was 9.2% due to the nonphysical change in the phantom thickness. Conclusions: The feasibility of robotic table-top TBI on a C-arm linac geometry was experimentally demonstrated. To achieve a more uniform dose distribution, inverse-planning allowing for a combination of dose rate modulation, jaw tracking and MLC motion is under investigation.« less

Environmental radioactivity levels, Browns Ferry Nuclear Plant: Annual report, 1986

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

Not Available

1986-04-01

The report presents data gathered during radiological monitoring program conducted in the environs of the Browns Ferry Nuclear Plant. Dose estimates were made from concentrations of radioactivity found in samples of media including air, milk, food products, drinking water, and fish. Inhalation and ingestion doses estimated for persons at the indicator locations were essentially identical to those determined for persons at control locations. Greater than 95% of those doses were contributed by the naturally occurring K-40 and by Sr-90 and Cs-137 which are long-lived radioisotopes found in fallout from nuclear weapons testing. Increased levels of I-131 were reported in air,more » milk, and rainwater following the accident at the Chernobyl nuclear power station. In addition, Ru-103, Cs-137, and Cs-134 were identified in air particulates, and traces of Ru-103 were found in rainwater. (ACR)« less

Radioactivity Risk Assessment of Radon and Gamma Dose at One Uranium Tailings Pond in China

NASA Astrophysics Data System (ADS)

Lou, Yalong; Liu, Yong; Peng, Guowen; Zhao, Guodong; Zhang, Yan; Yang, Zhu

2018-01-01

A year-long monitoring of gamma radiation effective dose rate and radon concentration had been done in the reservoir area of one uranium tailings pond in Hunan province (The monitoring area included indoor and outdoor area of residential buildings and workshops, tailings dam slope). Afterwards, the annual effective radiation dose of the people in that radiation environment had been calculated based on the results of monitoring, as well as a radiation risk assessment. According to the assessment, gamma radiation effective dose rate and radon concentration in the monitoring area were low, and the annual effective radiation dose was far below the international standard (30mSv), which showed that the radiation would not put the people’s health at risk. However, the annual effective radiation dose of gamma was far above that of radon in the area of uranium tailings pond; therefore, it’s advisable to take quarantine measures in in the area of uranium tailings pond to keep the surrounding residents away from unnecessary ionizing radiation.

[Information technologies: new partners in treating diabetes].

PubMed

Colombet, I; Chatellier, G

2001-10-15

The management of chronic diseases such as diabetes is becoming a crucial issue in developed countries. Innovative communication technologies should now be included as new partners in the health care system. These technologies can help both in managing patients and measuring quality of care. Internet-based health promotion programs may improve compliance with treatment. Decision systems are available on the Net to help patients monitoring their diet and insulin doses. The use of electronic medical record shared on Internet may help both physicians and patients to monitor on the long term the effect of interventions. It is now time to perform appropriate trials to determine, beside other interventions, the precise role of innovative communication technologies in diabetes management.

Maywood interim storage site. Annual site environmental report, calendar year 1985

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

Not Available

1986-05-01

During 1985, the environmental monitoring program was continued at the Maywood Interim Storage Site (MISS), a US Department of Energy (DOE) facility located in the Borough of Maywood and the Township of Rochelle Park, New Jersey. The MISS is presently used for the storage of low-level radioactively contaminated soils. Monitoring results show that the MISS is in compliance with DOE concentration guides and radiation protection standards. Derived Concentration Guides (DCGs) represent the concentrations of radionuclides in air or water that would limit the radiation dose to 100 mrem/yr. The applicable guides have been revised since the 1984 environmental monitoring reportmore » was published. The guides applied in 1984 were based on a radiation protection standard of 500 mrem/yr; the guides applied for 1985 are based on a standard of 100 mrem/yr.« less

Real-Time Patient and Staff Radiation Dose Monitoring in IR Practice

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

Sailer, Anna M., E-mail: karmanna@stanford.edu; Paulis, Leonie, E-mail: leonie.paulis@mumc.nl; Vergoossen, Laura

PurposeKnowledge of medical radiation exposure permits application of radiation protection principles. In our center, the first dedicated real-time, automated patient and staff dose monitoring system (DoseWise Portal, Philips Healthcare) was installed. Aim of this study was to obtain insight in the procedural and occupational doses.Materials and MethodsAll interventional radiologists, vascular surgeons, and technicians wore personal dose meters (PDMs, DoseAware, Philips Healthcare). The dose monitoring system simultaneously registered for each procedure dose-related data as the dose area product (DAP) and effective staff dose (E) from PDMs. Use and type of shielding were recorded separately. All procedures were analyzed according to proceduremore » type; these included among others cerebral interventions (n = 112), iliac and/or caval venous recanalization procedures (n = 68), endovascular aortic repair procedures (n = 63), biliary duct interventions (n = 58), and percutaneous gastrostomy procedure (n = 28).ResultsMedian (±IQR) DAP doses ranged from 2.0 (0.8–3.1) (percutaneous gastrostomy) to 84 (53–147) Gy cm{sup 2} (aortic repair procedures). Median (±IQR) first operator doses ranged from 1.6 (1.1–5.0) μSv to 33.4 (12.1–125.0) for these procedures, respectively. The relative exposure, determined as first operator dose normalized to procedural DAP, ranged from 1.9 in biliary interventions to 0.1 μSv/Gy cm{sup 2} in cerebral interventions, indicating large variation in staff dose per unit DAP among the procedure types.ConclusionReal-time dose monitoring was able to identify the types of interventions with either an absolute or relatively high staff dose, and may allow for specific optimization of radiation protection.« less

Device-based monitoring in physical activity and public health research.

PubMed

Bassett, David R

2012-11-01

Measurement of physical activity is important, given the vital role of this behavior in physical and mental health. Over the past quarter of a century, the use of small, non-invasive, wearable monitors to assess physical activity has become commonplace. This review is divided into three sections. In the first section, a brief history of physical activity monitoring is provided, along with a discussion of the strengths and weaknesses of different devices. In the second section, recent applications of physical activity monitoring in physical activity and public health research are discussed. Wearable monitors are being used to conduct surveillance, and to determine the extent and distribution of physical activity and sedentary behaviors in populations around the world. They have been used to help clarify the dose-response relation between physical activity and health. Wearable monitors that provide feedback to users have also been used in longitudinal interventions to motivate research participants and to assess their compliance with program goals. In the third section, future directions for research in physical activity monitoring are discussed. It is likely that new developments in wearable monitors will lead to greater accuracy and improved ease-of-use.

Noninvasive treatment efficacy monitoring and dose control for high-intensity focused ultrasound therapy using relative electrical impedance variation

NASA Astrophysics Data System (ADS)

Su, Huidan; Guo, Gepu; Ma, Qingyu; Tu, Juan; Zhang, Dong

2017-05-01

Not Available Project supported by the National Natural Science Foundation of China (Grant Nos. 11604156 and 11474166), the Science and Technology Cooperation Projects of China and Romania (Grant No. 42-23), the Natural Science Foundation of Jiangsu Province, China (Grant No. BK20161013), the Postdoctoral Science Foundation of China (Grant No. 2016M591874), and the Priority Academic Program Development of Jiangsu Higher Education Institutions, China.

Software for Dosage Individualization of Voriconazole for Immunocompromised Patients

PubMed Central

VanGuilder, Michael; Donnelly, J. Peter; Blijlevens, Nicole M. A.; Brüggemann, Roger J. M.; Jelliffe, Roger W.; Neely, Michael N.

2013-01-01

The efficacy of voriconazole is potentially compromised by considerable pharmacokinetic variability. There are increasing insights into voriconazole concentrations that are safe and effective for treatment of invasive fungal infections. Therapeutic drug monitoring is increasingly advocated. Software to aid in the individualization of dosing would be an extremely useful clinical tool. We developed software to enable the individualization of voriconazole dosing to attain predefined serum concentration targets. The process of individualized voriconazole therapy was based on concepts of Bayesian stochastic adaptive control. Multiple-model dosage design with feedback control was used to calculate dosages that achieved desired concentration targets with maximum precision. The performance of the software program was assessed using the data from 10 recipients of an allogeneic hematopoietic stem cell transplant (HSCT) receiving intravenous (i.v.) voriconazole. The program was able to model the plasma concentrations with a high level of precision, despite the wide range of concentration trajectories and interindividual pharmacokinetic variability. The voriconazole concentrations predicted after the last dosages were largely concordant with those actually measured. Simulations provided an illustration of the way in which the software can be used to adjust dosages of patients falling outside desired concentration targets. This software appears to be an extremely useful tool to further optimize voriconazole therapy and aid in therapeutic drug monitoring. Further prospective studies are now required to define the utility of the controller in daily clinical practice. PMID:23380734

Adherence to secondary prophylaxis for rheumatic heart disease is underestimated by register data

PubMed Central

de Dassel, Jessica Langloh; Fittock, Marea Therese; Wilks, Sagen Cheyenne; Poole, Jane Elizabeth; Carapetis, Jonathan Rhys; Ralph, Anna P.

2017-01-01

Objective In high-burden Australian states and territories, registers of patients with acute rheumatic fever and rheumatic heart disease are maintained for patient management, monitoring of system performance and research. Data validation was undertaken for the Australian Northern Territory Rheumatic Heart Disease Register to determine quality and impact of data cleaning on reporting against key performance indicators: overall adherence, and proportion of patients receiving ≥80% of scheduled penicillin doses for secondary prophylaxis. Methods Register data were compared with data from health centres. Inconsistencies were identified and corrected; adherence was calculated before and after cleaning. Results 2780 penicillin doses were validated; 426 inconsistencies were identified, including 102 incorrect dose dates. After cleaning, mean adherence increased (63.5% to 67.3%, p<0.001) and proportion of patients receiving ≥80% of doses increased (34.2% to 42.1%, p = 0.06). Conclusions The Northern Territory Rheumatic Heart Disease Register underestimates adherence, although the key performance indicator of ≥80% adherence was not significantly affected. Program performance is better than hitherto appreciated. However some errors could affect patient management, as well as accuracy of longitudinal or inter-jurisdictional comparisons. Adequate resources are needed for maintenance of data quality in acute rheumatic fever/rheumatic heart disease registers to ensure provision of evidence-based care and accurate assessment of program impact. PMID:28562621

Utilization of thermoluminescent dosimetry in total skin electron beam radiotherapy of mycosis fungoides.

PubMed

Antolak, J A; Cundiff, J H; Ha, C S

1998-01-01

The purpose of this report is to discuss the utilization of thermoluminescent dosimetry (TLD) in total skin electron beam (TSEB) radiotherapy to: (a) compare patient dose distributions for similar techniques on different machines, (b) confirm beam calibration and monitor unit calculations, (c) provide data for making clinical decisions, and (d) study reasons for variations in individual dose readings. We report dosimetric results for 72 cases of mycosis fungoides, using similar irradiation techniques on two different linear accelerators. All patients were treated using a modified Stanford 6-field technique. In vivo TLD was done on all patients, and the data for all patients treated on both machines was collected into a database for analysis. Means and standard deviations (SDs) were computed for all locations. Scatter plots of doses vs. height, weight, and obesity index were generated, and correlation coefficients with these variables were computed. The TLD results show that our current TSEB implementation is dosimetrically equivalent to the previous implementation, and that our beam calibration technique and monitor unit calculation is accurate. Correlations with obesity index were significant at several sites. Individual TLD results allow us to customize the boost treatment for each patient, in addition to revealing patient positioning problems and/or systematic variations in dose caused by patient variability. The data agree well with previously published TLD results for similar TSEB techniques. TLD is an important part of the treatment planning and quality assurance programs for TSEB, and routine use of TLD measurements for TSEB is recommended.

EYE LENS DOSIMETRY FOR FLUOROSCOPICALLY GUIDED CLINICAL PROCEDURES: PRACTICAL APPROACHES TO PROTECTION AND DOSE MONITORING.

PubMed

Martin, Colin J

2016-06-01

Doses to the eye lenses of clinicians undertaking fluoroscopically guided procedures can exceed the dose annual limit of 20 mSv, so optimisation of radiation protection is essential. Ceiling-suspended shields and disposable radiation absorbing pads can reduce eye dose by factors of 2-7. Lead glasses that shield against exposures from the side can lower doses by 2.5-4.5 times. Training in effective use of protective devices is an essential element in achieving good protection and acceptable eye doses. Effective methods for dose monitoring are required to identify protection issues. Dosemeters worn adjacent to the eye provide the better option for interventional clinicians, but an unprotected dosemeter worn at the neck will give an indication of eye dose that is adequate for most interventional staff. Potential requirements for protective devices and dose monitoring can be determined from risk assessments using generic values for dose linked to examination workload. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

78 FR 64030 - Monitoring Criteria and Methods To Calculate Occupational Radiation Doses

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-25

... NUCLEAR REGULATORY COMMISSION [NRC-2013-0234] Monitoring Criteria and Methods To Calculate... regulatory guide (DG), DG-8031, ``Monitoring Criteria and Methods to Calculate Occupational Radiation Doses.'' This guide describes methods that the NRC staff considers acceptable for licensees to use to determine...

Using Six Sigma to improve once daily gentamicin dosing and therapeutic drug monitoring performance.

PubMed

Egan, Sean; Murphy, Philip G; Fennell, Jerome P; Kelly, Sinead; Hickey, Mary; McLean, Carolyn; Pate, Muriel; Kirke, Ciara; Whiriskey, Annette; Wall, Niall; McCullagh, Eddie; Murphy, Joan; Delaney, Tim

2012-12-01

Safe, effective therapy with the antimicrobial gentamicin requires good practice in dose selection and monitoring of serum levels. Suboptimal therapy occurs with breakdown in the process of drug dosing, serum blood sampling, laboratory processing and level interpretation. Unintentional underdosing may result. This improvement effort aimed to optimise this process in an academic teaching hospital using Six Sigma process improvement methodology. A multidisciplinary project team was formed. Process measures considered critical to quality were defined, and baseline practice was examined through process mapping and audit. Root cause analysis informed improvement measures. These included a new dosing and monitoring schedule, and standardised assay sampling and drug administration timing which maximised local capabilities. Three iterations of the improvement cycle were conducted over a 24-month period. The attainment of serum level sampling in the required time window improved by 85% (p≤0.0001). A 66% improvement in accuracy of dosing was observed (p≤0.0001). Unnecessary dose omission while awaiting level results and inadvertent disruption to therapy due to dosing and monitoring process breakdown were eliminated. Average daily dose administered increased from 3.39 mg/kg to 4.78 mg/kg/day. Using Six Sigma methodology enhanced gentamicin usage process performance. Local process related factors may adversely affect adherence to practice guidelines for gentamicin, a drug which is complex to use. It is vital to adapt dosing guidance and monitoring requirements so that they are capable of being implemented in the clinical environment as a matter of routine. Improvement may be achieved through a structured localised approach with multidisciplinary stakeholder involvement.

A Changing Landscape for Vitamin A Programs: Implications for Optimal Intervention Packages, Program Monitoring, and Safety.

PubMed

Klemm, Rolf D W; Palmer, Amanda C; Greig, Alison; Engle-Stone, Reina; Dalmiya, Nita

2016-06-01

Vitamin A deficiency (VAD) remains a widespread public health problem in the developing world, despite changes in under-5 mortality rates, morbidity patterns, and intervention options. This article considers the implications of a changing epidemiologic and programmatic landscape for vitamin A (VA) programs. We review progress to prevent VAD and its health consequences, assess gaps in VA status and intervention coverage data, and assess data needed to guide decisions regarding the optimal mix, targeting, and dose of VA interventions to maximize benefit and minimize risk. Vitamin A supplementation programs have contributed to the reduction in under-5 mortality rates, but alone, do not address the underlying problem of inadequate dietary VA intakes and VAD among preschool-aged children in the developing world. A combination of VA interventions (eg, supplementation, fortified foods, multiple micronutrient powders, and lipid-based nutrient supplements) will be required to achieve VA adequacy in most settings. Current efforts to measure the coverage of multiple VA interventions, as well as whether and how much VA children are receiving, are few and fragmented. Where intervention overlap exists, further effort is needed to monitor VA intakes, ensuring that targeted groups are consuming adequate amounts but not exceeding the tolerable upper intake level. Vitamin A status data will also be critical for navigating the changing landscape of VA programs. Data from these monitoring efforts will help to guide decisions on the optimal mix, targeting, and exposure to VA interventions to maximize public health benefit while minimizing any potential risk. © The Author(s) 2016.

Cloud-Based CT Dose Monitoring using the DICOM-Structured Report: Fully Automated Analysis in Regard to National Diagnostic Reference Levels.

PubMed

Boos, J; Meineke, A; Rubbert, C; Heusch, P; Lanzman, R S; Aissa, J; Antoch, G; Kröpil, P

2016-03-01

To implement automated CT dose data monitoring using the DICOM-Structured Report (DICOM-SR) in order to monitor dose-related CT data in regard to national diagnostic reference levels (DRLs). We used a novel in-house co-developed software tool based on the DICOM-SR to automatically monitor dose-related data from CT examinations. The DICOM-SR for each CT examination performed between 09/2011 and 03/2015 was automatically anonymized and sent from the CT scanners to a cloud server. Data was automatically analyzed in accordance with body region, patient age and corresponding DRL for volumetric computed tomography dose index (CTDIvol) and dose length product (DLP). Data of 36,523 examinations (131,527 scan series) performed on three different CT scanners and one PET/CT were analyzed. The overall mean CTDIvol and DLP were 51.3% and 52.8% of the national DRLs, respectively. CTDIvol and DLP reached 43.8% and 43.1% for abdominal CT (n=10,590), 66.6% and 69.6% for cranial CT (n=16,098) and 37.8% and 44.0% for chest CT (n=10,387) of the compared national DRLs, respectively. Overall, the CTDIvol exceeded national DRLs in 1.9% of the examinations, while the DLP exceeded national DRLs in 2.9% of the examinations. Between different CT protocols of the same body region, radiation exposure varied up to 50% of the DRLs. The implemented cloud-based CT dose monitoring based on the DICOM-SR enables automated benchmarking in regard to national DRLs. Overall the local dose exposure from CT reached approximately 50% of these DRLs indicating that DRL actualization as well as protocol-specific DRLs are desirable. The cloud-based approach enables multi-center dose monitoring and offers great potential to further optimize radiation exposure in radiological departments. • The newly developed software based on the DICOM-Structured Report enables large-scale cloud-based CT dose monitoring • The implemented software solution enables automated benchmarking in regard to national DRLs • The local radiation exposure from CT reached approximately 50 % of the national DRLs • The cloud-based approach offers great potential for multi-center dose analysis. © Georg Thieme Verlag KG Stuttgart · New York.

Eye lens monitoring for interventional radiology personnel: dosemeters, calibration and practical aspects of H p (3) monitoring. A 2015 review.

PubMed

Carinou, Eleftheria; Ferrari, Paolo; Bjelac, Olivera Ciraj; Gingaume, Merce; Merce, Marta Sans; O'Connor, Una

2015-09-01

A thorough literature review about the current situation on the implementation of eye lens monitoring has been performed in order to provide recommendations regarding dosemeter types, calibration procedures and practical aspects of eye lens monitoring for interventional radiology personnel. Most relevant data and recommendations from about 100 papers have been analysed and classified in the following topics: challenges of today in eye lens monitoring; conversion coefficients, phantoms and calibration procedures for eye lens dose evaluation; correction factors and dosemeters for eye lens dose measurements; dosemeter position and influence of protective devices. The major findings of the review can be summarised as follows: the recommended operational quantity for the eye lens monitoring is H p (3). At present, several dosemeters are available for eye lens monitoring and calibration procedures are being developed. However, in practice, very often, alternative methods are used to assess the dose to the eye lens. A summary of correction factors found in the literature for the assessment of the eye lens dose is provided. These factors can give an estimation of the eye lens dose when alternative methods, such as the use of a whole body dosemeter, are used. A wide range of values is found, thus indicating the large uncertainty associated with these simplified methods. Reduction factors from most common protective devices obtained experimentally and using Monte Carlo calculations are presented. The paper concludes that the use of a dosemeter placed at collar level outside the lead apron can provide a useful first estimate of the eye lens exposure. However, for workplaces with estimated annual equivalent dose to the eye lens close to the dose limit, specific eye lens monitoring should be performed. Finally, training of the involved medical staff on the risks of ionising radiation for the eye lens and on the correct use of protective systems is strongly recommended.

RADIANCE: An automated, enterprise-wide solution for archiving and reporting CT radiation dose estimates.

PubMed

Cook, Tessa S; Zimmerman, Stefan L; Steingall, Scott R; Maidment, Andrew D A; Kim, Woojin; Boonn, William W

2011-01-01

There is growing interest in the ability to monitor, track, and report exposure to radiation from medical imaging. Historically, however, dose information has been stored on an image-based dose sheet, an arrangement that precludes widespread indexing. Although scanner manufacturers are beginning to include dose-related parameters in the Digital Imaging and Communications in Medicine (DICOM) headers of imaging studies, there remains a vast repository of retrospective computed tomographic (CT) data with image-based dose sheets. Consequently, it is difficult for imaging centers to monitor their dose estimates or participate in the American College of Radiology (ACR) Dose Index Registry. An automated extraction software pipeline known as Radiation Dose Intelligent Analytics for CT Examinations (RADIANCE) has been designed that quickly and accurately parses CT dose sheets to extract and archive dose-related parameters. Optical character recognition of information in the dose sheet leads to creation of a text file, which along with the DICOM study header is parsed to extract dose-related data. The data are then stored in a relational database that can be queried for dose monitoring and report creation. RADIANCE allows efficient dose analysis of CT examinations and more effective education of technologists, radiologists, and referring physicians regarding patient exposure to radiation at CT. RADIANCE also allows compliance with the ACR's dose reporting guidelines and greater awareness of patient radiation dose, ultimately resulting in improved patient care and treatment.

Rivaroxaban in the treatment of venous thromboembolism and the prevention of recurrences: a practical approach.

PubMed

Arcelus, Juan I; Domènech, Pere; Fernández-Capitan, Ma Del Carmen; Guijarro, Ricardo; Jiménez, David; Jiménez, Sonia; Lozano, Francisco S; Monreal, Manel; Nieto, José A; Páramo, José A

2015-05-01

Anticoagulation therapy is the standard treatment of patients with symptomatic venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism. Until recently, treatment of VTE was based on parenteral or low-molecular-weight heparin for initial therapy (5-10 days) and oral vitamin K antagonists for long-term therapy. Those treatments have some limitations, including parenteral administration (heparins), the need for frequent monitoring and dose adjustments, interactions with several medications, and dietary restrictions (vitamin K antagonists). Rivaroxaban is a new oral direct factor Xa inhibitor with a wide therapeutic window, predictable anticoagulant effect, no food interactions, and few drug interactions. Consequently, no periodic monitoring of anticoagulation is needed, and fixed doses can be prescribed. EINSTEIN program demonstrated that rivaroxaban was as effective as and significantly safer than standard therapy for treatment of VTE. Rivaroxaban was recently authorized so doubts exist about how to use it in daily clinical practice. This document aims to clarify common questions formulated by clinicians regarding the use of this new drug. © The Author(s) 2014.

Best Practices for Intrathecal Baclofen Therapy: Dosing and Long-Term Management.

PubMed

Boster, Aaron L; Adair, Roy L; Gooch, Judith L; Nelson, Mary Elizabeth S; Toomer, Andrea; Urquidez, Joe; Saulino, Michael

2016-08-01

Intrathecal baclofen (ITB) therapy aims to reduce spasticity and provide functional control. An expert panel consulted on best practices. Pump fill and drug delivery can be started intraoperatively, with monitoring for at least eight hours. Initiate with the 500 mcg/mL concentration. The starting daily dose should be twice the effective bolus screening dose, or the screening dose if the patient had a prolonged response (greater than eight hours) or negative reactions. Oral antispasmodics can be weaned, one drug at a time beginning with oral baclofen after ITB begins. Assessment should occur within 24 hours of a dose change. For adults, daily dose increases may be 5% to 15% once every 24 hours for cerebral-origin spasticity and 10% to 30% once every 24 hours for spinal-origin spasticity. Daily dose increases can be 5% to 15% once every 24 hours for children. Inpatients should be assessed at least every 24 hours and receive rehabilitation. Step dosing can be used for outpatients who cannot return daily. Dosing options include simple continuous dosing, variable 24-hour flex dosing, or regularly scheduled boluses. Patients/caregivers should understand the care plan, responsibilities, and possible side-effects. Low-reservoir alarm dates and refill schedules should be written down, along with emergency contact information. A higher concentration at refill can extend refill intervals, and a bridge bolus must be programmed. Time changes may affect flex dosing. Pump replacement should be scheduled at least three months in advance. ITB dosing is multistep and individualized. © 2016 International Neuromodulation Society.

Active personal radiation monitor for lunar EVA

NASA Astrophysics Data System (ADS)

Straume, Tore; Borak, Tom; Braby, L. A.; Lusby, Terry; Semones, Edward J.; Vazquez, Marcelo E.

As astronauts return to the Moon-and this time, work for extended periods-there will be a critical need for crew personnel radiation monitoring as they operate lunar rovers or otherwise perform a myriad of extravehicular activities (EVAs). Our focus is on development of a small personal radiation monitor for lunar EVA that responds to the complex radiation quality and changing dose rates on the Moon. Of particular concern are active monitoring capabilities that provide both early warning and radiation dosimetry information during solar particle events (SPEs). To accomplish this, we are developing small detectors integrated with modern high speed, low power microelectronics to measure dose-rate and dose-mean lineal energy in real time. The monitor is designed to perform over the range of dose rates and LETs expected from both GCR and SPE radiations during lunar EVA missions. The monitor design provides simultaneous measurement of dose-equivalent rates at two tissue-equivalent depths simulating skin and marrow. The compact personal monitor is estimated to be the size of a cell phone and would fit on an EVA spacesuit (e.g., in backpack) or in a toolbox. The four-year development effort (which began December 2007) will result in a prototype radiation monitor field tested and characterized for the major radiations expected on the surface of the Moon. We acknowledge support from NSBRI through grants to NASA Ames Research Center (T. Straume, PI) and Colorado State University (T. Borak, PI).

Introduction of Inactivated Poliovirus Vaccine and Impact on Vaccine-Associated Paralytic Poliomyelitis - Beijing, China, 2014-2016.

PubMed

Zhao, Dan; Ma, Rui; Zhou, Tao; Yang, Fan; Wu, Jin; Sun, Hao; Liu, Fang; Lu, Li; Li, Xiaomei; Zuo, Shuyan; Yao, Wei; Yin, Jian

2017-12-15

When included in a sequential polio vaccination schedule, inactivated polio vaccine (IPV) reduces the risk for vaccine-associated paralytic poliomyelitis (VAPP), a rare adverse event associated with receipt of oral poliovirus vaccine (OPV). During January 2014, the World Health Organization (WHO) recommended introduction of at least 1 IPV dose into routine immunization schedules in OPV-using countries (1). The Polio Eradication and Endgame Strategic Plan 2013-2018 recommended completion of IPV introduction in 2015 and globally synchronized withdrawal of OPV type 2 in 2016 (2). Introduction of 1 dose of IPV into Beijing's Expanded Program on Immunization (EPI) on December 5, 2014 represented China's first province-wide IPV introduction. Coverage with the first dose of polio vaccine was maintained from 96.2% to 96.9%, similar to coverage with the first dose of diphtheria and tetanus toxoids and pertussis vaccine (DTP) (96.5%-97.2%); the polio vaccine dropout rate (the percentage of children who received the first dose of polio vaccine but failed to complete the series) was 1.0% in 2015 and 0.4% in 2016. The use of 3 doses of private-sector IPV per child decreased from 18.1% in 2014, to 17.4% in 2015, and to 14.8% in 2016. No cases of VAPP were identified during 2014-2016. Successful introduction of IPV into the public sector EPI program was attributed to comprehensive planning, preparation, implementation, robust surveillance for adverse events after immunization (AEFI), and monitoring of vaccination coverage. This evaluation provided information that helped contribute to the expansion of IPV use in China and in other OPV-using countries.

Screening Doses for Induction of Cancers Calculated with the Interactive RadioEpidemiological Program (IREP)

DTIC Science & Technology

2007-03-01

unlimited. March 2007 DTRA01-03-C-0064 David C. Kocher and Julian A. Apostoaei Prepared by: SENES Oak Ridge, lnc. 102 Donner Drive Oak Ridge, TN 37830 W... 37830 8. PERFORMINGORGANIZATION REPORT NUMBER DTRA-TR-07-4 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) Defense Threat Reduction Agency N...DARE L3 Communications 11410 Isaac Newton Square North, Suite 103 Reston, VA 20190-5005 Senes Oak Ridge, Inc. 102 Donner Drive Oak Ridge, TN 37830

Overview of the AFRL’s Demonstration and Science Experiments (DSX) Program

DTIC Science & Technology

2006-09-01

most of the space weather data to-date has been accumulated in the LEO and GEO regimes, as illustrated in Figure 11 with data from dosimeters aboard...Composed of two dosimeters , two particle telescopes and a Single Event Effect detector, CEASE has the capability to monitor a broad range of space...panel of the payload module. One change for DSX is that CEASE will capture and downlink the full dose spectra from each dosimeter , whereas prior

Clinical Decision Support Improves Initial Dosing and Monitoring of Tobramycin and Amikacin

PubMed Central

Cox, Zachary L.; Nelsen, Cori L.; Waitman, Lemuel R.; McCoy, Jacob A.; Peterson, Josh F.

2010-01-01

Purpose Clinical decision support (CDS) systems could be valuable tools in reducing aminoglycoside prescribing errors. We evaluated the impact of CDS on initial dosing, interval, and pharmacokinetic outcomes of amikacin and tobramycin therapy. Methods A complex CDS advisor to provide guidance on initial dosing and monitoring, using both traditional and extended interval dosing strategies, was integrated into computerized provider order entry (CPOE) and compared to a control group which featured close pharmacy monitoring of all aminoglycoside orders. A random sample of 118 patients from an academic, tertiary care medical center prescribed amikacin and tobramycin prior to advisor implementation was compared to 98 patients admitted following advisor implementation. Primary outcome was an initial dose within 10% of a dose calculated to be adherent to published dose guidelines. Secondary outcomes were a guideline-adherent interval, trough and peak concentrations in goal range, and incidence of nephrotoxicity. Results Of 216 patients studied, 97 were prescribed amikacin and 119 were prescribed tobramycin. The primary outcome of initial dosing consistent with guideline-based care increased from 40% in the pre-advisor arm to 80% in the post-advisor arm (p<0.001), with a number needed to treat of 3 patients to prevent one incorrect dose. Correct initial interval based on renal function also increased from 63% to 87% (p<0.001). The changes in initial dosing and interval resulted in an increase of trough concentrations in the goal range from 59% pre-advisor to 89% post-advisor implementation (p=0.0004). There was no significant difference in peak concentrations in goal range or incidence of nephrotoxicity (25% vs. 17%, p=0.2). Conclusion An advisor for aminoglycoside dosing and monitoring integrated into CPOE significantly improves initial dosing, selection of interval, and trough concentrations at goal compared to unassisted physician dosing. PMID:21411805

Von Hippel-Lindau Disease (VHL)

MedlinePlus

... tumors can be treated with focused high-dose irradiation. Individuals with VHL need careful monitoring by a ... tumors can be treated with focused high-dose irradiation. Individuals with VHL need careful monitoring by a ...

Real-time colour pictorial radiation monitoring during coronary angiography: effect on patient peak skin and total dose during coronary angiography.

PubMed

Wilson, Sharon M; Prasan, Ananth M; Virdi, Amy; Lassere, Marissa; Ison, Glenn; Ramsay, David R; Weaver, James C

2016-10-10

The aim of this study was to evaluate whether a real-time (RT) colour pictorial radiation dose monitoring system reduces patient skin and total radiation dose during coronary angiography and intervention. Patient demographics, procedural variables and radiation parameters were recorded before and after institution of the RT skin dose recording system. Peak skin dose as well as traditionally available measures of procedural radiation dose were compared. A total of 1,077 consecutive patients underwent coronary angiography, of whom 460 also had PCI. Institution of the RT skin dose recording system resulted in a 22% reduction in peak skin dose after accounting for confounding variables. Radiation dose reduction was most pronounced in those having PCI but was also seen over a range of subgroups including those with prior coronary artery bypass surgery, high BMI, and with radial arterial access. This was associated with a significant reduction in the number of patients placed at risk of skin damage. Similar reductions in parameters reflective of total radiation dose were also demonstrated after institution of RT radiation monitoring. Institution of an RT skin dose recording reduced patient peak skin and total radiation dose during coronary angiography and intervention. Consideration should be given to widespread adoption of this technology.

Processing speed can monitor stimulant-medication effects in adults with attention deficit disorder with hyperactivity.

PubMed

Nielsen, Niels Peter; Wiig, Elisabeth H; Bäck, Svante; Gustafsson, Jan

2017-05-01

Treatment responses to methylphenidate by adults with ADHD are generally monitored against DSM-IV/DSM-V symptomatology, rating scales or interviews during reviews. To evaluate the use of single- and dual-dimension processing-speed and efficiency measures to monitor the effects of pharmacological treatment with methylphenidate after a short period off medication. A Quick Test of Cognitive Speed (AQT) monitored the effects of immediate-release methylphenidate in 40 previously diagnosed and medicated adults with ADHD. Processing speed was evaluated with prior prescription medication, without medication after a 2-day period off ADHD medication, and with low-dose (10/20 mg) and high-dose (20/40 mg) methylphenidate hydrochloride (Medikinet IR). Thirty-three participants responded to the experimental treatments. One-way ANOVA with post-hoc analysis (Scheffe) indicated significant main effects for single dimension colour and form and dual-dimension colour-form naming. Post-hoc analysis indicated statistical differences between the no- and high-dose medication conditions for colour and form, measures of perceptual speed. For colour-form naming, a measure of cognitive speed, there was a significant difference between no- and low-dose medication and between no- and high-dose medications, but not between low- and high-dose medications. Results indicated that the AQT tests effectively monitored incremental effects of the methylphenidate dose on processing speed after a 2-day period off medication. Thus, perceptual (colour and form) and cognitive speed (two-dimensional colour-form naming) and processing efficiency (lowered shift costs) increased measurably with high-dose medication. These preliminary findings warrant validation with added measures of associated behavioural and cognitive changes.

Potential hazard due to induced radioactivity secondary to radiotherapy: the report of task group 136 of the American Association of Physicists in Medicine.

PubMed

Thomadsen, Bruce; Nath, Ravinder; Bateman, Fred B; Farr, Jonathan; Glisson, Cal; Islam, Mohammad K; LaFrance, Terry; Moore, Mary E; George Xu, X; Yudelev, Mark

2014-11-01

External-beam radiation therapy mostly uses high-energy photons (x-rays) produced by medical accelerators, but many facilities now use proton beams, and a few use fast-neutron beams. High-energy photons offer several advantages over lower-energy photons in terms of better dose distributions for deep-seated tumors, lower skin dose, less sensitivity to tissue heterogeneities, etc. However, for beams operating at or above 10 MV, some of the materials in the accelerator room and the radiotherapy patient become radioactive due primarily to photonuclear reactions and neutron capture, exposing therapy staff and patients to unwanted radiation dose. Some recent advances in radiotherapy technology require treatments using a higher number of monitor units and monitor-unit rates for the same delivered dose, and compared to the conventional treatment techniques and fractionation schemes, the activation dose to personnel can be substantially higher. Radiotherapy treatments with proton and neutron beams all result in activated materials in the treatment room. In this report, the authors review critically the published literature on radiation exposures from induced radioactivity in radiotherapy. They conclude that the additional exposure to the patient due to induced radioactivity is negligible compared to the overall radiation exposure as a part of the treatment. The additional exposure to the staff due to induced activity from photon beams is small at an estimated level of about 1 to 2 mSv y. This is well below the allowed occupational exposure limits. Therefore, the potential hazard to staff from induced radioactivity in the use of high-energy x-rays is considered to be low, and no specific actions are considered necessary or mandatory. However, in the spirit of the "As Low as Reasonably Achievable (ALARA)" program, some reasonable steps are recommended that can be taken to reduce this small exposure to an even lower level. The dose reduction strategies suggested should be followed only if these actions are considered reasonable and practical in the individual clinics. Therapists working with proton beam and neutron beam units handle treatment devices that do become radioactive, and they should wear extremity monitors and make handling apertures and boluses their last task upon entering the room following treatment. Personnel doses from neutron-beam units can approach regulatory limits depending on the number of patients and beams, and strategies to reduce doses should be followed.

Upgrading of data acquisition software for centralized radiation monitoring system in Malaysian Nuclear Agency

NASA Astrophysics Data System (ADS)

Yussup, F.; Ibrahim, M. M.; Haris, M. F.; Soh, S. C.; Hasim, H.; Azman, A.; Razalim, F. A. A.; Yapp, R.; Ramli, A. A. M.

2016-01-01

With the growth of technology, many devices and equipments can be connected to the network and internet to enable online data acquisition for real-time data monitoring and control from monitoring devices located at remote sites. Centralized radiation monitoring system (CRMS) is a system that enables area radiation level at various locations in Malaysian Nuclear Agency (Nuklear Malaysia) to be monitored centrally by using a web browser. The Local Area Network (LAN) in Nuclear Malaysia is utilized in CRMS as a communication media for data acquisition of the area radiation levels from radiation detectors. The development of the system involves device configuration, wiring, network and hardware installation, software and web development. This paper describes the software upgrading on the system server that is responsible to acquire and record the area radiation readings from the detectors. The recorded readings are called in a web programming to be displayed on a website. Besides the main feature which is acquiring the area radiation levels in Nuclear Malaysia centrally, the upgrading involves new features such as uniform time interval for data recording and exporting, warning system and dose triggering.

Calibration of modified Liulin detector for cosmic radiation measurements on-board aircraft.

PubMed

Kyselová, D; Ambrožová, I; Krist, P; Kubančák, J; Uchihori, Y; Kitamura, H; Ploc, O

2015-06-01

The annual effective doses of aircrew members often exceed the limit of 1 mSv for the public due to the increased level of cosmic radiation at the flight altitudes, and thus, it is recommended to monitor them. Aircrew dosimetry is usually performed using special computer programs mostly based on results of Monte Carlo simulations. Contemporary, detectors are used mostly for validation of these computer codes, verification of effective dose calculations and for research purposes. One of such detectors is active silicon semiconductor deposited energy spectrometer Liulin. Output quantities of measurement with the Liulin detector are the absorbed dose in silicon D and the ambient dose equivalent H*(10); to determine it, two calibrations are necessary. The purpose of this work was to develop a calibration methodology that can be used to convert signal from the detector to D independently on calibration performed at Heavy Ion Medical Accelerator facility in Chiba, Japan. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Gaining competitive advantage in personal dosimetry services through ISO 9001 certification.

PubMed

Noriah, M A

2007-01-01

This paper discusses the advantage of certification process in the quality assurance of individual dose monitoring in Malaysia. The demand by customers and the regulatory authority for a higher degree of quality service requires a switch in emphasis from a technically focused quality assurance program to a comprehensive quality management for service provision. Achieving the ISO 9001:2000 certification by an accredited third party demonstrates acceptable recognition and documents the fact that the methods used are capable of generating results that satisfy the performance criteria of the certification program. It also offers a proof of the commitment to quality and, as a benchmark, allows measurement of the progress for continual improvement of service performance.

Implementation of a drug-use and disease-state management program.

PubMed

Skledar, S J; Hess, M M

2000-12-15

A drug-use and disease-state management (DUDSM) program was instituted in 1996 at a teaching hospital associated with a large nonprofit health care system. The program's goals are to optimize pharmacotherapeutic regimens, evaluate health outcomes of identified disease states, and evaluate the economic impact of pharmacotherapeutic options for given disease states by developing practice guidelines. Through a re-engineering process, resources within the pharmacy department were identified that could be devoted to the DUDSM program, including the use of clinical pharmacy specialists, promotion of staff pharmacists into the DUDSM program, a pharmacy technician, and information systems support. A strength of the program is its systematic approach for developing and implementing new initiatives, as well as monitoring compliance with all initiatives on an ongoing basis. The initiative-design process incorporates continuous quality improvement principles, outcome design and evaluation, competency assessment for all pharmacists, multidisciplinary collaboration, and sophisticated information systems. Seventy-five initiatives have been implemented, ranging from simple dose-optimization strategies for specific drugs to complicated practice guidelines for managing specific disease states. Improved patient outcomes have been documented, including reduced length of stay, postsurgical wound infection, adverse drug reactions, and medication errors. Documented cost savings exceeded $4 million annually for fiscal years 1996-97 through 1999-2000. Overall compliance with DUDSM initiatives exceeds 80%, and physician service profiling has been initiated to monitor variant prescribing. The DUDSM program has successfully integrated practice guidelines into therapeutic decision-making, resulting in improved patient-care outcomes and cost savings.

Application of ISO standard 27048: dose assessment for the monitoring of workers for internal radiation exposure.

PubMed

Henrichs, K

2011-03-01

Besides ongoing developments in the dosimetry of incorporated radionuclides, there are various efforts to improve the monitoring of workers for potential or real intakes of radionuclides. The disillusioning experience with numerous intercomparison projects identified substantial differences between national regulations, concepts, applied programmes and methods, and dose assessment procedures. Measured activities were not directly comparable because of significant differences between measuring frequencies and methods, but also results of case studies for dose assessments revealed differences of orders of magnitude. Besides the general common interest in reliable monitoring results, at least the cross-border activities of workers (e.g. nuclear power plant services) require consistent approaches and comparable results. The International Standardization Organization therefore initiated projects to standardise programmes for the monitoring of workers, the requirements for measuring laboratories and the processes for the quantitative evaluation of monitoring results in terms of internal assessed doses. The strength of the concepts applied by the international working group consists in a unified approach defining the requirements, databases and processes. This paper is intended to give a short introduction into the standardization project followed by a more detailed description of the dose assessment standard, which will be published in the very near future.

Outcomes from a university-based low-cost in vitro fertilization program providing access to care for a low-resource socioculturally diverse urban community.

PubMed

Herndon, Christopher N; Anaya, Yanett; Noel, Martha; Cakmak, Hakan; Cedars, Marcelle I

2017-10-01

To report on outcomes from a university-based low-cost and low-complexity IVF program using mild stimulation approaches and simplified protocols to provide basic access to ART to a socioculturally diverse low-income urban population. Retrospective cohort study. Academic infertility center. Sixty-five infertile couples were enrolled from a county hospital serving a low-resource largely immigrant population. Patients were nonrandomly allocated to one of four mild stimulation protocols: clomiphene/letrozole alone, two clomiphene/letrozole-based protocols involving sequential or flare addition of low-dose gonadotropins, and low-dose gonadotropins alone. Clinical fellows managed all aspects of cycle preparation, monitoring, oocyte retrieval, and embryo transfer under an attending preceptor. Retrieval was undertaken without administration of deep anesthesia, and laboratory interventions were minimized. All embryo transfers were performed at the cleavage stage. Sociomedical demographics, treatment response, and pregnancy outcomes were recorded. From August 2010 to June 2016, 65 patients initiated 161 stimulation IVF cycles, which resulted in 107 retrievals, 91 fresh embryo transfers, and 40 frozen embryo transfer cycles. The mean age of patients was 33.3 years, and mean reported duration of infertility was 5.3 years; 33.5% (54/161) of cycles were cancelled before oocyte retrieval, with 13% due to premature ovulation. Overall, cumulative live birth rates per retrieval including subsequent use of frozen embryos was 29.0%; 44.6% (29/65) of patients enrolled in the program achieved pregnancy. Use of mild stimulation protocols, simplified monitoring, and minimized laboratory handling procedures enabled access to care in a low-resource socioculturally diverse infertile population. Copyright © 2017. Published by Elsevier Inc.

TU-G-BRD-06: The Imaging and Radiation Oncology Core Houston (IROC Houston) QA Center International Activities Outside North America

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

Followill, D; Kry, S; Molineu, A

Purpose: To describe the extent of IROC Houston’s (formerly the RPC) QA activities and audit results for radiotherapy institutions outside of North America (NA). Methods: The IROC Houston’s QA program components were designed to audit the radiation dose calculation chain from the NIST traceable reference beam calibration, to inclusion of dosimetry parameters used to calculate tumor doses, to the delivery of the radiation dose. The QA program provided to international institutions includes: 1) remote TLD/OSLD audit of machine output, 2) credentialing for advanced technologies, and 3) review of patient treatment records. IROC Houston uses the same standards and acceptance criteriamore » for all of its audits whether for North American or international sites. Results: IROC Houston’s QA program has reached out to radiotherapy sites in 43 different countries since 2013 through their participation in clinical trials. In the past two years, 2,778 international megavoltage beam outputs were audited with OSLD/TLD. While the average IROC/Inst ratio is near unity for all sites monitored, there are international regions whose results are significantly different from the NA region. In the past 2 years, 477 and 87 IMRT H&N phantoms were irradiated at NA and international sites, respectively. Regardless of the OSLD beam audit results, the overall pass rate (87 percent) for all international sites (no region separation) is equal to the NA sites. Of the 182 international patient charts reviewed, 10.7 percent of the dose calculation points did not meet our acceptance criterion as compared to 13.6 percent for NA sites. The lower pass rate for NA sites results from a much larger brachytherapy component which has been shown to be more error prone. Conclusion: IROC Houston has expanded its QA services worldwide and continues a long history of improving radiotherapy dose delivery in many countries. Funding received for QA audit services from the Korean GOG, DAHANCA, EORTC, ICON and CMIC Group.« less

Continuing education: online monitoring of haemodialysis dose.

PubMed

Vartia, Aarne

2018-01-25

Kt/V urea reflects the efficacy of haemodialysis scaled to patient size (urea distribution volume). The guidelines recommend monthly Kt/V measurements based on blood samples. Modern haemodialysis machines are equipped with accessories monitoring the dose online at every session without extra costs, blood samples and computers. To describe the principles, devices, benefits and shortcomings of online monitoring of haemodialysis dose. A critical literature overview and discussion. UV absorbance methods measure Kt/V, ionic dialysance Kt (product of clearance and treatment time; cleared volume without scaling). Both are easy and useful methods, but comparison is difficult due to problems in scaling of the dialysis dose to the patient's size. The best dose estimation method is the one which predicts the quality of life and survival most accurately. There is some evidence on the predictive value of ionic dialysance Kt, but more documentation is required on the UV method. Online monitoring is a useful tool in everyday quality assurance, but blood samples are still required for more accurate kinetic modelling. After reading this article the reader should be able to: Understand the elements of the Kt/V equation for dialysis dose. Compare and contrast different methods of measurement of dialysis dose. Reflect on the importance of adequate dialysis dose for patient survival and life quality. © 2018 European Dialysis and Transplant Nurses Association/European Renal Care Association.

A New Approach for the Determination of Dose Rate and Radioactivity for Detected Gamma Nuclides Using an Environmental Radiation Monitor Based on an NaI(Tl) Detector.

PubMed

Ji, Young-Yong; Kim, Chang-Jong; Lim, Kyo-Sun; Lee, Wanno; Chang, Hyon-Sock; Chung, Kun Ho

2017-10-01

To expand the application of dose rate spectroscopy to the environment, the method using an environmental radiation monitor (ERM) based on a 3' × 3' NaI(Tl) detector was used to perform real-time monitoring of the dose rate and radioactivity for detected gamma nuclides in the ground around an ERM. Full-energy absorption peaks in the energy spectrum for dose rate were first identified to calculate the individual dose rates of Bi, Ac, Tl, and K distributed in the ground through interference correction because of the finite energy resolution of the NaI(Tl) detector used in an ERM. The radioactivity of the four natural radionuclides was then calculated from the in situ calibration factor-that is, the dose rate per unit curie-of the used ERM for the geometry of the ground in infinite half-space, which was theoretically estimated by Monte Carlo simulation. By an intercomparison using a portable HPGe and samples taken from the ground around an ERM, this method to calculate the dose rate and radioactivity of four nuclides using an ERM was experimentally verified and finally applied to remotely monitor them in real-time in the area in which the ERM had been installed.

Effect of reduced agalsidase Beta dosage in fabry patients: the Australian experience.

PubMed

Ghali, Joanna; Nicholls, Kathy; Denaro, Charles; Sillence, David; Chapman, Ian; Goldblatt, Jack; Thomas, Mark; Fletcher, Janice

2012-01-01

In Australia, enzyme replacement therapy (ERT) for Fabry Disease (FD), both Agalsidase alfa (Replagal, Shire HGT) and beta (Fabrazyme, Genzyme), is funded and monitored through a specific government program. Agalsidase beta supply has been rationed by Genzyme since 2009 due to manufacturing issues. Consequently, the Australian Fabry Disease Advisory Committee has treated patients on Agalsidase beta at 50% of their usual dose from mid-2009, with a further reduction to 30% for some patients from late 2009. To determine the clinical effect of Agalsidase beta dose reduction in the Australian FD patient cohort. A questionnaire assessing FD symptoms was administered to 40 patients on long-term ERT. Clinical data from The Fabry Registry for patients receiving Agalsidase alfa or beta, for at least 2 years prior to the time of enforced Agalsidase beta dose reduction, were reviewed. Disease burden and quality of life (QOL) were graded using the Disease Severity Scoring System, Mainz Severity Score Index, Brief Pain Inventory and Short Form 36 Health Survey at 2 years before dose reduction, at the time of dose reduction and at the most recent clinical review following dose reduction. Disease severity and QOL scores did not change between the ERT groups. Males on Agalsidase beta reported lower energy levels after dose reduction, while no change was reported by females on either product or by males on a stable dose of Agalsidase alfa. This study suggests that energy levels in male patients worsen after dose reduction of Agalsidase beta.

An automated dose tracking system for adaptive radiation therapy.

PubMed

Liu, Chang; Kim, Jinkoo; Kumarasiri, Akila; Mayyas, Essa; Brown, Stephen L; Wen, Ning; Siddiqui, Farzan; Chetty, Indrin J

2018-02-01

The implementation of adaptive radiation therapy (ART) into routine clinical practice is technically challenging and requires significant resources to perform and validate each process step. The objective of this report is to identify the key components of ART, to illustrate how a specific automated procedure improves efficiency, and to facilitate the routine clinical application of ART. Data was used from patient images, exported from a clinical database and converted to an intermediate format for point-wise dose tracking and accumulation. The process was automated using in-house developed software containing three modularized components: an ART engine, user interactive tools, and integration tools. The ART engine conducts computing tasks using the following modules: data importing, image pre-processing, dose mapping, dose accumulation, and reporting. In addition, custom graphical user interfaces (GUIs) were developed to allow user interaction with select processes such as deformable image registration (DIR). A commercial scripting application programming interface was used to incorporate automated dose calculation for application in routine treatment planning. Each module was considered an independent program, written in C++or C#, running in a distributed Windows environment, scheduled and monitored by integration tools. The automated tracking system was retrospectively evaluated for 20 patients with prostate cancer and 96 patients with head and neck cancer, under institutional review board (IRB) approval. In addition, the system was evaluated prospectively using 4 patients with head and neck cancer. Altogether 780 prostate dose fractions and 2586 head and neck cancer dose fractions went processed, including DIR and dose mapping. On average, daily cumulative dose was computed in 3 h and the manual work was limited to 13 min per case with approximately 10% of cases requiring an additional 10 min for image registration refinement. An efficient and convenient dose tracking system for ART in the clinical setting is presented. The software and automated processes were rigorously evaluated and validated using patient image datasets. Automation of the various procedures has improved efficiency significantly, allowing for the routine clinical application of ART for improving radiation therapy effectiveness. Copyright © 2017 Elsevier B.V. All rights reserved.

Diagnostic value of different adherence measures using electronic monitoring and virologic failure as reference standards.

PubMed

Deschamps, Ann E; De Geest, Sabina; Vandamme, Anne-Mieke; Bobbaers, Herman; Peetermans, Willy E; Van Wijngaerden, Eric

2008-09-01

Nonadherence to antiretroviral therapy is a substantial problem in HIV and jeopardizes the success of treatment. Accurate measurement of nonadherence is therefore imperative for good clinical management but no gold standard has been agreed on yet. In a single-center prospective study nonadherence was assessed by electronic monitoring: percentage of doses missed and drug holidays and by three self reports: (1) a visual analogue scale (VAS): percentage of overall doses taken; (2) the Swiss HIV Cohort Study Adherence Questionnaire (SHCS-AQ): percentage of overall doses missed and drug holidays and (3) the European HIV Treatment Questionnaire (EHTQ): percentage of doses missed and drug holidays for each antiretroviral drug separately. Virologic failure prospectively assessed during 1 year, and electronic monitoring were used as reference standards. Using virologic failure as reference standard, the best results were for (1) the SHCS-AQ after electronic monitoring (sensitivity, 87.5%; specificity, 78.6%); (2) electronic monitoring (sensitivity, 75%; specificity, 85.6%), and (3) the VAS combined with the SHCS-AQ before electronic monitoring (sensitivity, 87.5%; specificity, 58.6%). The sensitivity of the complex EHTQ was less than 50%. Asking simple questions about doses taken or missed is more sensitive than complex questioning about each drug separately. Combining the VAS with the SHCS-AQ seems a feasible nonadherence measure for daily clinical practice. Self-reports perform better after electronic monitoring: their diagnostic value could be lower when given independently.

Small Active Radiation Monitor

NASA Technical Reports Server (NTRS)

Badhwar, Gautam D.

2004-01-01

A device, named small active radiation monitor, allows on-orbit evaluations during periods of increased radiation, after extravehicular activities, or at predesignated times for crews on such long-duration space missions as on the International Space Station. It also permits direct evaluation of biological doses, a task now performed using a combination of measurements and potentially inaccurate simulations. Indeed the new monitor can measure a full array of radiation levels, from soft x-rays to hard galactic cosmic-ray particles. With refinement, it will benefit commercial (nuclear power-plant workers, airline pilots, medical technicians, physicians/dentists, and others) and military personnel as well as the astronauts for whom thermoluminescent dosimeters are inadequate. Civilian and military personnel have long since graduated from film badges to thermoluminescent dosimeters. Once used, most dosimeters must be returned to a central facility for processing, a step that can take days or even weeks. While this suffices for radiation workers for whom exposure levels are typically very low and of brief duration, it does not work for astronauts. Even in emergencies and using express mail, the results can often be delayed by as much as 24 hours. Electronic dosimeters, which are the size of electronic oral thermometers, and tattlers, small electronic dosimeters that sound an alarm when the dose/dose rate exceeds preset values, are also used but suffer disadvantages similar to those of thermoluminescent dosimeters. None of these devices fully answers the need of rapid monitoring during the space missions. Instead, radiation is monitored by passive detectors, which are read out after the missions. Unfortunately, these detectors measure only the absorbed dose and not the biologically relevant dose equivalent. The new monitor provides a real-time readout, a time history of radiation exposures (both absorbed dose and biologically relevant dose equivalent), and a count of the number of particles passing through a unit area. Better still, the monitor can be used anywhere.

Novel spectrometers for environmental dose rate monitoring.

PubMed

Kessler, P; Behnke, B; Dabrowski, R; Dombrowski, H; Röttger, A; Neumaier, S

2018-07-01

A new generation of dosemeters, based on the scintillators LaBr 3 , CeBr 3 and SrI 2 , read out with conventional photomultipliers, to be used in the field of environmental gamma-radiation monitoring, was investigated. The main features of these new instruments and especially their outdoor performance, studied by long-term investigations under real weather conditions, are presented. The systems were tested at the reference sites for environmental radiation of the Physikalisch-Technische Bundesanstalt. The measurements are compared with that of well characterized classical dose rate reference instruments to demonstrate the suitability of new spectrometers for environmental dose rate monitoring even in adverse weather conditions. Their potential to replace the (mainly Geiger Müller based) dose rate meters operated in about 5000 European early waning network stations as well as in environmental radiation monitoring in general is shown. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

RADRUE METHOD FOR RECONSTRUCTION OF EXTERNAL PHOTON DOSES TO CHERNOBYL LIQUIDATORS IN EPIDEMIOLOGICAL STUDIES

PubMed Central

Kryuchkov, Victor; Chumak, Vadim; Maceika, Evaldas; Anspaugh, Lynn R.; Cardis, Elisabeth; Bakhanova, Elena; Golovanov, Ivan; Drozdovitch, Vladimir; Luckyanov, Nickolas; Kesminiene, Ausrele; Voillequé, Paul; Bouville, André

2010-01-01

Between 1986 and 1990, several hundred thousand workers, called “liquidators” or “clean-up workers”, took part in decontamination and recovery activities within the 30-km zone around the Chernobyl nuclear power plant in Ukraine, where a major accident occurred in April 1986. The Chernobyl liquidators were mainly exposed to external ionizing radiation levels that depended primarily on their work locations and the time after the accident when the work was performed. Because individual doses were often monitored inadequately or were not monitored at all for the majority of liquidators, a new method of photon (i.e. gamma and x-rays) dose assessment, called “RADRUE” (Realistic Analytical Dose Reconstruction with Uncertainty Estimation) was developed to obtain unbiased and reasonably accurate estimates for use in three epidemiologic studies of hematological malignancies and thyroid cancer among liquidators. The RADRUE program implements a time-and-motion dose reconstruction method that is flexible and conceptually easy to understand. It includes a large exposure rate database and interpolation and extrapolation techniques to calculate exposure rates at places where liquidators lived and worked within ~70 km of the destroyed reactor. The RADRUE technique relies on data collected from subjects’ interviews conducted by trained interviewers, and on expert dosimetrists to interpret the information and provide supplementary information, when necessary, based upon their own Chernobyl experience. The RADRUE technique was used to estimate doses from external irradiation, as well as uncertainties, to the bone-marrow for 929 subjects and to the thyroid gland for 530 subjects enrolled in epidemiologic studies. Individual bone-marrow dose estimates were found to range from less than one μGy to 3,300 mGy, with an arithmetic mean of 71 mGy. Individual thyroid dose estimates were lower and ranged from 20 μGy to 507 mGy, with an arithmetic mean of 29 mGy. The uncertainties, expressed in terms of geometric standard deviations, ranged from 1.1 to 5.8, with an arithmetic mean of 1.9. PMID:19741357

Findings of the first comprehensive radiological monitoring program of the Republic of the Marshall Islands.

PubMed

Simon, S L; Graham, J C

1997-07-01

The Marshall Islands was the primary site of the United States atomic weapons testing program in the Pacific. From 1946 through 1958, 66 atomic weapons were detonated in the island country. For several decades, monitoring was conducted by the U.S. Department of Energy (or its predecessor agencies) on the test site atolls and neighboring atolls. However, 70% of the land area of the over 1,200 islands in the Marshall Islands was never systematically monitored prior to 1990. For the 5-y period from 1990 through 1994, the Government of the Republic of the Marshall Islands undertook an independent program to assess the radiological conditions throughout its 29 atolls. The scientific work was performed under the auspices of the Section 177 Agreement of the Compact of Free Association, U.S. public law 99-239, signed in 1986 by President Ronald Reagan. Although the total land area of the nations is a scant 180 km2, the islands are distributed over 6 x 10(5) km2 of ocean. Consequently, logistics and instrumentation were main considerations, in addition to cultural and language issues. The core of the monitoring program was in-situ gamma spectrometry measurements made on more than 400 islands. Native foods including coconuts and other tropical fruits were sampled as well as more than 200 soil profiles and more than 800 surface soil samples. The fruits, soil profiles and surface soil samples have been analyzed for all gamma emitters with an emphasis on determining concentrations of 137Cs; the surface soil samples were also analyzed for 239+240Pu. All measurements were conducted in a radiological laboratory built in the capital city of the Marshall Islands specifically for the purposes of this study. The program was extensively assisted in the field and in the laboratory by Marshallese workers. The interpretation of environmental radiation data in the Marshall Islands required thoughtful analysis because the atolls lie along a latitude and precipitation gradient that effected the deposition of local and global fallout. The objective of this paper is to report findings for all atolls of the Marshall Islands on the 137Cs areal inventory (Bq m(-2)) and the external effective dose-rate (mSv y(-1)), the projected internal effective dose-rate (mSv y(-1)) from an assumed diet model, and surface soil concentrations of 239,240Pu (Bq kg(-1)) for selected northern atolls. Interpretation is also provided on the degree of contamination above global fallout levels. This report provides the first comprehensive summary of the radiological conditions throughout the Marshall Islands.

Evaluation of the brain anaesthesia response monitor during anaesthesia for cardiac surgery: a double-blind, randomised controlled trial using two doses of fentanyl.

PubMed

Shoushtarian, Mehrnaz; McGlade, Desmond P; Delacretaz, Louis J; Liley, David T J

2016-12-01

The brain anaesthesia response (BAR) monitor uses a method of EEG analysis, based on a model of brain electrical activity, to monitor the cerebral response to anaesthetic and sedative agents via two indices, composite cortical state (CCS) and cortical input (CI). It was hypothesised that CCS would respond to the hypnotic component of anaesthesia and CI would differentiate between two groups of patients receiving different doses of fentanyl. Twenty-five patients scheduled to undergo elective first-time coronary artery bypass graft surgery were randomised to receive a total fentanyl dose of either 12 μg/kg (fentanyl low dose, FLD) or 24 μg/kg (fentanyl moderate dose, FMD), both administered in two divided doses. Propofol was used for anaesthesia induction and pancuronium for intraoperative paralysis. Hemodynamic management was protocolised using vasoactive drugs. BIS, CCS and CI were simultaneously recorded. Response of the indices (CI, CCS and BIS) to propofol and their differences between the two groups at specific points from anaesthesia induction through to aortic cannulation were investigated. Following propofol induction, CCS and BIS but not CI showed a significant reduction. Following the first dose of fentanyl, CI, CCS and BIS decreased in both groups. Following the second dose of fentanyl, there was a significant reduction in CI in the FLD group but not the FMD group, with no significant change found for BIS or CCS in either group. The BAR monitor demonstrates the potential to monitor the level of hypnosis following anaesthesia induction with propofol via the CCS index and to facilitate the titration of fentanyl as a component of balanced anaesthesia via the CI index.

Nevada Test Site annual site environmental report for calendar year 1996

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

Black, S.C.; Townsend, Y.E.

1997-10-01

Monitoring and surveillance on and around the Nevada Test Site (NTS) by US Department of Energy (DOE) contractors and NTS user organizations during 1996 indicated that operations on the NTS were conducted in compliance with applicable DOE, state, and federal regulations and guidelines. All discharges of radioactive liquids remained onsite in containment ponds, and there was no indication of potential migration of radioactivity to the offsite area through groundwater. Surveillance around the NTS indicated that airborne radioactivity from diffusion, evaporation of liquid effluents, or resuspension of soil was not detectable offsite, and exposure above background to members of the offsitemore » population was not measured by the offsite monitoring program. Using the US Environmental Protection Agency`s (EPA) Clean Air Package 1988 (CAP88)PC model and NTS radionuclide emissions and environmental monitoring data, the calculated effective dose equivalent (EDE) to the maximally exposed individual offsite would have been 0.11 mrem. This value is less than 2 percent of the federal dose limit prescribed for radionuclide air emissions. Any person receiving this dose would also have received 144 mrem from natural background radiation. There were no nonradiological releases to the offsite area. Hazardous wastes were shipped offsite to approved disposal facilities. Compliance with the various regulations stemming from the National Environmental Policy Act (NEPA) is being achieved and, where mandated, permits for air and water effluents and waste management have been obtained from the appropriate agencies. Cooperation with other agencies has resulted in seven different consent orders and agreements. Support facilities at off-NTS locations have complied with the requirements of air quality permits and state or local wastewater discharge and hazardous waste permits as mandated for each location.« less

Public exposure due to external gamma background radiation in boundary areas of Iran.

PubMed

Pooya, S M Hosseini; Dashtipour, M R; Enferadi, A; Orouji, T

2015-09-01

A monitoring program in boundary areas of a country is an appropriate way to indicate the level of public exposure. In this research, gamma background radiation was measured using TL dosimeters at 12 boundary areas as well as in the capital city of Iran during the period 2010 to 2011. The measurements were carried out in semi-annual time intervals from January to June and July to December in each year. The maximum average dose equivalent value measured was approximately 70 μSv/month for Tehran city. Also, the average dose values obtained were less than 40 μSv/month for all the cities located at the sea level except that of high level natural radiation area of Ramsar, and more than 55 μSv/month for the higher elevation cities. The public exposure due to ambient gamma dose equivalent in Iran is within the levels reported by UNSCEAR. Copyright © 2015 Elsevier Ltd. All rights reserved.

Environmental Radiation Measurements on MIR Station. Program 1; Internal Experiment

NASA Technical Reports Server (NTRS)

Benton, E. V.; Frank, A. L.; Benton, E. R.

1997-01-01

Environmental radiation levels on the Russian space station Mir are being monitored under differing shielding conditions by a series of six area passive dosimeters (APDs) placed at individual locations inside the Core and Kvant 2 modules, and by an External Dosimeter Array (EDA) to be-deployed on the exterior surface of the Kvant 2 module. Each APD and the EDA contains CR-39 plastic nuclear track detectors (PNTDs) for measurement of LET spectra and TLDs for absorbed dose measurements. Two of the missions, NASA-2/Mir-21 and NASA-3/Mir-22 have been completed and the six APDs from each mission returned to Earth from Mir. This report covers progress to date on the analysis of TLDs and PNTDs from these two missions. For NASA-2/Mir-21, average mission absorbed dose rates varied from 271 to 407 micro-Gy/d at the APDS. For NASA-3/Mir-22, average mission absorbed dose rates varied from 265 to 421 micro-Gy/d.

Environmental Report 2008

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

Gallegos, G; Bertoldo, N A; Campbell, C G

The purposes of the Lawrence Livermore National Laboratory Environmental Report 2008 are to record Lawrence Livermore National Laboratory's (LLNL's) compliance with environmental standards and requirements, describe LLNL's environmental protection and remediation programs, and present the results of environmental monitoring at the two LLNL sites - the Livermore site and Site 300. The report is prepared for the U.S. Department of Energy (DOE) by LLNL's Environmental Protection Department. Submittal of the report satisfies requirements under DOE Order 231.1A, Environmental Safety and Health Reporting, and DOE Order 5400.5, Radiation Protection of the Public and Environment. The report is distributed electronically and ismore » available at https://saer.lln.gov/, the website for the LLNL annual environmental report. Previous LLNL annual environmental reports beginning in 1994 are also on the website. Some references in the electronic report text are underlined, which indicates that they are clickable links. Clicking on one of these links will open the related document, data workbook, or website that it refers to. The report begins with an executive summary, which provides the purpose of the report and an overview of LLNL's compliance and monitoring results. The first three chapters provide background information: Chapter 1 is an overview of the location, meteorology, and hydrogeology of the two LLNL sites; Chapter 2 is a summary of LLNL's compliance with environmental regulations; and Chapter 3 is a description of LLNL's environmental programs with an emphasis on the Environmental Management System including pollution prevention. The majority of the report covers LLNL's environmental monitoring programs and monitoring data for 2008: effluent and ambient air (Chapter 4); waters, including wastewater, storm water runoff, surface water, rain, and groundwater (Chapter 5); and terrestrial, including soil, sediment, vegetation, foodstuff, ambient radiation, and special status wildlife and plants (Chapter 6). Complete monitoring data, which are summarized in the body of the report, are provided in Appendix A. The remaining three chapters discuss the radiological impact on the public from LLNL operations (Chapter 7), LLNL's groundwater remediation program (Chapter 8), and quality assurance for the environmental monitoring programs (Chapter 9). The report uses Systeme International units, consistent with the federal Metric Conversion Act of 1975 and Executive Order 12770, Metric Usage in Federal Government Programs (1991). For ease of comparison to environmental reports issued prior to 1991, dose values and many radiological measurements are given in both metric and U.S. customary units. A conversion table is provided in the glossary. The report is the responsibility of LLNL's Environmental Protection Department. Monitoring data were obtained through the combined efforts of the Environmental Protection Department; Environmental Restoration Department; Physical and Life Sciences Environmental Monitoring Radiation Laboratory; and the Hazards Control Department.« less

Technical aspects of quality assurance in radiation oncology

PubMed Central

Saw, CB; Ferenci, MS; Wanger, H

2008-01-01

The technical aspects of quality assurance (QA) in radiation oncology as practice in the United States will be reviewed and updated in the spirit of offering the experience to the radiation oncology communities in the Asia-Pacific region. The word “technical” is used to express the organisational components or processes and not the materials within the QA program. A comprehensive QA program in radiation oncology will have an official statement declaring the quality plan for effective patient care services it provides in a document. The QA program will include all aspects of patient care: physical, clinical, and medical aspects of the services. The document will describe the organisational structure, responsibilities, checks and procedures, and resources allocated to ensure the successful implementation of the quality of patient management. Regulatory guidelines and guidelines from accreditation agencies should be incorporated in the QA program to ensure compliance. The organisational structure will have a multidisciplinary QA committee that has the authority to evaluate continuously the effectiveness of the QA program to provide prompt corrective recommendations and to request feedback as needed to monitor the response. The continuous monitoring aspects require meetings to be held at regular intervals with the minutes of the meetings officially recorded and documented. To ensure that a QA program is effective, the program itself should be audited for quality at regular intervals at least annually. It has been recognised that the current QA program has not kept abreast with the rapid implementation of new and advanced radiation therapy technologies with the most recent in image-based radiation therapy technology. The societal bodies (ASTRO and AAPM) and federal agency (NCI) acknowledge this inadequacy and have held workshops to address this issue. The challenges for the societal bodies and federal agency are numerous that include (a) the prescriptive methodology used may not be appropriate for currently implemented new technologies, (b) resources are becoming scarce, (c) advanced radiation therapy technologies have been introduced too rapidly, (d) advances in radiation therapy technologies have become too sophisticated and specialised with each therapy modality having its own separate set of equipment, for example its own dose planning software, computer system and dose delivery systems requiring individualised QA procedures. At the present time, industrial engineers are being recruited to assist in devising a methodology that is broad-based and more process-oriented risk-based formulation of QA in radiation oncology. PMID:21611011

Implementation of Information Management System for Radiation Safety of Personnel at the Russian Northwest Center for Radioactive Waste Management 'SevRAO' - 13131

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

Chizhov, K.; Simakov, A.; Seregin, V.

2013-07-01

The report is an overview of the information-analytical system designed to assure radiation safety of workers. The system was implemented in the Northwest Radioactive Waste Management Center 'SevRAO' (which is a branch of the Federal State Unitary Enterprise 'Radioactive Waste Management Enterprise RosRAO'). The center is located in the Northwest Russia. In respect to 'SevRAO', the Federal Medical-Biological Agency is the regulatory body, which deals with issues of radiation control. The main document to regulate radiation control is 'Reference levels of radiation factors in radioactive wastes management center'. This document contains about 250 parameters. We have developed a software toolmore » to simplify control of these parameters. The software includes: input interface, the database, dose calculating module and analytical block. Input interface is used to enter radiation environment data. Dose calculating module calculates the dose on the route. Analytical block optimizes and analyzes radiation situation maps. Much attention is paid to the GUI and graphical representation of results. The operator can enter the route at the industrial site or watch the fluctuations of the dose rate field on the map. Most of the results are presented in a visual form. Here we present some analytical tasks, such as comparison of the dose rate in some point with control levels at this point, to be solved for the purpose of radiation safety control. The program helps to identify points making the largest contribution to the collective dose of the personnel. The tool can automatically calculate the route with the lowest dose, compare and choose the best route. The program uses several options to visualize the radiation environment at the industrial site. This system will be useful for radiation monitoring services during the operation, planning of works and development of scenarios. The paper presents some applications of this system on real data over three years - from March 2009 to February 2012. (authors)« less

Incorporating deliverable monitor unit constraints into spot intensity optimization in intensity modulated proton therapy treatment planning

PubMed Central

Cao, Wenhua; Lim, Gino; Li, Xiaoqiang; Li, Yupeng; Zhu, X. Ronald; Zhang, Xiaodong

2014-01-01

The purpose of this study is to investigate the feasibility and impact of incorporating deliverable monitor unit (MU) constraints into spot intensity optimization in intensity modulated proton therapy (IMPT) treatment planning. The current treatment planning system (TPS) for IMPT disregards deliverable MU constraints in the spot intensity optimization (SIO) routine. It performs a post-processing procedure on an optimized plan to enforce deliverable MU values that are required by the spot scanning proton delivery system. This procedure can create a significant dose distribution deviation between the optimized and post-processed deliverable plans, especially when small spot spacings are used. In this study, we introduce a two-stage linear programming (LP) approach to optimize spot intensities and constrain deliverable MU values simultaneously, i.e., a deliverable spot intensity optimization (DSIO) model. Thus, the post-processing procedure is eliminated and the associated optimized plan deterioration can be avoided. Four prostate cancer cases at our institution were selected for study and two parallel opposed beam angles were planned for all cases. A quadratic programming (QP) based model without MU constraints, i.e., a conventional spot intensity optimization (CSIO) model, was also implemented to emulate the commercial TPS. Plans optimized by both the DSIO and CSIO models were evaluated for five different settings of spot spacing from 3 mm to 7 mm. For all spot spacings, the DSIO-optimized plans yielded better uniformity for the target dose coverage and critical structure sparing than did the CSIO-optimized plans. With reduced spot spacings, more significant improvements in target dose uniformity and critical structure sparing were observed in the DSIO- than in the CSIO-optimized plans. Additionally, better sparing of the rectum and bladder was achieved when reduced spacings were used for the DSIO-optimized plans. The proposed DSIO approach ensures the deliverability of optimized IMPT plans that take into account MU constraints. This eliminates the post-processing procedure required by the TPS as well as the resultant deteriorating effect on ultimate dose distributions. This approach therefore allows IMPT plans to adopt all possible spot spacings optimally. Moreover, dosimetric benefits can be achieved using smaller spot spacings. PMID:23835656

Dose tracking and dose auditing in a comprehensive computed tomography dose-reduction program.

PubMed

Duong, Phuong-Anh; Little, Brent P

2014-08-01

Implementation of a comprehensive computed tomography (CT) radiation dose-reduction program is a complex undertaking, requiring an assessment of baseline doses, an understanding of dose-saving techniques, and an ongoing appraisal of results. We describe the role of dose tracking in planning and executing a dose-reduction program and discuss the use of the American College of Radiology CT Dose Index Registry at our institution. We review the basics of dose-related CT scan parameters, the components of the dose report, and the dose-reduction techniques, showing how an understanding of each technique is important in effective auditing of "outlier" doses identified by dose tracking. Copyright © 2014 Elsevier Inc. All rights reserved.

Status of eye lens radiation dose monitoring in European hospitals.

PubMed

Carinou, Eleftheria; Ginjaume, Merce; O'Connor, Una; Kopec, Renata; Sans Merce, Marta

2014-12-01

A questionnaire was developed by the members of WG12 of EURADOS in order to establish an overview of the current status of eye lens radiation dose monitoring in hospitals. The questionnaire was sent to medical physicists and radiation protection officers in hospitals across Europe. Specific topics were addressed in the questionnaire such as: knowledge of the proposed eye lens dose limit; monitoring and dosimetry issues; training and radiation protection measures. The results of the survey highlighted that the new eye lens dose limit can be exceeded in interventional radiology procedures and that eye lens protection is crucial. Personnel should be properly trained in how to use protective equipment in order to keep eye lens doses as low as reasonably achievable. Finally, the results also highlighted the need to improve the design of eye dosemeters in order to ensure satisfactory use by workers.

Development of a national cosmic-ray dose monitoring system with Health Canada's Fixed Point Surveillance network.

PubMed

Liu, Chuanlei; Zhang, Weihua; Ungar, Kurt; Korpach, Ed; White, Brian; Benotto, Mike; Pellerin, Eric

2018-05-07

This work explores the application of Health Canada's Fixed Point Surveillance (FPS) network for cosmic ray monitoring and dose estimation purposes. This network is comprised of RS250 3 inch by 3 inch Sodium Iodide (NaI) spectroscopic dosimeters distributed throughout Canada. The RS250's high channel count rate responds to the electromagnetic and muonic components of cosmic ray shower. These count rates are used to infer cosmic ray doses throughout FPS locations. The derived dose was found to have an accuracy within 6.5% deviation relative to theoretical calculation. The solar cycle effect and meteorologically induced fluctuation can be realistically reflected in the estimated dose. This work may serve as a basis to enable the FPS network to monitor and report both terrestrial and cosmic radiation in quasi-real time. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

Improving Warfarin Management Within the Medical Home: A Health-System Approach.

PubMed

Rose, Anne E; Robinson, Erin N; Premo, Joan A; Hauschild, Lori J; Trapskin, Philip J; McBride, Ann M

2017-03-01

Anticoagulation clinics have been considered the optimal strategy for warfarin management with demonstrated improved patient outcomes through increased time in therapeutic international normalized ratio (INR) range, decreased critical INR values, and decreased anticoagulation-related adverse events. However, not all health systems are able to support a specialized anticoagulation clinic or may see patient volume exceed available anticoagulation clinic resources. The purpose of this study was to utilize an anticoagulation clinic model to standardize warfarin management in a primary care clinic setting. A warfarin management program was developed that included standardized patient assessment, protocolized warfarin-dosing algorithm, and electronic documentation and reporting tools. Primary care clinics were targeted for training and implementation of this program. The warfarin management program was applied to over 2000 patients and implemented at 39 clinic sites. A total of 160 nurses and 15 pharmacists were trained on the program. Documentation of warfarin dose and date of the next INR increased from 70% to 90% (P <.0001), documentation occurring within 24 hours of the INR result increased from 75% to 87% (P <.0001), and monitoring the INR at least every 4 weeks increased from 71% to 83% (P <.0001) per patient encounter. Time in therapeutic INR range improved from 65% to 75%. Incorporating a standardized approach to warfarin management in the primary care setting significantly improves warfarin-related documentation and time in therapeutic INR range. Copyright © 2016 Elsevier Inc. All rights reserved.

SU-G-IeP3-13: Real-Time Patient and Staff Dose Monitoring in Fluoroscopy Guided Interventions

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

Vergoossen, L; Sailer, A; Paulis, L

Purpose: Interventional radiology procedures involve the use of X-rays, which can pose a large radiation burden on both patients and staff. Although some reports on radiation dose are available, most studies focus on limited types of procedures and only report patient dose. In our cathlabs a dedicated real-time patient and staff monitoring system was installed in November 2015. The aim of this study was to investigate the patient and staff dose exposure for different types of interventions. Methods: Radiologists involved in fluoroscopy guided interventional radiology procedures wore personal dose meters (PDM, DoseAware, Philips) on their lead-apron that measured the personalmore » dose equivalent Hp(10), a measure for the effective dose (E). Furthermore, reference PDMs were installed in the C-arms of the fluoroscopy system (Allura XPer, Philips). Patient dose-area-product (DAP) and PDM doses were retrieved from the monitoring system (DoseWise, Philips) for each procedure. A total of 399 procedures performed between November 2015 and February 2016 were analyzed with respect to the type of intervention. Interventions were grouped by anatomy and radiologist position. Results: The mean DAP for the different types of interventions ranged from 2.86±2.96 Gycm{sup 2} (percutaneous gastrostomy) to 147±178 Gycm{sup 2} (aortic repair procedures). The radiologist dose (E) ranged from 5.39±7.38 µSv (cerebral interventions) to 84.7±106 µSv (abdominal interventions) and strongly correlated with DAP (R{sup 2}=0.83). The E normalized to DAP showed that the relative radiologist dose was higher for interventions in larger body parts (e.g. abdomen) compared to smaller body parts (e.g. head). Conclusion: Using a real-time dose monitoring system we were able to assess the staff and patient dose revealing that the relative staff dose strongly depended on the type of procedure and patient anatomy. This could be explained by the position of the radiologist with respect to the patient and X-ray tube. To facilitate this study L Vergoossen received a scholarship from Philips Medical Systems.« less

Multileaf collimator-based linear accelerator radiosurgery: five-year efficiency analysis.

PubMed

Lawson, Joshua D; Fox, Tim; Waller, Anthony F; Davis, Lawrence; Crocker, Ian

2009-03-01

In 1989, Emory University initiated a linear accelerator (linac) radiosurgery program using circular collimators. In 2001, the program converted to a multileaf collimator. Since then, the treatment parameters of each patient have been stored in the record-and-verify system. Three major changes have occurred in the radiosurgery program in the past 6 years: in 2002, treatment was changed from static conformal beams to dynamic conformal arc (DCA) therapy, and all patients were imaged before treatment. Beginning in 2005, a linac was used, with the opportunity to treat at higher dose rates (600-1,000 monitor units/min). The aim of this study was to analyze the time required to deliver radiosurgery and the factors affecting treatment delivery. Benchmark data are provided for centers contemplating initiating linac radiosurgery programs. Custom software was developed to mine the record-and-verify system database and automatically perform a chart review on patients who underwent stereotactic radiosurgery from March 2001 to October 2006. The software extracted 510 patients who underwent stereotactic radiosurgery, and the following information was recorded for each patient: treatment technique, treatment time (from initiation of imaging, if done, to completion of therapy), number of isocenters, number of fields, total monitor units, and dose rate. Of the 510 patients, 395 were treated with DCA therapy and 115 with static conformal beams. The average number of isocenters treated was 1.06 (range, 1-4). The average times to deliver treatment were 24.1 minutes for patients who underwent DCA therapy and 19.3 minutes for those treated with static conformal beams, reflecting the lack of imaging in the latter patients. Eighty percent of patients were treated in <30 minutes. For the patients who underwent DCA therapy, the times required to treat 1, 2, 3, and 4 isocenters were 23.9, 24.8, 33.1, and 37.8 minutes, respectively. Average beam-on time for these patients was 11.4 minutes. There has been no significant reduction in treatment delivery with the use of 1,000 monitor units/min, reflecting the fact that beam-on time is not the major determinant of overall treatment time. Multileaf collimator-based linac radiosurgery can be delivered efficiently in <30 minutes in the vast majority of patients. Given the limited treatment room utilization required for stereotactic radiosurgery treatments, this study calls into question the need for a dedicated radiosurgery unit for even busy treatment centers.

Monitoring and Modeling Astronaut Occupational Radiation Exposures in Space: Recent Advances

NASA Technical Reports Server (NTRS)

Weyland, Mark; Golightly, Michael

1999-01-01

In 1982 astronauts were declared to be radiation workers by OSHA, and as such were subject to the rules and regulations applied to that group. NASA was already aware that space radiation was a hazard to crewmembers and had been studying and monitoring astronaut doses since 1962 at the Johnson Space Center. It was quickly realized NASA would not be able to accomplish all of its goals if the astronauts were subject to the ground based radiation worker limits, and thus received a waiver from OSHA to establish independent limits. As part of the stipulation attached to setting new limits, OSHA included a requirement to perform preflight dose projections for each crew and inform them of the associated risks. Additional requirements included measuring doses from various sources during the flight, making every effort to prevent a crewmember from exceeding the new limits, and keeping all exposures As Low As Reasonably Achievable (a.k.a. ALARA - a common health physics principle). The assembly of the International Space Station (ISS) and its initial manned operations will coincide with the 4-5 year period of high space weather activity at the next maximum in the solar cycle. For the first time in NASA's manned program, US astronauts will be in orbit continuously throughout a solar maximum period. During this period, crews are at risk of significantly increased radiation exposures due to solar particle events and trapped electron belt enhancements following geomagnetic storms. The problem of protecting crews is compounded by the difficulty of providing continuous real-time monitoring over a period of a decade in an era of tightly constrained budgets. In order to prepare for ISS radiological support needs, the NASA Space Radiation Analysis Group and the NOAA Space Environment Center have undertaken a multiyear effort to improve and automate ground-based space weather monitoring systems and real-time radiation analysis tools. These improvements include a coupled, automated space weather monitoring and alarm system--SPE exposure analysis system, an advanced space weather data distribution and display system, and a high-fidelity space weather simulation system. In addition, significant new real-time space weather data sets, which will enhance the forecasting and now-casting of near-Earth space environment conditions, are being made available through unique NASA-NOAA-USAF collaborations. These new data sets include coronal mass ejection monitoring by the Solar and Heliospheric Observatory (SOHO) and in-situ plasma and particle monitoring at the L1 libration point by the Solar Wind Monitor (SWIM) and Advanced Composition Explorer (ACE) spacecraft. Advanced real-time radiation monitoring data from charged particle telescopes and tissue equivalent proportional counters will also be available to assist crew and flight controllers in monitoring the external and intravehicular radiation environment.

Radiological assessment for bauxite mining and alumina refining.

PubMed

O'Connor, Brian H; Donoghue, A Michael; Manning, Timothy J H; Chesson, Barry J

2013-01-01

Two international benchmarks assess whether the mining and processing of ores containing Naturally Occurring Radioactive Material (NORM) require management under radiological regulations set by local jurisdictions. First, the 1 Bq/g benchmark for radionuclide head of chain activity concentration determines whether materials may be excluded from radiological regulation. Second, processes may be exempted from radiological regulation where occupational above-background exposures for members of the workforce do not exceed 1 mSv/year. This is also the upper-limit of exposure prescribed for members of the public. Alcoa of Australia Limited (Alcoa) has undertaken radiological evaluations of the mining and processing of bauxite from the Darling Range of Western Australia since the 1980s. Short-term monitoring projects have demonstrated that above-background exposures for workers do not exceed 1 mSv/year. A whole-of-year evaluation of above-background, occupational radiological doses for bauxite mining, alumina refining and residue operations was conducted during 2008/2009 as part of the Alcoa NORM Quality Assurance System (NQAS). The NQAS has been guided by publications from the International Commission on Radiological Protection (ICRP), the International Atomic Energy Agency (IAEA) and the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA). The NQAS has been developed specifically in response to implementation of the Australian National Directory on Radiation Protection (NDRP). Positional monitoring was undertaken to increase the accuracy of natural background levels required for correction of occupational exposures. This is important in view of the small increments in exposure that occur in bauxite mining, alumina refining and residue operations relative to natural background. Positional monitoring was also undertaken to assess the potential for exposure in operating locations. Personal monitoring was undertaken to characterise exposures in Similar Exposure Groups (SEGs). The monitoring was undertaken over 12 months, to provide annual average assessments of above-background doses, thereby reducing temporal variations, especially for radon exposures. The monitoring program concentrated on gamma and radon exposures, rather than gross alpha exposures, as past studies have shown that gross alpha exposures from inhalable dust for most of the workforce are small in comparison to combined gamma and radon exposures. The natural background determinations were consistent with data in the literature for localities near Alcoa's mining, refining and residue operations in Western Australia, and also with UNSCEAR global data. Within the mining operations, there was further consistency between the above-background dose estimates and the local geochemistry, with slight elevation of dose levels in mining pits. Conservative estimates of above-background levels for the workforce have been made using an assumption of 100% occupancy (1920 hours per year) for the SEGs considered. Total incremental composite doses for individuals were clearly less than 1.0 mSv/year when gamma, radon progeny and gross alpha exposures were considered. This is despite the activity concentration of some materials being slightly higher than the benchmark of 1 Bq/g. The results are consistent with previous monitoring and demonstrate compliance with the 1 mSv/year exemption level within mining, refining and residue operations. These results will be of value to bauxite mines and alumina refineries elsewhere in the world.

Techniques for Monitoring Drug Efficacy.

PubMed

Visser, Marike

2018-05-01

The efficacy of drugs can vary greatly between species and individuals. Establishing efficacious drug doses for a species requires integration of population pharmacokinetic and pharmacodynamic data into a dose-response curve. Unfortunately, these data sets are rarely available for exotic species. The use of alternative monitoring techniques is required to determine drug efficacy and safety. This article discusses methods to integrate efficacy monitoring into clinical practice, including the use of diagnostic testing and therapeutic drug monitoring. Copyright © 2018 Elsevier Inc. All rights reserved.

Triple ionization chamber method for clinical dose monitoring with a Be-covered Li BNCT field.

PubMed

Nguyen, Thanh Tat; Kajimoto, Tsuyoshi; Tanaka, Kenichi; Nguyen, Chien Cong; Endo, Satoru

2016-11-01

Fast neutron, gamma-ray, and boron doses have different relative biological effectiveness (RBE). In boron neutron capture therapy (BNCT), the clinical dose is the total of these dose components multiplied by their RBE. Clinical dose monitoring is necessary for quality assurance of the irradiation profile; therefore, the fast neutron, gamma-ray, and boron doses should be separately monitored. To estimate these doses separately, and to monitor the boron dose without monitoring the thermal neutron fluence, the authors propose a triple ionization chamber method using graphite-walled carbon dioxide gas (C-CO 2 ), tissue-equivalent plastic-walled tissue-equivalent gas (TE-TE), and boron-loaded tissue-equivalent plastic-walled tissue-equivalent gas [TE(B)-TE] chambers. To use this method for dose monitoring for a neutron and gamma-ray field moderated by D 2 O from a Be-covered Li target (Be-covered Li BNCT field), the relative sensitivities of these ionization chambers are required. The relative sensitivities of the TE-TE, C-CO 2 , and TE(B)-TE chambers to fast neutron, gamma-ray, and boron doses are calculated with the particle and heavy-ion transport code system (PHITS). The relative sensitivity of the TE(B)-TE chamber is calculated with the same method as for the TE-TE and C-CO 2 chambers in the paired chamber method. In the Be-covered Li BNCT field, the relative sensitivities of the ionization chambers to fast neutron, gamma-ray, and boron doses are calculated from the kerma ratios, mass attenuation coefficient tissue-to-wall ratios, and W-values. The Be-covered Li BNCT field consists of neutrons and gamma-rays which are emitted from a Be-covered Li target, and this resultant field is simulated by using PHITS with the cross section library of ENDF-VII. The kerma ratios and mass attenuation coefficient tissue-to-wall ratios are determined from the energy spectra of neutrons and gamma-rays in the Be-covered Li BNCT field. The W-value is calculated from recoil charged particle spectra by the collision of neutrons and gamma-rays with the wall and gas materials of the ionization chambers in the gas cavities of TE-TE, C-CO 2 , and TE(B)-TE chambers ( 10 B concentrations of 10, 50, and 100 ppm in the TE-wall). The calculated relative sensitivity of the C-CO 2 chamber to the fast neutron dose in the Be-covered Li BNCT field is 0.029, and those of the TE-TE and TE(B)-TE chambers are both equal to 0.965. The relative sensitivities of the C-CO 2 , TE-TE, and TE(B)-TE chambers to the gamma-ray dose in the Be-covered Li BNCT field are all 1 within the 1% calculation uncertainty. The relative sensitivities of TE(B)-TE to boron dose with concentrations of 10, 50, and 100 ppm 10 B are calculated to be 0.865 times the ratio of the in-tumor to in-chamber wall boron concentration. The fast neutron, gamma-ray, and boron doses of a tumor in-air can be separately monitored by the triple ionization chamber method in the Be-covered Li BNCT field. The results show that these doses can be easily converted to the clinical dose with the depth correction factor in the body and the RBE.

Method to monitor HC-SCR catalyst NOx reduction performance for lean exhaust applications

DOEpatents

Viola, Michael B [Macomb Township, MI; Schmieg, Steven J [Troy, MI; Sloane, Thompson M [Oxford, MI; Hilden, David L [Shelby Township, MI; Mulawa, Patricia A [Clinton Township, MI; Lee, Jong H [Rochester Hills, MI; Cheng, Shi-Wai S [Troy, MI

2012-05-29

A method for initiating a regeneration mode in selective catalytic reduction device utilizing hydrocarbons as a reductant includes monitoring a temperature within the aftertreatment system, monitoring a fuel dosing rate to the selective catalytic reduction device, monitoring an initial conversion efficiency, selecting a determined equation to estimate changes in a conversion efficiency of the selective catalytic reduction device based upon the monitored temperature and the monitored fuel dosing rate, estimating changes in the conversion efficiency based upon the determined equation and the initial conversion efficiency, and initiating a regeneration mode for the selective catalytic reduction device based upon the estimated changes in conversion efficiency.

AREA RADIATION MONITOR

DOEpatents

Manning, F.W.; Groothuis, S.E.; Lykins, J.H.; Papke, D.M.

1962-06-12

S>An improved area radiation dose monitor is designed which is adapted to compensate continuously for background radiation below a threshold dose rate and to give warning when the dose integral of the dose rate of an above-threshold radiation excursion exceeds a selected value. This is accomplished by providing means for continuously charging an ionization chamber. The chamber provides a first current proportional to the incident radiation dose rate. Means are provided for generating a second current including means for nulling out the first current with the second current at all values of the first current corresponding to dose rates below a selected threshold dose rate value. The second current has a maximum value corresponding to that of the first current at the threshold dose rate. The excess of the first current over the second current, which occurs above the threshold, is integrated and an alarm is given at a selected integrated value of the excess corresponding to a selected radiation dose. (AEC)

A comprehensive dose reconstruction methodology for former rocketdyne/atomics international radiation workers.

PubMed

Boice, John D; Leggett, Richard W; Ellis, Elizabeth Dupree; Wallace, Phillip W; Mumma, Michael; Cohen, Sarah S; Brill, A Bertrand; Chadda, Bandana; Boecker, Bruce B; Yoder, R Craig; Eckerman, Keith F

2006-05-01

Incomplete radiation exposure histories, inadequate treatment of internally deposited radionuclides, and failure to account for neutron exposures can be important uncertainties in epidemiologic studies of radiation workers. Organ-specific doses from lifetime occupational exposures and radionuclide intakes were estimated for an epidemiologic study of 5,801 Rocketdyne/Atomics International (AI) radiation workers engaged in nuclear technologies between 1948 and 1999. The entire workforce of 46,970 Rocketdyne/AI employees was identified from 35,042 Kardex work histories cards, 26,136 electronic personnel listings, and 14,189 radiation folders containing individual exposure histories. To obtain prior and subsequent occupational exposure information, the roster of all workers was matched against nationwide dosimetry files from the Department of Energy, the Nuclear Regulatory Commission, the Landauer dosimetry company, the U.S. Army, and the U.S. Air Force. Dosimetry files of other worker studies were also accessed. Computation of organ doses from radionuclide intakes was complicated by the diversity of bioassay data collected over a 40-y period (urine and fecal samples, lung counts, whole-body counts, nasal smears, and wound and incident reports) and the variety of radionuclides with documented intake including isotopes of uranium, plutonium, americium, calcium, cesium, cerium, zirconium, thorium, polonium, promethium, iodine, zinc, strontium, and hydrogen (tritium). Over 30,000 individual bioassay measurements, recorded on 11 different bioassay forms, were abstracted. The bioassay data were evaluated using ICRP biokinetic models recommended in current or upcoming ICRP documents (modified for one inhaled material to reflect site-specific information) to estimate annual doses for 16 organs or tissues taking into account time of exposure, type of radionuclide, and excretion patterns. Detailed internal exposure scenarios were developed and annual internal doses were derived on a case-by-case basis for workers with committed equivalent doses indicated by screening criteria to be greater than 10 mSv to the organ with the highest internal dose. Overall, 5,801 workers were monitored for radiation at Rocketdyne/AI: 5,743 for external exposure and 2,232 for internal intakes of radionuclides; 41,169 workers were not monitored for radiation. The mean cumulative external dose based on Rocketdyne/AI records alone was 10.0 mSv, and the dose distribution was highly skewed with most workers experiencing low cumulative doses and only a few with high doses (maximum 500 mSv). Only 45 workers received greater than 200 mSv while employed at Rocketdyne/AI. However, nearly 32% (or 1,833) of the Rocketdyne/AI workers had been monitored for radiation at other nuclear facilities and incorporation of these doses increased the mean dose to 13.5 mSv (maximum 1,005 mSv) and the number of workers with >200 mSv to 69. For a small number of workers (n=292), lung doses from internal radionuclide intakes were relatively high (mean 106 mSv; maximum 3,560 mSv) and increased the overall population mean dose to 19.0 mSv and the number of workers with lung dose>200 mSv to 109. Nearly 10% of the radiation workers (584) were monitored for neutron exposures (mean 1.2 mSv) at Rocketdyne/AI, and another 2% were monitored for neutron exposures elsewhere. Interestingly, 1,477 workers not monitored for radiation at Rocketdyne/AI (3.6%) were found to have worn dosimeters at other nuclear facilities (mean external dose of 2.6 mSv, maximum 188 mSv). Without considering all sources of occupational exposure, an incorrect characterization of worker exposure would have occurred with the potential to bias epidemiologic results. For these pioneering workers in the nuclear industry, 26.5% of their total occupational dose (collective dose) was received at other facilities both prior to and after employment at Rocketdyne/AI. In addition, a small number of workers monitored for internal radionuclides contributed disproportionately to the number of workers with high lung doses. Although nearly 12% of radiation workers had been monitored for neutron exposures during their career, the cumulative dose levels were small in comparison with other external and internal exposure. Risk estimates based on nuclear worker data must be interpreted cautiously if internally deposited radionuclides and occupational doses received elsewhere are not considered.

Automation of film densitometry for application in personal monitoring.

PubMed

Taheri, M; Movafeghi, A; Rastkhah, N

2011-03-01

In this research work, a semi-automatic densitometry system has been developed for large-scale monitoring services by use of film badge dosemeters. The system consists of a charge-coupled device (CCD)-based scanner that can scan optical densities (ODs) up to 4.2, a computer vision algorithm to improve the quality of digitised films and an analyser program to calculate the necessary information, e.g. the mean OD of region of interest and radiation doses. For calibration of the system, two reference films were used. The Microtek scanner International Color Consortium (ICC) profiler is applied for determining the colour attributes of the scanner accurately and a reference of the density step tablet, Bundesanstalt für Materialforschung und-prüfung (BAM) is used for calibrating the automatic conversion of gray-level values to OD values in the range of 0.2-4.0 OD. The system contributes to achieve more objectives and reliable results. So by applying this system, we can digitise a set of 20 films at once and calculate their relative doses less than about 4 min, and meanwhile it causes to avoid disadvantages of manual process and to enhance the accuracy of dosimetry.

Lawrence Livermore National Laboratory Environmental Report 2010

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

Jones, H E; Bertoldo, N A; Campbell, C G

The purposes of the Lawrence Livermore National Laboratory Environmental Report 2010 are to record Lawrence Livermore National Laboratory's (LLNL's) compliance with environmental standards and requirements, describe LLNL's environmental protection and remediation programs, and present the results of environmental monitoring at the two LLNL sites - the Livermore site and Site 300. The report is prepared for the U.S. Department of Energy (DOE) by LLNL's Environmental Protection Department. Submittal of the report satisfies requirements under DOE Order 231.1A, Environmental Safety and Health Reporting, and DOE Order 5400.5, Radiation Protection of the Public and Environment. The report is distributed electronically and ismore » available at https://saer.llnl.gov/, the website for the LLNL annual environmental report. Previous LLNL annual environmental reports beginning in 1994 are also on the website. Some references in the electronic report text are underlined, which indicates that they are clickable links. Clicking on one of these links will open the related document, data workbook, or website that it refers to. The report begins with an executive summary, which provides the purpose of the report and an overview of LLNL's compliance and monitoring results. The first three chapters provide background information: Chapter 1 is an overview of the location, meteorology, and hydrogeology of the two LLNL sites; Chapter 2 is a summary of LLNL's compliance with environmental regulations; and Chapter 3 is a description of LLNL's environmental programs with an emphasis on the Environmental Management System including pollution prevention. The majority of the report covers LLNL's environmental monitoring programs and monitoring data for 2010: effluent and ambient air (Chapter 4); waters, including wastewater, storm water runoff, surface water, rain, and groundwater (Chapter 5); and terrestrial, including soil, sediment, vegetation, foodstuff, ambient radiation, and special status wildlife and plants (Chapter 6). Complete monitoring data, which are summarized in the body of the report, are provided in Appendix A. The remaining three chapters discuss the radiological impact on the public from LLNL operations (Chapter 7), LLNL's groundwater remediation program (Chapter 8), and quality assurance for the environmental monitoring programs (Chapter 9). The report uses System International units, consistent with the federal Metric Conversion Act of 1975 and Executive Order 12770, Metric Usage in Federal Government Programs (1991). For ease of comparison to environmental reports issued prior to 1991, dose values and many radiological measurements are given in both metric and U.S. customary units. A conversion table is provided in the glossary.« less

Environmental Report 2007

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

Mathews, S; Gallegos, G; Berg, L L

2008-09-24

The purposes of the 'Lawrence Livermore National Laboratory Environmental Report 2007' are to record Lawrence Livermore National Laboratory's (LLNL's) compliance with environmental standards and requirements, describe LLNL's environmental protection and remediation programs, and present the results of environmental monitoring at the two LLNL sites--the Livermore site and Site 300. The report is prepared for the U.S. Department of Energy (DOE) by LLNL's Environmental Protection Department. Submittal of the report satisfies requirements under DOE Order 231.1A, Environmental Safety and Health Reporting, and DOE Order 5400.5, Radiation Protection of the Public and Environment. The report is distributed electronically and is available atmore » https://saer.lln.gov/, the website for the LLNL annual environmental report. Previous LLNL annual environmental reports beginning in 1994 are also on the website. Some references in the electronic report text are underlined, which indicates that they are clickable links. Clicking on one of these links will open the related document, data workbook, or website that it refers to. The report begins with an executive summary, which provides the purpose of the report and an overview of LLNL's compliance and monitoring results. The first three chapters provide background information: Chapter 1 is an overview of the location, meteorology, and hydrogeology of the two LLNL sites; Chapter 2 is a summary of LLNL's compliance with environmental regulations; and Chapter 3 is a description of LLNL's environmental programs with an emphasis on the Environmental Management System including pollution prevention. The majority of the report covers LLNL's environmental monitoring programs and monitoring data for 2007: effluent and ambient air (Chapter 4); waters, including wastewater, storm water runoff, surface water, rain, and groundwater (Chapter 5); and terrestrial, including soil, sediment, vegetation, foodstuff, ambient radiation, and special status wildlife and plants (Chapter 6). Complete monitoring data, which are summarized in the body of the report, are provided in Appendix A. The remaining three chapters discuss the radiological impact on the public from LLNL operations (Chapter 7), LLNL's groundwater remediation program (Chapter 8), and quality assurance for the environmental monitoring programs (Chapter 9). The report uses Systeme International units, consistent with the federal Metric Conversion Act of 1975 and Executive Order 12770, Metric Usage in Federal Government Programs (1991). For ease of comparison to environmental reports issued prior to 1991, dose values and many radiological measurements are given in both metric and U.S. customary units. A conversion table is provided in the glossary.« less

The atypical excretion profile of meldonium: Comparison of urinary detection windows after single- and multiple-dose application in healthy volunteers.

PubMed

Görgens, Christian; Guddat, Sven; Bosse, Christina; Geyer, Hans; Pop, Valentin; Schänzer, Wilhelm; Thevis, Mario

2017-05-10

Following a one-year monitoring program providing unequivocal analytical evidence for a high prevalence in international elite sports, meldonium has been included in the World Anti-Doping Agency's (WADA) list of prohibited substances that came into effect on 1 January 2016. Despite of the polar and hydrophilic nature of the molecule, an unusual long detection window was observed in pilot elimination studies. Consequently, in the present study, urinary excretion profiles after single-dose (5 volunteers, 1×500mg) and multiple-dose oral application (5 volunteers; 2×500mg/day for 6days) were determined in order to facilitate the result management concerning meldonium findings in doping controls. Particularly the option to differentiate between recent use and tapering concentrations was studied. Urinary meldonium concentrations were determined using an analytical approach based on hydrophilic interaction liquid chromatography and high resolution tandem mass spectrometry. The study corroborates the hypothesis of a non-linear, dose-depended and biphasic excretion profile after oral application of meldonium and demonstrates that urinary detection windows are of considerable extent with up to 65 and 117days (concentrations>LOQ of 10ng/mL) following single- and multiple-dose applications, respectively. Copyright © 2017 Elsevier B.V. All rights reserved.

THE CHALLENGE OF CIEMAT INTERNAL DOSIMETRY SERVICE FOR ACCREDITATION ACCORDING TO ISO/IEC 17025 STANDARD, FOR IN VIVO AND IN VITRO MONITORING AND DOSE ASSESSMENT OF INTERNAL EXPOSURES.

PubMed

Lopez, M A; Martin, R; Hernandez, C; Navarro, J F; Navarro, T; Perez, B; Sierra, I

2016-09-01

The accreditation of an Internal Dosimetry Service (IDS) according to ISO/IEC 17025 Standard is a challenge. The aim of this process is to guarantee the technical competence for the monitoring of radionuclides incorporated in the body and for the evaluation of the associated committed effective dose E(50). This publication describes the main accreditation issues addressed by CIEMAT IDS regarding all the procedures involving good practice in internal dosimetry, focussing in the difficulties to ensure the traceability in the whole process, the appropriate calculation of detection limit of measurement techniques, the validation of methods (monitoring and dose assessments), the description of all the uncertainty sources and the interpretation of monitoring data to evaluate the intake and the committed effective dose. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

SU-F-J-147: Magnetic Field Dose Response Considerations for a Linac Monitor Chamber

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

Reynolds, M; Fallone, B

Purpose: The impact of magnetic fields on the readings of a linac monitor chamber have not yet been investigated. Herein we examine the total dose response as well as any deviations in the beam parameters of flatness and symmetry when a Varian monitor chamber is irradiated within an applied magnetic field. This work has direct application to the development of Linac-MR systems worldwide. Methods: A Varian monitor chamber was modeled in the Monte Carlo code PENELOPE and irradiated in the presence of a magnetic field with a phase space generated from a model of a Linac-MR prototype system. The magneticmore » field strength was stepped from 0 to 3.0T in both parallel and perpendicular directions with respect to the normal surface of the phase space. Dose to each of the four regions in the monitor chamber were scored separately for every magnetic field adaptation to evaluate the effect of the magnetic field on flatness and symmetry. Results: When the magnetic field is perpendicular to the phase space normal we see a change in dose response with a maximal deviation (10–25% depending on the chamber region) near 0.75T. In the direction of electron deflection we expectedly see opposite responses in chamber regions leading to a measured asymmetry. With a magnetic field parallel to the phase space normal we see no measured asymmetries, however there is a monotonic rise in dose response leveling off at about +12% near 2.5T. Conclusion: Attention must be given to correct for the strength and direction of the magnetic field at the location of the linac monitor chamber in hybrid Linac-MR devices. Elsewise the dose sampled by these chambers may not represent the actual dose expected at isocentre; additionally there may be a need to correct for the symmetry of the beam recorded by the monitor chamber. Fallone is a co-founder and CEO of MagnetTx Oncology Solutions (under discussions to license Alberta bi-planar linac MR for commercialization).« less

Upgrading of data acquisition software for centralized radiation monitoring system in Malaysian Nuclear Agency

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

Yussup, F., E-mail: nolida@nm.gov.my; Ibrahim, M. M., E-mail: maslina-i@nm.gov.my; Soh, S. C.

With the growth of technology, many devices and equipments can be connected to the network and internet to enable online data acquisition for real-time data monitoring and control from monitoring devices located at remote sites. Centralized radiation monitoring system (CRMS) is a system that enables area radiation level at various locations in Malaysian Nuclear Agency (Nuklear Malaysia) to be monitored centrally by using a web browser. The Local Area Network (LAN) in Nuclear Malaysia is utilized in CRMS as a communication media for data acquisition of the area radiation levels from radiation detectors. The development of the system involves devicemore » configuration, wiring, network and hardware installation, software and web development. This paper describes the software upgrading on the system server that is responsible to acquire and record the area radiation readings from the detectors. The recorded readings are called in a web programming to be displayed on a website. Besides the main feature which is acquiring the area radiation levels in Nuclear Malaysia centrally, the upgrading involves new features such as uniform time interval for data recording and exporting, warning system and dose triggering.« less

INSREC: Computational System for Quantitative Analysis of Radiation Effects Covering All Radiation Field

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

Dong Hoon Shin; Young Wook Lee; Young Ho Cho

2006-07-01

In the nuclear energy field, there are so many difficult things that even people who are working in this field are not much familiar with, such as, Dose evaluation, Dose management, etc. Thus, so many efforts have been done to achieve the knowledge and data for understanding. Although some data had been achieved, the applications of these data to necessary cases were more difficult job. Moreover, the type of Dose evaluation program until now was 'Console type' which is not easy enough to use for the beginners. To overcome the above causes of difficulties, the window-based integrated program and databasemore » management were developed in our research lab. The program, called as INSREC, consists of four sub-programs as follow; INSREC-NOM, INSREC-ACT, INSREC-MED, and INSREC-EXI. In ICONE 11 conference, INSREC-program(ICONE-36203) which can evaluates on/off-site dose of nuclear power plant in normal operation was introduced. Upgraded INSREC-program which will be presented in ICONE 14 conference has three additional codes comparing with pre-presented INSREC-program. Those subprograms can evaluate on/off-site Dose of nuclear power plant in accident cases. And they also have the functions of 'Dose evaluation and management' in the hospital and provide the 'Expert system' based on knowledge related to nuclear energy/radiation field. The INSREC-NOM, one of subprograms, is composed of 'Source term evaluation program', 'Atmospheric diffusion factor evaluation program', 'Off-site dose evaluation program', and 'On-site database program'. The INSREC-ACT is composed of 'On/Off-site dose evaluation program' and 'Result analysis program' and the INSREC-MED is composed of 'Workers/patients dose database program' and 'Dose evaluation program for treatment room'. The final one, INSREC-EXI, is composed of 'Database searching program based on artificial intelligence', 'Instruction program,' and 'FAQ/Q and A boards'. Each program was developed by using of Visual C++, Microsoft Access mainly. To verify the reliability, some suitable programs were selected such as AZAP and Stardose programs for the comparison. The AZAP program was selected for the on/off-site dose evaluation during the normal operation of nuclear reactor and Stardose program was used for the on/off-site dose evaluation in accident. The MCNP code was used for the dose evaluation and management in the hospital. Each comparison result was acceptable in errors analysis. According to the reliable verification results, it was concluded that INSREC program had an acceptable reliability for dose calculation and could give many proper dada for the sites. To serve the INSREC to people, the proper server system was constructed. We gave chances for the people (user) to utilize the INSREC through network connected to server system. The reactions were pretty much good enough to be satisfied. For the future work, many efforts will be given to improve the better user-interface and more necessary data will be provided to more people through database supplement and management. (authors)« less

TH-E-BRE-09: TrueBeam Monte Carlo Absolute Dose Calculations Using Monitor Chamber Backscatter Simulations and Linac-Logged Target Current

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

A, Popescu I; Lobo, J; Sawkey, D

2014-06-15

Purpose: To simulate and measure radiation backscattered into the monitor chamber of a TrueBeam linac; establish a rigorous framework for absolute dose calculations for TrueBeam Monte Carlo (MC) simulations through a novel approach, taking into account the backscattered radiation and the actual machine output during beam delivery; improve agreement between measured and simulated relative output factors. Methods: The ‘monitor backscatter factor’ is an essential ingredient of a well-established MC absolute dose formalism (the MC equivalent of the TG-51 protocol). This quantity was determined for the 6 MV, 6X FFF, and 10X FFF beams by two independent Methods: (1) MC simulationsmore » in the monitor chamber of the TrueBeam linac; (2) linac-generated beam record data for target current, logged for each beam delivery. Upper head MC simulations used a freelyavailable manufacturer-provided interface to a cloud-based platform, allowing use of the same head model as that used to generate the publicly-available TrueBeam phase spaces, without revealing the upper head design. The MC absolute dose formalism was expanded to allow direct use of target current data. Results: The relation between backscatter, number of electrons incident on the target for one monitor unit, and MC absolute dose was analyzed for open fields, as well as a jaw-tracking VMAT plan. The agreement between the two methods was better than 0.15%. It was demonstrated that the agreement between measured and simulated relative output factors improves across all field sizes when backscatter is taken into account. Conclusion: For the first time, simulated monitor chamber dose and measured target current for an actual TrueBeam linac were incorporated in the MC absolute dose formalism. In conjunction with the use of MC inputs generated from post-delivery trajectory-log files, the present method allows accurate MC dose calculations, without resorting to any of the simplifying assumptions previously made in the TrueBeam MC literature. This work has been partially funded by Varian Medical Systems.« less

42 CFR 82.2 - What are the basics of dose reconstruction?

Code of Federal Regulations, 2014 CFR

2014-10-01

... reconstructions may use monitoring results for groups of workers with comparable activities and relationships to... SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES METHODS FOR CONDUCTING DOSE RECONSTRUCTION UNDER THE... found to be complete and adequate, individual worker monitoring data, such as dosimeter readings and...

42 CFR 82.2 - What are the basics of dose reconstruction?

Code of Federal Regulations, 2011 CFR

2011-10-01

... reconstructions may use monitoring results for groups of workers with comparable activities and relationships to... SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES METHODS FOR CONDUCTING DOSE RECONSTRUCTION UNDER THE... found to be complete and adequate, individual worker monitoring data, such as dosimeter readings and...

Radiological Monitoring for Instructors. Student Workbook. Revised.

ERIC Educational Resources Information Center

Office of Civil Defense (DOD), Washington, DC.

This student workbook includes the necessary materials and some of the references needed by each student during the conduct of the Radiological Monitoring for Instructors (RMI) course. The contents include a radiation exposure record, instrument exercise materials, fallout forecasting problems, dose and dose rate problems, source handling…

Safe practices and financial considerations in using oral chemotherapeutic agents.

PubMed

Bartel, Sylvia B

2007-05-01

Safe handling practices and financial concerns associated with oral chemotherapy in non-traditional settings are discussed. Oral chemotherapy may pose a risk to patients because of a narrow therapeutic index, complex dosing regimen, dispensing by community pharmacists without prescription order review by an oncology pharmacist or nurse, or self-administration in the home or another nontraditional setting, where patient monitoring is infrequent. Errors in prescribing, dispensing, and administration and patient or caregiver misunderstandings are potential problems with the use of oral chemotherapy that need to be addressed when developing safe practices. Changes in Medicare pharmaceutical reimbursement rates and rules need to be monitored because they have the potential to affect patient care and outcomes. Patient assistance programs and advocacy groups can help alleviate financial concerns associated with oral chemotherapy. Consensus guidelines specific to safe handling of oral chemotherapy in the home or other nontraditional setting need to be developed. Also, healthcare providers must understand reimbursement and provide direction to patients when patient assistance programs or advocacy groups can assist with the financial challenges of oral chemotherapy.

Influence of radiotherapy on the latest generation of implantable cardioverter-defibrillators

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

Hurkmans, Coen W.; Scheepers, Egon; Springorum, Bob G.F.

2005-09-01

Purpose: Radiotherapy can influence the functioning of pacemakers and implantable cardioverter-defibrillators (ICDs). ICDs offer the same functionality as pacemakers, but are also able to deliver a high-voltage shock to the heart if needed. Guidelines for radiotherapy treatment of patients with an implanted rhythm device have been published in 1994 by The American Association of Physicists in Medicine, and are based only on experience with pacemakers. Data on the influence of radiotherapy on ICDs are limited. The objective of our study is to determine the influence of radiotherapy on the latest generation of ICDs. Methods and Materials: Eleven modern ICDs havemore » been irradiated in our department. The irradiation was performed with a 6-MV photon beam. The given dose was fractionated up to a cumulative dose of 120 Gy. Two to 5 days passed between consecutive irradiations. Frequency, output, sensing, telemetry, and shock energy were monitored. Results: Sensing interference by ionizing radiation on all ICDs has been demonstrated. For four ICDs, this would have caused the inappropriate delivery of a shock because of interference. At the end of the irradiation sessions, all devices had reached their point of failure. Complete loss of function was observed for four ICDs at dose levels between 0.5 Gy and 1.5 Gy. Conclusions: The effect of radiation therapy on the newest generation of ICDs varies widely. If tachycardia monitoring and therapy are functional (programmed on) during irradiation, the ICD might inappropriately give antitachycardia therapy, often resulting in a shock. Although most ICDs did not fail below 80 Gy, some devices had already failed at doses below 1.5 Gy. Guidelines are formulated for the treatment of patients with an ICD.« less

Neurodevelopmental and body composition outcomes in children with congenital hypothyroidism treated with high-dose initial replacement and close monitoring.

PubMed

Albert, Benjamin B; Heather, Natasha; Derraik, José G B; Cutfield, Wayne S; Wouldes, Trecia; Tregurtha, Sheryl; Mathai, Sarah; Webster, Dianne; Jefferies, Craig; Gunn, Alistair J; Hofman, Paul L

2013-09-01

Despite newborn screening and early levothyroxine replacement, there are continued reports of mild neurocognitive impairment in children with congenital hypothyroidism (CHT). In Auckland, New Zealand, cases are identified by a neonatal screening program with rapid institution of high-dose levothyroxine replacement (10-15 μg/kg·d), producing prompt normalization of thyroid function. Subsequently, frequent monitoring and dose alterations are performed for 2 years. We aimed to assess whether the Auckland treatment strategy prevents impairment of intellectual and motor development. This study encompassed all children with CHT born in 1993-2006 in Auckland and their siblings. Neurocognitive assessments included the following: 1) intelligence quotient via Weschler Preschool and Primary Scale of Intelligence III or Weschler Intelligence Scale for Children IV; 2) Movement Assessment Battery for Children; and 3) Beery Developmental Test of Visual-Motor Integration. Body composition was assessed by dual-energy x-ray absorptiometry. Forty-four CHT cases and 53 sibling controls aged 9.6 ± 3.9 years were studied. Overall intelligence quotient was similar among CHT cases and controls (95.2 vs 98.6; P = .20), and there were also no differences in motor function. Severity of CHT did not influence outcome, but greater time to normalize free T4 was associated with worse motor balance. There were no differences in anthropometry or body composition between groups. These findings suggest that a strategy of rapidly identifying and treating infants with CHT using high-dose levothyroxine replacement is associated with normal intellectual and motor development. The subtle negative impact on motor function associated with time to normalize free T4 levels is consistent with benefit from rapid initial correction.

Dosing and Monitoring of Methadone in Pregnancy: Literature Review

PubMed Central

Shiu, Jennifer R; Ensom, Mary H H

2012-01-01

Background: The pharmacokinetics of methadone is altered during pregnancy, but the most appropriate dosing and monitoring regimen has yet to be identified. Objective: To review dosing and monitoring of methadone therapy in pregnancy. Methods: A literature search was performed in several databases (PubMed, MEDLINE, Embase, International Pharmaceutical Abstracts, and the Cochrane Database of Systematic Reviews) from inception to May 2012. The search terms were “methadone”, “pregnancy”, “pharmacokinetic”, “clearance”, “metabolism”, “therapeutic drug monitoring”, and “methadone dosing”. Additional papers were identified by searching the bibliographies of primary and review articles. All English-language primary articles related to methadone pharmacokinetics in pregnancy were included. Articles not related to maternal outcomes were excluded. Results: The literature search yielded 1 case report and 10 studies discussing use of methadone by pregnant women. Methadone pharmacokinetics in pregnancy has been studied in 3 pharmacokinetic trials, and split dosing of methadone in pregnant women has been described in 1 case report and 3 dosing trials. Only 4 trials evaluated monitoring of methadone concentration in pregnancy. The studies included in this review confirm that methadone pharmacokinetics is altered in pregnancy and is potentially correlated with increases in maternal withdrawal symptoms. Insufficient evidence is available to warrant routine monitoring of serum methadone concentrations in pregnant women with opioid dependence. Conclusions: Few studies of methadone pharmacokinetics and therapeutic drug monitoring are available for pregnant women with opioid dependence. Although it is known that methadone pharmacokinetics is altered in pregnancy, there is insufficient evidence to guide dosage adjustments and serum concentration monitoring. Until further studies are available, regular follow-up of maternal withdrawal symptoms and empiric dosage adjustments throughout pregnancy are still recommended. PMID:23129867

Phantom-derived estimation of effective dose equivalent from X rays with and without a lead apron.

PubMed

Mateya, C F; Claycamp, H G

1997-06-01

Organ dose equivalents were measured in a humanoid phantom in order to estimate effective dose equivalent (H(E)) and effective dose (E) from low-energy x rays and in the presence or absence of a protective lead apron. Plane-parallel irradiation conditions were approximated using direct x-ray beams of 76 and 104 kVp and resulting dosimetry data was adjusted to model exposures conditions in fluoroscopy settings. Values of H(E) and E estimated under-shielded conditions were compared to the results of several recent studies that used combinations of measured and calculated dosimetry to model exposures to radiologists. While the estimates of H(E) and E without the lead apron were within 0.2 to 20% of expected values, estimates based on personal monitors worn at the (phantom) waist (underneath the apron) underestimated either H(E) or E while monitors placed at the neck (above the apron) significantly overestimated both quantities. Also, the experimentally determined H(E) and E were 1.4 to 3.3 times greater than might be estimated using recently reported "two-monitor" algorithms for the estimation of effective dose quantities. The results suggest that accurate estimation of either H(E) or E from personal monitors under conditions of partial body exposures remains problematic and is likely to require the use of multiple monitors.

Automatic radiation dose monitoring for CT of trauma patients with different protocols: feasibility and accuracy.

PubMed

Higashigaito, K; Becker, A S; Sprengel, K; Simmen, H-P; Wanner, G; Alkadhi, H

2016-09-01

To demonstrate the feasibility and accuracy of automatic radiation dose monitoring software for computed tomography (CT) of trauma patients in a clinical setting over time, and to evaluate the potential of radiation dose reduction using iterative reconstruction (IR). In a time period of 18 months, data from 378 consecutive thoraco-abdominal CT examinations of trauma patients were extracted using automatic radiation dose monitoring software, and patients were split into three cohorts: cohort 1, 64-section CT with filtered back projection, 200 mAs tube current-time product; cohort 2, 128-section CT with IR and identical imaging protocol; cohort 3, 128-section CT with IR, 150 mAs tube current-time product. Radiation dose parameters from the software were compared with the individual patient protocols. Image noise was measured and image quality was semi-quantitatively determined. Automatic extraction of radiation dose metrics was feasible and accurate in all (100%) patients. All CT examinations were of diagnostic quality. There were no differences between cohorts 1 and 2 regarding volume CT dose index (CTDIvol; p=0.62), dose-length product (DLP), and effective dose (ED, both p=0.95), while noise was significantly lower (chest and abdomen, both -38%, p<0.017). Compared to cohort 1, CTDIvol, DLP, and ED in cohort 3 were significantly lower (all -25%, p<0.017), similar to the noise in the chest (-32%) and abdomen (-27%, both p<0.017). Compared to cohort 2, CTDIvol (-28%), DLP, and ED (both -26%) in cohort 3 was significantly lower (all, p<0.017), while noise in the chest (+9%) and abdomen (+18%) was significantly higher (all, p<0.017). Automatic radiation dose monitoring software is feasible and accurate, and can be implemented in a clinical setting for evaluating the effects of lowering radiation doses of CT protocols over time. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Prescription histories and dose strengths associated with overdose deaths.

PubMed

Hirsch, Anne; Proescholdbell, Scott K; Bronson, William; Dasgupta, Nabarun

2014-07-01

Misuse, abuse, and diversion of prescription drugs are large and growing public health problems that have resulted in an overdose epidemic. We investigated whether short-acting or extended-release opioids were more frequently prescribed to those who died of an overdose and whether there was a linear relationship between dose strength and associated overdose deaths. The study population was North Carolina residents in 2010. We conducted a retrospective, population-based, descriptive study of medication histories of overdose decedents using data from vital statistics, medical examiner records, and a prescription drug monitoring program. Unintentional or undetermined drug overdoses were responsible for 892 deaths. Out of 191 deaths involving methadone, only two were patients in opioid treatment programs. Immediate-release oxycodone was involved in the greatest number of opioid-related deaths. Out of 221 oxycodone deaths, 134 (61%) of the decedents filled a prescription for oxycodone in the 60 days prior to death. The most common strength dispensed within 60 days to a decedent who died of an oxycodone overdose was 10 mg for immediate-release (72 prescriptions). Immediate-release oxycodone products (rho = 1.00, P < 0.01) and extended-release fentanyl products (rho = 1.00, P < 0.01) showed strong increasing linear trends between dose strength and proportion of prescriptions dispensed to decedents. A significant proportion of overdose decedents had been prescribed the same type of drugs that contributed to their death, especially for decedents who died from overdoses involving oxycodone, hydrocodone, and alprazolam. Higher dose strengths for certain opioids had higher associated mortality, and certain immediate-release opioids may be considered for public health prevention efforts.

Estimation of patient-specific imaging dose for real-time tumour monitoring in lung patients during respiratory-gated radiotherapy

NASA Astrophysics Data System (ADS)

Shiinoki, Takehiro; Onizuka, Ryota; Kawahara, Daisuke; Suzuki, Tatsuhiko; Yuasa, Yuki; Fujimoto, Koya; Uehara, Takuya; Hanazawa, Hideki; Shibuya, Keiko

2018-03-01

Purpose: To quantify the patient-specific imaging dose for real-time tumour monitoring in the lung during respiratory-gated stereotactic body radiotherapy (SBRT) in clinical cases using SyncTraX. Methods and Materials: Ten patients who underwent respiratory-gated SBRT with SyncTraX were enrolled in this study. The imaging procedure for real-time tumour monitoring using SyncTraX was simulated using Monte Carlo. We evaluated the dosimetric effect of a real-time tumour monitoring in a critical organ at risk (OAR) and the planning target volume (PTV) over the course of treatment. The relationship between skin dose and gating efficiency was also investigated. Results: For all patients, the mean D50 to the PTV, ipsilateral lung, liver, heart, spinal cord and skin was 118.3 (21.5–175.9), 31.9 (9.5–75.4), 15.4 (1.1–31.6), 10.1 (1.3–18.1), 25.0 (1.6–101.8), and 3.6 (0.9–7.1) mGy, respectively. The mean D2 was 352.0 (26.5–935.8), 146.4 (27.3–226.7), 90.7 (3.6–255.0), 42.2 (4.8–82.7), 88.0 (15.4–248.5), and 273.5 (98.3–611.6) mGy, respectively. The D2 of the skin dose was found to increase as the gating efficiency decreased. Conclusions: The additional dose to the PTV was at most 1.9% of the prescribed dose over the course of treatment for real-time tumour monitoring. For OARs, we could confirm the high dose region, which may not be susceptible to radiation toxicity. However, to reduce the skin dose from SyncTraX, it is necessary to increase the gating efficiency.

Can Digital Tools Be Used for Improving Immunization Programs?

PubMed

Tozzi, Alberto E; Gesualdo, Francesco; D'Ambrosio, Angelo; Pandolfi, Elisabetta; Agricola, Eleonora; Lopalco, Pierluigi

2016-01-01

In order to successfully control and eliminate vaccine-preventable infectious diseases, an appropriate vaccine coverage has to be achieved and maintained. This task requires a high level of effort as it may be compromised by a number of barriers. Public health agencies have issued specific recommendations to address these barriers and therefore improve immunization programs. In the present review, we characterize issues and challenges of immunization programs for which digital tools are a potential solution. In particular, we explore previously published research on the use of digital tools in the following vaccine-related areas: immunization registries, dose tracking, and decision support systems; vaccine-preventable diseases surveillance; surveillance of adverse events following immunizations; vaccine confidence monitoring; and delivery of information on vaccines to the public. Subsequently, we analyze the limits of the use of digital tools in such contexts and envision future possibilities and challenges.

Can Digital Tools Be Used for Improving Immunization Programs?

PubMed Central

Tozzi, Alberto E.; Gesualdo, Francesco; D’Ambrosio, Angelo; Pandolfi, Elisabetta; Agricola, Eleonora; Lopalco, Pierluigi

2016-01-01

In order to successfully control and eliminate vaccine-preventable infectious diseases, an appropriate vaccine coverage has to be achieved and maintained. This task requires a high level of effort as it may be compromised by a number of barriers. Public health agencies have issued specific recommendations to address these barriers and therefore improve immunization programs. In the present review, we characterize issues and challenges of immunization programs for which digital tools are a potential solution. In particular, we explore previously published research on the use of digital tools in the following vaccine-related areas: immunization registries, dose tracking, and decision support systems; vaccine-preventable diseases surveillance; surveillance of adverse events following immunizations; vaccine confidence monitoring; and delivery of information on vaccines to the public. Subsequently, we analyze the limits of the use of digital tools in such contexts and envision future possibilities and challenges. PMID:27014673

Key Factors for a High-Quality Peritoneal Dialysis Program — The Role of the PD Team and Continuous Quality Improvement

PubMed Central

Fang, Wei; Ni, Zhaohui; Qian, Jiaqi

2014-01-01

The proportion of end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) has increased very fast in China over the last decade. Renji Hospital, affiliated with Shanghai Jiaotong University School of Medicine, is a recognized high-quality PD unit with a high PD utilization rate, excellent patient and technique survival (1-year and 5-year patient survival rate of 93% and 71%, and 1-year and 5-year technique survival of 96% and 82%, respectively), low peritonitis rate and a well-documented good quality of life of the treated patients. We believe that a dedicated and experienced PD team, a structured patient training program, continuous patient support, establishing and utilizing standardized protocols, starting PD with low dialysis dose, monitoring key performance indicators (KPIs), and continuous quality improvement (CQI) are the key factors underlying this successful PD program. PMID:24962961

Dose of physical activity, physical functioning and disability risk in mobility-limited older adults: Results from the LIFE study randomized trial

PubMed Central

Guralnik, Jack M.; King, Abby C.; Pahor, Marco; McDermott, Mary M.; Tudor-Locke, Catrine; Manini, Todd M.; Glynn, Nancy W.; Marsh, Anthony P.; Axtell, Robert S.; Hsu, Fang-Chi; Rejeski, W. Jack

2017-01-01

Understanding the minimal dose of physical activity required to achieve improvement in physical functioning and reductions in disability risk is necessary to inform public health recommendations. To examine the effect of physical activity dose on changes in physical functioning and the onset of major mobility disability in The Lifestyle Interventions and Independence for Elders (LIFE) Study. We conducted a multicenter single masked randomized controlled trial that enrolled participants in 2010 and 2011 and followed them for an average of 2.6 years. 1,635 sedentary men and women aged 70–89 years who had functional limitations were randomized to a structured moderate intensity walking, resistance, and flexibility physical activity program or a health education program. Physical activity dose was assessed by 7-day accelerometry and self-report at baseline and 24 months. Outcomes included the 400 m walk gait speed, the Short Physical Performance Battery (SPPB), assessed at baseline, 6, 12, and 24 months, and onset of major mobility disability (objectively defined by loss of ability to walk 400 m in 15 min). When the physical activity arm or the entire sample were stratified by change in physical activity from baseline to 24 months, there was a dose-dependent increase in the change in gait speed and SPPB from baseline at 6, 12, and 24 months. In addition, the magnitude of change in physical activity over 24 months was related to the reduction in the onset of major mobility disability (overall P < 0.001) (highest versus the lowest quartile of physical activity change HR 0.23 ((95% CI:0.10–0.52) P = 0.001) in the physical activity arm. We observed a dose-dependent effect of objectively monitored physical activity on physical functioning and onset of major mobility disability. Relatively small increases (> 48 minutes per week) in regular physical activity participation had significant and clinically meaningful effects on these outcomes. Trial registration: ClinicalsTrials.gov NCT00116194 PMID:28820909

Dose of physical activity, physical functioning and disability risk in mobility-limited older adults: Results from the LIFE study randomized trial.

PubMed

Fielding, Roger A; Guralnik, Jack M; King, Abby C; Pahor, Marco; McDermott, Mary M; Tudor-Locke, Catrine; Manini, Todd M; Glynn, Nancy W; Marsh, Anthony P; Axtell, Robert S; Hsu, Fang-Chi; Rejeski, W Jack

2017-01-01

Understanding the minimal dose of physical activity required to achieve improvement in physical functioning and reductions in disability risk is necessary to inform public health recommendations. To examine the effect of physical activity dose on changes in physical functioning and the onset of major mobility disability in The Lifestyle Interventions and Independence for Elders (LIFE) Study. We conducted a multicenter single masked randomized controlled trial that enrolled participants in 2010 and 2011 and followed them for an average of 2.6 years. 1,635 sedentary men and women aged 70-89 years who had functional limitations were randomized to a structured moderate intensity walking, resistance, and flexibility physical activity program or a health education program. Physical activity dose was assessed by 7-day accelerometry and self-report at baseline and 24 months. Outcomes included the 400 m walk gait speed, the Short Physical Performance Battery (SPPB), assessed at baseline, 6, 12, and 24 months, and onset of major mobility disability (objectively defined by loss of ability to walk 400 m in 15 min). When the physical activity arm or the entire sample were stratified by change in physical activity from baseline to 24 months, there was a dose-dependent increase in the change in gait speed and SPPB from baseline at 6, 12, and 24 months. In addition, the magnitude of change in physical activity over 24 months was related to the reduction in the onset of major mobility disability (overall P < 0.001) (highest versus the lowest quartile of physical activity change HR 0.23 ((95% CI:0.10-0.52) P = 0.001) in the physical activity arm. We observed a dose-dependent effect of objectively monitored physical activity on physical functioning and onset of major mobility disability. Relatively small increases (> 48 minutes per week) in regular physical activity participation had significant and clinically meaningful effects on these outcomes. ClinicalsTrials.gov NCT00116194.

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

SU-F-T-266: Dynalogs Based Evaluation of Different Dose Rate IMRT Using DVH and Gamma Index

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

Ahmed, S; Ahmed, S; Ahmed, F

2016-06-15

Purpose: This work investigates the impact of low and high dose rate on IMRT through Dynalogs by evaluating Gamma Index and Dose Volume Histogram. Methods: The Eclipse™ treatment planning software was used to generate plans on prostate and head and neck sites. A range of dose rates 300 MU/min and 600 MU/min were applied to each plan in order to investigate their effect on the beam ON time, efficiency and accuracy. Each plan had distinct monitor units per fraction, delivery time, mean dose rate and leaf speed. The DVH data was used in the assessment of the conformity and planmore » quality.The treatments were delivered on Varian™ Clinac 2100C accelerator equipped with 120 leaf millennium MLC. Dynalogs of each plan were analyzed by MATLAB™ program. Fluence measurements were performed using the Sun Nuclear™ 2D diode array and results were assessed, based on Gamma analysis of dose fluence maps, beam delivery statistics and Dynalogs data. Results: Minor differences found by adjusted R-squared analysis of DVH’s for all the plans with different dose rates. It has been also found that more and larger fields have greater time reduction at high dose rate and there was a sharp decrease in number of control points observed in dynalog files by switching dose rate from 300 MU/min to 600 MU/min. Gamma Analysis of all plans passes the confidence limit of ≥95% with greater number of passing points in 300 MU/min dose rate plans. Conclusion: The dynalog files are compatible tool for software based IMRT QA. It can work perfectly parallel to measurement based QA setup and stand-by procedure for pre and post delivery of treatment plan.« less

The impact of a multidisciplinary information technology-supported program on blood pressure control in primary care.

PubMed

Rinfret, Stéphane; Lussier, Marie-Thérèse; Peirce, Anthony; Duhamel, Fabie; Cossette, Sylvie; Lalonde, Lyne; Tremblay, Chantal; Guertin, Marie-Claude; LeLorier, Jacques; Turgeon, Jacques; Hamet, Pavel

2009-05-01

Hypertension is a leading mortality risk factor yet inadequately controlled in most affected subjects. Effective programs to address this problem are lacking. We hypothesized that an information technology-supported management program could help improve blood pressure (BP) control. This randomized controlled trial included 223 primary care hypertensive subjects with mean 24-hour BP >130/80 and daytime BP >135/85 mm Hg measured with ambulatory monitoring (ABPM). Intervention subjects received a BP monitor and access to an information technology-supported adherence and BP monitoring system providing nurses, pharmacists, and physicians with monthly reports. Control subjects received usual care. The mean (+/-SD) follow-up was 348 (+/-78) and 349 (+/-84) days in the intervention and control group, respectively. The primary end point of the change in the mean 24-hour ambulatory BP was consistently greater in intervention subjects for both systolic (-11.9 versus -7.1 mm Hg; P<0.001) and diastolic BP (-6.6 versus -4.5 mm Hg; P=0.007). The proportion of subjects that achieved Canadian Guideline target BP (46.0% versus 28.6%) was also greater in the intervention group (P=0.006). We observed similar BP declines for ABPM and self-recorded home BP suggesting the latter could be an alternative for confirming BP control. The intervention was associated with more physician-driven antihypertensive dose adjustments or changes in agents (P=0.03), more antihypertensive classes at study end (P=0.007), and a trend toward improved adherence measured by prescription refills (P=0.07). This multidisciplinary information technology-supported program that provided feedback to patients and healthcare providers significantly improved blood pressure levels in a primary care setting.

Site Environmental Report for Calendar Year 2013. DOE Operations at The Boeing Company, Santa Susana Field Laboratory, Area IV

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

None

2014-06-30

This Annual Site Environmental Report (ASER) for 2013 describes the environmental conditions related to work performed for the Department of Energy (DOE) at Area IV of the Santa Susana Field Laboratory (SSFL). The Energy Technology Engineering Center (ETEC), a government-owned, company-operated test facility, was located in Area IV. The operations in Area IV included development, fabrication, operation and disassembly of nuclear reactors, reactor fuel, and other radioactive materials. Other activities in the area involved the operation of large-scale liquid metal facilities that were used for testing non-nuclear liquid metal fast breeder reactor components. All nuclear work was terminated in 1988,more » and all subsequent radiological work has been directed toward environmental restoration and decontamination and decommissioning (D&D) of the former nuclear facilities and their associated sites. Liquid metal research and development ended in 2002. Since May 2007, the D&D operations in Area IV have been suspended by the DOE, but the environmental monitoring and characterization programs have continued. Results of the radiological monitoring program for the calendar year 2013 continue to indicate that there are no significant releases of radioactive material from Area IV of SSFL. All potential exposure pathways are sampled and/or monitored, including air, soil, surface water, groundwater, direct radiation, transfer of property (land, structures, waste), and recycling. Due to the suspension of D&D activities in Area IV, no effluents were released into the atmosphere during 2013. Therefore, the potential radiation dose to the general public through airborne release was zero. Similarly, the radiation dose to an offsite member of the public (maximally exposed individual) due to direct radiation from SSFL is indistinguishable from background. All radioactive wastes are processed for disposal at DOE disposal sites and/or other licensed sites approved by DOE for radioactive waste disposal. No liquid radioactive wastes were released into the environment in 2013.« less

Real-time measurement and monitoring of absorbed dose for electron beams

NASA Astrophysics Data System (ADS)

Korenev, Sergey; Korenev, Ivan; Rumega, Stanislav; Grossman, Leon

2004-09-01

The real-time method and system for measurement and monitoring of absorbed dose for industrial and research electron accelerators is considered in the report. The system was created on the basis of beam parameters method. The main concept of this method consists in the measurement of dissipated kinetic energy of electrons in the irradiated product, determination of number of electrons and mass of irradiated product in the same cell by following calculation of absorbed dose in the cell. The manual and automation systems for dose measurements are described. The systems are acceptable for all types of electron accelerators.

USING THE HERMITE POLYNOMIALS IN RADIOLOGICAL MONITORING NETWORKS.

PubMed

Benito, G; Sáez, J C; Blázquez, J B; Quiñones, J

2018-03-15

The most interesting events in Radiological Monitoring Network correspond to higher values of H*(10). The higher doses cause skewness in the probability density function (PDF) of the records, which there are not Gaussian anymore. Within this work the probability of having a dose >2 standard deviations is proposed as surveillance of higher doses. Such probability is estimated by using the Hermite polynomials for reconstructing the PDF. The result is that the probability is ~6 ± 1%, much >2.5% corresponding to Gaussian PDFs, which may be of interest in the design of alarm level for higher doses.

Blood cell transcriptomic-based early biomarkers of adverse programming effects of gestational calorie restriction and their reversibility by leptin supplementation

PubMed Central

Konieczna, Jadwiga; Sánchez, Juana; Palou, Mariona; Picó, Catalina; Palou, Andreu

2015-01-01

The challenge of preventing major chronic diseases requires reliable, early biomarkers. Gestational mild undernutrition in rats is enough to program the offspring to develop later pathologies; the intake of leptin, a breastmilk component, during lactation may reverse these programming effects. We used these models to identify, in peripheral blood mononuclear cells (PBMCs), transcriptomic-based early biomarkers of programmed susceptibility to later disorders, and explored their response to neonatal leptin intake. Microarray analysis was performed in PBMCs from the offspring of control and 20% gestational calorie-restricted dams (CR), and CR-rats supplemented with physiological doses of leptin throughout lactation. Notably, leptin supplementation normalised 218 of the 224 mRNA-levels identified in PBMCs associated to undernutrition during pregnancy. These markers may be useful for early identification and subsequent monitoring of individuals who are at risk of later diseases and would specifically benefit from the intake of appropriate amounts of leptin during lactation. PMID:25766068

Methods and Models of the Hanford Internal Dosimetry Program, PNNL-MA-860

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

Carbaugh, Eugene H.; Bihl, Donald E.; Maclellan, Jay A.

2009-09-30

The Hanford Internal Dosimetry Program (HIDP) provides internal dosimetry support services for operations at the Hanford Site. The HIDP is staffed and managed by the Radiation and Health Technology group, within the Pacific Northwest National Laboratory (PNNL). Operations supported by the HIDP include research and development, the decontamination and decommissioning of facilities formerly used to produce and purify plutonium, and waste management activities. Radioelements of particular interest are plutonium, uranium, americium, tritium, and the fission and activation product radionuclides 137Cs, 90Sr, and 60Co. This manual describes the technical basis for the design of the routine bioassay monitoring program and formore » assessment of internal dose. The purposes of the manual are as follows: • Provide assurance that the HIDP derives from a sound technical base. • Promote the consistency and continuity of routine program activities. • Provide a historical record. • Serve as a technical reference for radiation protection personnel. • Aid in identifying and planning for future needs.« less

Normalization of urinary drug concentrations with specific gravity and creatinine.

PubMed

Cone, Edward J; Caplan, Yale H; Moser, Frank; Robert, Tim; Shelby, Melinda K; Black, David L

2009-01-01

Excessive fluid intake can substantially dilute urinary drug concentrations and result in false-negative reports for drug users. Methods for correction ("normalization") of drug/metabolite concentrations in urine have been utilized by anti-doping laboratories, pain monitoring programs, and in environmental monitoring programs to compensate for excessive hydration, but such procedures have not been used routinely in workplace, legal, and treatment settings. We evaluated two drug normalization procedures based on specific gravity and creatinine. These corrections were applied to urine specimens collected from three distinct groups (pain patients, heroin users, and marijuana/ cocaine users). Each group was unique in characteristics, study design, and dosing conditions. The results of the two normalization procedures were highly correlated (r=0.94; range, 0.78-0.99). Increases in percent positives by specific gravity and creatinine normalization were small (0.3% and -1.0%, respectively) for heroin users (normally hydrated subjects), modest (4.2-9.8%) for pain patients (unknown hydration state), and substantial (2- to 38-fold increases) for marijuana/cocaine users (excessively hydrated subjects). Despite some limitations, these normalization procedures provide alternative means of dealing with highly dilute, dilute, and concentrated urine specimens. Drug/metabolite concentration normalization by these procedures is recommended for urine testing programs, especially as a means of coping with dilute specimens.

Monitoring Effective Doses Received By Air Crews With A Space Weather Application

NASA Astrophysics Data System (ADS)

Lantos, P.

To fulfil new requirements of the European Community concerning monitoring of effective doses received by air crews, the French Aviation Authority has developed an operational system called Sievert. The SIEVERT system is analysed as an exam- ple of Space Weather application. One of its characteristics is to calculate the dose received on-board each flight on the basis of the specific and detailled flight given by companies. Operational models will be used. As input to the models, the system needs monitoring of galactic cosmic rays and of solar flare particles. The French neu- tron monitors located in Kerguelen Islands (South Indian Ocean) and Terre Adélie (Antarctica) will be used for this purpose. Particular attention will be devoted to evo- lution of the system in conjunction with new measurements available in the frame of a permanent validation process.

Worker Alienation and Compensation at the Savannah River Site.

PubMed

Ashwood, Loka; Wing, Steve

2016-05-01

Corporations operating U.S. nuclear weapons plants for the federal government began tracking occupational exposures to ionizing radiation in 1943. However, workers, scholars, and policy makers have questioned the accuracy and completeness of radiation monitoring and its capacity to provide a basis for workers' compensation. We use interviews to explore the limitations of broad-scale, corporate epidemiological surveillance through worker accounts from the Savannah River Site nuclear weapons plant. Interviewees report inadequate monitoring, overbearing surveillance, limited venues to access medical support and exposure records, and administrative failure to report radiation and other exposures at the plant. The alienation of workers from their records and toil is relevant to worker compensation programs and the accuracy of radiation dose measurements used in epidemiologic studies of occupational radiation exposures at the Savannah River Site and other weapons plants. © The Author(s) 2016.

Self-Monitoring in Weight Loss: A Systematic Review of the Literature

PubMed Central

Wang, Jing; Sevick, Mary Ann

2011-01-01

Self-monitoring is the centerpiece of behavioral weight loss intervention programs. This article presents a systematic review of the literature on three components of self-monitoring in behavioral weight loss studies: diet, exercise and self-weighing. This review included articles that were published between 1993 and 2009 that reported on the relationship between weight loss and these self-monitoring strategies. Of the 22 studies identified, 14 focused on dietary self-monitoring, one on self-monitoring exercise and six on self-weighing. A wide array of methods was used to perform self-monitoring; the paper diary was used most often. Adherence to self-monitoring was reported most frequently as the number of diaries completed or the frequency of log-ins or reported weights. The use of technology, which included the Internet, personal digital assistants and electronic digital scales were reported in five studies. Descriptive designs were used in the earlier studies while more recent reports involved prospective studies and randomized trials that examined the effect of self-monitoring on weight loss. A significant association between self-monitoring and weight loss was consistently found; however, the level of evidence was weak because of methodological limitations. The most significant limitations of the reviewed studies were the homogenous samples and reliance on self-report. In all but two studies, the samples were predominantly White and female. This review highlights the need for studies in more diverse populations, for objective measures of adherence to self-monitoring, and for studies that establish the required dose of self-monitoring for successful outcomes. PMID:21185970

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

Anderson, J.; Lee, H.; De Lurgio, P.

Automated monitoring and tracking of materials with radio frequency identification (RFID) technology can significantly improve both the operating efficiency of radiological facilities and the application of the ALARA (as low as reasonably achievable) principle in them. One such system, called ARG-US, has been developed by Argonne National Laboratory for the U.S. Department of Energy (DOE) Packaging and Certification Program to use in managing sensitive nuclear and radioactive materials. Several ARG-US systems are in various stages of deployment and advanced testing across DOE sites. ARG-US utilizes sensors in the tags to continuously monitor the state of health of the packaging andmore » promptly disseminates alarms to authorized users. In conjunction with global positioning system (GPS) tracking provided by TRANSCOM, the system can also monitor and track packages during transport. A compact dosimeter has been incorporated in the ARG-US tags via an onboard universal asynchronous receiver/transmitter interface. The detector has a wide measurement range for gamma radiation - from 0.1 mSv/h to 8 Sv/h. The detector is able to generate alarms for both high and low radiation and for a high cumulative dose. In a large installation, strategically located dosimeter-enabled tags can yield an accurate, real-time, 2D or 3D dose field map that can be used to enhance facility safety, security, and safeguards. This implementation can also lead to a reduced need for manned surveillance and reduced exposure of personnel to radiation, consistent with the ALARA principle at workplaces. (authors)« less

High sensitivity charge amplifier for ion beam uniformity monitor

DOEpatents

Johnson, Gary W.

2001-01-01

An ion beam uniformity monitor for very low beam currents using a high-sensitivity charge amplifier with bias compensation. The ion beam monitor is used to assess the uniformity of a raster-scanned ion beam, such as used in an ion implanter, and utilizes four Faraday cups placed in the geometric corners of the target area. Current from each cup is integrated with respect to time, thus measuring accumulated dose, or charge, in Coulombs. By comparing the dose at each corner, a qualitative assessment of ion beam uniformity is made possible. With knowledge of the relative area of the Faraday cups, the ion flux and areal dose can also be obtained.

TH-EF-BRB-04: 4π Dynamic Conformal Arc Therapy Dynamic Conformal Arc Therapy (DCAT) for SBRT

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

Chiu, T; Long, T; Tian, Z.

2016-06-15

Purpose: To develop an efficient and effective trajectory optimization methodology for 4π dynamic conformal arc treatment (4π DCAT) with synchronized gantry and couch motion; and to investigate potential clinical benefits for stereotactic body radiation therapy (SBRT) to breast, lung, liver and spine tumors. Methods: The entire optimization framework for 4π DCAT inverse planning consists of two parts: 1) integer programming algorithm and 2) particle swarm optimization (PSO) algorithm. The integer programming is designed to find an optimal solution for arc delivery trajectory with both couch and gantry rotation, while PSO minimize a non-convex objective function based on the selected trajectorymore » and dose-volume constraints. In this study, control point interaction is explicitly taken into account. Beam trajectory was modeled as a series of control points connected together to form a deliverable path. With linear treatment planning objectives, a mixed-integer program (MIP) was formulated. Under mild assumptions, the MIP is tractable. Assigning monitor units to control points along the path can be integrated into the model and done by PSO. The developed 4π DCAT inverse planning strategy is evaluated on SBRT cases and compared to clinically treated plans. Results: The resultant dose distribution of this technique was evaluated between 3D conformal treatment plan generated by Pinnacle treatment planning system and 4π DCAT on a lung SBRT patient case. Both plans share the same scale of MU, 3038 and 2822 correspondingly to 3D conformal plan and 4π DCAT. The mean doses for most of OARs were greatly reduced at 32% (cord), 70% (esophagus), 2.8% (lung) and 42.4% (stomach). Conclusion: Initial results in this study show the proposed 4π DCAT treatment technique can achieve better OAR sparing and lower MUs, which indicates that the developed technique is promising for high dose SBRT to reduce the risk of secondary cancer.« less

42 CFR 82.10 - Overview of the dose reconstruction process.

Code of Federal Regulations, 2011 CFR

2011-10-01

... doses using techniques discussed in § 82.16. Once the resulting data set is complete, NIOSH will.... Additionally, NIOSH may compile data, and information from NIOSH records that may contribute to the dose... which dose and exposure monitoring data is incomplete or insufficient for dose reconstruction. (h) NIOSH...

42 CFR 82.10 - Overview of the dose reconstruction process.

Code of Federal Regulations, 2012 CFR

2012-10-01

... doses using techniques discussed in § 82.16. Once the resulting data set is complete, NIOSH will.... Additionally, NIOSH may compile data, and information from NIOSH records that may contribute to the dose... which dose and exposure monitoring data is incomplete or insufficient for dose reconstruction. (h) NIOSH...

42 CFR 82.10 - Overview of the dose reconstruction process.

Code of Federal Regulations, 2014 CFR

2014-10-01

... doses using techniques discussed in § 82.16. Once the resulting data set is complete, NIOSH will.... Additionally, NIOSH may compile data, and information from NIOSH records that may contribute to the dose... which dose and exposure monitoring data is incomplete or insufficient for dose reconstruction. (h) NIOSH...

42 CFR 82.10 - Overview of the dose reconstruction process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... doses using techniques discussed in § 82.16. Once the resulting data set is complete, NIOSH will.... Additionally, NIOSH may compile data, and information from NIOSH records that may contribute to the dose... which dose and exposure monitoring data is incomplete or insufficient for dose reconstruction. (h) NIOSH...

42 CFR 82.10 - Overview of the dose reconstruction process.

Code of Federal Regulations, 2013 CFR

2013-10-01

... doses using techniques discussed in § 82.16. Once the resulting data set is complete, NIOSH will.... Additionally, NIOSH may compile data, and information from NIOSH records that may contribute to the dose... which dose and exposure monitoring data is incomplete or insufficient for dose reconstruction. (h) NIOSH...

Prescribing patterns and the use of therapeutic drug monitoring of psychotropic medication in a psychiatric high-security unit.

PubMed

Castberg, Ingrid; Spigset, Olav

2008-10-01

The aim of this study was to investigate the use of psychotropic medication and therapeutic drug monitoring in a high-security psychiatric unit and to compare the doses and serum concentrations both with the recommended intervals and with the doses and serum concentrations in a control group. One hundred thirty-two patients were admitted in the period from January 2000 to December 2005. All available samples were used when comparing serum concentrations and doses with the recommended ranges. For the comparison of doses and serum concentration-to-dose (C:D) ratios with the control group only 1 sample from each patient was used. A total of 459 analyses of 27 different drugs in samples from 8 women and 73 men were included. The median number of therapeutic drug monitoring analyses per patient was 4 (range 1-29). Thirty-seven of the 81 patients (46%) used 2 or more antipsychotics at the same time. Clozapine, lamotrigine, olanzapine, quetiapine, ziprasidone, and zuclopenthixol were often given in doses above the recommended. The serum levels were frequently above those recommended for clozapine, olanzapine, quetiapine, risperidone, ziprasidone, and zuclopenthixol. The serum levels were significantly higher in the study group than in the control group for clozapine, lamotrigine, quetiapine, and zuclopenthixol. The given dose was significantly higher in the study group than in the control group for clozapine, lamotrigine and zuclopenthixol. The C:D ratio was significantly lower in the study group than in the control group for olanzapine but higher for quetiapine. The non-evidence based practice of high-dose polypharmacy with several antipsychotics is widely used in this unit. The use of higher doses in the study group than in the control group was not due to differences in metabolism or adherence to treatment between the 2 groups. The frequent use of therapeutic drug monitoring did not seem to have a great impact on the prescribed doses.

UV dose measurements of photosensitive dermatosis patients by polycrystalline GaN-based portable self-data-acquisition UV monitors.

PubMed

Yagi, Shigeru; Iwanaga, Takeshi; Kojima, Hiroshi; Shoji, Yoshio; Suzuki, Seiji; Seno, Kunihiro; Mori, Hisayoshi; Tokura, Yoshiki; Takigawa, Masahiro; Moriwaki, Shin-Ichi

2002-12-01

We have developed a UV monitor with polycrystalline (poly-) gallium nitride (GaN) UV sensors and evaluated its performance from the viewpoint of its effectiveness for use with photosensitive dermatosis patients. The poly-GaN UV sensor is sensitive to UV light from 280 to 410 nm even without optical filters. The UV monitor is a portable self-data-acquisition instrument with a minimum detection level (defined as average UV intensity over 290 to 400 nm) of 2 microW/cm2 and can store UV dose data for 128 days. It allows easy measurement of four orders of magnitude of ambient UV intensity and dose from indoor light to direct solar radiation in summer. Trial use of the UV monitor by five xeroderma pigmentosum patients started in June 2000 and was carried out for 1 year. It was demonstrated that the UV monitor was useful in improving their quality of life.

Environmental monitoring, restoration and assessment: What have we learned

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

Gray, R.H.

1990-01-01

The Twenty-Eighth Hanford Symposium on Health and the Environment was held in Richland, Washington, October 16--19, 1989. The symposium was sponsored by the US Department of Energy and the Pacific Northwest Laboratory, operated by Battelle Memorial Institute. The symposium was organized to review and evaluate some of the monitoring and assessment programs that have been conducted or are currently in place. Potential health and environmental effects of energy-related and other industrial activities have been monitored and assessed at various government and private facilities for over three decades. Most monitoring is required under government regulations; some monitoring is implemented because facilitymore » operators consider it prudent practice. As a result of these activities, there is now a substantial radiological, physical, and chemical data base for various environmental components, both in the United States and abroad. Symposium participants, both platform and poster presenters, were asked to consider, among other topics, the following: Has the expenditure of millions of dollars for radiological monitoring and assessment activities been worth the effort How do we decide when enough monitoring is enough Can we adequately assess the impacts of nonradiological components -- both inorganic and organic -- of wastes Are current regulatory requirements too restrictive or too lenient Can monitoring and assessment be made more cost effective Papers were solicited in the areas of environmental monitoring; environmental regulations; remediation, restoration, and decommissioning; modeling and dose assessment; uncertainty, design, and data analysis; and data management and quality assurance. Individual reports are processed separately for the databases.« less

Annual radiological environmental operating report, Browns Ferry Nuclear Plant, 1991

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

Not Available

1992-04-01

This report describes the environmental radiological monitoring program conducted by TVA in the vicinity of Browns Ferry Nuclear Plant in 1991. The program includes the collection of samples from the environment and the determination of the concentrations of radioactive materials in the samples. Samples are taken from stations in the general area of the plant and from areas not influenced by plant operations. Station locations are selected after careful consideration of the weather patterns and projected radiation doses to the various areas around the plant. Material sampled includes air, water, milk, foods, vegetation, soil, fish, sediment, and direct radiation levels.more » Results from stations near the plant are compared with concentrations from control stations and with preoperational measurements to determine potential impacts of plant operations.« less

Repeated sugammadex reversal of muscle relaxation during lumbar spine surgery with intraoperative neurophysiological multimodal monitoring.

PubMed

Errando, C L; Blanco, T; Díaz-Cambronero, Ó

2016-11-01

Intraoperative neurophysiological monitoring during spine surgery is usually acomplished avoiding muscle relaxants. A case of intraoperative sugammadex partial reversal of the neuromuscular blockade allowing adequate monitoring during spine surgery is presented. A 38 year-old man was scheduled for discectomy and vertebral arthrodesis throughout anterior and posterior approaches. Anesthesia consisted of total intravenous anesthesia plus rocuronium. Intraoperatively monitoring was needed, and the muscle relaxant reverted twice with low dose sugammadex in order to obtain adequate responses. The doses of sugammadex used were conservatively selected (0.1mg/kg boluses increases, total dose needed 0.4mg/kg). Both motor evoqued potentials, and electromyographic responses were deemed adequate by the neurophysiologist. If muscle relaxation was needed in the context described, this approach could be useful to prevent neurological sequelae. This is the first study using very low dose sugammadex to reverse rocuronium intraoperatively and to re-establish the neuromuscular blockade. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Characteristics and verification of a car-borne survey system for dose rates in air: KURAMA-II.

PubMed

Tsuda, S; Yoshida, T; Tsutsumi, M; Saito, K

2015-01-01

The car-borne survey system KURAMA-II, developed by the Kyoto University Research Reactor Institute, has been used for air dose rate mapping after the Fukushima Dai-ichi Nuclear Power Plant accident. KURAMA-II consists of a CsI(Tl) scintillation detector, a GPS device, and a control device for data processing. The dose rates monitored by KURAMA-II are based on the G(E) function (spectrum-dose conversion operator), which can precisely calculate dose rates from measured pulse-height distribution even if the energy spectrum changes significantly. The characteristics of KURAMA-II have been investigated with particular consideration to the reliability of the calculated G(E) function, dose rate dependence, statistical fluctuation, angular dependence, and energy dependence. The results indicate that 100 units of KURAMA-II systems have acceptable quality for mass monitoring of dose rates in the environment. Copyright © 2014 Elsevier Ltd. All rights reserved.

Design of early warning system for nuclear preparedness case study at Serpong

NASA Astrophysics Data System (ADS)

Farid, M. M.; Prawito, Susila, I. P.; Yuniarto, A.

2017-07-01

One effort to protect the environment from the increasing of potentially environmental radiation hazards as an impact of radiation discharge around nuclear facilities is by a continuous monitoring of the environmental radiation in real time It is important to disclose the dose rate information to public or authorities for radiological protection. In this research, we have designed a nuclear preparedness early warning system around the Serpong nuclear facility. The design is based on Arduino program, general packet radio service (GPRS) shield, and radio frequencies technology to transmit environmental radiation result of the measurement and meteorological data. Data was collected at a certain location at The Center for Informatics and Nuclear Strategic Zone Utilization BATAN Serpong. The system consistency models are defined by the quality of data and the level of radiation exposure in the deployed environment. Online users can access the website which displays the radiation dose on the environment marked on Google Map. This system is capable to issue an early warning emergency when the dose reaches three times of the background radiation exposure value, 250 nSv/hour.

Improving contraceptive choice: fidelity of implementation and the gap between effectiveness and efficacy.

PubMed

Garbers, Samantha; Flandrick, Kathleen; Bermudez, Dayana; Meserve, Allison; Chiasson, Mary Ann

2014-11-01

Interventions to reduce unintended pregnancy through improved contraceptive use are a public health priority. A comprehensive process evaluation of a contraceptive assessment module intervention with demonstrated efficacy was undertaken. The 12-month process evaluation goal was to describe the extent to which the intervention was implemented as intended over time, and to identify programmatic adjustments to improve implementation fidelity. Quantitative and qualitative methods included staff surveys, electronic health record data, usage monitoring, and observations. Fidelity of implementation was low overall (<10% of eligible patients completed the entire module [dose received]). Although a midcourse correction making the module available in clinical areas led to increased dose delivered (23% vs. 30%, chi-square test p = .006), dose received did not increase significantly after this adjustment. Contextual factors including competing organizational and staff priorities and staff buy-in limited the level of implementation and precluded adoption of some strategies such as adjusting patient flow. Using a process evaluation framework enabled the research team to identify and address complexities inherent in effectiveness studies and facilitated the alignment of program and context. © 2014 Society for Public Health Education.

Whole-body to tissue concentration ratios for use in biota dose assessments for animals.

PubMed

Yankovich, Tamara L; Beresford, Nicholas A; Wood, Michael D; Aono, Tasuo; Andersson, Pål; Barnett, Catherine L; Bennett, Pamela; Brown, Justin E; Fesenko, Sergey; Fesenko, J; Hosseini, Ali; Howard, Brenda J; Johansen, Mathew P; Phaneuf, Marcel M; Tagami, Keiko; Takata, Hyoe; Twining, John R; Uchida, Shigeo

2010-11-01

Environmental monitoring programs often measure contaminant concentrations in animal tissues consumed by humans (e.g., muscle). By comparison, demonstration of the protection of biota from the potential effects of radionuclides involves a comparison of whole-body doses to radiological dose benchmarks. Consequently, methods for deriving whole-body concentration ratios based on tissue-specific data are required to make best use of the available information. This paper provides a series of look-up tables with whole-body:tissue-specific concentration ratios for non-human biota. Focus was placed on relatively broad animal categories (including molluscs, crustaceans, freshwater fishes, marine fishes, amphibians, reptiles, birds and mammals) and commonly measured tissues (specifically, bone, muscle, liver and kidney). Depending upon organism, whole-body to tissue concentration ratios were derived for between 12 and 47 elements. The whole-body to tissue concentration ratios can be used to estimate whole-body concentrations from tissue-specific measurements. However, we recommend that any given whole-body to tissue concentration ratio should not be used if the value falls between 0.75 and 1.5. Instead, a value of one should be assumed.

Radiological operational scenario for a permanent lunar base

NASA Astrophysics Data System (ADS)

McCormack, Percival D.

An operational scenario for a lunar base is postulated based on 30 lunar base personnel and 2 year tours of duty plus stipulated numbers of EVA's and sorties in the lunar rover vehicles. It is also postulated that the main shielding material for the lunar base units (habitats, laboratories, etc.) will be lunar regolith. Using the solar minimum period as the basis, total accumulated dose equivalents for the galactic cosmic radiation over the two year period are computed at various shielding depths. Depths of regolith of over 20 g/sq cm are sufficient to reduce the total dose equivalents to well under the present limits. The second arm of the radiological health strategy -- continuous and all-encompassing radiation dosimetry -- is also discussed in some detail. It is also emphasized that monitoring of the base personnel for genetic mutations and chromosomal aberrations must be part of the radiological health program in the lunar base.

Compliance with occlusion therapy for childhood amblyopia.

PubMed

Wallace, Michael P; Stewart, Catherine E; Moseley, Merrick J; Stephens, David A; Fielder, Alistair R

2013-09-17

Explore compliance with occlusion treatment of amblyopia in the Monitored and Randomized Occlusion Treatment of Amblyopia Studies (MOTAS and ROTAS), using objective monitoring. Both studies had a three-phase protocol: initial assessment, refractive adaptation, and occlusion. In the occlusion phase, participants were instructed to dose for 6 hours/day (MOTAS) or randomized to 6 or 12 hour/day (ROTAS). Dose was monitored continuously using an occlusion dose monitor (ODM). One hundred and fifty-two patients (71 male, 81 female; 122 Caucasian, 30 non-Caucasian) of mean ± SD age 68 ± 18 months participated. Amblyopia was defined as an interocular acuity difference of at least 0.1 logMAR and was associated with anisometropia in 50, strabismus in 44, and both (mixed) in 58. Median duration of occlusion was 99 days (interquartile range 72 days). Mean compliance was 44%, mean proportion of days with no patch worn was 42%. Compliance was lower (39%) on weekends compared with weekdays (46%, P = 0.04), as was the likelihood of dosing at all (52% vs. 60%, P = 0.028). Compliance was lower when attendance was less frequent (P < 0.001) and with prolonged treatment duration (P < 0.001). Age, sex, amblyopia type, and severity were not associated with compliance. Mixture modeling suggested three subpopulations of patch day doses: less than 30 minutes; doses that achieve 30% to 80% compliance; and doses that achieve around 100% compliance. This study shows that compliance with patching treatment averages less than 50% and is influenced by several factors. A greater understanding of these influences should improve treatment outcome. (ClinicalTrials.gov number, NCT00274664).

American Society of Interventional Pain Physicians (ASIPP) guidelines for responsible opioid prescribing in chronic non-cancer pain: Part 2--guidance.

PubMed

Manchikanti, Laxmaiah; Abdi, Salahadin; Atluri, Sairam; Balog, Carl C; Benyamin, Ramsin M; Boswell, Mark V; Brown, Keith R; Bruel, Brian M; Bryce, David A; Burks, Patricia A; Burton, Allen W; Calodney, Aaron K; Caraway, David L; Cash, Kimberly A; Christo, Paul J; Damron, Kim S; Datta, Sukdeb; Deer, Timothy R; Diwan, Sudhir; Eriator, Ike; Falco, Frank J E; Fellows, Bert; Geffert, Stephanie; Gharibo, Christopher G; Glaser, Scott E; Grider, Jay S; Hameed, Haroon; Hameed, Mariam; Hansen, Hans; Harned, Michael E; Hayek, Salim M; Helm, Standiford; Hirsch, Joshua A; Janata, Jeffrey W; Kaye, Alan D; Kaye, Adam M; Kloth, David S; Koyyalagunta, Dhanalakshmi; Lee, Marion; Malla, Yogesh; Manchikanti, Kavita N; McManus, Carla D; Pampati, Vidyasagar; Parr, Allan T; Pasupuleti, Ramarao; Patel, Vikram B; Sehgal, Nalini; Silverman, Sanford M; Singh, Vijay; Smith, Howard S; Snook, Lee T; Solanki, Daneshvari R; Tracy, Deborah H; Vallejo, Ricardo; Wargo, Bradley W

2012-07-01

Part 2 of the guidelines on responsible opioid prescribing provides the following recommendations for initiating and maintaining chronic opioid therapy of 90 days or longer. 1. A) Comprehensive assessment and documentation is recommended before initiating opioid therapy, including documentation of comprehensive history, general medical condition, psychosocial history, psychiatric status, and substance use history. ( good) B) Despite limited evidence for reliability and accuracy, screening for opioid use is recommended, as it will identify opioid abusers and reduce opioid abuse. ( limited) C) Prescription monitoring programs must be implemented, as they provide data on patterns of prescription usage, reduce prescription drug abuse or doctor shopping. ( good to fair) D) Urine drug testing (UDT) must be implemented from initiation along with subsequent adherence monitoring to decrease prescription drug abuse or illicit drug use when patients are in chronic pain management therapy. ( good) 2. A) Establish appropriate physical diagnosis and psychological diagnosis if available prior to initiating opioid therapy. ( good) B) Caution must be exercised in ordering various imaging and other evaluations, interpretation and communication with the patient, to avoid increased fear, activity restriction, requests for increased opioids, and maladaptive behaviors. ( good) C) Stratify patients into one of the 3 risk categories - low, medium, or high risk. D) A pain management consultation, may assist non-pain physicians, if high-dose opioid therapy is utilized. ( fair) 3. Essential to establish medical necessity prior to initiation or maintenance of opioid therapy. ( good) 4. Establish treatment goals of opioid therapy with regard to pain relief and improvement in function. ( good) 5. A) Long-acting opioids in high doses are recommended only in specific circumstances with severe intractable pain that is not amenable to short-acting or moderate doses of long-acting opioids, as there is no significant difference between long-acting and short-acting opioids for their effectiveness or adverse effects. ( fair) B) The relative and absolute contraindications to opioid use in chronic non-cancer pain must be evaluated including respiratory instability, acute psychiatric instability, uncontrolled suicide risk, active or history of alcohol or substance abuse, confirmed allergy to opioid agents, coadministration of drugs capable of inducing life-limiting drug interaction, concomitant use of benzodiazepines, active diversion of controlled substances, and concomitant use of heavy doses of central nervous system depressants. ( fair to limited) 6. A robust agreement which is followed by all parties is essential in initiating and maintaining opioid therapy as such agreements reduce overuse, misuse, abuse, and diversion. ( fair) 7. A) Once medical necessity is established, opioid therapy may be initiated with low doses and short-acting drugs with appropriate monitoring to provide effective relief and avoid side effects. ( fair for short-term effectiveness, limited for long-term effectiveness) B) Up to 40 mg of morphine equivalent is considered as low dose, 41 to 90 mg of morphine equivalent as a moderate dose, and greater than 91 mg of morphine equivalence as high dose. ( fair) C) In reference to long-acting opioids, titration must be carried out with caution and overdose and misuse must be avoided. ( good) 8. A) Methadone is recommended for use in late stages after failure of other opioid therapy and only by clinicians with specific training in the risks and uses. ( limited) B) Monitoring recommendation for methadone prescription is that an electrocardiogram should be obtained prior to initiation, at 30 days and yearly thereafter. ( fair) 9. In order to reduce prescription drug abuse and doctor shopping, adherence monitoring by UDT and PMDPs provide evidence that is essential to the identification of those patients who are non-compliant or abusing prescription drugs or illicit drugs. ( fair) 10. Constipation must be closely monitored and a bowel regimen be initiated as soon as deemed necessary. ( good) 11. Chronic opioid therapy may be continued, with continuous adherence monitoring, in well-selected populations, in conjunction with or after failure of other modalities of treatments with improvement in physical and functional status and minimal adverse effects. ( fair). The guidelines are based on the best available evidence and do not constitute inflexible treatment recommendations. Due to the changing body of evidence, this document is not intended to be a "standard of care."

Error detection capability of a novel transmission detector: a validation study for online VMAT monitoring.

PubMed

Pasler, Marlies; Michel, Kilian; Marrazzo, Livia; Obenland, Michael; Pallotta, Stefania; Björnsgard, Mari; Lutterbach, Johannes

2017-09-01

The purpose of this study was to characterize a new single large-area ionization chamber, the integral quality monitor system (iRT, Germany), for online and real-time beam monitoring. Signal stability, monitor unit (MU) linearity and dose rate dependence were investigated for static and arc deliveries and compared to independent ionization chamber measurements. The dose verification capability of the transmission detector system was evaluated by comparing calculated and measured detector signals for 15 volumetric modulated arc therapy plans. The error detection sensitivity was tested by introducing MLC position and linac output errors. Deviations in dose distributions between the original and error-induced plans were compared in terms of detector signal deviation, dose-volume histogram (DVH) metrics and 2D γ-evaluation (2%/2 mm and 3%/3 mm). The detector signal is linearly dependent on linac output and shows negligible (<0.4%) dose rate dependence up to 460 MU min -1 . Signal stability is within 1% for cumulative detector output; substantial variations were observed for the segment-by-segment signal. Calculated versus measured cumulative signal deviations ranged from  -0.16%-2.25%. DVH, mean 2D γ-value and detector signal evaluations showed increasing deviations with regard to the respective reference with growing MLC and dose output errors; good correlation between DVH metrics and detector signal deviation was found (e.g. PTV D mean : R 2   =  0.97). Positional MLC errors of 1 mm and errors in linac output of 2% were identified with the transmission detector system. The extensive tests performed in this investigation show that the new transmission detector provides a stable and sensitive cumulative signal output and is suitable for beam monitoring during patient treatment.

Error detection capability of a novel transmission detector: a validation study for online VMAT monitoring

NASA Astrophysics Data System (ADS)

Pasler, Marlies; Michel, Kilian; Marrazzo, Livia; Obenland, Michael; Pallotta, Stefania; Björnsgard, Mari; Lutterbach, Johannes

2017-09-01

The purpose of this study was to characterize a new single large-area ionization chamber, the integral quality monitor system (iRT, Germany), for online and real-time beam monitoring. Signal stability, monitor unit (MU) linearity and dose rate dependence were investigated for static and arc deliveries and compared to independent ionization chamber measurements. The dose verification capability of the transmission detector system was evaluated by comparing calculated and measured detector signals for 15 volumetric modulated arc therapy plans. The error detection sensitivity was tested by introducing MLC position and linac output errors. Deviations in dose distributions between the original and error-induced plans were compared in terms of detector signal deviation, dose-volume histogram (DVH) metrics and 2D γ-evaluation (2%/2 mm and 3%/3 mm). The detector signal is linearly dependent on linac output and shows negligible (<0.4%) dose rate dependence up to 460 MU min-1. Signal stability is within 1% for cumulative detector output; substantial variations were observed for the segment-by-segment signal. Calculated versus measured cumulative signal deviations ranged from  -0.16%-2.25%. DVH, mean 2D γ-value and detector signal evaluations showed increasing deviations with regard to the respective reference with growing MLC and dose output errors; good correlation between DVH metrics and detector signal deviation was found (e.g. PTV D mean: R 2  =  0.97). Positional MLC errors of 1 mm and errors in linac output of 2% were identified with the transmission detector system. The extensive tests performed in this investigation show that the new transmission detector provides a stable and sensitive cumulative signal output and is suitable for beam monitoring during patient treatment.

Validation of a metered dose inhaler electronic monitoring device: implications for asthma clinical trial use.

PubMed

Pilcher, Janine; Holliday, Mark; Ebmeier, Stefan; McKinstry, Steve; Messaoudi, Fatiha; Weatherall, Mark; Beasley, Richard

2016-01-01

The SmartTouch Ventolin monitor (Adherium, Auckland, New Zealand) is an electronic monitor for use with a Ventolin metered dose inhaler, which records the date and time of inhaler actuations. This technology has the potential to allow in-depth analysis of patterns of inhaler use in clinical trial settings. The aim of this study was to determine the accuracy of the SmartTouch Ventolin monitor in recording Ventolin actuations. 20 SmartTouch Ventolin monitors were attached to Ventolin metered dose inhalers. Bench testing was performed over a 10-week period, to reflect the potential time frame between visits in a clinical trial. Inhaler actuations were recorded in a paper diary, which was compared with data uploaded from the monitors. 2560 actuations were performed during the 10-week study period. Monitor sensitivity for diary-recorded actuations was 99.9% with a lower 97.5% confidence bound of 99.7%. The positive predictive value for diary-recorded actuations was 100% with a 97.5% lower confidence bound of 99.9%. The SmartTouch Ventolin monitor is highly accurate in recording and retaining electronic data. It can be recommended for use in clinical trial settings in which training and quality control systems are incorporated into study protocols to ensure accurate data acquisition.

Validation of a metered dose inhaler electronic monitoring device: implications for asthma clinical trial use

PubMed Central

Pilcher, Janine; Holliday, Mark; Ebmeier, Stefan; McKinstry, Steve; Messaoudi, Fatiha; Weatherall, Mark; Beasley, Richard

2016-01-01

Background The SmartTouch Ventolin monitor (Adherium, Auckland, New Zealand) is an electronic monitor for use with a Ventolin metered dose inhaler, which records the date and time of inhaler actuations. This technology has the potential to allow in-depth analysis of patterns of inhaler use in clinical trial settings. The aim of this study was to determine the accuracy of the SmartTouch Ventolin monitor in recording Ventolin actuations. Methods 20 SmartTouch Ventolin monitors were attached to Ventolin metered dose inhalers. Bench testing was performed over a 10-week period, to reflect the potential time frame between visits in a clinical trial. Inhaler actuations were recorded in a paper diary, which was compared with data uploaded from the monitors. Results 2560 actuations were performed during the 10-week study period. Monitor sensitivity for diary-recorded actuations was 99.9% with a lower 97.5% confidence bound of 99.7%. The positive predictive value for diary-recorded actuations was 100% with a 97.5% lower confidence bound of 99.9%. Conclusions The SmartTouch Ventolin monitor is highly accurate in recording and retaining electronic data. It can be recommended for use in clinical trial settings in which training and quality control systems are incorporated into study protocols to ensure accurate data acquisition. PMID:27026805

A Commentary on: "A History of the United States Department of Energy (DOE) Low Dose Radiation Research Program: 1998-2008".

PubMed

Brooks, Antone L

2015-04-01

This commentary provides a very brief overview of the book "A History of the United States Department of Energy (DOE) Low Dose Radiation Research Program: 1998-2008" ( http://lowdose.energy.gov ). The book summarizes and evaluates the research progress, publications and impact of the U.S. Department of Energy Low Dose Radiation Research Program over its first 10 years. The purpose of this book was to summarize the impact of the program's research on the current thinking and low-dose paradigms associated with the radiation biology field and to help stimulate research on the potential adverse and/or protective health effects of low doses of ionizing radiation. In addition, this book provides a summary of the data generated in the low dose program and a scientific background for anyone interested in conducting future research on the effects of low-dose or low-dose-rate radiation exposure. This book's exhaustive list of publications coupled with discussions of major observations should provide a significant resource for future research in the low-dose and dose-rate region. However, because of space limitations, only a limited number of critical references are mentioned. Finally, this history book provides a list of major advancements that were accomplished by the program in the field of radiation biology, and these bulleted highlights can be found in last part of chapters 4-10.

Annual radiological environmental operating report, Browns Ferry Nuclear Plant, 1987

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

Not Available

1988-04-01

This report describes the environmental radiological monitoring programs conducted by TVA in the vicinity of Browns Ferry Nuclear Plant in 1987. The program includes the collection of samples from the environment and the determination of the concentrations of radioactive materials in the samples. Samples are taken from stations in the general area of the plant and from areas not influenced by plant operations. Station locations are selected after careful consideration of the weather patterns and projected radiation doses to the various areas around the plant. Material sampled includes air, water, milk, foods, vegetation, soil, fish, sediment, and direct radiation levels.more » Results from stations near the plant are compared with concentrations from control stations and with preoperational measurements to determine potential impacts of plant operations. The vast majority of the exposures calculated from environmental samples were contributed by naturally occurring radioactive materials or from materials commonly found in the environment as a result of atmospheric nuclear weapons fallout. Small amounts of Co-60 were found in sediment samples downstreams from the plant. This activity in stream sediment would result in no measurable increase over background in the dose to the general public. 3 refs., 2 figs., 34 tabs.« less

Browns Ferry Nuclear Plant annual radiological environmental operating report, 1990

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

Not Available

1991-04-01

This report describes the environmental radiological monitoring program conducted by TVA in the vicinity of Browns Ferry Nuclear Plant in 1990. The program includes the collection of samples from the environment and the determination of the concentrations of radioactive materials in the samples. Samples are taken from stations in the general area of the plant and from areas not influenced by plant operations. Station locations are selected after careful consideration of the weather patterns and projected radiation doses to the various areas around the plant. Material sampled includes air, water, milk, foods, vegetation, soil, fish, sediment, and direct radiation levels.more » Results from stations near the plant are compared with concentrations from control stations and with preoperational measurements to determine potential impacts of plant operations. The vast majority of the exposures calculated from environmental samples were contributed by naturally occurring radioactive materials or from materials commonly found in the environment as a result of atmospheric nuclear weapons fallout. Small amounts of Co-60 were found in sediment samples downstream from the plant. This activity in stream sediment would result in no measurable increase over background in the dose to the general public. 4 refs., 2 figs., 2 tabs.« less

Annual radiological environmental operating report, Browns Ferry Nuclear Plant, 1989

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

Not Available

1990-04-01

This report describes the environmental radiological monitoring program conducted by TVA in the vicinity of Browns Ferry Nuclear Plant (BFN) in 1989. The program includes the collection of samples from the environment and the determination of the concentrations of radioactive materials in the samples. Samples are taken from stations in the general area of the plant and from areas not influenced by plant operations. Station locations are selected after careful consideration of the weather patterns and projected radiation doses to the various areas around the plant. Material sampled includes air, water, milk, foods, vegetation, soil, fish, sediment, and direct radiationmore » levels. Results from stations near the plant are compared with concentrations from control stations and with preoperational measurements to determine potential impacts if plant operations. The vast majority of the exposures calculated from environmental samples were contributed by naturally occurring radioactive materials or from materials commonly found in the environment as a result of atmospheric nuclear weapons fallout. Small amounts of Co-60 were found in sediment samples downstream from the plant. This activity in river sediment would result in no measurable increase over background in the dose to the general public. 4 refs., 2 figs., 2 tabs.« less

Annual radiological environmental operating report, Browns Ferry Nuclear Plant, 1988

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

Not Available

1989-04-01

This report describes the environmental radiological monitoring program conducted by TVA in the vicinity of Browns Ferry Nuclear Plant in 1988. The program includes the collection of samples from the environment and the determination of the concentrations of radioactive materials in the samples. Samples are taken from stations in the general area of the plant and from areas not influenced by plant operations. Station locations are selected after careful consideration of the weather patterns and projected radiation doses to the various areas around the plant. Material sampled includes air, water, milk, foods, vegetation, soil, fish, sediment, and direct radiation levels.more » Results from stations near the plant are compared with concentrations from control stations and with preoperational measurements to determine potential impacts of plant operations. The vast majority of the exposures calculated from environmental samples were contributed by naturally occurring radioactive materials or from materials commonly found in the environment as a result of atmospheric nuclear weapons fallout. Small amounts of Co-60 were found in sediment samples downstream from the plant. This activity in stream sediment would result in no measurable increase over background in the dose to the general public. 3 refs., 2 figs., 2 tabs.« less

Comparative analysis of radioecological monitoring dosimeters

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

Sobolev, A.I.; Pol`skii, O.G.; Shanin, O.B.

1995-03-01

This paper describes comparative estimates of radiation doses measured by two types of thermoluminescence dosimeters and two types of background radiation radiometers. The dosimetry systems were tested by simultaneously recording background radiation and standard radiation sources at a radioactive waste storage facility. Statistical analysis of the measurement results is summarized. The maximum recorded exposure dose rate for the experiment was 19 microrads per hour. The DTK-2 dosimeter overestimated dose rates by 6 to 43% and the DTU-2 dosimeter underestimated dose rates by 7 to 21%. Both devices are recommended for radioecological monitoring in populated areas. 4 refs., 3 figs., 5more » tabs.« less

Continuous monitoring of prostate position using stereoscopic and monoscopic kV image guidance

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

Stevens, M. Tynan R.; Parsons, Dave D.; Robar, James L.

2016-05-15

Purpose: To demonstrate continuous kV x-ray monitoring of prostate motion using both stereoscopic and monoscopic localizations, assess the spatial accuracy of these techniques, and evaluate the dose delivered from the added image guidance. Methods: The authors implemented both stereoscopic and monoscopic fiducial localizations using a room-mounted dual oblique x-ray system. Recently developed monoscopic 3D position estimation techniques potentially overcome the issue of treatment head interference with stereoscopic imaging at certain gantry angles. To demonstrate continuous position monitoring, a gold fiducial marker was placed in an anthropomorphic phantom and placed on the Linac couch. The couch was used as a programmablemore » translation stage. The couch was programmed with a series of patient prostate motion trajectories exemplifying five distinct categories: stable prostate, slow drift, persistent excursion, transient excursion, and high frequency excursions. The phantom and fiducial were imaged using 140 kVp, 0.63 mAs per image at 1 Hz for a 60 s monitoring period. Both stereoscopic and monoscopic 3D localization accuracies were assessed by comparison to the ground-truth obtained from the Linac log file. Imaging dose was also assessed, using optically stimulated luminescence dosimeter inserts in the phantom. Results: Stereoscopic localization accuracy varied between 0.13 ± 0.05 and 0.33 ± 0.30 mm, depending on the motion trajectory. Monoscopic localization accuracy varied from 0.2 ± 0.1 to 1.1 ± 0.7 mm. The largest localization errors were typically observed in the left–right direction. There were significant differences in accuracy between the two monoscopic views, but which view was better varied from trajectory to trajectory. The imaging dose was measured to be between 2 and 15 μGy/mAs, depending on location in the phantom. Conclusions: The authors have demonstrated the first use of monoscopic localization for a room-mounted dual x-ray system. Three-dimensional position estimation from monoscopic imaging permits continuous, uninterrupted intrafraction motion monitoring even in the presence of gantry rotation, which may block kV sources or imagers. This potentially allows for more accurate treatment delivery, by ensuring that the prostate does not deviate substantially from the initial setup position.« less

77 FR 75417 - Renewal of the Veterans' Advisory Board on Dose Reconstruction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-20

...-discretionary federal advisory committee that shall provide review and oversight of the Radiation Dose... administration of the Radiation Dose Reconstruction Program as it considers appropriate as a result of the audits.... Conduct periodic, random audits of dose reconstructions under the Radiation Dose Reconstruction Program...

Feasibility study for distributed dose monitoring in ionizing radiation environments with standard and custom-made optical fibers

NASA Astrophysics Data System (ADS)

Van Uffelen, Marco; Berghmans, Francis; Brichard, Benoit; Borgermans, Paul; Decréton, Marc C.

2002-09-01

Optical fibers stimulate much interest since many years for their potential use in various nuclear environments, both for radiation tolerant and EMI-free data communication as well as for distributed sensing. Besides monitoring temperature and stress, measuring ionizing doses with optical fibers is particularly essential in applications such as long-term nuclear waste disposal monitoring, and for real-time aging monitoring of power and signal cables installed inside a reactor containment building. Two distinct options exist to perform optical fiber dosimetry. First, find an accurate model for a restricted application field that accounts for all the parameters that influence the radiation response of a standard fiber, or second, develop a dedicated fiber with a response that will solely depend on the deposited energy. Using various models presented in literature, we evaluate both standard commercially available and custom-made optical fibers under gamma radiation, particularly for distributed dosimetry applications with an optical time domain reflectometer (OTDR). We therefore present the radiation induced attenuation at near-infrared telecom wavelengths up to MGy total dose levels, with dose rates ranging from about 1 Gy/h up to 1 kGy/h, whereas temperature was raised step-wise from 25 °C to 85 °C. Our results allow to determine and compare the practical limitations of distributed dose measurements with both fiber types in terms of temperature sensitivity, dose estimation accuracy and spatial resolution.

Design and implementation of an integrated, continuous evaluation, and quality improvement system for a state-based home-visiting program.

PubMed

McCabe, Bridget K; Potash, Dru; Omohundro, Ellen; Taylor, Cathy R

2012-10-01

To describe the design and implementation of an evaluation system to facilitate continuous quality improvement (CQI) and scientific evaluation in a statewide home visiting program, and to provide a summary of the system's progress in meeting intended outputs and short-term outcomes. Help Us Grow Successfully (HUGS) is a statewide home visiting program that provides services to at-risk pregnant/post-partum women, children (0-5 years), and their families. The program goals are to improve parenting skills and connect families to needed services and thus improve the health of the service population. The evaluation system is designed to: (1) integrate evaluation into daily workflow; (2) utilize standardized screening and evaluation tools; (3) facilitate a culture of CQI in program management; and, (4) facilitate scientifically rigorous evaluations. The review of the system's design and implementation occurred through a formative evaluation process (reach, dose, and fidelity). Data was collected through electronic and paper surveys, administrative data, and notes from management meetings, and medical chart review. In the design phase, four process and forty outcome measures were selected and are tracked using standardized screening and monitoring tools. During implementation, the reach and dose of training were adequate to successfully launch the evaluation/CQI system. All staff (n = 165) use the system for management of families; the supervisors (n = 18) use the system to track routine program activities. Data quality and availability is sufficient to support periodic program reviews at the region and state level. In the first 7 months, the HUGS evaluation system tracked 3,794 families (7,937 individuals). System use and acceptance is high. A successful implementation of a structured evaluation system with a strong CQI component is feasible in an existing, large statewide program. The evaluation/CQI system is an effective mechanism to drive modest change in management of the program.

SU-E-T-585: Optically-Stimulated Luminescent Dosimeters for Monitoring Pacemaker Dose in Radiation Therapy

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

Apicello, L; Riegel, A; Jamshidi, A

2015-06-15

Purpose: A sufficient amount of ionizing radiation can cause failure to components of pacemakers. Studies have shown that permanent damage can occur after a dose of 10 Gy and minor damage to functionality occurs at doses as low as 2 Gy. Optically stimulated thermoluminescent dosimeters (OSLDs) can be used as in vivo dosimeters to predict dose to be deposited throughout the treatment. The purpose of this work is to determine the effectiveness of using OSLDs for in vivo dosimetry of pacemaker dose. Methods: As part of a clinical in vivo dosimetry experience, OSLDs were placed at the site of themore » pacemaker by the therapist for one fraction of the radiation treatment. OSLD measurements were extrapolated to the total dose to be received by the pacemaker during treatment. A total of 79 measurements were collected from November 2011 to December 2013 on six linacs. Sixty-six (66) patients treated in various anatomical sites had the dose of their pacemakers monitored. Results: Of the 79 measurements recorded, 76 measurements (96 %) were below 2 Gy. The mean and standard deviation were 50.12 ± 76.41 cGy. Of the 3 measurements that exceeded 2 Gy, 2 measurements matched the dose predicted in the treatment plan and 1 was repeated after an unexpectedly high Result. The repeated measurement yielded a total dose less than 2 Gy. Conclusion: This analysis suggests OSLDs may be used for in vivo monitoring of pacemaker dose. Further research should be performed to assess the effect of increased backscatter from the pacemaker device.« less

New antiarrhythmic agents for atrial fibrillation and atrial flutter: United States drug market response as an indicator of acceptance.

PubMed

LaPointe, Nancy M Allen; Pamer, Carol A; Kramer, Judith M

2003-10-01

To determine how well dofetilide and Betapace AF (sotalol, approved solely for atrial fibrillation and atrial flutter), with their detailed dosing and monitoring guidelines for safety, were accepted into clinical practice during the 2 calendar years after their introduction. We reviewed the number of new, refill, and total prescriptions of all antiarrhythmic agents in the United States from April 2000-December 2001 to assess use of dofetilide and Betapace AF in the drug market. Both were prescribed very infrequently throughout the study period. In addition, the infrequent reported use of these drugs for patients with atrial fibrillation and flutter indicated poor acceptance of these agents by prescribing physicians. We speculated that the restricted distribution and required educational program for dofetilide, as well as the availability of generic sotalol products, may have discouraged physicians from prescribing both dofetilide and Betapace AE CONCLUSION: A common goal for both the dofetilide risk-management program and the creation of a sotalol product indicated solely for atrial fibrillation and atrial flutter was to provide safer treatment for patients with these arrhythmias. Unfortunately, limited penetration of dofetilide and Betapace AF into the U.S. market suggests that drugs without a risk-management program or detailed dosing guidelines were more likely than dofetilide or Betapace AF to be selected for treatment of atrial fibrillation and atrial flutter.

Radiologic Monitoring of Faculty and Staff in an Electrophysiology Lab Using a Real-Time Dose Monitoring System

ERIC Educational Resources Information Center

Chardenet, Kathleen A.

2016-01-01

Purpose: A real-time dose management system was used to determine if radiation exposure levels would decrease when providers were privy to their real-time radiation exposure levels. Six aggregate categories of providers were first blinded (phase 1) and subsequently made aware of their radiation exposure levels during electrophysiology procedures…

A computer program for calculation of approximate embryo/fetus radiation dose in nuclear medicine applications.

PubMed

Bayram, Tuncay; Sönmez, Bircan

2012-04-01

In this study, we aimed to make a computer program that calculates approximate radiation dose received by embryo/fetus in nuclear medicine applications. Radiation dose values per MBq-1 received by embryo/fetus in nuclear medicine applications were gathered from literature for various stages of pregnancy. These values were embedded in the computer code, which was written in Fortran 90 program language. The computer program called nmfdose covers almost all radiopharmaceuticals used in nuclear medicine applications. Approximate radiation dose received by embryo/fetus can be calculated easily at a few steps using this computer program. Although there are some constraints on using the program for some special cases, nmfdose is useful and it provides practical solution for calculation of approximate dose to embryo/fetus in nuclear medicine applications. None declared.

Monitoring Results in Routine Immunization: Development of Routine Immunization Dashboard in Selected African Countries in the Context of the Polio Eradication Endgame Strategic Plan.

PubMed

Poy, Alain; van den Ent, Maya M V X; Sosler, Stephen; Hinman, Alan R; Brown, Sidney; Sodha, Samir; Ehlman, Daniel C; Wallace, Aaron S; Mihigo, Richard

2017-07-01

To monitor immunization-system strengthening in the Polio Eradication Endgame Strategic Plan 2013-2018 (PEESP), the Global Polio Eradication Initiative identified 1 indicator: 10% annual improvement in third dose of diphtheria- tetanus-pertussis-containing vaccine (DTP3) coverage in polio high-risk districts of 10 polio focus countries. A multiagency team, including staff from the African Region, developed a comprehensive list of outcome and process indicators measuring various aspects of the performance of an immunization system. The development and implementation of the dashboard to assess immunization system performance allowed national program managers to monitor the key immunization indicators and stratify by high-risk and non-high-risk districts. Although only a single outcome indicator goal (at least 10% annual increase in DTP3 coverage achieved in 80% of high-risk districts) initially existed in the endgame strategy, we successfully added additional outcome indicators (eg, decreasing the number of DTP3-unvaccinated children) as well as program process indicators focusing on cold chain, stock availability, and vaccination sessions to better describe progress on the pathway to raising immunization coverage. When measuring progress toward improving immunization systems, it is helpful to use a comprehensive approach that allows for measuring multiple dimensions of the system. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

High phenobarbital clearance during continuous renal replacement therapy: a case report and pharmacokinetic analysis.

PubMed

Rosenborg, Staffan; Saraste, Lars; Wide, Katarina

2014-08-01

Phenobarbital is an old antiepileptic drug used in severe epilepsy. Despite this, little is written about the need for dose adjustments in renal replacement therapy. Most sources recommend a moderately increased dose guided by therapeutic drug monitoring.A 14 year old boy with nonketotic hyperglycinemia, a rare inborn error of metabolism, characterized by high levels of glycine, epilepsy, spasticity, and cognitive impairment, was admitted to the emergency department with respiratory failure after a few days of fever and cough. The boy was unconscious at admittance and had acute renal and hepatic failure.Due to the acute respiratory infection, hypoxic hepatic and renal failure occurred and the patient had a status epilepticus.The patient was intubated and mechanically ventilated. Continuous renal replacement therapy was initiated. Despite increased phenobarbital doses, therapeutic levels were not reached until the dose was increased to 500 mg twice daily. Therapeutic drug monitoring was performed in plasma and dialysate. Calculations revealed that phenobarbital was almost freely dialyzed.Correct dosing of drugs in patients on renal replacement therapy may need a multidisciplinary approach and guidance by therapeutic drug monitoring.

High Phenobarbital Clearance During Continuous Renal Replacement Therapy

PubMed Central

Rosenborg, Staffan; Saraste, Lars; Wide, Katarina

2014-01-01

Abstract Phenobarbital is an old antiepileptic drug used in severe epilepsy. Despite this, little is written about the need for dose adjustments in renal replacement therapy. Most sources recommend a moderately increased dose guided by therapeutic drug monitoring. A 14 year old boy with nonketotic hyperglycinemia, a rare inborn error of metabolism, characterized by high levels of glycine, epilepsy, spasticity, and cognitive impairment, was admitted to the emergency department with respiratory failure after a few days of fever and cough. The boy was unconscious at admittance and had acute renal and hepatic failure. Due to the acute respiratory infection, hypoxic hepatic and renal failure occurred and the patient had a status epilepticus. The patient was intubated and mechanically ventilated. Continuous renal replacement therapy was initiated. Despite increased phenobarbital doses, therapeutic levels were not reached until the dose was increased to 500 mg twice daily. Therapeutic drug monitoring was performed in plasma and dialysate. Calculations revealed that phenobarbital was almost freely dialyzed. Correct dosing of drugs in patients on renal replacement therapy may need a multidisciplinary approach and guidance by therapeutic drug monitoring. PMID:25101986

Giving Back: Collaborations with Others in Ecological Studies on the Nevada National Security Site

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

Scott A. Wade; Kathryn S. Knapp; Cathy A. Wills

2013-02-24

Formerly named the Nevada Test Site, the Nevada National Security Site (NNSS) was the historical site for nuclear weapons testing from the 1950s to the early 1990s. The site was renamed in 2010 to reflect the diversity of nuclear, energy, and homeland security activities now conducted at the site. Biological and ecological programs and research have been conducted on the site for decades to address the impacts of radiation and to take advantage of the relatively undisturbed and isolated lands for gathering basic information on the occurrence and distribution of native plants and animals. Currently, the Office of the Assistantmore » Manager for Environmental Management of the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) oversees the radiological biota monitoring and ecological compliance programs on the NNSS. The top priority of these programs are compliance with federal and state regulations. They focus on performing radiological dose assessments for the public who reside near the NNSS and for populations of plants and animals on the NNSS and in protecting important species and habitat from direct impacts of mission activities. The NNSS serves as an invaluable outdoor laboratory. The geographic and ecological diversity of the site offers researchers many opportunities to study human influences on ecosystems. NNSA/NSO has pursued collaborations with outside agencies and organizations to be able to conduct programs and studies that enhance radiological biota monitoring and ecosystem preservation when budgets are restrictive, as well as to provide valuable scientific information to the human health and natural resource communities at large. NNSA/NSO is using one current collaborative study to better assess the potential dose to the off-site public from the ingestion of game animals, the most realistic pathway for off-site public exposure at this time from radionuclide contamination on the NNSS. A second collaborative study is furthering desert tortoise conservation measures onsite. It is the goal of NNSA/NSO to continue to develop such collaborations in the sharing of resources, such as personnel, equipment, expertise, and NNSS land access, with outside entities to meet mutually beneficial goals cost effectively.« less

Giving Back: Collaborations with Others in Ecological Studies on the Nevada National Security Site - 13058

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

Wade, Scott A.; Knapp, Kathryn S.; Wills, Cathy A.

2013-07-01

Formerly named the Nevada Test Site, the Nevada National Security Site (NNSS) was the historical site for nuclear weapons testing from the 1950's to the early 1990's. The site was renamed in 2010 to reflect the diversity of nuclear, energy, and homeland security activities now conducted at the site. Biological and ecological programs and research have been conducted on the site for decades to address the impacts of radiation and to take advantage of the relatively undisturbed and isolated lands for gathering basic information on the occurrence and distribution of native plants and animals. Currently, the Office of the Assistantmore » Manager for Environmental Management of the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) oversees the radiological biota monitoring and ecological compliance programs on the NNSS. The top priority of these programs are compliance with federal and state regulations. They focus on performing radiological dose assessments for the public who reside near the NNSS and for populations of plants and animals on the NNSS and in protecting important species and habitat from direct impacts of mission activities. The NNSS serves as an invaluable outdoor laboratory. The geographic and ecological diversity of the site offers researchers many opportunities to study human influences on ecosystems. NNSA/NSO has pursued collaborations with outside agencies and organizations to be able to conduct programs and studies that enhance radiological biota monitoring and ecosystem preservation when budgets are restrictive, as well as to provide valuable scientific information to the human health and natural resource communities at large. NNSA/NSO is using one current collaborative study to better assess the potential dose to the off-site public from the ingestion of game animals, the most realistic pathway for off-site public exposure at this time from radionuclide contamination on the NNSS. A second collaborative study is furthering desert tortoise conservation measures onsite. It is the goal of NNSA/NSO to continue to develop such collaborations in the sharing of resources, such as personnel, equipment, expertise, and NNSS land access, with outside entities to meet mutually beneficial goals cost effectively. (authors)« less

Methadone dose at the time of release from prison significantly influences retention in treatment: implications from a pilot study of HIV-infected prisoners transitioning to the community in Malaysia.

PubMed

Wickersham, Jeffrey A; Zahari, Muhammad Muhsin; Azar, Marwan M; Kamarulzaman, Adeeba; Altice, Frederick L

2013-09-01

To evaluate the impact of methadone dose on post-release retention in treatment among HIV-infected prisoners initiating methadone maintenance treatment (MMT) within prison. Thirty HIV-infected prisoners meeting DSM-IV pre-incarceration criteria for opioid dependence were enrolled in a prison-based, pre-release MMT program in Klang Valley, Malaysia; 3 died before release from prison leaving 27 evaluable participants. Beginning 4 months before release, standardized methadone initiation and dose escalation procedures began with 5mg daily for the first week and 5mg/daily increases weekly until 80 mg/day or craving was satisfied. Participants were followed for 12 months post-release at a MMT clinic within 25 kilometers of the prison. Kaplan-Meier survival analysis was used to evaluate the impact of methadone dose on post-release retention in treatment. Methadone dose ≥80 mg/day at the time of release was significantly associated with retention in treatment. After 12 months of release, only 21.4% of participants on <80 mg were retained at 12 months compared to 61.5% of those on ≥80 mg (Log Rank χ(2)=(1,26) 7.6, p<0.01). Higher doses of MMT at time of release are associated with greater retention on MMT after release to the community. Important attention should be given to monitoring and optimizing MMT doses to address cravings and side effects prior to community re-entry from prisons. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Methadone Dose at the Time of Release from Prison Significantly Influences Retention in Treatment: Implications From a Pilot Study of HIV-Infected Prisoners Transitioning to the Community in Malaysia

PubMed Central

Wickersham, Jeffrey A.; Muhsin Zahari, Muhammad; Azar, Marwan M.; Kamarulzaman, Adeeba; Altice, Frederick L.

2013-01-01

Objective To evaluate the impact of methadone dose on post-release retention in treatment among HIV-infected prisoners initiating methadone maintenance treatment (MMT) within prison. Methods Thirty HIV-infected prisoners meeting DSM-IV pre-incarceration criteria for opioid dependence were enrolled in a prison-based, pre-release MMT program in Klang Valley, Malaysia; 3 died before release from prison leaving 27 evaluable participants. Beginning 4 months before release, standardized methadone initiation and dose escalation procedures began with 5mg daily for the first week and 5mg/daily increases weekly until 80 mg/day or craving was satisfied. Participants were followed for 12 months post-release at a MMT clinic within 25 kilometers of the prison. Kaplan-Meier survival analysis was used to evaluate the impact of methadone dose on post-release retention in treatment. Findings Methadone dose ≥80 mg/day at the time of release was significantly associated with retention in treatment. After 12 months of release, only 21.4% of participants on <80mg were retained at 12 months compared to 61.5% of those on ≥80mg (Log Rank χ2=(1,26) 7.6, p <0.01). Conclusions Higher doses of MMT at time of release are associated with greater retention on MMT after release to the community. Important attention should be given to monitoring and optimizing MMT doses to address cravings and side effects prior to community re-entry from prisons. PMID:23414931

WE-D-17A-03: Improvement of Accuracy of Spot-Scanning Proton Beam Delivery for Liver Tumor by Real-Time Tumor-Monitoring and Gating System: A Simulation Study

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

Matsuura, T; Shimizu, S; Miyamoto, N

2014-06-15

Purpose: To improve the accuracy of spot-scanning proton beam delivery for target in motion, a real-time tumor-monitoring and gating system using fluoroscopy images was developed. This study investigates the efficacy of this method for treatment of liver tumors using simulation. Methods: Three-dimensional position of a fiducial marker inserted close to the tumor is calculated in real time and proton beam is gated according to the marker's distance from the planned position (Shirato, 2012). The efficient beam delivery is realized even for the irregular and sporadic motion signals, by employing the multiple-gated irradiations per operation cycle (Umezawa, 2012). For each ofmore » two breath-hold CTs (CTV=14.6cc, 63.1cc), dose distributions were calculated with internal margins corresponding to freebreathing (FB) and real-time gating (RG) with a 2-mm gating window. We applied 8 trajectories of liver tumor recorded during the treatment of RTRT in X-ray therapy and 6 initial timings. Dmax/Dmin in CTV, mean liver dose (MLD), and irradiation time to administer 3 Gy (RBE) dose were estimated assuming rigid motion of targets by using in-house simulation tools and VQA treatment planning system (Hitachi, Ltd., Tokyo). Results: Dmax/Dmin was degraded by less than 5% compared to the prescribed dose with all motion parameters for smaller CTV and less than 7% for larger CTV with one exception. Irradiation time showed only a modest increase if RG was used instead of FB; the average value over motion parameters was 113 (FB) and 138 s (RG) for smaller CTV and 120 (FB) and 207 s (RG) for larger CTV. In RG, it was within 5 min for all but one trajectory. MLD was markedly decreased by 14% and 5–6% for smaller and larger CTVs respectively, if RG was applied. Conclusions: Spot-scanning proton beam was shown to be delivered successfully to liver tumor without much lengthening of treatment time. This research was supported by the Cabinet Office, Government of Japan and the Japan Society for the Promotion of Science (JSPS) through the Funding Program for World-Leading Innovative R and D on Science and Technology (FIRST Program), initiated by the Council for Science and Technology Policy (CSTP)« less

[Personal dose monitoring of radiation workers in medical institutions at the municipal level and below in a city from 2011 to 2014].

PubMed

Wang, C; Mo, S F; Zhang, J B; Li, J R; Huang, R L; Tan, H Y

2017-08-20

Objective: To determine the personal dose level of radiation workers in medical institutions at the municipal level and below in a city, and to provide a scientific support for strengthening the radiation protection in the city's medical institutions. Methods: Information of the successful applicants for the "Radiation Worker Permit" from 174 medical institutions at the municipal level and below was collected from October 1, 2011 to December 31, 2014. The annual effective dose was calculated based on the personal dose monitoring report, and indicators including sex, permit application time, hospital level, type of occupational radiation, length of radiation work, blood test, and micronucleated lymphocyte rate were analyzed. Results: Of the 1 143 radiation worker permit applications submitted by medical institutions the municipal level and below in this city from 2011 to 2014, 1 123 provided at least one personal dose monitoring report. The annual effective dose of the radiation workers was 0-4.76 mSv (mean 0.31±0.40 mSv) , and the collective annual effective dose was 351.96 mSv. The annual effective dose was significantly different between radiation workers with different times of permit application, hospital levels, and types of occupational radiation ( P <0.05) . Interventional radiology workers had the highest annual effective dose (0.63 mSv) , and annual effective dose was significantly different between interventional radiology workers with different lengths of radiation work ( H =10.812, P <0.05) . Conclusion: The personal radiation dose of radiation workers in medical institutions at the municipal level and below in this city is maintained at a relatively low level, suggesting that the occupational environment is relatively safe for these workers. However, more focus should be placed on clinical interventional radiology workers.

Beyond the Dose-Limiting Toxicity Period: Dermatologic Adverse Events of Patients on Phase 1 Trials of the Cancer Therapeutics Evaluation Program

PubMed Central

Drilon, Alexander; Eaton, Anne A.; Schindler, Katja; Gounder, Mrinal M.; Spriggs, David R.; Harris, Pamela; Ivy, S. Percy; Iasonos, Alexia; Lacouture, Mario E.; Hyman, David M.

2017-01-01

BACKGROUND Dermatologic adverse events (AEs) can be key determinants of overall drug tolerability and of the maximum tolerated and recommended phase 2 doses in phase 1 trials. The authors present the largest dedicated analysis of dermatologic AEs on phase 1 trials to date. METHODS Data from a prospectively maintained database of patients with solid tumors who were enrolled onto Cancer Therapeutics Evaluation Program (CTEP)-sponsored phase 1 trials of cytotoxic or molecularly targeted agents (MTAs) from 2000 to 2010 were analyzed. Cumulative incidence, site, and type of drug-related dermatologic AEs were described and compared. The timing of worst drug-related dermatologic AEs was summarized. RESULTS In total, 3517 patients with solid tumors and 6165 unique, drug-related dermatologic AEs were analyzed, including 1545 patients on MTA-only trials, 671 on cytotoxic-only trials, and 1392 on combination MTA and cytotoxic trials. Of 1270 patients who had drug-related dermatologic events, the timing of the worst AE was as follows: 743 (cycle 1), 303 (cycle 2), and 224 (cycle 3 or later). Although the cumulative incidence of grade ≥3 drug-related AEs increased to 2.4% by cycle 6, it was only 1.6% at the end of cycle 1. The cumulative incidence of drug-related AEs was highest in patients who received MTA-only therapy (P <.001) and differed by dose level (P <.001). In patients who received MTA-only therapy, drug-related AEs were most common for combination kinase inhibitor-containing therapy (P <.001). CONCLUSIONS A substantial proportion of drug-related dermatologic AEs occur after the traditional dose-limiting toxicity monitoring period of phase 1 clinical trials. Future designs should account for late toxicities. PMID:26916138

Beyond the dose-limiting toxicity period: Dermatologic adverse events of patients on phase 1 trials of the Cancer Therapeutics Evaluation Program.

PubMed

Drilon, Alexander; Eaton, Anne A; Schindler, Katja; Gounder, Mrinal M; Spriggs, David R; Harris, Pamela; Ivy, S Percy; Iasonos, Alexia; Lacouture, Mario E; Hyman, David M

2016-04-15

Dermatologic adverse events (AEs) can be key determinants of overall drug tolerability and of the maximum tolerated and recommended phase 2 doses in phase 1 trials. The authors present the largest dedicated analysis of dermatologic AEs on phase 1 trials to date. Data from a prospectively maintained database of patients with solid tumors who were enrolled onto Cancer Therapeutics Evaluation Program (CTEP)-sponsored phase 1 trials of cytotoxic or molecularly targeted agents (MTAs) from 2000 to 2010 were analyzed. Cumulative incidence, site, and type of drug-related dermatologic AEs were described and compared. The timing of worst drug-related dermatologic AEs was summarized. In total, 3517 patients with solid tumors and 6165 unique, drug-related dermatologic AEs were analyzed, including 1545 patients on MTA-only trials, 671 on cytotoxic-only trials, and 1392 on combination MTA and cytotoxic trials. Of 1270 patients who had drug-related dermatologic events, the timing of the worst AE was as follows: 743 (cycle 1), 303 (cycle 2), and 224 (cycle 3 or later). Although the cumulative incidence of grade ≥3 drug-related AEs increased to 2.4% by cycle 6, it was only 1.6% at the end of cycle 1. The cumulative incidence of drug-related AEs was highest in patients who received MTA-only therapy (P < .001) and differed by dose level (P < .001). In patients who received MTA-only therapy, drug-related AEs were most common for combination kinase inhibitor-containing therapy (P < .001). A substantial proportion of drug-related dermatologic AEs occur after the traditional dose-limiting toxicity monitoring period of phase 1 clinical trials. Future designs should account for late toxicities. © 2016 American Cancer Society.

Poster - Thur Eve - 76: A quality control to achieve planning consistency in arc radiotherapy of the prostate.

PubMed

Zeng, G; Murphy, J; Annis, S-L; Wu, X; Wang, Y; McGowan, T; Macpherson, M

2012-07-01

To report a quality control program in prostate radiation therapy at our center that includes semi-automated planning process to generate high quality plans and in-house software to track plan quality in the subsequent clinical application. Arc planning in Eclipse v10.0 was preformed for both intact prostate and post-prostatectomy treatments. The planning focuses on DVH requirements and dose distributions being able to tolerate daily setup variations. A modified structure set is used to standardize the optimization, including short rectum and bladder in the fields to effectively tighten dose to target and a rectum expansion with 1cm cropped from PTV to block dose and shape posterior isodose lines. Structure, plan and optimization templates are used to streamline plan generation. DVH files are exported from Eclipse to a quality tracking software with GUI written in Matlab that can report the dose-volume data either for an individual patient or over a patient population. For 100 intact prostate patients treated with 78Gy, rectal D50, D25, D15 and D5 are 30.1±6.2Gy, 50.6±7.9Gy, 65.9±6.0Gy and 76.6±1.4Gy respectively, well below the limits 50Gy, 65Gy, 75Gy and 78Gy respectively. For prostate bed with prescription of 66Gy, rectal D50 is 35.9±6.9Gy. In both sites, PTV is covered by 95% prescription and the hotspots are less than 5%. The semi-automated planning method can efficiently create high quality plans while the tracking software can monitor the feedback from clinical application. It is a comprehensive and robust quality control program in radiation therapy. © 2012 American Association of Physicists in Medicine.

Development and Application of Direct Data Capture for Monitoring Medication Compliance in Clinical Trials.

PubMed

Kim, Eun-Young

2017-10-01

The monitoring of medication compliance in clinical trials is important but labor intensive. To check medication compliance in clinical trials, a system was developed, and its technical feasibility evaluated. The system consisted of three parts: a management part (clinical trial center database and a developed program), clinical trial investigator part (monitoring), and clinical trial participant part (personal digital assistant [PDA] with a barcode scanner). The system was tested with 20 participants for 2 weeks, and compliance was evaluated. This study developed a medication compliance monitoring system that used a PDA with a barcode scanner, which sent reminder/warning messages, logged medication barcode data, and provided compliance information to investigators. Registered participants received short message service (SMS) reminder/warning messages on their PDA and sent barcode data at the dosing time. The age range of the participants was 29 to 73 years. Five participants were <50 years old and 8 were ≥65 years old. The total mean compliance rate was 82.3%. The mean compliance rate was 83.1% in participants <65 years old and 81.1% in those ≥65 years old. The system was feasible, usable, and effective, even with elderly participants, for monitoring medication compliance in clinical trials using a PDA with a barcode scanner, and may improve the quality of clinical trials.

Skin dose mapping for fluoroscopically guided interventions.

PubMed

Johnson, Perry B; Borrego, David; Balter, Stephen; Johnson, Kevin; Siragusa, Daniel; Bolch, Wesley E

2011-10-01

To introduce a new skin dose mapping software system for interventional fluoroscopy dose assessment and to analyze the benefits and limitations of patient-phantom matching. In this study, a new software system was developed for visualizing patient skin dose during interventional fluoroscopy procedures. The system works by translating the reference point air kerma to the location of the patient's skin, which is represented by a computational model. In order to orient the model with the x-ray source, geometric parameters found within the radiation dose structured report (RDSR) are used along with a limited number of in-clinic measurements. The output of the system is a visual indication of skin dose mapped onto an anthropomorphic model at a resolution of 5 mm. In order to determine if patient-dependent and patient-sculpted models increase accuracy, peak skin dose was calculated for each of 26 patient-specific models and compared with doses calculated using an elliptical stylized model, a reference hybrid model, a matched patient-dependent model and one patient-sculpted model. Results were analyzed in terms of a percent difference using the doses calculated using the patient-specific model as the true standard. Anthropometric matching, including the use of both patient-dependent and patient-sculpted phantoms, was shown most beneficial for left lateral and anterior-posterior projections. In these cases, the percent difference using a reference model was between 8 and 20%, using a patient-dependent model between 7 and 15%, and using a patient-sculpted model between 3 and 7%. Under the table tube configurations produced errors less than 5% in most situations due to the flattening affects of the table and pad, and the fact that table height is the main determination of source-to-skin distance for these configurations. In addition to these results, several skin dose maps were produced and a prototype display system was placed on the in-clinic monitor of an interventional fluoroscopy system. The skin dose mapping program developed in this work represents a new tool that, as the RDSR becomes available through automated export or real-time streaming, can provide the interventional physician information needed to modify behavior when clinically appropriate. The program is nonproprietary and transferable, and also functions independent to the software systems already installed on the control room workstation. The next step will be clinical implementation where the workflow will be optimized along with further analysis of real-time capabilities.

Monitoring the eye lens: which dose quantity is adequate?

NASA Astrophysics Data System (ADS)

Behrens, R.; Dietze, G.

2010-07-01

Recent epidemiological studies suggest a rather low dose threshold (below 0.5 Gy) for the induction of a cataract of the eye lens. Some other studies even assume that there is no threshold at all. Therefore, protection measures have to be optimized and current dose limits for the eye lens may be reduced in the future. The question of which personal dose equivalent quantity is appropriate for monitoring the dose to the eye lens arises from this situation. While in many countries dosemeters calibrated in terms of the dose equivalent quantity Hp(0.07) have been seen as being adequate for monitoring the dose to the eye lens, this might be questionable in the case of reduced dose limits and, thus, it may become necessary to use the dose equivalent quantity Hp(3) for this purpose. To discuss this question, the dose conversion coefficients for the equivalent dose of the eye lens (in the following eye lens dose) were determined for realistic photon and beta radiation fields and compared with the values of the corresponding conversion coefficients for the different operational quantities. The values obtained lead to the following conclusions: in radiation fields where most of the dose comes from photons, especially x-rays, it is appropriate to use dosemeters calibrated in terms of Hp(0.07) on a slab phantom, while in other radiation fields (dominated by beta radiation or unknown contributions of photon and beta radiation) dosemeters calibrated in terms of Hp(3) on a slab phantom should be used. As an alternative, dosemeters calibrated in terms of Hp(0.07) on a slab phantom could also be used; however, in radiation fields containing beta radiation with the end point energy near 1 MeV, an overestimation of the eye lens dose by up to a factor of 550 is possible.

Monitoring the eye lens: which dose quantity is adequate?

PubMed

Behrens, R; Dietze, G

2010-07-21

Recent epidemiological studies suggest a rather low dose threshold (below 0.5 Gy) for the induction of a cataract of the eye lens. Some other studies even assume that there is no threshold at all. Therefore, protection measures have to be optimized and current dose limits for the eye lens may be reduced in the future. The question of which personal dose equivalent quantity is appropriate for monitoring the dose to the eye lens arises from this situation. While in many countries dosemeters calibrated in terms of the dose equivalent quantity H(p)(0.07) have been seen as being adequate for monitoring the dose to the eye lens, this might be questionable in the case of reduced dose limits and, thus, it may become necessary to use the dose equivalent quantity H(p)(3) for this purpose. To discuss this question, the dose conversion coefficients for the equivalent dose of the eye lens (in the following eye lens dose) were determined for realistic photon and beta radiation fields and compared with the values of the corresponding conversion coefficients for the different operational quantities. The values obtained lead to the following conclusions: in radiation fields where most of the dose comes from photons, especially x-rays, it is appropriate to use dosemeters calibrated in terms of H(p)(0.07) on a slab phantom, while in other radiation fields (dominated by beta radiation or unknown contributions of photon and beta radiation) dosemeters calibrated in terms of H(p)(3) on a slab phantom should be used. As an alternative, dosemeters calibrated in terms of H(p)(0.07) on a slab phantom could also be used; however, in radiation fields containing beta radiation with the end point energy near 1 MeV, an overestimation of the eye lens dose by up to a factor of 550 is possible.

Baseline susceptibility of Planococcus ficus (Hemiptera: Pseudococcidae) from California to select insecticides.

PubMed

Prabhaker, Nilima; Gispert, Carmen; Castle, Steven J

2012-08-01

Between 2006 and 2008, 20 populations of Planococcus ficus (Signoret), from Coachella and San Joaquin Valleys of California were measured in the laboratory for susceptibility to buprofezin, chlorpyrifos, dimethoate, methomyl, and imidacloprid. Toxicity was assessed using a petri dish bioassay technique for contact insecticides and by a systemic uptake technique for imidacloprid. Mixed life stages were tested for susceptibility to all insecticides except for buprofezin, which was measured against early and late instars (first, second, and third). Dose-response regression lines from the mortality data established LC50 and LC99 values by both techniques. Responses of populations from the two geographical locations to all five insecticides varied, in some cases significantly. Variations in susceptibility to each insecticide among sample sites showed a sevenfold difference for buprofezin, 11-fold to chlorpyrifos, ninefold to dimethoate, 24-fold to methomyl, and 8.5-fold to imidacloprid. In spite of susceptibility differences between populations, baseline toxicity data revealed that all five insecticides were quite effective based on low LC50s. Chlorpyrifos was the most toxic compound to Planococcus ficus populations as shown by lowest LC50s. Buprofezin was toxic to all immature stages but was more potent to first instars. The highest LC99 estimated by probit analysis of the bioassay data of all 20 populations for each compound was selected as a candidate discriminating dose for use in future resistance monitoring efforts. Establishment of baseline data and development of resistance monitoring tools such as bioassay methods and discriminating doses are essential elements of a sustainable management program for Planococcus ficus.

Imaging and characterization of primary and secondary radiation in ion beam therapy

NASA Astrophysics Data System (ADS)

Granja, Carlos; Martisikova, Maria; Jakubek, Jan; Opalka, Lukas; Gwosch, Klaus

2016-07-01

Imaging in ion beam therapy is an essential and increasingly significant tool for treatment planning and radiation and dose deposition verification. Efforts aim at providing precise radiation field characterization and online monitoring of radiation dose distribution. A review is given of the research and methodology of quantum-imaging, composition, spectral and directional characterization of the mixed-radiation fields in proton and light ion beam therapy developed by the IEAP CTU Prague and HIT Heidelberg group. Results include non-invasive imaging of dose deposition and primary beam online monitoring.

Enhancing Cytogenetic Biological Dosimetry Capabilities of the Philippines for Nuclear Incident Preparedness.

PubMed

Asaad, Celia O; Caraos, Gloriamaris L; Robles, Gerardo Jose M; Asa, Anie Day D C; Cobar, Maria Lucia C; Asaad, Al-Ahmadgaid

2016-01-01

The utility of a biological dosimeter based on the analysis of dicentrics is invaluable in the event of a radiological emergency wherein the estimated absorbed dose of an exposed individual is crucial in the proper medical management of patients. The technique is also used for routine monitoring of occupationally exposed workers to determine radiation exposure. An in vitro irradiation study of human peripheral blood lymphocytes was conducted to establish a dose-response curve for radiation-induced dicentric aberrations. Blood samples were collected from volunteer donors and together with optically stimulated luminescence (OSL) dosimeters and were irradiated at 0, 0.1, 0.25, 0.5, 0.75, 1, 2, 4, and 6 Gy using a cobalt-60 radiotherapy unit. Blood samples were cultured for 48 h, and the metaphase chromosomes were prepared following the procedure of the International Atomic Energy Agency's Emergency Preparedness and Response - Biodosimetry 2011 manual. At least 100 metaphases were scored for dicentric aberrations at each dose point. The data were analyzed using R language program. The results indicated that the distribution of dicentric cells followed a Poisson distribution and the dose-response curve was established using the estimated model, Y dic = 0.0003 (±0.0003) +0.0336 (±0.0115) × D + 0.0236 (±0.0054) × D 2 . In this study, the reliability of the dose-response curve in estimating the absorbed dose was also validated for 2 and 4 Gy using OSL dosimeters. The data were fitted into the constructed curve. The result of the validation study showed that the obtained estimate for the absorbed exposure doses was close to the true exposure doses.

Incorporation of additional radionuclides and the external exposure pathway into the BECAMP (Basic Environmental Compliance and Monitoring Program) radiological assessment model

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

Ng, Yook C.; Rodean, H.C.; Anspaugh, L.R.

The Nevada Applied Ecology Group (NAEG) Model of transport and dose for transuranic radionuclides was modified and expanded for the analysis of radionuclides other than pure alpha-emitters. Doses from internal and external exposures were estimated for the inventories and soil distributions of the individual radionuclides quantified in Areas 2 and 4 of the Nevada Test Site (NTS). We found that the dose equivalents via inhalation to liver, lungs, bone marrow, and bone surface from the plutonium isotopes and /sup 241/Am, those via ingestion to bone marrow and bone surfaces from /sup 90/Sr, and those via ingestion to all the targetmore » organs from /sup 137/Cs were the highest from internal exposures. The effective dose equivalents from /sup 137/Cs, /sup 152/Eu, and /sup 154/Eu were the highest from the external exposures. The /sup 60/Co, /sup 152/Eu, /sup 154/Eu, and /sup 155/Eu dose estimates for external exposures greatly exceeded those for internal exposures. The /sup 60/Co, /sup 90/Sr, and /sup 137/Cs dose equivalents from internal exposures were underestimated due to the adoption of some of the foodchain parameter values originally selected for /sup 239/Pu. Nonetheless, the ingestion pathway contributed significantly to the dose estimates for /sup 90/Sr and /sup 137/Cs, but contributed very much less than external exposures to the dose estimates for /sup 60/Co. Therefore, the use of more appropriate values would not alter the identification of important radionuclides, pathways, target organs, and exposure modes in this analysis. 19 refs., 13 figs., 12 tabs.« less

Psychosocial Correlates of Clinicians' Prescription Drug Monitoring Program Utilization.

PubMed

Pugliese, John A; Wintemute, Garen J; Henry, Stephen G

2018-05-01

The purpose of this study is to extend prior research on barriers to use of a prescription drug monitoring program by examining psychosocial correlates of intended use among physicians and pharmacists. Overall, 1,904 California physicians and pharmacists responded to a statewide survey (24.1% response rate) from August 2016 to January 2017. Participants completed an online survey examining attitudes toward prescription drug misuse and abuse, prescribing practices, prescription drug monitoring program design and ease of use, professional obligations, and normative beliefs regarding prescription drug monitoring program use. Data were analyzed in 2017. Perceived prescription drug monitoring program usefulness and normative beliefs fully mediated the relationship between concern about prescription drug abuse and intentions to use the prescription drug monitoring program. Clinicians' sense of professional and moral obligation to use the prescription drug monitoring program was unrelated to intention to use the prescription drug monitoring program despite a positive relationship with concern about misuse and abuse. Compared with physicians, pharmacists reported greater concern about prescription drug misuse, greater professional and moral obligation to use prescription drug monitoring program, and greater rating of prescription drug monitoring program usefulness. Interventions that target normative beliefs surrounding prescription drug monitoring program use and how to use prescription drug monitoring programs effectively are likely to be more effective than those that target professional obligations or moralize to the medical community. Published by Elsevier Inc.

In vivo dosimetry for external photon treatments of head and neck cancers by diodes and TLDS.

PubMed

Tung, C J; Wang, H C; Lo, S H; Wu, J M; Wang, C J

2004-01-01

In vivo dosimetry was implemented for treatments of head and neck cancers in the large fields. Diode and thermoluminescence dosemeter (TLD) measurements were carried out for the linear accelerators of 6 MV photon beams. ESTRO in vivo dosimetry protocols were followed in the determination of midline doses from measurements of entrance and exit doses. Of the fields monitored by diodes, the maximum absolute deviation of measured midline doses from planned target doses was 8%, with the mean value and the standard deviation of -1.0 and 2.7%. If planned target doses were calculated using radiological water equivalent thicknesses rather than patient geometric thicknesses, the maximum absolute deviation dropped to 4%, with the mean and the standard deviation of 0.7 and 1.8%. For in vivo dosimetry monitored by TLDs, the shift in mean dose remained small but the statistical precision became poor.

Listening to music with personal listening devices: monitoring the noise dose using a smartphone application.

PubMed

Kaplan-Neeman, Ricky; Muchnik, Chava; Amir, Noam

2017-06-01

To monitor listening habits to personal listening devices (PLDs) using a smartphone application and to compare actual listening habits to self-report data. Two stages: self-report listening habits questionnaire, and real-time monitoring of listening habits through a smartphone application. Overall 117 participants aged 18-34 years (mean 25.5 years) completed the questionnaire, and of them, 40 participants (mean age: 25.2 years) were monitored for listening habits during two weeks. Questionnaire main findings indicated that most of the participants reported listening for 4-7 days a week, for at least 30 min at high listening levels with volume control settings at 75-100%. Monitored data showed that actual listening days per week were 1.5-6.5 d, with mean continuous time of 1.56 h, and mean volume control setting of 7.39 (on a scale of 1-15). Eight participants (22%) were found to exceed the 100% noise dose at least once during the monitoring period. One participant (2.7%) exceeded the weekly 100% daily noise dose. Correlations between actual measurements and self-report data were low to moderate. Results confirmed the feasibility of monitoring listening habits by a smartphone application, and underscore the need for such a tool to enable safe listening behaviour.

DITTY - a computer program for calculating population dose integrated over ten thousand years

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

Napier, B.A.; Peloquin, R.A.; Strenge, D.L.

The computer program DITTY (Dose Integrated Over Ten Thousand Years) was developed to determine the collective dose from long term nuclear waste disposal sites resulting from the ground-water pathways. DITTY estimates the time integral of collective dose over a ten-thousand-year period for time-variant radionuclide releases to surface waters, wells, or the atmosphere. This document includes the following information on DITTY: a description of the mathematical models, program designs, data file requirements, input preparation, output interpretations, sample problems, and program-generated diagnostic messages.

10 CFR 835.703 - Other monitoring records.

Code of Federal Regulations, 2010 CFR

2010-01-01

....1102(d); (b) Results of monitoring used to determine individual occupational dose from external and internal sources; (c) Results of monitoring for the release and control of material and equipment as...

Radiation exposure of U.S. military individuals.

PubMed

Blake, Paul K; Komp, Gregory R

2014-02-01

The U.S. military consists of five armed services: the Army, Navy, Marine Corps, Air Force, and Coast Guard. It directly employs 1.4 million active duty military, 1.3 million National Guard and reserve military, and 700,000 civilian individuals. This paper describes the military guidance used to preserve and maintain the health of military personnel while they accomplish necessary and purposeful work in areas where they are exposed to radiation. It also discusses military exposure cohorts and associated radiogenic disease compensation programs administered by the U.S. Department of Veterans Affairs, the U.S. Department of Justice, and the U.S. Department of Labor. With a few exceptions, the U.S. military has effectively employed ionizing radiation since it was first introduced during the Spanish-American War in 1898. The U.S military annually monitors 70,000 individuals for occupational radiation exposure: ~2% of its workforce. In recent years, the Departments of the Navy (including the Marine Corps), the Army, and the Air Force all have a low collective dose that remains close to 1 person-Sv annually. Only a few Coast Guard individuals are now routinely monitored for radiation exposure. As with the nuclear industry as a whole, the Naval Reactors program has a higher collective dose than the remainder of the U.S. military. The U.S. military maintains occupational radiation exposure records on over two million individuals from 1945 through the present. These records are controlled in accordance with the Privacy Act of 1974 but are available to affected individuals or their designees and other groups performing sanctioned epidemiology studies.Introduction of Radiation Exposure of U.S. Military Individuals (Video 2:19, http://links.lww.com/HP/A30).

Usefulness of Maintaining a Normal Electrocardiogram Over Time for Predicting Cardiovascular Health.

PubMed

Soliman, Elsayed Z; Zhang, Zhu-Ming; Chen, Lin Y; Tereshchenko, Larisa G; Arking, Dan; Alonso, Alvaro

2017-01-15

We hypothesized that maintaining a normal electrocardiogram (ECG) status over time is associated with low cardiovascular (CV) disease in a dose-response fashion and subsequently could be used to monitor programs aimed at promoting CV health. This analysis included 4,856 CV disease-free participants from the Atherosclerosis Risk in Communities study who had a normal ECG at baseline (1987 to 1989) and complete electrocardiographic data in subsequent 3 visits (1990 to 1992, 1993 to 1995, and 1996 to 1998). Participants were classified based on maintaining their normal ECG status during these 4 visits into "maintained," "not maintained," or "inconsistent" normal ECG status as defined by the Minnesota ECG classification. CV disease events (coronary heart disease, heart failure, and stroke) were adjudicated from Atherosclerosis Risk in Communities visit-4 through 2010. Over a median follow-up of 13.2 years, 885 CV disease events occurred. The incidence rate of CV disease events was lowest among study participants who maintained a normal ECG status, followed by those with an inconsistent pattern, and then those who did not maintain their normal ECG status (trend p value <0.001). Similarly, the greater the number of visits with a normal ECG status, the lower was the incidence rate of CV disease events (trend p value <0.001). Maintaining (vs not maintaining) a normal ECG status was associated with a lower risk of CV disease, which was lower than that observed in those with inconsistent normal ECG pattern (trend p value <0.01). In conclusion, maintaining a normal ECG status over time is associated with low risk of CV disease in a dose-response fashion, suggesting its potential use as a monitoring tool for programs promoting CV health. Copyright © 2016 Elsevier Inc. All rights reserved.

Design of a tracking device for on-line dose monitoring in hadrontherapy

NASA Astrophysics Data System (ADS)

Battistoni, G.; Collamati, F.; De Lucia, E.; Faccini, R.; Marafini, M.; Mattei, I.; Muraro, S.; Paramatti, R.; Patera, V.; Pinci, D.; Rucinski, A.; Russomando, A.; Sarti, A.; Sciubba, A.; Solfaroli Camillocci, E.; Toppi, M.; Traini, G.; Voena, C.

2017-02-01

Hadrontherapy is a technique for cancer treatment that exploits ion beams (mostly protons and carbons). A critical issue is the accuracy that is achievable when monitoring the dose released by the beam to the tumor and to the surrounding tissues. We present the design of a tracking device, developed in the framework of the INSIDE project [1], capable of monitoring in real time the longitudinal profile of the dose delivered in the patient. This is possible by detecting the secondary particles produced by the interaction of the beam in the tissues. The position of the Bragg peak can be correlated to the charged particles emission point distribution measurement. The tracking device will be able to provide a fast response on the dose pattern by tracking the secondary charged fragments. The tracks are detected using 6 planes of scintillating fibers, providing the 3D coordinates of the track intersection with each plane. The fibers planes are followed by a plastic scintillator and by a small calorimeter built with a pixelated Lutetium Fine Silicate (LFS) crystal. A complete detector simulation, followed by the event reconstruction, has been performed to determine the achievable monitoring spatial resolution.

#2) Sensor Technology-State of the Science | Science ...

EPA Pesticide Factsheets

Establish market surveys of commercially-available air quality sensorsConduct an extensive literature survey describing the state of sensor technologiesInvestigate emerging technologies and their potential to meet future air quality monitoring needs for the Agency as well as other partners/stakeholders Develop sensor user guidesEducate sensor developers/sensors users on the state of low cost censorsFacilitate knowledge transfer to Federal/Regional/State air quality associatesWork directly with sensor developers to dramatically speed up the development of next generation air monitoring Support ORD’s Sensor Roadmap by focusing on areas of highest priority (NAAQS, Air Toxics, Citizen Science)Establish highly integrated research efforts across ORD and its partners (internal/external) to ensure consistent The National Exposure Research Laboratory (NERL) Human Exposure and Atmospheric Sciences Division (HEASD) conducts research in support of EPA mission to protect human health and the environment. HEASD research program supports Goal 1 (Clean Air) and Goal 4 (Healthy People) of EPA strategic plan. More specifically, our division conducts research to characterize the movement of pollutants from the source to contact with humans. Our multidisciplinary research program produces Methods, Measurements, and Models to identify relationships between and characterize processes that link source emissions, environmental concentrations, human exposures, and target-tissue dose.

Operational radiological support for the US manned space program

NASA Technical Reports Server (NTRS)

Golightly, Michael J.; Hardy, Alva C.; Atwell, William; Weyland, Mark D.; Kern, John; Cash, Bernard L.

1993-01-01

Radiological support for the manned space program is provided by the Space Radiation Analysis Group at NASA/JSC. This support ensures crew safety through mission design analysis, real-time space environment monitoring, and crew exposure measurements. Preflight crew exposure calculations using mission design information are used to ensure that crew exposures will remain within established limits. During missions, space environment conditions are continuously monitored from within the Mission Control Center. In the event of a radiation environment enhancement, the impact to crew exposure is assessed and recommendations are provided to flight management. Radiation dosimeters are placed throughout the spacecraft and provided to each crewmember. During a radiation contingency, the crew could be requested to provide dosimeter readings. This information would be used for projecting crew dose enhancements. New instrumentation and computer technology are being developed to improve the support. Improved instruments include tissue equivalent proportional counter (TEPC)-based dosimeters and charged particle telescopes. Data from these instruments will be telemetered and will provide flight controllers with unprecedented information regarding the radiation environment in and around the spacecraft. New software is being acquired and developed to provide 'smart' space environmental data displays for use by flight controllers.

[Evaluation of an Experimental Production Wireless Dose Monitoring System for Radiation Exposure Management of Medical Staff].

PubMed

Fujibuchi, Toshioh; Murazaki, Hiroo; Kuramoto, Taku; Umedzu, Yoshiyuki; Ishigaki, Yung

2015-08-01

Because of the more advanced and more complex procedures in interventional radiology, longer treatment times have become necessary. Therefore, it is important to determine the exposure doses received by operators and patients. The aim of our study was to evaluate an experimental production wireless dose monitoring system for pulse radiation in diagnostic X-ray. The energy, dose rate, and pulse fluoroscopy dependence were evaluated as the basic characteristics of this system for diagnostic X-ray using a fully digital fluoroscopy system. The error of 1 cm dose equivalent rate was less than 15% from 35.1 keV to 43.2 keV with energy correction using metal filter. It was possible to accurately measure the dose rate dependence of this system, which was highly linear until 100 μSv/h. This system showed a constant response to the pulse fluoroscopy. This system will become useful wireless dosimeter for the individual exposure management by improving the high dose rate and the energy characteristics.

Results from the first five years of radiation exposure monitoring aboard the ISS

NASA Astrophysics Data System (ADS)

Golightly, M.; Semones, E.; Shelfer, T.; Johnson, S.; Zapp, N.; Weyland, M.

NASA uses a variety of radiation monitoring devices aboard the International Space Station as part of its space flight radiation health program. This operational monitoring system consists of passive dosimeters, internal and external charged particle telescopes, and a tissue equivalent proportional counter (TEPC). Sixteen passive dosimeters, each consisting of TLD-100, TLD-300, TLD-600, and TLD-700 chips in a small acrylic holder, are placed throughout the habitable volume of the ISS. The TEPC and internal charged particle telescopes are portable and can be relocated to multiple locations in the Lab Module or Service Module. The external charged particle telescopes are mounted to a fixed boom attached to the starboard truss. Passive dosimeters were used in eleven monitoring periods over the period 20 May 1999 to 04 May 2003. Over this period exposure rates from TLD-100 measurements ranged from 0.120-0.300 mGy/d. Exposure rates inside the habitable volume are non-uniform: exposures vary by a factor of ˜ 1.7 from minimum to maximum, with the greatest non-uniformity occurring in the Lab Module. Highest daily exposure rates are near the window in the Lab Module, inside the Joint Airlock, and the sleep stations inside the Service Module, while the lowest rates occur inside the polyethylene-lined Temporary Sleep Station in the Lab Module, adjacent to the port ``arm'' of Node 1, and the aft end of the Service Module. The minimum exposure rates as measured by the passive dosimeters occurred in the spring of 2002, very close to the solar F10.7 emission maximum (Feb 2002), and two years after the sunspot maximum (Apr 2000). Exposure rates have since gradually increased as the sun's activity transitions towards solar minimum conditions. Since 01 Jun 2002, dose rates measured by the IV-CPDS, estimated from the count rate in first detector of the telescope's stack, ranged from ˜ 0.170-0.390 mGy/d. The maximum measured dose rate occurred 28 Oct 2003 during the ``Halloween'' space weather event. Interestingly, the minimum dose rate occurred 31 Oct 2003, near the end of the same remarkable space weather event, when the Earth was experiencing a significant Forbush decrease. The average IV-CPDS-measured dose rate increased from 0.194 to 0.234 mGy/d since 01 Jun 2002--an increase of ˜ 21% and a further indication that the low-Earth radiation environment is transitioning from solar maximum conditions towards solar minimum.

Radiation monitoring in interventional cardiology: a requirement

NASA Astrophysics Data System (ADS)

Rivera, T.; Uruchurtu, E. S.

2017-01-01

The increasing of procedures using fluoroscopy in interventional cardiology procedures may increase medical and patients to levels of radiation that manifest in unintended outcomes. Such outcomes may include skin injury and cancer. The cardiologists and other staff members in interventional cardiology are usually working close to the area under examination and they receive the dose primarily from scattered radiation from the patient. Mexico does not have a formal policy for monitoring and recording the radiation dose delivered in hemodynamic establishments. Deterministic risk management can be improved by monitoring the radiation delivered from X-ray devices. The objective of this paper is to provide cardiologist, techniques, nurses, and all medical staff an information on DR levels, about X-ray risks and a simple a reliable method to control cumulative dose.

Occlusion dose monitoring in amblyopia therapy: status, insights, and future directions.

PubMed

Stewart, Catherine E; Moseley, Merrick J; Georgiou, Pantelis; Fielder, Alistair R

2017-10-01

Occlusion therapy remains the mainstay treatment of amblyopia, but its outcome is not assured or universally excellent. Many factors are known to influence treatment outcome, among which compliance is foremost. The occlusion dose monitor (ODM) removes one variable from the treatment equation, because it records the occlusion actually received by-rather than prescribed for-the child. Improvement observed can thus be quantitatively related to the patching received. This review summarizes the insights the ODM has provided to date particularly in elucidating the dose-response relationship. We are entering the era of personalized ophthalmology in which treatments will be tailored to the needs of the individual child and facilitated by the use of wearable monitors. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Individual dose monitoring of the nuclear medicine departments staff controlled by Central Laboratory for Radiological Protection.

PubMed

Szewczak, Kamil; Jednoróg, Sławomir; Krajewski, Paweł

2013-01-01

Presented paper describes the results of the individual doses measurements for ionizing radiation, carried out by the Laboratory of Individual and Environmental Doses Monitoring (PDIS) of the Central Laboratory for Radiological Protection in Warsaw (CLOR) for the medical staff employees in several nuclear medicine (NM) departments across Poland. In total there are48 NM departments in operation in Poland [1] (consultation in Nuclear Atomic Agency). Presented results were collected over the period from January 2011 to December 2011 at eight NM departments located in Krakow, Warszawa (two departments), Rzeszow (two departments), Opole, Przemysl and Gorzow Wielkopolski. For radiation monitoring three kinds of thermo luminescence dosimeters (TLD) were used. The first TLD h collected information about whole body (C) effective dose, the second dosimeter was mounted in the ring (P) meanwhile the third on the wrist (N) of the tested person. Reading of TLDs was performed in quarterly periods. As a good approximation of effective and equivalent dose assessment of operational quantities both the individual dose equivalent Hp(10) and the Hp(0.07) were used. The analysis of the data was performed using two methods The first method was based on quarterly estimations of Hp(10)q and Hp(0.07)q while the second measured cumulative annual doses Hp(10)a and Hp(0.07)a. The highest recorded value of the radiation dose for quarterly assessments reached 24.4 mSv and was recorded by the wrist type dosimeter worn by a worker involved in source preparation procedure. The mean values of Hp(10)q(C type dosimeter) and Hp(0.07)q (P and N type dosimeter) for all monitored departments were respectively 0.46 mSv and 3.29 mSv. There was a strong correlation between the performed job and the value of the received dose. The highest doses always were absorbed by those staff members who were involved in sources preparation. The highest annual cumulative dose for a particular worker in the considered time period was 4.22 mSv for Hp(10)a and 67.7 mSv for Hp(0.07)a. In 2011 no case of exceeding the allowed dose limits was noted.

Automated Management of Exercise Intervention at the Point of Care: Application of a Web-Based Leg Training System

PubMed Central

2015-01-01

Background Recent advances in information and communication technology have prompted development of Web-based health tools to promote physical activity, the key component of cardiac rehabilitation and chronic disease management. Mobile apps can facilitate behavioral changes and help in exercise monitoring, although actual training usually takes place away from the point of care in specialized gyms or outdoors. Daily participation in conventional physical activities is expensive, time consuming, and mostly relies on self-management abilities of patients who are typically aged, overweight, and unfit. Facilitation of sustained exercise training at the point of care might improve patient engagement in cardiac rehabilitation. Objective In this study we aimed to test the feasibility of execution and automatic monitoring of several exercise regimens on-site using a Web-enabled leg training system. Methods The MedExercise leg rehabilitation machine was equipped with wireless temperature sensors in order to monitor its usage by the rise of temperature in the resistance unit (Δt°). Personal electronic devices such as laptop computers were fitted with wireless gateways and relevant software was installed to monitor the usage of training machines. Cloud-based software allowed monitoring of participant training over the Internet. Seven healthy participants applied the system at various locations with training protocols typically used in cardiac rehabilitation. The heart rates were measured by fingertip pulse oximeters. Results Exercising in home chairs, in bed, and under an office desk was made feasible and resulted in an intensity-dependent increase of participants’ heart rates and Δt° in training machine temperatures. Participants self-controlled their activities on smart devices, while a supervisor monitored them over the Internet. Individual Δt° reached during 30 minutes of moderate-intensity continuous training averaged 7.8°C (SD 1.6). These Δt° were used as personalized daily doses of exercise with automatic email alerts sent upon achieving them. During 1-week training at home, automatic notifications were received on 4.4 days (SD 1.8). Although the high intensity interval training regimen was feasible on-site, it was difficult for self- and remote management. Opportunistic leg exercise under the desk, while working with a computer, and training in bed while viewing television were less intensive than dosed exercise bouts, but allowed prolonged leg mobilization of 73.7 minutes/day (SD 29.7). Conclusions This study demonstrated the feasibility of self-control exercise training on-site, which was accompanied by online monitoring, electronic recording, personalization of exercise doses, and automatic reporting of adherence. The results suggest that this technology and its applications are useful for the delivery of Web-based exercise rehabilitation and cardiac training programs at the point of care. PMID:28582243

Evaluating social marketing programs.

PubMed

1988-01-01

Contraceptive social marketing programs (CSM) which use commercial marketing techniques and distribution networks to sell contraceptives at subsidized prices, have become an important source of contraceptives in many developing countries. However, research is needed to determine the extent to which CSM programs are recruiting new users or simply serving as an alternate source for those who already use contraceptives. 1st begun in India in 1967, today CSM programs are selling contraceptives in more than 20 countries, mostly selling condoms because they do not require medical supervision or usually have to be registered with governments as a pharmaceutical product. Most also sell oral contraceptives. Advertising is used to promote the program, both brand and generic, about family planning and the advantages of small families. In some countries only generic promotion is permitted. A CSM program begins with research on the marketplace and needs of potential customers, including baseline studies, group discussions, and personal interviews. Monitoring is done by market research on usage, acceptability and adequacy of distribution. Focus groups and surveys are also used. Evaluation methodologies are similar to those used in program planning and monitoring, including consumer intercept surveys and tracking studies. Program impact is an area often neglected, probably because of the unusual relationship between the private and public sectors that occurs in CSM. Couple-years of protection is the common measurement of impact, estimated from sales data (13 cycles of pills or 100 condoms or doses of spermicide/year is assumed to prevent conception). This method can be used to assess the contributions of different methods and distribution systems and to compare their cost-effectiveness by calculating the cost per couple-year of protection provided. Limitations on this measurement method are inability to discriminate sporadic use from careful compliance; sales may be substitutes for obtaining contraceptives from other sources. Consumer-intercept surveys can distinguish "switchers" from users. National, household and census surveys can also have a few questions directly related to CSM and provide secondary data to measure program impact.

A Quasi-Experiment To Study the Impact of Vancomycin Area under the Concentration-Time Curve-Guided Dosing on Vancomycin-Associated Nephrotoxicity

PubMed Central

Finch, Natalie A.; Zasowski, Evan J.; Murray, Kyle P.; Mynatt, Ryan P.; Zhao, Jing J.; Yost, Raymond; Pogue, Jason M.

2017-01-01

ABSTRACT Evidence suggests that maintenance of vancomycin trough concentrations at between 15 and 20 mg/liter, as currently recommended, is frequently unnecessary to achieve the daily area under the concentration-time curve (AUC24) target of ≥400 mg · h/liter. Many patients with trough concentrations in this range have AUC24 values in excess of the therapeutic threshold and within the exposure range associated with nephrotoxicity. On the basis of this, the Detroit Medical Center switched from trough concentration-guided dosing to AUC-guided dosing to minimize potentially unnecessary vancomycin exposure. The primary objective of this analysis was to assess the impact of this intervention on vancomycin-associated nephrotoxicity in a single-center, retrospective quasi-experiment of hospitalized adult patients receiving intravenous vancomycin from 2014 to 2015. The primary analysis compared the incidence of nephrotoxicity between patients monitored by assessment of the AUC24 and those monitored by assessment of the trough concentration. Multivariable logistic and Cox proportional hazards regression examined the independent association between the monitoring strategy and nephrotoxicity. Secondary analysis compared vancomycin exposures (total daily dose, AUC, and trough concentrations) between monitoring strategies. Overall, 1,280 patients were included in the analysis. After adjusting for severity of illness, comorbidity, duration of vancomycin therapy, and concomitant receipt of nephrotoxins, AUC-guided dosing was independently associated with lower nephrotoxicity by both logistic regression (odds ratio, 0.52; 95% confidence interval [CI], 0.34 to 0.80; P = 0.003) and Cox proportional hazards regression (hazard ratio, 0.53; 95% CI, 0.35 to 0.78; P = 0.002). AUC-guided dosing was associated with lower total daily vancomycin doses, AUC values, and trough concentrations. Vancomycin AUC-guided dosing was associated with reduced nephrotoxicity, which appeared to be a result of reduced vancomycin exposure. PMID:28923869

A Quasi-Experiment To Study the Impact of Vancomycin Area under the Concentration-Time Curve-Guided Dosing on Vancomycin-Associated Nephrotoxicity.

PubMed

Finch, Natalie A; Zasowski, Evan J; Murray, Kyle P; Mynatt, Ryan P; Zhao, Jing J; Yost, Raymond; Pogue, Jason M; Rybak, Michael J

2017-12-01

Evidence suggests that maintenance of vancomycin trough concentrations at between 15 and 20 mg/liter, as currently recommended, is frequently unnecessary to achieve the daily area under the concentration-time curve (AUC 24 ) target of ≥400 mg · h/liter. Many patients with trough concentrations in this range have AUC 24 values in excess of the therapeutic threshold and within the exposure range associated with nephrotoxicity. On the basis of this, the Detroit Medical Center switched from trough concentration-guided dosing to AUC-guided dosing to minimize potentially unnecessary vancomycin exposure. The primary objective of this analysis was to assess the impact of this intervention on vancomycin-associated nephrotoxicity in a single-center, retrospective quasi-experiment of hospitalized adult patients receiving intravenous vancomycin from 2014 to 2015. The primary analysis compared the incidence of nephrotoxicity between patients monitored by assessment of the AUC 24 and those monitored by assessment of the trough concentration. Multivariable logistic and Cox proportional hazards regression examined the independent association between the monitoring strategy and nephrotoxicity. Secondary analysis compared vancomycin exposures (total daily dose, AUC, and trough concentrations) between monitoring strategies. Overall, 1,280 patients were included in the analysis. After adjusting for severity of illness, comorbidity, duration of vancomycin therapy, and concomitant receipt of nephrotoxins, AUC-guided dosing was independently associated with lower nephrotoxicity by both logistic regression (odds ratio, 0.52; 95% confidence interval [CI], 0.34 to 0.80; P = 0.003) and Cox proportional hazards regression (hazard ratio, 0.53; 95% CI, 0.35 to 0.78; P = 0.002). AUC-guided dosing was associated with lower total daily vancomycin doses, AUC values, and trough concentrations. Vancomycin AUC-guided dosing was associated with reduced nephrotoxicity, which appeared to be a result of reduced vancomycin exposure. Copyright © 2017 American Society for Microbiology.

Quality assurance of the UV irradiances of the UV-B Monitoring and Research Program: the Mauna Loa test case

NASA Astrophysics Data System (ADS)

Zempila, Melina Maria; Davis, John; Janson, George; Olson, Becky; Chen, Maosi; Durham, Bill; Simpson, Scott; Straube, Jonathan; Sun, Zhibin; Gao, Wei

2017-09-01

The USDA UV-B Monitoring and Research Program (UVMRP) is an ongoing effort aiming to establish a valuable, longstanding database of ground-based ultraviolet (UV) solar radiation measurements over the US. Furthermore, the program aims to achieve a better understanding of UV variations through time, and develop a UV climatology for the Northern American section. By providing high quality radiometric measurements of UV solar radiation, UVMRP is also focusing on advancing science for agricultural, forest, and range systems in order to mitigate climate impacts. Within these foci, the goal of the present study is to investigate, analyze, and validate the accuracy of the measurements of the UV multi-filter rotating shadowband radiometer (UV-MFRSR) and Yankee (YES) UVB-1 sensor at the high altitude, pristine site at Mauna Loa, Hawaii. The response-weighted irradiances at 7 UV channels of the UV-MFRSR along with the erythemal dose rates from the UVB-1 radiometer are discussed, and evaluated for the period 2006-2015. Uncertainties during the calibration procedures are also analyzed, while collocated groundbased measurements from a Brewer spectrophotometer along with model simulations are used as a baseline for the validation of the data. Besides this quantitative research, the limitations and merits of the existing UVMRP methods are considered and further improvements are introduced.

Radiation dose-rate meter using an energy-sensitive counter

DOEpatents

Kopp, Manfred K.

1988-01-01

A radiation dose-rate meter is provided which uses an energy-sensitive detector and combines charge quantization and pulse-rate measurement to monitor radiation dose rates. The charge from each detected photon is quantized by level-sensitive comparators so that the resulting total output pulse rate is proportional to the dose-rate.

Radiological protection for pregnant women at a large academic medical Cancer Center.

PubMed

Chu, Bae; Miodownik, Daniel; Williamson, Matthew J; Gao, Yiming; St Germain, Jean; Dauer, Lawrence T

2017-11-01

Most radiation protection programs, regulations and guidance apply specific restrictions to the occupational exposure of pregnant workers. The aim of this study was to compile data from the declared pregnant woman (DPW) radiation protection program over more than 5years at a large, high-volume, comprehensive oncology academic/medical institution and to evaluate for effectiveness against existing regulations and guidance. A retrospective review was performed of the data collected as part of the DPW radiation protection program from January 2010 through May 2016, including the number of declared pregnancies, worker category, personal and fetal dosimetry monitoring measurements, workplace modifications, as well as the monthly and total recorded badge results during the entire pregnancy. 245 pregnancies were declared. The mean monthly fetal radiation dosimetry result was 0.009mSv with a median of 0.005mSv and a maximum of 0.39mSv. The mean total dose over the entire pregnancy was estimated to be 0.08mSv with a median of 0.05mSv and a maximum of 0.89mSv. Only 8 (3.2%) of the 245 declared pregnancies required that workplace modifications be implemented for the worker. The implementation of a declared pregnancy and fetal assessment program, careful planning, an understanding of the risks, and minimization of radiation dose by employing appropriate radiation safety measures as needed, can allow medical staff to perform procedures and normal activities without incurring significant risks to the conceptus, or significant interruptions of job activities for most medical workers. Copyright © 2017. Published by Elsevier Ltd.

The scope and value of an anticoagulation stewardship program at a community teaching hospital.

PubMed

Wychowski, Maura K; Ruscio, Christina I; Kouides, Peter A; Sham, Ronald L

2017-04-01

To report the impact of an inpatient anticoagulation stewardship program at a community hospital to promote optimal anticoagulant use. The anticoagulation team (ACT) stewardship program consists of two clinical pharmacists and hematologists to provide oversight of anticoagulants, high cost reversal agents including prothrombin complex concentrate (PCC, Kcentra™), and heparin-induced thrombocytopenia (HIT) management. Intervention data and number of charts reviewed were collected. Average cost avoidance data was applied to ACT interventions to estimate cost savings. The PCC analysis was conducted via retrospective chart review during the pre-intervention period. Prospective monitoring continued in the post-intervention period to determine the percentage of PCC use within the institution's guidelines or approved by ACT or hematology. A total of 19,445 patient charts were reviewed, and 1930 (10%) contained stewardship opportunity. Of the interventions, 71% were provided to the medical service and 22% to surgical services with acceptance rates of 91 and 83%, respectively. Intervention cost-avoidance calculated to be $694,217. Regarding HIT interventions, 52% of interventions involved pharmacokinetic/pharmacodynamics optimization in 18 patients with suspected or confirmed HIT. Regarding PCC use, 55.8% of PCC orders were considered inappropriate in the pre-invention period versus 2.6% post-intervention. Appropriate PCC doses per month post-intervention were consistent with pre-intervention doses (7.67 vs. 6.73, respectively). The projected annual PCC cost savings is $385,473. The overall estimated financial impact of ACT is $799,690 saved. Implementation of an anticoagulation stewardship program reduced costs and improved clinical outcomes. It is also expected that anticoagulant optimization and provider education improved overall safety.

Patient-specific radiation dose and cancer risk estimation in CT: Part I. Development and validation of a Monte Carlo program

PubMed Central

Li, Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Toncheva, Greta; Yoshizumi, Terry T.; Frush, Donald P.

2011-01-01

Purpose: Radiation-dose awareness and optimization in CT can greatly benefit from a dose-reporting system that provides dose and risk estimates specific to each patient and each CT examination. As the first step toward patient-specific dose and risk estimation, this article aimed to develop a method for accurately assessing radiation dose from CT examinations. Methods: A Monte Carlo program was developed to model a CT system (LightSpeed VCT, GE Healthcare). The geometry of the system, the energy spectra of the x-ray source, the three-dimensional geometry of the bowtie filters, and the trajectories of source motions during axial and helical scans were explicitly modeled. To validate the accuracy of the program, a cylindrical phantom was built to enable dose measurements at seven different radial distances from its central axis. Simulated radial dose distributions in the cylindrical phantom were validated against ion chamber measurements for single axial scans at all combinations of tube potential and bowtie filter settings. The accuracy of the program was further validated using two anthropomorphic phantoms (a pediatric one-year-old phantom and an adult female phantom). Computer models of the two phantoms were created based on their CT data and were voxelized for input into the Monte Carlo program. Simulated dose at various organ locations was compared against measurements made with thermoluminescent dosimetry chips for both single axial and helical scans. Results: For the cylindrical phantom, simulations differed from measurements by −4.8% to 2.2%. For the two anthropomorphic phantoms, the discrepancies between simulations and measurements ranged between (−8.1%, 8.1%) and (−17.2%, 13.0%) for the single axial scans and the helical scans, respectively. Conclusions: The authors developed an accurate Monte Carlo program for assessing radiation dose from CT examinations. When combined with computer models of actual patients, the program can provide accurate dose estimates for specific patients. PMID:21361208

Current status and performance of the BESIII electromagnetic calorimeter

NASA Astrophysics Data System (ADS)

Fang, Jian; Wang, Zhigang

2012-12-01

The design and construction of the BESIII electromagnetic calorimeter is introduced briefly. Radiation dose of CsI(Tl) crystals is monitored and history graph of integral dose of crystals is showed. LED-fiber system is used for monitoring the EMC light output, and large decrease of light output of several crystals is discussed. BESIII electromagnetic calorimeter works very well and its performance reach the design value.

An accurate derivation of the air dose-rate and the deposition concentration distribution by aerial monitoring in a low level contaminated area

NASA Astrophysics Data System (ADS)

Nishizawa, Yukiyasu; Sugita, Takeshi; Sanada, Yukihisa; Torii, Tatsuo

2015-04-01

Since 2011, MEXT (Ministry of Education, Culture, Sports, Science and Technology, Japan) have been conducting aerial monitoring to investigate the distribution of radioactive cesium dispersed into the atmosphere after the accident at the Fukushima Dai-ichi Nuclear Power Plant (FDNPP), Tokyo Electric Power Company. Distribution maps of the air dose-rate at 1 m above the ground and the radioactive cesium deposition concentration on the ground are prepared using spectrum obtained by aerial monitoring. The radioactive cesium deposition is derived from its dose rate, which is calculated by excluding the dose rate of the background radiation due to natural radionuclides from the air dose-rate at 1 m above the ground. The first step of the current method of calculating the dose rate due to natural radionuclides is calculate the ratio of the total count rate of areas where no radioactive cesium is detected and the count rate of regions with energy levels of 1,400 keV or higher (BG-Index). Next, calculate the air dose rate of radioactive cesium by multiplying the BG-Index and the integrated count rate of 1,400 keV or higher for the area where the radioactive cesium is distributed. In high dose-rate areas, however, the count rate of the 1,365-keV peak of Cs-134, though small, is included in the integrated count rate of 1,400 keV or higher, which could cause an overestimation of the air dose rate of natural radionuclides. We developed a method for accurately evaluating the distribution maps of natural air dose-rate by excluding the effect of radioactive cesium, even in contaminated areas, and obtained the accurate air dose-rate map attributed the radioactive cesium deposition on the ground. Furthermore, the natural dose-rate distribution throughout Japan has been obtained by this method.

Development of GUI Type On-Line Condition Monitoring Program for a Turboprop Engine Using Labview

NASA Astrophysics Data System (ADS)

Kong, Changduk; Kim, Keonwoo

2011-12-01

Recently, an aero gas turbine health monitoring system has been developed for precaution and maintenance action against faults or performance degradations of the advanced propulsion system which occurs in severe environments such as high altitude, foreign object damage particles, hot and heavy rain and snowy atmospheric conditions. However to establish this health monitoring system, the online condition monitoring program is firstly required, and the program must monitor the engine performance trend through comparison between measured engine performance data and base performance results calculated by base engine performance model. This work aims to develop a GUI type on-line condition monitoring program for the PT6A-67 turboprop engine of a high altitude and long endurance operation UAV using LabVIEW. The base engine performance of the on-line condition monitoring program is simulated using component maps inversely generated from the limited performance deck data provided by engine manufacturer. The base engine performance simulation program is evaluated because analysis results by this program agree well with the performance deck data. The proposed on-line condition program can monitor the real engine performance as well as the trend through precise comparison between clean engine performance results calculated by the base performance simulation program and measured engine performance signals. In the development phase of this monitoring system, a signal generation module is proposed to evaluate the proposed online monitoring system. For user friendly purpose, all monitoring program are coded by LabVIEW, and monitoring examples are demonstrated using the proposed GUI type on-condition monitoring program.

76 FR 9786 - NIOSH Dose Reconstruction Program Ten-Year Review-Phase I Report on Customer Service; Request for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention NIOSH Dose Reconstruction Program Ten-Year Review--Phase I Report on Customer Service; Request for Public Review and Comment... requests public review and comment on the draft publication, ``NIOSH Dose Reconstruction Program Ten-Year...

Impact of Florida's prescription drug monitoring program and pill mill law on high-risk patients: A comparative interrupted time series analysis.

PubMed

Chang, Hsien-Yen; Murimi, Irene; Faul, Mark; Rutkow, Lainie; Alexander, G Caleb

2018-04-01

We quantified the effects of Florida's prescription drug monitoring program and pill mill law on high-risk patients. We used QuintilesIMS LRx Lifelink data to identify patients receiving prescription opioids in Florida (intervention state, N: 1.13 million) and Georgia (control state, N: 0.54 million). The preintervention, intervention, and postintervention periods were July 2010 to June 2011, July 2011 to September 2011, and October 2011 to September 2012. We identified 3 types of high-risk patients: (1) concomitant users: patients with concomitant use of benzodiazepines and opioids; (2) chronic users: long-term, high-dose, opioid users; and (3) opioid shoppers: patients receiving opioids from multiple sources. We compared changes in opioid prescriptions between Florida and Georgia before and after policy implementation among high-risk/low-risk patients. Our monthly measures included (1) average morphine milligram equivalent per transaction, (2) total opioid volume across all prescriptions, (3) average days supplied per transaction, and (4) total number of opioid prescriptions dispensed. Among opioid-receiving individuals in Florida, 6.62% were concomitant users, 1.96% were chronic users, and 0.46% were opioid shoppers. Following policy implementation, Florida's high-risk patients experienced relative reductions in morphine milligram equivalent (opioid shoppers: -1.08 mg/month, 95% confidence interval [CI] -1.62 to -0.54), total opioid volume (chronic users: -4.58 kg/month, CI -5.41 to -3.76), and number of dispensed opioid prescriptions (concomitant users: -640 prescriptions/month, CI -950 to -340). Low-risk patients generally did not experience statistically significantly relative reductions. Compared with Georgia, Florida's prescription drug monitoring program and pill mill law were associated with large relative reductions in prescription opioid utilization among high-risk patients. Copyright © 2018 John Wiley & Sons, Ltd.

SU-E-T-614: Plan Averaging for Multi-Criteria Navigation of Step-And-Shoot IMRT

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

Guo, M; Gao, H; Craft, D

2015-06-15

Purpose: Step-and-shoot IMRT is fundamentally discrete in nature, while multi-criteria optimization (MCO) is fundamentally continuous: the MCO planning consists of continuous sliding across the Pareto surface (the set of plans which represent the tradeoffs between organ-at-risk doses and target doses). In order to achieve close to real-time dose display during this sliding, it is desired that averaged plans share many of the same apertures as the pre-computed plans, since dose computation for apertures generated on-the-fly would be expensive. We propose a method to ensure that neighboring plans on a Pareto surface share many apertures. Methods: Our baseline step-and-shoot sequencing methodmore » is that of K. Engel (a method which minimizes the number of segments while guaranteeing the minimum number of monitor units), which we customize to sequence a set of Pareto optimal plans simultaneously. We also add an error tolerance to study the relationship between the number of shared apertures, the total number of apertures needed, and the quality of the fluence map re-creation. Results: We run tests for a 2D Pareto surface trading off rectum and bladder dose versus target coverage for a clinical prostate case. We find that if we enforce exact fluence map recreation, we are not able to achieve much sharing of apertures across plans. The total number of apertures for all seven beams and 4 plans without sharing is 217. With sharing and a 2% error tolerance, this number is reduced to 158 (73%). Conclusion: With the proposed method, total number of apertures can be decreased by 42% (averaging) with no increment of total MU, when an error tolerance of 5% is allowed. With this large amount of sharing, dose computations for averaged plans which occur during Pareto navigation will be much faster, leading to a real-time what-you-see-is-what-you-get Pareto navigation experience. Minghao Guo and Hao Gao were partially supported by the NSFC (#11405105), the 973 Program (#2015CB856000) and the Shanghai Pujiang Talent Program (#14PJ1404500)« less

Environmental sampling plan for Kwajalein Atoll Lagoon: 2017 Kwajalein sampling event

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

Hamilton, T. F.

2017-07-01

Since the early 1980s, the U.S DOE Marshall Islands Program at LLNL has provided radiological monitoring of the marine and terrestrial environment at nuclear affected atolls in the northern Marshall Islands. The fundamental aim of these studies was to identify the level and distribution of key residual fallout radionuclide in the environment, improve understanding of prevalent radiation exposure pathways, and develop predictive dose assessments for resettled and resettling atoll population groups. These data and information were essential in terms of guiding the development of effective and environmentally protective remedial measures, and promoting potential actions to improve on food safety andmore » security.« less

Nevada Test Site Environmental Report 2005

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

Cathy A. Wills

2006-10-01

The Nevada Test Site Environmental Report 2005 (NTSER) was prepared to meet the information needs of the public and the requirements and guidelines of the U.S. Department of Energy (DOE) for annual site environmental reports. Its purpose is to (1) report compliance status with environmental standards and requirements, (2) present results of environmental monitoring of radiological and nonradiological effluents, (3) report estimated radiological doses to the public from releases of radioactive material, (4) summarize environmental incidents of noncompliance and actions taken in response to them, (5) describe the NTS Environmental Management System and characterize its performance, and (6) highlight significantmore » environmental programs and efforts.« less

Volumetric modulated arc therapy vs. IMRT for the treatment of distal esophageal cancer.

PubMed

Van Benthuysen, Liam; Hales, Lee; Podgorsak, Matthew B

2011-01-01

Several studies have demonstrated that volumetric modulated arc therapy (VMAT) has the ability to reduce monitor units and treatment time when compared with intensity-modulated radiation therapy (IMRT). This study aims to demonstrate that VMAT is able to provide adequate organs at risk (OAR) sparing and planning target volume (PTV) coverage for adenocarcinoma of the distal esophagus while reducing monitor units and treatment time. Fourteen patients having been treated previously for esophageal cancer were planned using both VMAT and IMRT techniques. Dosimetric quality was evaluated based on doses to several OARs, as well as coverage of the PTV. Treatment times were assessed by recording the number of monitor units required for dose delivery. Body V(5) was also recorded to evaluate the increased volume of healthy tissue irradiated to low doses. Dosimetric differences in OAR sparing between VMAT and IMRT were comparable. PTV coverage was similar for the 2 techniques but it was found that IMRT was capable of delivering a slightly more homogenous dose distribution. Of the 14 patients, 12 were treated with a single arc and 2 were treated with a double arc. Single-arc plans reduced monitor units by 42% when compared with the IMRT plans. Double-arc plans reduced monitor units by 67% when compared with IMRT. The V(5) for the body was found to be 18% greater for VMAT than for IMRT. VMAT has the capability to decrease treatment times over IMRT while still providing similar OAR sparing and PTV coverage. Although there will be a smaller risk of patient movement during VMAT treatments, this advantage comes at the cost of delivering small doses to a greater volume of the patient. Copyright © 2011 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

DOSESCREEN: a computer program to aid dose placement

Treesearch

Kimberly C. Smith; Jacqueline L. Robertson

1984-01-01

Careful selection of an experimental design for a bioassay substantially improves the precision of effective dose (ED) estimates. Design considerations typically include determination of sample size, dose selection, and allocation of subjects to doses. DOSESCREEN is a computer program written to help investigators select an efficient design for the estimation of an...

High dose-per-pulse electron beam dosimetry: Commissioning of the Oriatron eRT6 prototype linear accelerator for preclinical use.

PubMed

Jaccard, Maud; Durán, Maria Teresa; Petersson, Kristoffer; Germond, Jean-François; Liger, Philippe; Vozenin, Marie-Catherine; Bourhis, Jean; Bochud, François; Bailat, Claude

2018-02-01

The Oriatron eRT6 is an experimental high dose-per-pulse linear accelerator (linac) which was designed to deliver an electron beam with variable dose-rates, ranging from a few Gy/min up to hundreds of Gy/s. It was built to study the radiobiological effects of high dose-per-pulse/dose-rate electron beam irradiation, in the context of preclinical and cognitive studies. In this work, we report on the commissioning and beam monitoring of the Oriatron eRT6 prototype linac. The beam was characterized in different steps. The output stability was studied by performing repeated measurements over a period of 20 months. The relative output variations caused by changing beam parameters, such as the temporal electron pulse width, the pulse repetition frequency and the pulse amplitude were also analyzed. Finally, depth dose curves and field sizes were measured for two different beam settings, resulting in one beam with a conventional radiotherapy dose-rate and one with a much higher dose-rate. Measurements were performed with Gafchromic EBT3 films and with a PTW Advanced Markus ionization chamber. In addition, we developed a beam current monitoring system based on the signals from an induction torus positioned at the beam exit of the waveguide and from a graphite beam collimator. The stability of the output over repeated measurements was found to be good, with a standard deviation smaller than 1%. However, non-negligible day-to-day variations of the beam output were observed. Those output variations showed different trends depending on the dose-rate. The analysis of the relative output variation as a function of various beam parameters showed that in a given configuration, the dose-rate could be reliably varied over three orders of magnitude. Interdependence effects on the output variation between the parameters were also observed. The beam energy and field size were found to be slightly dose-rate-dependent and suitable mainly for small animal irradiation. The beam monitoring system was able to measure in a reproducible way the total charge of electrons that exit the machine, as long as the electron pulse amplitude remains above a given threshold. Furthermore, we were able to relate the charge measured with the monitoring system to the absorbed dose in a solid water phantom. The Oriatron eRT6 was successfully commissioned for preclinical use and is currently in full operation, with studies being performed on the radiobiological effects of high dose-per-pulse irradiation. © 2017 American Association of Physicists in Medicine.

Temporal variation of dose rate distribution around the Fukushima Daiichi nuclear power station using unmanned helicopter.

PubMed

Sanada, Yukihisa; Orita, Tadashi; Torii, Tatsuo

2016-12-01

Aerial radiological survey using an unmanned aerial vehicle (UAV) was applied to measurement surface contamination around the Fukushima Daiichi nuclear power station (FDNPS). An unmanned helicopter monitoring system (UHMS) was developed to survey the environmental effect of radioactive cesium scattered as a result of the FDNPS accident. The UHMS was used to monitor the area surrounding the FDNPS six times from 2012 to 2015. Quantitative changes in the radioactivity distribution trend were revealed from the results of these monitoring runs. With this information, we found that the actual reduction of dose rate was faster than the one calculated with radiocesium physical half-life. It is indicated that the attenuation effect of radiation by radiocesium penetration in soil is dominant as for reason of reduction of dose rate. Copyright © 2016 Elsevier Ltd. All rights reserved.

SU-E-T-108: Development of a Novel Clinical Neutron Dose Monitor for Proton Therapy Based On Twin TLD500 Chips in a Small PE Moderator

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

Hentschel, R; Mukherjee, B

2014-06-01

Purpose: In proton therapy, it could be desirable to measure out-of-field fast neutron doses at critical locations near and outside the patient body. Methods: The working principle of a novel clinical neutron dose monitor is verified by MCNPX simulation. The device is based on a small PE moderator of just 5.5cm side length for easy handling covered with a thermal neutron suppression layer. In the simulation, a polystyrene phantom is bombarded with a standard proton beam. The secondary thermal neutron flux produced inside the moderator by the impinging fast neutrons from the treatment volume is estimated by pairs of α-Al2O3:Cmore » (TLD500) chips which are evaluated offline after the treatment either by TL or OSL methods. The first chip is wrapped with 0.5mm natural Gadolinium foil converting the thermal neutrons to gammas via (n,γ) reaction. The second chip is wrapped with a dummy material. The chip centers have a distance of 2cm from each other. Results: The simulation shows that the difference of gamma doses in the TLD500 chips is correlated to the mean fast neutron dose delivered to the moderator material. Different outer shielding materials have been studied. 0.5mm Cadmium shielding is preferred for cost reasons and convenience. Replacement of PE moderator material by other materials like lead or iron at any place is unfavorable. The spatial orientation of the moderator cube is uncritical. Using variance reduction techniques like splitting/Russian roulette, the TLD500 gamma dose simulation give positive differences up to distances of 0.5m from the treatment volume. Conclusion: Applicability and basic layout of a novel clinical neutron dose monitor are demonstrated. The monitor measures PE neutron doses at locations outside the patient body up to distances of 0.5m from the treatment volume. Tissue neutron doses may be calculated using neutron kerma factors.« less

Considerations for Bioassay Monitoring of Mixtures of Radionuclides

DOE PAGES

Klumpp, John; Waters, Tom; Bertelli, Luiz

2017-10-01

Complying with regulations for bioassay monitoring of radionuclide intakes is significantly more complex for mixtures than it is for pure radionuclides. Different constituents will naturally have different dose coefficients, be detectable at significantly different levels, and may require very different amounts of effort to bioassay. The ability to use certain constituents as surrogates for others will depend on how well characterized the mixture is, as well as whether the employee is also working with other radionuclides. This is further compounded by the fact that the composition of a mixture (or even of a pure radionuclide) is likely to change overmore » time. Internal dosimetrists must decide how best to monitor employees who work with radionuclide mixtures. In particular, they must decide which constituents should be monitored routinely, which constituents only need to be monitored in the case of an intake, and how to estimate doses based on intakes of monitored and unmonitored constituents.« less

Absorbed Dose Rate Due to Intake of Natural Radionuclides by Tilapia Fish (Tilapia nilotica,Linnaeus, 1758) Estimated Near Uranium Mining at Caetité, Bahia, Brazil

NASA Astrophysics Data System (ADS)

Pereira, Wagner de S.; Kelecom, Alphonse; Py Júnior, Delcy de Azevedo

2008-08-01

The uranium mining at Caetité (Uranium Concentrate Unit—URA) is in its operational phase. Aiming to estimate the radiological environmental impact of the URA, a monitoring program is underway. In order to preserve the biota of the deleterious effects from radiation and to act in a pro-active way as expected from a licensing body, the present work aims to use an environmental protection methodology based on the calculation of absorbed dose rate in biota. Thus, selected target organism was the Tilapia fish (Tilapia nilotica, Linnaeus, 1758) and the radionuclides were: uranium (U-238), thorium (Th-232), radium (Ra-226 and Ra-228) and lead (Pb-210). As, in Brazil there are no radiation exposure limits adopted for biota the value proposed by the Department of Energy (DOE) of the United States of 3.5×103 μGy y-1 has been used. The derived absorbed dose rate calculated for Tilapia was 2.51×100 μGy y-1, that is less than 0.1% of the dose limit established by DOE. The critical radionuclide was Ra-226, with 56% of the absorbed dose rate, followed by U-238 with 34% and Th-232 with 9%. This value of 0.1% of the limit allows to state that, in the operational conditions analyzed, natural radionuclides do not represent a radiological problem to biota.

Absorbed Dose Rate Due to Intake of Natural Radionuclides by Tilapia Fish (Tilapia nilotica,Linnaeus, 1758) Estimated Near Uranium Mining at Caetite, Bahia, Brazil

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

Pereira, Wagner de S; Universidade Federal Fluminense, Programa de Pos-graduacao em Biologia Marinha; Kelecom, Alphonse

2008-08-07

The uranium mining at Caetite (Uranium Concentrate Unit--URA) is in its operational phase. Aiming to estimate the radiological environmental impact of the URA, a monitoring program is underway. In order to preserve the biota of the deleterious effects from radiation and to act in a pro-active way as expected from a licensing body, the present work aims to use an environmental protection methodology based on the calculation of absorbed dose rate in biota. Thus, selected target organism was the Tilapia fish (Tilapia nilotica, Linnaeus, 1758) and the radionuclides were: uranium (U-238), thorium (Th-232), radium (Ra-226 and Ra-228) and lead (Pb-210).more » As, in Brazil there are no radiation exposure limits adopted for biota the value proposed by the Department of Energy (DOE) of the United States of 3.5x10{sup 3} {mu}Gy y{sup -1} has been used. The derived absorbed dose rate calculated for Tilapia was 2.51x10{sup 0} {mu}Gy y{sup -1}, that is less than 0.1% of the dose limit established by DOE. The critical radionuclide was Ra-226, with 56% of the absorbed dose rate, followed by U-238 with 34% and Th-232 with 9%. This value of 0.1% of the limit allows to state that, in the operational conditions analyzed, natural radionuclides do not represent a radiological problem to biota.« less

Six steps to a successful dose-reduction strategy

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

Bennett, M.

1995-03-01

The increased importance of demonstrating achievement of the ALARA principle has helped produce a proliferation of dose-reduction ideas. Across a company there may be many dose-reduction items being pursued in a variety of areas. However, companies have a limited amount of resource and, therefore, to ensure funding is directed to those items which will produce the most benefit and that all areas apply a common policy, requires the presence of a dose-reduction strategy. Six steps were identified in formulating the dose-reduction strategy for Rolls-Royce and Associates (RRA): (1) collating the ideas; (2) quantitatively evaluating them on a common basis; (3)more » prioritizing the ideas in terms of cost benefit, (4) implementation of the highest priority items; (5) monitoring their success; (6) periodically reviewing the strategy. Inherent in producing the dose-reduction strategy has been a comprehensive dose database and the RRA-developed dose management computer code DOMAIN, which allows prediction of dose rates and dose. The database enabled high task dose items to be identified, assisted in evaluating dose benefits, and monitored dose trends once items had been implemented. The DOMAIN code was used both in quantifying some of the project dose benefits and its results, such as dose contours, used in some of the dose-reduction items themselves. In all, over fifty dose-reduction items were evaluated in the strategy process and the items which will give greatest benefit are being implemented. The strategy has been successful in giving renewed impetus and direction to dose-reduction management.« less

Compliance and patching and atropine amblyopia treatments.

PubMed

Wang, Jingyun

2015-09-01

In the past 20 years, there has been a great advancement in knowledge pertaining to compliance with amblyopia treatments. The occlusion dose monitor introduced quantitative monitoring methods in patching, which sparked our initial understanding of the dose-response relationship for patching amblyopia treatment. This review focuses on current compliance knowledge and the impact it has on patching and atropine amblyopia treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Treatment of Addison's disease during pregnancy.

PubMed

Oliveira, Diana; Lages, Adriana; Paiva, Sandra; Carrilho, Francisco

2018-01-01

Addison's disease, or primary adrenocortical insufficiency, is a long-term, potentially severe, rare endocrine disorder. In pregnancy, it is even rarer. We report the case of a 30-year-old pregnant patient with Addison's disease, referred to Obstetrics-Endocrinology specialty consult at 14 weeks gestation. She had been to the emergency department of her local hospital various times during the first trimester presenting with a clinical scenario suggestive of glucocorticoid under-replacement (nausea, persistent vomiting and hypotension), but this was interpreted as normal pregnancy symptoms. Hydrocortisone dose was adjusted, and the patient maintained regular follow-up. No complications were reported for the remainder of gestation and delivery. Pregnant patients with Addison's disease should be monitored during gestation and in the peripartum period by multidisciplinary teams. Adjustments in glucocorticoid and mineralocorticoid replacement therapy are often necessary, and monitoring should be based mainly on clinical findings, which becomes increasingly difficult during pregnancy. Patient education and specialized monitoring are key to avoiding complications from under- or over-replacement therapy in this period. An increase in glucocorticoid replacement dose is expected to be necessary during pregnancy in a woman with Addison's disease.Patient education regarding steroid cover and symptoms of acute adrenal crisis are fundamental.Monitoring in this period is challenging and remains mainly clinical.The increase in hydrocortisone dose often obviates the need to increase fludrocortisone dose.

The design of Radiation Accident Registry.

PubMed

Chen, Jing; Seely, Bob; Bergman, Lauren; Moir, Deborah

2011-03-01

In order to provide effective monitoring and follow-up on the health effects of individuals accidentally exposed to ionising radiation, a Radiation Accident Registry (RAR) has been designed and constructed as an extension to the existing National Dose Registry (NDR). The RAR has basic functions of recording, monitoring and reporting. This type of registry is able to assist responders in preparing for and managing situations during radiological events and in providing effective follow-up on the long-term health effects of persons exposed to ionising radiation. It is especially important to register radiation-exposed people in vulnerable population groups, such as children and pregnant women, to ensure proper long-term health care and protection. Even though radiation accidents are rare, a registry prepared for such accidents could involve a large population and, in some cases, require lifetime monitoring for individuals. One of the most challenging tasks associated with RAR is the assessment of radiation dose resulting from accidents. In some cases, the assessment of radiation doses to individuals could be a process requiring the involvement of various methods. The development of fast and accurate dose assessment tools will remain a long-term challenge associated with the RAR. To meet this challenge, further research activities in radiation dosimetry for individual monitoring are needed.

Wide-range radiation dose monitor

DOEpatents

Kopp, Manfred K.

1986-01-01

A radiation dose-rate monitor is provided which operates in a conventional linear mode for radiation in the 0 to 0.5 R/h range and utilizes a nonlinear mode of operation for sensing radiation from 0.5 R/h to over 500 R/h. The nonlinear mode is achieved by a feedback circuit which adjusts the high voltage bias of the proportional counter, and hence its gas gain, in accordance with the amount of radiation being monitored. This allows compression of readout onto a single scale over the range of 0 to greater than 500 R/h without scale switching operations.

Wide-range radiation dose monitor

DOEpatents

Kopp, M.K.

1984-09-20

A radiation dose-rate monitor is provided which operates in a conventional linear mode for radiation in the 0 to 0.5 R/h range and utilizes a nonlinear mode of operation for sensing radiation from 0.5 R/h to over 500 R/h. The nonlinear mode is achieved by a feedback circuit which adjusts the high voltage bias of the proportional counter, and hence its gas gain, in accordance with the amount of radiation being monitored. This allows compression of readout onto a single scale over the range of 0 to greater than 500 R/h without scale switching operations.

An updated dose assessment for resettlement options at Bikini Atoll--a U.S. nuclear test site.

PubMed

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

1997-07-01

On 1 March 1954, a nuclear weapon test, code-named BRAVO, conducted at Bikini Atoll in the northern Marshall Islands contaminated the major residence island. There has been a continuing effort since 1977 to refine dose assessments for resettlement options at Bikini Atoll. Here we provide a radiological dose assessment for the main residence island, Bikini, using extensive radionuclide concentration data derived from analysis of food crops, ground water, cistern water, fish and other marine species, animals, air, and soil collected at Bikini Island as part of our continuing research and monitoring program that began in 1978. The unique composition of coral soil greatly alters the relative contribution of 137Cs and 90Sr to the total estimated dose relative to expectations based on North American and European soils. Without counter measures, 137Cs produces 96% of the estimated dose for returning residents, mostly through uptake from the soil to terrestrial food crops but also from external gamma exposure. The doses are calculated assuming a resettlement date of 1999. The estimated maximum annual effective dose for current island conditions is 4.0 mSv when imported foods, which are now an established part of the diet, are available. The 30-, 50-, and 70-y integral effective doses are 91 mSv, 130 mSv, and 150 mSv, respectively. A detailed uncertainty analysis for these dose estimates is presented in a companion paper in this issue. We have evaluated various countermeasures to reduce 137Cs in food crops. Treatment with potassium reduces the uptake of 137Cs into food crops, and therefore the ingestion dose, to about 5% of pretreatment levels and has essentially no negative environmental consequences. We have calculated the dose for the rehabilitation scenario where the top 40 cm of soil is removed in the housing and village area, and the rest of the island is treated with potassium fertilizer; the maximum annual effective dose is 0.41 mSv and the 30-, 50-, and 70-y integral effective doses are 9.8 mSv, 14 mSv, and 16 mSv, respectively.

NSW Annual Immunisation Coverage Report, 2009.

PubMed

Hull, Brynley; Dey, Aditi; Mahajan, Deepika; Campbell-Lloyd, Sue; Menzies, Robert I; McIntyre, Peter B

2010-01-01

This is the first in a series of annual immunisation coverage reports that document trends in NSW for a range of standard measures derived from Australian Childhood Immunisation Register data, including overall coverage at standard age milestones and for individual vaccines. This report includes data up to and including 2009. Data from the Australian Childhood Immunisation Register, the NSW Health Survey and the NSW School Immunisation Program were used to calculate various measures of population coverage relating to childhood vaccines, adult influenza and pneumococcal vaccines and adolescent vaccination, respectively. Immunise Australia Program targets have been reached for children at 12 and 24 months of age but not for children at 5 years of age. Delayed receipt of vaccines is an issue for vaccines recommended for Aboriginal children. Pneumococcal vaccination in the elderly has been steadily rising, although it has remained lower than the influenza coverage estimates. For adolescents, there is better coverage for the first and second doses of human papillomavirus vaccine and the dose of dTpa than for varicella. This comprehensive analysis provides important baseline data for NSW against which future reports can be compared to monitor progress in improving immunisation coverage. Immunisation at the earliest appropriate age should be a public health goal for countries such as Australia where high levels of vaccine coverage at milestone ages have been achieved.

Extravasation of a therapeutic dose of 131I-metaiodobenzylguanidine: prevention, dosimetry, and mitigation.

PubMed

Bonta, Dacian V; Halkar, Raghuveer K; Alazraki, Naomi

2011-09-01

After the extravasation of a therapeutic dose of (131)I-metaiodobenzylguanidine that produced a radiation burn to a patient's forearm, we instituted a catheter placement verification protocol. Before therapy infusion, proper placement is verified by administering 37 MBq of (99m)Tc-pertechnetate through the catheter, and monitoring activity at the administration site and on the contralateral extremity. A dosimetric model describing both high-rate and low-rate dose components was developed and predicted that the basal epidermal layer received a radiation dose consistent with the observed moist desquamation radiation skin toxicity. No extravasation incidents have occurred since the verification procedure was instituted. To protect against radiation injury from extravasation of therapeutic radionuclides, test administration of a small (99m)Tc dose with probe monitoring of comparable sites in both upper extremities appears to be an effective preventive measure.

Microdosemeter instrument (MIDN) for assessing risk in space.

PubMed

Pisacane, V L; Dolecek, Q E; Malak, H; Cucinotta, F A; Zaider, M; Rosenfeld, A B; Rusek, A; Sivertz, M; Dicello, J F

2011-02-01

Radiation in space generally produces higher dose rates than that on the Earth's surface, and contributions from primary galactic and solar events increase with altitude within the magnetosphere. Presently, no personnel monitor is available to astronauts for real-time monitoring of dose, radiation quality and regulatory risk. This group is developing a prototypic instrument for use in an unknown, time-varying radiation field. This microdosemeter-dosemeter nucleon instrument is for use in a spacesuit, spacecraft, remote rover and other applications. It provides absorbed dose, dose rate and dose equivalent in real time so that action can be taken to reduce exposure. Such a system has applications in health physics, anti-terrorism and radiation-hardening of electronics as well. The space system is described and results of ground-based studies are presented and compared with predictions of transport codes. An early prototype in 2007 was successfully launched, the only solid-state microdosemeter to have flown in space.

[Effects of integrated disease management program on the outcome of patients with heart failure].

PubMed

Fan, Hui-hua; Shi, Hao-ying; Jin, Wei; Zhu, Ya-juan; Huang, Dai-ni; Yan, Yi-wen; Zhu, Feng; Li, Hong-li; Liu, Jian; Liu, Shao-wen

2010-07-01

To investigate the feasibility and efficacy on the outcome of patients with heart failure of integrated disease management program with heart failure clinic, patient education and telephone follow-up. A total of 145 hospitalized patients with chronic heart failure and LVEF ≤ 45% or patients with LVEF > 45% and NT-proBNP > 1500 ng/L were divided into conventional group (n = 71) and interventional group (n = 74). Patients were followed for 10 to 12 months. Baseline clinical characteristics, LVEF and dose of evidence-based medicine were similar between the 2 groups. During follow-up, the NYHA functional class was higher in conventional group than interventional group (3.2 ± 0.5 vs 1.4 ± 0.5, P < 0.05), and the LVEF deteriorated in the conventional group and improved from 34% to 40%in the interventional group. The proportions of self-monitoring of weight, blood pressure and pulse rate in the interventional group were significantly higher than those of conventional group (P < 0.05). Among patients with systolic heart failure, 40% patients in the interventional group and 11% patients in the conventional group achieved the target doses of β-blockers (P < 0.05). Cardiovascular event rate of conventional group and interventional group is 91.5% and 27.0% respectively (P < 0.05). Integrated disease management program with heart failure clinic, patient education and telephone follow-up can improve patient compliance to heart failure treatment, improve cardiac function and reduce cardiovascular event rate.

SU-E-I-10: Automatic Monitoring of Accumulated Dose Indices From DICOM RDSR to Improve Radiation Safety in X-Ray Angiography

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

Omar, A; Bujila, R; Nowik, P

2014-06-01

Purpose: To investigate the potential benefits of automatic monitoring of accumulated patient and staff dose indicators, i.e., CAK and KAP, from DICOM Radiation Dose Structured Reports (RDSR) in x-ray angiography (XA). Methods: Recently RDSR has enabled the convenient aggregation of dose indices and technique parameters for XA procedures. The information contained in RDSR objects for three XA systems, dedicated to different types of clinical procedures, has been collected and aggregated in a database for over one year using a system developed with open-source software at the Karolinska University Hospital. Patient weight was complemented to the RDSR data via an interfacemore » with the Hospital Information System (HIS). Results: The linearly approximated trend in KAP over a time period of a year for cerebrovascular, pelvic/peripheral vascular, and cardiovascular procedures showed a decrease of 12%, 20%, and 14%, respectively. The decrease was mainly due to hardware/software upgrades and new low-dose imaging protocols, and partially due to ongoing systematic radiation safety education of the clinical staff. The CAK was in excess of 3 Gy for 15 procedures, and exceeded 5 Gy for 3 procedures. The dose indices have also shown a significant dependence on patient weight for cardiovascular and pelvic/peripheral vascular procedures; a 10 kg shift in mean patient weight can result in a dose index increase of 25%. Conclusion: Automatic monitoring of accumulated dose indices can be utilized to notify the clinical staff and medical physicists when the dose index has exceeded a predetermined action level. This allows for convenient and systematic follow-up of patients in risk of developing deterministic skin injuries. Furthermore, trend analyses of dose indices over time is a valuable resource for the identification of potential positive or negative effects (dose increase/decrease) from changes in hardware, software, and clinical work habits.« less

Volunteer water monitoring: A guide for state managers

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

Not Available

1990-08-01

Contents: executive summary; volunteers in water monitoring; planning a volunteer monitoring program; implementing a volunteer monitoring program; providing credible information; costs and funding; and descriptions of five successful programs.

Dose-dependent effects of cannabis on the neural correlates of error monitoring in frequent cannabis users.

PubMed

Kowal, Mikael A; van Steenbergen, Henk; Colzato, Lorenza S; Hazekamp, Arno; van der Wee, Nic J A; Manai, Meriem; Durieux, Jeffrey; Hommel, Bernhard

2015-11-01

Cannabis has been suggested to impair the capacity to recognize discrepancies between expected and executed actions. However, there is a lack of conclusive evidence regarding the acute impact of cannabis on the neural correlates of error monitoring. In order to contribute to the available knowledge, we used a randomized, double-blind, between-groups design to investigate the impact of administration of a low (5.5 mg THC) or high (22 mg THC) dose of vaporized cannabis vs. placebo on the amplitudes of the error-related negativity (ERN) and error positivity (Pe) in the context of the Flanker task, in a group of frequent cannabis users (required to use cannabis minimally 4 times a week, for at least 2 years). Subjects in the high dose group (n=18) demonstrated a significantly diminished ERN in comparison to the placebo condition (n=19), whereas a reduced Pe amplitude was observed in both the high and low dose (n=18) conditions, as compared to placebo. The results suggest that a high dose of cannabis may affect the neural correlates of both the conscious (late), as well as the initial automatic processes involved in error monitoring, while a low dose of cannabis might impact only the conscious (late) processing of errors. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.

Changes in ambient dose equivalent rates around roads at Kawamata town after the Fukushima accident.

PubMed

Kinase, Sakae; Sato, Satoshi; Sakamoto, Ryuichi; Yamamoto, Hideaki; Saito, Kimiaki

2015-11-01

Changes in ambient dose equivalent rates noted through vehicle-borne surveys have elucidated ecological half-lives of radioactive caesium in the environment. To confirm that the ecological half-lives are appropriate for predicting ambient dose equivalent rates within living areas, it is important to ascertain ambient dose equivalent rates on/around roads. In this study, radiation monitoring on/around roads at Kawamata town, located about 37 km northwest of the Fukushima Daiichi Nuclear Power Plant, was performed using monitoring vehicles and survey meters. It was found that the ambient dose equivalent rates around roads were higher than those on roads as of October 2012. And withal the ecological half-lives on roads were essentially consistent with those around roads. With dose predictions using ecological half-lives on roads, it is necessary to make corrections to ambient dose equivalent rates through the vehicle-borne surveys against those within living areas. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

Hamliton, T F

Rongelap Atoll experienced close-in or local fallout from the U.S. nuclear test program conducted in the northern Marshall Islands between 1946 and 1958. By all internationally agreed scientific criteria, Rongelap Island is considered safe for permanent resettlement. However, the amount of bomb-related radioactivity in soil and vegetation is, on average, about 5 times greater in the northern islands of the atoll because the centerline of the fallout pattern from the 1954 thermonuclear ''Bravo'' test extended over this part of the atoll. The most important radioactive element remaining on the atoll is radioactive cesium (cesium-137). Cesium-137 emits what is called amore » ''gamma ray'' that can penetrate the body and deliver both an external (outside the body) and internal (from inside the body) gamma dose to inhabitants of Rongelap Atoll. Cesium-137 is taken up from the soil into locally grown foodstuffs such as coconut, Pandanus and breadfruit. Significant quantities of cesium-137 may also be found in coconut crab. The internal dose delivered to people eating these products will be directly proportional to the concentration of cesium-137 in the food and the amount consumed. The external gamma dose will depend on the concentration of cesium-137 in the soil and the amount of time spent in the area. The highest concentration of cesium-137 in surface soils of the northern islands of Rongelap Atoll is about equivalent to that measured on Bikini Island. Under the radiation protection criteria adopted by the Republic of the Marshall Islands Nuclear Claims Tribunal, permanent resettlement of these islands would require intervention because of the higher radiation doses that could potentially be delivered to inhabitants living on a diet derived largely from local foods. A more realistic lifestyle scenario is that the resettled population on Rongelap Island will occasionally visit the northern part of the atoll for food gathering, fishing and other recreational activities. It is estimated that a person spending 8 hours (1 work day) in the interior of the Rongelap Atoll northern islands will receive a maximum additional external dose of around 0.1-0.2 mrem per day. Furthermore, Lawrence Livermore National Laboratory's environmental monitoring continues to show that the marine environment contains very low levels of bomb radioactivity. Similarly, the occasional consumption of terrestrial foods including coconut crab from the northern islands is not expected to add significantly to the radiological health risk of living on Rongelap Island. The average annual effective ingestion dose for Rongelap Island resettlement in 2002 is estimated to be around 1-2 mrem per year when imported foods are made available and proposed remediation efforts take effect. This estimate is about twice that of the Rongelap Island resettlement worker population using direct measurements from the whole body counting program. Resettlement workers presently living on the islands receive an average internal dose from cesium-137 of less than 1 mrem (0.01 mSv) per year. These workers are known to eat locally grown foods and coconut crabs collected from the northern islands. The highest individual dose observed was 4 mrem (0.04 mSv) per year. Under the guidelines adopted by the Republic of the Marshall Islands Nuclear Claims Tribunal, it is concluded that diving, fishing and visiting any northern island of Rongelap Atoll are safe activities for limited periods. Eating local fish and other marine life such as clams would also be considered safe. Consumption of plant foods from the northern islands of Rongelap Atoll depends on successful implementation of specific remediation measures to ensure dietary intakes of cesium-137 remain at or below levels considered safe. The whole body counting program should continue to monitor the actual internal levels of cesium-137 among people eating plants and coconut crabs gathered from the northern islands of Rongelap Atoll islands until such time that the Nuclear Claims Tribunal guidelines are met.« less

Introduction of Sequential Inactivated Polio Vaccine–Oral Polio Vaccine Schedule for Routine Infant Immunization in Brazil’s National Immunization Program

PubMed Central

Domingues, Carla Magda Allan S.; de Fátima Pereira, Sirlene; Marreiros, Ana Carolina Cunha; Menezes, Nair; Flannery, Brendan

2015-01-01

In August 2012, the Brazilian Ministry of Health introduced inactivated polio vaccine (IPV) as part of sequential polio vaccination schedule for all infants beginning their primary vaccination series. The revised childhood immunization schedule included 2 doses of IPV at 2 and 4 months of age followed by 2 doses of oral polio vaccine (OPV) at 6 and 15 months of age. One annual national polio immunization day was maintained to provide OPV to all children aged 6 to 59 months. The decision to introduce IPV was based on preventing rare cases of vaccine-associated paralytic polio, financially sustaining IPV introduction, ensuring equitable access to IPV, and preparing for future OPV cessation following global eradication. Introducing IPV during a national multivaccination campaign led to rapid uptake, despite challenges with local vaccine supply due to high wastage rates. Continuous monitoring is required to achieve high coverage with the sequential polio vaccine schedule. PMID:25316829

Treatment of deep venous thrombosis and pulmonary embolism with low molecular weight heparin in the geriatric patient population.

PubMed

Merli, G J

2001-02-01

Low-molecular-weight heparins have provided a new approach to treating DVT-PE. These anticoagulants have better bioavailability, a longer half-life, and a more predictable antithrombotic effect than UFH. In the studies reviewed, LMWHs were shown to be safe and effective in preventing recurrent thrombotic events when compared with the more precise UFH dosing schedules. There has been no evidence of an increased incidence of major bleeding or recurrent thromboembolic events based on age in these trials. With these findings LMWHs given subcutaneously, without laboratory monitoring, in a dose determined by actual body weight allows clinicians involved in the care of the elderly to manage these patients with DVT with or without PE in the nursing home setting, skilled nursing care facilities, rehabilitation units, acute care hospital setting, or as described in this article at home. These patients can continue their physical therapy programs because intravenous infusion lines and the necessity to be maintained at bedrest do not encumber them.

Extended Detection of Amphetamine and Methamphetamine in Oral Fluid.

PubMed

Andås, Hilde T; Enger, Asle; Øiestad, Åse Marit L; Vindenes, Vigdis; Christophersen, Asbjørg S; Huestis, Marilyn A; Øiestad, Elisabeth L

2016-02-01

Amphetamine and methamphetamine are popular drugs of abuse worldwide and are important components of drug monitoring programs. Windows of detection for amphetamine and methamphetamine in oral fluid after high doses have not been investigated. Repeated high-dose ingestions are likely to cause positive samples for extended periods. Common routes of administration of amphetamine/methamphetamine in Norway are oral intake or injection. The aim of this study was to investigate windows of detection for amphetamine and methamphetamine in oral fluid from drug addicts under sustained abstinence during detoxification. Twenty-five patients admitted to a closed detoxification unit were included in this study. Oral fluid samples were collected daily in the morning and evening, and urine every morning for 10 days. A blood sample was drawn during the first 5 days after admission if the patient consented. Oral fluid results were compared with urine results to determine whether a new ingestion occurred. Oral fluid was collected with the Intercept oral fluid collection device. In-house cutoff concentrations for amphetamine and methamphetamine were 6.8 and 7.5 mcg/L, respectively, in oral fluid, and 135 and 149 mcg/L, respectively, in urine. Amphetamines were detected in 11 oral fluid, 5 urine, and 2 blood specimens from 25 patients. Patients self-reported amphetamines intake of up to 0.5-2 g daily. Windows of detection for amphetamine and methamphetamine in oral fluid were up to 8 days, longer than in urine at the applied cutoff values. These data confirm that oral fluid is a viable alternative to urine for monitoring amphetamine abuse, and that these substances might be detected in oral fluid for at least 1 week after ingestion of high doses. Such long detection times were, as far as we are aware, never reported previously for oral fluid amphetamines.

The Dose Response Relationship between In Ear Occupational Noise Exposure and Hearing Loss

PubMed Central

Rabinowitz, Peter M.; Galusha, Deron; Dixon-Ernst, Christine; Clougherty, Jane E.; Neitzel, Richard L.

2014-01-01

Objectives Current understanding of the dose-response relationship between occupational noise and hearing loss is based on cross-sectional studies prior to the widespread use hearing protection and with limited data regarding noise exposures below 85dBA. We report on the hearing loss experience of a unique cohort of industrial workers with daily monitoring of noise inside of hearing protection devices. Methods At an industrial facility, workers exhibiting accelerated hearing loss were enrolled in a mandatory program to monitor daily noise exposures inside of hearing protection. We compared these noise measurements (as time-weighted LAVG) to interval rates of high frequency hearing loss over a six year period using a mixed effects model, adjusting for potential confounders. Results Workers’ high frequency hearing levels at study inception averaged more than 40 dB hearing threshold level (HTL). Most noise exposures were less than 85dBA (mean LAVG 76 dBA, interquartile range 74 to 80 dBA). We found no statistical relationship between LAvg and high frequency hearing loss (p = 0.53). Using a metric for monthly maximum noise exposure did not improve model fit. Conclusion At-ear noise exposures below 85dBA did not show an association with risk of high frequency hearing loss among workers with substantial past noise exposure and hearing loss at baseline. Therefore, effective noise control to below 85dBA may lead to significant reduction in occupational hearing loss risk in such individuals. Further research is needed on the dose response relationship of noise and hearing loss in individuals with normal hearing and little prior noise exposure. PMID:23825197

Impact of a phenytoin loading dose program in the emergency department.

PubMed

Brancaccio, Adam; Giuliano, Christopher; McNorton, Kelly; Delgado, George

2014-11-01

The use of a combined physician-and pharmacist-directed phenytoin loading dose program in an emergency department (ED) was evaluated. This single-center, observational, preimplementation-postimplementation study evaluated adult patients who received a phenytoin loading dose in the ED. The primary outcome compared the proportion of optimal phenytoin loading doses in the preimplementation and postimplementation groups. The postimplementation group was further stratified into pharmacist- and prescriber-dosing groups. Other outcomes evaluated included the numbers of appropriate serum phenytoin concentrations measured, adverse drug reactions (ADRs), and recurrence of seizures within 24 hours of loading dose administration in the preimplementation and postimplementation groups. There was no difference in the proportion of optimal phenytoin loading doses between the preimplementation and postimplementation groups (50% versus 62%, respectively; p=0.19). When stratified by individual groups, the rate of optimal phenytoin loading doses increased by 64% in the postimplementation pharmacist group (50% versus 82%, p=0.007), while the rate in the prescriber-dosing group remained relatively unchanged (50% versus 49%, p=0.91). The number of appropriate serum phenytoin concentrations significantly improved in the postimplementation versus preimplementation group (65% versus 40%, p=0.025). Rates of ADRs and recurrence of seizures did not differ across the study groups. No change in the percentage of optimal phenytoin loading doses in the ED was observed after implementation of a combined pharmacist- and physician- dosing program. When stratified into pharmacist or prescriber dosing, the pharmacist-led dosing program significantly improved the proportion of patients who received optimal phenytoin loading doses. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

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

NSTec Environmental Restoration

Homeland Security Presidential Directive HSPD-5 requires all federal departments and agencies to adopt a National Incident Management System (NIMS)/Incident Command System (ICS) and use it in their individual domestic incident management and emergency prevention, preparedness, response, recovery, and mitigation programs and activities, as well as in support of those actions taken to assist state and local entities. This system provides a consistent nationwide template to enable federal, state, local, and tribal governments, private-sector, and nongovernmental organizations to work together effectively and efficiently to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity, includingmore » acts of catastrophic terrorism. This document identifies the operational concepts of the Federal Radiological Monitoring and Assessment Center's (FRMAC) implementation of the NIMS/ICS response structure under the National Response Plan (NRP). The construct identified here defines the basic response template to be tailored to the incident-specific response requirements. FRMAC's mission to facilitate interagency environmental data management, monitoring, sampling, analysis, and assessment and link this information to the planning and decision staff clearly places the FRMAC in the Planning Section. FRMAC is not a mitigating resource for radiological contamination but is present to conduct radiological impact assessment for public dose avoidance. Field monitoring is a fact-finding mission to support this effort directly. Decisions based on the assessed data will drive public protection and operational requirements. This organizational structure under NIMS is focused by the mission responsibilities and interface requirements following the premise to provide emergency responders with a flexible yet standardized structure for incident response activities. The coordination responsibilities outlined in the NRP are based on the NIMS/ICS construct and Unified Command (UC) for management of a domestic incident. The NRP Nuclear/Radiological Incident Annex (NUC) further provides requirements and protocols for coordinating federal government capabilities to respond to nuclear/radiological Incidents of National Significance (INS) and other radiological incidents. When a FRMAC is established, it operates under the parameters of NIMS as defined in the NRP. FRMAC and its operations have been modified to reflect NIMS/ICS concepts and principles and to facilitate working in a Unified Command structure. FRMAC is established at or near the scene of the incident to coordinate radiological monitoring and assessment and is established in coordination with the U.S. Department of Homeland Security (DHS); the coordinating agency; other federal agencies; and state, local, and tribal authorities. However, regardless of the coordinating agency designation, U.S. Department of Energy (DOE) coordinates radiological monitoring and assessment activities for the initial phases of the offsite federal incident response through the Radiological Assistance Program (RAP) and FRMAC assets. Monitoring and assessment data are managed by FRMAC in an accountable, secure, and retrievable format. Monitoring data interpretations, including exposure rate contours, dose projections, and any requested radiological assessments are to be provided to the DHS; to the coordinating agency; and to state, local, and tribal government agencies.« less

The immunization data quality audit: verifying the quality and consistency of immunization monitoring systems.

PubMed Central

Ronveaux, O.; Rickert, D.; Hadler, S.; Groom, H.; Lloyd, J.; Bchir, A.; Birmingham, M.

2005-01-01

OBJECTIVE: To evaluate the consistency and quality of immunization monitoring systems in 27 countries during 2002-03 using standardized data quality audits (DQAs) that had been launched within the framework of the Global Alliance for Vaccines and Immunization. METHODS: The consistency of reporting systems was estimated by determining the proportion of third doses of diphtheria-tetanuspertussis (DTP-3) vaccine reported as being administered that could be verified by written documentation at health facilities and districts. The quality of monitoring systems was measured using quality indices for different components of the monitoring systems. These indices were applied to each level of the health service (health unit, district and national). FINDINGS: The proportion of verified DTP-3 doses was lower than 85% in 16 countries. Difficulties in verifying the doses administered often arose at the peripheral level of the health service, usually as the result of discrepancies in information between health units and their corresponding districts or because completed recording forms were not available from health units. All countries had weaknesses in their monitoring systems; these included the inconsistent use of monitoring charts; inadequate monitoring of vaccine stocks, injection supplies and adverse events; unsafe computer practices; and poor monitoring of completeness and timeliness of reporting. CONCLUSION: Inconsistencies in immunization data occur in many countries, hampering their ability to manage their immunization programmes. Countries should use these findings to strengthen monitoring systems so that data can reliably guide programme activities. The DQA is an innovative tool that provides a way to independently assess the quality of immunization monitoring systems at all levels of a health service and serves as a point of entry to make improvements. It provides a useful example for other global health initiatives. PMID:16175824

Seasonal influenza vaccine dose distribution in 157 countries (2004-2011).

PubMed

Palache, Abraham; Oriol-Mathieu, Valerie; Abelin, Atika; Music, Tamara

2014-11-12

Globally there are an estimated 3-5 million cases of severe influenza illness every year, resulting in 250,000-500,000 deaths. At the World Health Assembly in 2003, World Health Organization (WHO) resolved to increase influenza vaccine coverage rates (VCR) for high-risk groups, particularly focusing on at least 75% of the elderly by 2010. But systematic worldwide data have not been available to assist public health authorities to monitor vaccine uptake and review progress toward vaccination coverage targets. In 2008, the International Federation of Pharmaceutical Manufacturers and Associations Influenza Vaccine Supply task force (IFPMA IVS) developed a survey methodology to assess global influenza vaccine dose distribution. The current survey results represent 2011 data and demonstrate the evolution of the absolute number distributed between 2004 and 2011 inclusive, and the evolution in the per capita doses distributed in 2008-2011. Global distribution of IFPMA IVS member doses increased approximately 86.9% between 2004 and 2011, but only approximately 12.1% between 2008 and 2011. The WHO's regions in Eastern Mediterranean (EMRO), Southeast Asian (SEARO) and Africa (AFRO) together account for about 47% of the global population, but only 3.7% of all IFPMA IVS doses distributed. While distributed doses have globally increased, they have decreased in EURO and EMRO since 2009. Dose distribution can provide a reasonable proxy of vaccine utilization. Based on the dose distribution, we conclude that seasonal influenza VCR in many countries remains well below the WHA's VCR targets and below the recommendations of the Council of the European Union in EURO. Inter- and intra-regional disparities in dose distribution trends call into question the impact of current vaccine recommendations at achieving coverage targets. Additional policy measures, particularly those that influence patients adherence to vaccination programs, such as reimbursement, healthcare provider knowledge, attitudes, practices, and communications, are required for VCR targets to be met and benefit public health. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

Yi, B; Chung, H; Mutaf, Y

Purpose: To test a novel total body irradiation (TBI) system using conformal partial arc with patient lying on the stationary couch which is biologically equivalent to a moving couch TBI. This improves the scanning field TBI, which is previously presented. Methods: The Uniform MU Modulated arc Segments TBI or UMMS-TBI scans the treatment plane with a constant machine dose rate and a constant gantry rotation speed. A dynamic MLC pattern which moves while gantry rotates has been designed so that the treatment field moves same distance at the treatment plane per each gantry angle, while maintaining same treatment field sizemore » (34cm) at the plane. Dose across the plane varies due to the geometric differences including the distance from the source to a point of interest and the different attenuation from the slanted depth which changes the effective depth. Beam intensity is modulated to correct the dose variation across the plane by assigning the number of gantry angles inversely proportional to the uncorrected dose. Results: Measured dose and calculated dose matched within 1 % for central axis and 3% for off axis for various patient scenarios. Dose from different distance does not follow the inverse square relation as it is predicted from calculation. Dose uniformity better than 5% across 180 cm at 10cm depth is achieved by moving the gantry from −55 to +55 deg. Total treatment time for 2 Gy AP/PA fields is 40–50 minutes excluding patient set up time, at the machine dose rate of 200 MU/min. Conclusion: This novel technique, yet accurate but easy to implement enables TBI treatment in a small treatment room with less program development preparation than other techniques. The VMAT function of treatment delivery is not required to modulate beams. One delivery pattern can be used for different patients by changing the monitor units.« less

CT scans for pulmonary surveillance may be overused in lower-grade sarcoma.

PubMed

Miller, Benjamin J; Carmody Soni, Emily E; Reith, John D; Gibbs, C Parker; Scarborough, Mark T

2012-01-01

Chest CT scans are often used to monitor patients after excision of a sarcoma. Although sensitive, CT scans are more expensive than chest radiographs and are associated with possible health risks from a higher radiation dose. We hypothesized that a program based upon limited CT scans in lower-grade sarcoma could be efficacious and less expensive. We retrospectively assigned patients to a high-risk or low-risk hypothetical protocol. Eighty-three low- or intermediate-grade soft tissue sarcomas met our inclusion criteria. Eight patients had pulmonary metastasis. A protocol based on selective CT scans for high-risk patients would have identified seven out of eight lesions. The incremental cost-effectiveness ratio for routine CT scans was $731,400. A program based upon selective CT scans for higher-risk patients is accurate, spares unnecessary radiation to many patients, and is less expensive.

Final environmental impact statement. Waste Isolation Pilot Plant

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

Not Available

1980-10-01

This volume contains the appendices for the Final Environmental Impact Statement for the Waste Isolation Pilot Plant (WIPP). Alternative geologic environs are considered. Salt, crystalline rock, argillaceous rock, and tuff are discussed. Studies on alternate geologic regions for the siting of WIPP are reviewed. President Carter's message to Congress on the management of radioactive wastes and the findings and recommendations of the interagency review group on nuclear waste management are included. Selection criteria for the WIPP site including geologic, hydrologic, tectonic, physicochemical compatability, and socio-economic factors are presented. A description of the waste types and the waste processing procedures aremore » given. Methods used to calculate radiation doses from radionuclide releases during operation are presented. A complete description of the Los Medanos site, including archaeological and historic aspects is included. Environmental monitoring programs and long-term safety analysis program are described. (DMC)« less

Experiences and Lessons From Polio Eradication Applied to Immunization in 10 Focus Countries of the Polio Endgame Strategic Plan

PubMed Central

Mallya, Apoorva; Sandhu, Hardeep; Anya, Blanche-Philomene; Yusuf, Nasir; Ntakibirora, Marcelline; Hasman, Andreas; Fahmy, Kamal; Agbor, John; Corkum, Melissa; Sumaili, Kyandindi; Siddique, Anisur Rahman; Bammeke, Jane; Braka, Fiona; Andriamihantanirina, Rija; Ziao, Antoine-Marie C.; Djumo, Clement; Yapi, Moise Desire; Sosler, Stephen; Eggers, Rudolf

2017-01-01

Abstract Nine polio areas of expertise were applied to broader immunization and mother, newborn and child health goals in ten focus countries of the Polio Eradication Endgame Strategic Plan: policy & strategy development, planning, management and oversight (accountability framework), implementation & service delivery, monitoring, communications & community engagement, disease surveillance & data analysis, technical quality & capacity building, and partnerships. Although coverage improvements depend on multiple factors and increased coverage cannot be attributed to the use of polio assets alone, 6 out of the 10 focus countries improved coverage in three doses of diphtheria tetanus pertussis containing vaccine between 2013 and 2015. Government leadership, evidence-based programming, country-driven comprehensive operational annual plans, community partnership and strong accountability systems are critical for all programs and polio eradication has illustrated these can be leveraged to increase immunization coverage and equity and enhance global health security in the focus countries. PMID:28838187

Effect of a Task-Oriented Rehabilitation Program on Upper Extremity Recovery Following Motor Stroke: The ICARE Randomized Clinical Trial.

PubMed

Winstein, Carolee J; Wolf, Steven L; Dromerick, Alexander W; Lane, Christianne J; Nelsen, Monica A; Lewthwaite, Rebecca; Cen, Steven Yong; Azen, Stanley P

2016-02-09

Clinical trials suggest that higher doses of task-oriented training are superior to current clinical practice for patients with stroke with upper extremity motor deficits. To compare the efficacy of a structured, task-oriented motor training program vs usual and customary occupational therapy (UCC) during stroke rehabilitation. Phase 3, pragmatic, single-blind randomized trial among 361 participants with moderate motor impairment recruited from 7 US hospitals over 44 months, treated in the outpatient setting from June 2009 to March 2014. Structured, task-oriented upper extremity training (Accelerated Skill Acquisition Program [ASAP]; n = 119); dose-equivalent occupational therapy (DEUCC; n = 120); or monitoring-only occupational therapy (UCC; n = 122). The DEUCC group was prescribed 30 one-hour sessions over 10 weeks; the UCC group was only monitored, without specification of dose. The primary outcome was 12-month change in log-transformed Wolf Motor Function Test time score (WMFT, consisting of a mean of 15 timed arm movements and hand dexterity tasks). Secondary outcomes were change in WMFT time score (minimal clinically important difference [MCID] = 19 seconds) and proportion of patients improving ≥25 points on the Stroke Impact Scale (SIS) hand function score (MCID = 17.8 points). Among the 361 randomized patients (mean age, 60.7 years; 56% men; 42% African American; mean time since stroke onset, 46 days), 304 (84%) completed the 12-month primary outcome assessment; in intention-to-treat analysis, mean group change scores (log WMFT, baseline to 12 months) were, for the ASAP group, 2.2 to 1.4 (difference, 0.82); DEUCC group, 2.0 to 1.2 (difference, 0.84); and UCC group, 2.1 to 1.4 (difference, 0.75), with no significant between-group differences (ASAP vs DEUCC: 0.14; 95% CI, -0.05 to 0.33; P = .16; ASAP vs UCC: -0.01; 95% CI, -0.22 to 0.21; P = .94; and DEUCC vs UCC: -0.14; 95% CI, -0.32 to 0.05; P = .15). Secondary outcomes for the ASAP group were WMFT change score, -8.8 seconds, and improved SIS, 73%; DEUCC group, WMFT, -8.1 seconds, and SIS, 72%; and UCC group, WMFT, -7.2 seconds, and SIS, 69%, with no significant pairwise between-group differences (ASAP vs DEUCC: WMFT, 1.8 seconds; 95% CI, -0.8 to 4.5 seconds; P = .18; improved SIS, 1%; 95% CI, -12% to 13%; P = .54; ASAP vs UCC: WMFT, -0.6 seconds, 95% CI, -3.8 to 2.6 seconds; P = .72; improved SIS, 4%; 95% CI, -9% to 16%; P = .48; and DEUCC vs UCC: WMFT, -2.1 seconds; 95% CI, -4.5 to 0.3 seconds; P = .08; improved SIS, 3%; 95% CI, -9% to 15%; P = .22). A total of 168 serious adverse events occurred in 109 participants, resulting in 8 patients withdrawing from the study. Among patients with motor stroke and primarily moderate upper extremity impairment, use of a structured, task-oriented rehabilitation program did not significantly improve motor function or recovery beyond either an equivalent or a lower dose of UCC upper extremity rehabilitation. These findings do not support superiority of this program among patients with motor stroke and primarily moderate upper extremity impairment. clinicaltrials.gov Identifier: NCT00871715.

Effect of a Task-Oriented Rehabilitation Program on Upper Extremity Recovery Following Motor Stroke

PubMed Central

Winstein, Carolee J.; Wolf, Steven L.; Dromerick, Alexander W.; Lane, Christianne J.; Nelsen, Monica A.; Lewthwaite, Rebecca; Cen, Steven Yong; Azen, Stanley P.

2016-01-01

IMPORTANCE Clinical trials suggest that higher doses of task-oriented training are superior to current clinical practice for patients with stroke with upper extremity motor deficits. OBJECTIVE To compare the efficacy of a structured, task-oriented motor training program vs usual and customary occupational therapy (UCC) during stroke rehabilitation. DESIGN, SETTING, AND PARTICIPANTS Phase 3, pragmatic, single-blind randomized trial among 361 participants with moderate motor impairment recruited from 7 US hospitals over 44 months, treated in the outpatient setting from June 2009 to March 2014. INTERVENTIONS Structured, task-oriented upper extremity training (Accelerated Skill Acquisition Program[ASAP]; n = 119); dose-equivalent occupational therapy (DEUCC; n = 120); or monitoring-only occupational therapy (UCC; n = 122). The DEUCC group was prescribed 30 one-hour sessions over 10 weeks; the UCC group was only monitored, without specification of dose. MAIN OUTCOMES AND MEASURES The primary outcome was 12-month change in log-transformed Wolf Motor Function Test time score (WMFT, consisting of a mean of 15 timed arm movements and hand dexterity tasks). Secondary outcomes were change in WMFT time score (minimal clinically important difference [MCID] = 19 seconds) and proportion of patients improving ≥25 points on the Stroke Impact Scale (SIS) hand function score (MCID = 17.8 points). RESULTS Among the 361 randomized patients (mean age, 60.7 years; 56% men; 42% African American; mean time since stroke onset, 46 days), 304 (84%) completed the 12-month primary outcome assessment; in intention-to-treat analysis, mean group change scores (log WMFT, baseline to 12 months) were, for the ASAP group, 2.2 to 1.4 (difference, 0.82); DEUCC group, 2.0 to 1.2 (difference, 0.84); and UCC group, 2.1 to 1.4 (difference, 0.75), with no significant between-group differences (ASAP vs DEUCC:0.14; 95% CI, −0.05 to 0.33; P = .16; ASAP vs UCC: −0.01; 95% CI, −0.22 to 0.21; P = .94; and DEUCC vs UCC: −0.14; 95% CI, −0.32 to 0.05; P = .15). Secondary outcomes for the ASAP group were WMFT change score, −8.8 seconds, and improved SIS, 73%; DEUCC group, WMFT, −8.1 seconds, and SIS, 72%; and UCC group, WMFT, −7.2 seconds, and SIS, 69%, with no significant pairwise between-group differences (ASAP vs DEUCC: WMFT, 1.8 seconds; 95% CI, −0.8 to 4.5 seconds; P = .18; improved SIS, 1%; 95% CI, −12% to 13%; P = .54; ASAP vs UCC: WMFT, −0.6 seconds, 95% CI, −3.8 to 2.6 seconds; P = .72; improved SIS, 4%; 95% CI, −9% to 16%; P = .48; and DEUCC vs UCC: WMFT, −2.1 seconds; 95% CI, −4.5 to 0.3 seconds; P = .08; improved SIS, 3%; 95% CI, −9% to 15%; P = .22). A total of 168 serious adverse events occurred in 109 participants, resulting in 8 patients withdrawing from the study. CONCLUSIONS AND RELEVANCE Among patients with motor stroke and primarily moderate upper extremity impairment, use of a structured, task-oriented rehabilitation program did not significantly improve motor function or recovery beyond either an equivalent or a lower dose of UCC upper extremity rehabilitation. These findings do not support superiority of this program among patients with motor stroke and primarily moderate upper extremity impairment. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00871715 PMID:26864411

Monitoring Haloperidol Plasma Concentration and Associated Adverse Events in Critically Ill Children With Delirium: First Results of a Clinical Protocol Aimed to Monitor Efficacy and Safety.

PubMed

Slooff, Valerie D; van den Dungen, Desley K; van Beusekom, Babette S; Jessurun, Naomi; Ista, Erwin; Tibboel, Dick; de Wildt, Saskia N

2018-02-01

As delirium in critically ill children is increasingly recognized, more children are treated with the antipsychotic drug haloperidol, while current dosing guidelines are lacking solid evidence and appear to be associated with a high risk of adverse events. We aim to report on the safety and efficacy of a recently implemented clinical dose-titration protocol with active monitoring of adverse events. From July 2014 until June 2015, when a potential delirium was identified by regular delirium scores and confirmed by a child psychiatrist, haloperidol was prescribed according to the Dutch Pediatric Formulary. Daily, adverse events were systematically assessed, haloperidol plasma concentrations were measured, and delirium symptoms followed. Dependent on the clinical response, plasma concentration, and adverse event, the dose was adjusted. A 28-bed tertiary PICU in the Netherlands. All patients admitted to the PICU diagnosed with delirium. Treatment with haloperidol according to a dose-titration protocol MEASUREMENTS AND MAIN RESULTS:: Thirteen children (median age [range] 8.3 yr [0.4-13.8 yr]) received haloperidol, predominantly IV (median dose [range] 0.027 mg/kg/d [0.005-0.085 mg/kg/d]). In all patients, pediatric delirium resolved, but five of 13 patients developed possible adverse event. These were reversed after biperiden (n = 2), discontinuing (n = 3), and/or lowering the dose (n = 3). Plasma concentrations were all below the presumed therapeutic threshold of 3-12 µg/L. Prospective systematic monitoring of adverse event in critically ill children receiving haloperidol revealed a significant proportion of possible adverse events. Adverse event developed despite low plasma concentrations and recommended dose administration in the majority of the patients. Our data suggest that haloperidol can potentially improve pediatric delirium, but it might also put patients at risk for developing adverse events.

Monitoring of timely and delayed vaccinations: a nation-wide registry-based study of Norwegian children aged < 2 years.

PubMed

Riise, Øystein Rolandsen; Laake, Ida; Bergsaker, Marianne Adeleide Riise; Nøkleby, Hanne; Haugen, Inger Lise; Storsæter, Jann

2015-11-13

Delayed vaccinations increase the risk for vaccine preventable diseases (VPDs). Monitoring of delayed vaccinations by using a national immunisation registry has not been studied in countries recommending a two-dose (3 and 5 months of age) primary series of e.g., pertussis vaccine. Surveillance/monitoring of all vaccinations may improve vaccination programmes functioning. We obtained information from the Norwegian immunisation registry (SYSVAK) on all programme vaccinations received at age up to 730 days in children born in 2010 (n = 63,382). Timely vaccinations were received up to 7 days after the recommended age. Vaccinations were considered delayed if they were received more than one month after the recommended age in the schedule. In vaccinated children, timely administration of the subsequent three doses of pertussis and one dose of measles occurred in 73.8, 47.6, 53.6 and 43.5 % respectively. Delay for one or more programme vaccinations (diphtheria, tetanus, pertussis, polio, Haemophilus influenza type B, invasive pneumococcal disease, measles, mumps or rubella) was present in 28,336 (44.7 %) children. Among those who were delayed the mean duration was 139 days. The proportion of children that had vaccinations delayed differed among counties (range 37.4 %-57.8 %). Immigrant children were more frequently delayed 52.3 % vs. 43.1 %, RR 1.21 (95 % CI 1.19, 1.24). Children scheduled for vaccines in the summer holiday month (July) were more frequently delayed than others (1(st) dose pertussis vaccine 6.5 % vs. 3.9 % RR 1.65 (95 % CI 1.48, 1.85). Priming against pertussis (2(nd) dose), pneumococcal (2(nd) dose) and measles (1(st) dose) was delayed in 16.8, 18.6 and 29.3 % respectively. Vaccinations were frequently delayed. Delayed vaccinations differed among counties and occurred more frequently during the summer vacation (July) and in the immigrant population. Monitoring improves programme surveillance and may be used on an annual basis.

Biological monitoring to determine worker dose in a butadiene processing plant

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

Bechtold, W.E.; Hayes, R.B.

1995-12-01

Butadiene (BD) is a reactive gas used extensively in the rubber industry and is also found in combustion products. Although BD is genotoxic and acts as an animal carcinogen, the evidence for carcinogenicity in humans is limited. Extrapolation from animal studies on BD carcinogenicity to risk in humans has been controversial because of uncertainties regarding relative biologic exposure and related effects in humans vs. experimental animals. To reduce this uncertainty, a study was designed to characterize exposure to BD at a polymer production facility and to relate this exposure to mutational and cytogenetic effects. Biological monitoring was used to bettermore » assess the internal dose of BD received by the workers. Measurement of 1,2-dihydroxy-4-(N-acetylcysteinyl) butane (M1) in urine served as the biomarker in this study. M1 has been shown to correlate with area monitoring in previous studies. Most studies that relate exposure to a toxic chemical with its biological effects rely on exposure concentration as the dose metric; however, exposure concentration may or may not reflect the actual internal dose of the chemical.« less

Self-indicating radiation alert dosemeter (SIRAD).

PubMed

Riel, Gordon K; Winters, Patrick; Patel, Gordhan; Patel, Paresh

2006-01-01

In an event of a nuclear or dirty bomb explosion and a radiological accident, there is a need for self-indicating instant radiation dosemeter for monitoring radiation exposure. The self-indicating instant radiation alert dosemeter (SIRAD) is a credit card size radiation dosemeter for monitoring ionising radiation from a few hundredths of a Gray to a few Gray. It is always active and is ready to use. It needs no battery. The dosemeter develops colour instantly upon exposure, and the colour intensifies with dose. It has a colour chart so that the dose on the active element may be read by matching its colour with the chart that is printed next to it on the card. However, in this work, the dose is measured by the optical density of the element. The dosemeter cannot be reset. The response changes by <1% per degrees C from -20 to +60 degrees C. The shelf-life is >3 y at room temperature. It contains no hazardous materials. The dosemeter would meet the requirements of instantly monitoring high dose in an event of a nuclear or dirty bomb explosion or a radiation accident.

Implementation and application of an interactive user-friendly validation software for RADIANCE

NASA Astrophysics Data System (ADS)

Sundaram, Anand; Boonn, William W.; Kim, Woojin; Cook, Tessa S.

2012-02-01

RADIANCE extracts CT dose parameters from dose sheets using optical character recognition and stores the data in a relational database. To facilitate validation of RADIANCE's performance, a simple user interface was initially implemented and about 300 records were evaluated. Here, we extend this interface to achieve a wider variety of functions and perform a larger-scale validation. The validator uses some data from the RADIANCE database to prepopulate quality-testing fields, such as correspondence between calculated and reported total dose-length product. The interface also displays relevant parameters from the DICOM headers. A total of 5,098 dose sheets were used to test the performance accuracy of RADIANCE in dose data extraction. Several search criteria were implemented. All records were searchable by accession number, study date, or dose parameters beyond chosen thresholds. Validated records were searchable according to additional criteria from validation inputs. An error rate of 0.303% was demonstrated in the validation. Dose monitoring is increasingly important and RADIANCE provides an open-source solution with a high level of accuracy. The RADIANCE validator has been updated to enable users to test the integrity of their installation and verify that their dose monitoring is accurate and effective.

The role of a microDiamond detector in the dosimetry of proton pencil beams.

PubMed

Gomà, Carles; Marinelli, Marco; Safai, Sairos; Verona-Rinati, Gianluca; Würfel, Jan

2016-03-01

In this work, the performance of a microDiamond detector in a scanned proton beam is studied and its potential role in the dosimetric characterization of proton pencil beams is assessed. The linearity of the detector response with the absorbed dose and the dependence on the dose-rate were tested. The depth-dose curve and the lateral dose profiles of a proton pencil beam were measured and compared to reference data. The feasibility of calibrating the beam monitor chamber with a microDiamond detector was also studied. It was found the detector reading is linear with the absorbed dose to water (down to few cGy) and the detector response is independent of both the dose-rate (up to few Gy/s) and the proton beam energy (within the whole clinically-relevant energy range). The detector showed a good performance in depth-dose curve and lateral dose profile measurements; and it might even be used to calibrate the beam monitor chambers-provided it is cross-calibrated against a reference ionization chamber. In conclusion, the microDiamond detector was proved capable of performing an accurate dosimetric characterization of proton pencil beams. Copyright © 2015. Published by Elsevier GmbH.

40 CFR 264.99 - Compliance monitoring program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... be based on a compliance monitoring program developed to meet the requirements of this section. (i... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Compliance monitoring program. 264.99... Releases From Solid Waste Management Units § 264.99 Compliance monitoring program. An owner or operator...

Analytical measurements of fission products during a severe nuclear accident

NASA Astrophysics Data System (ADS)

Doizi, D.; Reymond la Ruinaz, S.; Haykal, I.; Manceron, L.; Perrin, A.; Boudon, V.; Vander Auwera, J.; tchana, F. Kwabia; Faye, M.

2018-01-01

The Fukushima accident emphasized the fact that ways to monitor in real time the evolution of a nuclear reactor during a severe accident remain to be developed. No fission products were monitored during twelve days; only dose rates were measured, which is not sufficient to carry out an online diagnosis of the event. The first measurements were announced with little reliability for low volatile fission products. In order to improve the safety of nuclear plants and minimize the industrial, ecological and health consequences of a severe accident, it is necessary to develop new reliable measurement systems, operating at the earliest and closest to the emission source of fission products. Through the French program ANR « Projet d'Investissement d'Avenir », the aim of the DECA-PF project (diagnosis of core degradation from fission products measurements) is to monitor in real time the release of the major fission products (krypton, xenon, gaseous forms of iodine and ruthenium) outside the nuclear reactor containment. These products are released at different times during a nuclear accident and at different states of the nuclear core degradation. Thus, monitoring these fission products gives information on the situation inside the containment and helps to apply the Severe Accident Management procedures. Analytical techniques have been proposed and evaluated. The results are discussed here.

Charge amplifier with bias compensation

DOEpatents

Johnson, Gary W.

2002-01-01

An ion beam uniformity monitor for very low beam currents using a high-sensitivity charge amplifier with bias compensation. The ion beam monitor is used to assess the uniformity of a raster-scanned ion beam, such as used in an ion implanter, and utilizes four Faraday cups placed in the geometric corners of the target area. Current from each cup is integrated with respect to time, thus measuring accumulated dose, or charge, in Coulombs. By comparing the dose at each corner, a qualitative assessment of ion beam uniformity is made possible. With knowledge of the relative area of the Faraday cups, the ion flux and areal dose can also be obtained.

Upper-Bound Radiation Dose Assessment for Military Personnel at McMurdo Station, Antarctica, between 1962 and 1979

DTIC Science & Technology

2013-06-01

Belvoir, VA 22060-6201 10. SPONSOR/MONITOR’S ACRONYM(S) DTRA J9-NTSN 11 . SPONSORING/MONITORING AGENCY REPORT NUMBER DTRA-TR-12-003 12...average tritium activity in drinking water samples (Bq L-1) ......................... 43 Table 11 . Parameter values and assumptions for estimating...the ground, roads and ship loading areas .......................... 59 11 Table 23. Parameter values and assumptions for the internal dose from

Incorporating information from the U.S. Department of Energy low-dose program into regulatory decision-making: three policy integration challenges.

PubMed

Locke, Paul A

2009-11-01

The U.S. Department of Energy (U.S. DOE) sponsors a research program aimed at gaining a better understanding of how low-dose radiation affects cellular functioning and progression toward disease. There have been calls to incorporate into regulatory decision-making the scientific information that this program has produced. After a discussion of the evolution of radiation protection law and the weight-of-evidence approach that agencies employ, this paper offers some preliminary thoughts about how to approach this complex and important policy question. Three implementation challenges are identified and discussed. The first implementation challenge involves explaining low-dose effects in a systems biology model. The second challenge arises when issues of population susceptibility are juxtaposed against molecular and mechanistic studies, such as those that make up much of the U.S. DOE low-dose program. The third challenge concerns integrating the results of radiation epidemiology, especially epidemiologic studies among cohorts that are exposed to low dose and low-dose rate radiation, with the results of U.S. DOE low-dose studies.

Improved neutron activation prediction code system development

NASA Technical Reports Server (NTRS)

Saqui, R. M.

1971-01-01

Two integrated neutron activation prediction code systems have been developed by modifying and integrating existing computer programs to perform the necessary computations to determine neutron induced activation gamma ray doses and dose rates in complex geometries. Each of the two systems is comprised of three computational modules. The first program module computes the spatial and energy distribution of the neutron flux from an input source and prepares input data for the second program which performs the reaction rate, decay chain and activation gamma source calculations. A third module then accepts input prepared by the second program to compute the cumulative gamma doses and/or dose rates at specified detector locations in complex, three-dimensional geometries.

Understanding Program Monitoring: The Relationships among Outcomes, Indicators, Measures, and Targets. REL 2014-011

ERIC Educational Resources Information Center

Malone, Nolan; Mark, Lauren; Narayan, Krishna

2014-01-01

This guide offers educators, program managers, administrators, and researchers a resource for building capacity for monitoring program outcomes. It provides concise definitions of program monitoring components and a framework for assessing program progress. Examples demonstrate the relationships among program components: outcomes, indicators,…

Plasma, salivary and urinary cortisol levels following physiological and stress doses of hydrocortisone in normal volunteers.

PubMed

Jung, Caroline; Greco, Santo; Nguyen, Hanh H T; Ho, Jui T; Lewis, John G; Torpy, David J; Inder, Warrick J

2014-11-26

Glucocorticoid replacement is essential in patients with primary and secondary adrenal insufficiency, but many patients remain on higher than recommended dose regimens. There is no uniformly accepted method to monitor the dose in individual patients. We have compared cortisol concentrations in plasma, saliva and urine achieved following "physiological" and "stress" doses of hydrocortisone as potential methods for monitoring glucocorticoid replacement. Cortisol profiles were measured in plasma, saliva and urine following "physiological" (20 mg oral) or "stress" (50 mg intravenous) doses of hydrocortisone in dexamethasone-suppressed healthy subjects (8 in each group), compared to endogenous cortisol levels (12 subjects). Total plasma cortisol was measured half-hourly, and salivary cortisol and urinary cortisol:creatinine ratio were measured hourly from time 0 (between 0830 and 0900) to 5 h. Endogenous plasma corticosteroid-binding globulin (CBG) levels were measured at time 0 and 5 h, and hourly from time 0 to 5 h following administration of oral or intravenous hydrocortisone. Plasma free cortisol was calculated using Coolens' equation. Plasma, salivary and urine cortisol at 2 h after oral hydrocortisone gave a good indication of peak cortisol concentrations, which were uniformly supraphysiological. Intravenous hydrocortisone administration achieved very high 30 minute cortisol concentrations. Total plasma cortisol correlated significantly with both saliva and urine cortisol after oral and intravenous hydrocortisone (P <0.0001, correlation coefficient between 0.61 and 0.94). There was no difference in CBG levels across the sampling period. An oral dose of hydrocortisone 20 mg is supraphysiological for routine maintenance, while stress doses above 50 mg 6-hourly would rarely be necessary in managing acute illness. Salivary cortisol and urinary cortisol:creatinine ratio may provide useful alternatives to plasma cortisol measurements to monitor replacement doses in hypoadrenal patients.

Dose optimization of total or partial skin electron irradiation by thermoluminescent dosimetry.

PubMed

Schüttrumpf, Lars; Neumaier, Klement; Maihoefer, Cornelius; Niyazi, Maximilian; Ganswindt, Ute; Li, Minglun; Lang, Peter; Reiner, Michael; Belka, Claus; Corradini, Stefanie

2018-05-01

Due to the complex surface of the human body, total or partial skin irradiation using large electron fields is challenging. The aim of the present study was to quantify the magnitude of dose optimization required after the application of standard fields. Total skin electron irradiation (TSEI) was applied using the Stanford technique with six dual-fields. Patients presenting with localized lesions were treated with partial skin electron irradiation (PSEI) using large electron fields, which were individually adapted. In order to verify and validate the dose distribution, in vivo dosimetry with thermoluminescent dosimeters (TLD) was performed during the first treatment fraction to detect potential dose heterogeneity and to allow for an individual dose optimization with adjustment of the monitor units (MU). Between 1984 and 2017, a total of 58 patients were treated: 31 patients received TSEI using 12 treatment fields, while 27 patients underwent PSEI and were treated with 4-8 treatment fields. After evaluation of the dosimetric results, an individual dose optimization was necessary in 21 patients. Of these, 7 patients received TSEI (7/31). Monitor units (MU) needed to be corrected by a mean value of 117 MU (±105, range 18-290) uniformly for all 12 treatment fields, corresponding to a mean relative change of 12% of the prescribed MU. In comparison, the other 14 patients received PSEI (14/27) and the mean adjustment of monitor units was 282 MU (±144, range 59-500) to single or multiple fields, corresponding to a mean relative change of 22% of the prescribed MU. A second dose optimization to obtain a satisfying dose at the prescription point was need in 5 patients. Thermoluminescent dosimetry allows an individual dose optimization in TSEI and PSEI to enable a reliable adjustment of the MUs to obtain the prescription dose. Especially in PSEI in vivo dosimetry is of fundamental importance.

Establishing a national biological laboratory safety and security monitoring program.

PubMed

Blaine, James W

2012-12-01

The growing concern over the potential use of biological agents as weapons and the continuing work of the Biological Weapons Convention has promoted an interest in establishing national biological laboratory biosafety and biosecurity monitoring programs. The challenges and issues that should be considered by governments, or organizations, embarking on the creation of a biological laboratory biosafety and biosecurity monitoring program are discussed in this article. The discussion focuses on the following questions: Is there critical infrastructure support available? What should be the program focus? Who should be monitored? Who should do the monitoring? How extensive should the monitoring be? What standards and requirements should be used? What are the consequences if a laboratory does not meet the requirements or is not willing to comply? Would the program achieve the results intended? What are the program costs? The success of a monitoring program can depend on how the government, or organization, responds to these questions.

Variation in Prescribing Patterns and Therapeutic Drug Monitoring of Intravenous Busulfan in Pediatric Hematopoietic Cell Transplant Recipients

PubMed Central

McCune, Jeannine S.; Baker, K. Scott; Blough, David K.; Gamis, Alan; Bemer, Meagan J.; Kelton-Rehkopf, Megan C.; Winter, Laura; Barrett, Jeffrey S.

2016-01-01

Personalizing intravenous (IV) busulfan doses in children using therapeutic drug monitoring (TDM) is an integral component of hematopoietic cell transplant. The authors sought to characterize initial dosing and TDM of IV busulfan, along with factors associated with busulfan clearance, in 729 children who underwent busulfan TDM from December 2005 to December 2008. The initial IV busulfan dose in children weighing ≤12 kg ranged 4.8-fold, with only 19% prescribed the package insert dose of 1.1 mg/kg. In those children weighing >12 kg, the initial dose ranged 5.4-fold, and 79% were prescribed the package insert dose. The initial busulfan dose achieved the target exposure in only 24.3% of children. A wide range of busulfan exposures were targeted for children with the same disease (eg, 39 target busulfan exposures for the 264 children diagnosed with acute myeloid leukemia). Considerable heterogeneity exists regarding when TDM is conducted and the number of pharmacokinetic samples obtained. Busulfan clearance varied by age and dosing frequency but not by underlying disease. The authors’ group is currently evaluating how using population pharmacokinetics to optimize initial busulfan dose and TDM (eg, limited sampling schedule in conjunction with maximum a posteriori Bayesian estimation) may affect clinical outcomes in children. PMID:23444282

Novel Approaches for Visualizing and Analyzing Dose-Timing Data from Electronic Drug Monitors, or "How the 'Broken Window' Theory Pertains to ART Adherence".

PubMed

Gill, Christopher J; DeSilva, Mary Bachman; Hamer, Davidson H; Keyi, Xu; Wilson, Ira B; Sabin, Lora

2015-11-01

Adherence to antiretroviral medications is usually expressed in terms of the proportion of doses taken. However, the timing of doses taken may also be an important dimension to overall adherence. Little is known about whether patients who mistime doses are also more likely to skip doses. Using data from the completed Adherence for Life randomized controlled trial, we created visual and statistical models to capture and analyze dose timing data collected longitudinally with electronic drug monitors (EDM). From scatter plots depicting dose time versus calendar date, we identified dominant patterns of dose taking and calculated key features [slope of line over calendar date; residual mean standard error (RMSE)]. Each was assessed for its ability to categorize subjects with 'sub-optimal' (<95 % of doses taken) using area under the receiver operating characteristic (AROC) curve analysis. Sixty eight subjects contributed EDM data, with ~300 to 400 observations/subject. While regression line slopes did not predict 'sub-optimal' adherence (AROC 0.51, 95 % CI 0.26-0.75), the variability in dose timing (RMSE) was strongly predictive (AROC 0.79, 95 % CI 0.62-0.97). Compared with the lowest quartile of RMSE (minimal dose time variability), each successive quartile roughly doubled the odds of 'sub-optimal' adherence (OR 2.1, 95 % CI 1.3-3.4). Patterns of dose timing and mistiming are strongly related to overall adherence behavior. Notably, individuals who skip doses are more likely to mistime doses, with the degree of risk positively correlated with the extent of dose timing variability.

Effectiveness of home exercise on pain, function, and strength of manual wheelchair users with spinal cord injury: a high-dose shoulder program with telerehabilitation.

PubMed

Van Straaten, Meegan G; Cloud, Beth A; Morrow, Melissa M; Ludewig, Paula M; Zhao, Kristin D

2014-10-01

To test the effectiveness of a high-dose home exercise/telerehabilitation program for manual wheelchair users who have a spinal cord injury (SCI) by determining whether the intervention would reduce pain and increase function, as we hypothesized. A pre-post trial with outcomes measured at 3 time points: baseline, postintervention (12wk), and follow-up (>24 wk). Subjects performed an exercise program at their homes using telerehabilitation for therapist monitoring of technique and exercise advancement. Baseline and postintervention data were collected at a motion analysis laboratory in a tertiary medical center. A convenience sample of manual wheelchair users (N=16, 3 women; average age, 41y; average time in a wheelchair, 16y) with shoulder pain (average pain duration, 9y) and mechanical impingement signs on physical examination. A 12-week home exercise program of rotator cuff and scapular stabilization exercises was given to each participant. The program included a high dose of 3 sets of 30 repetitions, 3 times weekly, and regular physical therapist supervision via videoconferencing. Primary outcomes of pain and function were measured with the Wheelchair User's Shoulder Pain Index (WUSPI), Disabilities of Arm, Shoulder, and Hand (DASH) Index, and Shoulder Rating Questionnaire (SRQ). Secondary outcomes of strength were measured with isometric strength tests of scapulothoracic and glenohumeral muscles, and a static fatigue test of the lower trapezius. Pain was reduced and function improved after the intervention. There was a significant main effect for pain and function between the 3 time points based on the Friedman signed-ranked test, WUSPI (χ(2)2=5.10, P=.014), DASH Index (χ(2)2=5.41, P=.012), and SRQ (χ(2)2=23.71, P≤.001). Wilcoxon signed-rank tests demonstrated that isometric strength measurements of the serratus anterior and scapular retractors increased after the exercise intervention ([t=2.42, P=.04] and [t=4.67, P=.003], respectively). Muscle impulse produced by the lower trapezius during a fatigue task also improved (t=2.2, P=.02). No differences were measured in isometric strength for the lower trapezius, glenohumeral rotators, and abductors between the baseline and 12-week time points. A high-dose scapular stabilizer and rotator cuff strengthening program using telerehabilitation for supervision holds promise for shoulder pain treatment in manual wheelchair users with SCI. Additional work is needed to determine the effectiveness compared with other interventions, as well as the potential for earlier intervention to prevent development of shoulder pain. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Is there a role for pharmacokinetic/pharmacodynamic-guided dosing for novel oral anticoagulants?

PubMed

Chan, Noel; Sager, Philip T; Lawrence, Jack; Ortel, Thomas's; Reilly, Paul; Berkowitz, Scott; Kubitza, Dagmar; Eikelboom, John; Florian, Jeffry; Stockbridge, Norman; Rose, Martin; Temple, Robert; Seltzer, Jonathan H

2018-05-01

The novel direct oral anticoagulants (NOACs) represent a major advance in oral anticoagulant therapy and are replacing vitamin K antagonists as the preferred options for many indications. Given in fixed doses without routine laboratory monitoring, they have been shown to be at least as effective in reducing thromboembolic stroke as dose-adjusted warfarin in phase 3 randomized trials and less likely to cause hemorrhagic stroke. Pharmacokinetic and/or pharmacodynamic subanalyses of the major NOAC trials in patients with atrial fibrillation have established relationships between clinical characteristics, and drug levels and/or pharmacodynamic responses with both efficacy and safety. Based on these analyses, pharmaceutical manufacturers and regulatory authorities have provided contraindications and dosing recommendations based on clinical characteristics that are associated with drug levels and/or pharmacodynamic responses, stroke reduction, and bleeding risk to optimize the risk-benefit profile of the NOACs in the real world. The current fixed-dosing strategy of NOACs has triggered discussions about the potential value of laboratory monitoring and dose adjustment in customizing drug exposure to further improve the safety and efficacy of the NOACs in patients with atrial fibrillation. As there is neither high-quality evidence nor consensus about the potential role of laboratory monitoring and dose adjustment for the NOACs, a Cardiac Research Safety Consortium "Think Tank" meeting was held at the American College of Cardiology Heart House in December 2015 to discussions these issues. This manuscript reports on the deliberations and the conclusions reached at that meeting. Copyright © 2017. Published by Elsevier Inc.

OVERVIEW OF EPA'S HUMAN EXPOSURE AND SOURCE-TO-DOSE MODELING PROGRAM: HEADSUP

EPA Science Inventory

EPA's human exposure and source-to-dose modeling program is designed to provide a scientifically sound approach to understanding how people are actually exposed to pollutants and the magnitude of predicted exposures and dose. The objective of this research project is to develo...

Process Evaluation and Costing of a Multifaceted Population-Wide Intervention to Reduce Salt Consumption in Fiji.

PubMed

Webster, Jacqui; Pillay, Arti; Suku, Arleen; Gohil, Paayal; Santos, Joseph Alvin; Schultz, Jimaima; Wate, Jillian; Trieu, Kathy; Hope, Silvia; Snowdon, Wendy; Moodie, Marj; Jan, Stephen; Bell, Colin

2018-01-30

This paper reports the process evaluation and costing of a national salt reduction intervention in Fiji. The population-wide intervention included engaging food industry to reduce salt in foods, strategic health communication and a hospital program. The evaluation showed a 1.4 g/day drop in salt intake from the 11.7 g/day at baseline; however, this was not statistically significant. To better understand intervention implementation, we collated data to assess intervention fidelity, reach, context and costs. Government and management changes affected intervention implementation, meaning fidelity was relatively low. There was no active mechanism for ensuring food companies adhered to the voluntary salt reduction targets. Communication activities had wide reach but most activities were one-off, meaning the overall dose was low and impact on behavior limited. Intervention costs were moderate (FJD $277,410 or $0.31 per person) but the strategy relied on multi-sector action which was not fully operationalised. The cyclone also delayed monitoring and likely impacted the results. However, 73% of people surveyed had heard about the campaign and salt reduction policies have been mainstreamed into government programs. Longer-term monitoring of salt intake is planned through future surveys and lessons from this process evaluation will be used to inform future strategies in the Pacific Islands and globally.

Process Evaluation and Costing of a Multifaceted Population-Wide Intervention to Reduce Salt Consumption in Fiji

PubMed Central

Webster, Jacqui; Pillay, Arti; Suku, Arleen; Gohil, Paayal; Santos, Joseph Alvin; Schultz, Jimaima; Wate, Jillian; Trieu, Kathy; Hope, Silvia; Snowdon, Wendy; Moodie, Marj; Jan, Stephen; Bell, Colin

2018-01-01

This paper reports the process evaluation and costing of a national salt reduction intervention in Fiji. The population-wide intervention included engaging food industry to reduce salt in foods, strategic health communication and a hospital program. The evaluation showed a 1.4 g/day drop in salt intake from the 11.7 g/day at baseline; however, this was not statistically significant. To better understand intervention implementation, we collated data to assess intervention fidelity, reach, context and costs. Government and management changes affected intervention implementation, meaning fidelity was relatively low. There was no active mechanism for ensuring food companies adhered to the voluntary salt reduction targets. Communication activities had wide reach but most activities were one-off, meaning the overall dose was low and impact on behavior limited. Intervention costs were moderate (FJD $277,410 or $0.31 per person) but the strategy relied on multi-sector action which was not fully operationalised. The cyclone also delayed monitoring and likely impacted the results. However, 73% of people surveyed had heard about the campaign and salt reduction policies have been mainstreamed into government programs. Longer-term monitoring of salt intake is planned through future surveys and lessons from this process evaluation will be used to inform future strategies in the Pacific Islands and globally. PMID:29385758

Automated Management of Exercise Intervention at the Point of Care: Application of a Web-Based Leg Training System.

PubMed

Dedov, Vadim N; Dedova, Irina V

2015-11-23

Recent advances in information and communication technology have prompted development of Web-based health tools to promote physical activity, the key component of cardiac rehabilitation and chronic disease management. Mobile apps can facilitate behavioral changes and help in exercise monitoring, although actual training usually takes place away from the point of care in specialized gyms or outdoors. Daily participation in conventional physical activities is expensive, time consuming, and mostly relies on self-management abilities of patients who are typically aged, overweight, and unfit. Facilitation of sustained exercise training at the point of care might improve patient engagement in cardiac rehabilitation. In this study we aimed to test the feasibility of execution and automatic monitoring of several exercise regimens on-site using a Web-enabled leg training system. The MedExercise leg rehabilitation machine was equipped with wireless temperature sensors in order to monitor its usage by the rise of temperature in the resistance unit (Δt°). Personal electronic devices such as laptop computers were fitted with wireless gateways and relevant software was installed to monitor the usage of training machines. Cloud-based software allowed monitoring of participant training over the Internet. Seven healthy participants applied the system at various locations with training protocols typically used in cardiac rehabilitation. The heart rates were measured by fingertip pulse oximeters. Exercising in home chairs, in bed, and under an office desk was made feasible and resulted in an intensity-dependent increase of participants' heart rates and Δt° in training machine temperatures. Participants self-controlled their activities on smart devices, while a supervisor monitored them over the Internet. Individual Δt° reached during 30 minutes of moderate-intensity continuous training averaged 7.8°C (SD 1.6). These Δt° were used as personalized daily doses of exercise with automatic email alerts sent upon achieving them. During 1-week training at home, automatic notifications were received on 4.4 days (SD 1.8). Although the high intensity interval training regimen was feasible on-site, it was difficult for self- and remote management. Opportunistic leg exercise under the desk, while working with a computer, and training in bed while viewing television were less intensive than dosed exercise bouts, but allowed prolonged leg mobilization of 73.7 minutes/day (SD 29.7). This study demonstrated the feasibility of self-control exercise training on-site, which was accompanied by online monitoring, electronic recording, personalization of exercise doses, and automatic reporting of adherence. The results suggest that this technology and its applications are useful for the delivery of Web-based exercise rehabilitation and cardiac training programs at the point of care. ©Vadim N Dedov, Irina V Dedova. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 23.11.2015.

Impact of a pharmaceutical care program on liver transplant patients' compliance with immunosuppressive medication: a prospective, randomized, controlled trial using electronic monitoring.

PubMed

Klein, Anja; Otto, Gerd; Krämer, Irene

2009-03-27

Compliance with immunosuppressive therapy plays a major role in the long-term success of organ transplantation. Thus, strategies to promote compliance in posttransplant care are of particular interest. At the pharmacy department of the University Hospital Mainz, a program for pharmaceutical care of organ transplant patients has been developed for the first time ever. The main objective of the presented study was to examine the influence of this program on liver transplant patients' compliance with immunosuppressive therapy. To measure compliance, medication event monitoring systems were used. Dosing compliance (DC) was calculated for each patient and the mean DC was compared between the two groups. Further direct and indirect methods of measuring compliance served to confirm the electronic compliance data. Pharmaceutical care of liver transplant patients led to a significant increase in compliance with the immunosuppressive therapy. The mean DC of the intervention group was 90%+/-6% compared with 81%+/-12% in the control group (P=0.015). Only two patients (10%) in the intervention group and nine patients (43%) in the control group showed a DC less than 80% (P=0.032). Furthermore, patients in the intervention group were more likely to achieve target blood levels. Patients who received pharmaceutical care with traditional patient care showed significantly better compliance with their immunosuppressive medication than patients who received only traditional patient care. Pharmaceutical care proved to be an effective intervention that should be implemented in posttransplant care.

40 CFR 122.48 - Requirements for recording and reporting of monitoring results (applicable to State programs, see...

Code of Federal Regulations, 2013 CFR

2013-07-01

... representative of the monitored activity including, when appropriate, continuous monitoring; (c) Applicable... reporting of monitoring results (applicable to State programs, see § 123.25). 122.48 Section 122.48... recording and reporting of monitoring results (applicable to State programs, see § 123.25). All permits...

40 CFR 122.48 - Requirements for recording and reporting of monitoring results (applicable to State programs, see...

Code of Federal Regulations, 2014 CFR

2014-07-01

... representative of the monitored activity including, when appropriate, continuous monitoring; (c) Applicable... reporting of monitoring results (applicable to State programs, see § 123.25). 122.48 Section 122.48... recording and reporting of monitoring results (applicable to State programs, see § 123.25). All permits...

40 CFR 122.48 - Requirements for recording and reporting of monitoring results (applicable to State programs, see...

Code of Federal Regulations, 2012 CFR

2012-07-01

... representative of the monitored activity including, when appropriate, continuous monitoring; (c) Applicable... reporting of monitoring results (applicable to State programs, see § 123.25). 122.48 Section 122.48... recording and reporting of monitoring results (applicable to State programs, see § 123.25). All permits...

40 CFR 122.48 - Requirements for recording and reporting of monitoring results (applicable to State programs, see...

Code of Federal Regulations, 2010 CFR

2010-07-01

... representative of the monitored activity including, when appropriate, continuous monitoring; (c) Applicable... reporting of monitoring results (applicable to State programs, see § 123.25). 122.48 Section 122.48... recording and reporting of monitoring results (applicable to State programs, see § 123.25). All permits...

40 CFR 122.48 - Requirements for recording and reporting of monitoring results (applicable to State programs, see...

Code of Federal Regulations, 2011 CFR

2011-07-01

... representative of the monitored activity including, when appropriate, continuous monitoring; (c) Applicable... reporting of monitoring results (applicable to State programs, see § 123.25). 122.48 Section 122.48... recording and reporting of monitoring results (applicable to State programs, see § 123.25). All permits...

Measurement of charged particle yields from therapeutic beams in view of the design of an innovative hadrontherapy dose monitor

NASA Astrophysics Data System (ADS)

Battistoni, G.; Bellini, F.; Bini, F.; Collamati, F.; Collini, F.; De Lucia, E.; Durante, M.; Faccini, R.; Ferroni, F.; Frallicciardi, P. M.; La Tessa, C.; Marafini, M.; Mattei, I.; Miraglia, F.; Morganti, S.; Ortega, P. G.; Patera, V.; Piersanti, L.; Pinci, D.; Russomando, A.; Sarti, A.; Schuy, C.; Sciubba, A.; Senzacqua, M.; Solfaroli Camillocci, E.; Vanstalle, M.; Voena, C.

2015-02-01

Particle Therapy (PT) is an emerging technique, which makes use of charged particles to efficiently cure different kinds of solid tumors. The high precision in the hadrons dose deposition requires an accurate monitoring to prevent the risk of under-dosage of the cancer region or of over-dosage of healthy tissues. Monitoring techniques are currently being developed and are based on the detection of particles produced by the beam interaction into the target, in particular: charged particles, result of target and/or projectile fragmentation, prompt photons coming from nucleus de-excitation and back-to-back γ s, produced in the positron annihilation from β + emitters created in the beam interaction with the target. It has been showed that the hadron beam dose release peak can be spatially correlated with the emission pattern of these secondary particles. Here we report about secondary particles production (charged fragments and prompt γ s) performed at different beam and energies that have a particular relevance for PT applications: 12C beam of 80 MeV/u at LNS, 12C beam 220 MeV/u at GSI, and 12C, 4He, 16O beams with energy in the 50-300 MeV/u range at HIT. Finally, a project for a multimodal dose-monitor device exploiting the prompt photons and charged particles emission will be presented.

[EEG-adjusted target-controlled infusion : Propofol target concentration with different doses of remifentanil].

PubMed

Büttner, N; Schultz, B; Grouven, U; Schultz, A

2010-02-01

The aim of this study was to examine to what extent the use of electroencephalography (EEG) monitoring leads to an adaptation of the target-controlled infusion (TCI) concentration of propofol during propofol anaesthesia with different doses of remifentanil. With ethics committee approval 60 patients (27-69 years old) with American Society of Anesthesiologists classification (ASA) I-III received anaesthestics with propofol (TCI, Diprifusor, AstraZeneca, Wedel, Deutschland) and 0.2, 0.4, or 0.6 microg/kg body weight remifentanil, respectively (groups 1-3). Anaesthesia was maintained at a level of deep hypnosis (EEG stages D(2)/E(0), EEG monitor: Narcotrend, version 2.0/5.0, manufacturer: MT MonitorTechnik, Bad Bramstedt, Germany). During the steady state the propofol concentration in groups 1-3 was 3.02+/-0.86, 1.93+/-0.53 and 1.60+/-0.55 microg/ml, respectively (p<0.001). Women had a higher propofol consumption than men (p<0.05). Dreams during anaesthesia were more often reported by women than by men (p<0.05). The need for postoperative analgesia decreased with an increasing intraoperative remifentanil dose (p<0.05). The study demonstrates that remifentanil has both analgetic and hypnotic effects. With increasing remifentanil dose the propofol requirement decreased and in this context EEG monitoring is useful to adapt the target concentrations of propofol to the patients' age and gender.

UV254 absorbance as real-time monitoring and control parameter for micropollutant removal in advanced wastewater treatment with powdered activated carbon.

PubMed

Altmann, Johannes; Massa, Lukas; Sperlich, Alexander; Gnirss, Regina; Jekel, Martin

2016-05-01

This study investigates the applicability of UV absorbance measurements at 254 nm (UVA254) to serve as a simple and reliable surrogate parameter to monitor and control the removal of organic micropollutants (OMPs) in advanced wastewater treatment applying powdered activated carbon (PAC). Correlations between OMP removal and corresponding UVA254 reduction were determined in lab-scale adsorption batch tests and successfully applied to a pilot-scale PAC treatment stage to predict OMP removals in aggregate samples with good accuracy. Real-time UVA254 measurements were utilized to evaluate adapted PAC dosing strategies and proved to be effective for online monitoring of OMP removal. Furthermore, active PAC dosing control according to differential UVA254 measurements was implemented and tested. While precise removal predictions based on real-time measurements were not accurate for all OMPs, UVA254-controlled dynamic PAC dosing was capable of achieving stable OMP removals. UVA254 can serve as an effective surrogate parameter for OMP removal in technical PAC applications. Even though the applicability as control parameter to adjust PAC dosing to water quality changes might be limited to applications with fast response between PAC adjustment and adsorptive removal (e.g. direct filtration), UVA254 measurements can also be used to monitor the adsorption efficiency in more complex PAC applications. Copyright © 2016 Elsevier Ltd. All rights reserved.

Usefulness of simultaneous and sequential monitoring of glucose level and electrocardiogram in monkeys treated with gatifloxacin under conscious and nonrestricted conditions.

PubMed

Yoshimatsu, Yu; Ishizaka, Tomomichi; Chiba, Katsuyoshi; Mori, Kazuhiko

2018-05-10

Drug-induced cardiac electrophysiological abnormalities accompanied by hypoglycemia or hyperglycemia increase the risk for life-threatening arrhythmia. To assess the drug-induced cardiotoxic potential associated with extraordinary blood glucose (GLU) levels, the effect of gatifloxacin (GFLX) which was frequently associated with GLU abnormality and QT/QTc prolongations in the clinic on blood GLU and electrocardiogram (ECG) parameters was investigated in cynomolgus monkeys (n=4) given GFLX orally in an ascending dose regimen (10, 30, 60 and 100 mg/kg). Simultaneous and sequential GLU and ECG monitoring with a continuous GLU monitoring system and Holter ECG, respectively, were conducted for 24 h under free-moving conditions. Consequently, GFLX at 30 and 60 mg/kg dose-dependently induced a transient decrease in GLU without any ECG abnormality 2-4 h postdose. Highest dose of 100 mg/kg caused severe hypoglycemia with a mean GLU of <30 mg/dL, accompanied by remarkable QT/QTc prolongations by 20-30% in all animals. In contrast, hyperglycemia without QT/QTc prolongations was noted 24 h after dosing in one animal. A close correlation between GLU and QTc values was observed in animals treated with 100 mg/kg, suggesting that GFLX-induced hypoglycemia enhanced QT/QTc prolongations. Furthermore, the 24-h sequential GLU monitoring data clearly distinguished between GFLX-induced GLU abnormality and physiological GLU changes influenced by feeding throughout the day. In conclusion, the combined assessment of continuous GLU and ECG monitoring is valuable in predicting the drug-induced cardio-electrophysiological risk associated with both GLU and ECG abnormalities.

A comparison of the temporally integrated monitoring of ecosystems and Adirondack Long Term-Monitoring programs in the Adirondack Mountain region of New Yrok

EPA Science Inventory

This paper compares lake chemistry in the Adirondack region of New York measured by the Temporally Integrated Monitoring of Ecosystems (TIME) and Adirondack Long-Term Monitoring (ALTM) programs by examining the data from six lakes common to both programs. Both programs were initi...

Hanford Environmental Dose Reconstruction Project

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

Cannon, S.D.; Finch, S.M.

1992-10-01

The objective of the Hanford Environmental Dose Reconstruction (HEDR) Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The independent Technical Steering Panel (TSP) provides technical direction. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed from release to impact on humans (dose estimates):Source Terms, Environmental Transport, Environmental Monitoring Data, Demography, Food Consumption, and Agriculture, and Environmental Pathways and Dose Estimates.

SU-G-TeP2-15: Feasibility Study of Fiber-Optic Cerenkov Radiation Sensors for in Vivo Measurement: Dosimetric Characterization and Clinical Application in Proton Beams

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

Lah, J; Son, J; Kim, G

Purpose: To evaluate the possibility of a fiber-optic Cerenkov radiation sensor (FCRS) for in vivo dose verification in proton therapy. Methods: The Cerenkov radiation due to the proton beam was measured using a homemade phantom, consisting of a plastic optical fiber (POF, PGSCD1001-13-E, Toray, Tokyo, Japan) connected to each channel of a multianode photomultiplier tube (MAPMT:H7546, Hamamatsu Photonics, Shizuoka, Japan). Data were acquired using a multi-anode photomultiplier tube with the NI-DAQ system (National Instruments Texas, USA). The real-time monitoring graphic user interface was programmed using Labview. The FCRS was analyzed for its dosimetrics characteristic in proton beam. To determine themore » accuracy of the FCRS in proton dose measurements, we compared the ionization chamber dose measurements using a water phantom. We investigated the feasibility of the FCRS for the measurement of dose distributions near the superficial region for proton plans with a varying separation between the target volume and the surface of 3 patients using a humanoid phantom. Results: The dose-response has good linearity. Dose-rate and energy dependence were found to be within 1%. Depth-dose distributions in non-modulated proton beams obtained with the FCRS was in good agreement with the depth-dose measurements from the ionization chamber. To evaluate the dosimetric accuracy of the FCRS, the difference of isocenter dose between the delivery dose calculated by the treatment planning system and that measured by the FCRS was within 3%. With in vivo dosimetry using the humanoid phantom, the calculated surface doses overestimated measurements by 4%–8% using FCRS. Conclusion: In previous study, our results indicate that the performance of the array-type FCRS was comparable to that of the currently used a multi-layer ion chamber system. In this study, we also believe that the fiber-optic Cerenkov radiation sensor has considerable potential for use with in vivo patient proton dosimetry.« less

Strong relationship between oral dose and tenofovir hair levels in a randomized trial: hair as a potential adherence measure for pre-exposure prophylaxis (PrEP).

PubMed

Liu, Albert Y; Yang, Qiyun; Huang, Yong; Bacchetti, Peter; Anderson, Peter L; Jin, Chengshi; Goggin, Kathy; Stojanovski, Kristefer; Grant, Robert; Buchbinder, Susan P; Greenblatt, Ruth M; Gandhi, Monica

2014-01-01

Pre-exposure prophylaxis (PrEP) trials using tenofovir-based regimens have demonstrated that high levels of adherence are required to evaluate efficacy; the incorporation of objective biomarkers of adherence in trial design has been essential to interpretation, given the inaccuracy of self-report. Antiretroviral measurements in scalp hair have been useful as a marker of long-term exposure in the HIV treatment setting, and hair samples are relatively easy and inexpensive to collect, transport, and store for analysis. To evaluate the relationship between dose and tenofovir concentrations in hair, we examined the dose proportionality of tenofovir in hair in healthy, HIV-uninfected adults. A phase I, crossover pharmacokinetic study was performed in 24 HIV-negative adults receiving directly-observed oral tenofovir tablets administered 2, 4, and 7 doses/week for 6 weeks, with a ≥3-week break between periods. Small samples of hair were collected after each six-week period and analyzed for tenofovir concentrations. Geometric-mean-ratios compared levels between each pair of dosing conditions. Intensive plasma pharmacokinetic studies were performed during the daily-dosing period to calculate areas-under-the-time-concentration curves (AUCs). Over 90% of doses were observed per protocol. Median tenofovir concentrations in hair increased monotonically with dose. A log-linear relationship was seen between dose and hair levels, with an estimated 76% (95% CI 60-93%) increase in hair level per 2-fold dose increase. Tenofovir plasma AUCs modestly predicted drug concentrations in hair. This study found a strong linear relationship between frequency of dosing and tenofovir levels in scalp hair. The analysis of quantitative drug levels in hair has the potential to improve adherence measurement in the PrEP field and may be helpful in determining exposure thresholds for protection and explaining failures in PrEP trials. Hair measures for adherence monitoring may also facilitate adherence measurement in real-world settings and merit further investigation in upcoming PrEP implementation studies and programs. ClinicalTrials.gov NCT00903084.

Strong Relationship between Oral Dose and Tenofovir Hair Levels in a Randomized Trial: Hair as a Potential Adherence Measure for Pre-Exposure Prophylaxis (PrEP)

PubMed Central

Liu, Albert Y.; Yang, Qiyun; Huang, Yong; Bacchetti, Peter; Anderson, Peter L.; Jin, Chengshi; Goggin, Kathy; Stojanovski, Kristefer; Grant, Robert; Buchbinder, Susan P.; Greenblatt, Ruth M.; Gandhi, Monica

2014-01-01

Background Pre-exposure prophylaxis (PrEP) trials using tenofovir-based regimens have demonstrated that high levels of adherence are required to evaluate efficacy; the incorporation of objective biomarkers of adherence in trial design has been essential to interpretation, given the inaccuracy of self-report. Antiretroviral measurements in scalp hair have been useful as a marker of long-term exposure in the HIV treatment setting, and hair samples are relatively easy and inexpensive to collect, transport, and store for analysis. To evaluate the relationship between dose and tenofovir concentrations in hair, we examined the dose proportionality of tenofovir in hair in healthy, HIV-uninfected adults. Methods A phase I, crossover pharmacokinetic study was performed in 24 HIV-negative adults receiving directly-observed oral tenofovir tablets administered 2, 4, and 7 doses/week for 6 weeks, with a ≥3-week break between periods. Small samples of hair were collected after each six-week period and analyzed for tenofovir concentrations. Geometric-mean-ratios compared levels between each pair of dosing conditions. Intensive plasma pharmacokinetic studies were performed during the daily-dosing period to calculate areas-under-the-time-concentration curves (AUCs). Results Over 90% of doses were observed per protocol. Median tenofovir concentrations in hair increased monotonically with dose. A log-linear relationship was seen between dose and hair levels, with an estimated 76% (95% CI 60–93%) increase in hair level per 2-fold dose increase. Tenofovir plasma AUCs modestly predicted drug concentrations in hair. Conclusions This study found a strong linear relationship between frequency of dosing and tenofovir levels in scalp hair. The analysis of quantitative drug levels in hair has the potential to improve adherence measurement in the PrEP field and may be helpful in determining exposure thresholds for protection and explaining failures in PrEP trials. Hair measures for adherence monitoring may also facilitate adherence measurement in real-world settings and merit further investigation in upcoming PrEP implementation studies and programs. Trial Registration ClinicalTrials.gov +NCT00903084. PMID:24421901

Design and Operation of the Transformed National Healthy Start Evaluation.

PubMed

Banks, Jamelle E; Dwyer, Maura; Hirai, Ashley; Ghandour, Reem M; Atrash, Hani K

2017-12-01

Purpose Improving pregnancy outcomes for women and children is one of the nation's top priorities. The Healthy Start (HS) program was created to address factors that contribute to high infant mortality rates (IMRs) and persistent disparities in IMRs. The program began in 1991 and was transformed in 2014 to apply lessons from emerging research, past evaluation findings, and expert recommendations. To understand the implementation and impact of the transformed program, there is a need for a robust and comprehensive evaluation. Description The national HS evaluation will include an implementation evaluation, which will describe program components that affect outcomes; a utilization evaluation, which will examine the characteristics of women and infants who did and did not utilize the program; and an outcome evaluation, which will assess the program's effectiveness with regard to producing expected outcomes among the target population. Data sources include the National HS Program Survey, a HS participant survey, and individual-level program data linked to vital records and the Pregnancy Risk Assessment Monitoring System (PRAMS) survey. Assessment Descriptive analyses will be used to examine differences in risk profiles between participants and non-participants, as well as to calculate penetration rates for high-risk women in respective service areas. Multivariable analyses will be used to determine the impact of the program on key outcomes and will explore variation by dose, type of services received, and grantee characteristics. Conclusion Evaluation findings are expected to inform program decisions and direction, including identification of effective program components that can be spread and scaled.

Estimation of annual occupational effective doses from external ionizing radiation at medical institutions in Kenya

NASA Astrophysics Data System (ADS)

Korir, Geoffrey; Wambani, Jeska; Korir, Ian

2011-04-01

This study details the distribution and trends of doses due to occupational radiation exposure among radiation workers from participating medical institutions in Kenya, where monthly dose measurements were collected for a period of one year ranging from January to December in 2007. A total of 367 medical radiation workers were monitored using thermoluminescent dosemeters. They included radiologists (27%), oncologists (2%), dentists (4%), Physicists (5%), technologists (45%), nurses (4%), film processor technicians (3%), auxiliary staff (4%), and radiology office staff (5%). The average annual effective dose of all categories of staff was found to range from 1.19 to 2.52 mSv. This study formed the initiation stage of wider, comprehensive and more frequent monitoring of occupational radiation exposures and long-term investigations into its accumulation patterns in our country.

[An investigation of ionizing radiation dose in a manufacturing enterprise of ion-absorbing type rare earth ore].

PubMed

Zhang, W F; Tang, S H; Tan, Q; Liu, Y M

2016-08-20

Objective: To investigate radioactive source term dose monitoring and estimation results in a manufacturing enterprise of ion-absorbing type rare earth ore and the possible ionizing radiation dose received by its workers. Methods: Ionizing radiation monitoring data of the posts in the control area and supervised area of workplace were collected, and the annual average effective dose directly estimated or estimated using formulas was evaluated and analyzed. Results: In the control area and supervised area of the workplace for this rare earth ore, α surface contamination activity had a maximum value of 0.35 Bq/cm 2 and a minimum value of 0.01 Bq/cm 2 ; β radioactive surface contamination activity had a maximum value of 18.8 Bq/cm 2 and a minimum value of 0.22 Bq/cm 2 . In 14 monitoring points in the workplace, the maximum value of the annual average effective dose of occupational exposure was 1.641 mSv/a, which did not exceed the authorized limit for workers (5 mSv/a) , but exceeded the authorized limit for general personnel (0.25 mSv/a) . The radionuclide specific activity of ionic mixed rare earth oxides was determined to be 0.9. Conclusion: The annual average effective dose of occupational exposure in this enterprise does not exceed the authorized limit for workers, but it exceeds the authorized limit for general personnel. We should pay attention to the focus of the radiation process, especially for public works radiation.

Assessments of Voice Use and Voice Quality among College/University Singing Students Ages 18–24 through Ambulatory Monitoring with a Full Accelerometer Signal

PubMed Central

Schloneger, Matthew; Hunter, Eric

2016-01-01

The multiple social and performance demands placed on college/university singers could put their still developing voices at risk. Previous ambulatory monitoring studies have analyzed the duration, intensity, and frequency (in Hz) of voice use among such students. Nevertheless, no studies to date have incorporated the simultaneous acoustic voice quality measures into the acquisition of these measures to allow for direct comparison during the same voicing period. Such data could provide greater insight into how young singers use their voices, as well as identify potential correlations between vocal dose and acoustic changes in voice quality. The purpose of this study was to assess the voice use and estimated voice quality of college/university singing students (18–24 y/o, N = 19). Ambulatory monitoring was conducted over three full, consecutive weekdays measuring voice from an unprocessed accelerometer signal measured at the neck. From this signal were analyzed traditional vocal dose metrics such as phonation percentage, dose time, cycle dose, and distance dose. Additional acoustic measures included perceived pitch, pitch strength, LTAS slope, alpha ratio, dB SPL 1–3 kHz, and harmonic-to-noise ratio. Major findings from more than 800 hours of recording indicated that among these students (a) higher vocal doses correlated significantly with greater voice intensity, more vocal clarity and less perturbation; and (b) there were significant differences in some acoustic voice quality metrics between non-singing, solo singing and choral singing. PMID:26897545

Cost-effectiveness of introducing a rotavirus vaccine in developing countries: The case of Mexico

PubMed Central

Valencia-Mendoza, Atanacio; Bertozzi, Stefano M; Gutierrez, Juan-Pablo; Itzler, Robbin

2008-01-01

Background In developing countries rotavirus is the leading cause of severe diarrhoea and diarrhoeal deaths in children under 5. Vaccination could greatly alleviate that burden, but in Mexico as in most low- and middle-income countries the decision to add rotavirus vaccine to the national immunisation program will depend heavily on its cost-effectiveness and affordability. The objective of this study was to assess the cost-effectiveness of including the pentavalent rotavirus vaccine in Mexico's national immunisation program. Methods A cost-effectiveness model was developed from the perspective of the health system, modelling the vaccination of a hypothetical birth cohort of 2 million children monitored from birth through 60 months of age. It compares the cost and disease burden of rotavirus in an unvaccinated cohort of children with one vaccinated as recommended at 2, 4, and 6 months. Results Including the pentavalent vaccine in the national immunisation program could prevent 71,464 medical visits (59%), 5,040 hospital admissions (66%), and 612 deaths from rotavirus gastroenteritis (70%). At US$10 per dose and a cost of administration of US$13.70 per 3-dose regimen, vaccination would cost US$122,058 per death prevented, US$4,383 per discounted life-year saved, at a total net cost of US$74.7 million dollars to the health care system. Key variables influencing the results were, in order of importance, case fatality, vaccine price, vaccine efficacy, serotype prevalence, and annual loss of efficacy. The results are also very sensitive to the discount rate assumed when calculated per life-year saved. Conclusion At prices below US $15 per dose, the cost per life-year saved is estimated to be lower than one GNP per capita and hence highly cost effective by the WHO Commission on Macroeconomics and Health criteria. The cost-effectiveness estimates are highly dependent upon the mortality in the absence of the vaccine, which suggests that the vaccine is likely to be significantly more cost-effective among poorer populations and among those with less access to prompt medical care – such that poverty reduction programs would be expected to reduce the future cost-effectiveness of the vaccine. PMID:18664280

Cost-effectiveness of introducing a rotavirus vaccine in developing countries: the case of Mexico.

PubMed

Valencia-Mendoza, Atanacio; Bertozzi, Stefano M; Gutierrez, Juan-Pablo; Itzler, Robbin

2008-07-29

In developing countries rotavirus is the leading cause of severe diarrhoea and diarrhoeal deaths in children under 5. Vaccination could greatly alleviate that burden, but in Mexico as in most low- and middle-income countries the decision to add rotavirus vaccine to the national immunisation program will depend heavily on its cost-effectiveness and affordability. The objective of this study was to assess the cost-effectiveness of including the pentavalent rotavirus vaccine in Mexico's national immunisation program. A cost-effectiveness model was developed from the perspective of the health system, modelling the vaccination of a hypothetical birth cohort of 2 million children monitored from birth through 60 months of age. It compares the cost and disease burden of rotavirus in an unvaccinated cohort of children with one vaccinated as recommended at 2, 4, and 6 months. Including the pentavalent vaccine in the national immunisation program could prevent 71,464 medical visits (59%), 5,040 hospital admissions (66%), and 612 deaths from rotavirus gastroenteritis (70%). At US$10 per dose and a cost of administration of US$13.70 per 3-dose regimen, vaccination would cost US$122,058 per death prevented, US$4,383 per discounted life-year saved, at a total net cost of US$74.7 million dollars to the health care system. Key variables influencing the results were, in order of importance, case fatality, vaccine price, vaccine efficacy, serotype prevalence, and annual loss of efficacy. The results are also very sensitive to the discount rate assumed when calculated per life-year saved. At prices below US $15 per dose, the cost per life-year saved is estimated to be lower than one GNP per capita and hence highly cost effective by the WHO Commission on Macroeconomics and Health criteria. The cost-effectiveness estimates are highly dependent upon the mortality in the absence of the vaccine, which suggests that the vaccine is likely to be significantly more cost-effective among poorer populations and among those with less access to prompt medical care - such that poverty reduction programs would be expected to reduce the future cost-effectiveness of the vaccine.

An information and communication technology-based centralized clinical trial to determine the efficacy and safety of insulin dose adjustment education based on a smartphone personal health record application: a randomized controlled trial.

PubMed

Kim, Gyuri; Bae, Ji Cheol; Yi, Byoung Kee; Hur, Kyu Yeon; Chang, Dong Kyung; Lee, Moon-Kyu; Kim, Jae Hyeon; Jin, Sang-Man

2017-07-18

A Personal Health Record (PHR) is an online application that allows patients to access, manage, and share their health data. PHRs not only enhance shared decision making with healthcare providers, but also enable remote monitoring and at-home-collection of detailed data. The benefits of PHRs can be maximized in insulin dose adjustment for patients starting or intensifying insulin regimens, as frequent self-monitoring of glucose, self-adjustment of insulin dose, and precise at-home data collection during the visit-to-visit period are important for glycemic control. The aim of this study is to examine the efficacy and safety of insulin dose adjustment based on a smartphone PHR application in patients with diabetes mellitus (DM) and to confirm the validity and stability of an information and communication technology (ICT)-based centralized clinical trial monitoring system. This is a 24-week, open-label, randomized, multi-center trial. There are three follow-up measures: baseline, post-intervention at week 12, and at week 24. Subjects diagnosed with type 1 DM, type 2 DM, and/or post-transplant DM who initiate basal insulin or intensify their insulin regimen to a basal-bolus regimen are included. After education on insulin dose titration and prevention for hypoglycemia and a 1-week acclimation period, subjects are randomized in a 1:1 ratio to either an ICT-based intervention group or a conventional intervention group. Subjects in the conventional intervention group will save and send their health information to the server via a PHR application, whereas those in ICT-based intervention group will receive additional algorithm-based feedback messages. The health information includes level of blood glucose, insulin dose, details on hypoglycemia, food diary, and step count. The primary outcome will be the proportion of patients who reach an optimal insulin dose within 12 weeks of study enrollment, without severe hypoglycemia or unscheduled clinic visits. This clinical trial will reveal whether insulin dose adjustment based on a smartphone PHR application can facilitate the optimization of insulin doses in patients with DM. In addition, the process evaluation will provide information about the validity and stability of the ICT-based centralized clinical trial monitoring system in this research field. Clinicaltrials.gov NCT 03112343 . Registered on 12 April 2017.

Low dose megavoltage cone beam computed tomography with an unflattened 4 MV beam from a carbon target

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

Faddegon, Bruce A.; Wu, Vincent; Pouliot, Jean

2008-12-15

Megavoltage cone beam computed tomography (MVCBCT) is routinely used for visualizing anatomical structures and implanted fiducials for patient positioning in radiotherapy. MVCBCT using a 6 MV treatment beam with high atomic number (Z) target and flattening filter in the beamline, as done conventionally, has lower image quality than can be achieved with a MV beam due to heavy filtration of the low-energy bremsstrahlung. The unflattened beam of a low Z target has an abundance of diagnostic energy photons, detected with modern flat panel detectors with much higher efficiency given the same dose to the patient. This principle guided the developmentmore » of a new megavoltage imaging beamline (IBL) for a commercial radiotherapy linear accelerator. A carbon target was placed in one of the electron primary scattering foil slots on the target-foil slide. A PROM on a function controller board was programed to put the carbon target in place for MVCBCT. A low accelerating potential of 4.2 MV was used for the IBL to restrict leakage of primary electrons through the target such that dose from x rays dominated the signal in the monitor chamber and the patient surface dose. Results from phantom and cadaver images demonstrated that the IBL had much improved image quality over the treatment beam. For similar imaging dose, the IBL improved the contrast-to-noise ratio by as much as a factor of 3 in soft tissue over that of the treatment beam. The IBL increased the spatial resolution by about a factor of 2, allowing the visualization of finer anatomical details. Images of the cadaver contained useful information with doses as low as 1 cGy. The IBL may be installed on certain models of linear accelerators without mechanical modification and results in significant improvement in the image quality with the same dose, or images of the same quality with less than one-third of the dose.« less

WE-D-BRA-04: Online 3D EPID-Based Dose Verification for Optimum Patient Safety

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

Spreeuw, H; Rozendaal, R; Olaciregui-Ruiz, I

2015-06-15

Purpose: To develop an online 3D dose verification tool based on EPID transit dosimetry to ensure optimum patient safety in radiotherapy treatments. Methods: A new software package was developed which processes EPID portal images online using a back-projection algorithm for the 3D dose reconstruction. The package processes portal images faster than the acquisition rate of the portal imager (∼ 2.5 fps). After a portal image is acquired, the software seeks for “hot spots” in the reconstructed 3D dose distribution. A hot spot is in this study defined as a 4 cm{sup 3} cube where the average cumulative reconstructed dose exceedsmore » the average total planned dose by at least 20% and 50 cGy. If a hot spot is detected, an alert is generated resulting in a linac halt. The software has been tested by irradiating an Alderson phantom after introducing various types of serious delivery errors. Results: In our first experiment the Alderson phantom was irradiated with two arcs from a 6 MV VMAT H&N treatment having a large leaf position error or a large monitor unit error. For both arcs and both errors the linac was halted before dose delivery was completed. When no error was introduced, the linac was not halted. The complete processing of a single portal frame, including hot spot detection, takes about 220 ms on a dual hexacore Intel Xeon 25 X5650 CPU at 2.66 GHz. Conclusion: A prototype online 3D dose verification tool using portal imaging has been developed and successfully tested for various kinds of gross delivery errors. The detection of hot spots was proven to be effective for the timely detection of these errors. Current work is focused on hot spot detection criteria for various treatment sites and the introduction of a clinical pilot program with online verification of hypo-fractionated (lung) treatments.« less

Personalized Feedback on Staff Dose in Fluoroscopy-Guided Interventions: A New Era in Radiation Dose Monitoring.

PubMed

Sailer, Anna M; Vergoossen, Laura; Paulis, Leonie; van Zwam, Willem H; Das, Marco; Wildberger, Joachim E; Jeukens, Cécile R L P N

2017-11-01

Radiation safety and protection are a key component of fluoroscopy-guided interventions. We hypothesize that providing weekly personal dose feedback will increase radiation awareness and ultimately will lead to optimized behavior. Therefore, we designed and implemented a personalized feedback of procedure and personal doses for medical staff involved in fluoroscopy-guided interventions. Medical staff (physicians and technicians, n = 27) involved in fluoroscopy-guided interventions were equipped with electronic personal dose meters (PDMs). Procedure dose data including the dose area product and effective doses from PDMs were prospectively monitored for each consecutive procedure over an 8-month period (n = 1082). A personalized feedback form was designed displaying for each staff individually the personal dose per procedure, as well as relative and cumulative doses. This study consisted of two phases: (1) 1-5th months: Staff did not receive feedback (n = 701) and (2) 6-8th months: Staff received weekly individual dose feedback (n = 381). An anonymous evaluation was performed on the feedback and occupational dose. Personalized feedback was scored valuable by 76% of the staff and increased radiation dose awareness for 71%. 57 and 52% reported an increased feeling of occupational safety and changing their behavior because of personalized feedback, respectively. For technicians, the normalized dose was significantly lower in the feedback phase compared to the prefeedback phase: [median (IQR) normalized dose (phase 1) 0.12 (0.04-0.50) µSv/Gy cm 2 versus (phase 2) 0.08 (0.02-0.24) µSv/Gy cm 2 , p = 0.002]. Personalized dose feedback increases radiation awareness and safety and can be provided to staff involved in fluoroscopy-guided interventions.

Assessment of intake and internal dose from iodine-131 for exposed workers handling radiopharmaceutical products.

PubMed

Bitar, A; Maghrabi, M; Doubal, A W

2013-12-01

Two methods for determination of internal dose due to (131)I intake during the preparation and handling of iodine radiopharmaceutical products have been compared. The first method was based on the measurement of (131)I in 24-hour urine samples while the second method was based on the measurement in vivo of (131)I in thyroid. The results have shown that urine analysis method can be used as a screening test but not for internal dose assessment of exposed workers. Thyroid monitoring method was found to be more reliable and accurate method for assessing internal dose from (131)I intake. In addition, the assessed internal dose showed that the annual internal effective dose for some workers was below 1 mSv with no risk classification, whereas the results of other group of workers were between 1 and 6 mSv with low risk classification. Only one worker reached 7.66 mSv with high risk classification; and this worker must be monitored individually. © 2013 Elsevier Ltd. All rights reserved.

Cost considerations for long-term ecological monitoring

USGS Publications Warehouse

Caughlan, L.; Oakley, K.L.

2001-01-01

For an ecological monitoring program to be successful over the long-term, the perceived benefits of the information must justify the cost. Financial limitations will always restrict the scope of a monitoring program, hence the program's focus must be carefully prioritized. Clearly identifying the costs and benefits of a program will assist in this prioritization process, but this is easier said than done. Frequently, the true costs of monitoring are not recognized and are, therefore, underestimated. Benefits are rarely evaluated, because they are difficult to quantify. The intent of this review is to assist the designers and managers of long-term ecological monitoring programs by providing a general framework for building and operating a cost-effective program. Previous considerations of monitoring costs have focused on sampling design optimization. We present cost considerations of monitoring in a broader context. We explore monitoring costs, including both budgetary costs--what dollars are spent on--and economic costs, which include opportunity costs. Often, the largest portion of a monitoring program budget is spent on data collection, and other, critical aspects of the program, such as scientific oversight, training, data management, quality assurance, and reporting, are neglected. Recognizing and budgeting for all program costs is therefore a key factor in a program's longevity. The close relationship between statistical issues and cost is discussed, highlighting the importance of sampling design, replication and power, and comparing the costs of alternative designs through pilot studies and simulation modeling. A monitoring program development process that includes explicit checkpoints for considering costs is presented. The first checkpoint occur during the setting of objectives and during sampling design optimization. The last checkpoint occurs once the basic shape of the program is known, and the costs and benefits, or alternatively the cost-effectiveness, of each program element can be evaluated. Moving into the implementation phase without careful evaluation of costs and benefits is risky because if costs are later found to exceed benefits, the program will fail. The costs of development, which can be quite high, will have been largely wasted. Realistic expectations of costs and benefits will help ensure that monitoring programs survive the early, turbulent stages of development and the challenges posed by fluctuating budgets during implementation.

7 CFR 246.19 - Management evaluation and monitoring reviews.

Code of Federal Regulations, 2014 CFR

2014-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN Monitoring and Review § 246.19 Management evaluation and monitoring reviews... reports, the development of corrective action plans to resolve Program deficiencies, the monitoring of the...

7 CFR 246.19 - Management evaluation and monitoring reviews.

Code of Federal Regulations, 2012 CFR

2012-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN Monitoring and Review § 246.19 Management evaluation and monitoring reviews... reports, the development of corrective action plans to resolve Program deficiencies, the monitoring of the...

7 CFR 246.19 - Management evaluation and monitoring reviews.

Code of Federal Regulations, 2013 CFR

2013-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN Monitoring and Review § 246.19 Management evaluation and monitoring reviews... reports, the development of corrective action plans to resolve Program deficiencies, the monitoring of the...

7 CFR 246.19 - Management evaluation and monitoring reviews.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN Monitoring and Review § 246.19 Management evaluation and monitoring reviews... reports, the development of corrective action plans to resolve Program deficiencies, the monitoring of the...

7 CFR 246.19 - Management evaluation and monitoring reviews.

Code of Federal Regulations, 2011 CFR

2011-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN Monitoring and Review § 246.19 Management evaluation and monitoring reviews... reports, the development of corrective action plans to resolve Program deficiencies, the monitoring of the...

45 CFR 2543.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 2543.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

15 CFR 14.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2011 CFR

2011-01-01

...-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Reports and Records § 14.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

14 CFR 1260.151 - Monitoring and reporting program performance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Records § 1260.151 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subcontract, function or activity supported by the award. Recipients shall monitor subcontracts to ensure subcontractors have met the audit requirements as delineated...

14 CFR 1260.151 - Monitoring and reporting program performance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Records § 1260.151 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subcontract, function or activity supported by the award. Recipients shall monitor subcontracts to ensure subcontractors have met the audit requirements as delineated...

15 CFR 14.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2013 CFR

2013-01-01

...-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Reports and Records § 14.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

45 CFR 2543.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 2543.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

14 CFR 1260.151 - Monitoring and reporting program performance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Records § 1260.151 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subcontract, function or activity supported by the award. Recipients shall monitor subcontracts to ensure subcontractors have met the audit requirements as delineated...

45 CFR 2543.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 2543.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

45 CFR 2543.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 2543.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

15 CFR 14.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2014 CFR

2014-01-01

...-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Reports and Records § 14.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

15 CFR 14.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2012 CFR

2012-01-01

...-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Reports and Records § 14.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to...

Proposed patient motion monitoring system using feature point tracking with a web camera.

PubMed

Miura, Hideharu; Ozawa, Shuichi; Matsuura, Takaaki; Yamada, Kiyoshi; Nagata, Yasushi

2017-12-01

Patient motion monitoring systems play an important role in providing accurate treatment dose delivery. We propose a system that utilizes a web camera (frame rate up to 30 fps, maximum resolution of 640 × 480 pixels) and an in-house image processing software (developed using Microsoft Visual C++ and OpenCV). This system is simple to use and convenient to set up. The pyramidal Lucas-Kanade method was applied to calculate motions for each feature point by analysing two consecutive frames. The image processing software employs a color scheme where the defined feature points are blue under stable (no movement) conditions and turn red along with a warning message and an audio signal (beeping alarm) for large patient movements. The initial position of the marker was used by the program to determine the marker positions in all the frames. The software generates a text file that contains the calculated motion for each frame and saves it as a compressed audio video interleave (AVI) file. We proposed a patient motion monitoring system using a web camera, which is simple and convenient to set up, to increase the safety of treatment delivery.

Lawrence Livermore National Laboratory Environmental Report 2016

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

Rosene, Crystal

The purposes of the Environmental Report 2016 are to record LLNL’s compliance with environmental standards and requirements, describe LLNL’s environmental protection and remediation programs, and present the results of environmental monitoring. Specifically, the report discusses LLNL’s EMS; describes significant accomplishments in pollution prevention; presents the results of air, water, vegetation, and foodstuff monitoring; reports radiological doses from LLNL operations; summarizes LLNL’s activities involving special status wildlife, plants, and habitats; and describes the progress LLNL has made in remediating groundwater contamination. Environmental monitoring at LLNL, including analysis of samples and data, is conducted according to documented standard operating procedures. Duplicate samplesmore » are collected and analytical results are reviewed and compared to internal acceptance standards. This report is prepared for DOE by LLNL’s Environmental Functional Area (EFA). Submittal of the report satisfies requirements under DOE Order 231.1B, “Environment, Safety and Health Reporting,” and DOE Order 458.1, “Radiation Protection of the Public and Environment.” The report is distributed in electronic form and is available to the public at https://saer.llnl.gov/, the website for the LLNL annual environmental report. Previous LLNL annual environmental reports beginning with 1994 are also on the website.« less

Project 57 Air Monitoring Report: October 1, 2013, through December 31, 2014

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

Mizell, Steve A.; Nikolich, George; McCurdy, Greg

On April 24, 1957, the Atomic Energy Commission (AEC, now the Department of Energy [DOE]) conducted the Project 57 safety experiment in western Emigrant Valley north east of the Nevada National Security Site (NNSS, formerly the Nevada Test Site) on lands withdrawn by the Department of Defense (DoD) for the Nevada Test and Training Range (NTTR). The test was undertaken to develop (1) a means of estimating plutonium distribution resulting from a nonnuclear detonation; (2) biomedical evaluation techniques for use in plutonium-laden environments; (3) methods of surface decontamination; and (4) instruments and field procedures for prompt estimation of alpha contaminationmore » (Shreve, 1958). Although the test did not result in the fission of nuclear materials, it did disseminate plutonium across the land surface. Following the experiment, the AEC fenced the contaminated area and returned control of the surrounding land to the DoD. Various radiological surveys have been performed in the area and in 2007, the DOE expanded the demarked contamination area by posting signs 200 to 400 feet (60 to 120 meters) outside of the original fence. Plutonium in soil is thought to attach preferentially to smaller particles. Therefore, redistribution of soil particulates by wind (dust) is the mechanism most likely to transport plutonium beyond the boundary of the Project 57 contamination area. In 2011, DRI installed two instrumentation towers to measure radiological, meteorological, and dust conditions. The monitoring activity was implemented to determine if radionuclide contamination was detectable in samples of airborne dust and characterize meteorological and environmental parameters that influence dust transport. Collected data also permits comparison of radiological conditions at the Project 57 monitoring stations to conditions observed at Community Environmental Monitoring Program (CEMP) stations around the NTTR. Biweekly samples of airborne particulates are submitted for laboratory assessment of gross alpha and gross beta radioactivity and for determination of gamma-emitting radionuclides. Annual average gross alpha values at the Project 57 monitoring stations are in the same range as the highest two values reported for the CEMP stations surrounding the NTTR. Annual average gross beta values at the Project 57 monitoring stations are slightly higher than the lowest value reported for the CEMP stations surrounding the NTTR. Gamma spectroscopy analyses on samples collected from the Project 57 stations identified only naturally occurring radionuclides. No manmade radionuclides were detected. Thermoluminescent dosimeters (TLDs) indicated that the average annual radioactivity dose at the monitoring stations is higher than the dose determined at surrounding CEMP stations but approximately half of the estimated national average dose received by the general public as a result of exposure to natural sources. The TLDs at the Project 57 monitoring stations are exposed to both natural sources (terrestrial and cosmic) and radioactive releases from the Project 57 contamination area. These comparisons show that the gross alpha, gross beta, and gamma spectroscopy levels at the Project 57 monitoring stations are similar to levels observed at the CEMP stations but that the average annual dose rate is higher than at the CEMP stations. Winds in excess of approximately 15 mph begin to generate dust movement by saltation (migration of sand at the ground surface) or direct suspension in the air. Saltated sand, PM10 (inhalable) dust, and PM2.5 (fine particulate dust) exhibit an approximately exponential increase with increasing wind speed. The greatest concentrations of dust occur for winds exceeding 20 mph. During the reporting period, winds in excess of 20 mph occurred approximately 1.6 percent of the time. Preliminary assessment of individual wind events suggests that dust generation is highly variable likely because of the influence of other meteorological and environmental parameters. Although winds sufficient to generate significant amounts of dust occur at the Project 57 site, they are infrequent and of short duration. Additionally, the potential for wind transport of dust is dependent on other parameters whose influence have not yet been assessed.« less

Radiation doses to members of the public near to Sellafield, Cumbria, from liquid discharges 1952-98.

PubMed

Jackson, D; Lambers, B; Gray, J

2000-06-01

Liquid wastes containing low levels of radioactivity have been discharged to the Irish Sea from the nuclear fuel reprocessing site at Sellafield since operations began in the early 1950s, and monitoring of radioactivity in foodstuffs has been undertaken over many years. Based on the best available monitoring data, supplemented by modelled values where necessary, doses to local critical groups have been reassessed using the most recent dosimetry. Contemporary habits data have been used where available, again supplemented by assumed habits where necessary. During the 1950s and 1960s the highest doses were received by individuals consuming Cumbrian Porphyra as laverbread, and peak doses around 0.8 to 1.0 mSv year(-1) have been estimated. During the 1970s and 1980s the critical exposure group switched to consumers of local fish and shellfish, with peak doses possibly reaching 2.5 to 3.0 mSv year(-1). Latterly, doses to all marine-related groups have declined to less than 150 to 200 microSv year(-1). At all times, doses have been within the appropriate limits set for members of the public.

Comparison of radon doses based on different radon monitoring approaches.

PubMed

Vaupotič, Janja; Smrekar, Nataša; Žunić, Zora S

2017-04-01

In 43 places (23 schools, 3 kindergartens, 16 offices and one dwelling), indoor radon has been monitored as an intercomparison experiment, using α-scintillation cells (SC - Jožef Stefan Institute, Slovenia), various kinds of solid state nuclear track detectors (KfK - Karlsruhe Institute of Technology, Germany; UFO - National Institute of Radiological Sciences, Chiba, Japan; RET - University College Dublin, Ireland) and active electronic devices (EQF, Sarad, Germany). At the same place, the radon levels and, consequently, the effective doses obtained with different radon devices differed substantially (by a factor of 2 or more), and no regularity was observed as regards which detector would show a higher or lower dose. Copyright © 2016 Elsevier Ltd. All rights reserved.

Decontamination in a Russian settlement.

PubMed

Fogh, C L; Andersson, K G; Barkovsky, A N; Mishine, A S; Ponamarjov, A V; Ramzaev, V P; Roed, J

1999-04-01

Decontamination was carried out in an area with three houses in Novo Bobovichi, Bryansk region, Russia, in the autumn of 1995. It was demonstrated that significant reductions in the dose rate both indoor (DRF = 0.34) and outdoor (DRF = 0.20) can be achieved when a controlled cleaning is undertaken. This paper describes the decontamination work carried out and the results obtained. The roofs of the houses were swept and cleaned by special roof cleaning equipment. The soil around the houses was removed by hand while carefully monitoring the ground for residual contamination. By monitoring the decline in the dose rate during the different stages of the work the dose reducing effect of each action has been measured.

Polymedication Electronic Monitoring System (POEMS) - a new technology for measuring adherence.

PubMed

Arnet, Isabelle; Walter, Philipp N; Hersberger, Kurt E

2013-01-01

Reliable and precise measurement of patient adherence to medications is feasible by incorporating a microcircuitry into pharmaceutical packages of various designs, such that the maneuvers needed to remove a dose of drug are detected, time-stamped, and stored. The principle is called "electronic medication event monitoring" but is currently limited to the monitoring of a single drug therapy. Our aims were introducing a new technology; a clear, self-adhesive polymer film, with printed loops of conductive wires that can be affixed to multidrug punch cards for the electronic adherence monitoring of multiple medication regimens (Polymedication Electronic Monitoring System, POEMS), and illustrating potential benefits for patient care. We present a preliminary report with one patient experience. Our illustrative case was supplied with a pre-filled 7-day multiple medication punch card with unit-of-use doses for specific times of the day (six pills in the morning cavity, two pills in the evening cavity, and one pill in case of insomnia in the bedtime cavity), with the new electronic film affixed on it. The intake times over 1 week were extremely skewed (median intake hours at 2:00 pm for the morning doses and at 6:40 pm for the evening doses). After an intervention aimed at optimizing the timing adherence, the morning and evening intake hours became more balanced, with 42.3% of correct dosing intervals (±3 h) for drugs with twice daily intake (vs. 0% before the intervention). The electronic monitoring of the entire therapy revealed an intake pattern that would have remained undiscovered with any other device and allowed a personalized intervention to correct an inadequate medication intake behavior. POEMS may guide health professionals when they need to optimize a pharmacotherapy because of suspected insufficient adherence. Further, knowing the intake pattern of the entire pharmacotherapy can elucidate unreached clinical outcome, drug-drug interactions, and drug resistance. In the near future, one could imagine that medication adherence data over the entire therapy plan would be available as soon as the electronic wires are activated, so that a failure to take medication could be detected immediately and intervention could be taken if appropriate.

Review of present groundwater monitoring programs at the Nevada Test Site

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

Hershey, R.L.; Gillespie, D.

1993-09-01

Groundwater monitoring at the Nevada Test Site (NTS) is conducted to detect the presence of radionuclides produced by underground nuclear testing and to verify the quality and safety of groundwater supplies as required by the State of Nevada and federal regulations, and by U.S. Department of Energy (DOE) Orders. Groundwater is monitored at water-supply wells and at other boreholes and wells not specifically designed or located for traditional groundwater monitoring objectives. Different groundwater monitoring programs at the NTS are conducted by several DOE Nevada Operations Office (DOE/NV) contractors. Presently, these individual groundwater monitoring programs have not been assessed or administeredmore » under a comprehensive planning approach. Redundancy exists among the programs in both the sampling locations and the constituents analyzed. Also, sampling for certain radionuclides is conducted more frequently than required. The purpose of this report is to review the existing NTS groundwater monitoring programs and make recommendations for modifying the programs so a coordinated, streamlined, and comprehensive monitoring effort may be achieved by DOE/NV. This review will be accomplished in several steps. These include: summarizing the present knowledge of the hydrogeology of the NTS and the potential radionuclide source areas for groundwater contamination; reviewing the existing groundwater monitoring programs at the NTS; examining the rationale for monitoring and the constituents analyzed; reviewing the analytical methods used to quantify tritium activity; discussing monitoring network design criteria; and synthesizing the information presented and making recommendations based on the synthesis. This scope of work was requested by the DOE/NV Hydrologic Resources Management Program (HRMP) and satisfies the 1993 (fiscal year) HRMP Groundwater Monitoring Program Review task.« less

Meeting report: Estimating the benefits of reducing hazardous air pollutants--summary of 2009 workshop and future considerations.

PubMed

Gwinn, Maureen R; Craig, Jeneva; Axelrad, Daniel A; Cook, Rich; Dockins, Chris; Fann, Neal; Fegley, Robert; Guinnup, David E; Helfand, Gloria; Hubbell, Bryan; Mazur, Sarah L; Palma, Ted; Smith, Roy L; Vandenberg, John; Sonawane, Babasaheb

2011-01-01

Quantifying the benefits of reducing hazardous air pollutants (HAPs, or air toxics) has been limited by gaps in toxicological data, uncertainties in extrapolating results from high-dose animal experiments to estimate human effects at lower doses, limited ambient and personal exposure monitoring data, and insufficient economic research to support valuation of the health impacts often associated with exposure to individual air toxics. To address some of these issues, the U.S. Environmental Protection Agency held the Workshop on Estimating the Benefits of Reducing Hazardous Air Pollutants (HAPs) in Washington, DC, from 30 April to 1 May 2009. Experts from multiple disciplines discussed how best to move forward on air toxics benefits assessment, with a focus on developing near-term capability to conduct quantitative benefits assessment. Proposed methodologies involved analysis of data-rich pollutants and application of this analysis to other pollutants, using dose-response modeling of animal data for estimating benefits to humans, determining dose-equivalence relationships for different chemicals with similar health effects, and analysis similar to that used for criteria pollutants. Limitations and uncertainties in economic valuation of benefits assessment for HAPS were discussed as well. These discussions highlighted the complexities in estimating the benefits of reducing air toxics, and participants agreed that alternative methods for benefits assessment of HAPs are needed. Recommendations included clearly defining the key priorities of the Clean Air Act air toxics program to identify the most effective approaches for HAPs benefits analysis, focusing on susceptible and vulnerable populations, and improving dose-response estimation for quantification of benefits.

Implementation of an i.v.-compounding robot in a hospital-based cancer center pharmacy.

PubMed

Yaniv, Angela W; Knoer, Scott J

2013-11-15

The implementation of a robotic device for compounding patient-specific chemotherapy doses is described, including a review of data on the robot's performance over a 13-month period. The automated system prepares individualized i.v. chemotherapy doses in a variety of infusion bags and syringes; more than 50 drugs are validated for use in the machine. The robot is programmed to recognize the physical parameters of syringes and vials and uses photographic identification, barcode identification, and gravimetric measurements to ensure that the correct ingredients are compounded and the final dose is accurate. The implementation timeline, including site preparation, logistics planning, installation, calibration, staff training, development of a pharmacy information system (PIS) interface, and validation by the state board of pharmacy, was about 10 months. In its first 13 months of operation, the robot was used to prepare 7384 medication doses; 85 doses (1.2%) found to be outside the desired accuracy range (±4%) were manually modified by pharmacy staff. Ongoing system monitoring has identified mechanical and materials-related problems including vial-recognition failures (in many instances, these issues were resolved by the system operator and robotic compounding proceeded successfully), interface issues affecting robot-PIS communication, and human errors such as the loading of an incorrect vial or bag into the machine. Through staff training, information technology improvements, and workflow adjustments, the robot's throughput has been steadily improved. An i.v.-compounding robot was successfully implemented in a cancer center pharmacy. The robot performs compounding tasks safely and accurately and has been integrated into the pharmacy's workflow.

Inter-observer agreement of a multi-parameter campsite monitoring program on the Dixie National Forest, Utah

Treesearch

Nicholas J. Glidden; Martha E. Lee

2007-01-01

Precision is crucial to campsite monitoring programs. Yet, little empirical research has ever been published on the level of precision of this type of monitoring programs. The purpose of this study was to evaluate the level of agreement between observers of campsite impacts using a multi-parameter campsite monitoring program. Thirteen trained observers assessed 16...

An overview of a landbird monitoring program at Tortuguero, on the Caribbean coast of Costa Rica

Treesearch

C. John Ralph; Margaret J. Widdowson; Robert I. Frey; Pablo A. Herrera; Brian P. O' Donnell

2005-01-01

Since 1994, the Tortuguero Integrated Bird Monitoring Program has been monitoring birds in a coastal lowland rain forest of northeast Costa Rica. The Program has combined the use of area searches, constanteffort mist netting, and migration counts into a longterm landbird monitoring and training program following the recommendations of the Partners In Flight &ndash...

Successful withdrawal from high-dose benzodiazepine in a young patient through electronic monitoring of polypharmacy: a case report in an ambulatory setting.

PubMed

Loscertales, Hèctor R; Wentzky, Valerie; Dürsteler, Kenneth; Strasser, Johannes; Hersberger, Kurt E; Arnet, Isabelle

2017-05-01

Dependence on high-dose benzodiazepines (BZDs) is well known and discontinuation attempts are generally unsuccessful. A well established protocol for high-dose BZD withdrawal management is lacking. We present the case of withdrawal from high-dose lorazepam (>20 mg daily) in an unemployed 35-year-old male outpatient through agonist substitution with long-acting clonazepam and electronic monitoring over 28 weeks. All medicines were repacked into weekly 7 × 4 cavity multidose punch cards with an electronic monitoring system. The prescribed daily dosages of BZDs were translated into an optimal number of daily tablets, divided into up to four units of use. Withdrawal was achieved by individual leftover of a small quantity of BZDs that was placed in a separate compartment. Feedback with visualization of intake over the past week was given during weekly psychosocial sessions. Stepwise reduction was obtained by reducing the mg content of the cavities proportionally to the leftovers, keeping the number of cavities in order to maintain regular intake behavior, and to determine the dosage decrease. At week 28, the primary objectives were achieved, that is, lorazepam reduction to 5 mg daily and cannabis abstinence. Therapy was continued using multidrug punch cards without electronic monitoring to maintain the management system. At week 48, a smaller size weekly pill organizer with detachable daily containers was dispensed. At week 68, the patient's therapy was constant with 1.5 mg clonazepam + 5 mg lorazepam daily for anxiety symptoms and the last steps of withdrawal were started. Several key factors led to successful withdrawal from high-dose BZD in this outpatient, such as the use of weekly punch cards coupled with electronic monitoring, the patient's empowerment over the withdrawal process, and the collaboration of several healthcare professionals. The major implication for clinical care is reduction by following the leftovers, and not a diktat from the healthcare professionals.

Results of space environment measurement carried out by the Roscosmos monitoring system elements and their correlation with different space weather characteristics

NASA Astrophysics Data System (ADS)

Protopopov, Grigory; Anashin, Vasily; Elushov, Ilya; Kozyukova, Olga

The Monitoring System of space radiation exposure on electronic components is developed by the Institute of Space Device Engineering by order Roscosmos. The key targets of the Monitoring System are space environment measurements, space model correction, space weather characteristics forecast, improvement of radiation hardness technical requirements and etc. The Monitoring System includes two parts: the ground-based and the space-born segments. The ground-based segment includes the forecast station, the analytic complex and the data output system. The space-born segment base elements are TID sensors operating by MNOSFET dosimetry principle. Sensor temperature stabilization is achieved by choosing of operational point according to the minimal change of sensor current-voltage curve. The set of 38 TID sensors is placed on 19 spacecrafts currently. The spacecrafts operate in Medium Earth Orbit (MEO) (approximately 20 000 km with inclination of 65(°) ). The flight data obtained perfectly correlate with total dose flight data registered using MOSFET placed on Van Allen Probe spacecraft functioning in high elliptical orbit (apogee is 37 000 km, perigee is 650 km, inclination is 10(°) ). Also coincidence with the dose data from GIOVE-B spacecraft (circular orbit 23200 km, inclination of 56(°) ) of Galileo system is observed. We have observed several abrupt dose rate increases from April, 2010. The flight data are compared with other monitoring system data and ground measurements. The comparison results show that high energy electrons (> 1 MeV) give general contribution in accumulated dose and anomalous dose rate increases. These results are in agreement with shielding stopping power calculation results. The high electron fluxes rise significantly in MEO as a result of Van Allen belts shifting during geomagnetic storms. The flight data were compared with calculation results obtained using different space models. The comparison shows that for some long-term interval the distinction between experimental and calculated results can be 7 times less or more.

Dosimetric Accuracy of a Dual Photon Energy Linac at Low Monitor Setting for Various Pulse Repetition Frequencies

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

Sharma, Anil Kumar; Supe, Sanjay S.; Anantha, N.

2015-01-15

Accuracy of dose delivery at low monitor unit setting is studied for a dual photon energy linear accelerator. Dose delivered per MU is found to be constant for both the photon beams for MU settings above 30. For lower MUs there is definite deviation from the calibrated value and the error is found to be increasing as fewer MUs are set for dose delivery. This dose/MU ratio at low MU setting is found to be dose-rate dependent, showing an increasing trend with pulse repetition frequency (PRF). Also, the dosimetric ratio is observed to be mode dependent; its value for anmore » 18 MV beam is almost double that observed in the case of a 6 MV beam at very low MU setting. The magnitude of this error should be determined for each energy so that appropriate corrections can be applied if very low MUs are to be used.« less

A robust two-stage design identifying the optimal biological dose for phase I/II clinical trials.

PubMed

Zang, Yong; Lee, J Jack

2017-01-15

We propose a robust two-stage design to identify the optimal biological dose for phase I/II clinical trials evaluating both toxicity and efficacy outcomes. In the first stage of dose finding, we use the Bayesian model averaging continual reassessment method to monitor the toxicity outcomes and adopt an isotonic regression method based on the efficacy outcomes to guide dose escalation. When the first stage ends, we use the Dirichlet-multinomial distribution to jointly model the toxicity and efficacy outcomes and pick the candidate doses based on a three-dimensional volume ratio. The selected candidate doses are then seamlessly advanced to the second stage for dose validation. Both toxicity and efficacy outcomes are continuously monitored so that any overly toxic and/or less efficacious dose can be dropped from the study as the trial continues. When the phase I/II trial ends, we select the optimal biological dose as the dose obtaining the minimal value of the volume ratio within the candidate set. An advantage of the proposed design is that it does not impose a monotonically increasing assumption on the shape of the dose-efficacy curve. We conduct extensive simulation studies to examine the operating characteristics of the proposed design. The simulation results show that the proposed design has desirable operating characteristics across different shapes of the underlying true dose-toxicity and dose-efficacy curves. The software to implement the proposed design is available upon request. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

28 CFR 70.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Reports and Records § 70.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients must monitor subawards...

29 CFR 95.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2012 CFR

2012-07-01

...-Award Requirements Reports and Records § 95.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to ensure subrecipients have met the audit...

29 CFR 95.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2011 CFR

2011-07-01

...-Award Requirements Reports and Records § 95.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to ensure subrecipients have met the audit...

29 CFR 95.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2013 CFR

2013-07-01

...-Award Requirements Reports and Records § 95.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to ensure subrecipients have met the audit...

22 CFR 226.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2014 CFR

2014-04-01

... ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Reports and Records § 226.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor...

22 CFR 226.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2012 CFR

2012-04-01

... ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Reports and Records § 226.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor...

29 CFR 95.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2014 CFR

2014-07-01

...-Award Requirements Reports and Records § 95.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to ensure subrecipients have met the audit...

22 CFR 226.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2013 CFR

2013-04-01

... ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Reports and Records § 226.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor...

28 CFR 70.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Reports and Records § 70.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients must monitor subawards...

28 CFR 70.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Reports and Records § 70.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients must monitor subawards...

28 CFR 70.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Reports and Records § 70.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients must monitor subawards...

14 CFR § 1260.151 - Monitoring and reporting program performance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Records § 1260.151 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subcontract, function or activity supported by the award. Recipients shall monitor subcontracts to ensure subcontractors have met the audit requirements as delineated...

22 CFR 226.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Reports and Records § 226.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor...

Central Alaska Network vital signs monitoring plan

USGS Publications Warehouse

MacCluskie, Margaret C.; Oakley, Karen L.; McDonald, Trent; Wilder, Doug

2005-01-01

Denali National Park and Preserve, Wrangell-St. Elias National Park and Preserve, and Yukon-Charley Rivers National Preserve have been organized into the Central Alaska Network (CAKN) for the purposes of carrying out ecological monitoring activities under the National Park Services’ Vital Signs Monitoring program. The Phase III Report is the initial draft of the Vital Signs Monitoring Plan for the Central Alaska Network. It includes updated material from the Phase I and II documents. This report, and draft protocols for 11 of the network’s Vital Signs, were peer reviewed early in 2005. Review comments were incorporated into the document bringing the network to the final stage of having a Vital Signs Monitoring Plan. Implementation of the program will formally begin in FY 2006. The broad goals of the CAKN monitoring program are to: (1) better understand the dynamic nature and condition of park ecosystems; and (2) provide reference points for comparisons with other, altered environments. The focus of the CAKN program will be to monitor ecosystems in order to detect change in ecological components and in the relationships among the components. Water quality monitoring is fully integrated within the CAKN monitoring program. A monitoring program for lentic (non-moving water) has been determined, and the program for lotic systems (moving water) is under development.

TH-AB-202-09: Direct-Aperture Optimization for Combined MV+kV Dose Planning in Fluoroscopic Real-Time Tumor-Tracking Radiation Therapy

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

Liu, X; Belcher, AH; Grelewicz, Z

Purpose: Real-time kV fluoroscopic tumor tracking has the benefit of direct tumor position monitoring. However, there is clinical concern over the excess kV imaging dose cost to the patient when imaging in continuous fluoroscopic mode. This work addresses this specific issue by proposing a combined MV+kV direct-aperture optimization (DAO) approach to integrate the kV imaging beam into a treatment planning such that the kV radiation is considered as a contributor to the overall dose delivery. Methods: The combined MV+kV DAO approach includes three algorithms. First, a projected Quasi-Newton algorithm (L-BFGS) is used to find optimized fluence with MV+kV dose formore » the best possible dose distribution. Then, Engel’s algorithm is applied to optimize the total number of monitor units and heuristically optimize the number of apertures. Finally, an aperture shape optimization (ASO) algorithm is applied to locally optimize the leaf positions of MLC. Results: Compared to conventional DAO MV plans with continuous kV fluoroscopic tracking, combined MV+kV DAO plan leads to a reduction in the total number of MV monitor units due to inclusion of kV dose as part of the PTV, and was also found to reduce the mean and maximum doses on the organs at risk (OAR). Compared to conventional DAO MV plan without kV tracking, the OAR dose in the combined MV+kV DAO plan was only slightly higher. DVH curves show that combined MV+kV DAO plan provided about the same PTV coverage as that in the conventional DAO plans without kV imaging. Conclusion: We report a combined MV+kV DAO approach that allows real time kV imager tumor tracking with only a trivial increasing on the OAR doses while providing the same coverage to PTV. The approach is suitable for clinic implementation.« less

EMP Attachment 3 DOE-SC PNNL Site Dose Assessment Guidance

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

Snyder, Sandra F.

2011-12-21

This Dose Assessment Guidance (DAG) describes methods to use to determine the Maximally-Exposed Individual (MEI) location and to estimate dose impact to that individual under the U.S. Department of Energy Office of Science (DOE-SC) Pacific Northwest National Laboratory (PNNL) Site Environmental Monitoring Plan (EMP). This guidance applies to public dose from radioactive material releases to the air from PNNL Site operations. This document is an attachment to the Pacific Northwest National Laboratory (PNNL) Environmental Monitoring Plan (EMP) and describes dose assessment guidance for radiological air emissions. The impact of radiological air emissions from the U.S. Department of Energy Office ofmore » Science (DOE-SC) PNNL Site is indicated by dose estimates to a maximally exposed member of the public, referred to as the maximally exposed individual (MEI). Reporting requirements associated with dose to members of the public from radiological air emissions are in 40 CFR Part 61.94, WAC 246-247-080, and DOE Order 458.1. The DOE Order and state standards for dose from radioactive air emissions are consistent with U.S. Environmental Protection Agency (EPA) dose standards in 40 CFR 61.92 (i.e., 10 mrem/yr to a MEI). Despite the fact that the current Contract Requirements Document (CRD) for the DOE-SC PNNL Site operations does not include the requirement to meet DOE CRD 458.1, paragraph 2.b, public dose limits, the DOE dose limits would be met when EPA limits are met.« less

24 CFR 266.520 - Program monitoring and compliance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Project Management and Servicing § 266.520 Program monitoring and compliance. HUD will monitor the...

24 CFR 266.520 - Program monitoring and compliance.

Code of Federal Regulations, 2012 CFR

2012-04-01

... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Project Management and Servicing § 266.520 Program monitoring and compliance. HUD will monitor the...

24 CFR 266.520 - Program monitoring and compliance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Project Management and Servicing § 266.520 Program monitoring and compliance. HUD will monitor the...

24 CFR 266.520 - Program monitoring and compliance.

Code of Federal Regulations, 2013 CFR

2013-04-01

... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Project Management and Servicing § 266.520 Program monitoring and compliance. HUD will monitor the...

24 CFR 266.520 - Program monitoring and compliance.

Code of Federal Regulations, 2014 CFR

2014-04-01

... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Project Management and Servicing § 266.520 Program monitoring and compliance. HUD will monitor the...

TU-D-209-06: Head and Neck Tissue Dose From X-Ray Scatter to Physicians Performing Cardiovascular Procedures

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

Fetterly, K; Schueler, B; Grams, M

Purpose: The purpose of this work was to characterize the spatial distribution of scatter radiation to the head and neck of a physician performing an x-ray interventional procedure and assess brain, eye lens, and carotid artery dose. Methods: Radiographic x-ray beams were tuned to match the peak energy (56 to 106 keV) and HVL (3.5 to 6.5 mm Al) of x-ray scatter originating from a patient during a fluoroscopic procedure. The radiographic beam was directed upon a Rando phantom from an inferior-left location to mimic a typical patient-operator geometric relationship. A lead-equivalent protective garment was secured to the phantom. Directmore » exposure Gafchromic film (XRQA2) was placed between the transverse plane layers of the head and neck region of the phantom and exposed with 4 scatter-equivalent radiographic beams. A 3×3 cm{sup 2} film placed at the left collar of the phantom was used to monitor incident dose in the position of a radiation monitoring badge. The films were converted to 2D dose distribution maps using FilmQA Pro software and an Epson 11000-XL scanner. The 2D dose distributions maps were normalized by the left collar dose and the percent of left collar dose (%LCD) was calculated for select tissues. Results: The dose maps had high dynamic range (10{sub 4}) and spatial detail. Considering all transverse planes and 4 scatter beam qualities, the median %LCD values were: whole brain 8.5%, left brain 13%, right brain 5.4%, left eye lens 67%, right eye lens 25%, left carotid artery 72%, and right carotid artery 28%. Conclusion: Scatter radiation dose to an operator can be simulated using a tuned radiographic beam and used to expose a phantom and Gafchromic film, thereby creating detailed 2D dose distribution maps. This work facilitates individualized estimation of dose to select head and neck tissues based on an operator’s radiation monitoring badge value.« less

Hanford Environmental Dose Reconstruction Project. Monthly report

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

Cannon, S.D.; Finch, S.M.

1992-10-01

The objective of the Hanford Environmental Dose Reconstruction (HEDR) Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The independent Technical Steering Panel (TSP) provides technical direction. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed from release to impact on humans (dose estimates):Source Terms, Environmental Transport, Environmental Monitoring Data, Demography, Food Consumption, and Agriculture, and Environmental Pathways and Dose Estimates.

Cost-effectiveness of three different vaccination strategies against measles in Zambian children.

PubMed

Dayan, Gustavo H; Cairns, Lisa; Sangrujee, Nalinee; Mtonga, Anne; Nguyen, Van; Strebel, Peter

2004-01-02

The vaccination program in Zambia includes one dose of measles vaccine at 9 months of age. The objective of this study was to compare the cost-effectiveness of the current one-dose measles vaccination program with an immunization schedule in which a second dose is provided either through routine health services or through supplemental immunization activities (SIAs). We simulated the expected cost and impact of the vaccination strategies for an annual cohort of 400,000 children, assuming 80% vaccination coverage in both routine and SIAs and an analytic horizon of 15 years. A vaccination program which includes SIAs reaching children not previously vaccinated would prevent on additional 29,242 measles cases and 1462 deaths for each vaccinated birth cohort when compared with a one-dose program. Given the parameters established for this analysis, such a program would be cost-saving and the most cost-effective vaccination strategy for Zambia.

Technical basis for implementation of remote reading capabilities for radiological control instruments at tank farms

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

PIERSON, R.M.

1999-10-27

This document provides the technical basis for use of remote reading capabilities with radiological control instruments at River Protection Project facilities. The purpose of this document is to evaluate applications of remote reading capabilities with Radiological Control instrumentation to allow continuous monitoring of radiation dose rates at River Protection Project (RPP) facilities. In addition this document provides a technical basis and implementing guidelines for remote monitoring of dose rates and their potential contribution to maintaining radiation exposures ALARA.

The role of population monitoring in the management of North American waterfowl

USGS Publications Warehouse

Nichols, J.D.; Williams, B.K.; Johnson, F.A.

2000-01-01

Despite the effort and expense devoted to large-scale monitoring programs, few existing programs have been designed with specific objectives in mind and few permit strong inferences about the dynamics of monitored systems. The waterfowl population monitoring programs of the U.S. Fish and Wildlife Service, Canadian Wildlife Service and state and provincial agencies provide a nice example with respect to program objectives, design and implementation. The May Breeding Grounds Survey provides an estimate of system state (population size) that serves two primary purposes in the adaptive management process: identifying the appropriate time-specific management actions and updating the information state (model weights) by providing a basis for evaluating predictions of competing models. Other waterfowl monitoring programs (e.g., banding program, hunter questionnaire survey, parts collection survey, winter survey) provide estimates of vital rates (rates of survival, reproduction and movement) associated with system dynamics and variables associated with management objectives (e.g., harvest). The reliability of estimates resulting from monitoring programs depends strongly on whether considerations about spatial variation and detection probability have been adequately incorporated into program design and implementation. Certain waterfowl surveys again provide nice examples of monitoring programs that incorporate these considerations.

Community interventions for cardiovascular disease.

PubMed

Parker, Donna R; Assaf, Annlouise R

2005-12-01

Review of the community-based CVD intervention programs suggests that a number of components have been successful using varying methods and materials for CVD risk reduction. It should be noted, however, that in multi-intervention programs it is often difficult to determine which components of the intervention were responsible for the overall success of the study. The community-based approach to CVD prevention is generalizable, cost-effective (because of the use of mass communication methods), and has the potential for modifying the environment and influencing health policies. Based on the experiences and successes of a number of community projects, recommendations have been proposed for developing future programs. Although they are not totally comprehensive, it has been suggested that a community-based intervention program should consider the following recommendations: 1) An understanding of the community: the needs and priorities of the community should be assessed, and close collaboration with individuals from the community, including community leaders, opinion leaders, community health care providers, and community organizations from various sectors of the community, should be consulted. Efforts should be focused on underserved and vulnerable populations. 2) Inclusion of community activities: these activities should be integrated within the context of the community environment, including primary health care services, voluntary organizations, grocery stores, restaurants, work sites, schools, and local media. 3) Inclusion mass media messages: the mass media can provide information and reinforcement of the behavior change. 4) Develop cost-effective interventions to assure that the community is exposed to an effective dose of the intervention. 5) Work with community organizations to help change social and physical environments to make them more conducive to health and healthy life-styles changes. 6) Develop a reliable monitoring and evaluation system: monitor the change process and conduct summary evaluations. 7) Disseminate the results to ensure that the benefits from the community program reach all communities. 8) For national implementation, the intervention program should work closely with national policy makers throughout the project.

Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE): a randomized controlled trial protocol.

PubMed

Winstein, Carolee J; Wolf, Steven L; Dromerick, Alexander W; Lane, Christianne J; Nelsen, Monica A; Lewthwaite, Rebecca; Blanton, Sarah; Scott, Charro; Reiss, Aimee; Cen, Steven Yong; Holley, Rahsaan; Azen, Stanley P

2013-01-11

Residual disability after stroke is substantial; 65% of patients at 6 months are unable to incorporate the impaired upper extremity into daily activities. Task-oriented training programs are rapidly being adopted into clinical practice. In the absence of any consensus on the essential elements or dose of task-specific training, an urgent need exists for a well-designed trial to determine the effectiveness of a specific multidimensional task-based program governed by a comprehensive set of evidence-based principles. The Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE) Stroke Initiative is a parallel group, three-arm, single blind, superiority randomized controlled trial of a theoretically-defensible, upper extremity rehabilitation program provided in the outpatient setting.The primary objective of ICARE is to determine if there is a greater improvement in arm and hand recovery one year after randomization in participants receiving a structured training program termed Accelerated Skill Acquisition Program (ASAP), compared to participants receiving usual and customary therapy of an equivalent dose (DEUCC). Two secondary objectives are to compare ASAP to a true (active monitoring only) usual and customary (UCC) therapy group and to compare DEUCC and UCC. Following baseline assessment, participants are randomized by site, stratified for stroke duration and motor severity. 360 adults will be randomized, 14 to 106 days following ischemic or hemorrhagic stroke onset, with mild to moderate upper extremity impairment, recruited at sites in Atlanta, Los Angeles and Washington, D.C. The Wolf Motor Function Test (WMFT) time score is the primary outcome at 1 year post-randomization. The Stroke Impact Scale (SIS) hand domain is a secondary outcome measure.The design includes concealed allocation during recruitment, screening and baseline, blinded outcome assessment and intention to treat analyses. Our primary hypothesis is that the improvement in log-transformed WMFT time will be greater for the ASAP than the DEUCC group. This pre-planned hypothesis will be tested at a significance level of 0.05. ICARE will test whether ASAP is superior to the same number of hours of usual therapy. Pre-specified secondary analyses will test whether 30 hours of usual therapy is superior to current usual and customary therapy not controlled for dose. www.ClinicalTrials.gov Identifier: NCT00871715

ICRP Publication 137: Occupational Intakes of Radionuclides: Part 3.

PubMed

Paquet, F; Bailey, M R; Leggett, R W; Lipsztein, J; Marsh, J; Fell, T P; Smith, T; Nosske, D; Eckerman, K F; Berkovski, V; Blanchardon, E; Gregoratto, D; Harrison, J D

2017-12-01

The 2007 Recommendations of the International Commission on Radiological Protection (ICRP, 2007) introduced changes that affect the calculation of effective dose, and implied a revision of the dose coefficients for internal exposure, published previously in the Publication 30 series (ICRP, 1979, 1980, 1981, 1988) and Publication 68 (ICRP, 1994). In addition, new data are now available that support an update of the radionuclide-specific information given in Publications 54 and 78 (ICRP, 1988a, 1997b) for the design of monitoring programmes and retrospective assessment of occupational internal doses. Provision of new biokinetic models, dose coefficients, monitoring methods, and bioassay data was performed by Committee 2, Task Group 21 on Internal Dosimetry, and Task Group 4 on Dose Calculations. A new series, the Occupational Intakes of Radionuclides (OIR) series, will replace the Publication 30 series and Publications 54, 68, and 78. OIR Part 1 has been issued (ICRP, 2015), and describes the assessment of internal occupational exposure to radionuclides, biokinetic and dosimetric models, methods of individual and workplace monitoring, and general aspects of retrospective dose assessment. OIR Part 2 (ICRP, 2016), this current publication and upcoming publications in the OIR series (Parts 4 and 5) provide data on individual elements and their radioisotopes, including information on chemical forms encountered in the workplace; a list of principal radioisotopes and their physical half-lives and decay modes; the parameter values of the reference biokinetic model; and data on monitoring techniques for the radioisotopes encountered most commonly in workplaces. Reviews of data on inhalation, ingestion, and systemic biokinetics are also provided for most of the elements. Dosimetric data provided in the printed publications of the OIR series include tables of committed effective dose per intake (Sv Bq−1 intake) for inhalation and ingestion, tables of committed effective dose per content (Sv Bq−1 measurement) for inhalation, and graphs of retention and excretion data per Bq intake for inhalation. These data are provided for all absorption types and for the most common isotope(s) of each element. The electronic annex that accompanies the OIR series of publications contains a comprehensive set of committed effective and equivalent dose coefficients, committed effective dose per content functions, and reference bioassay functions. Data are provided for inhalation, ingestion, and direct input to blood. This third publication in the series provides the above data for the following elements: ruthenium (Ru), antimony (Sb), tellurium (Te), iodine (I), caesium (Cs), barium (Ba), iridium (Ir), lead (Pb), bismuth (Bi), polonium (Po), radon (Rn), radium (Ra), thorium (Th), and uranium (U).

ICRP Publication 134: Occupational Intakes of Radionuclides: Part 2.

PubMed

Paquet, F; Bailey, M R; Leggett, R W; Lipsztein, J; Fell, T P; Smith, T; Nosske, D; Eckerman, K F; Berkovski, V; Ansoborlo, E; Giussani, A; Bolch, W E; Harrison, J D

2016-12-01

The 2007 Recommendations of the International Commission on Radiological Protection (ICRP, 2007) introduced changes that affect the calculation of effective dose, and implied a revision of the dose coefficients for internal exposure, published previously in the Publication 30 series (ICRP, 1979, 1980, 1981, 1988b) and Publication 68 (ICRP, 1994b). In addition, new data are available that support an update of the radionuclide-specific information given in Publications 54 and 78 (ICRP, 1988a, 1997b) for the design of monitoring programmes and retrospective assessment of occupational internal doses. Provision of new biokinetic models, dose coefficients, monitoring methods, and bioassay data was performed by Committee 2, Task Group 21 on Internal Dosimetry, and Task Group 4 on Dose Calculations. A new series, the Occupational Intakes of Radionuclides (OIR) series, will replace the Publication 30 series and Publications 54, 68, and 78. Part 1 of the OIR series has been issued (ICRP, 2015), and describes the assessment of internal occupational exposure to radionuclides, biokinetic and dosimetric models, methods of individual and workplace monitoring, and general aspects of retrospective dose assessment. The following publications in the OIR series (Parts 2–5) will provide data on individual elements and their radioisotopes, including information on chemical forms encountered in the workplace; a list of principal radioisotopes and their physical half-lives and decay modes; the parameter values of the reference biokinetic model; and data on monitoring techniques for the radioisotopes encountered most commonly in workplaces. Reviews of data on inhalation, ingestion, and systemic biokinetics are also provided for most of the elements. Dosimetric data provided in the printed publications of the OIR series include tables of committed effective dose per intake (Sv per Bq intake) for inhalation and ingestion, tables of committed effective dose per content (Sv per Bq measurement) for inhalation, and graphs of retention and excretion data per Bq intake for inhalation. These data are provided for all absorption types and for the most common isotope(s) of each element. The electronic annex that accompanies the OIR series of reports contains a comprehensive set of committed effective and equivalent dose coefficients, committed effective dose per content functions, and reference bioassay functions. Data are provided for inhalation, ingestion, and direct input to blood. The present publication provides the above data for the following elements: hydrogen (H), carbon (C), phosphorus (P), sulphur (S), calcium (Ca), iron (Fe), cobalt (Co), zinc (Zn), strontium (Sr), yttrium (Y), zirconium (Zr), niobium (Nb), molybdenum (Mo), and technetium (Tc).

Evaluation of Accuracy of Six Blood Glucose Monitoring Systems and Modeling of Possibly Related Insulin Dosing Errors.

PubMed

Baumstark, Annette; Jendrike, Nina; Pleus, Stefan; Haug, Cornelia; Freckmann, Guido

2017-10-01

Self-monitoring of blood glucose (BG) is an essential part of diabetes therapy. Accurate and reliable results from BG monitoring systems (BGMS) are important especially when they are used to calculate insulin doses. This study aimed at assessing system accuracy of BGMS and possibly related insulin dosing errors. System accuracy of six different BGMS (Accu-Chek ® Aviva Nano, Accu-Chek Mobile, Accu-Chek Performa Nano, CONTOUR ® NEXT LINK 2.4, FreeStyle Lite, OneTouch ® Verio ® IQ) was assessed in comparison to a glucose oxidase and a hexokinase method. Study procedures and analysis were based on ISO 15197:2013/EN ISO 15197:2015, clause 6.3. In addition, insulin dosing error was modeled. In the comparison against the glucose oxidase method, five out of six BGMS fulfilled ISO 15197:2013 accuracy criteria. Up to 14.3%/4.3%/0.3% of modeled doses resulted in errors exceeding ±0.5/±1.0/±1.5 U and missing the modeled target by 20 mg/dL/40 mg/dL/60 mg/dL, respectively. Compared against the hexokinase method, five out of six BGMS fulfilled ISO 15197:2013 accuracy criteria. Up to 25.0%/10.5%/3.2% of modeled doses resulted in errors exceeding ±0.5/±1.0/±1.5 U, respectively. Differences in system accuracy were found, even among BGMS that fulfilled the minimum system accuracy criteria of ISO 15197:2013. In the error model, considerable insulin dosing errors resulted for some of the investigated systems. Diabetes patients on insulin therapy should be able to rely on their BGMS' readings; therefore, they require highly accurate BGMS, in particular, when making therapeutic decisions.

Radial to femoral arterial blood pressure differences in septic shock patients receiving high-dose norepinephrine therapy.

PubMed

Kim, Won Young; Jun, Jong Hun; Huh, Jin Won; Hong, Sang Bum; Lim, Chae-Man; Koh, Younsuck

2013-12-01

The accuracy of arterial blood pressure (ABP) monitoring is crucial in treating septic shock patients. Clinically significant differences in central to peripheral ABP could develop into sepsis during vasopressor therapy. The aim of this study was to investigate the difference between radial (peripheral) and femoral (central) ABP in septic shock patients receiving high-dose norepinephrine (NE) therapy. This prospective observational study comparing simultaneous intra-arterial measurements of radial and femoral ABP was performed at a university-affiliated, tertiary referral center between October 2008 and March 2009. Patients with septic shock who needed continuous blood pressure monitoring and high-dose NE therapy 0.1 µg/kg per minute or greater to maintain mean arterial pressure (MAP) of 65 mmHg or greater were included. Statistical analysis was conducted using the Bland-Altman method for comparison of repeated measures. In total, 250 sets of systolic, mean, and diastolic femoral and radial ABP were recorded at baseline and after NE titration. Arterial blood pressure readings from the radial artery were underestimated compared with those from the femoral artery. Overall bias (mean difference between simultaneous measurements) between radial and femoral MAP was +4.9 mmHg; however, during high-dose NE therapy, the bias increased to +6.2 mmHg (95% limits of agreement: -6.0 to +18.3 mmHg). Clinically significant radial-femoral MAP differences (MAP ≥5 mmHg) occurred in up to 62.2% of patients with high-dose NE therapy. Radial artery pressure frequently underestimates central pressure in septic shock patients receiving high-dose NE therapy. Femoral arterial pressure monitoring may be more appropriate when high-dose NE therapy is administered.

A Phase 1, Single-center, Double-blind, Placebo-controlled Study in Healthy Subjects to Assess the Safety, Tolerability, Clinical Effects, and Pharmacokinetics-Pharmacodynamics of Intravenous Cyclopropyl-methoxycarbonylmetomidate (ABP-700) after a Single Ascending Bolus Dose.

PubMed

Struys, Michel M R F; Valk, Beatrijs I; Eleveld, Douglas J; Absalom, Anthony R; Meyer, Peter; Meier, Sascha; den Daas, Izaak; Chou, Thomas; van Amsterdam, Kai; Campagna, Jason A; Sweeney, Steven P

2017-07-01

Cyclopropyl-methoxycarbonylmetomidate (ABP-700) is a new "soft" etomidate analog. The primary objectives of this first-in-human study were to describe the safety and efficacy of ABP-700 and to determine its maximum tolerated dose. Secondary objectives were to characterize the pharmacokinetics of ABP-700 and its primary metabolite (cyclopropyl-methoxycarbonyl acid), to assess the clinical effects of ABP-700, and to investigate the dose-response and pharmacokinetic/pharmacodynamic relationships. Sixty subjects were divided into 10 cohorts and received an increasing, single bolus of either ABP-700 or placebo. Safety was assessed by clinical laboratory evaluations, infusion-site reactions, continuous monitoring of vital signs, physical examination, adverse event monitoring, and adrenocorticotropic hormone stimulation testing. Clinical effects were assessed with modified observer's assessment of alertness/sedation and Bispectral Index monitoring. Pharmacokinetic parameters were calculated. Stopping criteria were met at 1.00 mg/kg dose. No serious adverse events were reported. Adverse events were dose-dependent and comprised involuntary muscle movement, tachycardia, and ventilatory effects. Adrenocorticotropic hormone stimulation evoked a physiologic cortisol response in all subjects, no different from placebo. Pharmacokinetics were dose-proportional. A three-compartment pharmacokinetic model described the data well. A rapid onset of anesthesia/sedation after bolus administration and also a rapid recovery were observed. A quantitative concentration-effect relationship was described for the modified observer's assessment of alertness/sedation and Bispectral Index. This first-in-human study of ABP-700 shows that ABP-700 was safe and well tolerated after single-bolus injections up to 1.00 mg/kg. Bolus doses of 0.25 and 0.35 mg/kg were found to provide the most beneficial clinical effect versus side-effect profile.

Treatment dose-response in amblyopia therapy: the Monitored Occlusion Treatment of Amblyopia Study (MOTAS).

PubMed

Stewart, Catherine E; Moseley, Merrick J; Stephens, David A; Fielder, Alistair R

2004-09-01

Amblyopia is the commonest visual disorder of childhood. Yet the contributions of the two principal treatments (spectacle wear and occlusion) to outcome are unknown. This study was undertaken to investigate the dose-response relationship of amblyopia therapy. The study comprised three distinct phases: baseline, in which repeat measures of visual function were undertaken to confirm the initial visual deficit; refractive adaptation: an 18-week period of spectacle wear with six weekly measurements of logarithm of the minimum angle of resolution (logMAR) visual acuity; occlusion: in which participants were prescribed 6 hours of "patching" per day. In the latter phase, occlusion was objectively monitored and logMAR visual acuity recorded at 2-week intervals until any observed gains had ceased. Data were obtained from 94 participants (mean age, 5.1 +/- 1.4 years) with amblyopia associated with strabismus (n = 34), anisometropia (n = 23), and both anisometropia and strabismus (n = 37). Eighty-six underwent refractive adaptation. Average concordance with patching was 48%. The relationship between logMAR visual acuity gain and total occlusion dose was monotonic and linear. Increasing dose rate beyond 2 h/d hastened the response but did not improve outcome. More than 80% of the improvement during occlusion occurred within 6 weeks. Treatment outcome was significantly better for children younger than 4 years (n = 17) than in those older than 6 years (n = 24; P = 0.0014). Continuous objective monitoring of the amount of patching therapy received has provided insight into the dose-response relationship of occlusion therapy for amblyopia. Patching is most effective within the first few weeks of treatment, even for those in receipt of a relatively small dose. Further studies are needed to elucidate the neural basis for the dose-response functions. Copyright Association for Research in Vision and Ophthalmology