External Beam Radiotherapy for Prostate Cancer Patients on Anticoagulation Therapy: How Significant is the Bleeding Toxicity?

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

Choe, Kevin S.; Jani, Ashesh B.; Liauw, Stanley L., E-mail: sliauw@radonc.uchicago.ed

Purpose: To characterize the bleeding toxicity associated with external beam radiotherapy for prostate cancer patients receiving anticoagulation (AC) therapy. Methods and Materials: The study cohort consisted of 568 patients with adenocarcinoma of the prostate who were treated with definitive external beam radiotherapy. Of these men, 79 were receiving AC therapy with either warfarin or clopidogrel. All patients were treated with three-dimensional conformal radiotherapy or intensity-modulated radiotherapy. Bleeding complications were recorded during treatment and subsequent follow-up visits. Results: With a median follow-up of 48 months, the 4-year actuarial risk of Grade 3 or worse bleeding toxicity was 15.5% for those receivingmore » AC therapy compared with 3.6% among those not receiving AC (p < .0001). On multivariate analysis, AC therapy was the only significant factor associated with Grade 3 or worse bleeding (p < .0001). For patients taking AC therapy, the crude rate of bleeding was 39.2%. Multivariate analysis within the AC group demonstrated that a higher radiotherapy dose (p = .0408), intensity-modulated radiotherapy (p = 0.0136), and previous transurethral resection of the prostate (p = .0001) were associated with Grade 2 or worse bleeding toxicity. Androgen deprivation therapy was protective against bleeding, with borderline significance (p = 0.0599). Dose-volume histogram analysis revealed that Grade 3 or worse bleeding was minimized if the percentage of the rectum receiving >=70 Gy was <10% or the rectum receiving >=50 Gy was <50%. Conclusion: Patients taking AC therapy have a substantial risk of bleeding toxicity from external beam radiotherapy. In this setting, dose escalation or intensity-modulated radiotherapy should be used judiciously. With adherence to strict dose-volume histogram criteria and minimizing hotspots, the risk of severe bleeding might be reduced.« less

Lack of Benefit for the Addition of Androgen Deprivation Therapy to Dose-Escalated Radiotherapy in the Treatment of Intermediate- and High-Risk Prostate Cancer

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

Krauss, Daniel, E-mail: dkrauss@beaumont.edu; Kestin, Larry; Ye, Hong

2011-07-15

Purpose: Assessment of androgen deprivation therapy (ADT) benefits for prostate cancer treated with dose-escalated radiotherapy (RT). Methods and Materials: From 1991 to 2004, 1,044 patients with intermediate- (n = 782) or high-risk (n = 262) prostate cancer were treated with dose-escalated RT at William Beaumont Hospital. Patients received external-beam RT (EBRT) alone, brachytherapy (high or low dose rate), or high dose rate brachytherapy plus pelvic EBRT. Intermediate-risk patients had Gleason score 7, prostate-specific antigen (PSA) 10.0-19.9 ng/mL, or Stage T2b-T2c. High-risk patients had Gleason score 8-10, PSA {>=}20, or Stage T3. Patients were additionally divided specifically by Gleason score, presencemore » of palpable disease, and PSA level to further define subgroups benefitting from ADT. Results: Median follow-up was 5 years; 420 patients received ADT + dose-escalated RT, and 624 received dose-escalated RT alone. For all patients, no advantages in any clinical endpoints at 8 years were associated with ADT administration. No differences in any endpoints were associated with ADT administration based on intermediate- vs. high-risk group or RT modality when analyzed separately. Patients with palpable disease plus Gleason {>=}8 demonstrated improved clinical failure rates and a trend toward improved survival with ADT. Intermediate-risk patients treated with brachytherapy alone had improved biochemical control when ADT was given. Conclusion: Benefits of ADT in the setting of dose-escalated RT remain poorly defined. This question must continue to be addressed in prospective study.« less

Salvage image guided radiation therapy to the prostate after cryotherapy failure.

PubMed

Hopper, Austin B; Sandhu, Ajay P S; Parsons, J Kellogg; Rose, Brent; Einck, John P

2018-01-01

Cryotherapy is an option for the primary treatment of localized prostate cancer, along with radical prostatectomy, external beam radiation therapy, and brachytherapy. Although it is known that local recurrence can occur in >20% of patients treated with primary cryotherapy, unfortunately there is a paucity of data on later salvage treatments. The use of external beam radiation therapy is an attractive option after cryotherapy failure, but there is little data on its efficacy and toxicity. We evaluated the biochemical control and complication rates of salvage dose-escalated image guided intensity modulated radiation therapy (IG-IMRT) after cryotherapy failure. Patients who were treated at our institution from 2005 to 2016 were reviewed for those who underwent cryotherapy as initial treatment followed by salvage IGRT. Patients were treated with dose-escalated IG-IMRT using standard treatment margins of 3 mm posterior and 7 mm in all other directions and daily cone beam computed tomography or kv imaging to implanted fiducial markers. Biochemical progression was defined in accordance with the Phoenix consensus conference definition. Eight patients were identified as having received post-cryotherapy salvage radiation within the study period. The median total dose was 77.7 Gy (range, 75.6-81.0 Gy). Median follow-up was 55 months (range, 6-88 months). Six patients remained biochemically controlled at the latest follow-up. One patient developed distant metastases after 22 months and one experienced biochemical failure at 30 months with no evidence of distant metastases. No patients experienced acute gastrointestinal toxicities of grade 2 or higher. There were no cases of late gastrointestinal or genitourinary toxicity. High-dose IG-IMRT results in high rates of salvage and extremely low rates of serious late toxicity for patients with locally recurrent prostate cancer after cryotherapy. Although the results are encouraging, given the small number of patients in this and other series, we remain cautious with regard to this treatment and believe the use of salvage radiation therapy after cryotherapy warrants further study.

External beam boost versus interstitial high-dose-rate brachytherapy boost in the adjuvant radiotherapy following breast-conserving therapy in early-stage breast cancer: a dosimetric comparison

PubMed Central

Melchert, Corinna; Kovács, György

2016-01-01

Purpose This study aims to compare the dosimetric data of local tumor's bed dose escalation (boost) with photon beams (external beam radiation therapy – EBRT) versus high-dose-rate interstitial brachytherapy (HDR-BT) after breast-conserving treatment in women with early-stage breast cancer. Material and methods We analyzed the treatment planning data of 136 irradiated patients, treated between 2006 and 2013, who underwent breast-conserving surgery and adjuvant whole breast irradiation (WBI; 50.4 Gy) and boost (HDR-BT: 10 Gy in one fraction [n = 36]; EBRT: 10 Gy in five fractions [n = 100]). Organs at risk (OAR; heart, ipsilateral lung, skin, most exposed rib segment) were delineated. Dosimetric parameters were calculated with the aid of dose-volume histograms (DVH). A non-parametric test was performed to compare the two different boost forms. Results There was no difference for left-sided cancers regarding the maximum dose to the heart (HDR-BT 29.8% vs. EBRT 29.95%, p = 0.34). The maximum doses to the other OAR were significantly lower for HDR-BT (Dmax lung 47.12% vs. 87.7%, p < 0.01; rib 61.17% vs. 98.5%, p < 0.01; skin 57.1% vs. 94.75%, p < 0.01; in the case of right-sided breast irradiation, dose of the heart 6.00% vs. 16.75%, p < 0.01). Conclusions Compared to EBRT, local dose escalation with HDR-BT presented a significant dose reduction to the investigated OAR. Only left-sided irradiation showed no difference regarding the maximum dose to the heart. Reducing irradiation exposure to OAR could result in a reduction of long-term side effects. Therefore, from a dosimetric point of view, an interstitial boost complementary to WBI via EBRT seems to be more advantageous in the adjuvant radiotherapy of breast cancer. PMID:27648082

The effect of anterior proton beams in the setting of a prostate-rectum spacer

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

Christodouleas, John P., E-mail: christojo@uphs.upenn.edu; Tang, Shikui; Susil, Robert C.

2013-10-01

Studies suggest that anterior beams with in vivo range verification would improve rectal dosimetry in proton therapy for prostate cancer. We investigated whether prostate-rectum spacers would enhance or diminish the benefits of anterior proton beams in these treatments. Twenty milliliters of hydrogel was injected between the prostate and rectum of a cadaver using a transperineal approach. Computed tomography (CT) and magnetic resonance (MR) images were used to generate 7 uniform scanning (US) and 7 single-field uniform dose pencil-beam scanning (PBS) plans with different beam arrangements. Pearson correlations were calculated between rectal, bladder, and femoral head dosimetric outcomes and beam arrangementmore » anterior scores, which characterize the degree to which dose is delivered anteriorly. The overall quality of each plan was compared using a virtual dose-escalation study. For US plans, rectal mean dose was inversely correlated with anterior score, but for PBS plans there was no association between rectal mean dose and anterior score. For both US and PBS plans, full bladder and empty bladder mean doses were correlated with anterior scores. For both US and PBS plans, femoral head mean doses were inversely correlated with anterior score. For US plans and a full bladder, 4 beam arrangements that included an anterior beam tied for the highest maximum prescription dose (MPD). For US plans and an empty bladder, the arrangement with 1 anterior and 2 anterior oblique beams achieved the highest MPD in the virtual dose-escalation study. The dose-escalation study did not differentiate beam arrangements for PBS. All arrangements in the dose-escalation study were limited by bladder constraints except for the arrangement with 2 posterior oblique beams. The benefits of anterior proton beams in the setting of prostate-rectum spacers appear to be proton modality dependent and may not extend to PBS.« less

The effect of anterior proton beams in the setting of a prostate-rectum spacer

PubMed Central

Christodouleas, John P.; Tang, Shikui; Susil, Robert C.; McNutt, Todd R.; Song, Danny Y.; Bekelman, Justin; Deville, Curtiland; Vapiwala, Neha; DeWeese, Theodore L.; Lu, Hsiao-Ming; Both, Stefan

2014-01-01

Studies suggest that anterior beams with in vivo range verification would improve rectal dosimetry in proton therapy for prostate cancer. We investigated whether prostate-rectum spacers would enhance or diminish the benefits of anterior proton beams in these treatments. Twenty milliliters of hydrogel was injected between the prostate and rectum of a cadaver using a transperineal approach. Computed tomography (CT) and magnetic resonance (MR) images were used to generate 7 uniform scanning (US) and 7 single-field uniform dose pencil-beam scanning (PBS) plans with different beam arrangements. Pearson correlations were calculated between rectal, bladder, and femoral head dosimetric outcomes and beam arrangement anterior scores, which characterize the degree to which dose is delivered anteriorly. The overall quality of each plan was compared using a virtual dose-escalation study. For US plans, rectal mean dose was inversely correlated with anterior score, but for PBS plans there was no association between rectal mean dose and anterior score. For both US and PBS plans, full bladder and empty bladder mean doses were correlated with anterior scores. For both US and PBS plans, femoral head mean doses were inversely correlated with anterior score. For US plans and a full bladder, 4 beam arrangements that included an anterior beam tied for the highest maximum prescription dose (MPD). For US plans and an empty bladder, the arrangement with 1 anterior and 2 anterior oblique beams achieved the highest MPD in the virtual dose-escalation study. The dose-escalation study did not differentiate beam arrangements for PBS. All arrangements in the dose-escalation study were limited by bladder constraints except for the arrangement with 2 posterior oblique beams. The benefits of anterior proton beams in the setting of prostate-rectum spacers appear to be proton modality dependent and may not extend to PBS. PMID:23578497

Dose-Volume Parameters of the Corpora Cavernosa Do Not Correlate With Erectile Dysfunction After External Beam Radiotherapy for Prostate Cancer: Results From a Dose-Escalation Trial

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

Wielen, Gerard J. van der; Hoogeman, Mischa S.; Dohle, Gert R.

2008-07-01

Purpose: To analyze the correlation between dose-volume parameters of the corpora cavernosa and erectile dysfunction (ED) after external beam radiotherapy (EBRT) for prostate cancer. Methods and Materials: Between June 1997 and February 2003, a randomized dose-escalation trial comparing 68 Gy and 78 Gy was conducted. Patients at our institute were asked to participate in an additional part of the trial evaluating sexual function. After exclusion of patients with less than 2 years of follow-up, ED at baseline, or treatment with hormonal therapy, 96 patients were eligible. The proximal corpora cavernosa (crura), the superiormost 1-cm segment of the crura, and themore » penile bulb were contoured on the planning computed tomography scan and dose-volume parameters were calculated. Results: Two years after EBRT, 35 of the 96 patients had developed ED. No statistically significant correlations between ED 2 years after EBRT and dose-volume parameters of the crura, the superiormost 1-cm segment of the crura, or the penile bulb were found. The few patients using potency aids typically indicated to have ED. Conclusion: No correlation was found between ED after EBRT for prostate cancer and radiation dose to the crura or penile bulb. The present study is the largest study evaluating the correlation between ED and radiation dose to the corpora cavernosa after EBRT for prostate cancer. Until there is clear evidence that sparing the penile bulb or crura will reduce ED after EBRT, we advise to be careful in sparing these structures, especially when this involves reducing treatment margins.« less

Dose-Escalated Robotic SBRT for Stage I–II Prostate Cancer

PubMed Central

Meier, Robert

2015-01-01

Stereotactic body radiotherapy (SBRT) is the precise external delivery of very high-dose radiotherapy to targets in the body, with treatment completed in one to five fractions. SBRT should be an ideal approach for organ-confined prostate cancer because (I) dose-escalation should yield improved rates of cancer control; (II) the unique radiobiology of prostate cancer favors hypofractionation; and (III) the conformal nature of SBRT minimizes high-dose radiation delivery to immediately adjacent organs, potentially reducing complications. This approach is also more convenient for patients, and is cheaper than intensity-modulated radiotherapy (IMRT). Several external beam platforms are capable of delivering SBRT for early-stage prostate cancer, although most of the mature reported series have employed a robotic non-coplanar platform (i.e., CyberKnife). Several large studies report 5-year biochemical relapse rates which compare favorably to IMRT. Rates of late GU toxicity are similar to those seen with IMRT, and rates of late rectal toxicity may be less than with IMRT and low-dose rate brachytherapy. Patient-reported quality of life (QOL) outcomes appear similar to IMRT in the urinary domain. Bowel QOL may be less adversely affected by SBRT than with other radiation modalities. After 5 years of follow-up, SBRT delivered on a robotic platform is yielding outcomes at least as favorable as IMRT, and may be considered appropriate therapy for stage I–II prostate cancer. PMID:25905037

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

Lee, E; Yuan, F; Templeton, A

Purpose: The ultimate goal of radiotherapy treatment planning is to find a treatment that will yield a high tumor-control-probability(TCP) with an acceptable normal-tissue-complication probability(NTCP). Yet most treatment planning today is not based upon optimization of TCPs and NTCPs, but rather upon meeting physical dose and volume constraints defined by the planner. We design treatment plans that optimize TCP directly and contrast them with the clinical dose-based plans. PET image is incorporated to evaluate gain in TCP for dose escalation. Methods: We build a nonlinear mixed integer programming optimization model that maximizes TCP directly while satisfying the dose requirements on themore » targeted organ and healthy tissues. The solution strategy first fits the TCP function with a piecewise-linear approximation, then solves the problem that maximizes the piecewise linear approximation of TCP, and finally performs a local neighborhood search to improve the TCP value. To gauge the feasibility, characteristics, and potential benefit of PET-image guided dose escalation, initial validation consists of fifteen cervical cancer HDR patient cases. These patients have all received prior 45Gy of external radiation dose. For both escalated strategies, we consider 35Gy PTV-dose, and two variations (37Gy-boost to BTV vs 40Gy-boost) to PET-image-pockets. Results: TCP for standard clinical plans range from 59.4% - 63.6%. TCP for dose-based PET-guided escalated-dose-plan ranges from 63.8%–98.6% for all patients; whereas TCP-optimized plans achieves over 91% for all patients. There is marginal difference in TCP among those with 37Gy-boosted vs 40Gy-boosted. There is no increase in rectum and bladder dose among all plans. Conclusion: Optimizing TCP directly results in highly conformed treatment plans. The TCP-optimized plan is individualized based on the biological PET-image of the patients. The TCP-optimization framework is generalizable and has been applied successfully to other external-beam delivery modalities. A clinical trial is on-going to gauge the clinical significance. Partially supported by the National Science Foundation.« less

The addition of low-dose-rate brachytherapy and androgen-deprivation therapy decreases biochemical failure and prostate cancer death compared with dose-escalated external-beam radiation therapy for high-risk prostate cancer.

PubMed

Shilkrut, Mark; Merrick, Gregory S; McLaughlin, P William; Stenmark, Matthew H; Abu-Isa, Eyad; Vance, Sean M; Sandler, Howard M; Feng, Felix Y; Hamstra, Daniel A

2013-02-01

The objective of this study was to determine whether the addition of low-dose-rate brachytherapy or androgen-deprivation therapy (ADT) improves clinical outcome in patients with high-risk prostate cancer (HiRPCa) who received dose-escalated radiotherapy (RT). Between 1995 and 2010, 958 patients with HiRPCa were treated at Schiffler Cancer Center (n = 484) or at the University of Michigan (n = 474) by receiving either dose-escalated external-beam RT (EBRT) (n = 510; minimum prescription dose, 75 grays [Gy]; median dose, 78 Gy) or combined-modality RT (CMRT) consisting of (103) Pd implants (n = 369) or (125) I implants (n = 79) both with pelvic irradiation (median prescription dose, 45 Gy). The cumulative incidences of biochemical failure (BF) and prostate cancer-specific mortality (PCSM) were estimated by using the Kaplan-Meier method and Fine and Gray regression analysis. The median follow-up was 63.2 months (interquartile range, 35.4-99.0 months), and 250 patients were followed for >8 years. Compared with CMRT, patients who received EBRT had higher prostate-specific antigen levels, higher tumor classification, lower Gleason sum, and more frequent receipt of ADT for a longer duration. The 8-year incidence BF and PCSM among patients who received EBRT was 40% (standard error, 38%-44%) and 13% (standard error, 11%-15%) compared with 14% (standard error, 12%-16%; P < .0001) and 7% (standard error 6%-9%; P = .003) among patients who received CMRT. On multivariate analysis, the hazard ratios (HRs) for BF and PCSM were 0.35 (95% confidence interval [CI], 0.23-0.52; P < .0001) and 0.41 (95% CI, 0.23-0.75; P < .003), favoring CMRT. Increasing duration of ADT predicted decreased BF (P = .04) and PCSM (P = .001), which was greatest with long-term ADT (BF: HR, 0.33; P < .0001; 95% CI, 0.21-0.52; PCSM: HR, 0.30; P = .001; 95% CI, 0.15-0.6) even in the subgroup that received CMRT. In this retrospective comparison, both low-dose-rate brachytherapy boost and ADT were associated with decreased risks of BF and PCSM compared with EBRT. Copyright © 2012 American Cancer Society.

Prostate-Specific Antigen (PSA) Bounce After Dose-Escalated External Beam Radiation Therapy Is an Independent Predictor of PSA Recurrence, Metastasis, and Survival in Prostate Adenocarcinoma Patients.

PubMed

Romesser, Paul B; Pei, Xin; Shi, Weiji; Zhang, Zhigang; Kollmeier, Marisa; McBride, Sean M; Zelefsky, Michael J

2018-01-01

To evaluate the difference in prostate-specific antigen (PSA) recurrence-free, distant metastasis-free, overall, and cancer-specific survival between PSA bounce (PSA-B) and non-bounce patients treated with dose-escalated external beam radiation therapy (DE-EBRT). During 1990-2010, 1898 prostate adenocarcinoma patients were treated with DE-EBRT to ≥75 Gy with ≥5 years follow-up. Patients receiving neoadjuvant/concurrent androgen-deprivation therapy (n=1035) or with fewer than 4 PSA values obtained 6 months or more after post-EBRT completion (n=87) were excluded. The evaluable 776 patients were treated (median, 81.0 Gy). Prostate-specific antigen bounce was defined as a ≥0.2-ng/mL increase above the interval PSA nadir, followed by a decrease to nadir or below. Prostate-specific antigen relapse was defined as post-radiation therapy PSA nadir + 2 ng/mL. Median follow-up was 9.2 years (interquartile range, 6.9-11.3 years). One hundred twenty-three patients (15.9%) experienced PSA-B after DE-EBRT at a median of 24.6 months (interquartile range, 16.1-38.5 months). On multivariate analysis, younger age (P=.001), lower Gleason score (P=.0003), and higher radiation therapy dose (P=.0002) independently predicted PSA-B. Prostate-specific antigen bounce was independently associated with decreased risk for PSA relapse (hazard ratio [HR] 0.53; 95% confidence interval [CI] 0.33-0.85; P=.008), distant metastatic disease (HR 0.34; 95% CI 0.12-0.94; P=.04), and all-cause mortality (HR 0.53; 95% CI 0.29-0.96; P=.04) on multivariate Cox analysis. Because all 50 prostate cancer-specific deaths in patients without PSA-B were in the non-bounce cohort, competing-risks analysis was not applicable. A nonparametric competing-risks test demonstrated that patients with PSA-B had superior cancer-specific survival compared with patients without PSA-B (P=.004). Patients treated with dose-escalated radiation therapy for prostate adenocarcinoma who experience posttreatment PSA-B have improved PSA recurrence-free survival, distant metastasis-free survival, overall survival, and cancer-specific survival outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

External Beam Accelerated Partial-Breast Irradiation Using 32 Gy in 8 Twice-Daily Fractions: 5-Year Results of a Prospective Study

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

Pashtan, Itai M.; Recht, Abram; Ancukiewicz, Marek

Purpose: External beam accelerated partial breast irradiation (APBI) is an increasingly popular technique for treatment of patients with early stage breast cancer following breast-conserving surgery. Here we present 5-year results of a prospective trial. Methods and Materials: From October 2003 through November 2005, 98 evaluable patients with stage I breast cancer were enrolled in the first dose step (32 Gy delivered in 8 twice-daily fractions) of a prospective, multi-institutional, dose escalation clinical trial of 3-dimensional conformal external beam APBI (3D-APBI). Median age was 61 years; median tumor size was 0.8 cm; 89% of tumors were estrogen receptor positive; 10% hadmore » a triple-negative phenotype; and 1% had a HER-2-positive subtype. Median follow-up was 71 months (range, 2-88 months; interquartile range, 64-75 months). Results: Five patients developed ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial IBTR rate of 5% (95% confidence interval [CI], 1%-10%). Three of these cases occurred in patients with triple-negative disease and 2 in non-triple-negative patients, for 5-year actuarial IBTR rates of 33% (95% CI, 0%-57%) and 2% (95% CI, 0%-6%; P<.0001), respectively. On multivariable analysis, triple-negative phenotype was the only predictor of IBTR, with borderline statistical significance after adjusting for tumor grade (P=.0537). Conclusions: Overall outcomes were excellent, particularly for patients with estrogen receptor-positive disease. Patients in this study with triple-negative breast cancer had a significantly higher IBTR rate than patients with other receptor phenotypes when treated with 3D-APBI. Larger, prospective 3D-APBI clinical trials should continue to evaluate the effect of hormone receptor phenotype on IBTR rates.« less

External beam accelerated partial-breast irradiation using 32 gy in 8 twice-daily fractions: 5-year results of a prospective study.

PubMed

Pashtan, Itai M; Recht, Abram; Ancukiewicz, Marek; Brachtel, Elena; Abi-Raad, Rita F; D'Alessandro, Helen A; Levy, Antonin; Wo, Jennifer Y; Hirsch, Ariel E; Kachnic, Lisa A; Goldberg, Saveli; Specht, Michelle; Gadd, Michelle; Smith, Barbara L; Powell, Simon N; Taghian, Alphonse G

2012-11-01

External beam accelerated partial breast irradiation (APBI) is an increasingly popular technique for treatment of patients with early stage breast cancer following breast-conserving surgery. Here we present 5-year results of a prospective trial. From October 2003 through November 2005, 98 evaluable patients with stage I breast cancer were enrolled in the first dose step (32 Gy delivered in 8 twice-daily fractions) of a prospective, multi-institutional, dose escalation clinical trial of 3-dimensional conformal external beam APBI (3D-APBI). Median age was 61 years; median tumor size was 0.8 cm; 89% of tumors were estrogen receptor positive; 10% had a triple-negative phenotype; and 1% had a HER-2-positive subtype. Median follow-up was 71 months (range, 2-88 months; interquartile range, 64-75 months). Five patients developed ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial IBTR rate of 5% (95% confidence interval [CI], 1%-10%). Three of these cases occurred in patients with triple-negative disease and 2 in non-triple-negative patients, for 5-year actuarial IBTR rates of 33% (95% CI, 0%-57%) and 2% (95% CI, 0%-6%; P<.0001), respectively. On multivariable analysis, triple-negative phenotype was the only predictor of IBTR, with borderline statistical significance after adjusting for tumor grade (P=.0537). Overall outcomes were excellent, particularly for patients with estrogen receptor-positive disease. Patients in this study with triple-negative breast cancer had a significantly higher IBTR rate than patients with other receptor phenotypes when treated with 3D-APBI. Larger, prospective 3D-APBI clinical trials should continue to evaluate the effect of hormone receptor phenotype on IBTR rates. Copyright © 2012 Elsevier Inc. All rights reserved.

Polyethylene glycol hydrogel rectal spacer implantation in patients with prostate cancer undergoing combination high-dose-rate brachytherapy and external beam radiotherapy.

PubMed

Yeh, Jekwon; Lehrich, Brandon; Tran, Carolyn; Mesa, Albert; Baghdassarian, Ruben; Yoshida, Jeffrey; Torrey, Robert; Gazzaniga, Michael; Weinberg, Alan; Chalfin, Stuart; Ravera, John; Tokita, Kenneth

2016-01-01

To present rectal toxicity rates in patients administered a polyethylene glycol (PEG) hydrogel rectal spacer in conjunction with combination high-dose-rate brachytherapy and external beam radiotherapy. Between February 2010 and April 2015, 326 prostate carcinoma patients underwent combination high-dose-rate brachytherapy of 16 Gy (average dose 15.5 Gy; standard deviation [SD] = 1.6 Gy) and external beam radiotherapy of 59.4 Gy (average dose 60.2 Gy; SD = 2.9 Gy). In conjunction with the radiation therapy regimen, each patient was injected with 10 mL of a PEG hydrogel in the anterior perirectal fat space. The injectable spacer (rectal spacer) creates a gap between the prostate and the rectum. The rectum is displaced from the radiation field, and rectal dose is substantially reduced. The goal is a reduction in rectal radiation toxicity. Clinical efficacy was determined by measuring acute and chronic rectal toxicity using the National Cancer Center Institute Common Terminology Criteria for Adverse Events v4.0 grading scheme. Median followup was 16 months. The mean anterior-posterior separation achieved was 1.6 cm (SD = 0.4 cm). Rates of acute Grade 1 and 2 rectal toxicity were 37.4% and 2.8%, respectively. There were no acute Grade 3/4 toxicities. Rates of late Grade 1, 2, and 3 rectal toxicity were 12.7%, 1.4%, and 0.7%, respectively. There were no late Grade 4 toxicities. PEG rectal spacer implantation is safe and well tolerated. Acute and chronic rectal toxicities are low despite aggressive dose escalation. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Assessment of normal tissue complications following prostate cancer irradiation: Comparison of radiation treatment modalities using NTCP models

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

Takam, Rungdham; Bezak, Eva; Yeoh, Eric E.

2010-09-15

Purpose: Normal tissue complication probability (NTCP) of the rectum, bladder, urethra, and femoral heads following several techniques for radiation treatment of prostate cancer were evaluated applying the relative seriality and Lyman models. Methods: Model parameters from literature were used in this evaluation. The treatment techniques included external (standard fractionated, hypofractionated, and dose-escalated) three-dimensional conformal radiotherapy (3D-CRT), low-dose-rate (LDR) brachytherapy (I-125 seeds), and high-dose-rate (HDR) brachytherapy (Ir-192 source). Dose-volume histograms (DVHs) of the rectum, bladder, and urethra retrieved from corresponding treatment planning systems were converted to biological effective dose-based and equivalent dose-based DVHs, respectively, in order to account for differences inmore » radiation treatment modality and fractionation schedule. Results: Results indicated that with hypofractionated 3D-CRT (20 fractions of 2.75 Gy/fraction delivered five times/week to total dose of 55 Gy), NTCP of the rectum, bladder, and urethra were less than those for standard fractionated 3D-CRT using a four-field technique (32 fractions of 2 Gy/fraction delivered five times/week to total dose of 64 Gy) and dose-escalated 3D-CRT. Rectal and bladder NTCPs (5.2% and 6.6%, respectively) following the dose-escalated four-field 3D-CRT (2 Gy/fraction to total dose of 74 Gy) were the highest among analyzed treatment techniques. The average NTCP for the rectum and urethra were 0.6% and 24.7% for LDR-BT and 0.5% and 11.2% for HDR-BT. Conclusions: Although brachytherapy techniques resulted in delivering larger equivalent doses to normal tissues, the corresponding NTCPs were lower than those of external beam techniques other than the urethra because of much smaller volumes irradiated to higher doses. Among analyzed normal tissues, the femoral heads were found to have the lowest probability of complications as most of their volume was irradiated to lower equivalent doses compared to other tissues.« less

Morbidity and prostate-specific antigen control of external beam radiation therapy plus low-dose-rate brachytherapy boost for low, intermediate, and high-risk prostate cancer.

PubMed

Koontz, Bridget F; Chino, Junzo; Lee, W Robert; Hahn, Carol A; Buckley, Niall; Huang, Samuel; Kim, Jay; Reagan, Robert; Joyner, Raymond; Anscher, Mitchell S

2009-01-01

Dose escalation has been shown beneficial in prostate cancer. Brachytherapy (BT) provides an opportunity for dose escalation beyond what can be safely delivered using only teletherapy methods. The purpose of this study was to determine cancer control and morbidity of external beam radiation therapy (EBRT) plus low-dose-rate (LDR) BT boost in patients with prostate cancer treated at Duke University Health System. Between June 1997 and August 2007, 199 patients were consecutively treated at our facility with 46Gy EBRT followed by 100Gy palladium-103 ((103)Pd) or 120Gy iodine-125 ((125)I) LDR prostate implant. Treatment characteristics and followup data were retrospectively analyzed. Intermediate risk was defined as T2b-c, Gleason score 7 (GS 7), or prostate-specific antigen (PSA) of 10.1-19.9ng/mL. High risk was defined as GS 8-10, PSA>20, T3+, or two intermediate risk factors. The Radiation Therapy Oncology Group toxicity scale was used to report morbidity for gastrointestinal (GI) and genitourinary (GU) effects. PSA recurrence was defined as nadir+2ng/mL. Median followup was 4.2 years for all patients, 4.8 years for high-risk patients. Risk categories were as follows: 20% low risk, 47% intermediate risk, and 33% high risk. Forty five percent of patients received adjuvant androgen deprivation therapy (ADT). The median length of time since end of ADT to last followup was 2.7 years in all patients, 2.0 years for high-risk patients. Five-year biochemical relapse-free survival was 87% for all, 81% for high-risk patients. PSA control was similar at 92% for all and 86% for high-risk patients. Five-year actuarial risk of any and Grade 3 late GI morbidity was 38% and 7% respectively, and any and Grade 3 late GU morbidity was 21% and 3%, respectively. There were no significant differences in risk of Grade 2+GI or GU morbidity with choice of isotope. EBRT plus LDR BT has acceptable morbidity and, with 5-year followup, provides excellent cancer control even in high-risk patients.

Brachytherapy Boost Utilization and Survival in Unfavorable-risk Prostate Cancer.

PubMed

Johnson, Skyler B; Lester-Coll, Nataniel H; Kelly, Jacqueline R; Kann, Benjamin H; Yu, James B; Nath, Sameer K

2017-11-01

There are limited comparative survival data for prostate cancer (PCa) patients managed with a low-dose rate brachytherapy (LDR-B) boost and dose-escalated external-beam radiotherapy (DE-EBRT) alone. To compare overall survival (OS) for men with unfavorable PCa between LDR-B and DE-EBRT groups. Using the National Cancer Data Base, we identified men with unfavorable PCa treated between 2004 and 2012 with androgen suppression (AS) and either EBRT followed by LDR-B or DE-EBRT (75.6-86.4Gy). Treatment selection was evaluated using logistic regression and annual percentage proportions. OS was analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards, and propensity score matching. We identified 25038 men between 2004 and 2012, during which LDR-B boost utilization decreased from 29% to 14%. LDR-B was associated with better OS on univariate (7-yr OS: 82% vs 73%; p<0.001) and multivariate analyses (hazard ratio [HR] 0.70, 95% confidence interval [CI] 0.64-0.77). Propensity score matching verified an OS benefit associated with LDR-B boost (HR 0.74, 95% CI 0.66-0.89). The OS benefit of LDR-B boost persisted when limited to men aged <60 yr with no comorbidities. On subset analysis, there was no interaction between treatment and age, risk group, or radiation dose. Limitations include the retrospective design, nonrandomized selection bias, and the absence of treatment toxicity, hormone duration, and cancer-specific outcomes. Between 2004 and 2012, LDR-B boost utilization declined and was associated with better OS compared to DE-EBRT alone. LDR-B boost is probably the ideal treatment option for men with unfavorable PCa, pending long-term results of randomized trials. We compared radiotherapy utilization and survival for prostate cancer (PCa) patients using a national database. We found that low-dose rate brachytherapy (LDR-B) boost, a method being used less frequently, was associated with better overall survival when compared to dose-escalated external-beam radiotherapy alone for men with unfavorable PCa. Randomized trials are needed to confirm that LDR-B boost is the ideal treatment. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Phase I Trial of Bortezomib and Concurrent External Beam Radiation in Patients With Advanced Solid Malignancies

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

Pugh, Thomas J.; Chen Changhu; Rabinovitch, Rachel

Purpose: To determine the maximal tolerated dose of bortezomib with concurrent external beam radiation therapy in patients with incurable solid malignant tumors requiring palliative therapy. Methods and Materials: An open label, dose escalation, phase I clinical trial evaluated the safety of three dose levels of bortezomib administered intravenously (1.0 mg/m{sup 2}, 1.3 mg/m{sup 2}, and 1.6 mg/m{sup 2}/ dose) once weekly with concurrent radiation in patients with histologically confirmed solid tumors and a radiographically appreciable lesion suitable for palliative radiation therapy. All patients received 40 Gy in 16 fractions to the target lesion. Dose-limiting toxicity was the primary endpoint, definedmore » as any grade 4 hematologic toxicity, any grade {>=}3 nonhematologic toxicity, or any toxicity requiring treatment to be delayed for {>=}2 weeks. Results: A total of 12 patients were enrolled. Primary sites included prostate (3 patients), head and neck (3 patients), uterus (1 patient), abdomen (1 patient), breast (1 patient), kidney (1 patient), lung (1 patient), and colon (1 patient). The maximum tolerated dose was not realized with a maximum dose of 1.6 mg/m{sup 2}. One case of dose-limiting toxicity was appreciated (grade 3 urosepsis) and felt to be unrelated to bortezomib. The most common grade 3 toxicity was lymphopenia (10 patients). Common grade 1 to 2 events included nausea (7 patients), infection without neutropenia (6 patients), diarrhea (5 patients), and fatigue (5 patients). Conclusions: The combination of palliative external beam radiation with concurrent weekly bortezomib therapy at a dose of 1.6 mg/m{sup 2} is well tolerated in patients with metastatic solid tumors. The maximum tolerated dose of once weekly bortezomib delivered concurrently with radiation therapy is greater than 1.6 mg/m{sup 2}.« less

[Clinical experience of carbon ion radiotherapy for malignant tumors].

PubMed

Ishikawa, Hitoshi; Tsuji, Hiroshi; Tsujii, Hirohiko

2006-04-01

The carbon ion (C-ion) beams provide unique advantageous biological and physical properties in radiotherapy (RT) for malignant tumors. C-ion beams have a high relative biological effectiveness (RBE) resulting from the high linear energy transfer (LET). In terms of their physical characteristics, C-ion beams exhibit a spread-out Bragg peak (SOBP) and make for a better dose distribution of the target volume by specified beam modulations. Between June 1994 and August 2005, a total of 2,371 patients with malignant tumors were registered in phase I/II dose-escalation studies and clinical phase II trials using C-ion beams generated at Heavy Ion Medical Accelerator in Chiba (HIMAC). In the initial dose-escalation studies, grade 3 or more late rectal complications had developed in some patients. However, the adverse effects were resolved because of the use of appropriate dose levels and modification of the radiation technique. C-ion beams can carry out hypofractionated radiotherapy with a large fraction dose and reduce the overall treatment times compared with conventional radiotherapy. They can also achieve better local tumor control even for radio-resistant tumors such as malignant melanoma, hepatocellular carcinoma and bone and soft tissue sarcomas with minimal morbidity to the normal surrounding tissues.

An update on the clinical trial of BNCT at the BMRR

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

Ma, R.; Capala, J.; Chanana, A.D.

1999-09-01

Boron neutron capture therapy (BNCT) was proposed more than six decades ago. It is a binary treatment modality that requires selective delivery of a {sup 10}B-labeled compound to a tumor and slow neutron irradiation of the tumor-bearing tissues. In order to improve the penetration of the neutron beam, an epithermal neutron beam was developed at the Brookhaven Medical Research Reactor (BMRR). This epithermal neutron beam can deliver relatively high thermal neutron fluence at depth without severe skin damage. Boronophenylalanine-fructose (BPA-F), a nontoxic boron carrier, was found to preferentially accumulate in tumor cells following intravenous infusion in patients with GBM. Inmore » preclinical BNCT studies in rats bearing 9L gliosarcoma, BPA-mediated BNCT was shown to be more efficacious than photon irradiation. In 1994, improvements in the neutron beam and in the understanding of the radiobiology of BPA-mediated BNCT led to the initiation of BNCT trials for human GBM at BMRR using BPA-F and epithermal neutrons. The primary objective of the phase I/II clinical trial of BPA-mediated BNCT at BMRR is to evaluate the safety of the BPA-F-mediated BNCT using epithermal neutrons in patients with GBM at a series of escalating BNCT doses. An incidental objective is to evaluate the therapeutic effectiveness of BNCT at each dose level. For each dose escalation group, the average brain dose (ABD) is escalated, as well as the minimum tumor dose. In summary, the BNCT procedure employed in the phase I/II clinical trial of BPA-F-mediated BNCT for GBM at BNL was found to be safe in all patients. The palliation afforded by a single session of BNCT compares favorably with palliation provided by fractionated photon therapy and adjuvant chemotherapy. If no evidence of radiation-induced brain toxicity is found in the current protocol, BNCT radiation dose will be further escalated.« less

Dosimetric impact of gold markers implanted closely to lung tumors: a Monte Carlo simulation.

PubMed

Shiinoki, Takehiro; Sawada, Akira; Ishihara, Yoshitomo; Miyabe, Yuki; Matsuo, Yukinori; Mizowaki, Takashi; Kokubo, Masaki; Hiraoka, Masahiro

2014-05-08

We are developing an innovative dynamic tumor tracking irradiation technique using gold markers implanted around a tumor as a surrogate signal, a real-time marker detection system, and a gimbaled X-ray head in the Vero4DRT. The gold markers implanted in a normal organ will produce uncertainty in the dose calculation during treatment planning because the photon mass attenuation coefficient of a gold marker is much larger than that of normal tissue. The purpose of this study was to simulate the dose variation near the gold markers in a lung irradiated by a photon beam using the Monte Carlo method. First, the single-beam and the opposing-beam geometries were simulated using both water and lung phantoms. Subsequently, the relative dose profiles were calculated using a stereotactic body radiotherapy (SBRT) treatment plan for a lung cancer patient having gold markers along the anterior-posterior (AP) and right-left (RL) directions. For the single beam, the dose at the gold marker-phantom interface laterally along the perpendicular to the beam axis increased by a factor of 1.35 in the water phantom and 1.58 in the lung phantom, respectively. Furthermore, the entrance dose at the interface along the beam axis increased by a factor of 1.63 in the water phantom and 1.91 in the lung phantom, while the exit dose increased by a factor of 1.00 in the water phantom and 1.12 in the lung phantom, respectively. On the other hand, both dose escalations and dose de-escalations were canceled by each beam for opposing portal beams with the same beam weight. For SBRT patient data, the dose at the gold marker edge located in the tumor increased by a factor of 1.30 in both AP and RL directions. In clinical cases, dose escalations were observed at the small area where the distance between a gold marker and the lung tumor was ≤ 5 mm, and it would be clinically negligible in multibeam treatments, although further investigation may be required.

Radiation therapy and esophageal cancer.

PubMed

Shridhar, Ravi; Almhanna, Khaldoun; Meredith, Kenneth L; Biagioli, Matthew C; Chuong, Michael D; Cruz, Alex; Hoffe, Sarah E

2013-04-01

Squamous cell carcinoma and adenocarcinoma account for more than 90% of all esophageal cancer cases. Although the incidence of squamous cell carcinoma has declined, the incidence of adenocarcinoma has risen due to increases in obesity and gastroesophageal reflux disease. The authors examine the role of radiation therapy alone (external beam and brachytherapy) for the management of esophageal cancer or combined with other modalities. The impact on staging and appropriate stratification of patients referred for curative vs palliative intent with modalities is reviewed. The authors also explore the role of emerging radiation technologies. Current data show that neoadjuvant chemoradiotherapy followed by surgical resection is the accepted standard of care, with 3-year overall survival rates ranging from 30% to 60%. The benefit of adjuvant radiation therapy is limited to patients with node-positive cancer. The survival benefit of surgical resection after chemoradiotherapy remains controversial. External beam radiation therapy alone results in few long-term survivors and is considered palliative at best. Radiation dose-escalation has failed to improve local control or survival. Brachytherapy can provide better long-term palliation of dysphagia than metal stent placement. Although three-dimensional conformal treatment planning is the accepted standard, the roles of IMRT and proton therapy are evolving and potentially reduce adverse events due to better sparing of normal tissue. Future directions will evaluate the benefit of induction chemotherapy followed by chemoradiotherapy, the role of surgery in locally advanced disease, and the identification of responders prior to treatment based on microarray analysis.

Dose escalation in permanent brachytherapy for prostate cancer: dosimetric and biological considerations

NASA Astrophysics Data System (ADS)

Li, X. Allen; Wang, Jian Z.; Stewart, Robert D.; Di Biase, Steven J.

2003-09-01

No prospective dose escalation study for prostate brachytherapy (PB) with permanent implants has been reported. In this work, we have performed a dosimetric and biological analysis to explore the implications of dose escalation in PB using 125I and 103Pd implants. The concept of equivalent uniform dose (EUD), proposed originally for external-beam radiotherapy (EBRT), is applied to low dose rate brachytherapy. For a given 125I or 103Pd PB, the EUD for tumour that corresponds to a dose distribution delivered by EBRT is calculated based on the linear quadratic model. The EUD calculation is based on the dose volume histogram (DVH) obtained retrospectively from representative actual patient data. Tumour control probabilities (TCPs) are also determined in order to compare the relative effectiveness of different dose levels. The EUD for normal tissue is computed using the Lyman model. A commercial inverse treatment planning algorithm is used to investigate the feasibility of escalating the dose to prostate with acceptable dose increases in the rectum and urethra. The dosimetric calculation is performed for five representative patients with different prostate sizes. A series of PB dose levels are considered for each patient using 125I and 103Pd seeds. It is found that the PB prescribed doses (minimum peripheral dose) that give an equivalent EBRT dose of 64.8, 70.2, 75.6 and 81 Gy with a fraction size of 1.8 Gy are 129, 139, 150 and 161 Gy for 125I and 103, 112, 122 and 132 Gy for 103Pd implants, respectively. Estimates of the EUD and TCP for a series of possible prescribed dose levels (e.g., 145, 160, 170 and 180 Gy for 125I and 125, 135, 145 and 155 for 103Pd implants) are tabulated. The EUD calculation was found to depend strongly on DVHs and radiobiological parameters. The dosimetric calculations suggest that the dose to prostate can be escalated without a substantial increase in both rectal and urethral dose. For example, increasing the PB prescribed dose from 145 to 180 Gy increases EUD for the rectum by only 3%. Our studies indicate that the dose to urethra can be kept within 100-120% of the prescription dose for all the dose levels studied. In conclusion, dose escalation in permanent implant for localized prostate cancer may be advantageous. It is dosimetrically possible to increase dose to prostate without a substantial increase in the dose to the rectum and urethra. Based on the results of our studies, a prospective dose escalation trial for prostate permanent implants has been initiated at our institution.

Radiation dose escalation or longer androgen suppression for locally advanced prostate cancer? Data from the TROG 03.04 RADAR trial.

PubMed

Denham, James W; Steigler, Allison; Joseph, David; Lamb, David S; Spry, Nigel A; Duchesne, Gillian; Atkinson, Chris; Matthews, John; Turner, Sandra; Kenny, Lizbeth; Tai, Keen-Hun; Gogna, Nirdosh Kumar; Gill, Suki; Tan, Hendrick; Kearvell, Rachel; Murray, Judy; Ebert, Martin; Haworth, Annette; Kennedy, Angel; Delahunt, Brett; Oldmeadow, Christopher; Holliday, Elizabeth G; Attia, John

2015-06-01

The relative effects of radiation dose escalation (RDE) and androgen suppression (AS) duration on local prostatic progression (LP) remain unclear. We addressed this in the TROG 03.04 RADAR trial by incorporating a RDE programme by stratification at randomisation. Men were allocated 6 or 18 months AS±18 months zoledronate (Z). The main endpoint was a composite of clinically diagnosed LP or PSA progression with a PSA doubling time ⩾6 months. Fine and Gray competing risk modelling with adjustment for site clustering produced cumulative incidence estimates at 6.5 years for each RDE group. Composite LP declined coherently in the 66, 70 and 74 Gy external beam dosing groups and was lowest in the high dose rate brachytherapy boost (HDRB) group. At 6.5 years, adjusted cumulative incidences were 22%, 15%, 13% and 7% respectively. Compared to 6 months AS, 18 months AS also significantly reduced LP (p<0.001). Post-radiation urethral strictures were documented in 45 subjects and increased incrementally in the dosing groups. Crude incidences were 0.8%, 0.9%, 3.8% and 12.7% respectively. RDE and increasing AS independently reduce LP and increase urethral strictures. The risks and benefits to the individual must be balanced when selecting radiation dose and AS duration. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Vaginal dose de-escalation in image guided adaptive brachytherapy for locally advanced cervical cancer.

PubMed

Mohamed, Sandy; Lindegaard, Jacob Christian; de Leeuw, Astrid A C; Jürgenliemk-Schulz, Ina; Kirchheiner, Kathrin; Kirisits, Christian; Pötter, Richard; Tanderup, Kari

2016-09-01

Vaginal stenosis is a major problem following radiotherapy in cervical cancer. We investigated a new dose planning strategy for vaginal dose de-escalation (VDD). Fifty consecutive locally advanced cervical cancer patients without lower or middle vaginal involvement at diagnosis from 3 institutions were analysed. External beam radiotherapy was combined with MRI-guided brachytherapy. VDD was obtained by decreasing dwell times in ovoid/ring and increasing dwell times in tandem/needles. The aim was to maintain the target dose (D90 of HR-CTV⩾85Gy EQD2) while reducing the dose to the surface of the vagina to <140% of the physical fractional brachytherapy dose corresponding to a total EQD2 of 85Gy. The mean vaginal loading (ovoid/ring) was reduced from 51% to 33% of the total loading with VDD, which significantly reduced the dose to the vaginal dose points (p<0.001) without compromising the target dose. The dose to the ICRU recto-vaginal point was reduced by a mean of 4±4Gy EQD2 (p<0.001), while doses to bladder and rectum (D 2cm 3 ) were reduced by 2±2Gy and 3±2Gy, respectively (p<0.001). VDD significantly reduces dose to the upper vagina which is expected to result in reduction of vaginal stenosis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Yttrium-90 microspheres for the treatment of hepatocellular carcinoma: A review

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

Salem, Riad; Hunter, Russell D.

2006-10-01

To present a critical review of yttrium-90 (TheraSphere) for the treatment of hepatocellular carcinoma (HCC). Medical literature databases (Medline, Cochrane Library, and CANCERLIT) were searched for available literature concerning the treatment of HCC with TheraSphere. These publications were reviewed for scientific and clinical validity. Studies pertaining to the use of yttrium-90 for HCC date back to the 1960s. The results from the early animal safety studies established a radiation exposure range of 50-100 Gy to be used in human studies. Phase I dose escalation studies followed, which were instrumental in delineating radiation dosimetry and safety parameters in humans. These earlymore » studies emphasized the importance of differential arteriolar density between hypervascular HCC and surrounding liver parenchyma. Current trends in research have focused on advancing techniques to safely implement this technology as an alternative to traditional methods of treating unresectable HCC, such as external beam radiotherapy, conformal beam radiotherapy, ethanol ablation, trans-arterial chemoembolization, and radiofrequency ablation. Yttrium-90 (TheraSphere) is an outpatient treatment option for HCC. Current and future research should focus on implementing multicenter phase II and III trials comparing TheraSphere with other therapies for HCC.« less

Promoting de-escalation of commitment: a regulatory-focus perspective on sunk costs.

PubMed

Molden, Daniel C; Hui, Chin Ming

2011-01-01

People frequently escalate their commitment to failing endeavors. Explanations for such behavior typically involve loss aversion, failure to recognize other alternatives, and concerns with justifying prior actions; all of these factors produce recommitment to previous decisions with the goal of erasing losses and vindicating these decisions. Solutions to escalation of commitment have therefore focused on external oversight and divided responsibility during decision making to attenuate loss aversion, blindness to alternatives, and justification biases. However, these solutions require substantial resources and have additional adverse effects. The present studies tested an alternative method for de-escalating commitment: activating broad motivations for growth and advancement (promotion). This approach should reduce concerns with loss and increase perceptions of alternatives, thereby attenuating justification motives. In two studies featuring hypothetical financial decisions, activating promotion motivations reduced recommitment to poorly performing investments as compared with both not activating any additional motivations and activating motivations for safety and security (prevention).

Continued Benefit to Androgen Deprivation Therapy for Prostate Cancer Patients Treated With Dose-Escalated Radiation Therapy Across Multiple Definitions of High-Risk Disease

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

Stenmark, Matthew H.; Blas, Kevin; Halverson, Schuyler

2011-11-15

Purpose: To analyze prognostic factors in patients with high-risk prostate cancer treated with dose-escalated external-beam radiation therapy (EBRT) and androgen deprivation (ADT). Methods and Materials: Between 1998 and 2008 at University of Michigan Medical Center, 718 men were consecutively treated with EBRT to at least 75 Gy. Seven definitions of high-risk prostate cancer, applying to 11-33% of patients, were evaluated. Biochemical failure (BF), salvage ADT use, metastatic progression, and prostate cancer-specific mortality (PCSM) were estimated by the Kaplan-Meier method and Cox proportional hazards regression. Results: Each high-risk definition was associated with increased BF (hazard ratio [HR] 2.8-3.9, p < 0.0001),more » salvage ADT use (HR 3.9-6.3, p < 0.0001), metastasis (HR 3.7-6.6, p < 0.0001), and PCSM (HR 3.7-16.2, p < 0.0001). Furthermore, an increasing number of high-risk features predicted worse outcome. Adjuvant ADT yielded significant reductions in both metastases (HR 0.19-0.38, p < 0.001) and PCSM (HR 0.38-0.50, p < 0.05) for all high-risk definitions (with the exception of clinical Stage T3-4 disease) but improved BF only for those with elevated Gleason scores (p < 0.03, HR 0.25-0.48). When treated with ADT and dose-escalated EBRT, patients with Gleason scores 8 to 10, without other high-risk features, had 8-year freedom from BF of 74%, freedom from distant metastases of 93%, and cause-specific survival of 92%, with salvage ADT used in 16% of patients. Conclusion: Adjuvant ADT results in a significant improvement in clinical progression and PCSM across multiple definitions of high-risk disease even with dose-escalated EBRT. There is a subset of patients, characterized by multiple high-risk features or the presence of Gleason Pattern 5, who remain at significant risk for metastasis and PCSM despite current treatment.« less

The power of friendship: protection against an escalating cycle of peer victimization.

PubMed

Hodges, E V; Boivin, M; Vitaro, F; Bukowski, W M

1999-01-01

This study examined 2 aspects of friendship (presence and perceived qualities of a best friend) as moderators of behavioral antecedents and outcomes of peer victimization. A total of 393 children (188 boys and 205 girls) in the 4th and 5th grades (mean age = 10 years 7 months) participated during each of 2 waves of data collection in this 1-year longitudinal study. Results indicated that teacher-reported internalizing and externalizing behaviors predicted increases in peer-reported victimization, but the relation of internalizing behaviors to increases in victimization was attenuated for children with a protective friendship. Victimization predicted increases in internalizing and externalizing behaviors but only for children without a mutual best friendship. Results highlight the importance of peer friendships in preventing an escalating cycle of peer abuse.

The clinical case for proton beam therapy

PubMed Central

2012-01-01

Abstract Over the past 20 years, several proton beam treatment programs have been implemented throughout the United States. Increasingly, the number of new programs under development is growing. Proton beam therapy has the potential for improving tumor control and survival through dose escalation. It also has potential for reducing harm to normal organs through dose reduction. However, proton beam therapy is more costly than conventional x-ray therapy. This increased cost may be offset by improved function, improved quality of life, and reduced costs related to treating the late effects of therapy. Clinical research opportunities are abundant to determine which patients will gain the most benefit from proton beam therapy. We review the clinical case for proton beam therapy. Summary sentence Proton beam therapy is a technically advanced and promising form of radiation therapy. PMID:23083010

Prospective evaluation of a 12-week walking exercise program and its effect on fatigue in prostate cancer patients undergoing radical external beam radiotherapy.

PubMed

Truong, Pauline T; Gaul, Catherine A; McDonald, Rachel E; Petersen, Ross B; Jones, Stuart O; Alexander, Abraham S; Lim, Jan T W; Ludgate, Charles

2011-08-01

To evaluate tolerability and compliance to a walking exercise program and its effect on fatigue during and after radical external beam radiation therapy (EBRT) for prostate cancer. A total of 50 subjects with prostate cancer undergoing EBRT over 6 to 8 weeks were prospectively accrued to an exercise intervention group, matched for age and clinical characteristics to 30 subjects in a historical control group who underwent EBRT with no specific exercise intervention. Starting 1 week before EBRT, exercise participants performed moderate-intensity walking targeting 60% to 70% age-predicted maximum heart rate, at least 20 min/d, 3 d/wk over 12 weeks. The Brief Fatigue Inventory was administered at baseline, mid-EBRT (week 3-4), end-EBRT (week 6-8), and 6 months post-EBRT. Of 50, 42 (84%) of exercise participants completed the walking program. There were no cardiovascular complications, musculoskeletal injuries, or other adverse events. A total of 89% subjects reported "Good-Excellent" satisfaction during and up to 6 months post-EBRT. Fatigue in control subjects escalated from baseline to end-EBRT, remaining high at 6 months post-EBRT (P[r] = 0.03). In contrast, mean total fatigue scores in exercise subjects were stable from baseline up to 6 months post-EBRT (P = 0.52). Trends for higher fatigue interference with quality of life were observed in the control group as compared with the exercise group. Moderate-intensity walking exercise during radical EBRT is safe and feasible. The high convenience and satisfaction ratings, in conjunction with the observed fatigue trends, indicate that this activity has the potential to attenuate fatigue and improve quality of life for patients with localized prostate cancer undergoing curative therapy.

The Cancer of the Prostate Risk Assessment (CAPRA) score predicts biochemical recurrence in intermediate-risk prostate cancer treated with external beam radiotherapy (EBRT) dose escalation or low-dose rate (LDR) brachytherapy.

PubMed

Krishnan, Vimal; Delouya, Guila; Bahary, Jean-Paul; Larrivée, Sandra; Taussky, Daniel

2014-12-01

To study the prognostic value of the University of California, San Francisco Cancer of the Prostate Risk Assessment (CAPRA) score to predict biochemical failure (bF) after various doses of external beam radiotherapy (EBRT) and/or permanent seed low-dose rate (LDR) prostate brachytherapy (PB). We retrospectively analysed 345 patients with intermediate-risk prostate cancer, with PSA levels of 10-20 ng/mL and/or Gleason 7 including 244 EBRT patients (70.2-79.2 Gy) and 101 patients treated with LDR PB. The minimum follow-up was 3 years. No patient received primary androgen-deprivation therapy. bF was defined according to the Phoenix definition. Cox regression analysis was used to estimate the differences between CAPRA groups. The overall bF rate was 13% (45/345). The CAPRA score, as a continuous variable, was statistically significant in multivariate analysis for predicting bF (hazard ratio [HR] 1.37, 95% confidence interval [CI] 1.10-1.72, P = 0.006). There was a trend for a lower bF rate in patients treated with LDR PB when compared with those treated by EBRT ≤ 74 Gy (HR 0.234, 95% CI 0.05-1.03, P = 0.055) in multivariate analysis. In the subgroup of patients with a CAPRA score of 3-5, CAPRA remained predictive of bF as a continuous variable (HR 1.51, 95% CI 1.01-2.27, P = 0.047) in multivariate analysis. The CAPRA score is useful for predicting biochemical recurrence in patients treated for intermediate-risk prostate cancer with EBRT or LDR PB. It could help in treatment decisions. © 2013 The Authors. BJU International © 2013 BJU International.

External Beam Radiation Therapy for Cancer

Cancer.gov

External beam radiation therapy is used to treat many types of cancer. it is a local treatment, where a machine aims radiation at your cancer. Learn more about different types of external beam radiation therapy, and what to expect if you're receiving treatment.

Intensity-modulated radiotherapy for locally advanced non-small-cell lung cancer: a dose-escalation planning study.

PubMed

Lievens, Yolande; Nulens, An; Gaber, Mousa Amr; Defraene, Gilles; De Wever, Walter; Stroobants, Sigrid; Van den Heuvel, Frank

2011-05-01

To evaluate the potential for dose escalation with intensity-modulated radiotherapy (IMRT) in positron emission tomography-based radiotherapy planning for locally advanced non-small-cell lung cancer (LA-NSCLC). For 35 LA-NSCLC patients, three-dimensional conformal radiotherapy and IMRT plans were made to a prescription dose (PD) of 66 Gy in 2-Gy fractions. Dose escalation was performed toward the maximal PD using secondary endpoint constraints for the lung, spinal cord, and heart, with de-escalation according to defined esophageal tolerance. Dose calculation was performed using the Eclipse pencil beam algorithm, and all plans were recalculated using a collapsed cone algorithm. The normal tissue complication probabilities were calculated for the lung (Grade 2 pneumonitis) and esophagus (acute toxicity, grade 2 or greater, and late toxicity). IMRT resulted in statistically significant decreases in the mean lung (p <.0001) and maximal spinal cord (p = .002 and 0005) doses, allowing an average increase in the PD of 8.6-14.2 Gy (p ≤.0001). This advantage was lost after de-escalation within the defined esophageal dose limits. The lung normal tissue complication probabilities were significantly lower for IMRT (p <.0001), even after dose escalation. For esophageal toxicity, IMRT significantly decreased the acute NTCP values at the low dose levels (p = .0009 and p <.0001). After maximal dose escalation, late esophageal tolerance became critical (p <.0001), especially when using IMRT, owing to the parallel increases in the esophageal dose and PD. In LA-NSCLC, IMRT offers the potential to significantly escalate the PD, dependent on the lung and spinal cord tolerance. However, parallel increases in the esophageal dose abolished the advantage, even when using collapsed cone algorithms. This is important to consider in the context of concomitant chemoradiotherapy schedules using IMRT. Copyright © 2011 Elsevier Inc. All rights reserved.

External beam radiotherapy with dose escalation in 1080 prostate cancer patients: definitive outcome and dose impact.

PubMed

Garibaldi, Elisabetta; Gabriele, Domenico; Maggio, Angelo; Delmastro, Elena; Garibaldi, Monica; Bresciani, Sara; Ortega, Cinzia; Stasi, Michele; Gabriele, Pietro

2016-06-01

The aim of this paper was to report definitive outcome of prostate cancer patients treated with dose escalation during a period of 12.5 years. From October 1999 to March 2012 we treated 1080 patients affected by prostate cancer, using External Beam Radiotherapy (EBRT). The mean age was 69.2 years. Most of the patients (69%) were staged as cT2, Gleason Score (GS)<7; the mean iPSA 18 ng/mL; the rate of clinical positive nodes was 1%. Our intention to treat was the following: for low risk patients 72 Gy; for intermediate risk patients 75.6 Gy and for high-very high risk patients 79.2 Gy in 1.8 Gy/day fractions. From 2008 we changed the fractionation scheme and the doses were the following: for low risk patients 74 Gy and for intermediate and high-very high risk patients 78 Gy in 2.0 Gy/day fractions. Whole pelvis irradiation was performed in high-very high risk patients with 43.2-50.4 Gy in 1.8 Gy per day. The mean follow-up was 81 months. For the whole population at 5 and 10 years, the prostate cancer specific overall survival (CSOS) was 96.7% and 92.2% respectively; the clinical disease free survival (CDFS) 88% and 77%; the biochemical disease free survival (BDFS) 75% and 58.5%. The 5 and 10 years CSOS was 98% and 96% respectively for low risk, 96% and 92% for intermediate risk and 89% and 82% for high-very high risk patients. In intermediate and high-very high risk groups at 5 and 10 years the CSOS was 95.2% and 89.2% respectively, the CDFS 84.5% and 70% and the BDFS 70% and 51% respectively. In high-very high risk patients at 5 and 10 years the CSOS were respectively 89% and 82% the CDFS was 78% and 61% and BDFS was 61% and 34%. In whole patient population the BDFS was related with the dose level (P=0.006) as well as the CDFS (P=0.003) with a cut off of 75.6 Gy. In the subgroup of intermediate plus high-very high risk patients the BDFS and the CDFS were dose-related with a cut off of 75.6 Gy (P=0.007 and P=0.0018 respectively). Finally, in the subgroup of high-very high risk patients we found that the CSOS, the BDFS and the CDFS were related to the dose level with a cut-off of 77.7 Gy (P=0.017; P=0.006 and P=0.038, respectively). Overall gastrointestinal (GI) acute and late G2 toxicities were respectively 5 % and 3.8%; GI acute and late >G3 toxicities were respectively 0.5% and 0.9%; acute and late >G2 genitourinary (GU) toxicities were respectively 10.5% and 2.6%; finally GU acute and late >G3 toxicities were respectively 0.6% and 0.5%. The dose escalation is not relevant for the outcome in low risk patients that can benefit from relatively moderate doses (72-74 Gy). For intermediate and high-very high risk patients the dose becomes significant to levels above 75.6 Gy; particularly in high-very high risk doses >77.7 Gy correlate with an improved outcome. Patients receiving dose >77.7 Gy presented a higher rate of overall GI and GU toxicity, but the number of grade >2 remains low. Our results, consolidated by a long follow-up, corroborate the literature data, confirming that 3D-CRT can allow a safe dose escalation without significantly increasing the severe toxicity.

The Impact of Parents, Child Care Providers, Teachers, and Peers on Early Externalizing Trajectories

PubMed Central

Silver, Rebecca B.; Measelle, Jeffrey R.; Armstrong, Jeffrey M.; Essex, Marilyn J.

2010-01-01

This study utilized growth mixture modeling to examine the impact of parents, child care providers, teachers, and peers on the prediction of distinct developmental patterns of classroom externalizing behavior in elementary school. Among 241 children, three groups were identified. 84.6% of children exhibited consistently low externalizing behavior. The externalizing behavior of the Chronic High group (5.8%) remained elevated throughout elementary school; it increased over time in the Low Increasing group (9.5%). Negative relationships with teachers and peers in the kindergarten classroom increased the odds of having chronically high externalizing behavior. Teacher–child conflict increased the likelihood of a developmental pattern of escalating externalizing behavior. Boys were overrepresented in the behaviorally risky groups, and no sex differences in trajectory types were found. PMID:21094398

nuSTORM Costing document

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

Bross, Alan D.

2013-10-01

Detailed costing of the nuSTORM conventional facilities has been done by the Fermilab Facilities Engineering Services Section (FESS) and is reported on in the nuSTORM Project Definition Report (PDR) 6-13-1. Estimates for outfitting the primary proton beam line, the target station, the pion capture/transport line and decay ring are based on either experience from existing Fermilab infrastructure (NuMI) or is based on the detailed costing exercises for DOE CD-1 approval for future experiments (mu2e and LBNE). The detector costing utilized the Euronu costing for the Neutrino Factory Magnetized Iron Neutrino Detector (MIND), extrapolations from MINOS as-built costs and from recentmore » vendor quotes. Costs included all manpower and are fully burdened (FY2013 dollars). The costs are not escalated, however, beyond the 5-year project timeline, since a project start for nuSTORM is unknown. Escalation can be estimated from various models (see Figure 1). LBNE has used the Jacob’s model to determine their cost escalation.« less

Conventional external beam radiotherapy for central nervous system malignancies

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

Halperin, E.C.; Burger, P.C.

1985-11-01

Fractionated external beam photon radiotherapy is an important component of the clinical management of malignant disease of the central nervous system. The practicing neurologist or neurosurgeon frequently relies on the consultative and treatment skills of a radiotherapist. This article provides a review for the nonradiotherapist of the place of conventional external beam radiotherapy in neuro-oncology. 23 references.

In-air RBS measurements at the LAMFI external beam setup

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

Silva, T. F.; Added, N.; Moro, M. V.

2014-11-11

This work describes new developments in the external beam setup of the Laboratory of Material Analysis with Ion Beams of the University of São Paulo (LAMFI-USP). This setup was designed to be a versatile analytical station to analyze a broad range of samples. In recent developments, we seek the external beam Rutherford Backscattering Spectroscopy (RBS) analysis to complement the Particle Induced X-ray Emission (PIXE) measurements. This work presents the initial results of the external beam RBS analysis as well as recent developments to improve the energy resolution RBS measurements, in particular tests to seek for sources of resolution degradation. Thesemore » aspects are discussed and preliminary results of in-air RBS analysis of some test samples are presented.« less

Multi-institutional Prospective Evaluation of Bowel Quality of Life After Prostate External Beam Radiation Therapy Identifies Patient and Treatment Factors Associated With Patient-Reported Outcomes: The PROSTQA Experience

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

Hamstra, Daniel A., E-mail: dhamm@med.umich.edu; Conlon, Anna S.C.; Daignault, Stephanie

Purpose: To evaluate patients treated with external beam radiation therapy as part of the multicenter Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment (PROSTQA), to identify factors associated with posttreatment patient-reported bowel health-related quality of life (HRQOL). Methods and Materials: Pretreatment characteristics and treatment details among 292 men were evaluated using a general linear mixed model for their association with measured HRQOL by the Expanded Prostate Cancer Index Composite instrument through 2 years after enrollment. Results: Bowel HRQOL had a median score of 100 (interquartile range 91.7-100) pretreatment and 95.8 (interquartile range 83.3-100) at 2 years, representing new moderate/bigmore » problems in 11% for urgency, 7% for frequency, 4% for bloody stools, and 8% for an overall bowel problems. Baseline bowel score was the strongest predictor for all 2-year endpoints. In multivariable models, a volume of rectum ≥25% treated to 70 Gy (V70) yielded a clinically significant 9.3-point lower bowel score (95% confidence interval [CI] 16.8-1.7, P=.015) and predicted increased risks for moderate to big fecal incontinence (P=.0008). No other radiation therapy treatment-related variables influenced moderate to big changes in rectal HRQOL. However, on multivariate analyses V70 ≥25% was associated with increases in small, moderate, or big problems with the following: incontinence (3.9-fold; 95% CI 1.1-13.4, P=.03), rectal bleeding (3.6-fold; 95% CI 1.3-10.2, P=.018), and bowel urgency (2.9-fold; 95% CI 1.1-7.6, P=.026). Aspirin use correlated with a clinically significant 4.7-point lower bowel summary score (95% CI 9.0-0.4, P=.03) and an increase in small, moderate, or big problems with bloody stools (2.8-fold; 95% CI 1.2-6.4, P=.018). Intensity modulated radiation therapy was associated with higher radiation therapy doses to the prostate and lower doses to the rectum but did not independently correlate with bowel HRQOL. Conclusion: After contemporary dose-escalated external beam radiation therapy up to 11% of patients have newly identified moderate/big problems with bowel HRQOL 2 years after treatment. Bowel HRQOL is related to baseline function, rectal V70, and aspirin use. Finally, our findings validate the commonly utilized cut-point of rectal V70 ≥25% as having significant impact on patient-reported outcomes.« less

Is modern external beam radiotherapy with androgen deprivation therapy still a viable alternative for prostate cancer in an era of robotic surgery and brachytherapy: a comparison of Australian series.

PubMed

Wilcox, Shea William; Aherne, Noel J; McLachlan, Craig Steven; McKay, Michael J; Last, Andrew J; Shakespeare, Thomas P

2015-02-01

We compare the results of modern external-beam radiotherapy (EBRT), using combined androgen deprivation and dose-escalated intensity-modulated radiotherapy with MRI-CT fusion and daily image guidance with fiducial markers (DE-IG-IMRT), with recently published Australian series of brachytherapy and surgery. Five-year actuarial biochemical disease-free survival (bDFS), metastasis-free survival (MFS) and prostate cancer-specific survival (PCaSS) were calculated for 675 patients treated with DE-IG-IMRT and androgen deprivation therapy (ADT). Patients had intermediate-risk (IR) and high-risk (HR) disease. A search was conducted identifying Australian reports from 2005 onwards of IR and HR patients treated with surgery or brachytherapy, reporting actuarial outcomes at 3 years or later. With a median follow-up of 59 months, our 5-year bDFS was 93.3% overall: 95.5% for IR and 91.3% for HR disease. MFS was 96.9% overall (99.0% IR, 94.9% HR), and PCaSS was 98.8% overall (100% IR, 97.7% HR). Prevalence of Grade 2 genitourinary and gastrointestinal toxicity at 5 years was 1.3% and 1.6%, with 0.3% Grade 3 genitourinary toxicity and no Grade 3 gastrointestinal toxicity. Eight reports of brachytherapy and surgery were identified. The HDR brachytherapy series' median 5-year bDFS was 82.5%, MFS 90.0% and PCaSS 97.9%. One surgical series reported 5-year bDFS of 65.5% for HR patients. One LDR series reported 5-year bDFS of 85% for IR patients. Modern EBRT is at least as effective as modern Australian surgical and brachytherapy techniques. All patients considering treatment for localised prostate cancer should be referred to a radiation oncologist to discuss EBRT as an equivalent option. © 2015 The Royal Australian and New Zealand College of Radiologists.

The Impact of Image Management, Self-Justification, and Escalation of Commitment on Knowledge Development in the Marketing Discipline

ERIC Educational Resources Information Center

Sharmaa, Dheeraj; Albers-Miller, Nancy D.; Pelton, Lou E.; Straughan, Robert D.

2006-01-01

The paramount role of scholarship in the modern academic environment is manifest across program accreditation, individual evaluation, and institutional reputation processes. At the microlevel, success in this domain positively influences scholars' performance evaluations and institutions' external reputations. At the macrolevel, research expands…

Natural calamities and 'the Big Migration': challenges to the Mongolian health system in 'the Age of the Market'.

PubMed

Lindskog, Benedikte V

2014-01-01

Beginning with the demise of the socialist state system in 1990, Mongolia embarked on a process of neoliberal economic reform, initiating what is known among the Mongols as 'the Age of the Market'. The socialist health system has been replaced by a series of reforms initiated and substantiated by foreign donor organisations. This paper critically examines Mongolia's health system and discusses the extent to which this 'system', despite its provision of universal, accessible and essential primary health care services, is unable to accommodate the health needs of poor urban in-migrants and nomadic herders in remote provinces. With a particular focus on recurrent natural winter disasters (dzud) and an escalating rural to urban migration, the paper argues that the issues of access to health services and health system strengthening must be understood in relation to factors external to the health system. Ethnographic research highlights that despite a growing economy, considerable external aid and an established primary health care model, weak rural politics, environmental challenges and economic constraints create escalating health vulnerability among the poorest in Mongolia.

Radiotherapy in poor risk patients with stage I cancer of the endometrium: results of not giving external beam radiotherapy.

PubMed

DeCruze, B; Guthrie, D

1999-01-01

Poor prognosis (poorly differentiated and/or deep myometrial invasion) Stage I endometrial cancer can have a relapse rate as high as 50%. Traditionally, most clinical oncologists treat these patients with external beam radiotherapy after surgery but there is no evidence to show that this improves survival. The retrospective study looks at the results of not giving external beam radiotherapy in 25 consecutive patients and compares the results with a group of 13 consecutive patients who did have such treatment. The two groups were comparable with regard to age, degree of differentiation and degree of invasion. Survival was comparable in the two groups. There is no evidence of any obvious decrease in survival from withholding external beam radiotherapy, but this was not a prospective randomized controlled trial. This study illustrates that it is essential that the Medical Research Council ASTEC trial should be supported because this will determine the true place of external beam radiotherapy in such patients.

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

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

Narayana, V; McLaughlin, P; University of Michigan, Ann Arbor, MI

2015-06-15

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

Sample holder with optical features

DOEpatents

Milas, Mirko; Zhu, Yimei; Rameau, Jonathan David

2013-07-30

A sample holder for holding a sample to be observed for research purposes, particularly in a transmission electron microscope (TEM), generally includes an external alignment part for directing a light beam in a predetermined beam direction, a sample holder body in optical communication with the external alignment part and a sample support member disposed at a distal end of the sample holder body opposite the external alignment part for holding a sample to be analyzed. The sample holder body defines an internal conduit for the light beam and the sample support member includes a light beam positioner for directing the light beam between the sample holder body and the sample held by the sample support member.

Transmission electron microscope sample holder with optical features

DOEpatents

Milas, Mirko [Port Jefferson, NY; Zhu, Yimei [Stony Brook, NY; Rameau, Jonathan David [Coram, NY

2012-03-27

A sample holder for holding a sample to be observed for research purposes, particularly in a transmission electron microscope (TEM), generally includes an external alignment part for directing a light beam in a predetermined beam direction, a sample holder body in optical communication with the external alignment part and a sample support member disposed at a distal end of the sample holder body opposite the external alignment part for holding a sample to be analyzed. The sample holder body defines an internal conduit for the light beam and the sample support member includes a light beam positioner for directing the light beam between the sample holder body and the sample held by the sample support member.

The role of external beam radiotherapy in the treatment of hepatocellular cancer.

PubMed

Chino, Fumiko; Stephens, Sarah Jo; Choi, Steve S; Marin, Daniele; Kim, Charles Y; Morse, Michael A; Godfrey, Devon J; Czito, Brian G; Willett, Christopher G; Palta, Manisha

2018-04-12

Hepatocellular carcinoma (HCC) is increasing in incidence and mortality. Although the prognosis remains poor, long-term survival has improved from 3% in 1970 to an 18% 5-year survival rate today. This is likely because of the introduction of well tolerated, oral antiviral therapies for hepatitis C. Curative options for patients with HCC are often limited by underlying liver dysfunction/cirrhosis and medical comorbidities. Less than one-third of patients are candidates for surgery, which is the current gold standard for cure. Nonsurgical treatments include embolotherapies, percutaneous ablation, and ablative radiation. Technological advances in radiation delivery in the past several decades now allow for safe and effective ablative doses to the liver. Conformal techniques allow for both dose escalation to target volumes and normal tissue sparing. Multiple retrospective and prospective studies have demonstrated that hypofractionated image-guided radiation therapy, used as monotherapy or in combination with other liver-directed therapies, can provide excellent local control that is cost effective. Therefore, as the HCC treatment paradigm continues to evolve, ablative radiation treatment has moved from a palliative treatment to both a "bridge to transplant" and a definitive treatment. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

Propagation characteristics of a focused laser beam in a strontium barium niobate photorefractive crystal under reverse external electric field.

PubMed

Guo, Q L; Liang, B L; Wang, Y; Deng, G Y; Jiang, Y H; Zhang, S H; Fu, G S; Simmonds, P J

2014-10-01

The propagation characteristics of a focused laser beam in a SBN:75 photorefractive crystal strongly depend on the signal-to-background intensity ratio (R=I_s/I_b) under reverse external electric field. In the range 20>R>0.05, the laser beam shows enhanced self-defocusing behavior with increasing external electric field, while it shows self-focusing in the range 0.03>R>0.01. Spatial solitons are observed under a suitable reverse external electric field for R=0.025. A theoretical model is proposed to explain the experimental observations, which suggest a new type of soliton formation due to "enhancement" not "screening" of the external electrical field.

Effect of electron beam cooling on transversal and longitudinal emittance of an external proton beam

NASA Astrophysics Data System (ADS)

Kilian, K.; Machner, H.; Magiera, A.; Prasuhn, D.; von Rossen, P.; Siudak, R.; Stein, H. J.; Stockhorst, H.

2018-02-01

Benefits of electron cooling to the quality of extracted ion beams from storage rings are discussed. The transversal emittances of an external proton beam with and without electron cooling at injection energy are measured with the GEM detector assembly. While the horizontal emittance remains the vertical emittance shrinks by the cooling process. The longitudinal momentum variance is also reduced by cooling.

Natural calamities and ‘the Big Migration’: Challenges to the Mongolian health system in ‘the Age of the Market’

PubMed Central

Lindskog, Benedikte V.

2014-01-01

Beginning with the demise of the socialist state system in 1990, Mongolia embarked on a process of neoliberal economic reform, initiating what is known among the Mongols as ‘the Age of the Market’. The socialist health system has been replaced by a series of reforms initiated and substantiated by foreign donor organisations. This paper critically examines Mongolia's health system and discusses the extent to which this ‘system’, despite its provision of universal, accessible and essential primary health care services, is unable to accommodate the health needs of poor urban in-migrants and nomadic herders in remote provinces. With a particular focus on recurrent natural winter disasters (dzud) and an escalating rural to urban migration, the paper argues that the issues of access to health services and health system strengthening must be understood in relation to factors external to the health system. Ethnographic research highlights that despite a growing economy, considerable external aid and an established primary health care model, weak rural politics, environmental challenges and economic constraints create escalating health vulnerability among the poorest in Mongolia. PMID:25132243

Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomised trials): pooled trial results, systematic review, and meta-analysis.

PubMed

Blake, P; Swart, Ann Marie; Orton, J; Kitchener, H; Whelan, T; Lukka, H; Eisenhauer, E; Bacon, M; Tu, D; Parmar, M K B; Amos, C; Murray, C; Qian, W

2009-01-10

Early endometrial cancer with low-risk pathological features can be successfully treated by surgery alone. External beam radiotherapy added to surgery has been investigated in several small trials, which have mainly included women at intermediate risk of recurrence. In these trials, postoperative radiotherapy has been shown to reduce the risk of isolated local recurrence but there is no evidence that it improves recurrence-free or overall survival. We report the findings from the ASTEC and EN.5 trials, which investigated adjuvant external beam radiotherapy in women with early-stage disease and pathological features suggestive of intermediate or high risk of recurrence and death from endometrial cancer. Between July, 1996, and March, 2005, 905 (789 ASTEC, 116 EN.5) women with intermediate-risk or high-risk early-stage disease from 112 centres in seven countries (UK, Canada, Poland, Norway, New Zealand, Australia, USA) were randomly assigned after surgery to observation (453) or to external beam radiotherapy (452). A target dose of 40-46 Gy in 20-25 daily fractions to the pelvis, treating five times a week, was specified. Primary outcome measure was overall survival, and all analyses were by intention to treat. These trials were registered ISRCTN 16571884 (ASTEC) and NCT 00002807 (EN.5). After a median follow-up of 58 months, 135 women (68 observation, 67 external beam radiotherapy) had died. There was no evidence that overall survival with external beam radiotherapy was better than observation, hazard ratio 1.05 (95% CI 0.75-1.48; p=0.77). 5-year overall survival was 84% in both groups. Combining data from ASTEC and EN.5 in a meta-analysis of trials confirmed that there was no benefit in terms of overall survival (hazard ratio 1.04; 95% CI 0.84-1.29) and can reliably exclude an absolute benefit of external beam radiotherapy at 5 years of more than 3%. With brachytherapy used in 53% of women in ASTEC/EN.5, the local recurrence rate in the observation group at 5 years was 6.1%. Adjuvant external beam radiotherapy cannot be recommended as part of routine treatment for women with intermediate-risk or high-risk early-stage endometrial cancer with the aim of improving survival. The absolute benefit of external beam radiotherapy in preventing isolated local recurrence is small and is not without toxicity.

An external milli-beam for archaeometric applications on the AGLAE IBA facility of the Louvre museum

NASA Astrophysics Data System (ADS)

Calligaro, T.; Dran, J.-C.; Hamon, H.; Moignard, B.; Salomon, J.

1998-03-01

External beam lines have been built on numerous IBA facilities for the analysis of works of art to avoid sampling and vacuum potentially detrimental to the integrity of such precious objects. On the other hand, growing interest lies on microprobe systems which provide a high lateral resolution but which usually work under vacuum. Until recently, the AGLAE facility was equipped with separate external beam and microprobe lines. The need of a better spatial resolution in the external beam mode has led us to combine them into a single system which exhibits numerous advantages and allows the analysis of small heterogeneities like inclusions in gemstones or tiny components of composite samples. The triplet of quadrupole lenses bought from Oxford is used to focus the beam. By using a 0.75 μm thick Al foil as the exit window, blowing a helium flow around the beam spot and reducing the window-sample distance below 3 mm, a beam size of about 30 μm can be reached. The experimental setup includes two Si(Li), a HPGe and a Si surface barrier detectors for the simultaneous implementation of PIXE, NRA and RBS. The full description of this device is given as well as a few applications to highlight its capability.

Development and Commissioning of an External Beam Facility in the Union College Ion Beam Analysis Laboratory

NASA Astrophysics Data System (ADS)

Yoskowitz, Joshua; Clark, Morgan; Labrake, Scott; Vineyard, Michael

2015-10-01

We have developed an external beam facility for the 1.1-MV tandem Pelletron accelerator in the Union College Ion Beam Analysis Laboratory. The beam is extracted from an aluminum pipe through a 1 / 4 ' ' diameter window with a 7.5- μm thick Kapton foil. This external beam facility allows us to perform ion beam analysis on samples that cannot be put under vacuum, including wet samples and samples too large to fit into the scattering chamber. We have commissioned the new facility by performing proton induced X-ray emission (PIXE) analysis of several samples of environmental interest. These include samples of artificial turf, running tracks, and a human tooth with an amalgam filling. A 1.7-MeV external proton beam was incident on the samples positioned 2 cm from the window. The resulting X-rays were measured using a silicon drift detector and were analyzed using GUPIX software to determine the concentrations of elements in the samples. The results on the human tooth indicate that while significant concentrations of Hg, Ag, and Sn are present in the amalgam filling, only trace amounts of Hg appear to have leached into the tooth. The artificial turf and running tracks show rather large concentrations of a broad range of elements and trace amounts of Pb in the turf infill.

External-cavity beam combining of 4-channel quantum cascade lasers

NASA Astrophysics Data System (ADS)

Zhao, Yue; Zhang, Jin-Chuan; Zhou, Yu-Hong; Jia, Zhi-Wei; Zhuo, Ning; Zhai, Shen-Qiang; Wang, Li-Jun; Liu, Jun-Qi; Liu, Shu-Man; Liu, Feng-Qi; Wang, Zhan-Guo

2017-09-01

We demonstrate an external-cavity (EC) beam combining of 4-channel quantum cascade lasers (QCLs) with an output coupler which makes different QCL beams propagating coaxially. A beam combining efficiency of 35% (up to 75% near threshold) is obtained with a beam quality M2 of 5.5. A peak power of 0.64 W is achieved at a wavelength of 4.7 μm. The differences of spot characteristic between coupled and uncoupled are also showed in this letter. The QCLs in this EC system do not have heat crosstalk so that the system can be used for high power beam combining of QCLs.

A rapid communication from the AAPM Task Group 201: recommendations for the QA of external beam radiotherapy data transfer. AAPM TG 201: quality assurance of external beam radiotherapy data transfer.

PubMed

Siochi, R Alfredo; Balter, Peter; Bloch, Charles D; Santanam, Lakshmi; Blodgett, Kurt; Curran, Bruce H; Engelsman, Martijn; Feng, Wenzheng; Mechalakos, Jim; Pavord, Dan; Simon, Tom; Sutlieff, Steven; Zhu, X Ronald

2010-12-04

The transfer of radiation therapy data among the various subsystems required for external beam treatments is subject to error. Hence, the establishment and management of a data transfer quality assurance program is strongly recommended. It should cover the QA of data transfers of patient specific treatments, imaging data, manually handled data and historical treatment records. QA of the database state (logical consistency and information integrity) is also addressed to ensure that accurate data are transferred.

Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomised trials): pooled trial results, systematic review, and meta-analysis

PubMed Central

2009-01-01

Summary Background Early endometrial cancer with low-risk pathological features can be successfully treated by surgery alone. External beam radiotherapy added to surgery has been investigated in several small trials, which have mainly included women at intermediate risk of recurrence. In these trials, postoperative radiotherapy has been shown to reduce the risk of isolated local recurrence but there is no evidence that it improves recurrence-free or overall survival. We report the findings from the ASTEC and EN.5 trials, which investigated adjuvant external beam radiotherapy in women with early-stage disease and pathological features suggestive of intermediate or high risk of recurrence and death from endometrial cancer. Methods Between July, 1996, and March, 2005, 905 (789 ASTEC, 116 EN.5) women with intermediate-risk or high-risk early-stage disease from 112 centres in seven countries (UK, Canada, Poland, Norway, New Zealand, Australia, USA) were randomly assigned after surgery to observation (453) or to external beam radiotherapy (452). A target dose of 40–46 Gy in 20–25 daily fractions to the pelvis, treating five times a week, was specified. Primary outcome measure was overall survival, and all analyses were by intention to treat. These trials were registered ISRCTN 16571884 (ASTEC) and NCT 00002807 (EN.5). Findings After a median follow-up of 58 months, 135 women (68 observation, 67 external beam radiotherapy) had died. There was no evidence that overall survival with external beam radiotherapy was better than observation, hazard ratio 1·05 (95% CI 0·75–1·48; p=0·77). 5-year overall survival was 84% in both groups. Combining data from ASTEC and EN.5 in a meta-analysis of trials confirmed that there was no benefit in terms of overall survival (hazard ratio 1·04; 95% CI 0·84–1·29) and can reliably exclude an absolute benefit of external beam radiotherapy at 5 years of more than 3%. With brachytherapy used in 53% of women in ASTEC/EN.5, the local recurrence rate in the observation group at 5 years was 6·1%. Interpretation Adjuvant external beam radiotherapy cannot be recommended as part of routine treatment for women with intermediate-risk or high-risk early-stage endometrial cancer with the aim of improving survival. The absolute benefit of external beam radiotherapy in preventing isolated local recurrence is small and is not without toxicity. Funding Medical Research Council, National Cancer Research Network, National Cancer Institute of Canada, with funds from the Canadian Cancer Society. PMID:19070891

Development of an external beam nuclear microprobe on the Aglae facility of the Louvre museum

NASA Astrophysics Data System (ADS)

Calligaro, T.; Dran, J.-C.; Ioannidou, E.; Moignard, B.; Pichon, L.; Salomon, J.

2000-03-01

The external beam line of our facility has been recently equipped with the focusing system previously mounted on a classical nuclear microprobe. When using a 0.1 μm thick Si 3N 4 foil for the exit window and flowing helium on the sample under analysis, a beam spot as small as 10 μm is attainable at a distance of 3 mm from the window. Elemental micromapping is performed by mechanical scanning. An electronic device has been designed which allows XY scanning by moving the sample under the beam by steps down to 0.1 μm. Beam monitoring is carried out by means of the weak X-ray signal emitted by the exit foil and detected by a specially designed Si(Li) detector cooled by Peltier effect. The characteristics of external beams of protons and alpha particles are evaluated by means of resonance scanning and elemental mapping of a grid. An example of application is presented, dealing with elemental micro-mapping of inclusions in gemstones.

Failure to Achieve a PSA Level {<=}1 ng/mL After Neoadjuvant LHRHA Therapy Predicts for Lower Biochemical Control Rate and Overall Survival in Localized Prostate Cancer Treated With Radiotherapy

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

Mitchell, Darren M.; McAleese, Jonathan; Park, Richard M.

2007-12-01

Purpose: To investigate whether failure to suppress the prostate-specific antigen (PSA) level to {<=}1 ng/mL after {>=}2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy in patients scheduled to undergo external beam radiotherapy for localized prostate carcinoma is associated with reduced biochemical failure-free survival. Methods and Materials: A retrospective case note review of consecutive patients with intermediate- or high-risk localized prostate cancer treated between January 2001 and December 2002 with neoadjuvant hormonal deprivation therapy, followed by concurrent hormonal therapy and radiotherapy was performed. Patient data were divided for analysis according to whether the PSA level in Week 1 of radiotherapymore » was {<=}1.0 ng/mL. Biochemical failure was determined using the American Society for Therapeutic Radiology and Oncology (Phoenix) definition. Results: A total of 119 patients were identified. The PSA level after neoadjuvant hormonal deprivation therapy was {<=}1 ng/mL in 67 patients and >1 ng/mL in 52. At a median follow-up of 49 months, the 4-year actuarial biochemical failure-free survival rate was 84% vs. 60% (p = 0.0016) in favor of the patients with a PSA level after neoadjuvant hormonal deprivation therapy of {<=}1 ng/mL. The overall survival rate was 94% vs. 77.5% (p = 0.0045), and the disease-specific survival rate at 4 years was 98.5% vs. 82.5%. Conclusions: The results of our study have shown that patients with a PSA level >1 ng/mL at the beginning of external beam radiotherapy after {>=}2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy have a significantly greater rate of biochemical failure and lower survival rate compared with those with a PSA level of {<=}1 ng/mL. Patients without adequate PSA suppression should be considered a higher risk group and considered for dose escalation or the use of novel treatments.« less

Normal Tissue Complication Probability (NTCP) modeling of late rectal bleeding following external beam radiotherapy for prostate cancer: A Test of the QUANTEC-recommended NTCP model.

PubMed

Liu, Mitchell; Moiseenko, Vitali; Agranovich, Alexander; Karvat, Anand; Kwan, Winkle; Saleh, Ziad H; Apte, Aditya A; Deasy, Joseph O

2010-10-01

Validating a predictive model for late rectal bleeding following external beam treatment for prostate cancer would enable safer treatments or dose escalation. We tested the normal tissue complication probability (NTCP) model recommended in the recent QUANTEC review (quantitative analysis of normal tissue effects in the clinic). One hundred and sixty one prostate cancer patients were treated with 3D conformal radiotherapy for prostate cancer at the British Columbia Cancer Agency in a prospective protocol. The total prescription dose for all patients was 74 Gy, delivered in 2 Gy/fraction. 159 3D treatment planning datasets were available for analysis. Rectal dose volume histograms were extracted and fitted to a Lyman-Kutcher-Burman NTCP model. Late rectal bleeding (>grade 2) was observed in 12/159 patients (7.5%). Multivariate logistic regression with dose-volume parameters (V50, V60, V70, etc.) was non-significant. Among clinical variables, only age was significant on a Kaplan-Meier log-rank test (p=0.007, with an optimal cut point of 77 years). Best-fit Lyman-Kutcher-Burman model parameters (with 95% confidence intervals) were: n = 0.068 (0.01, +infinity); m =0.14 (0.0, 0.86); and TD50 = 81 (27, 136) Gy. The peak values fall within the 95% QUANTEC confidence intervals. On this dataset, both models had only modest ability to predict complications: the best-fit model had a Spearman's rank correlation coefficient of rs = 0.099 (p = 0.11) and area under the receiver operating characteristic curve (AUC) of 0.62; the QUANTEC model had rs=0.096 (p= 0.11) and a corresponding AUC of 0.61. Although the QUANTEC model consistently predicted higher NTCP values, it could not be rejected according to the χ(2) test (p = 0.44). Observed complications, and best-fit parameter estimates, were consistent with the QUANTEC-preferred NTCP model. However, predictive power was low, at least partly because the rectal dose distribution characteristics do not vary greatly within this patient cohort.

Preoperative Single-Fraction Partial Breast Radiation Therapy: A Novel Phase 1, Dose-Escalation Protocol With Radiation Response Biomarkers

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

Horton, Janet K., E-mail: janet.horton@duke.edu; Blitzblau, Rachel C.; Yoo, Sua

Purpose: Women with biologically favorable early-stage breast cancer are increasingly treated with accelerated partial breast radiation (PBI). However, treatment-related morbidities have been linked to the large postoperative treatment volumes required for external beam PBI. Relative to external beam delivery, alternative PBI techniques require equipment that is not universally available. To address these issues, we designed a phase 1 trial utilizing widely available technology to 1) evaluate the safety of a single radiation treatment delivered preoperatively to the small-volume, intact breast tumor and 2) identify imaging and genomic markers of radiation response. Methods and Materials: Women aged ≥55 years with clinically node-negative,more » estrogen receptor–positive, and/or progesterone receptor–positive HER2−, T1 invasive carcinomas, or low- to intermediate-grade in situ disease ≤2 cm were enrolled (n=32). Intensity modulated radiation therapy was used to deliver 15 Gy (n=8), 18 Gy (n=8), or 21 Gy (n=16) to the tumor with a 1.5-cm margin. Lumpectomy was performed within 10 days. Paired pre- and postradiation magnetic resonance images and patient tumor samples were analyzed. Results: No dose-limiting toxicity was observed. At a median follow-up of 23 months, there have been no recurrences. Physician-rated cosmetic outcomes were good/excellent, and chronic toxicities were grade 1 to 2 (fibrosis, hyperpigmentation) in patients receiving preoperative radiation only. Evidence of dose-dependent changes in vascular permeability, cell density, and expression of genes regulating immunity and cell death were seen in response to radiation. Conclusions: Preoperative single-dose radiation therapy to intact breast tumors is well tolerated. Radiation response is marked by early indicators of cell death in this biologically favorable patient cohort. This study represents a first step toward a novel partial breast radiation approach. Preoperative radiation should be tested in future clinical trials because it has the potential to challenge the current treatment paradigm and provide a path forward to identify radiation response biomarkers.« less

Scaling the spectral beam combining channel by multiple diode laser stacks in an external cavity

NASA Astrophysics Data System (ADS)

Meng, Huicheng; Ruan, Xu; Du, Weichuan; Wang, Zhao; Lei, Fuchuan; Yu, Junhong; Tan, Hao

2017-04-01

Spectral beam combining of a broad area diode laser is a promising technique for direct diode laser applications. We present an experimental study of three mini-bar stacks in an external cavity on spectral beam combining in conjunction with spatial beam combining. At the pump current of 70 A, a CW output power of 579 W, spectral bandwidth of 18.8 nm and electro-optical conversion efficiency of 47% are achieved. The measured M 2 values of spectral beam combining are 18.4 and 14.7 for the fast and the slow axis, respectively. The brightness of the spectral beam combining output is 232 MW · cm-2 · sr-1.

What to Know about External Beam Radiation Therapy

MedlinePlus

... Radiation Therapy: What To Know About External Beam Radiation Therapy Before treatment starts: You will meet with a doctor or ... and show the therapist where to aim the radiation. When you go for treatment: ■ Don’t have powder, deodorant, Band-Aids ® , or ...

Deterrence Without Escalation:A Case for the Arctic in 2040

DTIC Science & Technology

2015-04-08

electromagnetic pulse (EMP) from a nuclear blast.69 Typical shielding used to protect an asset from an EMP generated by a nuclear blast is...weapons could travel at hypersonic speeds, but the beam must propagate through a plasma field—the same plasma field that causes the ‘radio blackout...Blechman and Stephen S Kaplan, Force Without War: U.S. Armed Forces as a Political Instrument. (Washington, DC: The Brookings Institution, 1978), 4

Electro-optic harmonic conversion to switch a laser beam out of a cavity

DOEpatents

Haas, Roger A.; Henesian, Mark A.

1987-01-01

The invention is a switch to permit a laser beam to escape a laser cavity through the use of an externally applied electric field across a harmonic conversion crystal. Amplification takes place in the laser cavity, and then the laser beam is switched out by the laser light being harmonically converted with dichroic or polarization sensitive elements present to alter the optical path of the harmonically converted laser light. Modulation of the laser beam can also be accomplished by varying the external electric field.

The Patient Burden of Bladder Outlet Obstruction after Prostate Cancer Treatment.

PubMed

Liberman, Daniel; Jarosek, Stephanie; Virnig, Beth A; Chu, Haitao; Elliott, Sean P

2016-05-01

Bladder outlet obstruction after prostate cancer therapy imposes a significant burden on health and quality of life in men. Our objective was to describe the burden of bladder outlet obstruction after prostate cancer therapy by detailing the type of procedures performed and how often those procedures were repeated in men with recurrent bladder outlet obstruction. Using SEER (Surveillance, Epidemiology and End Results)-Medicare linked data from 1992 to 2007 with followup through 2009 we identified 12,676 men who underwent at least 1 bladder outlet obstruction procedure after prostate cancer therapy, including external beam radiotherapy in 3,994, brachytherapy in 1,485, brachytherapy plus external beam radiotherapy in 1,847, radical prostatectomy in 4,736, radical prostatectomy plus external beam radiotherapy in 369 and cryotherapy in 245. Histogram, incidence rates and Cox proportional hazards models with repeat events analysis were done to describe the burden of repeat bladder outlet obstruction treatments stratified by prostate cancer therapy type. We describe the type of bladder outlet obstruction surgery grouped by level of invasiveness. At a median followup of 8.8 years 44.6% of men underwent 2 or more bladder outlet obstruction procedures. Compared to men who underwent radical prostatectomy those treated with brachytherapy and brachytherapy plus external beam radiotherapy were at increased adjusted risk for repeat bladder outlet obstruction treatment (HR 1.2 and 1.32, respectively, each p <0.05). After stricture incision the men treated with radical prostatectomy or radical prostatectomy plus external beam radiotherapy were most likely to undergo dilation at a rate of 34.7% to 35.0%. Stricture resection/ablation was more common after brachytherapy, external beam radiotherapy or brachytherapy plus external beam radiotherapy at a rate of 28.9% to 41.2%. Almost half of the men with bladder outlet obstruction after prostate cancer therapy undergo more than 1 procedure. Furthermore men with bladder outlet obstruction after radiotherapy undergo more invasive endoscopic therapies and are at higher risk for multiple treatments than men with bladder outlet obstruction after radical prostatectomy. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Beam profiles measured with thermoluminescent dosimeters

NASA Technical Reports Server (NTRS)

Lucks, H.; Marcowitz, S. M.; Wheeler, R. W.

1969-01-01

Beam profilometer, using thermoluminescent dosimeters, gives a quantitative and qualitative representation of the focus of an external protron beam of a synchrotron. The total number of particles in the beam, particle distribution, and the shape of the beam are determined.

Fast wavelength tuning techniques for external cavity lasers

DOEpatents

Wysocki, Gerard [Princeton, NJ; Tittel, Frank K [Houston, TX

2011-01-11

An apparatus comprising a laser source configured to emit a light beam along a first path, an optical beam steering component configured to steer the light beam from the first path to a second path at an angle to the first path, and a diffraction grating configured to reflect back at least a portion of the light beam along the second path, wherein the angle determines an external cavity length. Included is an apparatus comprising a laser source configured to emit a light beam along a first path, a beam steering component configured to redirect the light beam to a second path at an angle to the first path, wherein the optical beam steering component is configured to change the angle at a rate of at least about one Kilohertz, and a diffraction grating configured to reflect back at least a portion of the light beam along the second path.

External beam pixe programs at the University of California, Davis

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

Eldred, R.A.

A PIXE system in which large or delicate samples are excited by a low-current external proton beam is described. This system has been used to analyze historical printed books and manuscripts, as well as a large variety of archeological artifacts. The steps used to protect the sample from unnecessary beam current are examined. A recent thorough study of the first volume of the Gutenberg 42-line Bible is described in some detail.

The American Society for Therapeutic Radiology and Oncology (ASTRO) evidence-based review of the role of radiosurgery for malignant glioma

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

Tsao, May N.; Mehta, Minesh P.; Whelan, Timothy J.

2005-09-01

Purpose: To systematically review the evidence for the use of stereotactic radiosurgery or stereotactic fractionated radiation therapy in adult patients with malignant glioma. Methods: Key clinical questions to be addressed in this evidence-based review were identified. Outcomes considered were overall survival, quality of life or symptom control, brain tumor control or response and toxicity. MEDLINE (1990-2004 June Week 2), CANCERLIT (1990-2003), CINAHL (1990-2004 June Week 2), EMBASE (1990-2004 Week 25), and the Cochrane library (2004 issue 2) databases were searched using OVID. In addition, the Physician Data Query clinical trials database, the proceedings of the American Society of Clinical Oncologymore » (1997-2004), ASTRO (1997-2004), and the European Society of Therapeutic Radiology and Oncology (ESTRO) (1997-2003) were searched. Data from the literature search were reviewed and tabulated. This process included an assessment of the level of evidence. Results: For patients with newly diagnosed malignant glioma, radiosurgery as boost therapy with conventional external beam radiation was examined in one randomized trial, five prospective cohort studies, and seven retrospective series. There is Level I evidence that the use of radiosurgery boost followed by external beam radiotherapy and carmustine (BCNU) does not confer benefit with respect to overall survival, quality of life, or patterns of failure as compared with external beam radiotherapy and BCNU. There is Level I-III evidence of toxicity associated with radiosurgery boost as compared with external beam radiotherapy alone. The results of the prospective and retrospective studies may be influenced by selection bias. Radiosurgery used as salvage for recurrent or progressive malignant glioma after conventional external beam radiotherapy failure was reported in zero randomized trials, three prospective cohort studies, and five retrospective series. The available data are sparse and insufficient to make absolute recommendations. Stereotactic fractionated radiation therapy has been reported as boost therapy with external beam radiotherapy for patients with newly diagnosed malignant glioma in only three prospective studies. As primary therapy alone without conventional external beam radiotherapy for newly diagnosed malignant glioma patients, stereotactic fractionated radiation therapy has been reported in only one prospective study. There were only three prospective series and two retrospective studies reported for patients with recurrent or progressive malignant glioma. Conclusions: For patients with malignant glioma, there is Level I-III evidence that the use of radiosurgery boost followed by external beam radiotherapy and BCNU does not confer benefit in terms of overall survival, local brain control, or quality of life as compared with external beam radiotherapy and BCNU. The use of radiosurgery boost is associated with increased toxicity. For patients with malignant glioma, there is insufficient evidence regarding the benefits/harms of using radiosurgery at the time progression or recurrence. There is also insufficient evidence regarding the benefits/harms in the use of stereotactic fractionated radiation therapy for patients with newly diagnosed or progressive/recurrent malignant glioma.« less

Evaluation of surface and shallow depth dose reductions using a Superflab bolus during conventional and advanced external beam radiotherapy.

PubMed

Yoon, Jihyung; Xie, Yibo; Zhang, Rui

2018-03-01

The purpose of this study was to evaluate a methodology to reduce scatter and leakage radiations to patients' surface and shallow depths during conventional and advanced external beam radiotherapy. Superflab boluses of different thicknesses were placed on top of a stack of solid water phantoms, and the bolus effect on surface and shallow depth doses for both open and intensity-modulated radiotherapy (IMRT) beams was evaluated using thermoluminescent dosimeters and ion chamber measurements. Contralateral breast dose reduction caused by the bolus was evaluated by delivering clinical postmastectomy radiotherapy (PMRT) plans to an anthropomorphic phantom. For the solid water phantom measurements, surface dose reduction caused by the Superflab bolus was achieved only in out-of-field area and on the incident side of the beam, and the dose reduction increased with bolus thickness. The dose reduction caused by the bolus was more significant at closer distances from the beam. Most of the dose reductions occurred in the first 2-cm depth and stopped at 4-cm depth. For clinical PMRT treatment plans, surface dose reductions using a 1-cm Superflab bolus were up to 31% and 62% for volumetric-modulated arc therapy and 4-field IMRT, respectively, but there was no dose reduction for Tomotherapy. A Superflab bolus can be used to reduce surface and shallow depth doses during external beam radiotherapy when it is placed out of the beam and on the incident side of the beam. Although we only validated this dose reduction strategy for PMRT treatments, it is applicable to any external beam radiotherapy and can potentially reduce patients' risk of developing radiation-induced side effects. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Analysis of errors detected in external beam audit dosimetry program at Mexican radiotherapy centers

NASA Astrophysics Data System (ADS)

Álvarez-Romero, José T.; Tovar-Muñoz, Víctor M.

2012-10-01

Presented and analyzed are the causes of deviation observed in the pilot postal dosimetry audit program to verify the absorbed dose to water Dw in external beams of teletherapy 60Co and/or linear accelerators in Mexican radiotherapy centers, during the years 2007-2011.

A study of the effect of in-line and perpendicular magnetic fields on beam characteristics of electron guns in medical linear accelerators.

PubMed

Constantin, Dragoş E; Fahrig, Rebecca; Keall, Paul J

2011-07-01

Using magnetic resonance imaging (MRI) for real-time guidance during radiotherapy is an active area of research and development. One aspect of the problem is the influence of the MRI scanner, modeled here as an external magnetic field, on the medical linear accelerator (linac) components. The present work characterizes the behavior of two medical linac electron guns with external magnetic fields for in-line and perpendicular orientations of the linac with respect to the MRI scanner. Two electron guns, Litton L-2087 and Varian VTC6364, are considered as representative models for this study. Emphasis was placed on the in-line design approach in which case the MRI scanner and the linac axes of symmetry coincide and assumes no magnetic shielding of the linac. For the in-line case, the magnetic field from a 0.5 T open MRI (GE Signa SP) magnet with a 60 cm gap between its poles was computed and used in full three dimensional (3D) space charge simulations, whereas for the perpendicular case the magnetic field was constant. For the in-line configuration, it is shown that the electron beam is not deflected from the axis of symmetry of the gun and the primary beam current does not vanish even at very high values of the magnetic field, e.g., 0.16 T. As the field strength increases, the primary beam current has an initial plateau of constant value after which its value decreases to a minimum corresponding to a field strength of approximately 0.06 T. After the minimum is reached, the current starts to increase slowly. For the case when the beam current computation is performed at the beam waist position the initial plateau ends at 0.016 T for Litton L-2087 and at 0.012 T for Varian VTC6364. The minimum value of the primary beam current is 27.5% of the initial value for Litton L-2087 and 22.9% of the initial value for Varian VTC6364. The minimum current is reached at 0.06 and 0.062 T for Litton L-2087 and Varian VTC6364, respectively. At 0.16 T the beam current increases to 40.2 and 31.4% from the original value of the current for Litton L-2087 and Varian VTC6364, respectively. In contrast, for the case when the electron gun is perpendicular to the magnetic field, the electron beam is deflected from the axis of symmetry even at small values of the magnetic field. As the strength of the magnetic field increases, so does the beam deflection, leading to a sharp decrease of the primary beam current which vanishes at about 0.007 T for Litton L-2087 and at 0.006 T for Varian VTC6364, respectively. At zero external field, the beam rms emittance computed at beam waist is 1.54 and 1.29n-mm-mrad for Litton L-2087 and Varian VTC6364, respectively. For the inline configuration, there are two particular values of the external field where the beam rms emittance reaches a minimum. Litton L-2087 rms emittance reaches a minimum of 0.72n and 2.01 n-mm-mrad at 0.026 and 0.132 T, respectively. Varian VTC6364 rms emittance reaches a minimum of 0.34n and 0.35n-mm-mrad at 0.028 and 0.14 T, respectively. Beam radius dependence on the external field is shown for the in-line configuration for both electron guns. 3D space charge simulation of two electron guns, Litton L-2087 and Varian VTC6364, were performed for in-line and perpendicular external magnetic fields. A consistent behavior of Pierce guns in external magnetic fields was proven. For the in-line configuration, the primary beam current does not vanish but a large reduction of beam current (up to 77.1%) is observed at higher field strengths; the beam directionality remains unchanged. It was shown that for a perpendicular configuration the current vanishes due to beam bending under the action of the Lorentz force. For in-line configuration it was determined that the rms beam emittance reaches two minima for relatively high values of the external magnetic field.

A study of the effect of in-line and perpendicular magnetic fields on beam characteristics of electron guns in medical linear accelerators

PubMed Central

Constantin, Dragoş E.; Fahrig, Rebecca; Keall, Paul J.

2011-01-01

Purpose: Using magnetic resonance imaging (MRI) for real-time guidance during radiotherapy is an active area of research and development. One aspect of the problem is the influence of the MRI scanner, modeled here as an external magnetic field, on the medical linear accelerator (linac) components. The present work characterizes the behavior of two medical linac electron guns with external magnetic fields for in-line and perpendicular orientations of the linac with respect to the MRI scanner. Methods: Two electron guns, Litton L-2087 and Varian VTC6364, are considered as representative models for this study. Emphasis was placed on the in-line design approach in which case the MRI scanner and the linac axes of symmetry coincide and assumes no magnetic shielding of the linac. For the in-line case, the magnetic field from a 0.5 T open MRI (GE Signa SP) magnet with a 60 cm gap between its poles was computed and used in full three dimensional (3D) space charge simulations, whereas for the perpendicular case the magnetic field was constant. Results: For the in-line configuration, it is shown that the electron beam is not deflected from the axis of symmetry of the gun and the primary beam current does not vanish even at very high values of the magnetic field, e.g., 0.16 T. As the field strength increases, the primary beam current has an initial plateau of constant value after which its value decreases to a minimum corresponding to a field strength of approximately 0.06 T. After the minimum is reached, the current starts to increase slowly. For the case when the beam current computation is performed at the beam waist position the initial plateau ends at 0.016 T for Litton L-2087 and at 0.012 T for Varian VTC6364. The minimum value of the primary beam current is 27.5% of the initial value for Litton L-2087 and 22.9% of the initial value for Varian VTC6364. The minimum current is reached at 0.06 and 0.062 T for Litton L-2087 and Varian VTC6364, respectively. At 0.16 T the beam current increases to 40.2 and 31.4% from the original value of the current for Litton L-2087 and Varian VTC6364, respectively. In contrast, for the case when the electron gun is perpendicular to the magnetic field, the electron beam is deflected from the axis of symmetry even at small values of the magnetic field. As the strength of the magnetic field increases, so does the beam deflection, leading to a sharp decrease of the primary beam current which vanishes at about 0.007 T for Litton L-2087 and at 0.006 T for Varian VTC6364, respectively. At zero external field, the beam rms emittance computed at beam waist is 1.54 and 1.29π-mm-mrad for Litton L-2087 and Varian VTC6364, respectively. For the in-line configuration, there are two particular values of the external field where the beam rms emittance reaches a minimum. Litton L-2087 rms emittance reaches a minimum of 0.72π and 2.01π-mm-mrad at 0.026 and 0.132 T, respectively. Varian VTC6364 rms emittance reaches a minimum of 0.34π and 0.35π-mm-mrad at 0.028 and 0.14 T, respectively. Beam radius dependence on the external field is shown for the in-line configuration for both electron guns. Conclusions: 3D space charge simulation of two electron guns, Litton L-2087 and Varian VTC6364, were performed for in-line and perpendicular external magnetic fields. A consistent behavior of Pierce guns in external magnetic fields was proven. For the in-line configuration, the primary beam current does not vanish but a large reduction of beam current (up to 77.1%) is observed at higher field strengths; the beam directionality remains unchanged. It was shown that for a perpendicular configuration the current vanishes due to beam bending under the action of the Lorentz force. For in-line configuration it was determined that the rms beam emittance reaches two minima for relatively high values of the external magnetic field. PMID:21859019

The Electrical Structure of Discharges Modified by Electron Beams

NASA Astrophysics Data System (ADS)

Haas, F. A.; Braithwaite, N. St. J.

1997-10-01

Injection of an electron beam into a low pressure plasma modifies both the electrical structure and the distributions of charged particle energies. The electrical structure is investigated here in a one-dimensional model by representing the discharge as two collisionless sheaths with a monenergetic electron beam, linked by a quasi-neutral collisional region. The latter is modelled by fluid equations in which the beam current decreases with position. Since the electrodes are connected by an external conductor this implies through Kirchoff's laws that the thermal electron current must correspondingly increase with position. Given the boundary conditions and beam input at the first electrode then the rest of the system is uniquely described. The model reveals the dependence of the sheath potentials at the emitting and absorbing surfaces on the beam current. The model is relevant to externally injected beams and to electron beams originating from secondary processes on surfaces exposed to the plasma.

Improvements to the internal and external antenna H(-) ion sources at the Spallation Neutron Source.

PubMed

Welton, R F; Dudnikov, V G; Han, B X; Murray, S N; Pennisi, T R; Pillar, C; Santana, M; Stockli, M P; Turvey, M W

2014-02-01

The Spallation Neutron Source (SNS), a large scale neutron production facility, routinely operates with 30-40 mA peak current in the linac. Recent measurements have shown that our RF-driven internal antenna, Cs-enhanced, multi-cusp ion sources injects ∼55 mA of H(-) beam current (∼1 ms, 60 Hz) at 65-kV into a Radio Frequency Quadrupole (RFQ) accelerator through a closely coupled electrostatic Low-Energy Beam Transport system. Over the last several years a decrease in RFQ transmission and issues with internal antennas has stimulated source development at the SNS both for the internal and external antenna ion sources. This report discusses progress in improving internal antenna reliability, H(-) yield improvements which resulted from modifications to the outlet aperture assembly (applicable to both internal and external antenna sources) and studies made of the long standing problem of beam persistence with the external antenna source. The current status of the external antenna ion source will also be presented.

The Percent of Positive Biopsy Cores Improves Prediction of Prostate Cancer-Specific Death in Patients Treated With Dose-Escalated Radiotherapy

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

Qian Yushen; Feng, Felix Y.; Veterans Administration Medical Center, Ann Arbor, MI

2011-11-01

Purpose: To examine the prognostic utility of the percentage of positive cores (PPC) at the time of prostate biopsy for patients treated with dose-escalated external beam radiation therapy. Methods and Materials: We performed a retrospective analysis of patients treated at University of Michigan Medical Center to at least 75 Gy. Patients were stratified according to PPC by quartile, and freedom from biochemical failure (nadir + 2 ng/mL), freedom from metastasis (FFM), cause-specific survival (CSS), and overall survival (OS) were assessed by log-rank test. Receiver operator characteristic (ROC) curve analysis was used to determine the optimal cut point for PPC stratification.more » Finally, Cox proportional hazards multivariate regression was used to assess the impact of PPC on clinical outcome when adjusting for National Comprehensive Cancer Network (NCCN) risk group and androgen deprivation therapy. Results: PPC information was available for 651 patients. Increasing-risk features including T stage, prostate-specific antigen, Gleason score, and NCCN risk group were all directly correlated with increasing PPC. On log-rank evaluation, all clinical endpoints, except for OS, were associated with PPC by quartile, with worse clinical outcomes as PPC increased, with the greatest impact seen in the highest quartile (>66.7% of cores positive). ROC curve analysis confirmed that a cut point using two-thirds positive cores was most closely associated with CSS (p = 0.002; area under ROC curve, 0.71). On univariate analysis, stratifying patients according to PPC less than or equal to 66.7% vs. PPC greater than 66.7% was prognostic for freedom from biochemical failure (p = 0.0001), FFM (p = 0.0002), and CSS (p = 0.0003) and marginally prognostic for OS (p = 0.055). On multivariate analysis, after adjustment for NCCN risk group and androgen deprivation therapy use, PPC greater than 66.7% increased the risk for biochemical failure (p = 0.0001; hazard ratio [HR], 2.1 [95% confidence interval (CI), 1.4-3.0]) and FFM (p = 0.05; HR, 1.7 [95% CI, 1.1-2.9]) and marginally increased the risk for CSS (p = 0.057; HR, 2.1 [95% CI, 1.0-4.6]). Conclusion: PPC at the time of biopsy adds prognostic value for clinically meaningful endpoints for patients treated with dose-escalated radiation therapy. This was particularly true for NCCN-defined intermediate- and high-risk patients.« less

Influence of age on the pattern and outcome of external beam radiotherapy for clinically localized prostate cancer.

PubMed

Ogawa, Kazuhiko; Nakamura, Katsumasa; Onishi, Hiroshi; Koizumi, Masahiko; Sasaki, Tomonari; Araya, Masayuki; Miyabe, Yuuki; Otani, Yuuki; Teshima, Teruki

2006-01-01

The influence of age on the patterns and outcomes of external beam radiotherapy for clinically localized prostate cancer patients was examined. The Japanese Patterns of Care Study surveys were used to compare the processes and outcomes of radical external beam radiotherapy in 140 elderly patients (>75 years old) and 304 younger patients (<75 years old). Although the Karnofsky performance status was significantly different between elderly and younger patients, there were no significant differences in disease characteristics such as pretreatment PSA level, differentiation, Gleason combined score and clinical T stage. There were also no significant differences in the treatment characteristics such as CT-based treatment planning, conformal therapy, total radiation doses (both a median of 66.0 Gy) and hormonal therapy usage. Moreover, no significant differences in overall survival, biochemical relapse-free survival and late toxicity rates were observed between elderly and younger patients. Age did not influence the disease characteristics, patterns of external beam radiotherapy, survival and late toxicities for clinically localized prostate cancer patients. Therefore, radiotherapy could represent an important treatment modality for elderly patients as well as for younger ones.

The drift chamber array at the external target facility in HIRFL-CSR

NASA Astrophysics Data System (ADS)

Sun, Y. Z.; Sun, Z. Y.; Wang, S. T.; Duan, L. M.; Sun, Y.; Yan, D.; Tang, S. W.; Yang, H. R.; Lu, C. G.; Ma, P.; Yu, Y. H.; Zhang, X. H.; Yue, K.; Fang, F.; Su, H.

2018-06-01

A drift chamber array at the External Target Facility in HIRFL-CSR has been constructed for three-dimensional particle tracking in high-energy radioactive ion beam experiments. The design, readout, track reconstruction program and calibration procedures for the detector are described. The drift chamber array was tested in a 311 AMeV 40Ar beam experiment. The detector performance based on the measurements of the beam test is presented. A spatial resolution of 230 μm is achieved.

A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.

PubMed

Cohen, Deborah J; Balasubramanian, Bijal A; Gordon, Leah; Marino, Miguel; Ono, Sarah; Solberg, Leif I; Crabtree, Benjamin F; Stange, Kurt C; Davis, Melinda; Miller, William L; Damschroder, Laura J; McConnell, K John; Creswell, John

2016-06-29

The Agency for Healthcare Research and Quality (AHRQ) launched the EvidenceNOW Initiative to rapidly disseminate and implement evidence-based cardiovascular disease (CVD) preventive care in smaller primary care practices. AHRQ funded eight grantees (seven regional Cooperatives and one independent national evaluation) to participate in EvidenceNOW. The national evaluation examines quality improvement efforts and outcomes for more than 1500 small primary care practices (restricted to those with fewer than ten physicians per clinic). Examples of external support include practice facilitation, expert consultation, performance feedback, and educational materials and activities. This paper describes the study protocol for the EvidenceNOW national evaluation, which is called Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES). This prospective observational study will examine the portfolio of EvidenceNOW Cooperatives using both qualitative and quantitative data. Qualitative data include: online implementation diaries, observation and interviews at Cooperatives and practices, and systematic assessment of context from the perspective of Cooperative team members. Quantitative data include: practice-level performance on clinical quality measures (aspirin prescribing, blood pressure and cholesterol control, and smoking cessation; ABCS) collected by Cooperatives from electronic health records (EHRs); practice and practice member surveys to assess practice capacity and other organizational and structural characteristics; and systematic tracking of intervention delivery. Quantitative, qualitative, and mixed methods analyses will be conducted to examine how Cooperatives organize to provide external support to practices, to compare effectiveness of the dissemination and implementation approaches they implement, and to examine how regional variations and other organization and contextual factors influence implementation and effectiveness. ESCALATES is a national evaluation of an ambitious large-scale dissemination and implementation effort focused on transforming smaller primary care practices. Insights will help to inform the design of national health care practice extension systems aimed at supporting practice transformation efforts in the USA. NCT02560428 (09/21/15).

Positron Emission Tomography for Pre-Clinical Sub-Volume Dose Escalation

NASA Astrophysics Data System (ADS)

Bass, Christopher Paul

Purpose: This dissertation focuses on establishment of pre-clinical methods facilitating the use of PET imaging for selective sub-volume dose escalation. Specifically the problems addressed are 1.) The difficulties associated with comparing multiple PET images, 2.) The need for further validation of novel PET tracers before their implementation in dose escalation schema and 3.) The lack of concrete pre-clinical data supporting the use of PET images for guidance of selective sub-volume dose escalations. Methods and materials: In order to compare multiple PET images the confounding effects of mispositioning and anatomical change between imaging sessions needed to be alleviated. To mitigate the effects of these sources of error, deformable image registration was employed. A deformable registration algorithm was selected and the registration error was evaluated via the introduction of external fiducials to the tumor. Once a method for image registration was established, a procedure for validating the use of novel PET tracers with FDG was developed. Nude mice were used to perform in-vivo comparisons of the spatial distributions of two PET tracers, FDG and FLT. The spatial distributions were also compared across two separate tumor lines to determine the effects of tumor morphology on spatial distribution. Finally, the research establishes a method for acquiring pre-clinical data supporting the use of PET for image-guidance in selective dose escalation. Nude mice were imaged using only FDG PET/CT and the resulting images were used to plan PET-guided dose escalations to a 5 mm sub-volume within the tumor that contained the highest PET tracer uptake. These plans were then delivered using the Small Animal Radiation Research Platform (SARRP) and the efficacy of the PET-guided plans was observed. Results and Conclusions: The analysis of deformable registration algorithms revealed that the BRAINSFit B-spline deformable registration algorithm available in SLICER3D was capable of registering small animal PET/CT data sets in less than 5 minutes with an average registration error of .3 mm. The methods used in chapter 3 allowed for the comparison of the spatial distributions of multiple PET tracers imaged at different times. A comparison of FDG and FLT showed that both are positively correlated but that tumor morphology does significantly affect the correlation between the two tracers. An overlap analysis of the high intensity PET regions of FDG and FLT showed that FLT offers additional spatial information to that seen with FDG. In chapter 4 the SARRP allowed for the delivery of planned PET-guided selective dose escalations to a pre-clinical tumor model. This will facilitate future research validating the use of PET for clinical selective dose escalation.

On finding the analytic dependencies of the external field potential on the control function when optimizing the beam dynamics

NASA Astrophysics Data System (ADS)

Ovsyannikov, A. D.; Kozynchenko, S. A.; Kozynchenko, V. A.

2017-12-01

When developing a particle accelerator for generating the high-precision beams, the injection system design is of importance, because it largely determines the output characteristics of the beam. At the present paper we consider the injection systems consisting of electrodes with given potentials. The design of such systems requires carrying out simulation of beam dynamics in the electrostatic fields. For external field simulation we use the new approach, proposed by A.D. Ovsyannikov, which is based on analytical approximations, or finite difference method, taking into account the real geometry of the injection system. The software designed for solving the problems of beam dynamics simulation and optimization in the injection system for non-relativistic beams has been developed. Both beam dynamics and electric field simulations in the injection system which use analytical approach and finite difference method have been made and the results presented in this paper.

Simulation of the development and interaction of instabilities in a relativistic electron beam under variation of the beam wall thickness

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

Badarin, A. A.; Kurkin, S. A.; Koronovskii, A. A.

The development and interaction of Bursian and diocotron instabilities in an annular relativistic electron beam propagating in a cylindrical drift chamber are investigated analytically and numerically as functions of the beam wall thickness and the magnitude of the external uniform magnetic field. It is found that the interaction of instabilities results in the formation of a virtual cathode with a complicated rotating helical structure and several reflection regions (electron bunches) in the azimuthal direction. It is shown that the number of electron bunches in the azimuthal direction increases with decreasing beam wall thickness and depends in a complicated manner onmore » the magnitude of the external magnetic field.« less

Quasi-plane-hypothesis of strain coordination for RC beams seismically strengthened with externally-bonded or near-surface mounted fiber reinforced plastic

NASA Astrophysics Data System (ADS)

Ren, Zhenhua; Zeng, Xiantao; Liu, Hanlong; Zhou, Fengjun

2013-03-01

The application of fiber reinforced plastic (FRP), including carbon FRP and glass FRP, for structural repair and strengthening has grown due to their numerous advantages over conventional materials such as externally bonded reinforcement (EBR) and near-surface mounted (NSM) strengthening techniques. This paper summarizes the results from 21 reinforced concrete beams strengthened with different methods, including externally-bonded and near-surface mounted FRP, to study the strain coordination of the FRP and steel rebar of the RC beam. Since there is relative slipping between the RC beam and the FRP, the strain of the FRP and steel rebar of the RC beam satisfy the quasi-plane-hypothesis; that is, the strain of the longitudinal fiber that parallels the neutral axis of the plated beam within the scope of the effective height ( h 0) of the cross section is in direct proportion to the distance from the fiber to the neutral axis. The strain of the FRP and steel rebar satisfies the equation: ɛ FRP= βɛ steel, and the value of β is equal to 1.1-1.3 according to the test results.

The use of cognitive-behavioral treatment including hypnosis for claustrophobia in cancer patients.

PubMed

Steggles, S

1999-04-01

Two case studies are reported to illustrate the use of a comprehensive cognitive-behavioral approach to treat claustrophobia in cancer patients undergoing external beam radiation therapy. Hypnosis was an essential component of the cognitive-behavioral approach. Both patients responded favorably to the psychological intervention and completed the required external beam radiation therapy.

Hole-cyclotron instability in semiconductor quantum plasmas

NASA Astrophysics Data System (ADS)

Areeb, F.; Rasheed, A.; Jamil, M.; Siddique, M.; Sumera, P.

2018-01-01

The excitation of electrostatic hole-cyclotron waves generated by an externally injected electron beam in semiconductor plasmas is examined using a quantum hydrodynamic model. The quantum effects such as tunneling potential, Fermi degenerate pressure, and exchange-correlation potential are taken care of. The growth rate of the wave is analyzed on varying the parameters normalized by hole-plasma frequency, like the angle θ between propagation vector and B0∥z ̂ , speed of the externally injected electron beam v0∥k , thermal temperature of the electron beam τ, external magnetic field B0∥z ̂ that modifies the hole-cyclotron frequency, and finally, the semiconductor electron number density. The instability of the hole-cyclotron wave seeks its applications in semiconductor devices.

Metasurface external cavity laser

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

Xu, Luyao, E-mail: luyaoxu.ee@ucla.edu; Curwen, Christopher A.; Williams, Benjamin S.

2015-11-30

A vertical-external-cavity surface-emitting-laser is demonstrated in the terahertz range, which is based upon an amplifying metasurface reflector composed of a sub-wavelength array of antenna-coupled quantum-cascade sub-cavities. Lasing is possible when the metasurface reflector is placed into a low-loss external cavity such that the external cavity—not the sub-cavities—determines the beam properties. A near-Gaussian beam of 4.3° × 5.1° divergence is observed and an output power level >5 mW is achieved. The polarized response of the metasurface allows the use of a wire-grid polarizer as an output coupler that is continuously tunable.

Strengthening Performance of PALF-Epoxy Composite Plate on Reinforced Concrete Beams

NASA Astrophysics Data System (ADS)

Chin, Siew C.; Tong, Foo S.; Doh, Shu I.; Gimbun, Jolius; Ong, Huey R.; Serigar, Januar P.

2018-03-01

This paper presents the effective strengthening potential of pineapple leaves fiber (PALF)-epoxy composite plate on reinforced concrete (RC) beam. At first the PALF is treated with alkali (NaOH) and its morphology is observed via scanning electron microscope (SEM). The composite plates made of PALF and epoxy with fiber loading ranging from 0.1 to 0.4 v/v was tested for its flexural behaviour. The composite was then used for external RC beam strengthening. The structural properties of RC beams were evaluated and all the beams were tested under four-point bending. It was found that the flexural strength increased as the fiber volume ratio increases. The maximum flexural strength (301.94 MPa) was obtained at the fiber volume ratio of 40%. The beam strengthened with PALF-epoxy composite plate has a 7% higher beam capacity compared to the control beam. Cracks formed at the edge of the plate of PALF-strengthened beams resulted in diagonal cracking. Result from this work shows that the PALF-epoxy composite plate has the potential to be used as external strengthening material for RC beam.

Generation of a pulsed low-energy electron beam using the channel spark device

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

Elgarhy, M. A. I., E-mail: elgarhy@azhar.edu.eg; Hassaballa, S. E.; Rashed, U. M.

2015-12-15

For the generation of low-energy electron beam, the design and characteristics of channel spark discharge (CSD) operating at a low voltage are presented in this paper. The discharge voltage, discharge current, X-ray emissions, and electron beam current were experimentally determined. The effects of the applied voltage, working gas pressure, and external capacitance on the CSD and beam parameters were measured. At an applied voltage of 11 kV, an oxygen gas pressure of 25 mTorr, and an external capacitance of 16.45 nF, the maximum measured current was 900 A. The discharge current increased with the increase in the pressure and capacitance,more » while its periodic time decreased with the increase in the pressure. Two types of the discharge were identified and recorded: the hollow cathode discharge and the conduction discharge. A Faraday cup was used to measure the beam current. The maximum measured beam current was 120 A, and the beam signal exhibited two peaks. The increase in both the external capacitance and the applied discharge voltage increased the maximum electron beam current. The electron-beam pulse time decreased with the increase in the gas pressure at a constant voltage and increased with the decrease in the applied discharge voltage. At an applied voltage of 11 kV and an oxygen gas pressure of 15 mTorr, the maximum beam energy was 2.8 keV. The X-ray signal intensity decreased with the increase in the gas pressure and increased with the increase in the capacitance.« less

A study of the effect of in-line and perpendicular magnetic fields on beam characteristics of electron guns in medical linear accelerators

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

Constantin, Dragos E.; Fahrig, Rebecca; Keall, Paul J.

Purpose: Using magnetic resonance imaging (MRI) for real-time guidance during radiotherapy is an active area of research and development. One aspect of the problem is the influence of the MRI scanner, modeled here as an external magnetic field, on the medical linear accelerator (linac) components. The present work characterizes the behavior of two medical linac electron guns with external magnetic fields for in-line and perpendicular orientations of the linac with respect to the MRI scanner. Methods: Two electron guns, Litton L-2087 and Varian VTC6364, are considered as representative models for this study. Emphasis was placed on the in-line design approachmore » in which case the MRI scanner and the linac axes of symmetry coincide and assumes no magnetic shielding of the linac. For the in-line case, the magnetic field from a 0.5 T open MRI (GE Signa SP) magnet with a 60 cm gap between its poles was computed and used in full three dimensional (3D) space charge simulations, whereas for the perpendicular case the magnetic field was constant. Results: For the in-line configuration, it is shown that the electron beam is not deflected from the axis of symmetry of the gun and the primary beam current does not vanish even at very high values of the magnetic field, e.g., 0.16 T. As the field strength increases, the primary beam current has an initial plateau of constant value after which its value decreases to a minimum corresponding to a field strength of approximately 0.06 T. After the minimum is reached, the current starts to increase slowly. For the case when the beam current computation is performed at the beam waist position the initial plateau ends at 0.016 T for Litton L-2087 and at 0.012 T for Varian VTC6364. The minimum value of the primary beam current is 27.5% of the initial value for Litton L-2087 and 22.9% of the initial value for Varian VTC6364. The minimum current is reached at 0.06 and 0.062 T for Litton L-2087 and Varian VTC6364, respectively. At 0.16 T the beam current increases to 40.2 and 31.4% from the original value of the current for Litton L-2087 and Varian VTC6364, respectively. In contrast, for the case when the electron gun is perpendicular to the magnetic field, the electron beam is deflected from the axis of symmetry even at small values of the magnetic field. As the strength of the magnetic field increases, so does the beam deflection, leading to a sharp decrease of the primary beam current which vanishes at about 0.007 T for Litton L-2087 and at 0.006 T for Varian VTC6364, respectively. At zero external field, the beam rms emittance computed at beam waist is 1.54 and 1.29{pi}-mm-mrad for Litton L-2087 and Varian VTC6364, respectively. For the in-line configuration, there are two particular values of the external field where the beam rms emittance reaches a minimum. Litton L-2087 rms emittance reaches a minimum of 0.72{pi} and 2.01{pi}-mm-mrad at 0.026 and 0.132 T, respectively. Varian VTC6364 rms emittance reaches a minimum of 0.34{pi} and 0.35{pi}-mm-mrad at 0.028 and 0.14 T, respectively. Beam radius dependence on the external field is shown for the in-line configuration for both electron guns. Conclusions: 3D space charge simulation of two electron guns, Litton L-2087 and Varian VTC6364, were performed for in-line and perpendicular external magnetic fields. A consistent behavior of Pierce guns in external magnetic fields was proven. For the in-line configuration, the primary beam current does not vanish but a large reduction of beam current (up to 77.1%) is observed at higher field strengths; the beam directionality remains unchanged. It was shown that for a perpendicular configuration the current vanishes due to beam bending under the action of the Lorentz force. For in-line configuration it was determined that the rms beam emittance reaches two minima for relatively high values of the external magnetic field.« less

Multi-frequency klystron designed for high efficiency

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

Jensen, Aaron

A multi-frequency klystron has an electron gun which generates a beam, a circuit of bunch-align-collect (BAC) tuned cavities that bunch the beam and amplify an RF signal, a collector where the beam is collected and dumped, and a standard output cavity and waveguide coupled to a window to output RF power at a fundamental mode to an external load. In addition, the klystron has additional bunch-align-collect (BAC) cavities tuned to a higher harmonic frequency, and a harmonic output cavity and waveguide coupled via a window to an additional external load.

MO-A-BRB-03: Integration Issues in Electronic Charting for External Beam Therapy

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

Sutlief, S.

2015-06-15

The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiationmore » therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy.« less

SU-E-T-183: Feasibility of Extreme Dose Escalation for Glioblastoma Multiforme Using 4π Radiotherapy

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

Nguyen, D; Rwigema, J; Yu, V

Purpose: GBM recurrence primarily occurs inside or near the high-dose radiation field of original tumor site requiring greater than 100 Gy to significantly improve local control. We utilize 4π non-coplanar radiotherapy to test the feasibility of planning target volume (PTV) margin expansions or extreme dose escalations without incurring additional radiation toxicities. Methods: 11 GBM patients treated with VMAT to a prescription dose of 59.4 Gy or 60 Gy were replanned with 4π. Original VMAT plans were created with 2 to 4 coplanar or non-coplanar arcs using 3 mm hi-res MLC. The 4π optimization, using 5 mm MLC, selected and inversemore » optimized 30 beams from a candidate pool of 1162 beams evenly distributed through 4π steradians. 4π plans were first compared to clinical plans using the same prescription dose. Two more studies were then performed to respectively escalate the GTV and PTV doses to 100 Gy, followed by a fourth plan expanding the PTV by 5 mm and maintaining the prescription dose. Results: The standard 4π plan significantly reduced (p<0.01) max and mean doses to critical structures by a range of 47.0–98.4% and 61.0–99.2%, respectively. The high dose PTV/high dose GTV/expanded PTV studies showed a reduction (p<0.05) or unchanged* (p>0.05) maximum dose of 72.1%/86.7%/77.1% (chiasm), 7.2%*/27.7%*/30.7% (brainstem), 39.8%*/84.2%/51.9%* (spinal cord), 69.0%/87.0%/66.9% (L eye), 76.2%/88.1%/84.1% (R eye), 95.0%/98.6%/97.5% (L lens), 93.9%/98.8%/97.6% (R lens), 74.3%/88.5%/72.4% (L optical nerve), 80.4%/91.3%/75.7% (R optical nerve), 64.8%/84.2%/44.9%* (L cochlea), and 85.2%/93.0%/78.0% (R cochlea), respectively. V30 and V36 for both brain and (brain - PTV) were reduced for all cases except the high dose PTV plan. PTV dose coverage increased for all 4π plans. Conclusion: Extreme dose escalation or further margin expansion is achievable using 4π, maintaining or reducing OAR doses. This study indicates that clinical trials employing 4π delivery using prescription doses up to 100 Gy are feasible. Funding support partially contributed by Varian.« less

Optical properties of monolayer polystyrene microspheres driven by a direct current

NASA Astrophysics Data System (ADS)

Jiao, Xinbing; Pan, Qian; Zhao, Xinwei; Hao, Ruirui; Bai, Xue

2018-04-01

Polystyrene microspheres (PSMs) with diameters of 5 μm and 10 μm are prepared on garnet by a self-assembly method. The pressure generated by quartz sheet/PSM/garnet/graphite is measured by a resistance strain sensor as a function of the external direct current (DC) voltage. The surface morphology of the PSMs are observed by optical microscopy. The polarization properties of the linearly and circularly polarized laser beams with a wavelength of 1550 nm reflected from the different PSMs are researched by a Thorlabs PAX 5710 IR3 Polarization Analyzing System as a function of the external DC voltage. The results show that the PSMs with different sizes can be damaged when the external pressure exceeds its critical value of 3.0 MPa, but the critical DC voltages are different. The optical polarization properties of the circularly polarized laser beam can be changed with the external DC voltage, whereas the linearly polarized laser beam cannot be changed.

Stability of aerosol droplets in Bessel beam optical traps under constant and pulsed external forces

NASA Astrophysics Data System (ADS)

David, Grégory; Esat, Kıvanç; Hartweg, Sebastian; Cremer, Johannes; Chasovskikh, Egor; Signorell, Ruth

2015-04-01

We report on the dynamics of aerosol droplets in optical traps under the influence of additional constant and pulsed external forces. Experimental results are compared with simulations of the three-dimensional droplet dynamics for two types of optical traps, the counter-propagating Bessel beam (CPBB) trap and the quadruple Bessel beam (QBB) trap. Under the influence of a constant gas flow (constant external force), the QBB trap is found to be more stable compared with the CPBB trap. By contrast, under pulsed laser excitation with laser pulse durations of nanoseconds (pulsed external force), the type of trap is of minor importance for the droplet stability. It typically needs pulsed laser forces that are several orders of magnitude higher than the optical forces to induce escape of the droplet from the trap. If the droplet strongly absorbs the pulsed laser light, these escape forces can be strongly reduced. The lower stability of absorbing droplets is a result of secondary thermal processes that cause droplet escape.

Stability of aerosol droplets in Bessel beam optical traps under constant and pulsed external forces.

PubMed

David, Grégory; Esat, Kıvanç; Hartweg, Sebastian; Cremer, Johannes; Chasovskikh, Egor; Signorell, Ruth

2015-04-21

We report on the dynamics of aerosol droplets in optical traps under the influence of additional constant and pulsed external forces. Experimental results are compared with simulations of the three-dimensional droplet dynamics for two types of optical traps, the counter-propagating Bessel beam (CPBB) trap and the quadruple Bessel beam (QBB) trap. Under the influence of a constant gas flow (constant external force), the QBB trap is found to be more stable compared with the CPBB trap. By contrast, under pulsed laser excitation with laser pulse durations of nanoseconds (pulsed external force), the type of trap is of minor importance for the droplet stability. It typically needs pulsed laser forces that are several orders of magnitude higher than the optical forces to induce escape of the droplet from the trap. If the droplet strongly absorbs the pulsed laser light, these escape forces can be strongly reduced. The lower stability of absorbing droplets is a result of secondary thermal processes that cause droplet escape.

Intensity-modulated proton therapy further reduces normal tissue exposure during definitive therapy for locally advanced distal esophageal tumors: a dosimetric study.

PubMed

Welsh, James; Gomez, Daniel; Palmer, Matthew B; Riley, Beverly A; Mayankkumar, Amin V; Komaki, Ritsuko; Dong, Lei; Zhu, X Ronald; Likhacheva, Anna; Liao, Zhongxing; Hofstetter, Wayne L; Ajani, Jaffer A; Cox, James D

2011-12-01

We have previously found that ≤ 75% of treatment failures after chemoradiotherapy for unresectable esophageal cancer appear within the gross tumor volume and that intensity-modulated (photon) radiotherapy (IMRT) might allow dose escalation to the tumor without increasing normal tissue toxicity. Proton therapy might allow additional dose escalation, with even lower normal tissue toxicity. In the present study, we compared the dosimetric parameters for photon IMRT with that for intensity-modulated proton therapy (IMPT) for unresectable, locally advanced, distal esophageal cancer. Four plans were created for each of 10 patients. IMPT was delivered using anteroposterior (AP)/posteroanterior beams, left posterior oblique/right posterior oblique (LPO/RPO) beams, or AP/LPO/RPO beams. IMRT was delivered with a concomitant boost to the gross tumor volume. The dose was 65.8 Gy to the gross tumor volume and 50.4 Gy to the planning target volume in 28 fractions. Relative to IMRT, the IMPT (AP/posteroanterior) plan led to considerable reductions in the mean lung dose (3.18 vs. 8.27 Gy, p<.0001) and the percentage of lung volume receiving 5, 10, and 20 Gy (p≤.0006) but did not reduce the cardiac dose. The IMPT LPO/RPO plan also reduced the mean lung dose (4.9 Gy vs. 8.2 Gy, p<.001), the heart dose (mean cardiac dose and percentage of the cardiac volume receiving 10, 20, and 30 Gy, p≤.02), and the liver dose (mean hepatic dose 5 Gy vs. 14.9 Gy, p<.0001). The IMPT AP/LPO/RPO plan led to considerable reductions in the dose to the lung (p≤.005), heart (p≤.003), and liver (p≤.04). Compared with IMRT, IMPT for distal esophageal cancer lowered the dose to the heart, lung, and liver. The AP/LPO/RPO beam arrangement was optimal for sparing all three organs. The dosimetric benefits of protons will need to be tailored to each patient according to their specific cardiac and pulmonary risks. IMPT for esophageal cancer will soon be investigated further in a prospective trial at our institution. Copyright © 2011 Elsevier Inc. All rights reserved.

Radiotherapy for Prostate Cancer: is it 'what you do' or 'the way that you do it'? A UK Perspective on Technique and Quality Assurance.

PubMed

Mason, M D; Moore, R; Jones, G; Lewis, G; Donovan, J L; Neal, D E; Hamdy, F C; Lane, J A; Staffurth, J N

2016-09-01

The treatment of prostate cancer has evolved markedly over the last 40 years, including radiotherapy, notably with escalated dose and targeting. However, the optimal treatment for localised disease has not been established in comparative randomised trials. The aim of this article is to describe the history of prostate radiotherapy trials, including their quality assurance processes, and to compare these with the ProtecT trial. The UK ProtecT randomised trial compares external beam conformal radiotherapy, surgery and active monitoring for clinically localised prostate cancer and will report on the primary outcome (disease-specific mortality) in 2016 following recruitment between 1999 and 2009. The embedded quality assurance programme consists of on-site machine dosimetry at the nine trial centres, a retrospective review of outlining and adherence to dose constraints based on the trial protocol in 54 participants (randomly selected, around 10% of the total randomised to radiotherapy, n = 545). These quality assurance processes and results were compared with prostate radiotherapy trials of a comparable era. There has been an increasingly sophisticated quality assurance programme in UK prostate radiotherapy trials over the last 15 years, reflecting dose escalation and treatment complexity. In ProtecT, machine dosimetry results were comparable between trial centres and with the UK RT01 trial. The outlining review showed that most deviations were clinically acceptable, although three (1.4%) may have been of clinical significance and were related to outlining of the prostate. Seminal vesicle outlining varied, possibly due to several prostate trials running concurrently with different protocols. Adherence to dose constraints in ProtecT was considered acceptable, with 80% of randomised participants having two or less deviations and planning target volume coverage was excellent. The ProtecT trial quality assurance results were satisfactory and comparable with trials of its era. Future trials should aim to standardise treatment protocols and quality assurance programmes where possible to reduce complexities for centres involved in multiple trials. Copyright © 2016. Published by Elsevier Ltd.

Dose escalation using conformal high-dose-rate brachytherapy improves outcome in unfavorable prostate cancer.

PubMed

Martinez, Alvaro A; Gustafson, Gary; Gonzalez, José; Armour, Elwood; Mitchell, Chris; Edmundson, Gregory; Spencer, William; Stromberg, Jannifer; Huang, Raywin; Vicini, Frank

2002-06-01

To overcome radioresistance for patients with unfavorable prostate cancer, a prospective trial of pelvic external beam irradiation (EBRT) interdigitated with dose-escalating conformal high-dose-rate (HDR) prostate brachytherapy was performed. Between November 1991 and August 2000, 207 patients were treated with 46 Gy pelvic EBRT and increasing HDR brachytherapy boost doses (5.50-11.5 Gy/fraction) during 5 weeks. The eligibility criteria were pretreatment prostate-specific antigen level >or=10.0 ng/mL, Gleason score >or=7, or clinical Stage T2b or higher. Patients were divided into 2 dose levels, low-dose biologically effective dose <93 Gy (58 patients) and high-dose biologically effective dose >93 Gy (149 patients). No patient received hormones. We used the American Society for Therapeutic Radiology and Oncology definition for biochemical failure. The median age was 69 years. The mean follow-up for the group was 4.4 years, and for the low and high-dose levels, it was 7.0 and 3.4 years, respectively. The actuarial 5-year biochemical control rate was 74%, and the overall, cause-specific, and disease-free survival rate was 92%, 98%, and 68%, respectively. The 5-year biochemical control rate for the low-dose group was 52%; the rate for the high-dose group was 87% (p <0.001). Improvement occurred in the cause-specific survival in favor of the brachytherapy high-dose level (p = 0.014). On multivariate analysis, a low-dose level, higher Gleason score, and higher nadir value were associated with increased biochemical failure. The Radiation Therapy Oncology Group Grade 3 gastrointestinal/genitourinary complications ranged from 0.5% to 9%. The actuarial 5-year impotency rate was 51%. Pelvic EBRT interdigitated with transrectal ultrasound-guided real-time conformal HDR prostate brachytherapy boost is both a precise dose delivery system and a very effective treatment for unfavorable prostate cancer. We demonstrated an incremental beneficial effect on biochemical control and cause-specific survival with higher doses. These results, coupled with the low risk of complications, the advantage of not being radioactive after implantation, and the real-time interactive planning, define a new standard for treatment.

The curative management of synchronous rectal and prostate cancer

PubMed Central

Kavanagh, Dara O; Martin, Joseph; Small, Cormac; Joyce, Myles R; Faul, Clare M; Kelly, Paul J; O'Riordain, Michael; Gillham, Charles M; Armstrong, John G; Salib, Osama; McNamara, Deborah A; McVey, Gerard; O'Neill, Brian D P

2016-01-01

Objective: Neoadjuvant “long-course” chemoradiation is considered a standard of care in locally advanced rectal cancer. In addition to prostatectomy, external beam radiotherapy and brachytherapy with or without androgen suppression (AS) are well established in prostate cancer management. A retrospective review of ten cases was completed to explore the feasibility and safety of applying these standards in patients with dual pathology. To our knowledge, this is the largest case series of synchronous rectal and prostate cancers treated with curative intent. Methods: Eligible patients had synchronous histologically proven locally advanced rectal cancer (defined as cT3-4Nx; cTxN1-2) and non-metastatic prostate cancer (pelvic nodal disease permissible). Curative treatment was delivered to both sites simultaneously. Follow-up was as per institutional guidelines. Acute and late toxicities were reviewed, and a literature search performed. Results: Pelvic external beam radiotherapy (RT) 45–50.4 Gy was delivered concurrent with 5-fluorouracil (5FU). Prostate total dose ranged from 70.0 to 79.2 Gy. No acute toxicities occurred, excluding AS-induced erectile dysfunction. Nine patients proceeded to surgery, and one was managed expectantly. Three relapsed with metastatic colorectal cancer, two with metastatic prostate cancer. Five patients have no evidence of recurrence, and four remain alive with metastatic disease. With a median follow-up of 2.2 years (range 1.2–6.3 years), two significant late toxicities occurred; G3 proctitis in a patient receiving palliative bevacizumab and a G3 anastomotic stricture precluding stoma reversal. Conclusion: Patients proceeding to synchronous radical treatment of both primary sites should receive 45–50.4 Gy pelvic RT with infusional 5FU. Prostate dose escalation should be given with due consideration to the potential impact of prostate cancer on patient survival, as increasing dose may result in significant late morbidity. Review of published series explores the possibility of prostate brachytherapy as an alternative method of boost delivery. Frequent use of bevacizumab in metastatic rectal cancer may compound late rectal morbidity in this cohort. Advances in knowledge: To our knowledge, this is the largest case series of synchronous rectal and prostate cancers treated with curative intent. This article contributes to the understanding of how best to approach definitive treatment in these patients. PMID:26539631

Photovoltaic spatial solitons affected by a resistor in the external circuit

NASA Astrophysics Data System (ADS)

Wang, Xiao Sheng; She, Wei Long

2002-09-01

We have found that the FWHM of one-dimensional photovoltaic spatial soliton is modified by the space-charge field in the crystal, which can be controlled by a resistor in the external circuit. In this case, the photovoltaic contribution of a background beam is taken into account. In a crystal with a positive perturbation of refractive index, the FWHM of dark soliton decreases with the resistance of the resistor, while the FWHM of bright soliton increases with the resistance. Furthermore, when R (the ratio of the effective Glass constant of a signal beam over a background beam) is higher than 1, we can switch a dark soliton to a bright soliton by decreasing the resistance or vice versa. During such process, both the wavelengths and the intensities of the signal beam and the background beam are kept unchanged.

External audits of electron beams using mailed TLD dosimetry: preliminary results.

PubMed

Gomola, I; Van Dam, J; Isern-Verdum, J; Verstraete, J; Reymen, R; Dutreix, A; Davis, B; Huyskens, D

2001-02-01

A feasibility study has been performed to investigate the possibility of using mailed thermoluminescence dosimetry (TLD) for external audits of clinical electron beams in Europe. In the frame of the EC Network Project for Quality Assurance in Radiotherapy, instruction sheets and mailing procedures have been defined for mailed TLD dosimetry using the dedicated holder developed by a panel of experts of the International Atomic Energy Agency (IAEA). Three hundred and thirty electron beam set-ups have been checked in the reference centres and some local centres of the EC Network Project and in addition through the centres participating to the EORTC Radiotherapy Group trial 22922. The mean ratio of measured dose to stated dose is 0.2% and the standard deviation of measured dose to stated dose is 3.2%. In seven beam set-ups, deviations greater than 10% were observed (max. 66%), showing the usefulness of these checks. The results of this feasibility study (instruction sheets, mailing procedures, holder) are presently endorsed by the EQUAL-ESTRO structure in order to offer in the future to all ESTRO members the possibility to request external audits of clinical electron beams.

Effect of External Post-tensioning in Retrofitting of RC Beams

NASA Astrophysics Data System (ADS)

Manisekar, R.

2018-05-01

There are large number of existing concrete bridges in distressed condition in India and other countries, and they need retrofitting solutions. External post-tensioning is a prime technique for bridge retrofitting. It is being applied for retrofitting of bridges in India and other countries. Although the technique is becoming popular in retrofitting, various issues regarding performance of post-retrofitting behaviour need to be studied in detail. RC beam specimens of rectangular section were distressed by means of cracks to a certain limit, and were retrofitted by external post-tensioning. Retrofitted specimens were tested to fail to study the post-retrofitting behaviour. Retrofitting has increased the ultimate load carrying capacity by 81% with reference to the control beam, and recovered the deflection. This paper intends to report the results of the experimental investigations, and conclusions.

Experiment study on RC frame retrofitted by the external structure

NASA Astrophysics Data System (ADS)

Liu, Chunyang; Shi, Junji; Hiroshi, Kuramoto; Taguchi, Takashi; Kamiya, Takashi

2016-09-01

A new retrofitting method is proposed herein for reinforced concrete (RC) structures through attachment of an external structure. The external structure consists of a fiber concrete encased steel frame, connection slab and transverse beams. The external structure is connected to the existing structure through a connection slab and transverse beams. Pseudostatic experiments were carried out on one unretrofitted specimen and three retrofitted frame specimens. The characteristics, including failure mode, crack pattern, hysteresis loops behavior, relationship of strain and displacement of the concrete slab, are demonstrated. The results show that the load carrying capacity is obviously increased, and the extension length of the slab and the number of columns within the external frame are important influence factors on the working performance of the existing structure. In addition, the displacement difference between the existing structure and the outer structure was caused mainly by three factors: shear deformation of the slab, extraction of transverse beams, and drift of the conjunction part between the slab and the existing frame. Furthermore, the total deformation determined by the first two factors accounted for approximately 80% of the damage, therefore these factors should be carefully considered in engineering practice to enhance the effects of this new retrofitting method.

On Interactions of Oscillation Modes for a Weakly Non-Linear Undamped Elastic Beam with AN External Force

NASA Astrophysics Data System (ADS)

BOERTJENS, G. J.; VAN HORSSEN, W. T.

2000-08-01

In this paper an initial-boundary value problem for the vertical displacement of a weakly non-linear elastic beam with an harmonic excitation in the horizontal direction at the ends of the beam is studied. The initial-boundary value problem can be regarded as a simple model describing oscillations of flexible structures like suspension bridges or iced overhead transmission lines. Using a two-time-scales perturbation method an approximation of the solution of the initial-boundary value problem is constructed. Interactions between different oscillation modes of the beam are studied. It is shown that for certain external excitations, depending on the phase of an oscillation mode, the amplitude of specific oscillation modes changes.

Study on shear strengthening of RC continuous T-beams using different layers of CFRP strips

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

Alferjani, M. B. S.; Samad, A. A. Abdul; Mohamad, Noridah

2015-05-15

Carbon fiber reinforced polymer (CFRP) laminates are externally bonded to reinforced concrete (RC) members to provide additional strength such as flexural, shear, etc. However, this paper presents the results of an experimental investigation for enhancing the shear capacity of reinforced concrete (RC) continuous T- beams using different layers of CFRP wrapping schemes. A total of three concrete beams were tested and various sheet configurations and layouts were studied to determine their effects on ultimate shear strength and shear capacity of the beams. One beam was kept as control beams, while other beams were strengthened with externally bonded CFRP strips withmore » three side bonding and one or two layers of CFRP strips. From the test results, it was found that all schemes were found to be effective in enhancing the shear strength of RC beams. It was observed that the strength increases with the number of sheet layers provided the most effective strengthening for RC continuous T- beam. Beam strengthened using this scheme showed 23.21% increase in shear capacity as compared to the control beam. Two prediction models available in literature were used for computing the contribution of CFRP strips and compared with the experimental results.« less

Influence of thermal deformation in cavity mirrors on beam propagation characteristics of high-power slab lasers

NASA Astrophysics Data System (ADS)

Wang, Zhen; Xiao, Longsheng; Wang, Wei; Wu, Chao; Tang, Xiahui

2018-01-01

Owing to their good diffusion cooling and low sensitivity to misalignment, slab-shape negative-branch unstable-waveguide resonators are widely used for high-power lasers in industry. As the output beam of the resonator is astigmatic, an external beam shaping system is required. However, the transverse dimension of the cavity mirrors in the resonator is large. For a long-time operation, the heating of cavity mirrors can be non-uniform. This results in micro-deformation and a change in the radius of curvature of the cavity mirrors, and leads to an output beam of an offset optical axis of the resonator. It was found that a change in the radius of curvature of 0.1% (1 mm) caused by thermal deformation generates a transverse displacement of 1.65 mm at the spatial filter of the external beam shaping system, and an output power loss of more than 80%. This can potentially burn out the spatial filter. In order to analyze the effect of the offset optical axis of the beam on the external optical path, we analyzed the transverse displacement and rotational misalignments of the spatial filter. For instance, if the transverse displacement was 0.3 mm, the loss in the output power was 9.6% and a sidelobe appeared in the unstable direction. If the angle of rotation was 5°, the loss in the output power was 2%, and the poles were in the direction of the waveguide. Based on these results, by adjusting the bending mirror, the deviation angle of the output beam of the resonator cavity was corrected, in order to obtain maximum output power and optimal beam quality. Finally, the propagation characteristics of the corrected output beam were analyzed.

The Resistive-Wall Instability in Multipulse Linear Induction Accelerators

DOE PAGES

Ekdahl, Carl

2017-05-01

The resistive-wall instability results from the Lorentz force on the beam due to the beam image charge and current. If the beam pipe is perfectly conducting, the electric force due to the image charge attracts the beam to the pipe wall, and the magnetic force due to the image current repels the beam from the wall. For a relativistic beam, these forces almost cancel, leaving a slight attractive force, which is easily overcome by external magnetic focusing. However, if the beam pipe is not perfectly conducting, the magnetic field due to the image current decays on a magnetic-diffusion time scale.more » If the beam pulse is longer than the magnetic diffusion time, the repulsion of the beam tail will be weaker than the repulsion of the beam head. In the absence of an external focusing force, this causes a head-to-tail sweep of the beam toward the wall. This instability is usually thought to be a concern only for long-pulse relativistic electron beams. However, with the advent of multipulse, high current linear induction accelerators, the possibility of pulse-to-pulse coupling of this instability should be investigated. Lastly, we have explored pulse-to-pulse coupling using the linear accelerator model for Dual Axis Radiography for Hydrodynamic Testing beam dynamics code, and we present the results of this paper.« less

The Resistive-Wall Instability in Multipulse Linear Induction Accelerators

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

Ekdahl, Carl

The resistive-wall instability results from the Lorentz force on the beam due to the beam image charge and current. If the beam pipe is perfectly conducting, the electric force due to the image charge attracts the beam to the pipe wall, and the magnetic force due to the image current repels the beam from the wall. For a relativistic beam, these forces almost cancel, leaving a slight attractive force, which is easily overcome by external magnetic focusing. However, if the beam pipe is not perfectly conducting, the magnetic field due to the image current decays on a magnetic-diffusion time scale.more » If the beam pulse is longer than the magnetic diffusion time, the repulsion of the beam tail will be weaker than the repulsion of the beam head. In the absence of an external focusing force, this causes a head-to-tail sweep of the beam toward the wall. This instability is usually thought to be a concern only for long-pulse relativistic electron beams. However, with the advent of multipulse, high current linear induction accelerators, the possibility of pulse-to-pulse coupling of this instability should be investigated. Lastly, we have explored pulse-to-pulse coupling using the linear accelerator model for Dual Axis Radiography for Hydrodynamic Testing beam dynamics code, and we present the results of this paper.« less

The external scanning proton microprobe of Firenze: A comprehensive description

NASA Astrophysics Data System (ADS)

Giuntini, L.; Massi, M.; Calusi, S.

2007-06-01

An external proton scanning microbeam setup is installed on the -30° line of the new 3 MV tandem accelerator in Firenze; the most relevant features of the line, such as detection setup for IBA measurements, target viewing system, beam diagnostic and transport are described here. With our facility we can work with a beam spot on sample better than 10 μm full-width half-maximum (FWHM) and an intensity of some nanoamperes. Standard beam exit windows are silicon nitride (Si 3N 4) TEM membranes, 100 nm thick and 0.5×0.5 mm 2 wide; we also successfully performed measurements using membranes 1×1 mm 2 wide, 100 nm thick, and 2×2 mm 2 wide, 200 and 500 nm thick. Exploiting the yield of Si X-rays produced by the beam in the exit window as an indirect measurement of the charge, a beam charge monitor system was implemented. The analytical capabilities of the microbeam have been extended by integrating a two-detector PIXE setup with BS and PIGE detectors; the external scanning proton microprobe in Firenze is thus a powerful instrument to fully characterize samples by ion beam analysis, through the simultaneous collection of PIXE, PIGE and BS elemental maps. Its characteristics can make it often competitive with traditional in vacuum microbeam for measurements of thick targets.

Overview of escalator applications in rail transit

NASA Technical Reports Server (NTRS)

Deshpande, G.; Rubenstein, L.

1980-01-01

The difference in operating environment and in construction between escalators in transit and nontransit use, the impact of recent escalator innovations, and areas which could benefit from urban mass transportation administration sponsored research and development are determined. Several factors causing a more severe transit escalator operating environment are identified. There are no significant design differences between transit and nontransit escalators. Recent innovations that have affected performance and cost include outdoor escalators, extra flat steps at both landings, and modular escalators. Data were collected by interviews at transit agencies. Long term, unscheduled, escalator maintenance records were available for analysis from one property. A description of escalator operating principles is provided. Transit represents less than 5% of the U.S. escalator market. Transit agencies have limited leverage on escalator industry practices. A substantial impact on transit escalator cost and performance can be achieved by research identifying when and how to apply and specify several of the more recent innovations. Purchase of escalators under long term (25 year) maintenance contracts is one method that has been used to promote escalators manufactured for minimum life cycle cost.

Stability of aerosol droplets in Bessel beam optical traps under constant and pulsed external forces

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

David, Grégory; Esat, Kıvanç; Hartweg, Sebastian

We report on the dynamics of aerosol droplets in optical traps under the influence of additional constant and pulsed external forces. Experimental results are compared with simulations of the three-dimensional droplet dynamics for two types of optical traps, the counter-propagating Bessel beam (CPBB) trap and the quadruple Bessel beam (QBB) trap. Under the influence of a constant gas flow (constant external force), the QBB trap is found to be more stable compared with the CPBB trap. By contrast, under pulsed laser excitation with laser pulse durations of nanoseconds (pulsed external force), the type of trap is of minor importance formore » the droplet stability. It typically needs pulsed laser forces that are several orders of magnitude higher than the optical forces to induce escape of the droplet from the trap. If the droplet strongly absorbs the pulsed laser light, these escape forces can be strongly reduced. The lower stability of absorbing droplets is a result of secondary thermal processes that cause droplet escape.« less

Liquid metal ion source assembly for external ion injection into an electron string ion source (ESIS)

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

Segal, M. J., E-mail: mattiti@gmail.com; University of Cape Town, Rondebosch, Cape Town 7700; Bark, R. A.

An assembly for a commercial Ga{sup +} liquid metal ion source in combination with an ion transportation and focusing system, a pulse high-voltage quadrupole deflector, and a beam diagnostics system has been constructed in the framework of the iThemba LABS (Cape Town, South Africa)—JINR (Dubna, Russia) collaboration. First, results on Ga{sup +} ion beam commissioning will be presented. Outlook of further experiments for measurements of charge breeding efficiency in the electron string ion source with the use of external injection of Ga{sup +} and Au{sup +} ion beams will be reported as well.

Moment redistribution in continuous reinforced concrete beams strengthened with carbon-fiber-reinforced polymer laminates

NASA Astrophysics Data System (ADS)

Aiello, M. A.; Valente, L.; Rizzo, A.

2007-09-01

The results of tests on continuous steel-fiber-reinforced concrete (RC) beams, with and without an external strengthening, are presented. The internal flexural steel reinforcement was designed so that to allow steel yielding before the collapse of the beams. To prevent the shear failure, steel stirrups were used. The tests also included two nonstrengthened control beams; the other specimens were strengthened with different configurations of externally bonded carbon-fiber-reinforced polymer (CFRP) laminates. In order to prevent the premature failure from delamination of the CFRP strengthening, a wrapping was also applied. The experimental results obtained show that it is possible to achieve a sufficient degree of moment redistribution if the strengthening configuration is chosen properly, confirming the results provided by two simple numerical models.

Space Construction Automated Fabrication Experiment Definition Study. (SCAFEDS), part 3. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1979-01-01

A range of tasks focused on a baseline system concept is discussed. A beam builder concept developed to produce a triangular beam is discussed. Beam elements used laminated graphite and glass composite strip material with external surface coatings are described.

NONVIOLENT RESISTANCE: HELPING CAREGIVERS REDUCE PROBLEMATIC BEHAVIORS IN CHILDREN AND ADOLESCENTS

PubMed Central

Omer, Haim; Lebowitz, Eli R.

2017-01-01

In this review, the principles of nonviolent resistance (NVR) and studies examining its acceptability and efficacy are reviewed. Originating in the sociopolitical field, NVR has been adapted for numerous settings including parents of youth with externalizing and other problems, foster parents, teachers and school personnel, and caregivers of psychiatric inpatients. NVR has also been applied to reduce accommodation of highly dependent adult children and to improve novice driving habits. The principles of NVR include refraining from violence, reducing escalation, utilizing outside support, and maintaining respect for the other. PMID:27292182

Method for energy recovery of spent ERL beams

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

Marhauser, Frank; Hannon, Fay; Rimmer, Robert

A method for recovering energy from spent energy recovered linac (ERL) beams. The method includes adding a plurality of passive decelerating cavities at the beam dump of the ERL, adding one or more coupling waveguides between the passive decelerating cavities, setting an adequate external Q (Qext) to adjust to the beam loading situation, and extracting the RF energy through the coupling waveguides.

Prefabricated Roof Beams for Hardened Shelters

DTIC Science & Technology

1993-08-01

beam with a composite concrete slab. Based on the results of the concept evaluation, a test program was designed and conducted to validate the steel...ultimaw, strength. The results of these tests showed that the design procedure accurately predicts the response of the ste,-confined concrete composite...BENDING OF EXTERNALLY REINFORCED CONCRETE BEAMS ........ 67 TABLE 9. SINGLE POINT LOAD BEAM TEST RESULTS

Carcinoma of the cervix, stage III. Results of radiation therapy.

PubMed

Montana, G S; Fowler, W C; Varia, M A; Walton, L A; Mack, Y; Shemanski, L

1986-01-01

From April 1969 through December 1980, 203 patients with Stage III epidermoid carcinoma of the cervix were treated with radiation therapy with curative intent. The disease-free survival at 2, 5, and 10 years was 50%, 33%, and 27%, respectively. The survival was better for patients with Stage IIIB disease than for those with Stage IIIA disease. Eighty-eight patients were treated with external beam therapy only, and 115 received external beam and brachytherapy. The disease-free survival was better for the combination therapy group initially, but this difference was not sustained beyond 5 years. One hundred eight patients experienced recurrence within the irradiated field, for a locoregional recurrence rate of 53%. Twenty-seven patients had complications (13%). The complications were mild in 13 patients, moderate in 4 patients, and severe in 10 patients. A study was made of the relationship of the dose to Point A and the occurrence of complications. Similar analyses were made of the bladder and rectal doses and the subsequent occurrence of urinary and intestinal complications. In these analyses, the mean dose to Point A and the critical organs was higher for the groups of patients with complications than for those patients without complications. This relationship was also observed when the patients were stratified for treatment with either external beam plus brachytherapy or external beam therapy alone.

TU-D-201-03: Results of a Survey On the Implementation of the TG-51 Protocol and Associated Addendum On Reference Dosimetry of External Beams

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

Kim, G; Muir, B; Culberson, W

Purpose: The working group on the review and extension of the TG-51 protocol (WGTG51) collected data from American Association of Physicists in Medicine (AAPM) members with respect to their current TG-51 and associated addendum usage in the interest of considering future protocol addenda and guidance on reference dosimetry best practices. This study reports an overview of this survey on dosimetry of external beams. Methods: Fourteen survey questions were developed by WGTG51 and released in November 2015. The questions collected information on reference dosimetry, beam quality specification, and ancillary calibration equipment. Results: Of the 190 submissions completed worldwide (U.S. 70%), 83%more » were AAPM members. Of the respondents, 33.5% implemented the TG-51 addendum, with the maximum calibration difference for any photon beam, with respect to the original TG-51 protocol, being <1% for 97.4% of responses. One major finding is that 81.8% of respondents used the same cylindrical ionization chamber for photon and electron dosimetry, implying that many clinics are foregoing the use of parallel-plate chambers. Other evidence suggests equivalent dosimetric results can be obtained with both cylindrical and parallel-plate chambers in electron beams. This, combined with users comfort with cylindrical chambers for electrons will likely impact recommendations put forward in an upcoming electron beam addendum to the TG-51 protocol. Data collected on ancillary equipment showed 58.2% (45.0%) of the thermometers (barometers) in use for beam calibration had NIST traceable calibration certificates, but 48.4% (42.7%) were never recalibrated. Conclusion: This survey provides a snapshot of TG-51 external beam reference dosimetry practice in radiotherapy centers. Findings demonstrate the rapid take-up of the TG-51 photon beam addendum and raise issues for the WGTG51 to focus on going forward, including guidelines on ancillary equipment and the choice of chamber for electron beam dosimetry.« less

WE-EF-303-08: Proton Radiography Using Pencil Beam Scanning and Novel Micromegas Detectors

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

Dolney, D; Lustig, R; Teo, B

Purpose: While the energy of therapeutic proton beams can be adjusted to penetrate to any given depth in water, range uncertainties arise in patients due in part to imprecise knowledge of the stopping power of protons in human tissues. Proton radiography is one approach to reduce the beam range uncertainty, thereby allowing for a reduction in treatment margins and dose escalation. Methods: The authors have adapted a novel detector technology based on Micromesh Gaseous Structure (“Micromegas”) for proton therapy beams and have demonstrated fine spatial and time resolution of magnetically scanned proton pencil beams, as well as wide dynamic rangemore » for dosimetry. In this work, proton radiographs were obtained using Micromegas 2D planes positioned downstream of solid water assemblies. The position-sensitive monitor chambers in the IBA proton delivery nozzle provide the beam entrance position. Results: Radiography with Micromegas detectors and actively scanned beams provide spatial resolution of up to 300 µm and water-equivalent thickness (WET) resolution as good as 0.02% (60 µm out of 31 cm total thickness), with the dose delivered to the patient kept below 2 cGy. The spatial resolution as a function of sample rate and number of delivered protons is found to be near the theoretical Cramer-Rao lower bound. Using the CR bound, we argue that the imaging dose could be further lowered to 1 mGy, while still achieving sub-mm spatial resolution, by relatively simple instrumentation upgrades and beam delivery modifications. Conclusion: For proton radiography, high spatial and WET resolution can be achieved, with minimal additional dose to patient, by using magnetically scanned proton pencil beams and Micromegas detectors.« less

Design concept for improved photo-scan tube

NASA Technical Reports Server (NTRS)

Malling, L. R.

1967-01-01

Conceptual photo-scan tube avoids complexity of internal beam scanning and beam-current adjustment by optical scan readout. It differs from a conventional image orthicon in its use of an external oscilloscope tube.

Dynamic assessment of reinforced concrete beams repaired with externally bonded FRP sheets

NASA Astrophysics Data System (ADS)

Bonfiglioli, B.; Pascale, G.

2006-01-01

This research deals with RC beams strengthened with FRP. An experimental research is presented which is aimed at evaluating the capability of an experimental modal analysis to assess the stiffness decrease due to damage, as well as the stiffness recovery due to strengthening. Ten beams were tested. All of them were subjected to loading cycles with increasing load levels in order to induce cracking of different severity in them. The beams were then retrofitted by externally bonded FRP sheets. Three types of composites were used. The number of layers was varied, too. Modal tests were carried out after each loading-unloading cycle. The modal frequencies and damping ratios were determined for the first four vibration modes. The results obtained indicate that an experimental modal analysis can give useful information on the severity of damage and the effectiveness of strengthening.

Improving Outcomes for Esophageal Cancer using Proton Beam Therapy

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

Chuong, Michael D.; Hallemeier, Christopher L.; Jabbour, Salma K.

Radiation therapy (RT) plays an essential role in the management of esophageal cancer. Because the esophagus is a centrally located thoracic structure there is a need to balance the delivery of appropriately high dose to the target while minimizing dose to nearby critical structures. Radiation dose received by these critical structures, especially the heart and lungs, may lead to clinically significant toxicities, including pneumonitis, pericarditis, and myocardial infarction. Although technological advancements in photon RT delivery like intensity modulated RT have decreased the risk of such toxicities, a growing body of evidence indicates that further risk reductions are achieved with protonmore » beam therapy (PBT). Herein we review the published dosimetric and clinical PBT literature for esophageal cancer, including motion management considerations, the potential for reirradiation, radiation dose escalation, and ongoing esophageal PBT clinical trials. We also consider the potential cost-effectiveness of PBT relative to photon RT.« less

Improving Outcomes for Esophageal Cancer using Proton Beam Therapy.

PubMed

Chuong, Michael D; Hallemeier, Christopher L; Jabbour, Salma K; Yu, Jen; Badiyan, Shahed; Merrell, Kenneth W; Mishra, Mark V; Li, Heng; Verma, Vivek; Lin, Steven H

2016-05-01

Radiation therapy (RT) plays an essential role in the management of esophageal cancer. Because the esophagus is a centrally located thoracic structure there is a need to balance the delivery of appropriately high dose to the target while minimizing dose to nearby critical structures. Radiation dose received by these critical structures, especially the heart and lungs, may lead to clinically significant toxicities, including pneumonitis, pericarditis, and myocardial infarction. Although technological advancements in photon RT delivery like intensity modulated RT have decreased the risk of such toxicities, a growing body of evidence indicates that further risk reductions are achieved with proton beam therapy (PBT). Herein we review the published dosimetric and clinical PBT literature for esophageal cancer, including motion management considerations, the potential for reirradiation, radiation dose escalation, and ongoing esophageal PBT clinical trials. We also consider the potential cost-effectiveness of PBT relative to photon RT. Copyright © 2016 Elsevier Inc. All rights reserved.

External-Beam Radiation Therapy and High-Dose Rate Brachytherapy Combined With Long-Term Androgen Deprivation Therapy in High and Very High Prostate Cancer: Preliminary Data on Clinical Outcome

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

Martinez-Monge, Rafael, E-mail: rmartinezm@unav.es; Moreno, Marta; Ciervide, Raquel

2012-03-01

Purpose: To determine the feasibility of combined long-term androgen deprivation therapy (ADT) and dose escalation with high-dose-rate (HDR) brachytherapy. Methods and Materials: Between 2001 and 2007, 200 patients with high-risk prostate cancer (32.5%) or very high-risk prostate cancer (67.5%) were prospectively enrolled in this Phase II trial. Tumor characteristics included a median pretreatment prostate-specific antigen of 15.2 ng/mL, a clinical stage of T2c, and a Gleason score of 7. Treatment consisted of 54 Gy of external irradiation (three-dimensional conformal radiotherapy [3DCRT]) followed by 19 Gy of HDR brachytherapy in four twice-daily treatments. ADT started 0-3 months before 3DCRT and continuedmore » for 2 years. Results: One hundred and ninety patients (95%) received 2 years of ADT. After a median follow-up of 3.7 years (range, 2-9), late Grade {>=}2 urinary toxicity was observed in 18% of the patients and Grade {>=}3 was observed in 5%. Prior transurethral resection of the prostate (p = 0.013) and bladder D{sub 50} {>=}1.19 Gy (p = 0.014) were associated with increased Grade {>=}2 urinary complications; age {>=}70 (p = 0.05) was associated with Grade {>=}3 urinary complications. Late Grade {>=}2 gastrointestinal toxicity was observed in 9% of the patients and Grade {>=}3 in 1.5%. CTV size {>=}35.8 cc (p = 0.007) and D{sub 100} {>=}3.05 Gy (p = 0.01) were significant for increased Grade {>=}2 complications. The 5-year and 9-year biochemical relapse-free survival (nadir + 2) rates were 85.1% and 75.7%, respectively. Patients with Gleason score of 7-10 had a decreased biochemical relapse-free survival (p = 0.007). Conclusions: Intermediate-term results at the 5-year time point indicate a favorable outcome without an increase in the rate of late complications.« less

SU-E-T-217: Intrinsic Respiratory Gating in Small Animal CT

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

Liu, Y; Smith, M; Mistry, N

Purpose: Preclinical animal models of lung cancer can provide a controlled test-bed for testing dose escalation or function-based-treatment-planning studies. However, to extract lung function, i.e. ventilation, one needs to be able to image the lung at different phases of ventilation (in-hale / ex-hale). Most respiratory-gated imaging using micro-CT involves using an external ventilator and surgical intervention limiting the utility in longitudinal studies. A new intrinsic respiratory retrospective gating method was developed and tested in mice. Methods: A fixed region of interest (ROI) that covers the diaphragm was selected on all projection images to estimate the mean intensity (M). The meanmore » intensity depends on the projection angle and diaphragm position. A 3-point moving average (A) of consecutive M values: Mpre, Mcurrent and Mpost, was calculated to be subtracted from Mcurrent. A fixed threshold was used to enable amplitude based sorting into 4 different phases of respiration. Images at full-inhale and end-exhale phases of respiration were reconstructed using the open source OSCaR. Lung volumes estimated at the 2 phases of respiration were validated against literature values. Results: Intrinsic retrospective gating was accomplished without the use of any external breathing waveform. While projection images were acquired at 360 different angles. Only 138 and 104 projections were used to reconstruct images at full-inhale and end-exhale. This often results in non-uniform under-sampled angular projections leading to some minor streaking artifacts. The calculated expiratory, inspiratory and tidal lung volumes correlated well with the values known from the literature. Conclusion: Our initial result demonstrates an intrinsic gating method that is suitable for flat panel cone beam small animal CT systems. Reduction in streaking artifacts can be accomplished by oversampling the data or using iterative reconstruction methods. This initial experience will enable freebreathing small animal micro-CT imaging to fuel longitudinal studies of lung function.« less

An external domino effects investment approach to improve cross-plant safety within chemical clusters.

PubMed

Reniers, Genserik

2010-05-15

Every company situated within a chemical cluster faces the risk of being struck by an escalating accident at one of its neighbouring plants (the so-called external domino effect risks). These cross-plant risks can be reduced or eliminated if neighbouring companies are willing to invest in systems and measures to prevent them. However, since reducing such multi-plant risks does not lead to direct economic benefits, enterprises tend to be reluctant to invest more than needed for meeting minimal legal requirements and they tend to invest without collaborating. The suggested approach in this article indicates what information is required to evaluate the available investment options in external domino effects prevention. To this end, game theory is used as a promising scientific technique to investigate the decision-making process on investments in prevention measures simultaneously involving several plants. The game between two neighbouring chemical plants and their strategic investment behaviour regarding the prevention of external domino effects is described and an illustrative example is provided. Recommendations are formulated to advance cross-plant prevention investments in a two-company cluster. Copyright (c) 2009 Elsevier B.V. All rights reserved.

External-beam irradiation of carcinoma of the penis

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

Sagerman, R.H.; Yu, W.S.; Chung, C.T.

1984-07-01

Twenty-four patients with biopsy-proved squamous-cell carcinoma of the penis underwent external-beam radiation therapy between 1966 and 1980. Fifteen were treated for the primary tumor and 9 for metastatic inguinal lymphadenopathy; no patient received prophylactic nodal irradiation. Seven out of 9 tumors in stage I, 2/3 in stage II, and 1/3 in stage IV were controlled for three years. Control of fixed, inoperable groin nodes was poor, and none of these patients survived beyond 1 1/2 years.

Optimal Treatment of Malignant Long Bone Fracture: Influence of Method of Repair and External Beam Irradiation on the Pathway and Efficacy of Fracture Healing

DTIC Science & Technology

2014-10-01

Long Bone Fracture: Influence of Method of Repair and External Beam Irradiation on the Pathway and Efficacy of Fracture Healing 5a. CONTRACT NUMBER...in the fifth quarter of the award. 15. SUBJECT TERMS Fracture healing , bone healing , endochondral ossification, intramembranous ossification...of radiation on the two pathways of bone healing and propose an optimal method of surgical fracture repair for managing malignant osteoporotic

High Contrast Internal and External Coronagraph Masks Produced by Various Techniques

NASA Technical Reports Server (NTRS)

Balasubramanian, Kunjithapatha; Wilson, Daniel; White, Victor; Muller, Richard; Dickie, Matthew; Yee, Karl; Ruiz, Ronald; Shaklan, Stuart; Cady, Eric; Kern, Brian;

When Action-Inaction Framing Leads to Higher Escalation of Commitment: A New Inaction-Effect Perspective on the Sunk-Cost Fallacy.

PubMed

Feldman, Gilad; Wong, Kin Fai Ellick

2018-04-01

Escalation of commitment to a failing course of action occurs in the presence of (a) sunk costs, (b) negative feedback that things are deviating from expectations, and (c) a decision between escalation and de-escalation. Most of the literature to date has focused on sunk costs, yet we offer a new perspective on the classic escalation-of-commitment phenomenon by focusing on the impact of negative feedback. On the basis of the inaction-effect bias, we theorized that negative feedback results in the tendency to take action, regardless of what that action may be. In four experiments, we demonstrated that people facing escalation-decision situations were indeed action oriented and that framing escalation as action and de-escalation as inaction resulted in a stronger tendency to escalate than framing de-escalation as action and escalation as inaction (mini-meta-analysis effect d = 0.37, 95% confidence interval = [0.21, 0.53]).

High energy micro electron beam generation using chirped laser pulse in the presence of an axial magnetic field

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

Akou, H., E-mail: h.akou@nit.ac.ir; Hamedi, M.

2015-10-15

In this paper, the generation of high-quality and high-energy micro electron beam in vacuum by a chirped Gaussian laser pulse in the presence of an axial magnetic field is numerically investigated. The features of energy and angular spectra, emittances, and position distribution of electron beam are compared in two cases, i.e., in the presence and absence of an external magnetic field. The electron beam is accelerated with higher energy and qualified in spatial distribution in the presence of the magnetic field. The presence of an axial magnetic field improves electron beam spatial quality as well as its gained energy throughmore » keeping the electron motion parallel to the direction of propagation for longer distances. It has been found that a 64 μm electron bunch with about MeV initial energy becomes a 20 μm electron beam with high energy of the order of GeV, after interacting with a laser pulse in the presence of an external magnetic field.« less

A simulation-based study on the influence of beam hardening in X-ray computed tomography for dimensional metrology.

PubMed

Lifton, Joseph J; Malcolm, Andrew A; McBride, John W

2015-01-01

X-ray computed tomography (CT) is a radiographic scanning technique for visualising cross-sectional images of an object non-destructively. From these cross-sectional images it is possible to evaluate internal dimensional features of a workpiece which may otherwise be inaccessible to tactile and optical instruments. Beam hardening is a physical process that degrades the quality of CT images and has previously been suggested to influence dimensional measurements. Using a validated simulation tool, the influence of spectrum pre-filtration and beam hardening correction are evaluated for internal and external dimensional measurements. Beam hardening is shown to influence internal and external dimensions in opposition, and to have a greater influence on outer dimensions compared to inner dimensions. The results suggest the combination of spectrum pre-filtration and a local gradient-based surface determination method are able to greatly reduce the influence of beam hardening in X-ray CT for dimensional metrology.

External cervical resorption: an analysis using cone beam and microfocus computed tomography and scanning electron microscopy.

PubMed

Gunst, V; Mavridou, A; Huybrechts, B; Van Gorp, G; Bergmans, L; Lambrechts, P

2013-09-01

To provide a three-dimensional representation of external cervical resorption (ECR) with microscopy, stereo microscopy, cone beam computed tomography (CT), microfocus CT and scanning electron microscopy (SEM). External cervical resorption is an aggressive form of root resorption, leading to a loss of dental hard tissues. This is due to clastic action, activated by a damage of the covering cementum and stimulated probably by infection. Clinically, it is a challenging situation as it is characterized by a late symptomatology. This is due to the pericanalar protection from a resorption-resistant sheet, composed of pre-dentine and surrounding dentine. The clastic activity is often associated with an attempt to repair, seen by the formation of osteoid tissue. Cone beam CT is extremely useful in the diagnoses and treatment planning of ECR. SEM analyses provide a better insight into the activity of osteoclasts. The root canal is surrounded by a layer of dentine that is resistant to resorption. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Histological changes in the human prostate after radiotherapy and salvage high intensity focused ultrasound

PubMed Central

Chalasani, Venu; Martinez, Carlos H.; Williams, Andrew K.; Kwan, Kevin; Chin, Joseph L.

2010-01-01

The histological changes (both macroscopic and microscopic) in the prostate following the combination of external beam radiotherapy and salvage high intensity focused ultrasound (HIFU) have not been previously described. This article describes the case of a 65-year-old male who presented with recurrent localized prostate cancer after undergoing external beam radiotherapy for low-risk prostate cancer. He was treated with salvage HIFU, and 4 weeks later presented with symptoms and signs consistent with a prostatorectal fistula. During a period of conservative management, his serum prostate-specific antigen levels started rising after having reached a nadir. A radical cystoprostatectomy and repair of fistula were performed after conservative management failed. Histological changes of dense fibrosis were noted in the region where the prostate should have been located. A literature review of the histological findings in the prostate after HIFU is discussed in this article, as well as the available evidence for the management of patients with local failure after the combination of external beam radiotherapy and salvage HIFU. PMID:20694085

Patient safety in external beam radiotherapy, results of the ACCIRAD project: Recommendations for radiotherapy institutions and national authorities on assessing risks and analysing adverse error-events and near misses.

PubMed

Malicki, Julian; Bly, Ritva; Bulot, Mireille; Godet, Jean-Luc; Jahnen, Andreas; Krengli, Marco; Maingon, Philippe; Prieto Martin, Carlos; Skrobala, Agnieszka; Valero, Marc; Jarvinen, Hannu

2018-05-02

The ACCIRAD project, commissioned by the European Commission (EC) to develop guidelines for risk analysis of accidental and unintended exposures in external beam radiotherapy (EBRT), was completed in the year 2014. In 2015, the "General guidelines on risk management in external beam radiotherapy" were published as EC report Radiation Protection (RP)-181. The present document is the third and final report of the findings from the ACCIRAD project. The main aim of this paper is to describe the key features of the risk management process and to provide general guidelines for radiotherapy departments and national authorities on risk assessment and analysis of adverse error-events and near misses. The recommendations provided here and in EC report RP-181 are aimed at promoting the harmonisation of risk management systems across Europe, improving patient safety, and enabling more reliable inter-country comparisons. Copyright © 2018 Elsevier B.V. All rights reserved.

Generating AN Optimum Treatment Plan for External Beam Radiation Therapy.

NASA Astrophysics Data System (ADS)

Kabus, Irwin

1990-01-01

The application of linear programming to the generation of an optimum external beam radiation treatment plan is investigated. MPSX, an IBM linear programming software package was used. All data originated from the CAT scan of an actual patient who was treated for a pancreatic malignant tumor before this study began. An examination of several alternatives for representing the cross section of the patient showed that it was sufficient to use a set of strategically placed points in the vital organs and tumor and a grid of points spaced about one half inch apart for the healthy tissue. Optimum treatment plans were generated from objective functions representing various treatment philosophies. The optimum plans were based on allowing for 216 external radiation beams which accounted for wedges of any size. A beam reduction scheme then reduced the number of beams in the optimum plan to a number of beams small enough for implementation. Regardless of the objective function, the linear programming treatment plan preserved about 95% of the patient's right kidney vs. 59% for the plan the hospital actually administered to the patient. The clinician, on the case, found most of the linear programming treatment plans to be superior to the hospital plan. An investigation was made, using parametric linear programming, concerning any possible benefits derived from generating treatment plans based on objective functions made up of convex combinations of two objective functions, however, this proved to have only limited value. This study also found, through dual variable analysis, that there was no benefit gained from relaxing some of the constraints on the healthy regions of the anatomy. This conclusion was supported by the clinician. Finally several schemes were found that, under certain conditions, can further reduce the number of beams in the final linear programming treatment plan.

Cervix regression and motion during the course of external beam chemoradiation for cervical cancer.

PubMed

Beadle, Beth M; Jhingran, Anuja; Salehpour, Mohammad; Sam, Marianne; Iyer, Revathy B; Eifel, Patricia J

2009-01-01

To evaluate the magnitude of cervix regression and motion during external beam chemoradiation for cervical cancer. Sixteen patients with cervical cancer underwent computed tomography scanning before, weekly during, and after conventional chemoradiation. Cervix volumes were calculated to determine the extent of cervix regression. Changes in the center of mass and perimeter of the cervix between scans were used to determine the magnitude of cervix motion. Maximum cervix position changes were calculated for each patient, and mean maximum changes were calculated for the group. Mean cervical volumes before and after 45 Gy of external beam irradiation were 97.0 and 31.9 cc, respectively; mean volume reduction was 62.3%. Mean maximum changes in the center of mass of the cervix were 2.1, 1.6, and 0.82 cm in the superior-inferior, anterior-posterior, and right-left lateral dimensions, respectively. Mean maximum changes in the perimeter of the cervix were 2.3 and 1.3 cm in the superior and inferior, 1.7 and 1.8 cm in the anterior and posterior, and 0.76 and 0.94 cm in the right and left lateral directions, respectively. Cervix regression and internal organ motion contribute to marked interfraction variations in the intrapelvic position of the cervical target in patients receiving chemoradiation for cervical cancer. Failure to take these variations into account during the application of highly conformal external beam radiation techniques poses a theoretical risk of underdosing the target or overdosing adjacent critical structures.

An experimentally based analytical model for the shear capacity of FRP-strengthened reinforced concrete beams

NASA Astrophysics Data System (ADS)

Pellegrino, C.; Modena, C.

2008-05-01

This paper deals with the shear strengthening of Reinforced Concrete (RC) flexural members with externally bonded Fiber-Reinforced Polymers (FRPs). The interaction between an external FRP and an internal transverse steel reinforcement is not considered in actual code recommendations, but it strongly influences the efficiency of the shear strengthening rehabilitation technique and, as a consequence, the computation of interacting contributions to the nominal shear strength of beams. This circumstance is also discussed on the basis of the results of an experimental investigation of rectangular RC beams strengthened in shear with "U-jacketed" carbon FRP sheets. Based on experimental results of the present and other investigations, a new analytical model for describing the shear capacity of RC beams strengthened according to the most common schemes (side-bonded and "U-jacketed"), taking into account the interaction between steel and FRP shear strength contributions, is proposed.

SU-C-207A-02: Proton Radiography Using Pencil Beam Scanning and a Novel, Low-Cost Range Telescope

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

Dolney, D; Mayers, G; Newcomer, M

Purpose: While the energy of therapeutic proton beams can be adjusted to penetrate to any given depth in water, range uncertainties arise in patients due in part to imprecise knowledge of the stopping power of protons in human tissues [1]. Proton radiography is one approach to reduce the beam range uncertainty [2], thereby allowing for a reduction in treatment margins and dose escalation. Methods: The authors have adapted a novel detector technology based on Micromesh Gaseous Structure (“Micromegas”) for proton therapy beams and have demonstrated fine spatial and time resolution of magnetically scanned proton pencil beams, as well as widemore » dynamic range for dosimetry [3]. The authors have constructed a prototype imaging system comprised of 5 Micromegas layers. Proton radiographs were obtained downstream of solid water assemblies. The position-sensitive monitor chambers in the IBA proton delivery nozzle provide the beam entrance position. Results: Our technique achieves spatial resolution as low as 300 µm and water-equivalent thickness (WET) resolution as good as 0.02% (60 µm out of 31 cm total thickness). The dose delivered to the patient is kept below 2 cGy. The spatial resolution as a function of sample rate and number of delivered protons is found to be near the theoretical Cramer-Rao lower bound. By extrapolating the CR bound, we argue that the imaging dose could be further lowered to 1 mGy, while still achieving submillimeter spatial resolution, by achievable instrumentation and beam delivery modifications. Conclusion: For proton radiography, high spatial and WET resolution can be achieved, with minimal additional dose to patient, by using magnetically scanned proton pencil beams and Micromegas detectors.« less

An Examination of Escalation in Burglaries Committed by Sexual Offenders.

PubMed

Pedneault, Amelie; Harris, Danielle A; Knight, Raymond A

2015-10-01

Research in the field of sexual aggression often assumes escalation in the criminal careers of sexual offenders. Sexual offenders are thought to begin their criminal careers with non-contact sexual offenses or non-sexual offenses and then escalate to more serious crimes, specifically sexual violence. The commission of one crime in particular--burglary--has been found to be a predictor of future violence in sexual offenders. The present study investigated the nature and extent of escalation in the criminal histories of 161 sex offenders who committed at least two burglaries. Six types of escalations were considered: type of burglary, occupancy, violence, weapon, frequency, and the victim-offender relationship. Escalators and non-escalators were compared, differences between the groups were reviewed, and the cumulative effect of various forms of escalation was analyzed. Results indicated that escalators and non-escalators could be differentiated on a number of important dimensions that might assist in the earlier detection of subsequently more dangerous offenders. © The Author(s) 2014.

Proton Beam Therapy

NASA Astrophysics Data System (ADS)

Paganetti, Harald

2017-01-01

Cancer therapy is a multi-modality approach including surgery, systemic or targeted chemotherapy, radiation (external beam or radionuclide), and immunotherapy. Radiation is typically administered using external beam photon therapy. Proton therapy has been around for more than 60 years but was restricted to research laboratories until the 1990s. Since then clinical proton therapy has been growing rapidly with currently more than 50 facilities worldwide. The interest in proton therapy stems from the physical properties of protons allowing for advanced dose sculpting around the target and sparing of healthy tissue. This review first evaluates the basics of proton therapy physics and technology and then outlines some of the current physical, biological, and clinical challenges. Solving these will ultimately determine whether proton therapy will continue on its path to becoming mainstream.

Green high-power tunable external-cavity GaN diode laser at 515  nm.

PubMed

Chi, Mingjun; Jensen, Ole Bjarlin; Petersen, Paul Michael

2016-09-15

A 480 mW green tunable diode laser system is demonstrated for the first time to our knowledge. The laser system is based on a GaN broad-area diode laser and Littrow external-cavity feedback. The green laser system is operated in two modes by switching the polarization direction of the laser beam incident on the grating. When the laser beam is p-polarized, an output power of 50 mW with a tunable range of 9.2 nm is achieved. When the laser beam is s-polarized, an output power of 480 mW with a tunable range of 2.1 nm is obtained. This constitutes the highest output power from a tunable green diode laser system.

Selectively bred crossed high-alcohol-preferring mice drink to intoxication and develop functional tolerance, but not locomotor sensitization during free-choice ethanol access.

PubMed

Matson, Liana M; Kasten, Chelsea R; Boehm, Stephen L; Grahame, Nicholas J

2014-01-01

Crossed high-alcohol-preferring (cHAP) mice were selectively bred from a cross of the HAP1 × HAP2 replicate lines and demonstrate blood ethanol concentrations (BECs) during free-choice drinking reminiscent of those observed in alcohol-dependent humans. In this report, we investigated the relationship between free-choice drinking, intoxication, tolerance, and sensitization in cHAP mice. We hypothesized that initially mice would become ataxic after drinking alcohol, but that increased drinking over days would be accompanied by increasing tolerance to the ataxic effects of ethanol (EtOH). Male and female cHAP mice had free-choice access to 10% EtOH and water (E), while Water mice (W) had access to water alone. In experiment 1, the first drinking experience was monitored during the dark portion of the cycle. Once E mice reached an average intake rate of ≥1.5 g/kg/h, they, along with W mice, were tested for footslips on a balance beam, and BECs were assessed. In experiments 2, 3, and 4, after varying durations of free-choice 10% EtOH access (0, 3, 14, or 21 days), mice were challenged with 20% EtOH and tested for number of footslips on a balance beam or locomotor stimulant response. Blood was sampled for BEC determination. We found that cHAP mice rapidly acquire alcohol intakes that lead to ataxia. Over time, cHAP mice developed behavioral tolerance to the ataxic effects of alcohol, paralleled by escalating alcohol consumption. However, locomotor sensitization did not develop following 14 days of free-choice EtOH access. Overall, we observed increases in free-choice drinking with extended alcohol access paralleled by increases in functional tolerance, but not locomotor sensitization. These data support our hypothesis that escalating free-choice drinking over days in cHAP mice is driven by tolerance to alcohol's behavioral effects. These data are the first to demonstrate that escalating free-choice consumption is accompanied by increasing alcohol tolerance. In addition to buttressing the hypothesized importance of tolerance in drinking, our findings suggest that cHAP mice may be a unique, translational resource for studying tolerance as a contributor to and consequence of chronic, excessive EtOH consumption. Copyright © 2013 by the Research Society on Alcoholism.

Dose escalation study of proton beam therapy with concurrent chemotherapy for stage III non-small cell lung cancer.

PubMed

Harada, Hideyuki; Fuji, Hiroshi; Ono, Akira; Kenmotsu, Hirotsugu; Naito, Tateaki; Yamashita, Haruo; Asakura, Hirofumi; Nishimura, Tetsuo; Takahashi, Toshiaki; Murayama, Shigeyuki

2016-07-01

The purpose of this study is to determine the recommended dose (RD) of proton beam therapy (PBT) for inoperable stage III non-small cell lung cancer (NSCLC). We tested two prescribed doses of PBT: 66 Gy (relative biological effectiveness [RBE]) in 33 fractions and 74 Gy (RBE) in 37 fractions in arms 1 and 2, respectively. The planning target volume (PTV) included the primary tumor and metastatic lymph nodes with adequate margins. Concurrent chemotherapy included intravenous cisplatin (60 mg/m(2) , day 1) and oral S-1 (80, 100 or 120 mg based on body surface area, days 1-14), repeated as four cycles every 4 weeks. Dose-limiting toxicity (DLT) was defined as grade 3 or severe toxicities related to PBT during days 1-90. Each dose level was performed in three patients, and then escalated to the next level if no DLT occurred. When one patient developed a DLT, three additional patients were enrolled. Overall, nine patients (five men, four women; median age, 72 years) were enrolled, including six in arm 1 and three in arm 2. The median follow-up time was 43 months, and the median progression-free survival was 15 months. In arm 1, grade 3 infection occurred in one of six patients, but no other DLT was reported. Similarly, no DLT occurred in arm 2. However, one patient in arm 2 developed grade 3 esophageal fistula at 9 months after the initiation of PBT. Therefore, we determined that 66 Gy (RBE) is the RD from a clinical viewpoints. (Clinical trial registration no. UMIN000005585). © 2016 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

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

Nunes, R. P.; Rizzato, F. B.

This work analyzes the transversal dynamics of an inhomogeneous and mismatched charged particle beam. The beam is azimuthally symmetric, initially cold, and evolves in a linear channel permeated by an external constant magnetic field. Based on a Lagrangian approach, a low-dimensional model for the description of the beam dynamics has been obtained. The small set of nonlinear dynamical equations provided results that are in reasonable agreement with that ones observed in full self-consistent N-particle beam numerical simulations.

De-escalation as part of a global strategy of empiric antibiotherapy management. A retrospective study in a medico-surgical intensive care unit

PubMed Central

2010-01-01

Introduction Most data on de-escalation of empirical antimicrobial therapy has focused on ventilator-associated pneumonia. In this retrospective monocentric study, we evaluated de-escalation as part of a global strategy of empiric antibiotherapy management irrespective of the location and the severity of the infection. The goal of this trial was to assess the application of a de-escalation strategy and the impact in terms of re-escalation, recurrent infection and to identify variables associated with de-escalation. Methods All consecutive patients treated with empiric antibiotic therapy and hospitalized in the intensive care unit for at least 72 hours within a period of 16 months were included. We compared the characteristics and outcome of patients who have experienced de-escalation therapy with those who have not. Results A total of 116 patients were studied corresponding to 133 infections. Antibiotic therapy was de-escalated in 60 cases (45%). De-escalation, primarily accomplished by a reduction in the number of antibiotics used, was observed in 52% of severe sepsis or septic shock patients. Adequate empiric antibiotic and use of aminoglycoside were independently linked with de-escalation. De-escalation therapy was associated with a significant reduction of recurrent infection (19% vs 5% P = 0.01). Mortality was not changed by de-escalation. Conclusions As part of a global management of empiric antibiotherapy in an intensive care unit, de-escalation might be safe and feasible in a large proportion of patients. PMID:21167047

De-escalation as part of a global strategy of empiric antibiotherapy management. A retrospective study in a medico-surgical intensive care unit.

PubMed

Morel, Jérôme; Casoetto, Julie; Jospé, Richard; Aubert, Gérald; Terrana, Raphael; Dumont, Alain; Molliex, Serge; Auboyer, Christian

2010-01-01

Most data on de-escalation of empirical antimicrobial therapy has focused on ventilator-associated pneumonia. In this retrospective monocentric study, we evaluated de-escalation as part of a global strategy of empiric antibiotherapy management irrespective of the location and the severity of the infection. The goal of this trial was to assess the application of a de-escalation strategy and the impact in terms of re-escalation, recurrent infection and to identify variables associated with de-escalation. All consecutive patients treated with empiric antibiotic therapy and hospitalized in the intensive care unit for at least 72 hours within a period of 16 months were included. We compared the characteristics and outcome of patients who have experienced de-escalation therapy with those who have not. A total of 116 patients were studied corresponding to 133 infections. Antibiotic therapy was de-escalated in 60 cases (45%). De-escalation, primarily accomplished by a reduction in the number of antibiotics used, was observed in 52% of severe sepsis or septic shock patients. Adequate empiric antibiotic and use of aminoglycoside were independently linked with de-escalation. De-escalation therapy was associated with a significant reduction of recurrent infection (19% vs 5% P = 0.01). Mortality was not changed by de-escalation. As part of a global management of empiric antibiotherapy in an intensive care unit, de-escalation might be safe and feasible in a large proportion of patients.

Optimal Treatment of Malignant Long Bone Fracture: Influence of Method of Repair and External Beam Irradiation on the Pathway and Efficacy of Fracture Healing

DTIC Science & Technology

2015-10-01

stiffness, or a partial snap with lower yield force and stiffness (Figure 4). Three dimensional micro CT analysis around fracture Figure 3. (a-b... fractures with plate fixation on both sides and irradiation on the left while the contralateral limb serves as a non-radiated internal control. The...AWARD NUMBER: W81XWH-13-1-0430 TITLE: Optimal Treatment of Malignant Long Bone Fracture : Influence of Method of Repair and External Beam

SU-E-T-571: Newly Emerging Integrated Transmission Detector Systems Provide Online Quality Assurance of External Beam Radiation Therapy

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

Hoffman, D; Chung, E; Hess, C

2015-06-15

Purpose: Two newly emerging transmission detectors positioned upstream from the patient have been evaluated for online quality assurance of external beam radiotherapy. The prototype for the Integral Quality Monitor (IQM), developed by iRT Systems GmbH (Koblenz, Germany) is a large-area ion chamber mounted on the linac accessory tray to monitor photon fluence, energy, beam shape, and gantry position during treatment. The ion chamber utilizes a thickness gradient which records variable response dependent on beam position. The prototype of Delta4 Discover™, developed by ScandiDos (Uppsala, Sweden) is a linac accessory tray mounted 4040 diode array that measures photon fluence during patientmore » treatment. Both systems are employable for patient specific QA prior to treatment delivery. Methods: Our institution evaluated the reproducibility of measurements using various beam types, including VMAT treatment plans with both the IQM ion chamber and the Delta4 Discover diode array. Additionally, the IQM’s effect on photon fluence, dose response, simulated beam error detection, and the accuracy of the integrated barometer, thermometer, and inclinometer were characterized. The evaluated photon beam errors are based on the annual tolerances specified in AAPM TG-142. Results: Repeated VMAT treatments were measured with 0.16% reproducibility by the IQM and 0.55% reproducibility by the Delta4 Discover. The IQM attenuated 6, 10, and 15 MV photon beams by 5.43±0.02%, 4.60±0.02%, and 4.21±0.03% respectively. Photon beam profiles were affected <1.5% in the non-penumbra regions. The IQM’s ion chamber’s dose response was linear and the thermometer, barometer, and inclinometer agreed with other calibrated devices. The device detected variations in monitor units delivered (1%), field position (3mm), single MLC leaf positions (13mm), and photon energy. Conclusion: We have characterized two new transmissions detector systems designed to provide in-vivo like measurements upstream from the patient. Both systems demonstrate substantial utility for online treatment verification and QA of photon external beam radiotherapy.« less

Polymeric Materials

DTIC Science & Technology

2009-06-01

funding have been established, including membership at the BNLS X27C Beam Line, two visiting ASEE Summer faculty, two EOARD programs, two CINT...complement these efforts, collaborative programs with external funding have been established, including membership at the BNLS X27C Beam Line, one visiting

Survival Outcomes of Whole-Pelvic Versus Prostate-Only Radiation Therapy for High-Risk Prostate Cancer Patients With Use of the National Cancer Data Base

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

Amini, Arya; Jones, Bernard L.; Yeh, Norman

Purpose/Objectives: The addition of whole pelvic (WP) compared with prostate-only (PO) radiation therapy (RT) for clinically node-negative prostate cancer remains controversial. The purpose of our study was to evaluate the survival benefit of adding WPRT versus PO-RT for high-risk, node-negative prostate cancer, using the National Cancer Data Base (NCDB). Methods and Materials: Patients with high-risk prostate cancer treated from 2004 to 2006, with available data for RT volume, coded as prostate and pelvis (WPRT) or prostate alone (PO-RT) were included. Multivariate analysis (MVA) and propensity-score matched analysis (PSM) were performed. Recursive partitioning analysis (RPA) based on overall survival (OS) usingmore » Gleason score (GS), T stage, and pretreatment prostate-specific antigen (PSA) was also conducted. Results: A total of 14,817 patients were included: 7606 (51.3%) received WPRT, and 7211 (48.7%) received PO-RT. The median follow-up time was 81 months (range, 2-122 months). Under MVA, the addition of WPRT for high-risk patients had no OS benefit compared with PO-RT (HR 1.05; P=.100). On subset analysis, patients receiving dose-escalated RT also did not benefit from WPRT (HR 1.01; P=.908). PSM confirmed no survival benefit with the addition of WPRT for high-risk patients (HR 1.05; P=.141). In addition, RPA was unable to demonstrate a survival benefit of WPRT for any subset. Other prognostic factors for inferior OS under MVA included older age (HR 1.25; P<.001), increasing comorbidity scores (HR 1.46; P<.001), higher T stage (HR 1.17; P<.001), PSA (HR 1.81; P<.001), and GS (HR 1.29; P<.001), and decreasing median county household income (HR 1.15; P=.011). Factors improving OS included the addition of androgen deprivation therapy (HR 0.92; P=.033), combination external beam RT plus brachytherapy boost (HR 0.71; P<.001), and treatment at an academic/research institution (HR 0.84; P=.002). Conclusion: In the largest reported analysis of WPRT for patients with high-risk prostate cancer treated in the dose-escalated era, the addition of WPRT demonstrated no survival advantage compared with PO-RT.« less

Smartphone-Based Escalator Recognition for the Visually Impaired

PubMed Central

Nakamura, Daiki; Takizawa, Hotaka; Aoyagi, Mayumi; Ezaki, Nobuo; Mizuno, Shinji

2017-01-01

It is difficult for visually impaired individuals to recognize escalators in everyday environments. If the individuals ride on escalators in the wrong direction, they will stumble on the steps. This paper proposes a novel method to assist visually impaired individuals in finding available escalators by the use of smartphone cameras. Escalators are recognized by analyzing optical flows in video frames captured by the cameras, and auditory feedback is provided to the individuals. The proposed method was implemented on an Android smartphone and applied to actual escalator scenes. The experimental results demonstrate that the proposed method is promising for helping visually impaired individuals use escalators. PMID:28481270

Acceleration and stability of a high-current ion beam in induction fields

NASA Astrophysics Data System (ADS)

Karas', V. I.; Manuilenko, O. V.; Tarakanov, V. P.; Federovskaya, O. V.

2013-03-01

A one-dimensional nonlinear analytic theory of the filamentation instability of a high-current ion beam is formulated. The results of 2.5-dimensional numerical particle-in-cell simulations of acceleration and stability of an annular compensated ion beam (CIB) in a linear induction particle accelerator are presented. It is shown that additional transverse injection of electron beams in magnetically insulated gaps (cusps) improves the quality of the ion-beam distribution function and provides uniform beam acceleration along the accelerator. The CIB filamentation instability in both the presence and the absence of an external magnetic field is considered.

Shear Strengthening of RC Deep Beam Using Externally Bonded GFRP Fabrics

NASA Astrophysics Data System (ADS)

Kumari, A.; Patel, S. S.; Nayak, A. N.

2018-06-01

This work presents the experimental investigation of RC deep beams wrapped with externally bonded Glass Fibre Reinforced Polymer (GFRP) fabrics in order to study the Load versus deflection behavior, cracking pattern, failure modes and ultimate shear strength. A total number of five deep beams have been casted, which is designed with conventional steel reinforcement as per IS: 456 (Indian standard plain and reinforced concrete—code for practice, Bureau of Indian Standards, New Delhi, 2000). The spans to depth ratio for all RC deep beams have been kept less than 2 as per the above specification. Out of five RC deep beams, one without retrofitting serves as a reference beam and the rest four have been wrapped with GFRP fabrics in multiple layers and tested with two point loading condition. The first cracking load, ultimate load and the shear contribution of GFRP to the deep beams have been observed. A critical discussion is made with respect to the enhancement of the strength, behaviour and performance of retrofitted deep beams in comparison to the deep beam without GFRP in order to explore the potential use of GFRP for strengthening the RC deep beams. Test results have demonstrated that the deep beams retrofitted with GFRP shows a slower development of the diagonal cracks and improves shear carrying capacity of the RC deep beam. A comparative study of the experimental results with the theoretical ones predicted by various researchers available in the literatures has also been presented. It is observed that the ultimate load of the beams retrofitted with GFRP fabrics increases with increase of number of GFRP layers up to a specific number of layers, i.e. 3 layers, beyond which it decreases.

Shear Strengthening of RC Deep Beam Using Externally Bonded GFRP Fabrics

NASA Astrophysics Data System (ADS)

Kumari, A.; Patel, S. S.; Nayak, A. N.

2018-02-01

This work presents the experimental investigation of RC deep beams wrapped with externally bonded Glass Fibre Reinforced Polymer (GFRP) fabrics in order to study the Load versus deflection behavior, cracking pattern, failure modes and ultimate shear strength. A total number of five deep beams have been casted, which is designed with conventional steel reinforcement as per IS: 456 (Indian standard plain and reinforced concrete—code for practice, Bureau of Indian Standards, New Delhi, 2000). The spans to depth ratio for all RC deep beams have been kept less than 2 as per the above specification. Out of five RC deep beams, one without retrofitting serves as a reference beam and the rest four have been wrapped with GFRP fabrics in multiple layers and tested with two point loading condition. The first cracking load, ultimate load and the shear contribution of GFRP to the deep beams have been observed. A critical discussion is made with respect to the enhancement of the strength, behaviour and performance of retrofitted deep beams in comparison to the deep beam without GFRP in order to explore the potential use of GFRP for strengthening the RC deep beams. Test results have demonstrated that the deep beams retrofitted with GFRP shows a slower development of the diagonal cracks and improves shear carrying capacity of the RC deep beam. A comparative study of the experimental results with the theoretical ones predicted by various researchers available in the literatures has also been presented. It is observed that the ultimate load of the beams retrofitted with GFRP fabrics increases with increase of number of GFRP layers up to a specific number of layers, i.e. 3 layers, beyond which it decreases.

Longitudinal density modulation and energy conversion in intense beams.

PubMed

Harris, J R; Neumann, J G; Tian, K; O'Shea, P G

2007-08-01

Density modulation of charged particle beams may occur as a consequence of deliberate action, or may occur inadvertently because of imperfections in the particle source or acceleration method. In the case of intense beams, where space charge and external focusing govern the beam dynamics, density modulation may, under some circumstances, be converted to velocity modulation, with a corresponding conversion of potential energy to kinetic energy. Whether this will occur depends on the properties of the beam and the initial modulation. This paper describes the evolution of discrete and continuous density modulations on intense beams and discusses three recent experiments related to the dynamics of density-modulated electron beams.

Betatron radiation based diagnostics for plasma wakefield accelerated electron beams at the SPARC_LAB test facility

NASA Astrophysics Data System (ADS)

Shpakov, V.; Anania, M. P.; Biagioni, A.; Chiadroni, E.; Cianchi, A.; Curcio, A.; Dabagov, S.; Ferrario, M.; Filippi, F.; Marocchino, A.; Paroli, B.; Pompili, R.; Rossi, A. R.; Zigler, A.

2016-09-01

Recent progress with wake-field acceleration has shown a great potential in providing high gradient acceleration fields, while the quality of the beams remains relatively poor. Precise knowledge of the beam size at the exit from the plasma and matching conditions for the externally injected beams are the key for improvement of beam quality. Betatron radiation emitted by the beam during acceleration in the plasma is a powerful tool for the transverse beam size measurement, being also non-intercepting. In this work we report on the technical solutions chosen at SPARC_LAB for such diagnostics tool, along with expected parameters of betatron radiation.

MO-C-17A-10: Comparison of Dose Deformable Accumulation by Using Parallel and Serial Approaches

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

Gao, Z; Li, M; Wong, J

Purpose: The uncertainty of dose accumulation over multiple CT datasets with deformable fusion may have significant impact on clinical decisions. In this study, we investigate the difference of two dose summation approaches involving deformable fusion. Methods: Five patients, four external beam and one brachytherapy(BT), were chosen for the study. The BT patient was treated with CT-based HDR. The CT image sets acquired in the imageguidance process (8-11 CTs/patient) were used to determine the dose delivered to the four external beam patients. (prostate, pelvis, lung and head and neck). For the HDR patient (cervix), five CT image sets and the correspondingmore » BT plans were used. In total 44 CT datasets and RT dose/plans were imported into the image fusion software MiM (6.0.4) for analysis.For each of the five clinical cases, the dose from each fraction was accumulated into the primary CT dataset by using both Parallel and Serial approaches. The dose-volume histogram (DVH) for CTV and selected organs-at-risks (OAR) were generated. The D95(CTV), OAR(mean) and OAR(max) for the four external beam cases the D90(CTV), and the max dose to bladder and rectum for the BT case were compared. Results: For the four external beam patients, the difference in D95(CTV) were <1.2% PD between the parallel and the serial approaches. The differences of the OAR(mean) and the OAR(max ) range from 0 to 3.7% and <1% PD respectively. For the HDR patient, the dose difference for D90 is 11% PD while that of the max dose to bladder and rectum were 11.5% and 23.3% respectively. Conclusion: For external beam treatments, the parallel and serial approaches have <5% difference probably because tumor volume and OAR have less changes from fraction to fraction. For the brachytherapy case, >10% dose difference between the two approaches was observed as significant volume changes of tumor and OAR were observed among treatment fractions.« less

Quality of life and satisfaction with information after radical prostatectomy, radical external beam radiotherapy and postoperative radiotherapy: a long-term follow-up study.

PubMed

Nicolaisen, Marianne; Müller, Stig; Patel, Hitendra R H; Hanssen, Tove Aminda

2014-12-01

To assess patients' symptoms, quality of life and satisfaction with information three to four years after radical prostatectomy, radical external beam radiotherapy and postoperative radiotherapy and to analyse differences between treatment groups and the relationship between disease-specific, health-related and overall quality of life and satisfaction with information. Radical prostate cancer treatments are associated with changes in quality of life. Differences between patients undergoing different treatments in symptoms and quality of life have been reported, but there are limited long-term data comparing radical prostatectomy with radical external beam radiotherapy and postoperative radiotherapy. A cross-sectional survey design was used. The study sample included 143 men treated with radical prostatectomy and/or radical external beam radiotherapy. Quality of life was measured using the 12-item Short Form Health Survey and the 50-item Expanded Prostate Cancer Index Composite Instrument. Questions assessing overall Quality of life and satisfaction with information were included. Descriptive statistics and interference statistical methods were applied to analyse the data. Radical external beam radiotherapy was associated with less urinary incontinence and better urinary function. There were no differences between the groups for disease-specific quality of life sum scores. Sexual quality of life was reported very low in all groups. Disease-specific quality of life and health-related quality of life were associated with overall quality of life. Patients having undergone surgery were more satisfied with information, and there was a positive correlation between quality of life and patient satisfaction. Pretreatment information and patient education lead to better quality of life and satisfaction. This study indicates a need for structured, pretreatment information and follow-up for all men going through radical prostate cancer treatment. Long-term quality of life effects should be considered when planning follow-up and information for men after radical prostate cancer treatment. Structured and organised information/education may increase preparedness for symptoms and bother after the treatment, improve symptom management strategies and result in improved quality of life. © 2014 John Wiley & Sons Ltd.

Modified BEAM with triple autologous stem cell transplantation for patients with relapsed aggressive non-Hodgkin lymphoma.

PubMed

Hohloch, Karin; Zeynalova, Samira; Chapuy, Björn; Pfreundschuh, Michael; Loeffler, Markus; Ziepert, Marita; Feller, Alfred C; Trümper, Lorenz; Hasenclever, Dirk; Wulf, Gerald; Schmitz, Norbert

2016-06-01

Treatment of relapse and primary progression in aggressive lymphoma remains unsatisfactory; outcome is still poor. Better treatment strategies are much needed for this patient population. The R1 study is a prospective multi-center phase I/II study evaluating a dose finding approach with a triple transplant regimen in four BEAM dose levels in patients with relapsed aggressive non-Hodgkin lymphoma. The aim of the study was to determine feasibility, toxicity, and remission rate. In a total of 39 patients (pts.) enrolled in the study, 24 pts. were evaluated in the following analysis. Twenty pts. had aggressive B cell lymphoma, and two pts. had T cell lymphoma. All evaluated patients responded to DexaBEAM with a sufficient stem cell harvest. The phase I/II study was started with BEAM dose level II. Four patients were treated at dose level II, and 20 pts. were treated at dose level III. Due to the early termination of the study, dose levels I and IV were never administered. Sixteen pts. completed therapy according to protocol, and eight pts. (33.3 %) stopped treatment early. Infections (27 %) and stomatitis (13 %) were the most frequent grade III/IV non-hematologic toxicities. Thirteen percent of patients presented with severe grade III/IV lung toxicity during modified BEAM (m-BEAM). Fourteen pts. achieved a complete response (CR), one pt. achieved no change (NC), six pts. had progressive disease (PD), and two pts. died; for one pt., outcome is not known. One-year and 3-year event-free survival (EFS) was 38 and 33 %, respectively. Overall survival (OS) after 1 and 3 years was 50 and 38 %. In conclusion, dose escalation of standard BEAM is not feasible due to toxicity.

External radiotherapy and brachytherapy in the management of extrahepatic and intrahepatic cholangiocarcinoma: available evidence.

PubMed

Sahai, Puja; Kumar, Senthil

2017-08-01

This review aims to summarize the currently available evidence for the role of external radiotherapy and brachytherapy in the management of cholangiocarcinoma. High locoregional disease recurrence rates after surgical resection alone for both the extrahepatic cholangiocarcinoma (EHCC) and intrahepatic cholangiocarcinoma (IHCC) provide a rationale for using adjuvant radiotherapy with chemotherapy. We performed a literature search related to radiotherapy in cholangiocarcinoma published between 2000 and 2016. The role of radiation is discussed in the adjuvant, neoadjuvant, definitive and the palliative setting. Evidence from Phase II trials have demonstrated efficacy of adjuvant chemoradiation in combination with chemotherapy in EHCC. Locally advanced cholangiocarcinoma may be treated with neoadjuvant chemoradiotherapy. In the case of downsizing, assessment for resection may be considered. Brachytherapy offers dose escalation after external radiotherapy. Selected unresectable cases of cholangiocarcinoma may be considered for stereotactic body radiation therapy with neoadjuvant and/or concurrent chemotherapy. Liver transplantation is a treatment option in selected patients with EHCC and IHCC after neoadjuvant chemoradiation. Stenting in combination with palliative external radiotherapy and/or brachytherapy provides improved stent patency and survival. Newer advanced radiation techniques provide a scope for achieving better disease control with reduced morbidity. Effective multimodality treatment incorporating radiotherapy is the way forward for improving survival in patients with cholangiocarcinoma.

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

Mechalakos, J.

The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiationmore » therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy.« less

Complete response in a patient with gynecological hidradenocarcinoma treated with exclusive external beam radiotherapy and brachytherapy: a case report.

PubMed

Giannelli, Flavio; Chiola, Ilaria; Belgioia, Liliana; Garelli, Stefania; Pastorino, Alice; Marcenaro, Michela; Mammoliti, Serafina; Costantini, Sergio; Bizzarri, Nicolò; Vellone, Valerio; Barra, Salvina; Corvò, Renzo

2017-12-01

Hidradenocarcinoma (HC) is a very rare disease. This case report illustrates a successful treatment of a 60-year-old woman with vulvo-vaginal localization of hidradenocarcinoma treated with external beam radiotherapy delivered by helical tomotherapy with a simultaneous integrated boost (SIB), followed by brachytherapy. External beam radiotherapy dose prescription was 50.4 Gy in 28 fractions, five fractions per week to whole pelvis (planning target volume 1 - PTV1), 60.2 Gy in 28 fractions to SIB1 (fundus of uterus and right inguinal node), and 58.8 Gy in 28 fractions to SIB2 (lower/middle third of vagina, paraurethral region and right inguinal lymph nodes). Brachytherapy dose prescription was 28 Gy in 4 fractions for cervix, fundus of uterus and upper third of vagina (HR-CTV1), and 22 Gy in 4 fractions to middle third of vagina and paraurethral region (HR-CTV2). D 90 for whole treatment was 91.9 Gy and 86.0 Gy for HR-CTV1 and HR-CTV2, respectively. Patient remained 12-months disease-free without treatment related side effects.

Differential lead component pulling as a possible mechanism of inside-out abrasion and conductor cable externalization.

PubMed

Lau, Ernest W

2013-09-01

Conductor cable externalization with protrusion (CCE*) is highly prevalent among the Riata 8F and ST 7F defibrillation (DF) leads and infrequently present in the QuickSite and the QuickFlex coronary sinus (CS) leads (St. Jude Medical, Sylmar, CA, USA). A model for CCE* based on differential lead component pulling and conjugate extension with reciprocal compression-bending was developed. Extension of a proximal lead body segment by pectoral or cardiac movements causes reciprocal compression-bending of a distal lead body segment mediated by inextensible conductor cables running down a lead body fixed at various points by fibrous adhesions. The "sawing" action of these cables under tension causes inside-out abrasion of insulation leading to CCE*. DF leads from different manufacturers and the QuickFlex and QuickFlex μ CS leads were subjected to simulated differential pulling. Restitution from differential pulling followed three patterns: complete, partial without escalation, and incomplete with escalation. Only the last pattern (only shown by the Riata 8F and ST 7F leads) was associated with an increased risk to CCE*. For CS leads, deformation concentrated on the more flexible segment when the lead body did not have a uniform construction. The Durata, Riata ST Optim, QuickFlex μ, and Quartet leads should be relatively immune to CCE*. The Durata leads are extremely resistant to longitudinal deformation and probably cause mediastinal displacement rather than differential pulling in response to pectoral movements in vivo. Implantation techniques and lead designs can be used to minimize the risk of CCE*. A bench test for CCE* can be constructed. ©2013, The Author. Journal compilation ©2013 Wiley Periodicals, Inc.

Generation of a cylindrically symmetric, polarized laser beam with narrow linewidth and fine tunability

NASA Astrophysics Data System (ADS)

Hirayama, Toru; Kozawa, Yuichi; Nakamura, Takahiro; Sato, Shunichi

2006-12-01

We demonstrated a generation of cylindrically symmetric, polarized laser beams with narrow linewidth and fine tunability. Since an LP11 mode beam in an optical fiber is a superposition of an HE21 (hybrid) mode beam and a TE01 or TM01 mode beam, firstly, a higher order transverse (TEM01 or TEM10) mode laser beam with narrow linewidth and fine tunability was generated from an external cavity diode laser (ECDL) in conjunction with a phase adjustment plate. Then the beam generated was passed in a two mode optical fiber. A doughnut shaped laser beam with the cylindrically symmetric polarization (a radially or azimuthally polarized beam) was obtained by properly adding stress-induced birefringence in the optical fiber.

Stereotactic body radiation therapy of early-stage non-small-cell lung carcinoma: Phase I study

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

McGarry, Ronald C.; Papiez, Lech; Williams, Mark

Purpose: A Phase I dose escalation study of stereotactic body radiation therapy to assess toxicity and local control rates for patients with medically inoperable Stage I lung cancer. Methods and Materials: All patients had non-small-cell lung carcinoma, Stage T1a or T1b N0, M0. Patients were immobilized in a stereotactic body frame and treated in escalating doses of radiotherapy beginning at 24 Gy total (3 x 8 Gy fractions) using 7-10 beams. Cohorts were dose escalated by 6.0 Gy total with appropriate observation periods. Results: The maximum tolerated dose was not achieved in the T1 stratum (maximum dose = 60 Gy),more » but within the T2 stratum, the maximum tolerated dose was realized at 72 Gy for tumors larger than 5 cm. Dose-limiting toxicity included predominantly bronchitis, pericardial effusion, hypoxia, and pneumonitis. Local failure occurred in 4/19 T1 and 6/28 T2 patients. Nine local failures occurred at doses {<=}16 Gy and only 1 at higher doses. Local failures occurred between 3 and 31 months from treatment. Within the T1 group, 5 patients had distant or regional recurrence as an isolated event, whereas 3 patients had both distant and regional recurrence. Within the T2 group, 2 patients had solitary regional recurrences, and the 4 patients who failed distantly also failed regionally. Conclusions: Stereotactic body radiation therapy seems to be a safe, effective means of treating early-stage lung cancer in medically inoperable patients. Excellent local control was achieved at higher dose cohorts with apparent dose-limiting toxicities in patients with larger tumors.« less

Integrated Electro-optical Laser-Beam Scanners

NASA Technical Reports Server (NTRS)

Boord, Warren T.

1990-01-01

Scanners using solid-state devices compact, consume little power, and have no moving parts. Integrated electro-optical laser scanner, in conjunction with external lens, points outgoing beam of light in any number of different directions, depending on number of upper electrodes. Offers beam-deflection angles larger than those of acousto-optic scanners. Proposed for such diverse applications as nonimpact laser printing, color imaging, ranging, barcode reading, and robotic vision.

Microdosimetric investigation at the therapeutic proton beam facility of CATANA.

PubMed

De Nardo, L; Moro, D; Colautti, P; Conte, V; Tornielli, G; Cuttone, G

2004-01-01

Proton beams (62 Mev) are used by the Laboratori Nazionali del Sud of the Italian Institute of Nuclear Physics to treat eye melanoma tumours at the therapeutic facility called CATANA. A cylindrical slim tissue-equivalent proportional counter (TEPC) of 2.7 mm external diameter has been used to compare the radiation quality of two spread-out Bragg peaks (SOBP) at the CATANA proton beam.

Phase Space Generation for Proton and Carbon Ion Beams for External Users' Applications at the Heidelberg Ion Therapy Center.

PubMed

Tessonnier, Thomas; Marcelos, Tiago; Mairani, Andrea; Brons, Stephan; Parodi, Katia

2015-01-01

In the field of radiation therapy, accurate and robust dose calculation is required. For this purpose, precise modeling of the irradiation system and reliable computational platforms are needed. At the Heidelberg Ion Therapy Center (HIT), the beamline has been already modeled in the FLUKA Monte Carlo (MC) code. However, this model was kept confidential for disclosure reasons and was not available for any external team. The main goal of this study was to create efficiently phase space (PS) files for proton and carbon ion beams, for all energies and foci available at HIT. PSs are representing the characteristics of each particle recorded (charge, mass, energy, coordinates, direction cosines, generation) at a certain position along the beam path. In order to achieve this goal, keeping a reasonable data size but maintaining the requested accuracy for the calculation, we developed a new approach of beam PS generation with the MC code FLUKA. The generated PSs were obtained using an infinitely narrow beam and recording the desired quantities after the last element of the beamline, with a discrimination of primaries or secondaries. In this way, a unique PS can be used for each energy to accommodate the different foci by combining the narrow-beam scenario with a random sampling of its theoretical Gaussian beam in vacuum. PS can also reproduce the different patterns from the delivery system, when properly combined with the beam scanning information. MC simulations using PS have been compared to simulations, including the full beamline geometry and have been found in very good agreement for several cases (depth dose distributions, lateral dose profiles), with relative dose differences below 0.5%. This approach has also been compared with measured data of ion beams with different energies and foci, resulting in a very satisfactory agreement. Hence, the proposed approach was able to fulfill the different requirements and has demonstrated its capability for application to clinical treatment fields. It also offers a powerful tool to perform investigations on the contribution of primary and secondary particles produced in the beamline. These PSs are already made available to external teams upon request, to support interpretation of their measurements.

SU-D-202-01: Functional Lung Avoidance and Response-Adaptive Escalation (FLARE) RT: Feasibility of a Precision Radiation Oncology Strategy

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

Bowen, S; Lee, E; Miyaoka, R

Purpose: NSCLC patient RT is planned without consideration of spatial heterogeneity in lung function or tumor response, which may have contributed to failed uniform dose escalation in a randomized trial. The feasibility of functional lung avoidance and response-adaptive escalation (FLARE) RT to reduce dose to [{sup 99m}Tc]MAA-SPECT/CT perfused lung while redistributing 74Gy within [{sup 18}F]FDG-PET/CT biological target volumes was assessed. Methods: Eight Stage IIB–IIIB NSCLC patients underwent FDG-PET/CT and MAA-SPECT/CT treatment planning scans. Perfused lung objectives were derived from scatter/collimator/attenuation-corrected MAA-SPECT uptake relative to ITV-subtracted lung to maintain <20Gy mean lung dose (MLD). Prescriptions included 60Gy to PTV and concomitantmore » boost of 74Gy mean to biological target volumes (BTV=GTV+PET margin) scaled to each BTV voxel by relative FDG-PET SUV. Dose-painting-by-numbers prescriptions were integrated into commercial TPS via previously reported ROI discretization. Dose constraints for lung, heart, cord, and esophagus were defined. FLARE RT plans were optimized with VMAT, proton pencil beam scanning (PBS) with 3%-3mm robust optimization, and combination PBS (avoidance) plus VMAT (escalation). Dosimetric differences were evaluated by Friedman non-parametric paired test with multiple sampling correction. Results: PTV and normal tissue objectives were not violated in 24 FLARE RT plans. Population median of mean BTV dose was 73.7Gy (68.5–75.5Gy), mean FDG-PET peak dose was 89.7Gy (73.5–103Gy), MLD was 12.3Gy (7.5–19.6Gy), and perfused MLD was 4.8Gy (0.9–12.1Gy). VMAT achieved higher dose to the FDG-PET peak subvolume (p=0.01), while PBS delivered lower dose to lung (p<0.001). Voxelwise linear correlation between BTV dose and FDG-PET uptake was higher for VMAT (R=0.93) and PBS+VMAT (R=0.94) compared to PBS alone (R=0.89). Conclusion: FLARE RT is feasible with VMAT and PBS. A combination of PBS for functional lung avoidance and VMAT for FDG-PET dose escalation balances target/normal tissue objective tradeoffs. These results support future testing of FLARE RT safety and efficacy within a precision radiation oncology trial. This work was supported by a Research Scholar grant from the Radiological Society of North American Research & Education Foundation.« less

Accelerator/Experiment Operations - FY 2015

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

Czarapata, P.

2015-10-01

This Technical Memorandum summarizes the Fermilab accelerator and experiment operations for FY 2015. It is one of a series of annual publications intended to gather information in one place. In this case, the information concerns the FY 2015 NOvA, MINOS+ and MINERvA experiments using the Main Injector Neutrino Beam (NuMI), the activities in the SciBooNE Hall using the Booster Neutrino Beam (BNB), and the SeaQuest experiment and Meson Test Beam (MTest) activities in the 120 GeV external Switchyard beam (SY120).

Pilot Quality Control Program for Audit RT External Beams at Mexican Hospitals

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

Alvarez R, J T; Tovar M, V M

2008-08-11

A pilot quality control program for audit 18 radiotherapy RT external beams at 13 Mexican hospitals is described--for eleven {sup 60}Co beams and seven photon beams of 6, 10 and 15 MV from accelerators. This program contains five parts: a) Preparation of the TLD-100 powder: washing, drying and annealing (one hour 400 deg. C plus 24 hrs 80 deg. C). b) Sending two IAEA type capsules to the hospitals for irradiation at the hospital to a nominal D{sub W} = 2 Gy{center_dot}c) Preparation at the SSDL of ten calibration curves CC in the range of 0.5 Gy to 6 Gymore » in terms of absorbed dose to water D{sub W} for {sup 60}Co with traceability to primary laboratory NRC (Canada), according to a window irradiation: 26/10/2007-7/12/2007. d) Reading all capsules that match their hospital time irradiation and the SSDL window irradiation. f) Evaluation of the Dw imparted by the hospitals.« less

Trace element fingerprinting of jewellery rubies by external beam PIXE

NASA Astrophysics Data System (ADS)

Calligaro, T.; Poirot, J.-P.; Querré, G.

1999-04-01

External beam PIXE analysis allows the non-destructive in situ characterisation of gemstones mounted on jewellery pieces. This technique was used for the determination of the geographical origin of 64 rubies set on a high-valued necklace. The trace element content of these gemstones was measured and compared to that of a set of rubies of known sources. Multivariate statistical processing of the results allowed us to infer the provenance of rubies : one comes from Thailand/Cambodia deposit while the remaining are attributed to Burma. This highlights the complementary capabilities of PIXE and conventional gemological observations.

Adjuvant radiotherapy for stage I endometrial cancer.

PubMed

Kong, A; Johnson, N; Cornes, P; Simera, I; Collingwood, M; Williams, C; Kitchener, H

2007-04-18

The role of adjuvant radiotherapy (both pelvic external beam radiotherapy and vaginal intracavity brachytherapy) in stage I endometrial cancer following total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH and BSO) remains unclear. To assess the efficacy of adjuvant radiotherapy following surgery for stage I endometrial cancer. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CancerLit, Physician Data Query (PDQ) of National Cancer Institute. Handsearching was also carried out where appropriate. Randomised controlled trials (RCTs) which compared adjuvant radiotherapy versus no radiotherapy following surgery for patients with stage I endometrial cancer were included. Quality of the studies was assessed and data collected using a predefined data collection form. The primary endpoint was overall survival. Secondary endpoints were locoregional recurrence, distant recurrence and endometrial cancer death. Data on quality of life (QOL) and morbidity were also collected. A meta-analysis on included trials was performed using the Cochrane Collaboration Review Manager Software 4.2. The meta-analysis was performed on four trials (1770 patients). The addition of pelvic external beam radiotherapy to surgery reduced locoregional recurrence, a relative risk (RR) of 0.28 (95% confidence interval (CI) 0.17 to 0.44, p < 0.00001), which is a 72% reduction in the risk of pelvic relapse (95% CI 56% to 83%) and an absolute risk reduction of 6% (95% CI of 4 to 8%). The number needed to treat (NNT) to prevent one locoregional recurrence is 16.7 patients (95% CI 12.5 to 25). The reduction in the risk of locoregional recurrence did not translate into either a reduction in the risk of distant recurrence or death from all causes or endometrial cancer death. A subgroup analysis of women with multiple high risk factors (including stage 1c and grade 3) showed a trend toward the reduction in the risk of death from all causes and endometrial cancer death in patients who underwent adjuvant external beam radiotherapy. Patients with stage I endometrial carcinoma have different risks of local and distant recurrence depending on the presence of risk factors including stage 1c, grade 3, lymphovascular space invasion and age. Though external beam pelvic radiotherapy reduced locoregional recurrence by 72%, there is no evidence to suggest that it reduced the risk of death. In patients with multiple high risk factors, including stage 1c and grade 3, there was a trend towards a survival benefit and adjuvant external beam radiotherapy may be justified. For patients with only one risk factor, grade 3 or stage 1c, no definite conclusion can be made and data from ongoing studies ( ASTEC; Lukka) are awaited. External beam radiotherapy carries a risk of toxicity and should be avoided in stage 1 endometrial cancer patients with no high risk factors.

SU-F-T-471: Simulated External Beam Delivery Errors Detection with a Large Area Ion Chamber Transmission Detector

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

Hoffman, D; Dyer, B; Kumaran Nair, C

Purpose: The Integral Quality Monitor (IQM), developed by iRT Systems GmbH (Koblenz, Germany) is a large-area, linac-mounted ion chamber used to monitor photon fluence during patient treatment. Our previous work evaluated the change of the ion chamber’s response to deviations from static 1×1 cm2 and 10×10 cm2 photon beams and other characteristics integral to use in external beam detection. The aim of this work is to simulate two external beam radiation delivery errors, quantify the detection of simulated errors and evaluate the reduction in patient harm resulting from detection. Methods: Two well documented radiation oncology delivery errors were selected formore » simulation. The first error was recreated by modifying a wedged whole breast treatment, removing the physical wedge and calculating the planned dose with Pinnacle TPS (Philips Radiation Oncology Systems, Fitchburg, WI). The second error was recreated by modifying a static-gantry IMRT pharyngeal tonsil plan to be delivered in 3 unmodulated fractions. A radiation oncologist evaluated the dose for simulated errors and predicted morbidity and mortality commiserate with the original reported toxicity, indicating that reported errors were approximately simulated. The ion chamber signal of unmodified treatments was compared to the simulated error signal and evaluated in Pinnacle TPS again with radiation oncologist prediction of simulated patient harm. Results: Previous work established that transmission detector system measurements are stable within 0.5% standard deviation (SD). Errors causing signal change greater than 20 SD (10%) were considered detected. The whole breast and pharyngeal tonsil IMRT simulated error increased signal by 215% and 969%, respectively, indicating error detection after the first fraction and IMRT segment, respectively. Conclusion: The transmission detector system demonstrated utility in detecting clinically significant errors and reducing patient toxicity/harm in simulated external beam delivery. Future work will evaluate detection of other smaller magnitude delivery errors.« less

THE EFFECTS OF FIXED VERSUS ESCALATING REINFORCEMENT SCHEDULES ON SMOKING ABSTINENCE

PubMed Central

Romanowich, Paul; Lamb, R. J.

2015-01-01

Studies indicate that when abstinence is initiated, escalating reinforcement schedules maintain continuous abstinence longer than fixed reinforcement schedules. However, these studies were conducted for shorter durations than most clinical trials and also resulted in larger reinforcer value for escalating participants during the 1st week of the experiment. We tested whether escalating reinforcement schedules maintained abstinence longer than fixed reinforcement schedules in a 12-week clinical trial. Smokers (146) were randomized to an escalating reinforcement schedule, a fixed reinforcement schedule, or a control condition. Escalating reinforcement participants received $5.00 for their first breath carbon monoxide (CO) sample <3 ppm, with a $0.50 increase for each consecutive sample. Fixed reinforcement participants received $19.75 for each breath CO sample <3 ppm. Control participants received payments only for delivering a breath CO sample. Similar proportions of escalating and fixed reinforcement participants met the breath CO criterion at least once. Escalating reinforcement participants maintained criterion breath CO levels longer than fixed reinforcement and control participants. Similar to previous short-term studies, escalating reinforcement schedules maintained longer durations of abstinence than fixed reinforcement schedules during a clinical trial. PMID:25640764

Tuning the Brake While Raising the Stake: Network Dynamics during Sequential Decision-Making.

PubMed

Meder, David; Haagensen, Brian Numelin; Hulme, Oliver; Morville, Tobias; Gelskov, Sofie; Herz, Damian Marc; Diomsina, Beata; Christensen, Mark Schram; Madsen, Kristoffer Hougaard; Siebner, Hartwig Roman

2016-05-11

When gathering valued goods, risk and reward are often coupled and escalate over time, for instance, during foraging, trading, or gambling. This escalating frame requires agents to continuously balance expectations of reward against those of risk. To address how the human brain dynamically computes these tradeoffs, we performed whole-brain fMRI while healthy young individuals engaged in a sequential gambling task. Participants were repeatedly confronted with the option to continue with throwing a die to accumulate monetary reward under escalating risk, or the alternative option to stop to bank the current balance. Within each gambling round, the accumulation of gains gradually increased reaction times for "continue" choices, indicating growing uncertainty in the decision to continue. Neural activity evoked by "continue" choices was associated with growing activity and connectivity of a cortico-subcortical "braking" network that positively scaled with the accumulated gains, including pre-supplementary motor area (pre-SMA), inferior frontal gyrus, caudate, and subthalamic nucleus (STN). The influence of the STN on continue-evoked activity in the pre-SMA was predicted by interindividual differences in risk-aversion attitudes expressed during the gambling task. Furthermore, activity in dorsal anterior cingulate cortex (ACC) reflected individual choice tendencies by showing increased activation when subjects made nondefault "continue" choices despite an increasing tendency to stop, but ACC activity did not change in proportion with subjective choice uncertainty. Together, the results implicate a key role of dorsal ACC, pre-SMA, inferior frontal gyrus, and STN in computing the trade-off between escalating reward and risk in sequential decision-making. Using a paradigm where subjects experienced increasing potential rewards coupled with increasing risk, this study addressed two unresolved questions in the field of decision-making: First, we investigated an "inhibitory" network of regions that has so far been investigated with externally cued action inhibition. In this study, we show that the dynamics in this network under increasingly risky decisions are predictive of subjects' risk attitudes. Second, we contribute to a currently ongoing debate about the anterior cingulate cortex's role in sequential foraging decisions by showing that its activity is related to making nondefault choices rather than to choice uncertainty. Copyright © 2016 Meder, Haagensen, et al.

Targets for production of the medical radioisotopes with alpha and proton or deuteron beams

NASA Astrophysics Data System (ADS)

Stolarz, Anna; Kowalska, J. A.; Jastrzebski, J.; Choiński, J.; Sitarz, M.; Szkliniarz, K.; Trzcińska, A.; Zipper, W.

2018-05-01

The research quantities of some medical radioisotopes were produced in reactions induced by 32 MeV internal alpha beam (211At, Sc isotopes), 16 MeV and 28 MeV proton beams (Sc isotopes) and 8 MeV deuteron beam (Sc isotopes). The frame-less targets used for irradiation with internal alpha beam were prepared from elemental (Bi for 211At) and compound (CaCO3 for Sc radioisotopes) materials. The CaCO3 powder targets were also used for production of Sc radioisotopes with proton or deuteron external beams. Methods developed for preparation of the targets suitable for the irradiating beam type are described in this work.

Predicting fatigue service life extension of RC bridges with externally bonded CFRP repairs.

DOT National Transportation Integrated Search

2015-12-01

This paper presents the results of an experimental study on the fatigue performance of RC beams : strengthened with different externally bonded CFRP systems. Seven specimens were fabricated; three had : no CFRP; the remaining four had one of two CFRP...

Emergency Department Escalation in Theory and Practice: A Mixed-Methods Study Using a Model of Organizational Resilience.

PubMed

Back, Jonathan; Ross, Alastair J; Duncan, Myanna D; Jaye, Peter; Henderson, Katherine; Anderson, Janet E

2017-11-01

Escalation policies are used by emergency departments (EDs) when responding to an increase in demand (eg, a sudden inflow of patients) or a reduction in capacity (eg, a lack of beds to admit patients). The policies aim to maintain the ability to deliver patient care, without compromising safety, by modifying "normal" processes. The study objective is to examine escalation policies in theory and practice. This was a mixed-method study involving a conceptual analysis of National Health Service escalation policies (n=12) and associated escalation actions (n=92), as well as a detailed ethnographic study of escalation in situ during a 16-month period in a large UK ED (n=30 observations). The conceptual analysis of National Health Service escalation policies found that their use requires the ability to dynamically reconfigure resources (staff and equipment), change work flow, and relocate patients. In practice, it was discovered that when the ED is under pressure, these prerequisites cannot always be attained. Instead, escalation processes were adapted to manage pressures informally. This adaptive need ("work as done") was found to be incompletely specified in policies ("work as imagined"). Formal escalation actions and their implementation in practice differed and varied in their effectiveness. Monitoring how escalation works in practice is essential in understanding whether and how escalation policies help to manage workload. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Flexural behaviour of RCC beams with externally bonded FRP

NASA Astrophysics Data System (ADS)

Vignesh, S. Arun; Sumathi, A.; Saravana Raja Mohan, K.

2017-07-01

The increasing use of carbon and glass fibre reinforced polymer (FRP) sheets for strengthening existing reinforced concrete beams has generated considerable interest in understanding the behavior of the FRP sheets when subjected to bending. The study on flexure includes various parameters like percentage of increase in strength of the member due to the externally bonded Fiber reinforced polymer, examining the crack patterns, reasons of debonding of the fibre from the structure, scaling, convenience of using the fibres, cost effectiveness etc. The present work aims to study experimentally about the reasons behind the failure due to flexure of an EB-FRP concrete beam by studying the various parameters. Deflection control may become as important as flexural strength for the design of FRPreinforced concrete structures. A numerical model is created using FEM software and the results are compared with that of the experiment.

Positron emission tomography imaging approaches for external beam radiation therapies: current status and future developments

PubMed Central

Price, P M; Green, M M

2011-01-01

In an era in which it is possible to deliver radiation with high precision, there is a heightened need for enhanced imaging capabilities to improve tumour localisation for diagnostic, planning and delivery purposes. This is necessary to increase the accuracy and overall efficacy of all types of external beam radiotherapy (RT), including particle therapies. Positron emission tomography (PET) has the potential to fulfil this need by imaging fundamental aspects of tumour biology. The key areas in which PET may support the RT process include improving disease diagnosis and staging; assisting tumour volume delineation; defining tumour phenotype or biological tumour volume; assessment of treatment response; and in-beam monitoring of radiation dosimetry. The role of PET and its current developmental status in these key areas are overviewed in this review, highlighting the advantages and drawbacks. PMID:21427180

An Apparatus For Student Projects Using External-Beam PIXE And PIGE

NASA Astrophysics Data System (ADS)

Correll, Francis D.; Edsall, Douglas W.; DePooter, Katherine A.; Maskell, Nicholas D.; Vanhoy, Jeffrey R.

2011-06-01

We recently installed a simple endstation at the Naval Academy Tandem Accelerator Laboratory to support student projects using external-beam PIXE and PIGE. It consists of a short, graphite-lined beamline extension with a thin window, an interlocked box that surrounds the target, detectors for x- and gamma rays, provision for flooding the target with helium gas, easily changed x-ray absorbers, and a compact video camera for monitoring the position of the beam spot. We used this system to measure the elemental composition of colonial-era architectural materials, principally bricks and mortar, from James Madison's Montpelier, the reconstructed Virginia estate of the fourth President of the United States. We describe the design and construction of the system, relate some of our experiences using it, and present some preliminary data from our investigations.

From headache to tumour: An examination of health anxiety, health-related Internet use and 'query escalation'.

PubMed

Singh, Karmpaul; Brown, Richard J

2016-09-01

The current study aimed to explore the phenomenon of disease-related 'query escalation' in high/low health anxious Internet users (N = 40). During a 15-minute health-related Internet search, participants rated their anxiety and the perceived seriousness of information on each page. Post-search interviews determined the reasons for, and effects of, escalating queries to consider serious diseases. Both groups were found to be significantly more anxious after escalating queries. The high group was significantly more likely to escalate queries. Evaluating personal relevance of material was the main reason for escalations and moderated anxiety post-escalation. We conclude that searching for online disease information can increase anxiety, particularly for people worried about their health. © The Author(s) 2015.

Bremsstrahlung Diode Performance on Mercury MIV A

DTIC Science & Technology

2005-06-01

generator, experiments are performed utilizing both carbon (C) and tantalum (Ta) converters. An array of CaF2 thermoluminescent dosimeters ( TLDs ...an Al cylinder of 4-mm wall thickness; this thickness is sufficient to isolate the TLDs from externally produced Compton electrons . The measured PD...production of Mercury, a series of large-area electron -beam (e-beam) diode experiments are performed in which the e-beam is deposited onto either a

Technologies for delivery of proton and ion beams for radiotherapy

NASA Astrophysics Data System (ADS)

Owen, Hywel; Holder, David; Alonso, Jose; Mackay, Ranald

2014-05-01

Recent developments for the delivery of proton and ion beam therapy have been significant, and a number of technological solutions now exist for the creation and utilisation of these particles for the treatment of cancer. In this paper we review the historical development of particle accelerators used for external beam radiotherapy and discuss the more recent progress towards more capable and cost-effective sources of particles.

Flexural strength using Steel Plate, Carbon Fiber Reinforced Polymer (CFRP) and Glass Fiber Reinforced Polymer (GFRP) on reinforced concrete beam in building technology

NASA Astrophysics Data System (ADS)

Tarigan, Johannes; Patra, Fadel Muhammad; Sitorus, Torang

2018-03-01

Reinforced concrete structures are very commonly used in buildings because they are cheaper than the steel structures. But in reality, many concrete structures are damaged, so there are several ways to overcome this problem, by providing reinforcement with Fiber Reinforced Polymer (FRP) and reinforcement with steel plates. Each type of reinforcements has its advantages and disadvantages. In this study, researchers discuss the comparison between flexural strength of reinforced concrete beam using steel plates and Fiber Reinforced Polymer (FRP). In this case, the researchers use Carbon Fiber Reinforced Polymer (CFRP) and Glass Fiber Reinforced Polymer (GFRP) as external reinforcements. The dimension of the beams is 15 x 25 cm with the length of 320 cm. Based on the analytical results, the strength of the beam with CFRP is 1.991 times its initial, GFRP is 1.877 times while with the steel plate is 1.646 times. Based on test results, the strength of the beam with CFRP is 1.444 times its initial, GFRP is 1.333 times while the steel plate is 1.167 times. Based on these test results, the authors conclude that beam with CFRP is the best choice for external reinforcement in building technology than the others.

Fabrication of a self-sensing electroactive polymer bimorph actuator based on polyvinylidene fluoride and its electrostrictive terpolymer

NASA Astrophysics Data System (ADS)

Engel, Leeya; Van Volkinburg, Kyle R.; Ben-David, Moti; Washington, Gregory N.; Krylov, Slava; Shacham-Diamand, Yosi

2016-04-01

In this paper, we report on the fabrication of a self-sensing electroactive polymer cantilevered bimorph beam actuator and its frequency response. Tip deflections of the beam, induced by applying an AC signal across ferroelectric relaxor polyvinylidene fluoride-trifluoroethylene chlorotrifluoroethylene (P(VDF-TrFE-CTFE)), reached a magnitude of 350μm under a field of ~55MV/m and were recorded externally using a laser Doppler vibrometer (LDV). Deflections were determined simultaneously by applying a sensing model to the voltage measured across the bimorph's integrated layer of piezoelectric polymer polyvinylidene fluoride (PVDF). The sensing model treats the structure as a simple Euler- Bernoulli cantilevered beam with two distributed active elements represented through the use of generalized functions and offers a method through which real time tip deflection can be measured without the need for external visualization. When not being used as a sensing element, the PVDF layer can provide an additional means for actuation of the beam via the converse piezoelectric effect, resulting in bidirectional control of the beam's deflections. Integration of flexible sensing elements together with modeling of the electroactive polymer beam can benefit the developing field of polymer microactuators which have applications in soft robotics as "smart" prosthetics/implants, haptic displays, tools for less invasive surgery, and sensing.

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

Sole, Claudio V., E-mail: cvsole@uc.cl; School of Medicine, Complutense University, Madrid; Service of Radiation Oncology, Instituto de Radiomedicina, Santiago

Purpose: To perform a joint analysis of data from 3 contributing centers within the intraoperative electron-beam radiation therapy (IOERT)-Spanish program, to determine the potential of IOERT as an anticipated boost before external beam radiation therapy in the multidisciplinary treatment of pediatric extremity soft-tissue sarcomas. Methods and Materials: From June 1993 to May 2013, 62 patients (aged <21 years) with a histologic diagnosis of primary extremity soft-tissue sarcoma with absence of distant metastases, undergoing limb-sparing grossly resected surgery, external beam radiation therapy (median dose 40 Gy) and IOERT (median dose 10 Gy) were considered eligible for this analysis. Results: After a median follow-up ofmore » 66 months (range, 4-235 months), 10-year local control, disease-free survival, and overall survival was 85%, 76%, and 81%, respectively. In multivariate analysis after adjustment for other covariates, tumor size >5 cm (P=.04) and R1 margin status (P=.04) remained significantly associated with local relapse. In regard to overall survival only margin status (P=.04) retained association on multivariate analysis. Ten patients (16%) reported severe chronic toxicity events (all grade 3). Conclusions: An anticipated IOERT boost allowed for external beam radiation therapy dose reduction, with high local control and acceptably low toxicity rates. The combined radiosurgical approach needs to be tested in a prospective trial to confirm these results.« less

Maintenance and Safety Practices of Escalator in Commercial Buildings

NASA Astrophysics Data System (ADS)

Afida Isnaini Janipha, Nurul; Nur Aina Syed Alwee, Sharifah; Ariff, Raihan Mohd; Ismail, Faridah

2018-02-01

The escalator is very crucial to transport a person from one place to another. Nevertheless, there are many cases recorded the accidents in relation to escalator. These may occur due to lack of maintenance which leads to systems breakdown, poor safety practices, wear and tear, users’ negligence and others. Thus, proper maintenance systems need to be improvised to prevent and reduce escalator accident in future. This research was aimed to determine the escalator maintenance activities and safety practices in a commercial building. Three case studies were selected within Selangor area. Semi-structured interviews were conducted for collecting data from these three case studies. To achieve the aim of this research, the study was carried out on the maintenance activities, safety practices and cost related to escalator maintenance. As one of the important means of access in building, it is very crucial to increase effectiveness of escalator particularly in commercial building. It is expected that readers will get clear information on the maintenance activities and safety practices of escalator in commercial building.

Photon Beaming in External Compton models

NASA Astrophysics Data System (ADS)

Hutter, Anne; Spanier, Felix

In attempt to model blazar emission spectra, External Compton models have been employed to fit the observed data. In these models photons from the accretion disk or the CMB are upscat-tered via the Compton effect by the electrons and contribute to the emission. In previous works the resulting scattered photon angular distribution has been calculated for ultrarelativistic elec-trons. This work aims to extend the result to the case of mildly relativistic electrons. Hence, the beaming pattern produced by a relativistic moving blob consisting of isotropic distributed electrons, which scatter photons of an isotropic external radiation is calculated numerically. The isotropic photon density distribution in the blob frame is Lorentz-transformed into the rest frame of the electron and results in an anisotropic distribution with a preferred direction where it is upscattered by the electrons. The photon density distribution is determined and transformed back into the blob frame. As the photons in the rest frame of the electrons are dis-tributed anisotropically the scattering does not reproduce this anisotropic distribution. When transforming back into the blob frame the resulting photon distribution won't be isotropic. Approximations have shown that the resulting photon distribution is boosted more strongly than a distribution assumed to be isotropic in the rest frame of the electrons. Hence, in order to obtain the beaming caused by external Compton it is of particular interest to derive a more exact approximation of the resulting photon angular distribution.

External Beam Boost for Cancer of the Cervix Uteri When Intracavitary Therapy Cannot Be Performed

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

Barraclough, Lisa Helen; Swindell, Ric; Livsey, Jacqueline E.

2008-07-01

Purpose: To assess the outcome of patients treated with radical radiotherapy for cervical cancer who received an external beam boost, in place of intracavitary brachytherapy (ICT), after irradiation to the whole pelvis. Methods and Materials: Case notes were reviewed for all patients treated in this way in a single center between 1996 and 2004. Patient and tumor details, the reasons why ICT was not possible, and treatment outcome were documented. Results: Forty-four patients were identified. The mean age was 56.4 years (range, 26-88 years). Clinical International Federation of Gynecology and Obstetrics or radiologic stage for Stages I, II, III, andmore » IV, respectively, was 16%, 48%, 27%, and 7%. A total radiation dose of 54-70 Gy was given (75% received {>=}60 Gy). Reasons for ICT not being performed were technical limitations in 73%, comorbidity or isolation limitations in 23%, and patient choice in 4%. The median follow-up was 2.3 years. Recurrent disease was seen in 48%, with a median time to recurrence of 2.3 years. Central recurrence was seen in 16 of the 21 patients with recurrent disease. The 5-year overall survival rate was 49.3%. The 3-year cancer-specific survival rate by stage was 100%, 70%, and 42% for Stages I, II, and III, respectively. Late Grades 1 and 2 bowel, bladder, and vaginal toxicity were seen in 41%. Late Grade 3 toxicity was seen in 2%. Conclusion: An external beam boost is a reasonable option after external beam radiotherapy to the pelvis when it is not possible to perform ICT.« less

Accelerated partial breast irradiation with external beam radiotherapy : First results of the German phase 2 trial.

PubMed

Ott, Oliver J; Strnad, Vratislav; Stillkrieg, Wilhelm; Uter, Wolfgang; Beckmann, Matthias W; Fietkau, Rainer

2017-01-01

To evaluate the feasibility and efficacy of external beam three-dimensional (3D) conformal accelerated partial breast irradiation (APBI) for selected patients with early breast cancer. Between 2011 and 2016, 72 patients were recruited for this prospective phase 2 trial. Patients were eligible for APBI if they had histologically confirmed breast cancer or pure ductal carcinoma in situ (DCIS), a tumor diameter ≤3 cm, clear resection margins ≥2 mm, no axillary lymph node involvement, no distant metastases, tumor bed clips, and were aged ≥50 years. Patients were excluded if mammography showed a multicentric invasive growth pattern, or if they had residual diffuse microcalcifications postoperatively, an extensive intraductal component, or vessel invasion. Patients received 3D conformal external beam APBI with a total dose of 38 Gy in 10 fractions in 1-2 weeks. The trial had been registered at the German Clinical Trials Register, DRKS-ID: DRKS00004417. Median follow-up was 25.5 months (range 1-61 months). Local control was maintained in 71 of 72 patients. The 3‑year local recurrence rate was 2.1% (95% confidence interval, CI: 0-6.1%). Early toxicity (grade 1 radiodermatitis) was seen in 34.7% (25/72). Late side effects ≥ grade 3 did not occur. Cosmetic results were rated as excellent/good in 96.7% (59/61). APBI with external beam radiotherapy techniques is feasible with low toxicity and, according to the results of the present and other studies, on the way to becoming a standard treatment option for a selected subgroup of patients.

Helping parents deal with children's acute disciplinary problems without escalation: the principle of nonviolent resistance.

PubMed

Omer, H

2001-01-01

There are two kinds of escalation between parents and children with acute discipline problems: (a) complementary escalation, in which parental giving-in leads to a progressive increase in the child's demands, and (b) reciprocal escalation, in which hostility begets hostility. Extant programs for helping parents deal with children with such problems focus mainly on one kind of escalation to the neglect of the other. The systematic use of Gandhi's principle of "nonviolent resistance" allows for a parental attitude that counters both kinds of escalation. An intervention is described, which allows parents to put this principle into practice.

Escalate shamefully, de-escalate angrily or gratefully: the influence of discrete emotions on escalation of commitment.

PubMed

Dang, Junhua; Xiao, Shanshan; Liljedahl, Sophie

2014-08-01

Decision makers often tend to escalate their commitment when faced with a dilemma of whether to continue a losing course of action. Researchers recently began to investigate the influence of discrete emotions on this decision tendency. However, this work has mainly focused on negative emotions and rarely considered positive emotions, to say nothing of comparing the effects of both of them simultaneously. The current study addresses this need by presenting the results of three experiments that examined the effects of four emotions of both positive and negative valences in escalation situations. Experiment 1 investigated the relationships of three trait emotions (hope, shame, and anger) and escalation of commitment. Experiments 2 and 3 examined the effects of three induced emotions (anger, shame, and gratitude) on escalation of commitment in a student sample and an employee sample, respectively. The results revealed that the effects of discrete emotions in escalation situations are mainly due to their associated differences on the appraisal dimension of responsibility that is related to escalation situations rather than their valence. The theoretical and practical implications are discussed. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Secondary radiation measurements for particle therapy applications: charged particles produced by 4He and 12C ion beams in a PMMA target at large angle

NASA Astrophysics Data System (ADS)

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

2018-03-01

Proton and carbon ion beams are used in the clinical practice for external radiotherapy treatments achieving, for selected indications, promising and superior clinical results with respect to x-ray based radiotherapy. Other ions, like \

Continuous wavelength tunable laser source with optimum positioning of pivot axis for grating

DOEpatents

Pushkarsky, Michael; Amone, David F.

2010-06-08

A laser source (10) for generating a continuously wavelength tunable light (12) includes a gain media (16), an optical output coupler (36F), a cavity collimator (38A), a diffraction grating (30), a grating beam (54), and a beam attacher (56). The diffraction grating (30) is spaced apart from the cavity collimator (38A) and the grating (30) cooperates with the optical output coupler (36F) to define an external cavity (32). The grating (30) includes a grating face surface (42A) that is in a grating plane (42B). The beam attacher (56) retains the grating beam (54) and allows the grating beam (54) and the grating (30) to effectively pivot about a pivot axis (33) that is located approximately at an intersection of a pivot plane (50) and the grating plane (42B). As provided herein, the diffraction grating (30) can be pivoted about the unique pivot axis (33) to move the diffraction grating (30) relative to the gain media (16) to continuously tune the lasing frequency of the external cavity (32) and the wavelength of the output light (12) so that the output light (12) is mode hop free.

Effective ingredients of verbal de-escalation: validating an English modified version of the 'De-Escalating Aggressive Behaviour Scale'.

PubMed

Mavandadi, V; Bieling, P J; Madsen, V

2016-08-01

WHAT IS KNOWN ON THE SUBJECT?: Verbal de-escalation is an intervention aimed at calmly managing an agitated client to prevent violence. Effective de-escalation can help reduce the use of seclusion and restraint in psychiatric settings. Despite its importance in practice, there is little agreement on the necessary techniques of de-escalation and most of the research on the topic is based on expert opinion. To our knowledge, only one attempt at quantifying de-escalation skill has been pursued through the German-language De-Escalating Aggressive Behaviour Scale (DABS). While the DABS identified seven qualities necessary for de-escalation, it has not been validated in English and may lack important descriptors. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The present study enhanced the original DABS with best, acceptable and least desirable staff de-escalation practice descriptions for each of the seven items. This enhancement of the DABS lead to the creation of the English modified DABS (EMDABS). The EMDABS was psychometrically validated for use in research and practice: raters could use the EMDABS with a high level of agreement and consistency. Also, the scale appeared to measure a single cohesive construct - de-escalation. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: With further validation, the EMDABS has potential to be the first English quantitative measure of de-escalation. The EMDABS offers seven items, with associated best practice descriptions, that may be used to inform de-escalation practice. The EMDABS can be used to evaluate training and education programmes and inform how these programmes and independent de-escalation practice may be improved. Introduction Verbal de-escalation is crucial to a non-coercive psychiatric environment. Despite its importance, the literature on de-escalation is sparse and mostly qualitative. To address this, Nau et al. (2009) quantified de-escalation by creating the German-language De-Escalating Aggressive Behaviour Scale (DABS). The DABS provides seven skills necessary for de-escalation, however it has not been validated in English and lacks the necessary anchor descriptions to make it useful. Aim To modify the DABS to include descriptions of best, acceptable and least desirable staff practice and to validate the English modified DABS (EMDABS). Method To develop item descriptions for the EMDABS, 50 conflictual staff-patient interactions were reviewed, summarized and cross-referenced with the literature (n = 19). Three raters then used the EMDABS to evaluate 272 simulations depicting these interactions. Results The EMDABS demonstrated very good inter-rater reliability [ICC (3, 1) = 0.752] and strong internal consistency (α = 0.901). A factor analysis revealed that the seven items were best represented by a single factor. Discussion The EMDABS was validated for future use in research and practice. Additional validation and future research directions are discussed. Implications for practice The EMDABS holds promise as a quantitative measure of de-escalation. Its seven items and best practice guidelines have clinical implications for improving practice and training. © 2016 John Wiley & Sons Ltd.

Multi-shaped beam: development status and update on lithography results

NASA Astrophysics Data System (ADS)

Slodowski, Matthias; Doering, Hans-Joachim; Dorl, Wolfgang; Stolberg, Ines A.

2011-04-01

According to the ITRS [1] photo mask is a significant challenge for the 22nm technology node requirements and beyond. Mask making capability and cost escalation continue to be critical for future lithography progress. On the technological side mask specifications and complexity have increased more quickly than the half-pitch requirements on the wafer designated by the roadmap due to advanced optical proximity correction and double patterning demands. From the economical perspective mask costs have significantly increased each generation, in which mask writing represents a major portion. The availability of a multi-electron-beam lithography system for mask write application is considered a potential solution to overcome these challenges [2, 3]. In this paper an update of the development status of a full-package high-throughput multi electron-beam writer, called Multi Shaped Beam (MSB), will be presented. Lithography performance results, which are most relevant for mask writing applications, will be disclosed. The MSB technology is an evolutionary development of the matured single Variable Shaped Beam (VSB) technology. An arrangement of Multi Deflection Arrays (MDA) allows operation with multiple shaped beams of variable size, which can be deflected and controlled individually [4]. This evolutionary MSB approach is associated with a lower level of risk and a relatively short time to implementation compared to the known revolutionary concepts [3, 5, 6]. Lithography performance is demonstrated through exposed pattern. Further details of the substrate positioning platform performance will be disclosed. It will become apparent that the MSB operational mode enables lithography on the same and higher performance level compared to single VSB and that there are no specific additional lithography challenges existing beside those which have already been addressed [1].

Submillimeter Schottky Diodes with Electron Beam Lithography.

DTIC Science & Technology

1979-12-01

Timer 2: external clock, oneshot , 0’ sixteen bit counting modes are .,selected, no data is entered; interrupts are disabled. Timer 3: external clock and...CLOCK, ONESHOT MODE, NO INTERRUPTS, 00031* 16 BIT COUNTING MODE, OUTPUT IS EN- 00032 * ABLED; NO DATA IS ENTERED, 00033 00034 * TIMER3: EXT CLOCK

Longitudinal Fracture Analysis of a Two-Dimensional Functionally Graded Beam

NASA Astrophysics Data System (ADS)

Rizov, V.

2017-11-01

Longitudinal fracture in a two-dimensional functionally graded beam is analyzed. The modulus of elasticity varies continuously in the beam cross-section. The beam is clamped in its right-hand end. The external loading consists of one longitudinal force applied at the free end of the lower crack arm. The longitudinal crack is located in the beam mid-plane. The fracture is studied in terms of the strain energy release rate. The solution derived is used to elucidate the effects of material gradients along the height as well as along the width of the beam cross-section on the fracture behaviour. The results obtained indicate that the fracture in two-dimensional functionally graded beams can be regulated efficiently by employing appropriate material gradients.

CW 50W/M2 = 10.9 diode laser source by spectral beam combining based on a transmission grating.

PubMed

Zhang, Jun; Peng, Hangyu; Fu, Xihong; Liu, Yun; Qin, Li; Miao, Guoqing; Wang, Lijun

2013-02-11

An external cavity structure based on the -1st transmission grating is introduced to spectral beam combining a 970 nm diode laser bar. A CW output power of 50.8 W, an electro-optical conversion efficiency of 45%, a spectral beam combining efficiency of 90.2% and a holistic M(2) value of 10.9 are achieved. This shows a way for a diode laser source with several KW power and diffraction-limited beam quality at the same time.

Experimental and numerical investigation on laser-assisted bending of pre-loaded metal plate

NASA Astrophysics Data System (ADS)

Nowak, Zdzisław; Nowak, Marcin; Widłaszewski, Jacek; Kurp, Piotr

2018-01-01

The laser forming technique has an important disadvantage, which is the limitation of plastic deformation generated by a single laser beam pass. To increase the plastic deformation it is possible to apply external forces in the laser forming process. In this paper, we investigate the influence of external pre-loads on the laser bending of steel plate. The pre-loads investigated generate bending towards the laser beam. The thermal, elastic-plastic analysis is performed using the commercial nonlinear finite element analysis package ABAQUS. The focus of the paper is to identify how this pattern of the pre-load influence the final bend angle of the plate.

Outcomes of Pituitary Radiation for Cushing's Disease.

PubMed

Ironside, Natasha; Chen, Ching-Jen; Lee, Cheng-Chia; Trifiletti, Daniel M; Vance, Mary Lee; Sheehan, Jason P

2018-06-01

Achievement of biochemical remission with preservation of normal pituitary function is the goal of treatment for Cushing's disease. For patients with persistent or recurrent Cushing's disease after transsphenoidal resection, radiation therapy may be a safe and effective treatment. Stereotactic radiosurgery is favored over conventional fractionated external beam radiation. Hormonal recurrence rates range from 0% to 36% at 8 years after treatment. Tumor control rates are high. New pituitary hormone deficiency is the most common adverse effect after stereotactic radiosurgery and external beam radiation. The effects of radiation planning optimization and use of adjuvant medication on endocrine remission rates warrant investigation. Copyright © 2018 Elsevier Inc. All rights reserved.

MO-A-BRB-02: Considerations and Issues in Electronic Charting for Brachytherapy

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

Richardson, S.

2015-06-15

The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiationmore » therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy.« less

The success of primary chemotherapy for group D heritable retinoblastoma.

PubMed

Cohen, V M L; Kingston, J; Hungerford, J L

2009-07-01

To report the ocular survival and event-free survival following primary multiagent chemotherapy for group D, heritable bilateral retinoblastoma (RB). The RB database was used to identify children with heritable, bilateral RB treated with primary chemotherapy (six cycles of vincristine, etoposide and carboplatin). Only Group D eyes with more than 12 months' follow-up were analysed. The timing, number and type of salvage treatments were recorded. Kaplan-Meier estimates for the ocular survival and event-free survival (percentage of eyes that avoided external beam radiotherapy and/or enucleation) were performed as a function of time. Of 18 group D eyes, two (11%) were treated successfully with chemotherapy alone, nine (50%) underwent successful salvage treatment, and seven (39%) were enucleated. The median time from completing chemotherapy to enucleation was 9 months (range 4 to 25 months). Ocular survival was 67% at 2 years. External beam radiotherapy proved successful salvage treatment in five of nine eyes, so the event-free survival was 34% at 2 years. Multiagent chemotherapy alone is rarely sufficient for the preservation of group D eyes. External beam radiotherapy and plaque radiotherapy remain important salvage treatments for advanced, heritable retinoblastoma.

Fast neutron detection at near-core location of a research reactor with a SiC detector

NASA Astrophysics Data System (ADS)

Wang, Lei; Jarrell, Josh; Xue, Sha; Tan, Chuting; Blue, Thomas; Cao, Lei R.

2018-04-01

The measurable charged-particle produced from the fast neutron interactions with the Si and C nucleuses can make a wide bandgap silicon carbide (SiC) sensor intrinsically sensitive to neutrons. The 4H-SiC Schottky detectors have been fabricated and tested at up to 500 °C, presenting only a slightly degraded energy resolution. The response spectrum of the SiC detectors were also obtained by exposing the detectors to external neutron beam irradiation and at a near-core location where gamma-ray field is intense. The fast neutron flux of these two locations are ∼ 4 . 8 × 104cm-2 ṡs-1 and ∼ 2 . 2 × 107cm-2 ṡs-1, respectively. At the external beam location, a Si detector was irradiated side-by-side with SiC detector to disjoin the neutron response from Si atoms. The contribution of gamma ray, neutron scattering, and charged-particles producing reactions in the SiC was discussed. The fast neutron detection efficiencies were determined to be 6 . 43 × 10-4 for the external fast neutron beam irradiation and 6 . 13 × 10-6 for the near-core fast neutron irradiation.

Linear induction accelerators made from pulse-line cavities with external pulse injection.

PubMed

Smith, I

1979-06-01

Two types of linear induction accelerator have been reported previously. In one, unidirectional voltage pulses are generated outside the accelerator and injected into the accelerator cavity modules, which contain ferromagnetic material to reduce energy losses in the form of currents induced, in parallel with the beam, in the cavity structure. In the other type, the accelerator cavity modules are themselves pulse-forming lines with energy storage and switches; parallel current losses are made zero by the use of circuits that generate bidirectional acceleration waveforms with a zero voltage-time integral. In a third type of design described here, the cavities are externally driven, and 100% efficient coupling of energy to the beam is obtained by designing the external pulse generators to produce bidirectional voltage waveforms with zero voltage-time integral. A design for such a pulse generator is described that is itself one hundred percent efficient and which is well suited to existing pulse power techniques. Two accelerator cavity designs are described that can couple the pulse from such a generator to the beam; one of these designs provides voltage doubling. Comparison is made between the accelerating gradients that can be obtained with this and the preceding types of induction accelerator.

Complete response in a patient with gynecological hidradenocarcinoma treated with exclusive external beam radiotherapy and brachytherapy: a case report

PubMed Central

Giannelli, Flavio; Chiola, Ilaria; Garelli, Stefania; Pastorino, Alice; Marcenaro, Michela; Mammoliti, Serafina; Costantini, Sergio; Bizzarri, Nicolò; Vellone, Valerio; Barra, Salvina; Corvò, Renzo

2017-01-01

Hidradenocarcinoma (HC) is a very rare disease. This case report illustrates a successful treatment of a 60-year-old woman with vulvo-vaginal localization of hidradenocarcinoma treated with external beam radiotherapy delivered by helical tomotherapy with a simultaneous integrated boost (SIB), followed by brachytherapy. External beam radiotherapy dose prescription was 50.4 Gy in 28 fractions, five fractions per week to whole pelvis (planning target volume 1 – PTV1), 60.2 Gy in 28 fractions to SIB1 (fundus of uterus and right inguinal node), and 58.8 Gy in 28 fractions to SIB2 (lower/middle third of vagina, paraurethral region and right inguinal lymph nodes). Brachytherapy dose prescription was 28 Gy in 4 fractions for cervix, fundus of uterus and upper third of vagina (HR-CTV1), and 22 Gy in 4 fractions to middle third of vagina and paraurethral region (HR-CTV2). D90 for whole treatment was 91.9 Gy and 86.0 Gy for HR-CTV1 and HR-CTV2, respectively. Patient remained 12-months disease-free without treatment related side effects. PMID:29441103

A TCP model for external beam treatment of intermediate-risk prostate cancer

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

Walsh, Sean; Putten, Wil van der

2013-03-15

Purpose: Biological models offer the ability to predict clinical outcomes. The authors describe a model to predict the clinical response of intermediate-risk prostate cancer to external beam radiotherapy for a variety of fractionation regimes. Methods: A fully heterogeneous population averaged tumor control probability model was fit to clinical outcome data for hyper, standard, and hypofractionated treatments. The tumor control probability model was then employed to predict the clinical outcome of extreme hypofractionation regimes, as utilized in stereotactic body radiotherapy. Results: The tumor control probability model achieves an excellent level of fit, R{sup 2} value of 0.93 and a root meanmore » squared error of 1.31%, to the clinical outcome data for hyper, standard, and hypofractionated treatments using realistic values for biological input parameters. Residuals Less-Than-Or-Slanted-Equal-To 1.0% are produced by the tumor control probability model when compared to clinical outcome data for stereotactic body radiotherapy. Conclusions: The authors conclude that this tumor control probability model, used with the optimized radiosensitivity values obtained from the fit, is an appropriate mechanistic model for the analysis and evaluation of external beam RT plans with regard to tumor control for these clinical conditions.« less

De-escalating aggression and violence in the mental health setting.

PubMed

Cowin, Leanne; Davies, Rhian; Estall, Graham; Berlin, Theresa; Fitzgerald, Maria; Hoot, Sandra

2003-03-01

Aggressive and violent incidents in the health-care setting are increasing phenomena around the world. The evidence from current literature suggests that changes in health-care access, nursing staff shortages and patient acuity are some of the possible causes. De-escalation is a valuable intervention that can be used by nurses to help counter the growing problems of aggression and violence. The de-escalation project, discussed in the present paper, aimed to explore de-escalation as an important therapeutic process and is an event of considerable potential in the management of aggression and violence. While de-escalation is not a new tool, particularly in the mental health-care setting, an educative programme aimed at renewing nurses' knowledge and skills in de-escalation is a timely project. The final de-escalation kit included a large glossy poster, a nursing staff survey, an in-service education session and a literature-based discussion paper. The de-escalation kit can be of considerable benefit to those nurses who are transient within the workplace, such as casual and agency nurses.

Thermodynamic aspects of an LNG tank in fire and experimental validation

NASA Astrophysics Data System (ADS)

Hulsbosch-Dam, Corina; Atli-Veltin, Bilim; Kamperveen, Jerry; Velthuis, Han; Reinders, Johan; Spruijt, Mark; Vredeveldt, Lex

Mechanical behaviour of a Liquefied Natural Gas (LNG) tank and the thermodynamic behaviour of its containment under extreme heat load - for instance when subjected to external fire source as might occur during an accident - are extremely important when addressing safety concerns. In a scenario where external fire is present and consequent release of LNG from pressure relief valves (PRV) has occurred, escalation of the fire might occur causing difficulty for the fire response teams to approach the tank or to secure the perimeter. If the duration of the tank exposure to fire is known, the PRV opening time can be estimated based on the thermodynamic calculations. In this paper, such an accidental scenario is considered, relevant thermodynamic equations are derived and presented. Moreover, an experiment is performed with liquid nitrogen and the results are compared to the analytical ones. The analytical results match very well with the experimental observations. The resulting analytical models are suitable to be applied to other cryogenic liquids.

Pros and cons of characterising an optical translocation setup

NASA Astrophysics Data System (ADS)

Maphanga, Charles; Malabi, Rudzani; Ombinda-Lemboumba, Saturnin; Maaza, Malik; Mthunzi-Kufa, Patience

2017-02-01

The delivery of genetic material and drugs into mammalian cells using femtosecond (fs) laser pulses is escalating rapidly. This novel light based technique achieved through a precise focusing of a laser beam on the plasma membrane is called photoporation. This technique is attained using ultrashort laser pulses to irradiate plasma membrane of mammalian cells, thus resulting in the accumulation of a vast amount of free electrons. These generated electrons react photochemically with the cell membrane, resulting in the generation of sub-microscopic pores on the cell membrane enabling a variety of extracellular media to diffuse into the cell. This study is aimed at critically analysing the "do's and don'ts" of designing, assembling, and characterising an optical translocation setup using a femtosecond legend titanium sapphire regenerative amplifier pulsed laser (Gaussian beam, 800 nm, 1 kHz, 113 fs, and an output power of 850 mW). The main objective in our study is to determine optical phototranslocation parameters which are compatible to the plasma membrane and cell viability. Such parameters included beam profiling, testing a range of laser fluencies suitable for photoporation, assessment of the beam quality and laser-cell interaction time. In our study, Chinese Hamster Ovary-K1 (CHO-K1) cells were photoporated in the presence of trypan blue to determine optimal parameters for photoporation experiment. An average power of 4.5 μW, exposure time of 7 ms, with a laser beam spot of 1.1 μm diameter at the focus worked optimally without any sign of cell stress and cytoplasmic bleeding. Cellular responses post laser treatment were analysed using cell morphology studies.

Pseudomorphic In(y)Ga(1-y)As/GaAs/Al(x)Ga(1-x)As single quantum well surface-emitting lasers with integrated 45 deg beam deflectors

NASA Technical Reports Server (NTRS)

Kim, Jae-Hoon; Larsson, Anders; Lee, Luke P.

1991-01-01

The paper reports on the first demonstration of pseudomorphic InGaAs single quantum well surface-emitting lasers (SELs), with etched vertical mirrors and integrated 45-deg beam deflectors fabricated by ion beam etching. 100-micron-wide broad-area SELs exhibited a threshold current of 320 mA, a total power of 126 mW, and a total external differential quantum efficiency of 0.09 W/A for a 500-micron-long cavity. The perpendicular far-field pattern of broad-area SELs showed a full width at half maximum of about 20 deg. Lasers with various types of cavities fabricated from the same wafer were compared. Broad-area edge-emitting lasers had a threshold current of 200 mA, a total power of 700 mW, and a total external differential quantum efficiency of 0.52 W/A.

Observation of divergent-beam X-ray diffraction from a crystal of diamond using synchrotron radiation.

PubMed

Glazer, A M; Collins, S P; Zekria, D; Liu, J; Golshan, M

2004-03-01

In 1947 Kathleen Lonsdale conducted a series of experiments on X-ray diffraction using a divergent beam external to a crystal sample. Unlike the Kossel technique, where divergent X-rays are excited by the presence of fluorescing atoms within the crystal, the use of an external divergent source made it possible to study non-fluorescing crystals. The resulting photographs not only illustrated the complexity of X-ray diffraction from crystals in a truly beautiful way, but also demonstrated unprecedented experimental precision. This long-forgotten work is repeated here using a synchrotron radiation source and, once again, considerable merit is found in Lonsdale's technique. The results of this experiment suggest that, through the use of modern 'third-generation' synchrotron sources, divergent-beam diffraction could soon enjoy a renaissance for high-precision lattice-parameter determination and the study of crystal perfection.

Production of Astatine-211 at the Duke University Medical Center for its regional distribution

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

Zalutsky, Michael

Systemic targeted radiation therapy and radioimmunotherapy continue to be important tools in the treatment of certain cancers. Because of their high energy and short path length, alpha particle emitters such as 211At are more effective than either external beam x- ray or in vivo beta radiation in delivering potentially curative doses of radiation. The limited clinical trials that have been conducted to date have yielded encouraging responses in some patients, e.g., malignant brain tumors. In order to escalate the additional necessary research and development in radiochemistry, radiobiology and efficacy evaluation of alpha particle radiotherapeutics, it is universally agreed that accessmore » to an affordable, reliable supply of 211At is warranted. In conjunction with the Department of Energy's intent to enhance stable and radioactive isotope availability for research applications, it is the primary objective of this project to improve 211At production and purification capabilities at Duke so that this radionuclide can be supplied to researchers at other institutions throughout the US.The most widely used 211At production method involves the α,2n reaction on Bismuth using a cyclotron with beams ≤ 28 MeV. Yields can be enhanced with use of an internal target that allows for a higher alpha fluence plus efficient heat dissipation in the target. Both of these items are in place at Duke; however, in order to support production for multi-institutional use, irradiation campaigns in excess of 50 µAp and four hours duration will be needed. Further, post-irradiation processing equipment is lacking that will enable the distribution process. Financial support is sought for i) a shielded, ventilated processing/containment hood; ii) development of a post-irradiation target retrieval system; iii) fabrication of a 211At distillation and recovery module and iv) a performance review and, where needed, an enhancement of seven major subsystems that comprise the CS-30 Cyclotron. With these modifications in place, routine production of ≥200 mCi of At-211 should be readily achievable, given our methodological development of At-211 target preparation, internal target irradiation and dry distillation to recover the radionuclide.« less

De-Escalation of Antibiotics Does Not Increase Mortality in Critically Ill Surgical Patients.

PubMed

Turza, Kristin C; Politano, Amani D; Rosenberger, Laura H; Riccio, Lin M; McLeod, Matthew; Sawyer, Robert G

2016-02-01

Overuse of broad-spectrum antibiotics results in microbial resistance and financially is a healthcare burden. Antibiotic de-escalation refers to starting treatment of a presumed infection with broad-spectrum antibiotics and narrowing drug spectrum based on culture sensitivities. A study was designed to evaluate antibiotic de-escalation at a tertiary care center. We hypothesized that antibiotic de-escalation would not be associated with increased patient mortality rates or worsening of the primary infection. All infections treated in a single, tertiary care Surgical ICU between August 2009 and December 2011 were reviewed. Antibiotic treatment was classified by skilled reviewers as being either de-escalated or not. Outcomes were evaluated. Univariate statistics were performed (Fisher exact test, Chi-square for categorical data; student t-test for continuous variables). Multivariable logistic regression was completed. A total of 2,658 infections were identified. De-escalation was identified for 995 infections and non-deescalation occurred in 1,663. Patients were similar in age (de-escalated 55 ± 16 y vs. 56 ± 16, p = 0.1) and gender (de-escalated 60% males vs. 58%, p = 0.4). There were substantially greater APACHE II scores in non-deescalated patients (15 ± 8 vs. 14 ± 8, p = 0.03). A greater mortality rate among patients with infections treated without de-escalation was observed compared with those treated with de-escalation (9% vs. 6%, p = 0.002). Total antibiotic duration was substantially longer in the de-escalated group (15 ± 13 d vs. 13 ± 13, p = 0.0001). Multivariable analysis found that de-escalation decreased mortality rates (OR = 0.69; 95%CI, 0.49-0.97; p = 0.04) and high APACHE II score independently increased mortality rates (OR = 1.2; 95%CI, 1.1-1.2; p = 0.0001). Other parameters included were age and infection site. Antibiotic de-escalation was not associated with increased mortality rates, but the duration of antibiotic use was longer in this group. Greater mortality rates were observed in the non-deescalated group, but this likely owes at least in part to their relatively greater severity of disease classification (APACHE II). Further investigation will help evaluate whether antibiotic de-escalation will improve the quality of patient care.

Cherenkov imaging during volumetric modulated arc therapy for real-time radiation beam tracking and treatment response monitoring

NASA Astrophysics Data System (ADS)

Andreozzi, Jacqueline M.; Zhang, Rongxiao; Glaser, Adam K.; Gladstone, David J.; Jarvis, Lesley A.; Pogue, Brian W.

2016-03-01

External beam radiotherapy utilizes high energy radiation to target cancer with dynamic, patient-specific treatment plans. The otherwise invisible radiation beam can be observed via the optical Cherenkov photons emitted from interaction between the high energy beam and tissue. Using a specialized camera-system, the Cherenkov emission can thus be used to track the radiation beam on the surface of the patient in real-time, even for complex cases such as volumetric modulated arc therapy (VMAT). Two patients undergoing VMAT of the head and neck were imaged and analyzed, and the viability of the system to provide clinical feedback was established.

Off-axis spectral beam combining of Bragg reflection waveguide photonic crystal diode lasers

NASA Astrophysics Data System (ADS)

Sun, Fangyuan; Wang, Lijie; Zhao, Yufei; Hou, Guanyu; Shu, Shili; Zhang, Jun; Peng, Hangyu; Tian, Sicong; Tong, Cunzhu; Wang, Lijun

2018-06-01

The spectral beam combining (SBC) of Bragg reflection waveguide photonic crystal (BRW-PC) diode lasers was studied for the first time. An off-axis feedback system was constructed using a stripe mirror and a spatial filter to control beam quality in the external cavity. It was found that the BRW-PC diode lasers with a low divergence and a circular beam provided a simplified and cost-effective SBC. The off-axis feedback broke the beam quality limit of a single element, and an M 2 factor of 3.8 times lower than that of a single emitter in the slow axis was demonstrated.

High-power continuous-wave tunable 544- and 272-nm beams based on a diode-oscillator fiber-amplifier for calcium spectroscopy

NASA Astrophysics Data System (ADS)

Ko, Kwang-Hoon; Kim, Yonghee; Park, Hyunmin; Cha, Yong-Ho; Kim, Taek-Soo; Lee, Lim; Lim, Gwon; Han, Jaemin; Ko, Kwang-Hee; Jeong, Do-Young

2015-08-01

Continuous-wave single-frequency tunable 544- and 272-nm beams have been demonstrated by the second- and fourth-harmonic conversions of a 1088-nm fundamental beam from a diode-oscillator fiber-amplifier. The single-pass second-harmonic generation with a MgO-doped periodically poled stoichiometric LiTaO3 crystal and the external-cavity frequency-doubling technique with a bulk BBO crystal were employed to achieve an approximately 6-W 544-nm beam and a 1.5-W 272-nm beam, respectively. We characterized the second- and fourth-harmonic generations and discussed their applications to calcium spectroscopy.

Phase-locking of annular-combination CO2 laser

NASA Astrophysics Data System (ADS)

Qi, Tingxiang; Chen, Mei; Zhang, Rongzhu; Xiao, Qianyi

2015-07-01

A new annular-combination resonator structure adopting the external-injection phase-locking technology is presented theoretically for that the beam quality of stable annular resonator is not satisfying. The phase-locking principle and feasibility are characterized by energy density of injection beam and coupling coefficient. Based on the diffraction theory, output mode of the resonator with phase-locking is deduced and simulated. Results also confirm that injection beam have a good control effect on output mode. The intensity distributions of output beam are studied briefly and indicate that this new resonator which is adaptable to annular gain media can produce high-power laser beam with high quality.

Coherent phonon optics in a chip with an electrically controlled active device.

PubMed

Poyser, Caroline L; Akimov, Andrey V; Campion, Richard P; Kent, Anthony J

2015-02-05

Phonon optics concerns operations with high-frequency acoustic waves in solid media in a similar way to how traditional optics operates with the light beams (i.e. photons). Phonon optics experiments with coherent terahertz and sub-terahertz phonons promise a revolution in various technical applications related to high-frequency acoustics, imaging, and heat transport. Previously, phonon optics used passive methods for manipulations with propagating phonon beams that did not enable their external control. Here we fabricate a phononic chip, which includes a generator of coherent monochromatic phonons with frequency 378 GHz, a sensitive coherent phonon detector, and an active layer: a doped semiconductor superlattice, with electrical contacts, inserted into the phonon propagation path. In the experiments, we demonstrate the modulation of the coherent phonon flux by an external electrical bias applied to the active layer. Phonon optics using external control broadens the spectrum of prospective applications of phononics on the nanometer scale.

Automatic external filling for the ion source gas bottle of a Van de Graaff accelerator

NASA Astrophysics Data System (ADS)

Strivay, D.; Bastin, T.; Dehove, C.; Dumont, P. D.; Marchal, A.; Garnir, H.; Weber, G.

1997-09-01

We describe a fully automatic system we developed to fill, from an external gas bottle, the ion source terminal gas storage bottle of a 2 MV Van de Graaff accelerator without depressing the 25 bar insulating gas. The system is based on a programmable automate ordering electropneumatical valves. The only manual operation is the connection of the external gas cylinder. The time needed for a gas change is reduced to typically 15 min (depending on the residual pressure wished for the gas removed from the terminal bottle). To check this system we study the ionic composition of the ion beam delivered by our accelerator after different gas changes. The switching magnet of our accelerator was used to analyse the ionic composition of the accelerated beams in order to verify the degree of elimination of the previous gases in the system.

Guidelines on the implementation of diode in vivo dosimetry programs for photon and electron external beam therapy.

PubMed

Alecu, R; Loomis, T; Alecu, J; Ochran, T

1999-01-01

Semiconductor diodes offer many advantages for clinical dosimetry: high sensitivity, real-time readout, simple instrumentation, robustness and air pressure independence. The feasibility and usefulness of in vivo dosimetry with diodes has been shown by numerous publications, but very few, if any, refer to the utilization of diodes in electron beam dosimetry. The purpose of this paper is to present our methods for implementing an effective IVD program for external beam therapy with photons and electrons and to evaluate a new type of diodes. Methods of deciding on reasonable action levels along with calibration procedures, established according to the type of measurements intended to be performed and the action limits, are discussed. Correction factors to account for nonreference clinical conditions for new types of diodes (designed for photon and electron beams) are presented and compared with those required by older models commercially available. The possibilities and limitations of each type of diode are presented, emphasizing the importance of using the appropriate diode for each task and energy range.

On charged particle equilibrium violation in external photon fields.

PubMed

Bouchard, Hugo; Seuntjens, Jan; Palmans, Hugo

2012-03-01

In a recent paper by Bouchard et al. [Med. Phys. 36(10), 4654-4663 (2009)], a theoretical model of quality correction factors for idealistic so-called plan-class specific reference (PCSR) fields was proposed. The reasoning was founded on the definition of PCSR fields made earlier by Alfonso et al. [Med. Phys. 35(11), 5179-5186 (2008)], requiring the beam to achieve charged particle equilibrium (CPE), in a time-averaged sense, in the reference medium. The relation obtained by Bouchard et al. was derived using Fano's theorem (1954) which states that if CPE is established in a given medium, the dose is independent of point-to-point density variations. A potential misconception on the achievability of the condition required by Fano (1954) might be responsible for false practical conclusions, both in the definition of PCSR fields as well as the theoretical model of quality correction factor. In this paper, the practical achievability of CPE in external beams is treated in detail. The fact that this condition is not achievable in single or composite deliveries is illustrated by an intuitive method and is also formally demonstrated. Fano's theorem is not applicable in external beam radiation dosimetry without (virtually) removing attenuation effects, and therefore, the relation conditionally defined by Bouchard et al. (2009) cannot be valid in practice. A definition of PCSR fields in the recent formalism for nonstandard beams proposed by Alfonso et al. (2008) should be modified, revising the criterion of CPE condition. The authors propose reconsidering the terminology used to describe standard and nonstandard beams. The authors argue that quality correction factors of intensity modulated radiation therapy PCSR fields (i.e., k(Q(pcsr),Q) (f(pcsr),f(ref) )) could be unity under ideal conditions, but it is concluded that further investigation is necessary to confirm that hypothesis.

Steady states of a diode with counterstreaming electron and positron beams

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

Ender, A. Ya.; Kuznetsov, V. I., E-mail: victor.kuznetsov@mail.ioffe.ru; Gruzdev, A. A.

2016-10-15

Steady states of a plasma layer with counterstreaming beams of oppositely charged particles moving without collisions in a self-consistent electric field are analyzed. The study is aimed at clarifying the mechanism of generation and reconstruction of pulsar radiation. Such a layer also models the processes occurring in Knudsen plasma diodes with counterstreaming electron and ion beams. The steady-state solutions are exhaustively classified. The existence of several solutions at the same external parameters is established.

The formation of an ion beam in a vacuum neutron tube

NASA Astrophysics Data System (ADS)

Agafonov, A. V.; Tarakanov, V. P.

2014-09-01

The formation of a deuteron beam in a diode with a plasma emitter that is integrated into the structure of a vacuum neutron tube is considered. Computations are carried out for plasma with given time dependences of parameters (density, relative concentration, and expansion velocity) at the inlet to an accelerating gap. It is shown that it is possible to increase the ion-beam current possible by sectioning the diode at the given external parameters.

Steady states of a diode with counterstreaming electron and positron beams

NASA Astrophysics Data System (ADS)

Ender, A. Ya.; Kuznetsov, V. I.; Gruzdev, A. A.

2016-10-01

Steady states of a plasma layer with counterstreaming beams of oppositely charged particles moving without collisions in a self-consistent electric field are analyzed. The study is aimed at clarifying the mechanism of generation and reconstruction of pulsar radiation. Such a layer also models the processes occurring in Knudsen plasma diodes with counterstreaming electron and ion beams. The steady-state solutions are exhaustively classified. The existence of several solutions at the same external parameters is established.

Electrostatically frequency tunable micro-beam-based piezoelectric fluid flow energy harvester

NASA Astrophysics Data System (ADS)

Rezaee, Mousa; Sharafkhani, Naser

2017-07-01

This research investigates the dynamic behavior of a sandwich micro-beam based piezoelectric energy harvester with electrostatically adjustable resonance frequency. The system consists of a cantilever micro-beam immersed in a fluid domain and is subjected to the simultaneous action of cross fluid flow and nonlinear electrostatic force. Two parallel piezoelectric laminates are extended along the length of the micro-beam and connected to an external electric circuit which generates an output power as a result of the micro-beam oscillations. The fluid-coupled structure is modeled using Euler-Bernoulli beam theory and the equivalent force terms for the fluid flow. Fluid induced forces comprise the added inertia force which is evaluated using equivalent added mass and the drag and lift forces which are evaluated using relative velocity and Van der Pol equation. In addition to flow velocity and fluid density, the influence of several design parameters such as external electrical resistance, piezo layer position, and dc voltage on the generated power are investigated by using Galerkin and step by step linearization method. It is shown that for given flowing fluid parameters, i.e., density and velocity, one can adjust the applied dc voltage to tune resonance frequency so that the lock-in phenomenon with steady large amplitude oscillations happens, also by adjusting the harvester parameters including the mechanical and electrical ones, the maximal output power of the harvester becomes possible.

Directionality of nose-emitted echolocation calls from bats without a nose leaf (Plecotus auritus).

PubMed

Jakobsen, Lasse; Hallam, John; Moss, Cynthia F; Hedenström, Anders

2018-02-13

All echolocating bats and whales measured to date emit a directional bio-sonar beam that affords them a number of advantages over an omni-directional beam, i.e. reduced clutter, increased source level and inherent directional information. In this study, we investigated the importance of directional sound emission for navigation through echolocation by measuring the sonar beam of brown long-eared bats, Plecotus auritus Plecotus auritus emits sound through the nostrils but has no external appendages to readily facilitate a directional sound emission as found in most nose emitters. The study shows that P. auritus , despite lacking an external focusing apparatus, emits a directional echolocation beam (directivity index=13 dB) and that the beam is more directional vertically (-6 dB angle at 22 deg) than horizontally (-6 dB angle at 35 deg). Using a simple numerical model, we found that the recorded emission pattern is achievable if P. auritus emits sound through the nostrils as well as the mouth. The study thus supports the hypothesis that a directional echolocation beam is important for perception through echolocation and we propose that animals with similarly non-directional emitter characteristics may facilitate a directional sound emission by emitting sound through both the nostrils and the mouth. © 2018. Published by The Company of Biologists Ltd.

Non-linear Multidimensional Optimization for use in Wire Scanner Fitting

NASA Astrophysics Data System (ADS)

Henderson, Alyssa; Terzic, Balsa; Hofler, Alicia; Center Advanced Studies of Accelerators Collaboration

2014-03-01

To ensure experiment efficiency and quality from the Continuous Electron Beam Accelerator at Jefferson Lab, beam energy, size, and position must be measured. Wire scanners are devices inserted into the beamline to produce measurements which are used to obtain beam properties. Extracting physical information from the wire scanner measurements begins by fitting Gaussian curves to the data. This study focuses on optimizing and automating this curve-fitting procedure. We use a hybrid approach combining the efficiency of Newton Conjugate Gradient (NCG) method with the global convergence of three nature-inspired (NI) optimization approaches: genetic algorithm, differential evolution, and particle-swarm. In this Python-implemented approach, augmenting the locally-convergent NCG with one of the globally-convergent methods ensures the quality, robustness, and automation of curve-fitting. After comparing the methods, we establish that given an initial data-derived guess, each finds a solution with the same chi-square- a measurement of the agreement of the fit to the data. NCG is the fastest method, so it is the first to attempt data-fitting. The curve-fitting procedure escalates to one of the globally-convergent NI methods only if NCG fails, thereby ensuring a successful fit. This method allows for the most optimal signal fit and can be easily applied to similar problems.

On the direct acquisition of beam’s-eye-view images in MRI for integration with external beam radiotherapy

NASA Astrophysics Data System (ADS)

Wachowicz, K.; Murray, B.; Fallone, B. G.

2018-06-01

The recent interest in the integration of external beam radiotherapy with a magnetic resonance (MR) imaging unit offers the potential for real-time adaptive tumour tracking during radiation treatment. The tracking of large tumours which follow a rapid trajectory may best be served by the generation of a projection image from the perspective of the beam source, or ‘beam’s eye view’ (BEV). This type of image projection represents the path of the radiation beam, thus enabling rapid compensations for target translations, rotations and deformations, as well time-dependent critical structure avoidance. MR units have been traditionally incapable of this type of imaging except through lengthy 3D acquisitions and ray tracing procedures. This work investigates some changes to the traditional MR scanner architecture that would permit the direct acquisition of a BEV image suitable for integration with external beam radiotherapy. Based on the theory presented in this work, a phantom was imaged with nonlinear encoding-gradient field patterns to demonstrate the technique. The phantom was constructed with agarose gel tubes spaced two cm apart at their base and oriented to converge towards an imaginary beam source 100 cm away. A corresponding virtual phantom was also created and subjected to the same encoding technique as in the physical demonstration, allowing the method to be tested without hardware limitations. The experimentally acquired and simulated images indicate the feasibility of the technique, showing a substantial amount of blur reduction in a diverging phantom compared to the conventional imaging geometry, particularly with the nonlinear gradients ideally implemented. The theory is developed to demonstrate that the method can be adapted in a number of different configurations to accommodate all proposed integration schemes for MR units and radiotherapy sources. Depending on the configuration, the implementation of this technique will require between two and four additional nonlinear encoding coils.

Experimental investigation of a 1 kA/cm² sheet beam plasma cathode electron gun.

PubMed

Kumar, Niraj; Pal, Udit Narayan; Pal, Dharmendra Kumar; Prajesh, Rahul; Prakash, Ram

2015-01-01

In this paper, a cold cathode based sheet-beam plasma cathode electron gun is reported with achieved sheet-beam current density ∼1 kA/cm(2) from pseudospark based argon plasma for pulse length of ∼200 ns in a single shot experiment. For the qualitative assessment of the sheet-beam, an arrangement of three isolated metallic-sheets is proposed. The actual shape and size of the sheet-electron-beam are obtained through a non-conventional method by proposing a dielectric charging technique and scanning electron microscope based imaging. As distinct from the earlier developed sheet beam sources, the generated sheet-beam has been propagated more than 190 mm distance in a drift space region maintaining sheet structure without assistance of any external magnetic field.

Escalation of Commitment in the Surgical ICU.

PubMed

Braxton, Carla C; Robinson, Celia N; Awad, Samir S

2017-04-01

Escalation of commitment is a business term that describes the continued investment of resources into a project even after there is objective evidence of the project's impending failure. Escalation of commitment may be a contributor to high healthcare costs associated with critically ill patients as it has been shown that, despite almost certain futility, most ICU costs are incurred in the last week of life. Our objective was to determine if escalation of commitment occurs in healthcare settings, specifically in the surgical ICU. We hypothesize that factors previously identified in business and organizational psychology literature including self-justification, accountability, sunk costs, and cognitive dissonance result in escalation of commitment behavior in the surgical ICU setting resulting in increased utilization of resources and cost. A descriptive case study that illustrates common ICU narratives in which escalation of commitment can occur. In addition, we describe factors that are thought to contribute to escalation of commitment behaviors. Escalation of commitment behavior was observed with self-justification, accountability, and cognitive dissonance accounting for the majority of the behavior. Unlike in business decisions, sunk costs was not as evident. In addition, modulating factors such as personality, individual experience, culture, and gender were identified as contributors to escalation of commitment. Escalation of commitment occurs in the surgical ICU, resulting in significant expenditure of resources despite a predicted and often known poor outcome. Recognition of this phenomenon may lead to actions aimed at more rational decision making and may contribute to lowering healthcare costs. Investigation of objective measures that can help aid decision making in the surgical ICU is warranted.

Robotic crabs reveal that female fiddler crabs are sensitive to changes in male display rate.

PubMed

Mowles, Sophie L; Jennions, Michael D; Backwell, Patricia R Y

2018-01-01

Males often produce dynamic, repetitive courtship displays that can be demanding to perform and might advertise male quality to females. A key feature of demanding displays is that they can change in intensity: escalating as a male increases his signalling effort, but de-escalating as a signaller becomes fatigued. Here, we investigated whether female fiddler crabs, Uca mjoebergi , are sensitive to changes in male courtship wave rate. We performed playback experiments using robotic male crabs that had the same mean wave rate, but either escalated, de-escalated or remained constant. Females demonstrated a strong preference for escalating robots, but showed mixed responses to robots that de-escalated ('fast' to 'slow') compared to those that waved at a constant 'medium' rate. These findings demonstrate that females can discern changes in male display rate, and prefer males that escalate, but that females are also sensitive to past display rates indicative of prior vigour. © 2018 The Authors.

DEVELOPMENT OF SHORT UNDULATORS FOR ELECTRON-BEAM-RADIATION INTERACTION STUDIES

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

Piot, P.; Andorf, M. B.; Fagerberg, G.

Interaction of an electron beam with external field or its own radiation has widespread applications ranging from coherent-radiation generation, phase space cooling or formation of temporally-structured beams. An efficient coupling mechanism between an electron beam and radiation field relies on the use of a magnetic undulator. In this contribution we detail our plans to build short (11-period) undulators with 7-cm period refurbishing parts of the aladdin U3 undulator [1]. Possible use of these undulators at available test facilities to support experiments relevant to cooling techniques and radiation sources are outlined.

Accelerator/Experiment Operations - FY 2014

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

Czarapata, P.; Geer, S.; Geesaman, D.

2014-10-01

This Technical Memorandum (TM) summarizes the Fermilab accelerator and accelerator experiment operations for FY 2014. It is one of a series of annual publications intended to gather information in one place. In this case, the information concerns the FY 2014 MINOS and MINERvA experiments using the Main Injector Neutrino Beam (NuMI), the MiniBooNE experiment running in the Booster Neutrino Beam (BNB), and the SeaQuest experiment and Meson Test Beam (MTest) activities in the 120 GeV external Switchyard beam (SY120). Each section was prepared by the relevant authors, and was somewhat edited for inclusion in this summary.

Beam Propagator for Weather Radars, Modules 1 and 2

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

Ortega, Edwin Campos

2013-10-08

This program simulates the beam propagation of weather radar pulses under particular and realistic atmospheric conditions (without using the assumption of standard refraction conditions). It consists of two modules: radiosondings_refract_index_many.pro (MAIN MODULE) beam_propagation_function.pro(EXTERNAL FUNCTION) FOR THE MAIN MODULE, THE CODE DOES OUTPUT--INTO A FILE--THE BEAM HEIGHT AS A FUNCTION OF RANGE. THE RADIOSONDE INPUT FILES SHOULD BE ALREADY AVAILABLE BY THE USER. FOR EXAMPLE, RADIOSONDE OBSERVATION FILES CAN BE OBTAINED AT: RADIOSONDE OBSERVATIONS DOWNLOADED AT "http://weather.uwyo.edu/upperair/soounding.html" OR "http://jervis.pyr.ec.gc.ca" THE EXTERNAL FUNCTION DOES THE ACTUAL COMPUTATION OF BEAM PROPAGATION. IT INCLUDES CONDITIONS OF ANOMALOUS PROPAGATION AND NEGATIVE ELEVATION ANGLES. THE EQUATIONSmore » USED HERE WERE DERIVED BY EDWIN CAMPOS, BASED ON THE SNELL-DESCARTES LAW OF REFRACTION, CONSIDERING THE EARTH CURVATURE. THE PROGRAM REQUIRES A COMPILER FOR THE INTERACTIVE DATA LANGUAGE (IDL). DESCRIPTION AND VALIDATION DETAILS HAVE BEEN PUBLISHED IN THE PEER-REVIEWED SCIENTIFIC LITERATURE, AS FOLLOWS: Campos E. 2012. Estimating weather radar coverage over complex terrain, pp.26-32, peer reviewed, in Weather Radar and Hydrology, edited by Moore RJ, Cole SJ and Illingworth AJ. International Association of Hydrological Sciences (IAHS) Press, IAHS Publ. 351. ISBN 978-1-907161-26-1.« less

[Successful electroconvulsive therapy of Cotard syndrome with bitemporal hypoperfusion].

PubMed

Lohmann, T; Nishimura, K; Sabri, O; Klosterkötter, J

1996-05-01

A case study is presented to illustrate a rare condition described by Cotard as "délire de négation". The central symptom is a nihilistic delusion with denial of one's own existence of oneself and that of the external world. In the present case, the syndrome became manifest as an escalation of a recurrent depressive disorder late in life. After initial resistance to therapy, the syndrome was successfully treated with electroconvulsive therapy. For the first time, we report the regional cerebral blood flow measured by 99mTc-HMPAO-SPECT before and after therapy. Before treatment, significant bitemporal hypoperfusion relative to the cerebellum was found, which was no longer demonstrable on remission.

Resilience and reactivity of global food security.

PubMed

Suweis, Samir; Carr, Joel A; Maritan, Amos; Rinaldo, Andrea; D'Odorico, Paolo

2015-06-02

The escalating food demand by a growing and increasingly affluent global population is placing unprecedented pressure on the limited land and water resources of the planet, underpinning concerns over global food security and its sensitivity to shocks arising from environmental fluctuations, trade policies, and market volatility. Here, we use country-specific demographic records along with food production and trade data for the past 25 y to evaluate the stability and reactivity of the relationship between population dynamics and food availability. We develop a framework for the assessment of the resilience and the reactivity of the coupled population-food system and suggest that over the past two decades both its sensitivity to external perturbations and susceptibility to instability have increased.

Elemental analysis with external-beam PIXE

NASA Astrophysics Data System (ADS)

Lin, E. K.; Wang, C. W.; Teng, P. K.; Huang, Y. M.; Chen, C. Y.

1992-05-01

A beamline system and experimental setup has been established for elemental analysis using PIXE with an external beam. Experiments for the study of the elemental composition of ancient Chinese potsherds (the Min and Ching ages) were performed. Continuum X-ray spectra from the samples bombarded by 3 MeV protons have been measured with a Si(Li) detector. From the analysis of PIXE data, the concentration of the main elements (Al, Si, K, and Ca) and of more than ten trace elements in the matrices and glazed surfaces were determined. Results for two different potsherds are presented, and those obtained from the glaze colorants are compared with the results of measurements on a Ching blue-and-white porcelain vase.

PIXE analysis of cystic fibrosis sweat samples with an external proton beam

NASA Astrophysics Data System (ADS)

Sommer, F.; Massonnet, B.

1987-03-01

PIXE analysis with an external proton beam is used to study, in four control and five cystic fibrosis children, the elemental composition of sweat samples collected from different parts of the body during entire body hyperthermia. We observe no significant difference of sweat rates and of temperature variations between the two groups during sweat test. The statistical study of results obtained by PIXE analysis allows us to pick out amongst 8 elements studied, 6 elements (Na, Cl, Ca, Mn, Cu, Br) significatively different between the two groups of subjects. Using regression analysis, Na, Cl and Br concentrations could be used in a predictive equation of the state of health.

Development of a RadFET Linear Array for Intracavitary in vivo Dosimetry During External Beam Radiotherapy and Brachytherapy

NASA Astrophysics Data System (ADS)

Price, R. A.; Benson, C.; Joyce, M. J.; Rodgers, K.

2004-08-01

We present the details of a new linear array dosimeter consisting of a chain of semiconductors mounted on an ultra-thin (50 /spl mu/m thick) flexible substrate and housed in an intracavitary catheter. The semiconductors, manufactured by NMRC Cork, have not been packaging and incorporate a passivation layer that allows them to be mounted on the substrate using flip-chip-bonding. This paper reports, for the first time, the construction of a multiple (ten) detector array suited to in vivo dosimetry in the rectum, esophagus and vagina during external beam radiotherapy, as well as being adaptable to in vivo dosimetry during brachytherapy and diagnostic radiology.

The light wave flow effect in a plane-parallel layer with a quasi-zero refractive index under the action of bounded light beams

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

Gadomsky, O. N., E-mail: gadomsky@mail.ru; Shchukarev, I. A., E-mail: blacxpress@gmail.com

2016-08-15

It is shown that external optical radiation in the 450–1200 nm range can be efficiently transformed under the action of bounded light beams to a surface wave that propagates along the external and internal boundaries of a plane-parallel layer with a quasi-zero refractive index. Reflection regimes with complex and real angles of refraction in the layer are considered. The layer with a quasi-zero refractive index in this boundary problem is located on a highly reflective metal substrate; it is shown that the uniform low reflection of light is achieved in the wavelength range under study.

External-beam PIXE spectrometry for the study of Punic jewellery (SW Spain): The geographical provenance of the palladium-bearing gold

NASA Astrophysics Data System (ADS)

Ontalba Salamanca, M. Á.; Gómez-Tubío, B.; Ortega-Feliu, I.; Respaldiza, M. Á.; Luisa de la Bandera, M.; Ovejero Zappino, G.; Bouzas, A.; Gómez-Morón, A.

2006-08-01

This paper presents the study of a set of Punic gold items (400 B.C.), from the Museum of Cádiz (Spain). An external beam set-up has been employed for the absolutely non-destructive analysis of the objects. PIXE spectrometry has been performed in order to characterize the metallic alloys and the manufacturing techniques. Compositional differences have been found and soldering procedures have been identified. By comparison with the rings and other coetaneous jewellery, the presence of palladium in the bulk alloy of the earrings can be pointed out. The geographical provenance of the palladium-bearing gold is discussed based on geological and archaeological considerations.

NuMI Beam Flux Studies for MINERvA

NASA Astrophysics Data System (ADS)

Aliaga Soplin, Leonidas

2012-03-01

MINERνA is a few-GeV neutrino scattering experiment which is required to understand the neutrino beam flux in order to make absolute cross section measurements. We have three techniques for constraining the flux: in situ measurements, external hadron production data and muon monitors. In this presentation I will discuss the details and our progress on these efforts.

Study of Italian Renaissance sculptures using an external beam nuclear microprobe

NASA Astrophysics Data System (ADS)

Zucchiatti, A.; Bouquillon, A.; Moignard, B.; Salomon, J.; Gaborit, J. R.

2000-03-01

The use of an extracted proton micro-beam for the PIXE analysis of glazes is discussed in the context of the growing interest in the creation of an analytical database on Italian Renaissance glazed terracotta sculptures. Some results concerning the frieze of an altarpiece of the Louvre museum, featuring white angels and cherubs heads, are presented.

Bidirectional Associations Between Externalizing Behavior Problems and Maladaptive Parenting Within Parent-Son Dyads Across Childhood

PubMed Central

Loeber, Rolf; Hinshaw, Stephen P.; Pardini, Dustin A.

2018-01-01

Coercive parent–child interaction models posit that an escalating cycle of negative, bidirectional interchanges influences the development of boys’ externalizing problems and caregivers’ maladaptive parenting over time. However, longitudinal studies examining this hypothesis have been unable to rule out the possibility that between-individual factors account for bidirectional associations between child externalizing problems and maladaptive parenting. Using a longitudinal sample of boys (N = 503) repeatedly assessed eight times across 6-month intervals in childhood (in a range between 6 and 13 years), the current study is the first to use novel within-individual change (fixed effects) models to examine whether parents tend to increase their use of maladaptive parenting strategies following an increase in their son’s externalizing problems, or vice versa. These bidirectional associations were examined using multiple facets of externalizing problems (i.e., interpersonal callousness, conduct and oppositional defiant problems, hyperactivity/impulsivity) and parenting behaviors (i.e., physical punishment, involvement, parent–child communication). Analyses failed to support the notion that when boys increase their typical level of problem behaviors, their parents show an increase in their typical level of maladaptive parenting across the subsequent 6 month period, and vice versa. Instead, across 6-month intervals, within parent-son dyads, changes in maladaptive parenting and child externalizing problems waxed and waned in concert. Fixed effects models to address the topic of bidirectional relations between parent and child behavior are severely underrepresented. We recommend that other researchers who have found significant bidirectional parent–child associations using rank-order change models reexamine their data to determine whether these findings hold when examining changes within parent–child dyads. PMID:26780209

Bidirectional Associations Between Externalizing Behavior Problems and Maladaptive Parenting Within Parent-Son Dyads Across Childhood.

PubMed

Besemer, Sytske; Loeber, Rolf; Hinshaw, Stephen P; Pardini, Dustin A

2016-10-01

Coercive parent-child interaction models posit that an escalating cycle of negative, bidirectional interchanges influences the development of boys' externalizing problems and caregivers' maladaptive parenting over time. However, longitudinal studies examining this hypothesis have been unable to rule out the possibility that between-individual factors account for bidirectional associations between child externalizing problems and maladaptive parenting. Using a longitudinal sample of boys (N = 503) repeatedly assessed eight times across 6-month intervals in childhood (in a range between 6 and 13 years), the current study is the first to use novel within-individual change (fixed effects) models to examine whether parents tend to increase their use of maladaptive parenting strategies following an increase in their son's externalizing problems, or vice versa. These bidirectional associations were examined using multiple facets of externalizing problems (i.e., interpersonal callousness, conduct and oppositional defiant problems, hyperactivity/impulsivity) and parenting behaviors (i.e., physical punishment, involvement, parent-child communication). Analyses failed to support the notion that when boys increase their typical level of problem behaviors, their parents show an increase in their typical level of maladaptive parenting across the subsequent 6 month period, and vice versa. Instead, across 6-month intervals, within parent-son dyads, changes in maladaptive parenting and child externalizing problems waxed and waned in concert. Fixed effects models to address the topic of bidirectional relations between parent and child behavior are severely underrepresented. We recommend that other researchers who have found significant bidirectional parent-child associations using rank-order change models reexamine their data to determine whether these findings hold when examining changes within parent-child dyads.

Beam Splitter For Welding-Torch Vision System

NASA Technical Reports Server (NTRS)

Gilbert, Jeffrey L.

1991-01-01

Compact welding torch equipped with along-the-torch vision system includes cubic beam splitter to direct preview light on weldment and to reflect light coming from welding scene for imaging. Beam splitter integral with torch; requires no external mounting brackets. Rugged and withstands vibrations and wide range of temperatures. Commercially available, reasonably priced, comes in variety of sizes and optical qualities with antireflection and interference-filter coatings on desired faces. Can provide 50 percent transmission and 50 percent reflection of incident light to exhibit minimal ghosting of image.

Effective shielding to measure beam current from an ion source

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

Bayle, H., E-mail: bayle@bergoz.com; Delferrière, O.; Gobin, R.

To avoid saturation, beam current transformers must be shielded from solenoid, quad, and RFQ high stray fields. Good understanding of field distribution, shielding materials, and techniques is required. Space availability imposes compact shields along the beam pipe. This paper describes compact effective concatenated magnetic shields for IFMIF-EVEDA LIPAc LEBT and MEBT and for FAIR Proton Linac injector. They protect the ACCT Current Transformers beyond 37 mT radial external fields. Measurements made at Saclay on the SILHI source are presented.

SINGLE BUNCH BEAM BREAKUP - A GENERAL SOLUTION.

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

WANG,J.M.; MANE,S.R.; TOWNE,N.

2000-06-26

Caporaso, Barletta and Neil (CBN) found in a solution to the problem of the single-bunch beam breakup in a linac[1]. However, their method applies only to the case of a beam traveling in a strongly betatron-focused linac under the influence of the resistive wall impedance. We suggest in this paper a method for dealing with the same problem. Our methods is more general; it applies to the same problem under any impedance, and it applies to a linac with or without external betatron focusing.

Catheter tip force transducer for cardiovascular research

NASA Technical Reports Server (NTRS)

Feldstein, C.; Lewis, G. W.; Silver, R. H.; Culler, V. H. (Inventor)

1976-01-01

A force transducer for measuring dynamic force activity within the heart of a subject essentially consists of a U-shaped beam of low elastic compliance material. Two lines extend from the beams's legs and a long coil spring is attached to the beam. A strain gauge is coupled to one of the beam's legs to sense deflections thereof. The beam with the tines and most of the spring are surrounded by a flexible tube, defining a catheter, which is insertable into a subject's heart through an appropriate artery. The tines are extractable from the catheter for implantation into the myocardium by pushing on the end of the spring which extends beyond the external end of the catheter.

Development of an antibiotic spectrum score based on veterans affairs culture and susceptibility data for the purpose of measuring antibiotic de-escalation: a modified Delphi approach.

PubMed

Madaras-Kelly, Karl; Jones, Makoto; Remington, Richard; Hill, Nicole; Huttner, Benedikt; Samore, Matthew

2014-09-01

Development of a numerical score to measure the microbial spectrum of antibiotic regimens (spectrum score) and method to identify antibiotic de-escalation events based on application of the score. Web-based modified Delphi method. Physician and pharmacist antimicrobial stewards practicing in the United States recruited through infectious diseases-focused listservs. Three Delphi rounds investigated: organisms and antibiotics to include in the spectrum score, operationalization of rules for the score, and de-escalation measurement. A 4-point ordinal scale was used to score antibiotic susceptibility for organism-antibiotic domain pairs. Antibiotic regimen scores, which represented combined activity of antibiotics in a regimen across all organism domains, were used to compare antibiotic spectrum administered early (day 2) and later (day 4) in therapy. Changes in spectrum score were calculated and compared with Delphi participants' judgments on de-escalation with 20 antibiotic regimen vignettes and with non-Delphi steward judgments on de-escalation of 300 pneumonia regimen vignettes. Method sensitivity and specificity to predict expert de-escalation status were calculated. Twenty-four participants completed all Delphi rounds. Expert support for concepts utilized in metric development was identified. For vignettes presented in the Delphi, the sign of change in score correctly classified de-escalation in all vignettes except those involving substitution of oral antibiotics. The sensitivity and specificity of the method to identify de-escalation events as judged by non-Delphi stewards were 86.3% and 96.0%, respectively. Identification of de-escalation events based on an algorithm that measures microbial spectrum of antibiotic regimens generally agreed with steward judgments of de-escalation status.

Multileaf collimator tracking integrated with a novel x-ray imaging system and external surrogate monitoring

NASA Astrophysics Data System (ADS)

Krauss, Andreas; Fast, Martin F.; Nill, Simeon; Oelfke, Uwe

2012-04-01

We have previously developed a tumour tracking system, which adapts the aperture of a Siemens 160 MLC to electromagnetically monitored target motion. In this study, we exploit the use of a novel linac-mounted kilovoltage x-ray imaging system for MLC tracking. The unique in-line geometry of the imaging system allows the detection of target motion perpendicular to the treatment beam (i.e. the directions usually featuring steep dose gradients). We utilized the imaging system either alone or in combination with an external surrogate monitoring system. We equipped a Siemens ARTISTE linac with two flat panel detectors, one directly underneath the linac head for motion monitoring and the other underneath the patient couch for geometric tracking accuracy assessments. A programmable phantom with an embedded metal marker reproduced three patient breathing traces. For MLC tracking based on x-ray imaging alone, marker position was detected at a frame rate of 7.1 Hz. For the combined external and internal motion monitoring system, a total of only 85 x-ray images were acquired prior to or in between the delivery of ten segments of an IMRT beam. External motion was monitored with a potentiometer. A correlation model between external and internal motion was established. The real-time component of the MLC tracking procedure then relied solely on the correlation model estimations of internal motion based on the external signal. Geometric tracking accuracies were 0.6 mm (1.1 mm) and 1.8 mm (1.6 mm) in directions perpendicular and parallel to the leaf travel direction for the x-ray-only (the combined external and internal) motion monitoring system in spite of a total system latency of ˜0.62 s (˜0.51 s). Dosimetric accuracy for a highly modulated IMRT beam-assessed through radiographic film dosimetry-improved substantially when tracking was applied, but depended strongly on the respective geometric tracking accuracy. In conclusion, we have for the first time integrated MLC tracking with x-ray imaging in the in-line geometry and demonstrated highly accurate respiratory motion tracking.

Evaluation of the response of concurrent high dose rate intracavitary brachytherapy with external beam radiotherapy in management of early stage carcinoma cervix.

PubMed

Patidar, Arvind Kumar; Kumar, H S; Walke, Rahul V; Hirapara, Pushpendra H; Jakhar, Shankar Lal; Bardia, M R

2012-10-01

To evaluate local disease control and early complications of concomitant brachytherapy with external beam-radiotherapy in early stage carcinoma cervix. Fifty patients of early stage carcinoma cervix (FIGO-IB/IIA) were randomly divided into study group concomitant external beam irradiation (EBRT) and HDR-ICBT (intra-cavitary brachytherapy, xrt = 50 Gy/25 Fr, HDR 5.2 Gy*5 Fr) and the control group EBRT followed by HDR-ICBT (xrt = 50 Gy/25 Fr, HDR 7.5 Gy*3 Fr). Acute reactions and local disease response were compared between treatment and at 6-month follow up. Median overall treatment times were 38 and 61 days in the study and the control groups, respectively. Acute skin reactions and diarrhea were more in the study but manageable. At the completion of the study, there were 80 and 68 % complete responses, 16 and 20 % partial responses, 0 and 8 % stable diseases in the study group and the control group, respectively. Response was better in the study group but statistically insignificant. Larger number of patients and longer follow up are required to arrive at concrete conclusion.

TOPICAL REVIEW: A review of dosimetry studies on external-beam radiation treatment with respect to second cancer induction

NASA Astrophysics Data System (ADS)

Xu, X. George; Bednarz, Bryan; Paganetti, Harald

2008-07-01

It has been long known that patients treated with ionizing radiation carry a risk of developing a second cancer in their lifetimes. Factors contributing to the recently renewed concern about the second cancer include improved cancer survival rate, younger patient population as well as emerging treatment modalities such as intensity-modulated radiation treatment (IMRT) and proton therapy that can potentially elevate secondary exposures to healthy tissues distant from the target volume. In the past 30 years, external-beam treatment technologies have evolved significantly, and a large amount of data exist but appear to be difficult to comprehend and compare. This review article aims to provide readers with an understanding of the principles and methods related to scattered doses in radiation therapy by summarizing a large collection of dosimetry and clinical studies. Basic concepts and terminology are introduced at the beginning. That is followed by a comprehensive review of dosimetry studies for external-beam treatment modalities including classical radiation therapy, 3D-conformal x-ray therapy, intensity-modulated x-ray therapy (IMRT and tomotherapy) and proton therapy. Selected clinical data on second cancer induction among radiotherapy patients are also covered. Problems in past studies and controversial issues are discussed. The needs for future studies are presented at the end.

Primary radiotherapy for carcinoma of the endometrium using external beam radiotherapy and single line source brachytherapy.

PubMed

Churn, M; Jones, B

1999-01-01

A small proportion of patients with adenocarcinoma of the endometrium are inoperable by virtue of severe concurrent medical conditions, gross obesity or advanced stage disease. They can be treated with primary radiotherapy with either curative or palliative intent. We report 37 such patients treated mainly with a combination of external beam radiotherapy and intracavitary brachytherapy using a single line source technique. The 5-year disease-specific survival for nonsurgically staged patients was 68.4% for FIGO Stages I and II and 33.3% for Stages III and IV. The incidence of late morbidity was acceptably low. Using the Franco-Italian Glossary, there was 27.0% grade 1 but no grade 2-4 bladder toxicity. For the rectum the rates were 18.9% grade 1, 5.4% grade 2, 2.7% grade 3, and no grade 4 toxicity. Methods of optimizing the dose distribution of the brachytherapy by means of variation of treatment length, radioactive source positions, and prescription point according to tumour bulk and individual anatomy are discussed. The biologically equivalent doses (BED) for combined external beam radiotherapy and brachytherapy were calculated to be in the range of 78-107 Gy(3) or 57-75 Gy(10) at point 'A' and appear adequate for the control of Stage I cancers.

The Randomized CRM: An Approach to Overcoming the Long-Memory Property of the CRM

PubMed Central

Koopmeiners, Joseph S.; Wey, Andrew

2017-01-01

The primary object of a phase I clinical trial is to determine the maximum tolerated dose (MTD). Typically, the MTD is identified using a dose-escalation study, where initial subjects are treated at the lowest dose level and subsequent subjects are treated at progressively higher dose levels until the MTD is identified. The continual reassessment method (CRM) is a popular model-based dose-escalation design, which utilizes a formal model for the relationship between dose and toxicity to guide dose-finding. Recently, it was shown that the CRM has a tendency to get “stuck” on a dose-level, with little escalation or de-escalation in the late stages of the trial, due to the long-memory property of the CRM. We propose the randomized CRM (rCRM), which introduces random escalation and de-escalation into the standard CRM dose-finding algorithm, as well as a hybrid approach that incorporates escalation and de-escalation only when certain criteria are met. Our simulation results show that both the rCRM and the hybrid approach reduce the trial-to-trial variability in the number of cohorts treated at the MTD but that the hybrid approach has a more favorable trade-off with respect to the average number treated at the MTD. PMID:28340333

The Randomized CRM: An Approach to Overcoming the Long-Memory Property of the CRM.

PubMed

Koopmeiners, Joseph S; Wey, Andrew

2017-01-01

The primary object of a Phase I clinical trial is to determine the maximum tolerated dose (MTD). Typically, the MTD is identified using a dose-escalation study, where initial subjects are treated at the lowest dose level and subsequent subjects are treated at progressively higher dose levels until the MTD is identified. The continual reassessment method (CRM) is a popular model-based dose-escalation design, which utilizes a formal model for the relationship between dose and toxicity to guide dose finding. Recently, it was shown that the CRM has a tendency to get "stuck" on a dose level, with little escalation or de-escalation in the late stages of the trial, due to the long-memory property of the CRM. We propose the randomized CRM (rCRM), which introduces random escalation and de-escalation into the standard CRM dose-finding algorithm, as well as a hybrid approach that incorporates escalation and de-escalation only when certain criteria are met. Our simulation results show that both the rCRM and the hybrid approach reduce the trial-to-trial variability in the number of cohorts treated at the MTD but that the hybrid approach has a more favorable tradeoff with respect to the average number treated at the MTD.

Escalator design features evaluation

NASA Technical Reports Server (NTRS)

Zimmerman, W. F.; Deshpande, G. K.

1982-01-01

Escalators are available with design features such as dual speed (90 and 120 fpm), mat operation and flat steps. These design features were evaluated based on the impact of each on capital and operating costs, traffic flow, and safety. A human factors engineering model was developed to analyze the need for flat steps at various speeds. Mat operation of escalators was found to be cost effective in terms of energy savings. Dual speed operation of escalators with the higher speed used during peak hours allows for efficient operation. A minimum number of flat steps required as a function of escalator speed was developed to ensure safety for the elderly.

Experimental investigation of a 1 kA/cm{sup 2} sheet beam plasma cathode electron gun

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

Kumar, Niraj, E-mail: niraj.ceeri@gmail.com; Narayan Pal, Udit; Prajesh, Rahul

In this paper, a cold cathode based sheet-beam plasma cathode electron gun is reported with achieved sheet-beam current density ∼1 kA/cm{sup 2} from pseudospark based argon plasma for pulse length of ∼200 ns in a single shot experiment. For the qualitative assessment of the sheet-beam, an arrangement of three isolated metallic-sheets is proposed. The actual shape and size of the sheet-electron-beam are obtained through a non-conventional method by proposing a dielectric charging technique and scanning electron microscope based imaging. As distinct from the earlier developed sheet beam sources, the generated sheet-beam has been propagated more than 190 mm distance inmore » a drift space region maintaining sheet structure without assistance of any external magnetic field.« less

Generation of low-emittance electron beams in electrostatic accelerators for FEL applications

NASA Astrophysics Data System (ADS)

Chen, Teng; Elias, Luis R.

1995-02-01

This paper reports results of transverse emittance studies and beam propagation in electrostatic accelerators for free electron laser applications. In particular, we discuss emittance growth analysis of a low current electron beam system consisting of a miniature thermoionic electron gun and a National Electrostatics Accelerator (NEC) tube. The emittance growth phenomenon is discussed in terms of thermal effects in the electron gun cathode and aberrations produced by field gradient changes occurring inside the electron gun and throughout the accelerator tube. A method of reducing aberrations using a magnetic solenoidal field is described. Analysis of electron beam emittance was done with the EGUN code. Beam propagation along the accelerator tube was studied using a cylindrically symmetric beam envelope equation that included beam self-fields and the external accelerator fields which were derived from POISSON simulations.

Escalator Design Features Evaluation

DOT National Transportation Integrated Search

1982-05-01

This study provides an evaluation of the effectiveness of several special design features associated with escalators in rail transit systems. The objective of the study was to evaluate the effectiveness of three escalator design features: (1) mat ope...

Escalated conflict in a social hierarchy

PubMed Central

Cant, M.A; English, S; Reeve, H.K; Field, J

2006-01-01

Animals that live in cooperative societies form hierarchies in which dominant individuals reap disproportionate benefits from group cooperation. The stability of these societies requires subordinates to accept their inferior status rather than engage in escalated conflict with dominants over rank. Applying the logic of animal contests to these cases predicts that escalated conflict is more likely where subordinates are reproductively suppressed, where group productivity is high, relatedness is low, and where subordinates are relatively strong. We tested these four predictions in the field on co-foundress associations of the paper wasp Polistes dominulus by inducing contests over dominance rank experimentally. Subordinates with lower levels of ovarian development, and those in larger, more productive groups, were more likely to escalate in conflict with their dominant, as predicted. Neither genetic relatedness nor relative body size had significant effects on the probability of escalation. The original dominant emerged as the winner in all except one escalated contest. The results provide the first evidence that reproductive suppression of subordinates increases the threat of escalated conflict, and hence that reproductive sharing can promote stability of the dominant–subordinate relationship. PMID:17015353

Phase II Trial of Combined High-Dose-Rate Brachytherapy and External Beam Radiotherapy for Adenocarcinoma of the Prostate: Preliminary Results of RTOG 0321

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

Hsu, I-Chow, E-mail: ihsu@radonc.ucsf.ed; Bae, Kyounghwa; Shinohara, Katsuto

2010-11-01

Purpose: To estimate the rate of late Grade 3 or greater genitourinary (GU) and gastrointestinal (GI) adverse events (AEs) after treatment with external beam radiotherapy and prostate high-dose-rate (HDR) brachytherapy. Methods and Materials: Each participating institution submitted computed tomography-based HDR brachytherapy dosimetry data electronically for credentialing and for each study patient. Patients with locally confined Stage T1c-T3b prostate cancer were eligible for the present study. All patients were treated with 45 Gy in 25 fractions using external beam radiotherapy and one HDR implant delivering 19 Gy in two fractions. All AEs were graded according to the Common Terminology Criteria formore » Adverse Events, version 3.0. Late GU/GI AEs were defined as those occurring >9 months from the start of the protocol treatment, in patients with {>=}18 months of potential follow-up. Results: A total of 129 patients from 14 institutions were enrolled in the present study. Of the 129 patients, 125 were eligible, and AE data were available for 112 patients at analysis. The pretreatment characteristics of the patients were as follows: Stage T1c-T2c, 91%; Stage T3a-T3b, 9%; prostate-specific antigen level {<=}10 ng/mL, 70%; prostate-specific antigen level >10 but {<=}20 ng/mL, 30%; and Gleason score 2-6, 10%; Gleason score 7, 72%; and Gleason score 8-10, 18%. At a median follow-up of 29.6 months, three acute and four late Grade 3 GU/GI AEs were reported. The estimated rate of late Grade 3-5 GU and GI AEs at 18 months was 2.56%. Conclusion: This is the first prospective, multi-institutional trial of computed tomography-based HDR brachytherapy and external beam radiotherapy. The technique and doses used in the present study resulted in acceptable levels of AEs.« less

Modelling second malignancy risks from low dose rate and high dose rate brachytherapy as monotherapy for localised prostate cancer.

PubMed

Murray, Louise; Mason, Joshua; Henry, Ann M; Hoskin, Peter; Siebert, Frank-Andre; Venselaar, Jack; Bownes, Peter

2016-08-01

To estimate the risks of radiation-induced rectal and bladder cancers following low dose rate (LDR) and high dose rate (HDR) brachytherapy as monotherapy for localised prostate cancer and compare to external beam radiotherapy techniques. LDR and HDR brachytherapy monotherapy plans were generated for three prostate CT datasets. Second cancer risks were assessed using Schneider's concept of organ equivalent dose. LDR risks were assessed according to a mechanistic model and a bell-shaped model. HDR risks were assessed according to a bell-shaped model. Relative risks and excess absolute risks were estimated and compared to external beam techniques. Excess absolute risks of second rectal or bladder cancer were low for both LDR (irrespective of the model used for calculation) and HDR techniques. Average excess absolute risks of rectal cancer for LDR brachytherapy according to the mechanistic model were 0.71 per 10,000 person-years (PY) and 0.84 per 10,000 PY respectively, and according to the bell-shaped model, were 0.47 and 0.78 per 10,000 PY respectively. For HDR, the average excess absolute risks for second rectal and bladder cancers were 0.74 and 1.62 per 10,000 PY respectively. The absolute differences between techniques were very low and clinically irrelevant. Compared to external beam prostate radiotherapy techniques, LDR and HDR brachytherapy resulted in the lowest risks of second rectal and bladder cancer. This study shows both LDR and HDR brachytherapy monotherapy result in low estimated risks of radiation-induced rectal and bladder cancer. LDR resulted in lower bladder cancer risks than HDR, and lower or similar risks of rectal cancer. In absolute terms these differences between techniques were very small. Compared to external beam techniques, second rectal and bladder cancer risks were lowest for brachytherapy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Comparative sensitivities of functional MRI sequences in detection of local recurrence of prostate carcinoma after radical prostatectomy or external-beam radiotherapy.

PubMed

Roy, Catherine; Foudi, Fatah; Charton, Jeanne; Jung, Michel; Lang, Hervé; Saussine, Christian; Jacqmin, Didier

2013-04-01

The aim of this retrospective study was to determine the respective accuracies of three types of functional MRI sequences-diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE) MRI, and 3D (1)H-MR spectroscopy (MRS)-in the depiction of local prostate cancer recurrence after two different initial therapy options. From a cohort of 83 patients with suspicion of local recurrence based on prostate-specific antigen (PSA) kinetics who were imaged on a 3-T MRI unit using an identical protocol including the three functional sequences with an endorectal coil, we selected 60 patients (group A, 28 patients who underwent radical prostatectomy; group B, 32 patients who underwent external-beam radiation) who had local recurrence ascertained on the basis of a transrectal ultrasound-guided biopsy results and a reduction in PSA level after salvage therapy. All patients presented with a local relapse. Sensitivity with T2-weighted MRI and 3D (1)H-MRS sequences was 57% and 53%, respectively, for group A and 71% and 78%, respectively, for group B. DCE-MRI alone showed a sensitivity of 100% and 96%, respectively, for groups A and B. DWI alone had a higher sensitivity for group B (96%) than for group A (71%). The combination of T2-weighted imaging plus DWI plus DCE-MRI provided a sensitivity as high as 100% in group B. The performance of functional imaging sequences for detecting recurrence is different after radical prostatectomy and external-beam radiotherapy. DCE-MRI is a valid and efficient tool to detect prostate cancer recurrence in radical prostatectomy as well as in external-beam radiotherapy. The combination of DCE-MRI and DWI is highly efficient after radiation therapy. Three-dimensional (1)H-MRS needs to be improved. Even though it is not accurate enough, T2-weighted imaging remains essential for the morphologic analysis of the area.

Comprehensive MRI simulation methodology using a dedicated MRI scanner in radiation oncology for external beam radiation treatment planning

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

Paulson, Eric S., E-mail: epaulson@mcw.edu; Erickson, Beth; Schultz, Chris

Purpose: The use of magnetic resonance imaging (MRI) in radiation oncology is expanding rapidly, and more clinics are integrating MRI into their radiation therapy workflows. However, radiation therapy presents a new set of challenges and places additional constraints on MRI compared to diagnostic radiology that, if not properly addressed, can undermine the advantages MRI offers for radiation treatment planning (RTP). The authors introduce here strategies to manage several challenges of using MRI for virtual simulation in external beam RTP. Methods: A total of 810 clinical MRI simulation exams were performed using a dedicated MRI scanner for external beam RTP ofmore » brain, breast, cervix, head and neck, liver, pancreas, prostate, and sarcoma cancers. Patients were imaged in treatment position using MRI-optimal immobilization devices. Radiofrequency (RF) coil configurations and scan protocols were optimized based on RTP constraints. Off-resonance and gradient nonlinearity-induced geometric distortions were minimized or corrected prior to using images for RTP. A multidisciplinary MRI simulation guide, along with window width and level presets, was created to standardize use of MR images during RTP. A quality assurance program was implemented to maintain accuracy and repeatability of MRI simulation exams. Results: The combination of a large bore scanner, high field strength, and circumferentially wrapped, flexible phased array RF receive coils permitted acquisition of thin slice images with high contrast-to-noise ratio (CNR) and image intensity uniformity, while simultaneously accommodating patient setup and immobilization devices. Postprocessing corrections and alternative acquisition methods were required to reduce or correct off-resonance and gradient nonlinearity induced geometric distortions. Conclusions: The methodology described herein contains practical strategies the authors have implemented through lessons learned performing clinical MRI simulation exams. In their experience, these strategies provide robust, high fidelity, high contrast MR images suitable for external beam RTP.« less

Validating dose rate calibration of radiotherapy photon beams through IAEA/WHO postal audit dosimetry service.

PubMed

Jangda, Abdul Qadir; Hussein, Sherali

2012-05-01

In external beam radiation therapy (EBRT), the quality assurance (QA) of the radiation beam is crucial to the accurate delivery of the prescribed dose to the patient. One of the dosimetric parameters that require monitoring is the beam output, specified as the dose rate on the central axis under reference conditions. The aim of this project was to validate dose rate calibration of megavoltage photon beams using the International Atomic Energy Agency (IAEA)/World Health Organisation (WHO) postal audit dosimetry service. Three photon beams were audited: a 6 MV beam from the low-energy linac and 6 and 18 MV beams from a dual high-energy linac. The agreement between our stated doses and the IAEA results was within 1% for the two 6 MV beams and within 2% for the 18 MV beam. The IAEA/WHO postal audit dosimetry service provides an independent verification of dose rate calibration protocol by an international facility.

Escalation research: Providing new frontiers for applying behavior analysis to organizational behavior

PubMed Central

Goltz, Sonia M.

2000-01-01

Decision fiascoes such as escalation of commitment, the tendency of decision makers to “throw good money after bad,” can have serious consequences for organizations and are therefore of great interest in applied research. This paper discusses the use of behavior analysis in organizational behavior research on escalation. Among the most significant aspects of behavior-analytic research on escalation is that it has indicated that both the patterns of outcomes that decision makers have experienced for past decisions and the patterns of responses that they make are critical for understanding escalation. This research has also stimulated the refinement of methods by researchers to better assess decision making and the role reinforcement plays in it. Finally, behavior-analytic escalation research has not only indicated the utility of reinforcement principles for predicting more complex human behavior but has also suggested some additional areas for future exploration of decision making using behavior analysis. PMID:22478347

Smoker Identity Development among Adolescents who Smoke

PubMed Central

Hertel, Andrew W.; Mermelstein, Robin J.

2016-01-01

Adolescents who smoke are more likely to escalate their smoking frequency if they believe smoking is self-defining. Knowing factors that are associated with development of a smoker identity among adolescents who smoke may help to identify who will become a regular smoker. We investigated whether smoker identity development is associated with internal and external motives for smoking. For comparison, we also investigated whether social smoker identity development is associated with internal and external motives for smoking. Adolescents who smoke (n = 292) completed measures of smoker and social smoker identity, internal motives for smoking (negative affect coping, positive affect enhancement), and external motives for smoking (social fit) at baseline, 6-, 15-, and 24-month assessments of an ongoing longitudinal study of smoking patterns. We examined whether change in smoker and social smoker identity from 6 to 24 months was associated with change in motives at earlier assessment waves. We also explored whether gender moderated these relationships. Increases in negative affect coping motives were associated with smoker identity development among both males and females. Increases in social motives were associated with smoker identity development among males, and increases in negative affect coping motives were associated with social smoker identity development among females. Smoker and social smoker identities are signaled by negative affect coping as well as social motives for smoking. PMID:27136374

Primary treatments for clinically localized prostate cancer: a comprehensive lifetime cost-utility analysis

PubMed Central

Cooperberg, Matthew R.; Ramakrishna, Naren R.; Duff, Steven B.; Hughes, Kathleen E.; Sadownik, Sara; Smith, Joseph A.; Tewari, Ashutosh K.

2012-01-01

Objectives To characterize the costs and outcomes associated with radical prostatectomy (open, laparoscopic, or robot-assisted) and radiation therapy (dose-escalated 3-dimensional conformal radiation, intensity-modulated radiation, brachytherapy, or combination), using a comprehensive, lifetime decision analytic model. Patients and Methods A Markov model was constructed to follow hypothetical men with low-, intermediate-, and high-risk prostate cancer over their lifetimes following primary treatment; probabilities of outcomes were based on an exhaustive literature search yielding 232 unique publications. Patients could experience remission, recurrence, salvage treatment, metastasis, death from prostate cancer, and death from other causes. Utilities for each health state were determined, and disutilities were applied for complications and toxicities of treatment. Costs were determined from the U.S. payer perspective, with incorporation of patient costs in a sensitivity analysis. Results Differences in quality-adjusted life years across modalities were modest, ranging from 10.3 to 11.3 for low-risk patients, 9.6 to 10.5 for intermediate-risk patients, and 7.8 to 9.3 for high-risk patients. There were no statistically significant differences among surgical modalities, which tended to be more effective than radiation modalities, with the exception of combination external beam + brachytherapy for high-risk disease. Radiation modalities were consistently more expensive than surgical modalities; costs ranged from $19,901 (robot-assisted prostatectomy for low-risk disease) to $50,276 (combination radiation for high-risk disease). These findings were robust to an extensive set of sensitivity analyses. Conclusions Our analysis found small differences in outcomes and substantial differences in payer and patient costs across treatment alternatives. These findings may inform future policy discussions regarding strategies to improve efficiency of treatment selection for localized prostate cancer. PMID:23279038

An epidermal growth factor receptor variant III–targeted vaccine is safe and immunogenic in patients with glioblastoma multiforme

PubMed Central

Sampson, John H.; Archer, Gary E.; Mitchell, Duane A.; Heimberger, Amy B.; Herndon, James E.; Lally-Goss, Denise; McGehee-Norman, Sharon; Paolino, Alison; Reardon, David A.; Friedman, Allan H.; Friedman, Henry S.; Bigner, Darell D.

2010-01-01

Conventional therapies for glioblastoma multiforme (GBM) fail to target tumor cells exclusively, such that their efficacyis ultimately limited by nonspecific toxicity. Immunologic targeting of tumor-specific gene mutations, however, may allow more precise eradication of neoplastic cells. The epidermal growth factor receptor variant III (EGFRvIII) is a consistent and tumor-specific mutation widely expressed in GBMs and other neoplasms. The safety and immunogenicity of a dendritic cell (DC)–based vaccine targeting the EGFRvIII antigen was evaluated in this study. Adults with newly diagnosed GBM, who had undergone gross-total resection and standard conformal external beam radiotherapy, received three consecutive intradermal vaccinations with autologous mature DCs pulsed with an EGFRvIII-specific peptide conjugated to keyhole limpet hemocyanin. The dose of DCs was escalated in cohorts of three patients. Patients were monitored for toxicity, immune response, radiographic and clinical progression, and death. No allergic reactions or serious adverse events were seen. Adverse events were limited to grade 2 toxicities. The maximum feasible dose of antigen-pulsed mature DCs was reached at 5.7 × 107 ± 2.9 × 107 SD without dose-limiting toxicity. EGFRvIII-specific immune responses were evident in most patients. The mean time from histologic diagnosis to vaccination was 3.6 ± 0.6 SD months. Median time to progression from vaccination was 6.8 months [95% confidence interval (C.I.95), 2.5–8.8], and median survival time from vaccination was 18.7 months (C.I.95, 14.5–25.6). Overall median survival from time of histologic diagnosis was 22.8 months (C.I.95, 17.5–29). This study establishes the EGFRvIII mutation as a safe and immunogenic tumor-specific target for immunotherapy. PMID:19825799

Deep convolutional neural network with transfer learning for rectum toxicity prediction in cervical cancer radiotherapy: a feasibility study

NASA Astrophysics Data System (ADS)

Zhen, Xin; Chen, Jiawei; Zhong, Zichun; Hrycushko, Brian; Zhou, Linghong; Jiang, Steve; Albuquerque, Kevin; Gu, Xuejun

2017-11-01

Better understanding of the dose-toxicity relationship is critical for safe dose escalation to improve local control in late-stage cervical cancer radiotherapy. In this study, we introduced a convolutional neural network (CNN) model to analyze rectum dose distribution and predict rectum toxicity. Forty-two cervical cancer patients treated with combined external beam radiotherapy (EBRT) and brachytherapy (BT) were retrospectively collected, including twelve toxicity patients and thirty non-toxicity patients. We adopted a transfer learning strategy to overcome the limited patient data issue. A 16-layers CNN developed by the visual geometry group (VGG-16) of the University of Oxford was pre-trained on a large-scale natural image database, ImageNet, and fine-tuned with patient rectum surface dose maps (RSDMs), which were accumulated EBRT  +  BT doses on the unfolded rectum surface. We used the adaptive synthetic sampling approach and the data augmentation method to address the two challenges, data imbalance and data scarcity. The gradient-weighted class activation maps (Grad-CAM) were also generated to highlight the discriminative regions on the RSDM along with the prediction model. We compare different CNN coefficients fine-tuning strategies, and compare the predictive performance using the traditional dose volume parameters, e.g. D 0.1/1/2cc, and the texture features extracted from the RSDM. Satisfactory prediction performance was achieved with the proposed scheme, and we found that the mean Grad-CAM over the toxicity patient group has geometric consistence of distribution with the statistical analysis result, which indicates possible rectum toxicity location. The evaluation results have demonstrated the feasibility of building a CNN-based rectum dose-toxicity prediction model with transfer learning for cervical cancer radiotherapy.

Deep convolutional neural network with transfer learning for rectum toxicity prediction in cervical cancer radiotherapy: a feasibility study.

PubMed

Zhen, Xin; Chen, Jiawei; Zhong, Zichun; Hrycushko, Brian; Zhou, Linghong; Jiang, Steve; Albuquerque, Kevin; Gu, Xuejun

2017-10-12

Better understanding of the dose-toxicity relationship is critical for safe dose escalation to improve local control in late-stage cervical cancer radiotherapy. In this study, we introduced a convolutional neural network (CNN) model to analyze rectum dose distribution and predict rectum toxicity. Forty-two cervical cancer patients treated with combined external beam radiotherapy (EBRT) and brachytherapy (BT) were retrospectively collected, including twelve toxicity patients and thirty non-toxicity patients. We adopted a transfer learning strategy to overcome the limited patient data issue. A 16-layers CNN developed by the visual geometry group (VGG-16) of the University of Oxford was pre-trained on a large-scale natural image database, ImageNet, and fine-tuned with patient rectum surface dose maps (RSDMs), which were accumulated EBRT  +  BT doses on the unfolded rectum surface. We used the adaptive synthetic sampling approach and the data augmentation method to address the two challenges, data imbalance and data scarcity. The gradient-weighted class activation maps (Grad-CAM) were also generated to highlight the discriminative regions on the RSDM along with the prediction model. We compare different CNN coefficients fine-tuning strategies, and compare the predictive performance using the traditional dose volume parameters, e.g. D 0.1/1/2cc , and the texture features extracted from the RSDM. Satisfactory prediction performance was achieved with the proposed scheme, and we found that the mean Grad-CAM over the toxicity patient group has geometric consistence of distribution with the statistical analysis result, which indicates possible rectum toxicity location. The evaluation results have demonstrated the feasibility of building a CNN-based rectum dose-toxicity prediction model with transfer learning for cervical cancer radiotherapy.

Considerations for the application of finite element beam modeling to vibration analysis of flight vehicle structures. Ph.D. Thesis - Case Western Reserve Univ.

NASA Technical Reports Server (NTRS)

Kvaternik, R. G.

1976-01-01

The manner of representing a flight vehicle structure as an assembly of beam, spring, and rigid-body components for vibration analysis is described. The development is couched in terms of a substructures methodology which is based on the finite-element stiffness method. The particular manner of employing beam, spring, and rigid-body components to model such items as wing structures, external stores, pylons supporting engines or external stores, and sprung masses associated with launch vehicle fuel slosh is described by means of several simple qualitative examples. A detailed numerical example consisting of a tilt-rotor VTOL aircraft is included to provide a unified illustration of the procedure for representing a structure as an equivalent system of beams, springs, and rigid bodies, the manner of forming the substructure mass and stiffness matrices, and the mechanics of writing the equations of constraint which enforce deflection compatibility at the junctions of the substructures. Since many structures, or selected components of structures, can be represented in this manner for vibration analysis, the modeling concepts described and their application in the numerical example shown should prove generally useful to the dynamicist.

Progression-free survival of early interim PET-positive patients with advanced stage Hodgkin's lymphoma treated with BEACOPPescalated alone or in combination with rituximab (HD18): an open-label, international, randomised phase 3 study by the German Hodgkin Study Group.

PubMed

Borchmann, Peter; Haverkamp, Heinz; Lohri, Andreas; Mey, Ulrich; Kreissl, Stefanie; Greil, Richard; Markova, Jana; Feuring-Buske, Michaela; Meissner, Julia; Dührsen, Ulrich; Ostermann, Helmut; Keller, Ulrich; Maschmeyer, Georg; Kuhnert, Georg; Dietlein, Markus; Kobe, Carsten; Eich, Hans; Baues, Christian; Stein, Harald; Fuchs, Michael; Diehl, Volker; Engert, Andreas

2017-04-01

Advanced stage Hodgkin's lymphoma represents a heterogeneous group of patients with different risk profiles. Data suggests that interim PET assessment during chemotherapy is superior to baseline international prognostic scoring in terms of predicting long-term treatment outcome in patients with Hodgkin's lymphoma. We therefore hypothesised that early interim PET-imaging after two courses of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) might be suitable for guiding treatment in patients with advanced stage Hodgkin's lymphoma. We aimed to assess whether intensifying standard chemotherapy (BEACOPP escalated ) by adding rituximab would improve progression-free survival in patients with positive PET after two courses of chemotherapy. In this open-label, international, randomised, phase 3 study, we recruited patients aged 18-60 years with newly diagnosed, advanced stage Hodgkin's lymphoma from 160 hospitals and 77 private practices in Germany, Switzerland, Austria, the Netherlands, and the Czech Republic. Interim PET-imaging was done after two cycles of BEACOPP escalated and centrally assessed by an expert panel. Patients with a positive PET after 2 cycles of BEACOPP escalated chemotherapy (PET-2) were randomly assigned (1:1) to receive six additional courses of either BEACOPP escalated (BEACOPP escalated group) or BEACOPP escalated plus rituximab (R-BEACOPP escalated group). PET-2 was assessed using a 5-point scale with 18 FDG uptake higher than the mediastinal blood pool (corresponding to Deauville scale 3) defined as positive. BEACOPP escalated was given as previously described; rituximab was given intravenously at a dose of 375 mg/m 2 (maximum total dose 700 mg), the first administration starting 24 h before starting the fourth cycle of BEACOPP escalated (day 0 and day 3 in cycle 4, day 1 in cycles 5-8). Randomisation was done centrally and used the minimisation method including a random component, stratified according to centre, age, stage, international prognostic score, and sex. The primary efficacy endpoint was 5 year progression-free survival, analysed in the intention-to-treat population. We are reporting this second planned interim analysis as the final report of the trial. The trial is registered with ClinicalTrials.gov, number NCT00515554. Between May 14, 2008, and May 31, 2011, we enrolled 1100 patients. 440 patients had a positive PET-2 and were randomly assigned to either the BEACOPP escalated group (n=220) or the R-BEACOPP escalated group (n=220). With a median follow-up of 33 months (IQR 25-42) for progression-free survival, estimated 3 year progression-free survival was 91·4% (95% CI 87·0-95·7) for patients in the BEACOPP escalated group and 93·0% (89·4-96·6) for those in the R-BEACOPP escalated group (difference 1·6%, 95% CI -4·0 to 7·3; log rank p=0·99). Common grade 3-4 adverse events were leucopenia (207 [95%] of 218 patients in the BEACOPP escalated group vs 211 [96%] of 220 patients in the R-BEACOPP escalated group), and severe infections (51 [23%] vs 43 [20%] patients). Based on a futility analysis, the independent data monitoring committee recommended publication of this second planned interim analysis as the final result. Six (3%) of 219 patients in the BEACOPP escalated group and ten (5%) of 220 in the R-BEACOPP escalated group died; fatal treatment-related toxic effects occurred in one (<1%) patient in the BEACOPP escalated group and three (1%) in the R-BEACOPP escalated group, all of them due to infection. The addition of rituximab to BEACOPP escalated did not improve the progression-free survival of PET-2 positive patients with advanced stage Hodgkin's lymphoma. However, progression-free survival for PET-2 positive patients was much better than expected, exceeding even the outcome of PET-2-unselected patients in the previous HD15 trial. Thus, PET-2 cannot identify patients at high-risk for treatment failure in the context of the very effective German Hodgkin Study Group standard treatment for advanced stage Hodgkin's lymphoma. Deutsche Krebshilfe; Swiss State Secretariat for Education, Research and Innovation (SERI); and Roche Pharma. Copyright © 2017 Elsevier Ltd. All rights reserved.

Ferroelectric properties of Pb(Zr,Ti)O3 films under ion-beam induced strain

NASA Astrophysics Data System (ADS)

Lee, Jung-Kun; Nastasi, Michael

2012-11-01

The influence of an ion-beam induced biaxial stress on the ferroelectric and dielectric properties of Pb(Zr,Ti)O3 (PZT) films is investigated using the ion beam process as a novel approach to control external stress. Tensile stress is observed to decrease the polarization, permittivity, and ferroelectric fatigue resistance of the PZT films whose structure is monoclinic. However, a compressive stress increases all of them in monoclinic PZT films. The dependence of the permittivity on stress is found not to follow the phenomenological theory relating external forces to intrinsic properties of ferroelectric materials. Changes in the ferroelectric and dielectric properties indicate that the application of a biaxial stress modulates both extrinsic and intrinsic properties of PZT films. Different degrees of dielectric non-linearity suggests the density and mobility of non-180o domain walls, and the domain switching can be controlled by an applied biaxial stress and thereby influence the ferroelectric and dielectric properties.

A novel coaxial Ku-band transit radiation oscillator without external guiding magnetic field

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

Ling, Junpu, E-mail: lingjunpu@163.com; Zhang, Jiande; He, Juntao

2014-02-15

A novel coaxial transit radiation oscillator without external guiding magnetic field is designed to generate high power microwave at Ku-band. By using a coaxial structure, the space-charge potential energy is suppressed significantly, that is good for enhancing efficient beam-wave interaction. In order to improve the transmission stability of the unmagnetized intense relativistic electron beam, a Pierce-like cathode is employed in the novel device. By contrast with conventional relativistic microwave generators, this kind of device has the advantages of high stability, non-guiding magnetic field, and high efficiency. Moreover, with the coaxial design, it is possible to improve the power-handing capacity bymore » increasing the radial dimension of the Ku-band device. With a 550 keV and 7.5 kA electron beam, a 1.25 GW microwave pulse at 12.08 GHz has been obtained in the simulation. The power conversion efficiency is about 30%.« less

Glutamate input in the dorsal raphe nucleus as a determinant of escalated aggression in male mice.

PubMed

Takahashi, Aki; Lee, Ray X; Iwasato, Takuji; Itohara, Shigeyoshi; Arima, Hiroshi; Bettler, Bernhard; Miczek, Klaus A; Koide, Tsuyoshi

2015-04-22

Although the dorsal raphe nucleus (DRN) has long been linked to neural control of aggression, little is known about the regulatory influences of the DRN when an animal engages in either adaptive species-typical aggressive behavior or escalated aggression. Therefore it is important to explore which neurotransmitter inputs into the DRN determine the escalation of aggression in male mice. Previously, we observed that microinjection of the GABAB receptor agonist baclofen into the DRN escalates aggressive behavior in male mice. Here, we used a serotonin (5-HT) neuron-specific GABAB receptor knock-out mouse to demonstrate that baclofen acts on nonserotonergic neurons to escalate aggression. Intra-DRN baclofen administration increased glutamate release, but did not alter GABA release, within the DRN. Microinjection of l-glutamate into the DRN escalated dose-dependently attack bites toward an intruder. In vivo microdialysis showed that glutamate release increased in the DRN during an aggressive encounter, and the level of glutamate was further increased when the animal was engaged in escalated aggressive behavior after social instigation. Finally, 5-HT release was increased within the DRN and also in the medial prefrontal cortex when animals were provoked by social instigation, and during escalated aggression after social instigation, but this increase in 5-HT release was not observed when animals were engaged in species-typical aggression. In summary, glutamate input into the DRN is enhanced during escalated aggression, which causes a phasic increase of 5-HT release from the DRN 5-HT neurons. Copyright © 2015 the authors 0270-6474/15/356452-12$15.00/0.

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

PubMed

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

2003-12-01

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

Investigation of the optimum location of external markers for patient setup accuracy enhancement at external beam radiotherapy

PubMed Central

Torshabi, Ahmad Esmaili; Nankali, Saber

2016-01-01

In external beam radiotherapy, one of the most common and reliable methods for patient geometrical setup and/or predicting the tumor location is use of external markers. In this study, the main challenging issue is increasing the accuracy of patient setup by investigating external markers location. Since the location of each external marker may yield different patient setup accuracy, it is important to assess different locations of external markers using appropriate selective algorithms. To do this, two commercially available algorithms entitled a) canonical correlation analysis (CCA) and b) principal component analysis (PCA) were proposed as input selection algorithms. They work on the basis of maximum correlation coefficient and minimum variance between given datasets. The proposed input selection algorithms work in combination with an adaptive neuro‐fuzzy inference system (ANFIS) as a correlation model to give patient positioning information as output. Our proposed algorithms provide input file of ANFIS correlation model accurately. The required dataset for this study was prepared by means of a NURBS‐based 4D XCAT anthropomorphic phantom that can model the shape and structure of complex organs in human body along with motion information of dynamic organs. Moreover, a database of four real patients undergoing radiation therapy for lung cancers was utilized in this study for validation of proposed strategy. Final analyzed results demonstrate that input selection algorithms can reasonably select specific external markers from those areas of the thorax region where root mean square error (RMSE) of ANFIS model has minimum values at that given area. It is also found that the selected marker locations lie closely in those areas where surface point motion has a large amplitude and a high correlation. PACS number(s): 87.55.km, 87.55.N PMID:27929479

Willingness to trade-off: An intermediate factor in patient decision-making regarding escalating care.

PubMed

Seng, Elizabeth K; Grinberg, Amy S; Fraenkel, Liana

2018-01-01

This study aimed to evaluate treatment necessity, treatment concern, and willingness to engage in decisional trade-offs in the context of treatment escalation decision-making. Participants ( n  = 147) recruited online were randomized to read a vignette about escalating care in psoriasis in a 2 (high treatment concern vs moderate treatment concern) × 2 (high perceived treatment necessity vs moderate perceived treatment necessity) design. High treatment concern was associated with choosing to defer treatment escalation and being unwilling to engage in decisional trade-offs if disease risk changed. Results highlight the importance of treatment concern and willingness trade-off in treatment escalation decision-making.

Willingness to trade-off: An intermediate factor in patient decision-making regarding escalating care

PubMed Central

Seng, Elizabeth K; Grinberg, Amy S; Fraenkel, Liana

2018-01-01

This study aimed to evaluate treatment necessity, treatment concern, and willingness to engage in decisional trade-offs in the context of treatment escalation decision-making. Participants (n = 147) recruited online were randomized to read a vignette about escalating care in psoriasis in a 2 (high treatment concern vs moderate treatment concern) × 2 (high perceived treatment necessity vs moderate perceived treatment necessity) design. High treatment concern was associated with choosing to defer treatment escalation and being unwilling to engage in decisional trade-offs if disease risk changed. Results highlight the importance of treatment concern and willingness trade-off in treatment escalation decision-making. PMID:29662681

On-chip interference of single photons from an embedded quantum dot and an external laser

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

Prtljaga, N., E-mail: n.prtljaga@sheffield.ac.uk; Bentham, C.; O'Hara, J.

2016-06-20

In this work, we demonstrate the on-chip two-photon interference between single photons emitted by a single self-assembled InGaAs quantum dot and an external laser. The quantum dot is embedded within one arm of an air-clad directional coupler which acts as a beam-splitter for incoming light. Photons originating from an attenuated external laser are coupled to the second arm of the beam-splitter and then combined with the quantum dot photons, giving rise to two-photon quantum interference between dissimilar sources. We verify the occurrence of on-chip Hong-Ou-Mandel interference by cross-correlating the optical signal from the separate output ports of the directional coupler.more » This experimental approach allows us to use a classical light source (laser) to assess in a single step the overall device performance in the quantum regime and probe quantum dot photon indistinguishability on application realistic time scales.« less

Influence of (11)C-choline PET/CT on radiotherapy planning in prostate cancer.

PubMed

López, Escarlata; Lazo, Antonio; Gutiérrez, Antonio; Arregui, Gregorio; Núñez, Isabel; Sacchetti, Antonio

2015-01-01

To evaluate the influence of (11)C-choline PET/CT on radiotherapy planning in prostate cancer patients. Precise information on the extension of prostate cancer is crucial for the choice of an appropriate therapeutic strategy. (11)C-choline positron emission tomography ((11)C-choline PET/CT) has two roles in radiation oncology (RT): (1) patient selection for treatment and (2) target volume selection and delineation. In conjunction with high-accuracy techniques, it might offer an opportunity of dose escalation and better tumour control while sparing healthy tissues. We carried out a retrospective study in order to analyse RT planning modification based on (11)C-choline PET/CT in 16 prostate cancer patients. Patients were treated with hypofractionated step-and-shoot Intensity Modulated Radiotherapy (IMRT), or Volumetric Modulated Arc Therapy (VMAT), and a daily cone-beam CT for Image Guided Radiation Therapy (IGRT). All patients underwent a (11)C-choline-PET/CT scan prior to radiotherapy. In 37.5% of cases, a re-delineation and new dose prescription occurred. Data show good preliminary clinical results in terms of biochemical control and toxicity. No gastrointestinal (GI)/genitourinary (GU) grade III toxicities were observed after a median follow-up of 9.5 months. In our experience, concerning the treatment of prostate cancer (PCa), (11)C-choline PET/CT may be helpful in radiotherapy planning, either for dose escalation or exclusion of selected sites.

De-escalation, adequacy of antibiotic therapy and culture positivity in septic patients: an observational study.

PubMed

Moraes, Rafael Barberena; Guillén, Julián Alberto Viteri; Zabaleta, William Javier Castillo; Borges, Flavia Kessler

2016-09-01

To evaluate the prevalence of antibiotic de-escalation in patients diagnosed with severe sepsis or septic shock at a public academic tertiary hospital and to evaluate antibiotic adequacy and culture positivity. The prevalence of antibiotic de-escalation, the adequacy of antibiotic treatment and the rates of culture positivity were analyzed in patients with severe sepsis and septic shock between April and December 2013 at an intensive care unit in a tertiary university hospital. Among the 224 patients included in the study, de-escalation was appropriate in 66 patients (29.4%) but was implemented in 44 patients (19.6%). Among the patients who underwent de-escalation, half experienced narrowing of the antimicrobial spectrum. The mortality rate was 56.3%, with no differences between the patients with or without de-escalation (56.8% versus 56.1%; p = 0.999) nor in the length of hospital stay. Empirical antibiotic therapy was appropriate in 89% of cases. Microorganisms were isolated from total cultures in 30% of cases and from blood cultures in 26.3% of cases. The adequacy rate of empirical antibiotic therapy was high, reflecting an active institutional policy of monitoring epidemiological profiles and institutional protocols on antimicrobial use. However, antibiotic de-escalation could have been implemented in a greater number of patients. De-escalation did not affect mortality rates.

The use of a single multielement standard for trace analysis in biological materials by external beam PIXE

NASA Astrophysics Data System (ADS)

Biswas, S. K.; Khaliquzzaman, M.; Islam, M. M.; Khan, A. H.

1984-04-01

The validity of the use of a single multielement standard for mass calibration in thick-target external beam PIXE analysis of biological materials has been investigated. In this study, the NBS orchard leaf, SRM 1571, was used as the basic standard for trace element analysis in other biological materials. Using the present procedure, the concentrations of K, Ca, Mn, Fe, Ni, Cu, Zn, Br, Rb and Sr were determined in several NBS reference materials such as bovine liver, spinach, rice flour, etc., generally in 20 μC irradiations with 2.0 MeV protons. The analytical results are compared with certified values of the NBS as well as with other measurements and the sources of errors are discussed.

Electron energy boosting in laser-wake-field acceleration with external magnetic field Bapprox1 T and laser prepulses

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

Hosokai, Tomonao; Zhidkov, Alexei; Yamazaki, Atsushi

2010-03-22

Hundred-mega-electron-volt electron beams with quasi-monoenergetic distribution, and a transverse geometrical emittance as small as approx0.02 pi mm mrad are generated by low power (7 TW, 45 fs) laser pulses tightly focused in helium gas jets in an external static magnetic field, Bapprox1 T. Generation of monoenergetic beams strongly correlates with appearance of a straight, at least 2 mm length plasma channel in a short time before the main laser pulse and with the energy of copropagating picosecond pedestal pulses (PPP). For a moderate energy PPP, the multiple or staged electron self-injection in the channel gives several narrow peaks in themore » electron energy distribution.« less

High external quantum efficiency and fill-factor InGaN/GaN heterojunction solar cells grown by NH3-based molecular beam epitaxy

NASA Astrophysics Data System (ADS)

Lang, J. R.; Neufeld, C. J.; Hurni, C. A.; Cruz, S. C.; Matioli, E.; Mishra, U. K.; Speck, J. S.

2011-03-01

High external quantum efficiency (EQE) p-i-n heterojunction solar cells grown by NH3-based molecular beam epitaxy are presented. EQE values including optical losses are greater than 50% with fill-factors over 72% when illuminated with a 1 sun AM0 spectrum. Optical absorption measurements in conjunction with EQE measurements indicate an internal quantum efficiency greater than 90% for the InGaN absorbing layer. By adjusting the thickness of the top p-type GaN window contact layer, it is shown that the short-wavelength (<365 nm) quantum efficiency is limited by the minority carrier diffusion length in highly Mg-doped p-GaN.

SU-F-T-485: Independent Remote Audits for TG51 NonCompliant Photon Beams Performed by the IROC Houston QA Center

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

Alvarez, P; Molineu, A; Lowenstein, J

Purpose: IROC-H conducts external audits for output check verification of photon and electron beams. Many of these beams can meet the geometric requirements of the TG 51 calibration protocol. For those photon beams that are non TG 51 compliant like Elekta GammaKnife, Accuray CyberKnife and TomoTherapy, IROC-H has specific audit tools to monitor the reference calibration. Methods: IROC-H used its TLD and OSLD remote monitoring systems to verify the output of machines with TG 51 non compliant beams. Acrylic OSLD miniphantoms are used for the CyberKnife. Special TLD phantoms are used for TomoTherapy and GammaKnife machines to accommodate the specificmore » geometry of each machine. These remote audit tools are sent to institutions to be irradiated and returned to IROC-H for analysis. Results: The average IROC-H/institution ratios for 480 GammaKnife, 660 CyberKnife and 907 rotational TomoTherapy beams are 1.000±0.021, 1.008±0.019, 0.974±0.023, respectively. In the particular case of TomoTherapy, the overall ratio is 0.977±0.022 for HD units. The standard deviations of all results are consistent with values determined for TG 51 compliant photon beams. These ratios have shown some changes compared to values presented in 2008. The GammaKnife results were corrected by an experimentally determined scatter factor of 1.025 in 2013. The TomoTherapy helical beam results are now from a rotational beam whereas in 2008 the results were from a static beam. The decision to change modality was based on recommendations from the users. Conclusion: External audits of beam outputs is a valuable tool to confirm the calibrations of photon beams regardless of whether the machine is TG 51 or TG 51 non compliant. The difference found for TomoTherapy units is under investigation. This investigation was supported by IROC grant CA180803 awarded by the NCI.« less

Megavoltage planar and cone-beam imaging with low-Z targets: dependence of image quality improvement on beam energy and patient separation.

PubMed

Robar, James L; Connell, Tanner; Huang, Weihong; Kelly, Robin G

2009-09-01

The purpose of this study is to investigate the improvement of megavoltage planar and cone-beam CT (CBCT) image quality with the use of low atomic number (Z) external targets in the linear accelerator. In this investigation, two experimental megavoltage imaging beams were generated by using either 3.5 or 7.0 MeV electrons incident on aluminum targets installed above the level of the carousel in a linear accelerator (2100EX, Varian Medical, Inc., Palo Alto, CA). Images were acquired using an amorphous silicon detector panel. Contrast-to-noise ratio (CNR) in planar and CBCT images was measured as a function of dose and a comparison was made between the imaging beams and the standard 6 MV therapy beam. Phantoms of variable diameter were used to examine the loss of contrast due to beam hardening. Porcine imaging was conducted to examine qualitatively the advantages of the low-Z target approach in CBCT. In CBCT imaging CNR increases by factors as high as 2.4 and 4.3 for the 7.0 and 3.5 MeV/Al beams, respectively, compared to images acquired with 6 MV. Similar factors of improvement are observed in planar imaging. For the imaging beams, beam hardening causes a significant loss of the contrast advantage with increasing phantom diameter; however, for the 3.5 MeV/Al beam and a phantom diameter of 25 cm, a contrast advantage remains, with increases of contrast by factors of 1.5 and 3.4 over 6 MV for bone and lung inhale regions, respectively. The spatial resolution is improved slightly in CBCT images for the imaging beams. CBCT images of a porcine cranium demonstrate qualitatively the advantages of the low-Z target approach, showing greater contrast between tissues and improved visibility of fine detail. The use of low-Z external targets in the linear accelerator improves megavoltage planar and CBCT image quality significantly. CNR may be increased by a factor of 4 or greater. Improvement of the spatial resolution is also apparent.

Free electron laser using Rf coupled accelerating and decelerating structures

DOEpatents

Brau, Charles A.; Swenson, Donald A.; Boyd, Jr., Thomas J.

1984-01-01

A free electron laser and free electron laser amplifier using beam transport devices for guiding an electron beam to a wiggler of a free electron laser and returning the electron beam to decelerating cavities disposed adjacent to the accelerating cavities of the free electron laser. Rf energy is generated from the energy depleted electron beam after it emerges from the wiggler by means of the decelerating cavities which are closely coupled to the accelerating cavities, or by means of a second bore within a single set of cavities. Rf energy generated from the decelerated electron beam is used to supplement energy provided by an external source, such as a klystron, to thereby enhance overall efficiency of the system.

First experimental demonstration of magnetic-field assisted fast heating of a dense plasma core

NASA Astrophysics Data System (ADS)

Fujioka, Shinsuke; Sakata, Shohei; Lee, Seung Ho; Matsuo, Kazuki; Sawada, Hiroshi; Iwasa, Yuki; Law, King Fai Farley; Morita, Hitoki; Kojima, Sadaoki; Abe, Yuki; Yao, Akira; Hata, Masayasu; Johzaki, Tomoyuki; Sunahara, Atsushi; Ozaki, Tetsuo; Sakagami, Hitoshi; Morace, Alessio; Arikawa, Yasunobu; Yogo, Akifumi; Nishimura, Hiroaki; Nakai, Mitsuo; Shiraga, Hiroyuki; Sentoku, Yasuhiko; Nagatomo, Hideo; Azechi, Hiroshi; Firex Project Team

2016-10-01

Fast heating of a dense plasma core by an energetic electron beam is being studied on GEKKO-LFEX laser facility. Here, we introduce a laser-driven kilo-tesla external magnetic field to guide the diverging electron beam to the dense plasma core. This involve placing a spherical target in the magnetic field, compressing it with the GEKKO-XII laser beams and then using the LFEX laser beams injected into the dense plasma to generate the electron beam which do the fast heating. Cu-Ka emission is used to visualize transport or heating processes of a dense plasma. X-ray spectrum from a highly ionized Cu ions indicates several keV of the temperature increment induced by the LFEX.

Optimum location of external markers using feature selection algorithms for real-time tumor tracking in external-beam radiotherapy: a virtual phantom study.

PubMed

Nankali, Saber; Torshabi, Ahmad Esmaili; Miandoab, Payam Samadi; Baghizadeh, Amin

2016-01-08

In external-beam radiotherapy, using external markers is one of the most reliable tools to predict tumor position, in clinical applications. The main challenge in this approach is tumor motion tracking with highest accuracy that depends heavily on external markers location, and this issue is the objective of this study. Four commercially available feature selection algorithms entitled 1) Correlation-based Feature Selection, 2) Classifier, 3) Principal Components, and 4) Relief were proposed to find optimum location of external markers in combination with two "Genetic" and "Ranker" searching procedures. The performance of these algorithms has been evaluated using four-dimensional extended cardiac-torso anthropomorphic phantom. Six tumors in lung, three tumors in liver, and 49 points on the thorax surface were taken into account to simulate internal and external motions, respectively. The root mean square error of an adaptive neuro-fuzzy inference system (ANFIS) as prediction model was considered as metric for quantitatively evaluating the performance of proposed feature selection algorithms. To do this, the thorax surface region was divided into nine smaller segments and predefined tumors motion was predicted by ANFIS using external motion data of given markers at each small segment, separately. Our comparative results showed that all feature selection algorithms can reasonably select specific external markers from those segments where the root mean square error of the ANFIS model is minimum. Moreover, the performance accuracy of proposed feature selection algorithms was compared, separately. For this, each tumor motion was predicted using motion data of those external markers selected by each feature selection algorithm. Duncan statistical test, followed by F-test, on final results reflected that all proposed feature selection algorithms have the same performance accuracy for lung tumors. But for liver tumors, a correlation-based feature selection algorithm, in combination with a genetic search algorithm, proved to yield best performance accuracy for selecting optimum markers.

Clinical benefits of antimicrobial de-escalation in adults with community-onset monomicrobial Escherichia coli, Klebsiella species and Proteus mirabilis bacteremia.

PubMed

Lee, Ching-Chi; Wang, Jiun-Ling; Lee, Chung-Hsun; Hung, Yuan-Pin; Hong, Ming-Yuan; Tang, Hung-Jen; Ko, Wen-Chien

2017-09-01

The clinical benefits of an antimicrobial de-escalation strategy were compared with those of a no-switch strategy in bacteremic patients. Adults with community-onset monomicrobial Escherichia coli, Klebsiella species and Proteus mirabilis bacteremia treated empirically using broad-spectrum beta-lactams, including third-generation cephalosporins (GCs), fourth-GC or carbapenems, were treated definitively with first- or second-GCs (de-escalation group), the same regimens as empirical antibiotics (no-switch group), or antibiotics with a broader-spectrum than empirical antibiotics (escalation group). The eligible 454 adults were categorized as the de-escalation (231 patients, 50.9%), no-switch (177, 39.0%), and escalation (46, 10.1%) groups. Patients with de-escalation therapy were more often female, had less critical illness and fatal comorbidity, and had a higher survival rate than patients in the other two groups. After propensity score matching in the de-escalation and no-switch groups, critical illness at onset (Pitt bacteremia score ≥ 4; 16.5% vs. 12.7%; P = 0.34) or day 3 (2.5% vs. 2.5%; P = 1.00), fatal comorbidity (16.5% vs. 21.5%; P = 0.25), time to defervescence (4.6 vs. 4.7 days; P = 0.89), hospital stays (11.5 vs. 10.3 days; P = 0.13) and 4-week crude mortality rate (4.4% vs. 4.4%; P = 1.00) were similar. However, lower antibiotic cost (mean: 212.1 vs. 395.6 US$, P <0.001) and fewer complications of bloodstream infections due to resistant pathogens (0% vs. 5.1%, P = 0.004) were observed in the de-escalation group. De-escalation to narrower-spectrum cephalosporins is safe and cost-effective for adults with community-onset EKP bacteremia stabilized by empirical broad-spectrum beta-lactams. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Using an intense laser beam in interaction with muon/electron beam to probe the noncommutative QED

NASA Astrophysics Data System (ADS)

Tizchang, S.; Batebi, S.; Haghighat, M.; Mohammadi, R.

2017-02-01

It is known that the linearly polarized photons can partly transform to circularly polarized ones via forward Compton scattering in a background such as the external magnetic field or noncommutative space time. Based on this fact we explore the effects of the NC-background on the scattering of a linearly polarized laser beam from an intense beam of charged leptons. We show that for a muon/electron beam flux {overline{ɛ}}_{μ, e}˜ 1{0}^{12}/{10}^{10} TeV cm-2 sec-1 and a linearly polarized laser beam with energy k 0 ˜1 eV and average power {overline{P}}_{laser}˜eq 1{0}^3 KW, the generation rate of circularly polarized photons is about R V ˜ 104 /sec for noncommutative energy scale ΛNC ˜ 10 TeV. This is fairly large and can grow for more intense beams in near future.

High-intensity polarized H- ion source for the RHIC SPIN physics

NASA Astrophysics Data System (ADS)

Zelenski, A.; Atoian, G.; Raparia, D.; Ritter, J.; Kolmogorov, A.; Davydenko, V.

2017-08-01

A novel polarization technique had been successfully implemented for the RHIC polarized H- ion source upgrade to higher intensity and polarization. In this technique a proton beam inside the high magnetic field solenoid is produced by ionization of the atomic hydrogen beam (from external source) in the He-gas ionizer cell. Further proton polarization is produced in the process of polarized electron capture from the optically-pumped Rb vapour. The use of high-brightness primary beam and large cross-sections of charge-exchange cross-sections resulted in production of high intensity H- ion beam of 85% polarization. High beam brightness and polarization resulted in 75% polarization at 23 GeV out of AGS and 60-65% beam polarization at 100-250 GeV colliding beams in RHIC. The status of un-polarized magnetron type (Cs-vapour loaded) BNL source is also discussed.

Feedback stabilization of quantum cascade laser beams for stand-off applications

NASA Astrophysics Data System (ADS)

Müller, Reik; Kendziora, Christopher A.; Furstenberg, Robert

2017-05-01

Techniques which apply tunable quantum cascade lasers (QCLs) for target illumination suffer from fluctuations of the laser beam direction. This manuscript describes a method to stabilize the beam direction by using an active feedback loop. This approach corrects and stabilizes the laser pointing direction using the signal from a 4-element photo sensor as input to control an active 2 dimensional Galvo mirror system. Results are presented for measurements using known perturbations as well as actual mode hops intrinsic to external cavity QCL during wavelength tuning.

[A comparative study of the effectiveness and tolerability of a procedure involving slow dose-escalation of rivastigmine in patients with mild or moderate Alzheimer-type dementia: the SCALEX study].

PubMed

Agüera-Ortiz, L F; Ramos-García, M; Gobartt, A L

To determine and to compare the tolerability and effectiveness of a slow escalation of the dose of rivastigmine in patients with Alzheimer's disease with respect to using it with a faster escalation. We conducted a multi-centre, naturalistic, open-label, randomised trial with 429 hospital outpatients diagnosed with Alzheimer-type dementia (according to DSM-IV and NINCDS-ADRA criteria) and in whom treatment with rivastigmine was clinically indicated. Two study groups were established: slow escalation and fast escalation (in accordance with usual clinical practice); effectiveness and tolerability variables were analysed in the two groups, as was the proportion of patients who reached therapeutic doses (> 6 mg/day). The scores obtained on the CGI, MMSE, NPI and Barthel index scales were analysed, together with adverse events and reactions concerning spontaneous communication, and scores on the UKU scale. The slow escalation group displayed slightly higher percentages of sub-therapeutic anticipated interruptions than the fast escalation group (chi-square test; p < 0.05). On comparing the two treatment groups, no statistically significant differences were observed for the evolution of the scores on the different scales of effectiveness; no statistically significant differences were found between the two groups in the safety and tolerability analyses (chi-square test, exact test; p > 0.05) for most of the parameters that were studied (adverse reactions in spontaneous communication and the modified UKU scale). Slow escalation of the dose of rivastigmine did not display greater effectiveness or tolerability in comparison to an escalation applied in accordance with usual clinical practice.

Simulating the influence of scatter and beam hardening in dimensional computed tomography

NASA Astrophysics Data System (ADS)

Lifton, J. J.; Carmignato, S.

2017-10-01

Cone-beam x-ray computed tomography (XCT) is a radiographic scanning technique that allows the non-destructive dimensional measurement of an object’s internal and external features. XCT measurements are influenced by a number of different factors that are poorly understood. This work investigates how non-linear x-ray attenuation caused by beam hardening and scatter influences XCT-based dimensional measurements through the use of simulated data. For the measurement task considered, both scatter and beam hardening are found to influence dimensional measurements when evaluated using the ISO50 surface determination method. On the other hand, only beam hardening is found to influence dimensional measurements when evaluated using an advanced surface determination method. Based on the results presented, recommendations on the use of beam hardening and scatter correction for dimensional XCT are given.

Soft beams: When capillarity induces axial compression

NASA Astrophysics Data System (ADS)

Neukirch, S.; Antkowiak, A.; Marigo, J.-J.

2014-01-01

We study the interaction of an elastic beam with a liquid drop in the case where bending and extensional effects are both present. We use a variational approach to derive equilibrium equations and constitutive relation for the beam. This relation is shown to include a term due to surface energy in addition to the classical Young's modulus term, leading to a modification of Hooke's law. At the triple point where solid, liquid, and vapor phases meet, we find that the external force applied on the beam is parallel to the liquid-vapor interface. Moreover, in the case where solid-vapor and solid-liquid interface energies do not depend on the extension state of the beam, we show that the extension in the beam is continuous at the triple point and that the wetting angle satisfies the classical Young-Dupré relation.

Soft beams: when capillarity induces axial compression.

PubMed

Neukirch, S; Antkowiak, A; Marigo, J-J

2014-01-01

We study the interaction of an elastic beam with a liquid drop in the case where bending and extensional effects are both present. We use a variational approach to derive equilibrium equations and constitutive relation for the beam. This relation is shown to include a term due to surface energy in addition to the classical Young's modulus term, leading to a modification of Hooke's law. At the triple point where solid, liquid, and vapor phases meet, we find that the external force applied on the beam is parallel to the liquid-vapor interface. Moreover, in the case where solid-vapor and solid-liquid interface energies do not depend on the extension state of the beam, we show that the extension in the beam is continuous at the triple point and that the wetting angle satisfies the classical Young-Dupré relation.

Non-linear Multidimensional Optimization for use in Wire Scanner Fitting

NASA Astrophysics Data System (ADS)

Henderson, Alyssa; Terzic, Balsa; Hofler, Alicia; CASA and Accelerator Ops Collaboration

2013-10-01

To ensure experiment efficiency and quality from the Continuous Electron Beam Accelerator at Jefferson Lab, beam energy, size, and position must be measured. Wire scanners are devices inserted into the beamline to produce measurements which are used to obtain beam properties. Extracting physical information from the wire scanner measurements begins by fitting Gaussian curves to the data. This study focuses on optimizing and automating this curve-fitting procedure. We use a hybrid approach combining the efficiency of Newton Conjugate Gradient (NCG) method with the global convergence of three nature-inspired (NI) optimization approaches: genetic algorithm, differential evolution, and particle-swarm. In this Python-implemented approach, augmenting the locally-convergent NCG with one of the globally-convergent methods ensures the quality, robustness, and automation of curve-fitting. After comparing the methods, we establish that given an initial data-derived guess, each finds a solution with the same chi-square- a measurement of the agreement of the fit to the data. NCG is the fastest method, so it is the first to attempt data-fitting. The curve-fitting procedure escalates to one of the globally-convergent NI methods only if NCG fails, thereby ensuring a successful fit. This method allows for the most optimal signal fit and can be easily applied to similar problems. Financial support from DoE, NSF, ODU, DoD, and Jefferson Lab.

Preoperative single fraction partial breast radiotherapy for early-stage breast cancer.

PubMed

Palta, Manisha; Yoo, Sua; Adamson, Justus D; Prosnitz, Leonard R; Horton, Janet K

2012-01-01

Several recent series evaluating external beam accelerated partial breast irradiation (PBI) have reported adverse cosmetic outcomes, possibly related to large volumes of normal tissue receiving near-prescription doses. We hypothesized that delivery of external beam PBI in a single fraction to the preoperative tumor volume would be feasible and result in a decreased dose to the uninvolved breast compared with institutional postoperative PBI historical controls. A total of 17 patients with unifocal Stage T1 breast cancer were identified. Contrast-enhanced subtraction magnetic resonance images were loaded into an Eclipse treatment planning system and used to define the target volumes. A "virtual plan" was created using four photon beams in a noncoplanar beam arrangement and optimized to deliver 15 Gy to the planning target volume. The median breast volume was 1,713 cm(3) (range: 1,014-2,140), and the median clinical target volume was 44 cm(3) (range: 26-73). In all cases, 100% of the prescription dose covered 95% of the clinical target volume. The median conformity index was 0.86 (range: 0.70-1.12). The median percentage of the ipsilateral breast volume receiving 100% and 50% of the prescribed dose was 3.8% (range: 2.2-6.9) and 13.3% (range: 7.5-20.8) compared with 18% (range: 3-42) and 53% (range: 24-65) in the institutional historical controls treated with postoperative external beam PBI (p = .002). The median maximum skin dose was 9 Gy. The median dose to 1 and 10 cm(3) of skin was 6.7 and 4.9 Gy. The doses to the heart and ipsilateral lung were negligible. Preoperative PBI resulted in a substantial reduction in ipsilateral breast tissue dose compared with postoperative PBI. The skin dose appeared reasonable, given the small volumes. A prospective Phase I trial evaluating this technique is ongoing. Copyright © 2012 Elsevier Inc. All rights reserved.

Experimental measurements and Monte Carlo simulations of dose perturbation around a nonradioactive brachytherapy seed due to 6- and 18-MV photons.

PubMed

Steinman, James Paul; Bakhtiari, Mohammad; Malhotra, Harish Kumar

2012-01-01

Radioactive seeds used in permanent prostate brachytherapy are composed of high-Z metals and may exceed 100 in a patient. If supplemental external beam treatment is administered afterward, the seeds may cause substantial dose perturbation, which is being investigated in this article. Film measurements using 6-MV beam were primarily carried out using Kodak XV2 film layered above and below a nonradioactive iodine-125 ((125)I) seed. Monte Carlo simulations were carried out using DOSXYZnrc. Other experimental comparisons looked at changing beam energy, depth, and field size, including two opposing fields' pair. Effect of multiple seeds spatially spaced 0.5cm vertically was also studied. For a single (125)I seed, on XV film, there is a localized dose enhancement of 6.3% upstream and -10.9% downstream. With two opposing fields, a cold spot around the seed of ∼3% was noticed. Increasing beam energy and field size decreased the magnitude of this effect, whereas the effect was found to increase with the increasing Z of material. DOSXYZnrc and EBT-2 film verified maximum dose enhancement of +15% upstream and -20% downstream of the (125)I seed surface. In general, the dose perturbation because of the seeds was spatially limited to ∼2mm upstream and ∼5mm downstream to the incident beam. Similar to other heterogeneities, the seeds perturbation depends on incident beam energy, field size, and its Z. With multiple seeds spatially apart and multiple radiation fields routinely used in external beam radiotherapy, the cumulative effect may not result in clinically significant dose perturbation. Copyright © 2012 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Contest experience and body size affect different types of contest decisions.

PubMed

Chen, Yu-Ju; Hsu, Yuying

2016-11-01

This study examined the relative importance of contest experience and size differences to behavioral decisions over the course of contests. Using a mangrove rivulus fish, Kryptolebias marmoratus, we showed that although contest experience and size differences jointly determined contest outcomes, they affected contestants' interactions at different stages of contests. Contest experience affected behavioral decisions at earlier stages of contests, including the tendency and latency to launch attacks, the tendency to escalate contests into mutual attacks and the outcome of non-escalated contests. Once contests were escalated into mutual attacks, the degree of size difference affected the fish's persistence in escalation and chance of winning, but contest experience did not. These results support the hypothesis that contest experience modifies individuals' estimation of their fighting ability rather than their actual strength. Furthermore, (1) in contests between two naïve contestants, more than 60 % of fish that were 2-3 mm smaller than their opponent escalated the contest to physical fights, even though their larger opponents eventually won 92 % of escalated fights and (2) fish with a losing experience were very likely to retreat in the face of an opponent 2-3 mm smaller than them without escalating. The result that a 2-3 mm size advantage could not offset the influence of a losing experience on the tendency to escalate suggests that, as well as depending on body size, the fish's physical strength is influenced by other factors which require further investigation.

Validation of the French version of the Acceptability E-scale (AES) for mental E-health systems.

PubMed

Micoulaud-Franchi, Jean-Arthur; Sauteraud, Alain; Olive, Jérôme; Sagaspe, Patricia; Bioulac, Stéphanie; Philip, Pierre

2016-03-30

Despite the increasing use of E-health systems for mental-health organizations, there is a lack of psychometric tools to evaluate their acceptability by patients with mental disorders. Thus, this study aimed to translate and validate a French version of the Acceptability E-scale (AES), a 6-item self-reported questionnaire that evaluates the extent to which patients find E-health systems acceptable. A forward-backward translation of the AES was performed. The psychometric properties of the French AES version, with construct validity, internal structural validity and external validity (Pearson's coefficient between AES scores and depression symptoms on the Beck Depression Inventory II) were analyzed. In a sample of 178 patients (mean age=46.51 years, SD=12.91 years), the validation process revealed satisfactory psychometric properties: factor analysis revealed two factors: "Satisfaction" (3 items) and "Usability" (3 items) and Cronbach's alpha was 0.7. No significant relation was found between AES scores and depression symptoms. The French version of the AES revealed a two-factor scale that differs from the original version. In line with the importance of acceptability in mental health and with a view to E-health systems for patients with mental disorders, the use of the AES in psychiatry may provide important information on acceptability (i.e., satisfaction and usability). Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effects of radiation type and delivery mode on a radioresistant eukaryote Cryptococcus neoformans

PubMed Central

Shuryak, Igor; Bryan, Ruth A.; Broitman, Jack; Marino, Stephen A.; Morgenstern, Alfred; Apostolidis, Christos; Dadachova, Ekaterina

2015-01-01

Introduction Most research on radioresistant fungi, particularly on human pathogens such as Cryptococcus neoformans, involves sparsely-ionizing radiation. Consequently, fungal responses to densely-ionizing radiation, which can be harnessed to treat life-threatening fungal infections, remain incompletely understood. Methods We addressed this issue by quantifying and comparing the effects of densely-ionizing α-particles (delivered either by external beam or by 213Bi-labeled monoclonal antibodies), and sparsely-ionizing 137Cs γ-rays, on Cryptococus neoformans. Results The best-fit linear-quadratic parameters for clonogenic survival were the following: α=0.24×10−2 Gy−1 for γ-rays and 1.07×10−2 Gy−1 for external-beam α-particles, and β=1.44×10−5 Gy−2 for both radiation types. Fungal cell killing by radiolabeled antibodies was consistent with predictions based on the α-particle dose to the cell nucleus and the linear-quadratic parameters for external-beam α-particles. The estimated RBE (for α-particles vs γ-rays) at low doses was 4.47 for the initial portion of the α-particle track, and 7.66 for the Bragg peak. Non-radiological antibody effects accounted for up to 23% of cell death. Conclusions These results quantify the degree of C. neoformans resistance to densely-ionizing radiations, and show how this resistance can be overcome with fungus-specific radiolabeled antibodies. PMID:25800676

Combination of external beam irradiation and multiple-site perineal applicator (MUPIT) for treatment of locally advanced or recurrent prostatic, anorectal, and gynecologic malignancies

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

Martinez, A.; Edmundson, G.K.; Cox, R.S.

1985-02-01

The authors have devised a single after-loading applicator, the Martinez Universal Perineal Interstitital Template (MUPIT), which has been used in combination with external beam irradiation to treat 104 patients with either locally advanced or recurrent malignancies of the cervix, vagina, female uretha, prostate, or anorectal region. Twenty-six patients treated for prostate cancer are excluded because of their short follow-up. Local failure developed in 13 of the 78 remaining patients (16.6%) - major complications developed in 4 patients (5.1%). All local recurrences and complications occurred before 18 months. The device consists of two acrylic cyclinders, an acrylic template with an arraymore » of holes that serve as guides for trocars, and a cover plate. In use, the cylinders are placed in the vagina and/or rectum or both and then fastened to the template so that a fixed geometric relationship among the tumor volume, normal structures, and source placement is preserved throughout the course of the implantation. Appropriate computer programs have been developed to calculate the dose from these implants. They conclude that the local control rate (83.4%) with low morbidity (5.1%) achieved with the combination of external beam irradiation and MUPIT applicator in these patients with locally advanced malignancies represents an improvement over previous published results with other applicators.« less

Experimental Research Into the Effect Of External Actions and Polluting Environments on the Serviceablity of Fiber-Reinforced Polymer Composite Materials

NASA Astrophysics Data System (ADS)

Lobanov, D. S.; Vildeman, V. E.; Babin, A. D.; Grinev, M. A.

2015-03-01

The results of mechanical tests of fiberglass and CFRP specimens in transverse bending and interlaminar shear (the short-beam method) and of sandwich panels in tension and compression are presented. The effect of external polluting environments on the mechanical properties of fiber-reinforced polymer composite materials and structures is estimated. Stress-strain diagrams are constructed.

Signal acquisition and scale calibration for beam power density distribution of electron beam welding

NASA Astrophysics Data System (ADS)

Peng, Yong; Li, Hongqiang; Shen, Chunlong; Guo, Shun; Zhou, Qi; Wang, Kehong

2017-06-01

The power density distribution of electron beam welding (EBW) is a key factor to reflect the beam quality. The beam quality test system was designed for the actual beam power density distribution of high-voltage EBW. After the analysis of characteristics and phase relationship between the deflection control signal and the acquisition signal, the Post-Trigger mode was proposed for the signal acquisition meanwhile the same external clock source was shared by the control signal and the sampling clock. The power density distribution of beam cross-section was reconstructed using one-dimensional signal that was processed by median filtering, twice signal segmentation and spatial scale calibration. The diameter of beam cross-section was defined by amplitude method and integral method respectively. The measured diameter of integral definition is bigger than that of amplitude definition, but for the ideal distribution the former is smaller than the latter. The measured distribution without symmetrical shape is not concentrated compared to Gaussian distribution.

Evaluation of the radiation hazard for ion-beam analysis with MeV external proton beams (X-IBA)

NASA Astrophysics Data System (ADS)

Hofsäss, Hans

2018-07-01

MeV ion beams which are extracted into air or He atmosphere are used in many labs for proton-induced X-ray emission (PIXE), proton induced gamma ray emission (PIGE) or Rutherford backscattering (RBS) to analyze samples which are difficult or impossible to handle in vacuum. When MeV proton beams are extracted into air through thin Kapton foils or nowadays thin silicon nitride membranes, the protons will interact with air, as well as elements present in the analyzed samples. Typically the range of MeV protons in air is several cm, in Helium atmosphere several 10 cm and in human skin around 100 μm. Besides the severe radiation hazard in case of a direct exposure of skin with protons, there are a manifold of nuclear reactions or inelastic proton scattering processes which may cause activation of air and target materials but also prompt radiation. The radiation hazard associated with the direct and scattered beam, nuclear reaction products and radionuclide production in air have been discussed in a publication by Doyle et al. in 1991 which was used as a reference in several later publications. I have reevaluated the radiation hazards for external proton beams with up to 4.5 MeV using proton reaction cross sections taken from the JANIS book of proton induced cross sections. The radionuclide production in air is about 3 orders of magnitude lower compared to values given in the 1991 publication. Radionuclide production as well as generation of prompt alpha, gamma and neutron radiation in target materials for elements up to molybdenum is also evaluated.

Physics of the current injection process during localized helicity injection

NASA Astrophysics Data System (ADS)

Hinson, Edward Thomas

An impedance model has been developed for the arc-plasma cathode electron current source used in localized helicity injection tokamak startup. According to this model, a potential double layer (DL) is established between the high-density arc plasma (narc ˜ 1021 m-3) in the electron source, and the less-dense external tokamak edge plasma (nedge ˜ 10 18 m-3) into which current is injected. The DL launches an electron beam at the applied voltage with cross-sectional area close to that of the source aperture: Ainj ≈ 2 cm 2. The injected current, Iinj, increases with applied voltage, Vinj, according to the standard DL scaling, Iinj ˜ V(3/2/ inj), until the more restrictive of two limits to beam density nb arises, producing Iinj ˜ V(1/2/inj), a scaling with beam drift velocity. For low external tokamak edge density nedge, space-charge neutralization of the intense electron beam restricts the injected beam density to nb ˜ nedge. At high Jinj and sufficient edge density, the injected current is limited by expansion of the DL sheath, which leads to nb ˜ narc. Measurements of narc, Iinj , nedge, Vinj, support these predicted scalings, and suggest narc as a viable control actuator for the source impedance. Magnetic probe signals ≈ 300 degrees toroidally from the injection location are consistent with expectations for a gyrating, coherent electron beam with a compact areal cross-section. Technological development of the source has allowed an extension of the favorable Iinj ˜ V(1/2/inj) to higher power without electrical breakdown.

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

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

Wroe, Andrew; Centre for Medical Radiation Physics, University of Wollongong, Wollongong; Clasie, Ben

2009-01-01

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

Accelerator/Experiment Operations - FY 2016

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

Blake, A.; Convery, M.; Geer, S.

2016-10-01

This Technical Memorandum summarizes the Fermilab accelerator and experiment operations for FY 2016. It is one of a series of annual publications intended to gather information in one place. In this case, the information concerns the FY 2016 NOvA, MINOS+ and MINERvA experiments using the Main Injector Neutrino Beam (NuMI), the MicroBooNE experiment and the activities in the SciBooNE Hall using the Booster Neutrino Beam (BNB), and the SeaQuest experiment, LArIAT experiment and Meson Test Beam activities in the 120 GeV external switchyard beam (SY120). Each section was prepared by the relevant authors, and was then edited for inclusion inmore » this summary.« less

Stabilization of exact nonlinear Timoshenko beams in space by boundary feedback

NASA Astrophysics Data System (ADS)

Do, K. D.

2018-05-01

Boundary feedback controllers are designed to stabilize Timoshenko beams with large translational and rotational motions in space under external disturbances. The exact nonlinear partial differential equations governing motion of the beams are derived and used in the control design. The designed controllers guarantee globally practically asymptotically (and locally practically exponentially) stability of the beam motions at the reference state. The control design, well-posedness and stability analysis are based on various relationships between the earth-fixed and body-fixed coordinates, Sobolev embeddings, and a Lyapunov-type theorem developed to study well-posedness and stability for a class of evolution systems in Hilbert space. Simulation results are included to illustrate the effectiveness of the proposed control design.

Use of a Linear Paul Trap to Study Random Noise-Induced Beam Degradation in High-Intensity Accelerators

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

Chung, Moses; Gilson, Erik P.; Davidson, Ronald C.

2009-04-10

A random noise-induced beam degradation that can affect intense beam transport over long propagation distances has been experimentally studied by making use of the transverse beam dynamics equivalence between an alternating-gradient (AG) focusing system and a linear Paul trap system. For the present studies, machine imperfections in the quadrupole focusing lattice are considered, which are emulated by adding small random noise on the voltage waveform of the quadrupole electrodes in the Paul trap. It is observed that externally driven noise continuously produces a nonthermal tail of trapped ions, and increases the transverse emittance almost linearly with the duration of themore » noise.« less

29 CFR 1917.116 - Elevators and escalators.

Code of Federal Regulations, 2011 CFR

2011-07-01

... or more floors of a structure. The term excludes such devices as conveyors, tiering or piling... vicinity of the escalator or be available at the terminal. (f) Elevator landing openings shall be provided... landing, to prevent employees from falling into the shaft. (g) The elevator's or escalator's maximum load...

41 CFR 102-85.55 - What are the terms and conditions included in an OA?

Code of Federal Regulations, 2011 CFR

2011-01-01

... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 85-PRICING... used; (d) Operating costs and escalations; (e) One time charges; e.g., lump sum payments by the customer; (f) Real estate tax and escalations; (g) Parking and escalations; (h) Additional/reduced services...

41 CFR 102-85.55 - What are the terms and conditions included in an OA?

Code of Federal Regulations, 2012 CFR

2012-01-01

... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 85-PRICING... used; (d) Operating costs and escalations; (e) One time charges; e.g., lump sum payments by the customer; (f) Real estate tax and escalations; (g) Parking and escalations; (h) Additional/reduced services...

41 CFR 102-85.55 - What are the terms and conditions included in an OA?

Code of Federal Regulations, 2013 CFR

2013-07-01

... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 85-PRICING... used; (d) Operating costs and escalations; (e) One time charges; e.g., lump sum payments by the customer; (f) Real estate tax and escalations; (g) Parking and escalations; (h) Additional/reduced services...

41 CFR 102-85.55 - What are the terms and conditions included in an OA?

Code of Federal Regulations, 2014 CFR

2014-01-01

... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 85-PRICING... used; (d) Operating costs and escalations; (e) One time charges; e.g., lump sum payments by the customer; (f) Real estate tax and escalations; (g) Parking and escalations; (h) Additional/reduced services...

A Comparison of Escalating versus Fixed Reinforcement Schedules on Undergraduate Quiz Taking

ERIC Educational Resources Information Center

Mahoney, Amanda

2017-01-01

Drug abstinence studies indicate that escalating reinforcement schedules maintain abstinence for longer periods than fixed reinforcement schedules. The current study evaluated whether escalating reinforcement schedules would maintain more quiz taking than fixed reinforcement schedules. During baseline and for the control group, bonus points were…

41 CFR 102-85.55 - What are the terms and conditions included in an OA?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 85-PRICING... used; (d) Operating costs and escalations; (e) One time charges; e.g., lump sum payments by the customer; (f) Real estate tax and escalations; (g) Parking and escalations; (h) Additional/reduced services...

The support-control continuum: An investigation of staff perspectives on factors influencing the success or failure of de-escalation techniques for the management of violence and aggression in mental health settings.

PubMed

Price, Owen; Baker, John; Bee, Penny; Lovell, Karina

2018-01-01

De-escalation techniques are recommended to manage violence and aggression in mental health settings yet restrictive practices continue to be frequently used. Barriers and enablers to the implementation and effectiveness of de-escalation techniques in practice are not well understood. To obtain staff descriptions of de-escalation techniques currently used in mental health settings and explore factors perceived to influence their implementation and effectiveness. Qualitative, semi-structured interviews and Framework Analysis. Five in-patient wards including three male psychiatric intensive care units, one female acute ward and one male acute ward in three UK Mental Health NHS Trusts. 20 ward-based clinical staff. Individual semi-structured interviews were digitally recorded, transcribed verbatim and analysed using a qualitative data analysis software package. Participants described 14 techniques used in response to escalated aggression applied on a continuum between support and control. Techniques along the support-control continuum could be classified in three groups: 'support' (e.g. problem-solving, distraction, reassurance) 'non-physical control' (e.g. reprimands, deterrents, instruction) and 'physical control' (e.g. physical restraint and seclusion). Charting the reasoning staff provided for technique selection against the described behavioural outcome enabled a preliminary understanding of staff, patient and environmental influences on de-escalation success or failure. Importantly, the more coercive 'non-physical control' techniques are currently conceptualised by staff as a feature of de-escalation techniques, yet, there was evidence of a link between these and increased aggression/use of restrictive practices. Risk was not a consistent factor in decisions to adopt more controlling techniques. Moral judgements regarding the function of the aggression; trial-and-error; ingrained local custom (especially around instruction to low stimulus areas); knowledge of the patient; time-efficiency and staff anxiety had a key role in escalating intervention. This paper provides a new model for understanding staff intervention in response to escalated aggression, a continuum between support and control. It further provides a preliminary explanatory framework for understanding the relationship between patient behaviour, staff response and environmental influences on de-escalation success and failure. This framework reveals potentially important behaviour change targets for interventions seeking to reduce violence and use of restrictive practices through enhanced de-escalation techniques. Copyright © 2017 Elsevier Ltd. All rights reserved.

An experimental investigation for external RC shear wall applications

NASA Astrophysics Data System (ADS)

Kaltakci, M. Y.; Ozturk, M.; Arslan, M. H.

2010-09-01

The strength and rigidity of most reinforced concrete (RC) buildings in Turkey, which are frequently hit by destructive earthquakes, is not at a sufficient level. Therefore, the result of earthquakes is a significant loss of life and property. The strengthening method most commonly preferred for these type of RC buildings is the application of RC infilled walls (shear walls) in the frame openings of the building. However, since the whole building has to be emptied and additional heavy costs arise during this type of strengthening, users prefer not to strengthen their buildings despite the heavy risk they are exposed to. Therefore, it is necessary to develop easier-to-apply and more effective methods for the rapid strengthening of housing and the heavily-used public buildings which cannot be emptied during the strengthening process (such as hospitals and schools). This study empirically analyses the different methods of a new system which can meet this need. In this new system, named "external shear wall application", RC shear walls are applied on the external surface of the building, along the frame plane rather than in the building. To this end, 7 test samples in 1/2 and 1/3 geometrical scale were designed to analyse the efficiency of the strengthening technique where the shear wall leans on the frame from outside of the building (external shear wall application) and of the strengthening technique where a specific space is left between the frame and the external shear wall by using a coupling beam to connect elements (application of external shear wall with coupling beam). Test results showed that the maximum lateral load capacity, initial rigidity and energy dissipation behaviours of the samples strengthened with external shear wall were much better than those of the bare frames.

SU-F-T-151: Measurement Evaluation of Skin Dose in Scanning Proton Beam Therapy for Breast Cancer

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

Yu, J; Nichols, E; Strauss, D

Purpose: To measure the skin dose and compare it with the calculated dose from a treatment planning system (TPS) for breast cancer treatment using scanning proton beam therapy (SPBT). Methods: A single en-face-beam SPBT plan was generated by a commercial TPS for two breast cancer patients. The treatment volumes were the entire breasts (218 cc and 1500 cc) prescribed to 50.4 Gy (RBE) in 28 fractions. A range shifter of 5 cm water equivalent thickness was used. The organ at risk (skin) was defined to be 5 mm thick from the surface. The skin doses were measured in water withmore » an ADCL calibrated parallel plate (PP) chamber. The measured data were compared with the values calculated in the TPS. Skin dose calculations can be subject to uncertainties created by the definition of the external contour and the limitations of the correction based algorithms, such as proton convolution superposition. Hence, the external contours were expanded by 0, 3 mm and 1 cm to include additional pixels for dose calculation. In addition, to examine the effects of the cloth gown on the skin dose, the skin dose measurements were conducted with and without gown. Results: On average the measured skin dose was 4% higher than the calculated values. At deeper depths, the measured and calculated doses were in better agreement (< 2%). Large discrepancy occur for the dose calculated without external expansion due to volume averaging. The addition of the gown only increased the measured skin dose by 0.4%. Conclusion: The implemented TPS underestimated the skin dose for breast treatments. Superficial dose calculation without external expansion would result in large errors for SPBT for breast cancer.« less

Development of a new in-air micro-PIXE set-up with in-vacuum charge measurements in Atomki

NASA Astrophysics Data System (ADS)

Török, Zs.; Huszánk, R.; Csedreki, L.; Dani, J.; Szoboszlai, Z.; Kertész, Zs.

2015-11-01

A new external microbeam set-up has recently been installed as the extension of the existing microprobe system at the Laboratory of Ion Beam Applications of Atomki, Debrecen, Hungary. The external beam set-up, based on the system of Oxford Microbeams (OM), is equipped with two X-ray detectors for PIXE analysis, a digital microscope, two alignment lasers and a precision XYZ stage for easy and reproducible positioning of the sample. Exit windows with different thicknesses and of different materials can be used according to the actual demands, currently silicon-nitride (Si3N4) film with 200 nm thickness is employed in our laboratory. The first application was demonstrated in the field of archaeometry, on Bronze Age hoards from Hungary.

Analysis of Slab-column Shearwall Structure of 6000 Tons Cold Storage

NASA Astrophysics Data System (ADS)

He, Dongqing; Song, Pengwei; Jie, Pengyu

2018-05-01

Combining with the functional requirements, the site conditions and the 6000 tons load characteristics of cold storage, so determine its structure system for the slab-column-shear wall structure. The paper recommends the design of foundation, the settings of column cap, the arrangement of shear wall, the punching shear of floor slab and the analysis and calculation results of main structure. By addition shear wall in slab-column structure to increase the overall stiffness of structure and improve the seismic performance of structure. Take the detached form between the main structure and the external wall insulation, while set anchorage beam between in the main floor and the ring beam along the axis of the column grid to enhance the overall stability of the external wall insulation.

Investigation of High-Intensity Ion Beam Generation in the Diode with External Magnetic Insulation and Explosive Plasma Emission Source

NASA Astrophysics Data System (ADS)

Shamanin, V. I.; Stepanov, A. V.; Rysbaev, K. Zh.

2018-04-01

The ion Br-diode in which plasma is generated under the action of a negative pre-pulse voltage is presented. Preliminary plasma formation allows the energy released in the diode during a positive voltage pulse to be increased. The high-energy ion beam parameters are investigated for the magnetic field induction changing from 0.8Bcr to 1.7Bcr.

Evolution of a Gaussian laser beam in warm collisional magnetoplasma

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

Jafari, M. J.; Jafari Milani, M. R., E-mail: mrj.milani@gmail.com; Niknam, A. R.

2016-07-15

In this paper, the spatial evolution of an intense circularly polarized Gaussian laser beam propagated through a warm plasma is investigated, taking into account the ponderomotive force, Ohmic heating, external magnetic field, and collisional effects. Using the momentum transfer and energy equations, both modified electron temperature and electron density in plasma are obtained. By introducing the complex dielectric permittivity of warm magnetized plasma and using the complex eikonal function, coupled differential equations for beam width parameter are established and solved numerically. The effects of polarization state of laser and magnetic field on the laser spot size evolution are studied. Itmore » is observed that in case of the right-handed polarization, an increase in the value of external magnetic field causes an increase in the strength of the self-focusing, especially in the higher values, and consequently, the self-focusing occurs in shorter distance of propagation. Moreover, the results demonstrate the existence of laser intensity and electron temperature ranges where self-focusing can occur, while the beam diverges outside of these regions; meanwhile, in these intervals, there exists a turning point for each of intensity and temperature in which the self-focusing process has its strongest strength. Finally, it is found that the self-focusing effect can be enhanced by increasing the plasma frequency (plasma density).« less

Real-time in vivo Cherenkoscopy imaging during external beam radiation therapy.

PubMed

Zhang, Rongxiao; Gladstone, David J; Jarvis, Lesley A; Strawbridge, Rendall R; Jack Hoopes, P; Friedman, Oscar D; Glaser, Adam K; Pogue, Brian W

2013-11-01

Cherenkov radiation is induced when charged particles travel through dielectric media (such as biological tissue) faster than the speed of light through that medium. Detection of this radiation or excited luminescence during megavoltage external beam radiotherapy (EBRT) can allow emergence of a new approach to superficial dose estimation, functional imaging, and quality assurance for radiation therapy dosimetry. In this letter, the first in vivo Cherenkov images of a real-time Cherenkoscopy during EBRT are presented. The imaging system consisted of a time-gated intensified charge coupled device (ICCD) coupled with a commercial lens. The ICCD was synchronized to the linear accelerator to detect Cherenkov photons only during the 3.25-μs radiation bursts. Images of a tissue phantom under irradiation show that the intensity of Cherenkov emission is directly proportional to radiation dose, and images can be acquired at 4.7 frames/s with SNR>30. Cherenkoscopy was obtained from the superficial regions of a canine oral tumor during planned, Institutional Animal Care and Use Committee approved, conventional (therapeutically appropriate) EBRT irradiation. Coregistration between photography and Cherenkoscopy validated that Cherenkov photons were detected from the planned treatment region. Real-time images correctly monitored the beam field changes corresponding to the planned dynamic wedge movement, with accurate extent of overall beam field, and expected cold and hot regions.

Single laser beam of spatial coherence from an array of GaAs lasers - Free-running mode

NASA Technical Reports Server (NTRS)

Philipp-Rutz, E. M.

1975-01-01

Spatially coherent radiation from a monolithic array of three GaAs lasers in a free-running mode is reported. The lasers, with their mirror faces antireflection coated, are operated in an external optical cavity built of spherical lenses and plane mirrors. The spatially coherent-beam formation makes use of the Fourier-transformation property of the internal lenses. Transverse mode control is accomplished by a spatial filter. The optical cavity is similar to that used for the phase-controlled mode of spatially coherent-beam formation; only the spatial filters are different. In the far field (when restored by an external lens), the intensities of the lasers in the array are concentrated in a single laser beam of spatial coherence, without any grating lobes. The far-field distribution of the laser array in the free-running mode differs significantly from the interference pattern of the phase-controlled mode. The modulation characteristics of the optical waveforms of the two modes are also quite different because modulation is related to the interaction of the spatial filter with the longitudinal modes of the laser array within the optical cavity. The modulation of the optical waveform of the free-running mode is nonperiodic, confirming that the fluctuations of the optical fields of the lasers are random.

Prevention and reversal of social stress-escalated cocaine self-administration in mice by intra-VTA CRFR1 antagonism.

PubMed

Han, Xiao; DeBold, Joseph F; Miczek, Klaus A

2017-09-01

A history of brief intermittent social defeat stress can escalate cocaine self-administration and induce long-term adaptations in the mesolimbic dopamine system. Extra-hypothalamic corticotrophin releasing factor (CRF) has been shown to be closely associated with stress-induced escalation of drug use. How repeated stress modulates CRF release in the ventral tegmental area (VTA) and the roles of CRF receptors during different phases of stress-induced cocaine self-administration remain to be defined. The current study examines the roles of CRF and CRF receptor 1 (CRFR1) in escalated intravenous cocaine self-administration after exposure to social defeat stress in mice. First, CRFR1 antagonist (CP 376,395, 15 mg/kg, i.p.) given 30 min prior to each social defeat episode prevented later escalated cocaine self-administration. When CP 376,395 (5 and 15 mg/kg, i.p.) was administered 10 days after the last episode of social stress, the escalation of cocaine intake was dose-dependently reversed. Moreover, socially defeated mice showed increased CRF release in the VTA compared to controls. To further explore the role of CRFR1, CP 376,395 (0.5 and 1 μg/0.2 μl) was infused directly into the VTA before the cocaine self-administration session. Intra-VTA antagonism of CRFR1 was sufficient to reverse social defeat stress-escalated cocaine self-administration. These findings suggest that CRF and CRFR1 exert multiple roles in the response to social stress that are relevant to escalated cocaine self-administration.

Off-line commissioning of EBIS and plans for its integration into ATLAS and CARIBU.

PubMed

Ostroumov, P N; Barcikowski, A; Dickerson, C A; Mustapha, B; Perry, A; Sharamentov, S I; Vondrasek, R C; Zinkann, G

2016-02-01

An Electron Beam Ion Source Charge Breeder (EBIS-CB) has been developed at Argonne to breed radioactive beams from the CAlifornium Rare Isotope Breeder Upgrade (CARIBU) facility at Argonne Tandem Linac Accelerator System (ATLAS). The EBIS-CB will replace the existing ECR charge breeder to increase the intensity and significantly improve the purity of reaccelerated radioactive ion beams. The CARIBU EBIS-CB has been successfully commissioned offline with an external singly charged cesium ion source. The performance of the EBIS fully meets the specifications to breed rare isotope beams delivered from CARIBU. The EBIS is being relocated and integrated into ATLAS and CARIBU. A long electrostatic beam transport system including two 180° bends in the vertical plane has been designed. The commissioning of the EBIS and the beam transport system in their permanent location will start at the end of this year.

Off-line commissioning of EBIS and plans for its integration into ATLAS and CARIBU

NASA Astrophysics Data System (ADS)

Ostroumov, P. N.; Barcikowski, A.; Dickerson, C. A.; Mustapha, B.; Perry, A.; Sharamentov, S. I.; Vondrasek, R. C.; Zinkann, G.

2016-02-01

An Electron Beam Ion Source Charge Breeder (EBIS-CB) has been developed at Argonne to breed radioactive beams from the CAlifornium Rare Isotope Breeder Upgrade (CARIBU) facility at Argonne Tandem Linac Accelerator System (ATLAS). The EBIS-CB will replace the existing ECR charge breeder to increase the intensity and significantly improve the purity of reaccelerated radioactive ion beams. The CARIBU EBIS-CB has been successfully commissioned offline with an external singly charged cesium ion source. The performance of the EBIS fully meets the specifications to breed rare isotope beams delivered from CARIBU. The EBIS is being relocated and integrated into ATLAS and CARIBU. A long electrostatic beam transport system including two 180° bends in the vertical plane has been designed. The commissioning of the EBIS and the beam transport system in their permanent location will start at the end of this year.

Fast Estimation of Strains for Cross-Beams Six-Axis Force/Torque Sensors by Mechanical Modeling

PubMed Central

Ma, Junqing; Song, Aiguo

2013-01-01

Strain distributions are crucial criteria of cross-beams six-axis force/torque sensors. The conventional method for calculating the criteria is to utilize Finite Element Analysis (FEA) to get numerical solutions. This paper aims to obtain analytical solutions of strains under the effect of external force/torque in each dimension. Genetic mechanical models for cross-beams six-axis force/torque sensors are proposed, in which deformable cross elastic beams and compliant beams are modeled as quasi-static Timoshenko beam. A detailed description of model assumptions, model idealizations, application scope and model establishment is presented. The results are validated by both numerical FEA simulations and calibration experiments, and test results are found to be compatible with each other for a wide range of geometric properties. The proposed analytical solutions are demonstrated to be an accurate estimation algorithm with higher efficiency. PMID:23686144

Understanding the Emotional Aspects of Escalation of Commitment: The Role of Negative Affect

ERIC Educational Resources Information Center

Wong, Kin Fai Ellick; Yik, Michelle; Kwong, Jessica Y. Y.

2006-01-01

Despite the importance of understanding the emotional aspects of organizational decision making, prior research has paid scant attention to the role of emotion in escalation of commitment. This article attempts to fill this gap by examining the relationship between negative affect and escalation of commitment. Results showed that regardless of…

Water and Wastewater Annual Price Escalation Rates for Selected Cities across the United States

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

None, None

Pacific Northwest National Laboratory conducted this study for the Federal Energy Management Program to identify trends in annual water and wastewater price escalation rates across the United States. This study can be used to inform the selection of an appropriate escalation rates for inclusion in LCCA.

Measurement and properties of the dose-area product ratio in external small-beam radiotherapy.

PubMed

Niemelä, Jarkko; Partanen, Mari; Ojala, Jarkko; Sipilä, Petri; Björkqvist, Mikko; Kapanen, Mika; Keyriläinen, Jani

2017-06-21

In small-beam radiation therapy (RT) the measurement of the beam quality parameter, i.e. the tissue-phantom ratio or TPR 20,10 , using a conventional point detector is a challenge. To obtain reliable results, one has to consider potential sources of error, including volume averaging and adjustment of the point detector into the narrow beam. To overcome these challenges, a different type of beam quality parameter in small beams was studied, namely the dose-area product ratio, or DAPR 20,10 . With this method, the measurement of a dose-area product (DAP) using a large-area plane-parallel chamber (LAC) eliminates the uncertainties in detector positioning and volume averaging that are present when using a point detector. In this study, the properties of the DAPR 20,10 of a cone-collimated 6 MV photon beam were investigated using Monte Carlo (MC) calculations and the obtained values were compared to measurements obtained using two LAC detectors, PTW Type 34073 and PTW Type 34070. In addition, the possibility of determining the DAP using EBT3 film and a Razor diode detector was studied. The determination of the DAPR 20,10 value was found to be feasible in external small-beam radiotherapy using cone-collimated beams with diameters from 4-40 mm, based on the results of the two LACs, the MC calculations and the Razor diode. The measurements indicated a constant DAPR 20,10 value for fields 20-40 mm in diameter, with a maximum relative change of 0.6%, but an increase of 7.0% for fields from 20-4 mm in diameter for the PTW Type 34070 chamber. Simulations and measurements showed an increase of DAPR 20,10 with increasing LAC size or dose integral area for the studied 4-40 mm cone-collimated 6 MV photon beams. This has the consequence that there should be a reference to the size of the used LAC active area or the DAP integration area with the reported DAPR 20,10 value.

Superconducting resonators as beam splitters for linear-optics quantum computation.

PubMed

Chirolli, Luca; Burkard, Guido; Kumar, Shwetank; Divincenzo, David P

2010-06-11

We propose and analyze a technique for producing a beam-splitting quantum gate between two modes of a ring-resonator superconducting cavity. The cavity has two integrated superconducting quantum interference devices (SQUIDs) that are modulated by applying an external magnetic field. The gate is accomplished by applying a radio frequency pulse to one of the SQUIDs at the difference of the two mode frequencies. Departures from perfect beam splitting only arise from corrections to the rotating wave approximation; an exact calculation gives a fidelity of >0.9992. Our construction completes the toolkit for linear-optics quantum computing in circuit quantum electrodynamics.

Considerations on the Design of a Molecular Frequency Standard Based on the Molecular Beam Electric Resonance Method

NASA Technical Reports Server (NTRS)

Hughes, Vernon W.

1959-01-01

The use of a rotational state transition as observed by the molecular beam electric resonance method is discussed as a possible frequency standard particularly in the millimeter wavelength range. As a promising example the 100 kMc transition between the J = 0 and J = 1 rotational states of Li 6F19 is considered. The relative insensitivity of the transition frequency to external electric and magnetic fields and the low microwave power requirements appear favorable; the small fraction of the molecular beam that is in a single rotational state is a limiting factor.

Effect of climate-related mass extinctions on escalation in molluscs

NASA Astrophysics Data System (ADS)

Hansen, Thor A.; Kelley, Patricia H.; Melland, Vicky D.; Graham, Scott E.

1999-12-01

We test the hypothesis that escalated species (e.g., those with antipredatory adaptations such as heavy armor) are more vulnerable to extinctions caused by changes in climate. If this hypothesis is valid, recovery faunas after climate-related extinctions should include significantly fewer species with escalated shell characteristics, and escalated species should undergo greater rates of extinction than nonescalated species. This hypothesis is tested for the Cretaceous-Paleocene, Eocene-Oligocene, middle Miocene, and Pliocene-Pleistocene mass extinctions. Gastropod and bivalve molluscs from the U.S. coastal plain were evaluated for 10 shell characters that confer resistance to predators. Of 40 tests, one supported the hypothesis; highly ornamented gastropods underwent greater levels of Pliocene-Pleistocene extinction than did nonescalated species. All remaining tests were nonsignificant. The hypothesis that escalated species are more vulnerable to climate-related mass extinctions is not supported.

Effect of External Vibration on PZT Impedance Signature.

PubMed

Yang, Yaowen; Miao, Aiwei

2008-11-01

Piezoelectric ceramic Lead Zirconate Titanate (PZT) transducers, working on the principle of electromechanical impedance (EMI), are increasingly applied for structural health monitoring (SHM) in aerospace, civil and mechanical engineering. The PZT transducers are usually surface bonded to or embedded in a structure and subjected to actuation so as to interrogate the structure at the desired frequency range. The interrogation results in the electromechanical admittance (inverse of EMI) signatures which can be used to estimate the structural health or integrity according to the changes of the signatures. In the existing EMI method, the monitored structure is only excited by the PZT transducers for the interrogating of EMI signature, while the vibration of the structure caused by the external excitations other than the PZT actuation is not considered. However, many structures work under vibrations in practice. To monitor such structures, issues related to the effects of vibration on the EMI signature need to be addressed because these effects may lead to misinterpretation of the structural health. This paper develops an EMI model for beam structures, which takes into account the effect of beam vibration caused by the external excitations. An experimental study is carried out to verify the theoretical model. A lab size specimen with different external excitations is tested and the effect of vibration on EMI signature is discussed.

Nonlinear dynamic analysis of cantilevered piezoelectric energy harvesters under simultaneous parametric and external excitations

NASA Astrophysics Data System (ADS)

Fang, Fei; Xia, Guanghui; Wang, Jianguo

2018-02-01

The nonlinear dynamics of cantilevered piezoelectric beams is investigated under simultaneous parametric and external excitations. The beam is composed of a substrate and two piezoelectric layers and assumed as an Euler-Bernoulli model with inextensible deformation. A nonlinear distributed parameter model of cantilevered piezoelectric energy harvesters is proposed using the generalized Hamilton's principle. The proposed model includes geometric and inertia nonlinearity, but neglects the material nonlinearity. Using the Galerkin decomposition method and harmonic balance method, analytical expressions of the frequency-response curves are presented when the first bending mode of the beam plays a dominant role. Using these expressions, we investigate the effects of the damping, load resistance, electromechanical coupling, and excitation amplitude on the frequency-response curves. We also study the difference between the nonlinear lumped-parameter and distributed-parameter model for predicting the performance of the energy harvesting system. Only in the case of parametric excitation, we demonstrate that the energy harvesting system has an initiation excitation threshold below which no energy can be harvested. We also illustrate that the damping and load resistance affect the initiation excitation threshold.

Enhanced proton acceleration in an applied longitudinal magnetic field

DOE PAGES

Arefiev, A.; Toncian, T.; Fiksel, G.

2016-10-31

Using two-dimensional particle-in-cell simulations, we examine how an externally applied strong magnetic field impacts proton acceleration in laser-irradiated solid-density targets. We find that a kT-level external magnetic field can sufficiently inhibit transverse transport of hot electrons in a flat laser-irradiated target. While the electron heating by the laser remains mostly unaffected, the reduced electron transport during proton acceleration leads to an enhancement of maximum proton energies and the overall number of energetic protons. The resulting proton beam is much better collimated compared to a beam generated without applying a kT-level magnetic field. A factor of three enhancement of the lasermore » energy conversion efficiency into multi-MeV protons is another effect of the magnetic field. The required kT-level magnetic fields are becoming feasible due to a significant progress that has been made in generating magnetic fields with laser-driven coils using ns-long laser pulses. The possibility of improving characteristics of laser-driven proton beams using such fields is a strong motivation for further development of laser-driven magnetic field capabilities.« less

The 1998 Australian external beam radiotherapy survey and IAEA/WHO TLD postal dose quality audit.

PubMed

Huntley, R; Izewska, J

2000-03-01

The results of an updated Australian survey of external beam radiotherapy centres are presented. Most of the centres provided most of the requested information. The relative caseloads of various linear accelerator photon and electron beams have not changed significantly since the previous survey in 1995. The mean age of Australian LINACs is 7.1 years and that of other radiotherapy machines is 14.7 years. Every Australian radiotherapy centre participated in a special run of the IAEA/WHO TLD postal dose quality audit program, which was provided for Australian centres by the IAEA and WHO in May 1998. The dose quoted by the centres was in nearly every case within 1.5% of the dose assessed by the IAEA. This is within the combined standard uncertainty of the IAEA TLD service (1.8%). The results confirm the accuracy and precision of radiotherapy dosimetry in Australia and the adequate dissemination of the Australian standards from ARL (now ARPANSA) to the centres. The Australian standards have recently been shown to agree with those of other countries to within 0.25% by comparison with the BIPM.

RC beams shear-strengthened with fabric-reinforced-cementitious-matrix (FRCM) composite

NASA Astrophysics Data System (ADS)

Loreto, Giovanni; Babaeidarabad, Saman; Leardini, Lorenzo; Nanni, Antonio

2015-12-01

The interest in retrofit/rehabilitation of existing concrete structures has increased due to degradation and/or introduction of more stringent design requirements. Among the externally-bonded strengthening systems fiber-reinforced polymers is the most widely known technology. Despite its effectiveness as a material system, the presence of an organic binder has some drawbacks that could be addressed by using in its place a cementitious binder as in fabric-reinforced cementitious matrix (FRCM) systems. The purpose of this paper is to evaluate the behavior of reinforced concrete (RC) beams strengthened in shear with U-wraps made of FRCM. An extensive experimental program was undertaken in order to understand and characterize this composite when used as a strengthening system. The laboratory results demonstrate the technical viability of FRCM for shear strengthening of RC beams. Based on the experimental and analytical results, FRCM increases shear strength but not proportionally to the number of fabric plies installed. On the other hand, FRCM failure modes are related with a high consistency to the amount of external reinforcement applied. Design considerations based on the algorithms proposed by ACI guidelines are also provided.

Recording of absorption spectra by a three-beam integral technique with a tunable laser and external cavity

NASA Astrophysics Data System (ADS)

Korolenko, P. V.; Nikolaev, I. V.; Ochkin, V. N.; Tskhai, S. N.

2014-04-01

An integral method is considered for recording absorption using three laser beams transmitted through and reflected from an external cavity with the absorbing medium (R-ICOS). The method is the elaboration of a known single-beam ICOS method and allows suppression of the influence of radiation phase fluctuations in the resonator on recording weak absorption spectra. First of all, this reduces high-frequency instabilities and gives a possibility to record spectra during short time intervals. In this method, mirrors of the resonator may have moderate reflection coefficients. Capabilities of the method have been demonstrated by the examples of weak absorption spectra of atmospheric methane and natural gas in a spectral range around 1650 nm. With the mirrors having the reflection coefficients of 0.8-0.99, a spectrum can be recorded for 320 μs with the accuracy sufficient for detecting a background concentration of methane in atmosphere. For the acquisition time of 20 s, the absorption coefficients of ~2×10-8 cm-1 can be measured, which corresponds to a 40 times less molecule concentration than the background value.

Nonlinear dynamic analysis of cantilevered piezoelectric energy harvesters under simultaneous parametric and external excitations

NASA Astrophysics Data System (ADS)

Fang, Fei; Xia, Guanghui; Wang, Jianguo

2018-06-01

The nonlinear dynamics of cantilevered piezoelectric beams is investigated under simultaneous parametric and external excitations. The beam is composed of a substrate and two piezoelectric layers and assumed as an Euler-Bernoulli model with inextensible deformation. A nonlinear distributed parameter model of cantilevered piezoelectric energy harvesters is proposed using the generalized Hamilton's principle. The proposed model includes geometric and inertia nonlinearity, but neglects the material nonlinearity. Using the Galerkin decomposition method and harmonic balance method, analytical expressions of the frequency-response curves are presented when the first bending mode of the beam plays a dominant role. Using these expressions, we investigate the effects of the damping, load resistance, electromechanical coupling, and excitation amplitude on the frequency-response curves. We also study the difference between the nonlinear lumped-parameter and distributed-parameter model for predicting the performance of the energy harvesting system. Only in the case of parametric excitation, we demonstrate that the energy harvesting system has an initiation excitation threshold below which no energy can be harvested. We also illustrate that the damping and load resistance affect the initiation excitation threshold.

Enhanced proton acceleration in an applied longitudinal magnetic field

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

Arefiev, A.; Toncian, T.; Fiksel, G.

Using two-dimensional particle-in-cell simulations, we examine how an externally applied strong magnetic field impacts proton acceleration in laser-irradiated solid-density targets. We find that a kT-level external magnetic field can sufficiently inhibit transverse transport of hot electrons in a flat laser-irradiated target. While the electron heating by the laser remains mostly unaffected, the reduced electron transport during proton acceleration leads to an enhancement of maximum proton energies and the overall number of energetic protons. The resulting proton beam is much better collimated compared to a beam generated without applying a kT-level magnetic field. A factor of three enhancement of the lasermore » energy conversion efficiency into multi-MeV protons is another effect of the magnetic field. The required kT-level magnetic fields are becoming feasible due to a significant progress that has been made in generating magnetic fields with laser-driven coils using ns-long laser pulses. The possibility of improving characteristics of laser-driven proton beams using such fields is a strong motivation for further development of laser-driven magnetic field capabilities.« less

Micro-resonator-based electric field sensors with long durations of sensitivity

NASA Astrophysics Data System (ADS)

Ali, Amir R.

2017-05-01

In this paper, we present a new fabrication method for the whispering gallery mode (WGM) micro-sphere based electric field sensor that which allows for longer time periods of sensitivity. Recently, a WGM-based photonic electric field sensor was proposed using a coupled dielectric microsphere-beam. The external electric field imposes an electrtrostriction force on the dielectric beam, deflecting it. The beam, in turn compresses the sphere causing a shift in its WGM. As part of the fabrication process, the PDMS micro-beams and the spheres are curied at high-temperature (100oC) and subsequently poled by exposing to strong external electric field ( 8 MV/m) for two hours. The poling process allows for the deposition of surface charges thereby increasing the electrostriction effect. This methodology is called curing-then-poling (CTP). Although the sensors do become sufficiently sensitive to electric field, they start de-poling after a short period (within 10 minutes) after poling, hence losing sensitivity. In an attempt to mitigate this problem and to lock the polarization for a longer period, we use an alternate methodology whereby the beam is poled and cured simultaneously (curing-while-poling or CWP). The new fabrication method allows for the retention of polarization (and hence, sensitivity to electric field) longer ( 1500 minutes). An analysis is carried out along with preliminary experiments. Results show that electric fields as small as 100 V/m can be detected with a 300 μm diameter sphere sensor a day after poling.

Lévy-Student distributions for halos in accelerator beams.

PubMed

Cufaro Petroni, Nicola; De Martino, Salvatore; De Siena, Silvio; Illuminati, Fabrizio

2005-12-01

We describe the transverse beam distribution in particle accelerators within the controlled, stochastic dynamical scheme of stochastic mechanics (SM) which produces time reversal invariant diffusion processes. This leads to a linearized theory summarized in a Schrödinger-like (SL) equation. The space charge effects have been introduced in recent papers by coupling this S-L equation with the Maxwell equations. We analyze the space-charge effects to understand how the dynamics produces the actual beam distributions, and in particular we show how the stationary, self-consistent solutions are related to the (external and space-charge) potentials both when we suppose that the external field is harmonic (constant focusing), and when we a priori prescribe the shape of the stationary solution. We then proceed to discuss a few other ideas by introducing generalized Student distributions, namely, non-Gaussian, Lévy infinitely divisible (but not stable) distributions. We will discuss this idea from two different standpoints: (a) first by supposing that the stationary distribution of our (Wiener powered) SM model is a Student distribution; (b) by supposing that our model is based on a (non-Gaussian) Lévy process whose increments are Student distributed. We show that in the case (a) the longer tails of the power decay of the Student laws and in the case (b) the discontinuities of the Lévy-Student process can well account for the rare escape of particles from the beam core, and hence for the formation of a halo in intense beams.

Levy-Student distributions for halos in accelerator beams

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

Cufaro Petroni, Nicola; De Martino, Salvatore; De Siena, Silvio

2005-12-15

We describe the transverse beam distribution in particle accelerators within the controlled, stochastic dynamical scheme of stochastic mechanics (SM) which produces time reversal invariant diffusion processes. This leads to a linearized theory summarized in a Schroedinger-like (SL) equation. The space charge effects have been introduced in recent papers by coupling this S-L equation with the Maxwell equations. We analyze the space-charge effects to understand how the dynamics produces the actual beam distributions, and in particular we show how the stationary, self-consistent solutions are related to the (external and space-charge) potentials both when we suppose that the external field is harmonicmore » (constant focusing), and when we a priori prescribe the shape of the stationary solution. We then proceed to discuss a few other ideas by introducing generalized Student distributions, namely, non-Gaussian, Levy infinitely divisible (but not stable) distributions. We will discuss this idea from two different standpoints: (a) first by supposing that the stationary distribution of our (Wiener powered) SM model is a Student distribution; (b) by supposing that our model is based on a (non-Gaussian) Levy process whose increments are Student distributed. We show that in the case (a) the longer tails of the power decay of the Student laws and in the case (b) the discontinuities of the Levy-Student process can well account for the rare escape of particles from the beam core, and hence for the formation of a halo in intense beams.« less

External Beam Therapy (EBT)

MedlinePlus

... deliver the daily treatments. top of page What equipment is used? Radiation oncologists use linear accelerators or ... accelerator page top of page Who operates the equipment? The equipment is operated by a radiation therapist, ...

Randomized control trial: evaluating aluminum-based antiperspirant use, axilla skin toxicity, and reported quality of life in women receiving external beam radiotherapy for treatment of Stage 0, I, and II breast cancer.

PubMed

Watson, Linda C; Gies, Donna; Thompson, Emmanuel; Thomas, Bejoy

2012-05-01

Standard skin care instructions regarding the use of antiperspirants during radiotherapy to the breast varies across North America. Women have articulated that when instructed to not use antiperspirant, the potential for body odor is distressing. Historical practices and individual opinions have often guided practice in this field. The present study had 2 purposes. To evaluate whether the use of aluminum-based antiperspirant while receiving external beam radiotherapy for stage 0, I, or II breast cancer will increase axilla skin toxicity and to evaluate whether the use of antiperspirant during external beam radiotherapy improves quality of life. A total of 198 participants were randomized to either the experimental group (antiperspirant) or control group (standard care-wash only). The skin reactions in both groups were measured weekly and 2 weeks after treatment using the National Cancer Institute Common Toxicity Criteria Adverse Events, version 3, toxicity grading criteria. Both groups completed the Functional Assessment for Chronic Illness Therapy's questionnaire for the breast population quality of life assessment tool, with additional questions evaluating the effect of underarm antiperspirant use on quality of life before treatment, immediately after treatment, and 2 weeks after treatment during the study. The skin reaction data were analyzed using the generalized estimating equation. No statistically significant difference was seen in the skin reaction between the 2 groups over time. The quality of life data also revealed no statistically significant difference between the 2 groups over time. Data analysis indicates that using antiperspirant routinely during external beam radiotherapy for Stage 0, I, or II breast cancer does not affect the intensity of the skin reaction or the self-reported quality of life. This evidence supports that in this particular population, there is no purpose to restrict these women from using antiperspirants during their treatment, and the decision to use an antiperspirant or not in this setting should be left to the discretion of the patient. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

The status of the SNS external antenna ion source and spare RFQ test facility

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

Welton, R. F., E-mail: welton@ornl.gov; Aleksandrov, A. V.; Han, B. X.

The Oak Ridge National Laboratory operates the Spallation Neutron Source, consisting of a H{sup −} ion source, a 1 GeV linac and an accumulator ring. The accumulated <1 μs-long, ∼35 A beam pulses are extracted from the ring at 60 Hz and directed onto a liquid Hg target. Spalled neutrons are directed to ∼20 world class instruments. Currently, the facility operates routinely with ∼1.2 MW of average beam power, which soon will be raised to 1.4 MW. A future upgrade with a second target station calls for raising the power to 2.8 MW. This paper describes the status of twomore » accelerator components expected to play important roles in achieving these goals: a recently acquired RFQ accelerator and the external antenna ion source. Currently, the RFQ is being conditioned in a newly constructed 2.5 MeV Integrated Test Facility (ITF) and the external antenna source is also being tested on a separate test stand. This paper presents the results of experiments and the testing of these systems.« less

Multielemental analyses of isomorphous Indian garnet gemstones by XRD and external pixe techniques.

PubMed

Venkateswarulu, P; Srinivasa Rao, K; Kasipathi, C; Ramakrishna, Y

2012-12-01

Garnet gemstones were collected from parts of Eastern Ghats geological formations of Andhra Pradesh, India and their gemological studies were carried out. Their study of chemistry is not possible as they represent mixtures of isomorphism nature, and none of the individual specimens indicate independent chemistry. Hence, non-destructive instrumental methodology of external PIXE technique was employed to understand their chemistry and identity. A 3 MeV proton beam was employed to excite the samples. In the present study geochemical characteristics of garnet gemstones were studied by proton induced X-ray emission. Almandine variety of garnet is found to be abundant in the present study by means of their chemical contents. The crystal structure and the lattice parameters were estimated using X-Ray Diffraction studies. The trace and minor elements are estimated using PIXE technique and major compositional elements are confirmed by XRD studies. The technique is found very useful in characterizing the garnet gemstones. The present work, thus establishes usefulness and versatility of the PIXE technique with external beam for research in Geo-scientific methodology. Copyright © 2012 Elsevier Ltd. All rights reserved.

Improving external beam radiotherapy by combination with internal irradiation.

PubMed

Dietrich, A; Koi, L; Zöphel, K; Sihver, W; Kotzerke, J; Baumann, M; Krause, M

2015-07-01

The efficacy of external beam radiotherapy (EBRT) is dose dependent, but the dose that can be applied to solid tumour lesions is limited by the sensitivity of the surrounding tissue. The combination of EBRT with systemically applied radioimmunotherapy (RIT) is a promising approach to increase efficacy of radiotherapy. Toxicities of both treatment modalities of this combination of internal and external radiotherapy (CIERT) are not additive, as different organs at risk are in target. However, advantages of both single treatments are combined, for example, precise high dose delivery to the bulk tumour via standard EBRT, which can be increased by addition of RIT, and potential targeting of micrometastases by RIT. Eventually, theragnostic radionuclide pairs can be used to predict uptake of the radiotherapeutic drug prior to and during therapy and find individual patients who may benefit from this treatment. This review aims to highlight the outcome of pre-clinical studies on CIERT and resultant questions for translation into the clinic. Few clinical data are available until now and reasons as well as challenges for clinical implementation are discussed.

Microsecond Electron Beam Source with Electron Energy Up to 400 Kev and Plasma Anode

NASA Astrophysics Data System (ADS)

Abdullin, É. N.; Basov, G. F.; Shershnev, S.

2017-12-01

A new high-power source of electrons with plasma anode for producing high-current microsecond electron beams with electron energy up to 400 keV has been developed, manufactured, and put in operation. To increase the cross section and pulse current duration of the beam, a multipoint explosive emission cathode is used in the electron beam source, and the beam is formed in an applied external guiding magnetic field. The Marx generator with vacuum insulation is used as a high-voltage source. Electron beams with electron energy up to 300-400 keV, current of 5-15 kA, duration of 1.5-3 μs, energy up to 4 kJ, and cross section up to 150 cm2 have been produced. The operating modes of the electron beam source are realized in which the applied voltage is influenced weakly on the current. The possibility of source application for melting of metal surfaces is demonstrated.

Planar dynamics of a uniform beam with rigid bodies affixed to the ends

NASA Technical Reports Server (NTRS)

Storch, J.; Gates, S.

1983-01-01

The planar dynamics of a uniform elastic beam subject to a variety of geometric and natural boundary conditions and external excitations were analyzed. The beams are inextensible and capable of small transverse bending deformations only. Classical beam vibration eigenvalue problems for a cantilever with tip mass, a cantilever with tip body and an unconstrained beam with rigid bodies at each are examined. The characteristic equations, eigenfunctions and orthogonality relations for each are derived. The forced vibration of a cantilever with tip body subject to base acceleration is analyzed. The exact solution of the governing nonhomogeneous partial differential equation with time dependent boundary conditions is presented and compared with a Rayleigh-Ritz approximate solution. The arbitrary planar motion of an elastic beam with rigid bodies at the ends is addressed. Equations of motion are derived for two modal expansions of the beam deflection. The motion equations are cast in a first order form suitable for numerical integration. Selected FORTRAN programs are provided.

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

PubMed

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

2017-06-13

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

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

PubMed Central

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

2017-01-01

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

Attribution Bias and Overconfidence in Escalation of Commitment: The Role of Desire to Rectify Past Outcomes

ERIC Educational Resources Information Center

Tine, Delilah Castillo

2013-01-01

Escalation of commitment is the voluntary continuation of investing resources into what appears to be a failing course of action whose outcome is uncertain. Investigation into the escalation of commitment phenomenon is important to organizations because such behavior could result in grave economic loss. This research investigates two cognitive…

14 CFR Appendix A to Part 1215 - Estimated Service Rates in 1997 Dollars for TDRSS Standard Services (Based on NASA Escalation...

Code of Federal Regulations, 2014 CFR

2014-01-01

... Services (Based on NASA Escalation Estimate) Time: Project conceptualization (at least two years before... TDRSS Standard Services (Based on NASA Escalation Estimate) A Appendix A to Part 1215 Aeronautics and... the service requirements by NASA Headquarters, communications for the reimbursable development of a...

14 CFR Appendix A to Part 1215 - Estimated Service Rates in 1997 Dollars for TDRSS Standard Services (Based on NASA Escalation...

Code of Federal Regulations, 2013 CFR

2013-01-01

... Services (Based on NASA Escalation Estimate) Time: Project conceptualization (at least two years before... TDRSS Standard Services (Based on NASA Escalation Estimate) A Appendix A to Part 1215 Aeronautics and... the service requirements by NASA Headquarters, communications for the reimbursable development of a...

Development and Analysis of Security Policies in Security Enhanced Android

DTIC Science & Technology

2012-12-01

Privilege - Escalation Attacks on Android ,” Proc. 19th Annual...Services, Bethesda, MD, 2011, pp. 239–252. 98 [43] L. Davi, et al. “ Privilege Escalation Attacks on Android ,” Proc. 13th Int. Conf. on Information...TaintDroid. XManDroid dynamically analyzes applications’ transitive permission usage in order to prevent application-level privilege escalation attacks

External quantum efficiency enhancement by photon recycling with backscatter evasion.

PubMed

Nagano, Koji; Perreca, Antonio; Arai, Koji; Adhikari, Rana X

2018-05-01

The nonunity quantum efficiency (QE) in photodiodes (PD) causes deterioration of signal quality in quantum optical experiments due to photocurrent loss as well as the introduction of vacuum fluctuations into the measurement. In this paper, we report that the external QE enhancement of a PD was demonstrated by recycling the reflected photons. The external QE for an InGaAs PD was increased by 0.01-0.06 from 0.86-0.92 over a wide range of incident angles. Moreover, we confirmed that this technique does not increase backscattered light when the recycled beam is properly misaligned.

Method and design for externally applied laser welding of internal connections in a high power electrochemical cell

DOEpatents

Martin, Charles E; Fontaine, Lucien; Gardner, William H

2014-01-21

An electrochemical cell includes components that are welded from an external source after the components are assembled in a cell canister. The cell canister houses electrode tabs and a core insert. An end cap insert is disposed opposite the core insert. An external weld source, such as a laser beam, is applied to the end cap insert, such that the end cap insert, the electrode tabs, and the core insert are electrically coupled by a weld which extends from the end cap insert to the core insert.

Shielding design of the Mayo Clinic Scottsdale cyclotron vault

NASA Astrophysics Data System (ADS)

Riper, Kenneth A. Van; Metzger, Robert L.; Nelson, Kevin

2017-09-01

Mayo Clinic Scottsdale (Scottsdale, Arizona) is building a cyclotron vault containing a cyclotron with adjacent targets and a beam line leading to an external target. The targets are irradiated by high energy (15 to 16.5 MeV) protons for the production of radioisotopes. We performed Monte Carlo radiation transport simulations to calculate the radiation dose outside of the vault during irradiation of the cyclotron and external targets. We present the Monte Carlo model including the geometry, sources, and variance reduction methods. Mesh tallies surrounding the vault show the external dose rate is within acceptable limits.

Hypersonic aerodynamic characteristics of NR-ATP orbiter, orbiter with external tank, and ascent configuration

NASA Technical Reports Server (NTRS)

Ashby, G. C., Jr.

1973-01-01

A scale model of the North American Rockwell ATP Orbiter with and without the external tank has been tested in a 22-inch helium tunnel at Mach 20 and a Reynolds number based on model length, of 2.14 times one million. Longitudinal and lateral-directional data were determined for the orbiter alone while only longitudinal characteristics and elevon roll effectiveness were investigated for the orbiter/tank combination. Oil flow and electron beam flow visualization studies were conducted for the orbiter alone, orbiter with external tank and the ascent configuration.

Electromagnetic radiation from beam-plasma instabilities

NASA Technical Reports Server (NTRS)

Pritchett, P. L.; Dawson, J. M.

1983-01-01

A computer simulation is developed for the generation of electromagnetic radiation in an electron beam-plasma interaction. The plasma is treated as a two-dimensional finite system, and effects of a continuous nonrelativistic beam input are accounted for. Three momentum and three field components are included in the simulation, and an external magnetic field is excluded. EM radiation generation is possible through interaction among Langmuir oscillations, ion-acoustic waves, and the electromagnetic wave, producing radiation perpendicular to the beam. The radiation is located near the plasma frequency, and polarized with the E component parallel to the beam. The scattering of Langmuir waves caused by ion-acoustic fluctuations generates the radiation. Comparison with laboratory data for the three-wave interactions shows good agreement in terms of the radiation levels produced, which are small relative to the plasma thermal energy.

Sweep excitation with order tracking: A new tactic for beam crack analysis

NASA Astrophysics Data System (ADS)

Wei, Dongdong; Wang, KeSheng; Zhang, Mian; Zuo, Ming J.

2018-04-01

Crack detection in beams and beam-like structures is an important issue in industry and has attracted numerous investigations. A local crack leads to global system dynamics changes and produce non-linear vibration responses. Many researchers have studied these non-linearities for beam crack diagnosis. However, most reported methods are based on impact excitation and constant frequency excitation. Few studies have focused on crack detection through external sweep excitation which unleashes abundant dynamic characteristics of the system. Together with a signal resampling technique inspired by Computed Order Tracking, this paper utilize vibration responses under sweep excitations to diagnose crack status of beams. A data driven method for crack depth evaluation is proposed and window based harmonics extracting approaches are studied. The effectiveness of sweep excitation and the proposed method is experimentally validated.

Photonic crystal microchip laser

NASA Astrophysics Data System (ADS)

Gailevicius, D.; Koliadenko, V.; Purlys, V.; Peckus, M.; Taranenko, V.; Staliunas, K.

2017-02-01

The microchip lasers, being sources of coherent light, suffer from one serious drawback: low spatial quality of the beam, strongly reducing the brightness of emitted radiation. Attempts to improve the beam quality, such as pump-beam guiding, external feedback, either strongly reduce the emission power, or drastically increase the size and complexity of the lasers. Here we propose that specially designed photonic crystal in the cavity of a microchip laser, can significantly improve the beam quality. We experimentally show that a microchip laser, due to spatial filtering functionality of intracavity photonic crystal, improves the beam quality factor M2 reducing it by factor of 2, and thus increase the brightness of radiation by a factor of 4. This comprises a new kind of laser, the "photonic crystal microchip laser", a very compact and efficient light source emitting high spatial high brightness radiation.

Photonic Crystal Microchip Laser.

PubMed

Gailevicius, Darius; Koliadenko, Volodymyr; Purlys, Vytautas; Peckus, Martynas; Taranenko, Victor; Staliunas, Kestutis

2016-09-29

The microchip lasers, being very compact and efficient sources of coherent light, suffer from one serious drawback: low spatial quality of the beam strongly reducing the brightness of emitted radiation. Attempts to improve the beam quality, such as pump-beam guiding, external feedback, either strongly reduce the emission power, or drastically increase the size and complexity of the lasers. Here it is proposed that specially designed photonic crystal in the cavity of a microchip laser, can significantly improve the beam quality. Experiments show that a microchip laser, due to spatial filtering functionality of intracavity photonic crystal, improves the beam quality factor M 2 reducing it by a factor of 2, and increase the brightness of radiation by a factor of 3. This comprises a new kind of laser, the "photonic crystal microchip laser", a very compact and efficient light source emitting high spatial quality high brightness radiation.

Oscillations of end loaded cantilever beams

NASA Astrophysics Data System (ADS)

Macho-Stadler, E.; Elejalde-García, M. J.; Llanos-Vázquez, R.

2015-09-01

This article presents several simple experiments based on changing transverse vibration frequencies in a cantilever beam, when acted on by an external attached mass load at the free end. By using a mechanical wave driver, available in introductory undergraduate laboratories, we provide various experimental results for end loaded cantilever beams that fit reasonably well into a linear equation. The behaviour of the cantilever beam’s weak-damping resonance response is studied for the case of metal resonance strips. As the mass load increases, a more pronounced decrease occurs in the fundamental frequency of beam vibration. It is important to note that cantilever construction is often used in architectural design and engineering construction projects but current analysis also predicts the influence of mass load on the sound generated by musical free reeds with boundary conditions similar to a cantilever beam.

Coherent control of the Goos-Hänchen shift via Fano interference

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

Liu, Shaopeng; Yang, Wen-Xing, E-mail: wenxingyang@seu.edu.cn; Zhu, Zhonghu

2016-04-14

A scheme of enhanced Goos-Hänchen (GH) shifts in reflected and transmitted light beams is exploited in a cavity, where an asymmetric double AlGaAs/GaAs quantum well structure with resonant tunneling to a common continuum is employed as the intracavity medium. With the help of Fano-type interference induced by resonant tunneling, the generated GH shifts that contain a negative lateral shift in reflected light beam and a positive lateral shift in transmitted light beam are found to be significantly enhanced. More interestingly, these GH shifts in reflected and transmitted light beams are modulated by means of a control beam and external biasmore » voltage, in which maximum negative shift of 1.86 mm and positive shift of 0.37 mm are achievable.« less

Laser beam centering and pointing system

DOEpatents

Rushford, Michael Charles

2015-01-13

An optical instrument aligns an optical beam without the need for physical intervention of the instrument within the apparatus or platforms from which the trajectory of the beam to be ascertained. The alignment apparatus and method enable the desired function to be realized without the placement of physical apertures or sensors directly in the path of the beam through the system whose spatial position and slope is to be sought. An image plane provides the observer with a pair of well-defined images that are indicative of the beam centering and pointing alignment parameters. The optical alignment can be realized without the need for referencing to an external or fixed set of coordinates or fiducials. The instrument can therefore service situations where adverse environments would otherwise prohibit the use of such instruments, including regions of high radiation, high temperature, vacuum and/or cryogenic atmospheres.

High and escalating levels of cocaine intake are dissociable from subsequent incentive motivation for the drug in rats.

PubMed

Allain, Florence; Bouayad-Gervais, Karim; Samaha, Anne-Noël

2018-01-01

Taking high and increasing amounts of cocaine is thought to be necessary for the development of addiction. Consequently, a widely used animal model of drug self-administration involves giving animals continuous drug access during long sessions (LgA), as this produces high and escalating levels of intake. However, human cocaine addicts likely use the drug with an intermittent rather than continuous pattern, producing spiking brain cocaine levels. Using an intermittent-access (IntA) cocaine self-administration procedure in rats, we studied the relationship between escalation of cocaine intake and later incentive motivation for the drug, as measured by responding under a progressive ratio schedule of cocaine reinforcement. First, under IntA, rats escalated their cocaine use both within and between sessions. However, escalation did not predict later incentive motivation for the drug. Second, incentive motivation for cocaine was similar in IntA-rats limited to low- and non-escalating levels of drug intake (IntA-Lim) and in IntA-rats that took high and escalating levels of drug. Finally, IntA-Lim rats took much less cocaine than rats given continuous drug access during each self-administration session (LgA-rats). However, IntA-Lim rats later responded more for cocaine under a progressive ratio schedule of reinforcement. Taking large and escalating quantities of cocaine does not appear necessary to increase incentive motivation for the drug. Taking cocaine in an intermittent pattern-even in small amounts-is more effective in producing this addiction-relevant change. Thus, beyond the amount of drug taken, the temporal kinetics of drug use predict change in drug use over time.

Evaluation of empiric antibiotic de-escalation in febrile neutropenia.

PubMed

Kroll, Amanda L; Corrigan, Patricia A; Patel, Shejal; Hawks, Kelly G

2016-10-01

Up until 2010, the recommended duration of empiric broad-spectrum antibiotics for febrile neutropenia was until absolute neutrophil count (ANC) recovery. An updated guideline on the use of antimicrobial agents in neutropenic patients with cancer indicates that patients who have completed an appropriate treatment course of broad-spectrum antibiotics, with resolution of signs and symptoms of infection but persistent neutropenia, can be de-escalated to oral fluoroquinolone prophylaxis until ANC recovery. The primary objective of this retrospective investigation was to evaluate the safety and efficacy of de-escalating broad-spectrum antibiotics in patients remaining neutropenic after at least 14 days of empiric broadspectrum antibiotics for febrile neutropenia compared to patients continuing broad-spectrum antibiotics until ANC recovery. There were 16 patients (61.5%) in the comparator group who met the primary endpoint of remaining afebrile and without escalation of antibiotics for at least 72 hours after 14 days of broad-spectrum antibiotics and 21 patients (80.7%) in the de-escalation group who met the primary endpoint of remaining afebrile and without reinitiation of broad-spectrum antibiotics for at least 72 hours after de-escalation to levofloxacin therapy (p = 0.11). Mean total duration of broad-spectrum antibiotic therapy was 23.5 ± 1.5 days in the comparator group versus 22.2 ± 1.43 days in the de-escalation group (p = 0.39). Results of this investigation indicate that broad-spectrum antibiotics can be safely de-escalated to levofloxacin prophylaxis prior to ANC recovery in select patients. This practice may decrease the duration of broad-spectrum antibiotic exposure and associated complications. © The Author(s) 2015.

Individualized Radiation Dose Escalation Based on the Decrease in Tumor FDG Uptake and Normal Tissue Constraints Improve Survival in Patients With Esophageal Carcinoma.

PubMed

Ma, Jinbo; Wang, Zhaoyang; Wang, Chengde; Chen, Ercheng; Dong, Yaozong; Song, Yipeng; Wang, Wei; You, Dong; Jiang, Wei; Zang, Rukun

2017-02-01

To determine whether individualized radiation dose escalation after planned chemoradiation based on the decrease in tumor and normal tissue constraints can improve survival in patients with esophageal carcinoma. From August 2005 to December 2010, 112 patients with squamous esophageal carcinoma were treated with radical concurrent chemoradiation. Patients received positron emission tomography-computer tomography scan twice, before radiation and after radiation dose of 50.4 Gy. All patients were noncomplete metabolic response groups according to the Response Evaluation Criteria in solid tumors. Only 52 patients with noncomplete metabolic response received individualized dose escalation based on tumor and normal tissue constraints. Survival and treatment failure were observed and analyzed using SPSS (13.0). The rate of complete metabolic response for patients with noncomplete metabolic response after dose escalation reached 17.3% (9 of 52). The 2-year overall survival rates for patients with noncomplete metabolic response in the conventional and dose-escalation groups were 20.5% and 42.8%, respectively( P = .001). The 2-year local control rates for patients were 35.7% and 76.2%, respectively ( P = .002). When patients were classified into partial metabolic response and no metabolic response, 2-year overall survival rates for patients with partial metabolic response were significantly different in conventional and dose-escalation groups (33.8% vs 78.4%; P = .000). The 2-year overall survival rates for patients with no metabolic response in two groups (8.6% vs 15.1%) did not significantly differ ( P = .917). Individualized radiation dose escalation has the potential to improve survival in patients with esophageal carcinoma according to increased rate of complete metabolic response. However, further trials are needed to confirm this and to identify patients who may benefit from dose escalation.

Hollow cathode startup using a microplasma discharge

NASA Technical Reports Server (NTRS)

Aston, G.

1981-01-01

Attention is given to a microplasma discharge to initiate a hollow cathode discharge for such applications as plasma flow experiments, the electric propulsion of space vehicles, and as a replacement for filament cathodes in neutral beam injector ion sources. The technique results in a cathode that is easy to start, simple in design, and which does not require external RF exciters, inserts or heating elements. Future applications may include ion beam milling and ion implantation.

Experimental setup for Single Event Effects at the São Paulo 8UD Pelletron Accelerator

NASA Astrophysics Data System (ADS)

Aguiar, V. A. P.; Added, N.; Medina, N. H.; Macchione, E. L. A.; Tabacniks, M. H.; Aguirre, F. R.; Silveira, M. A. G.; Santos, R. B. B.; Seixas, L. E.

2014-08-01

In this work we present an experimental setup mounted in one of the beam lines at the São Paulo 8UD Pelletron Accelerator in order to study Single Event Effects in electronic devices. The basic idea is to use elastic scattering collisions to achieve a low-flux with a high-uniformity ion beam to irradiate several devices. 12C, 16O, 28Si, 35Cl and 63Cu beams were used to test the experimental setup. In this system it is possible to use efficiently LET values of 17 MeV/mg/cm2 for an external beam arrangement and up to 32 MeV/mg/cm2 for in-vacuum irradiation.

TSR: A storage and cooling ring for HIE-ISOLDE

NASA Astrophysics Data System (ADS)

Butler, P. A.; Blaum, K.; Davinson, T.; Flanagan, K.; Freeman, S. J.; Grieser, M.; Lazarus, I. H.; Litvinov, Yu. A.; Lotay, G.; Page, R. D.; Raabe, R.; Siesling, E.; Wenander, F.; Woods, P. J.

2016-06-01

It is planned to install the heavy-ion, low-energy ring TSR, currently at the Max-Planck-Institute for Nuclear Physics in Heidelberg, at the HIE-ISOLDE facility in CERN, Geneva. Such a facility will provide a capability for experiments with stored, cooled secondary beams that is rich and varied, spanning from studies of nuclear ground-state properties and reaction studies of astrophysical relevance, to investigations with highly-charged ions and pure isomeric beams. In addition to experiments performed using beams recirculating within the ring, the cooled beams can be extracted and exploited by external spectrometers for high-precision measurements. The capabilities of the ring facility as well as some physics cases will be presented, together with a brief report on the status of the project.

Optimum location of external markers using feature selection algorithms for real‐time tumor tracking in external‐beam radiotherapy: a virtual phantom study

PubMed Central

Nankali, Saber; Miandoab, Payam Samadi; Baghizadeh, Amin

2016-01-01

In external‐beam radiotherapy, using external markers is one of the most reliable tools to predict tumor position, in clinical applications. The main challenge in this approach is tumor motion tracking with highest accuracy that depends heavily on external markers location, and this issue is the objective of this study. Four commercially available feature selection algorithms entitled 1) Correlation‐based Feature Selection, 2) Classifier, 3) Principal Components, and 4) Relief were proposed to find optimum location of external markers in combination with two “Genetic” and “Ranker” searching procedures. The performance of these algorithms has been evaluated using four‐dimensional extended cardiac‐torso anthropomorphic phantom. Six tumors in lung, three tumors in liver, and 49 points on the thorax surface were taken into account to simulate internal and external motions, respectively. The root mean square error of an adaptive neuro‐fuzzy inference system (ANFIS) as prediction model was considered as metric for quantitatively evaluating the performance of proposed feature selection algorithms. To do this, the thorax surface region was divided into nine smaller segments and predefined tumors motion was predicted by ANFIS using external motion data of given markers at each small segment, separately. Our comparative results showed that all feature selection algorithms can reasonably select specific external markers from those segments where the root mean square error of the ANFIS model is minimum. Moreover, the performance accuracy of proposed feature selection algorithms was compared, separately. For this, each tumor motion was predicted using motion data of those external markers selected by each feature selection algorithm. Duncan statistical test, followed by F‐test, on final results reflected that all proposed feature selection algorithms have the same performance accuracy for lung tumors. But for liver tumors, a correlation‐based feature selection algorithm, in combination with a genetic search algorithm, proved to yield best performance accuracy for selecting optimum markers. PACS numbers: 87.55.km, 87.56.Fc PMID:26894358

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

Gomez, Daniel R., E-mail: dgomez@mdanderson.org; Gillin, Michael; Liao, Zhongxing

Background: Many patients with locally advanced non-small cell lung cancer (NSCLC) cannot undergo concurrent chemotherapy because of comorbidities or poor performance status. Hypofractionated radiation regimens, if tolerable, may provide an option to these patients for effective local control. Methods and Materials: Twenty-five patients were enrolled in a phase 1 dose-escalation trial of proton beam therapy (PBT) from September 2010 through July 2012. Eligible patients had histologically documented lung cancer, thymic tumors, carcinoid tumors, or metastatic thyroid tumors. Concurrent chemotherapy was not allowed, but concurrent treatment with biologic agents was. The dose-escalation schema comprised 15 fractions of 3 Gy(relative biological effectivenessmore » [RBE])/fraction, 3.5 Gy(RBE)/fraction, or 4 Gy(RBE)/fraction. Dose constraints were derived from biologically equivalent doses of standard fractionated treatment. Results: The median follow-up time for patients alive at the time of analysis was 13 months (range, 8-28 months). Fifteen patients received treatment to hilar or mediastinal lymph nodes. Two patients experienced dose-limiting toxicity possibly related to treatment; 1 received 3.5-Gy(RBE) fractions and experienced an in-field tracheoesophageal fistula 9 months after PBT and 1 month after bevacizumab. The other patient received 4-Gy(RBE) fractions and was hospitalized for bacterial pneumonia/radiation pneumonitis 4 months after PBT. Conclusion: Hypofractionated PBT to the thorax delivered over 3 weeks was well tolerated even with significant doses to the lungs and mediastinal structures. Phase 2/3 trials are needed to compare the efficacy of this technique with standard treatment for locally advanced NSCLC.« less

Does Proton Therapy Offer Demonstrable Clinical Advantages for Treating Thoracic Tumors?

PubMed

Liao, Zhongxing; Gandhi, Saumil J; Lin, Steven H; Bradley, Jeffrey

2018-04-01

The finite range of proton beams in tissues offers unique dosimetric advantages that theoretically allow dose to the target to be escalated while minimizing exposure of surrounding tissues and thus minimizing radiation-induced toxicity. This theoretical advantage has led to widespread adoption of proton therapy around the world for a wide variety of tumors at different anatomical sites. Many treatment-planning comparisons have shown that proton therapy has substantial dosimetric advantages over conventional radiotherapy. However, given the significant difference in cost for proton vs conventional photon therapy, thorough investigation of the evidence of proton therapy's clinical benefits in terms of toxicity and survival is warranted. Some data from retrospective studies, single-arm prospective studies, and a very few randomized clinical trials comparing these modalities are beginning to emerge. In this review, we examine the available data with regard to proton therapy for thoracic malignancies. We begin by discussing the unique challenges involved in treating moving targets with significant tissue heterogeneity and the technologic efforts underway to overcome these challenges. We then discuss the rationale for minimizing normal tissue toxicity, particularly pulmonary, cardiac, and hematologic toxicity, within the context of previously unsuccessful attempts at dose escalation for lung and esophageal cancer. Finally, we explore strategies for accelerating the development of trials aimed at measuring meaningful clinical endpoints and for maximizing the value of proton therapy by personalizing its use for individual patients. Copyright © 2018 Elsevier Inc. All rights reserved.

The practices of expert psychiatric nurses: accompanying the patient to a calmer personal space.

PubMed

Johnson, M E; Hauser, P M

2001-01-01

The focus of the care of potentially aggressive psychiatric patients has been on the use of seclusion and restraints. Recent concerns, however, about the potential for patient injury have made it imperative that nurses use alternative methods to calm patients who are escalating. Little is known about how expert nurses de-escalate the escalating patient. The purpose of this interpretive phenomenological study was to uncover and describe the knowledge embedded in the stories of psychiatric nurses who are skilled in the practices of de-escalating an escalating patient. Twenty registered nurses were interviewed using an unstructured format. The analysis of the data revealed that these nurses were skilled at noticing the patient, reading the situation and the patient, knowing where the patient was on the continuum, understanding the meaning of the behavior, knowing what the patient needed, connecting with the patient, and matching the intervention with the patient's needs.

Treat-early and treat-mild: role of fast vs. slow escalation of headaches.

PubMed

Ng-Mak, D S; Ma, L; Hu, X H; Chen, Y-T

2009-04-01

This prospective, multi-center, observational study aimed to examine patients' early treatment decision process. Specifically, we assessed if the association between mild headache pain at treatment initiation and early treatment differed by the speed of headache escalation. Patients (n = 168) were instructed to collect information on their headache experience during the study period via an electronic diary over 30 consecutive days after enrollment. At the time of treatment, patients who treated early were 2.3 times as likely to experience mild headache pain as those who treated late. Controlling for the effect of escalation of headache, patients who treated early were three times as likely to report mild headache pain at dosing as those who treated late. The interaction between fast escalation of headache and mild pain was not statistically significant. Early treatment is associated with mild pain, regardless of the speed of headache escalation.

TH-CD-207A-04: Optimized Respiratory Gating for Abnormal Breathers in Pancreatic SBRT

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

Campbell, W; Miften, M; Schefter, T

Purpose: Pancreatic SBRT is uniquely challenging due to both the erratic/unstable motion of the pancreas and the close proximity of the radiosensitive small bowel. Respiratory gating can mitigate this effect, but the irregularity of motion severely affects traditional phase-based gating. The purpose of this study was to analyze real-time motion data of pancreatic tumors to optimize the efficacy and accuracy of respiratory gating, with the overall goal of enabling dose escalated pancreatic SBRT. Methods: Fifteen pancreatic SBRT patients received 30–33 Gy in 5 fractions on a Varian TrueBeam STx unit. Abdominal compression was used to reduce the amplitude of tumormore » motion, and daily cone-beam computed tomography (CBCT) scans were acquired prior to each treatment for target localization purposes. For this study, breathing data (phase and amplitude) were collected during each CBCT scan using Varian’s Real-Time Position Management system. An in-house template matching technique was used to track the superior-inferior motion of implanted fiducial markers in CBCT projection images. Using tumor motion and breathing data, phase-based or amplitude-based respiratory gating was simulated for all 75 fractions, targeting either end-exhalation or end-inhalation phases of breathing. Results: For the average patient, gating at end-exhalation offered the best reductions in effective motion for equal duty cycles. However, optimal central phase angle varied widely (range: 0–92%, mean±SD: 49±12%), and phase-based gating windows typically associated with end-exhalation (i.e., “30–70%”) were rarely ideal. Amplitude-based gating significantly outperformed phase-based gating, with average effective ranges for amplitude-based gating 25% lower than phase-based gating ranges (as much as 73% lower). Amplitude-based gating was consistently better suited to accommodate abnormal breathing patterns. For both phase-based and amplitude-based gating, end-exhalation provided significantly better results than end-inhalation. Conclusion: Amplitude-based gating reliably outperformed phase-based gating, and end-exhalation was more suitable than end-inhalation. These results will be used to guide future dose-escalation trials. Research funding provided by Varian Medical Systems to Miften and Jones.« less

First Demonstration of ECHO: an External Calibrator for Hydrogen Observatories

NASA Astrophysics Data System (ADS)

Jacobs, Daniel C.; Burba, Jacob; Bowman, Judd D.; Neben, Abraham R.; Stinnett, Benjamin; Turner, Lauren; Johnson, Kali; Busch, Michael; Allison, Jay; Leatham, Marc; Serrano Rodriguez, Victoria; Denney, Mason; Nelson, David

2017-03-01

Multiple instruments are pursuing constraints on dark energy, observing reionization and opening a window on the dark ages through the detection and characterization of the 21 cm hydrogen line for redshifts ranging from ˜1 to 25. These instruments, including CHIME in the sub-meter and HERA in the meter bands, are wide-field arrays with multiple-degree beams, typically operating in transit mode. Accurate knowledge of their primary beams is critical for separation of bright foregrounds from the desired cosmological signals, but difficult to achieve through astronomical observations alone. Previous beam calibration work at low frequencies has focused on model verification and does not address the need of 21 cm experiments for routine beam mapping, to the horizon, of the as-built array. We describe the design and methodology of a drone-mounted calibrator, the External Calibrator for Hydrogen Observatories (ECHO), that aims to address this need. We report on a first set of trials to calibrate low-frequency dipoles at 137 MHz and compare ECHO measurements to an established beam-mapping system based on transmissions from the Orbcomm satellite constellation. We create beam maps of two dipoles at a 9° resolution and find sample noise ranging from 1% at the zenith to 100% in the far sidelobes. Assuming this sample noise represents the error in the measurement, the higher end of this range is not yet consistent with the desired requirement but is an improvement on Orbcomm. The overall performance of ECHO suggests that the desired precision and angular coverage is achievable in practice with modest improvements. We identify the main sources of systematic error and uncertainty in our measurements and describe the steps needed to overcome them.

Partial breast radiation therapy - external beam

MedlinePlus

APBI is used to prevent breast cancer from coming back. When radiation therapy is given after breast- ... breast conservation therapy reduces the risk of cancer coming back, and possibly even death from breast cancer.

Dual beam photoacoustic infrared spectroscopy of solids using an external cavity quantum cascade laser.

PubMed

Dehghany, M; Michaelian, K H

2012-06-01

Quantum cascade laser-based instrumentation for dual beam photoacoustic (PA) spectroscopy is described in this article. Experimental equipment includes a 4.55 μm (2141-2265 cm(-1)) continuous wave external cavity quantum cascade laser (EC-QCL), two gas-microphone PA cells, and two lock-in amplifiers. Correction for the time and wavenumber dependence of the laser output is effected through real-time division of the PA signals derived from the sample and reference channels. Source-compensated mid-infrared absorption spectra of carbon black powder and aromatic hydrocarbon solids were obtained to confirm the reliability of the method. Absorption maxima in the EC-QCL PA spectra of hydrocarbons are better defined than those in Fourier transform infrared spectra acquired under similar conditions, enabling the detection of several previously unknown bands.

Endometrial cancer - reduce to the minimum. A new paradigm for adjuvant treatments?

PubMed Central

2011-01-01

Background Up to now, the role of adjuvant radiation therapy and the extent of lymph node dissection for early stage endometrial cancer are controversial. In order to clarify the current position of the given adjuvant treatment options, a systematic review was performed. Materials and methods Both, Pubmed and ISI Web of Knowledge database were searched using the following keywords and MESH headings: "Endometrial cancer", "Endometrial Neoplasms", "Endometrial Neoplasms/radiotherapy", "External beam radiation therapy", "Brachytherapy" and adequate combinations. Conclusion Recent data from randomized trials indicate that external beam radiation therapy - particularly in combination with extended lymph node dissection - or radical lymph node dissection increases toxicity without any improvement of overall survival rates. Thus, reduced surgical aggressiveness and limitation of radiotherapy to vaginal-vault-brachytherapy only is sufficient for most cases of early stage endometrial cancer. PMID:22118369

External beam techniques to boost cervical cancer when brachytherapy is not an option—theories and applications

PubMed Central

Kilic, Sarah; Khan, Atif J.; Beriwal, Sushil; Small, William

2017-01-01

The management of locally advanced cervical cancer relies on brachytherapy (BT) as an integral part of the radiotherapy delivery armamentarium. Occasionally, intracavitary BT is neither possible nor available. In these circumstances, post-external beam radiotherapy (EBRT) interstitial brachytherapy and/or hysterectomy may represent viable options that must be adequately executed in a timely manner. However, if these options are not applicable due to patient related or facility related reasons, a formal contingency plan should be in place. Innovative EBRT techniques such as intensity modulated and stereotactic radiotherapy may be considered for patients unable to undergo brachytherapy. Relying on provocative arguments and recent data, this review explores the rationale for and limitations of non-brachytherapy substitutes in that setting aiming to establish a formal process for the optimal execution of this alternative plan. PMID:28603722

Scanning-PIXE analysis of gold lace embroideries in a relic of St. Francis

NASA Astrophysics Data System (ADS)

Migliori, A.; Grassi, N.; Mandò, P. A.

2008-05-01

In this work, we describe the compositional analysis performed by scanning-mode PIXE on the metal threads of a XIII century embroidery. The precious work analysed is the pillow-case used to cover the pillow, on which - according to tradition - St. Francis of Assisi was resting his head when he died. Measurements were performed in order to characterise the embroideries of the two sides and the passementerie in the lateral hems. Several areas, each of the order of two square millimetres, were scanned with a 3 MeV proton external beam of 20 μm size on target, using the external micro-beam facility of our laboratory, with list-mode acquisition. Analysis of elemental maps and spectra from selected homogeneous sub-areas allowed us to extract the quantitative composition of the gilded tape and estimates of its thickness.

External-PIXE analysis for the study of pigments from a painting from the Museum of Contemporary Art

NASA Astrophysics Data System (ADS)

Rizzutto, M. A.; Moro, M. V.; Silva, T. F.; Trindade, G. F.; Added, N.; Tabacniks, M. H.; Kajiya, E. M.; Campos, P. H. V.; Magalhães, A. G.; Barbosa, M.

2014-08-01

External Ion Beam Analysis is a useful tool for the characterization of cultural heritage objects. During the last decade, several significant collaborations have been established between Ion Beam Analysis (IBA) scientists and art or archeology professionals, demanding in-air IBA for a variety of different cultural heritage objects. In-air Particle Induced X-ray Emission (PIXE) analyses of an oil painting by the Italian painter, Mario Sironi, from the Museum of Contemporary Art of the University of São Paulo (MAC-USP), were examined. This painting is particularly interesting due to paintings on both sides (oil on canvas on the front and oil on wood on the back side). PIXE analysis helped the identification of the pigment similarities on both sides of the painting, suggesting the same authorship.

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

Beadle, Beth M.; Jhingran, Anuja; Salehpour, Mohammad

Purpose: To evaluate the magnitude of cervix regression and motion during external beam chemoradiation for cervical cancer. Methods and Materials: Sixteen patients with cervical cancer underwent computed tomography scanning before, weekly during, and after conventional chemoradiation. Cervix volumes were calculated to determine the extent of cervix regression. Changes in the center of mass and perimeter of the cervix between scans were used to determine the magnitude of cervix motion. Maximum cervix position changes were calculated for each patient, and mean maximum changes were calculated for the group. Results: Mean cervical volumes before and after 45 Gy of external beam irradiationmore » were 97.0 and 31.9 cc, respectively; mean volume reduction was 62.3%. Mean maximum changes in the center of mass of the cervix were 2.1, 1.6, and 0.82 cm in the superior-inferior, anterior-posterior, and right-left lateral dimensions, respectively. Mean maximum changes in the perimeter of the cervix were 2.3 and 1.3 cm in the superior and inferior, 1.7 and 1.8 cm in the anterior and posterior, and 0.76 and 0.94 cm in the right and left lateral directions, respectively. Conclusions: Cervix regression and internal organ motion contribute to marked interfraction variations in the intrapelvic position of the cervical target in patients receiving chemoradiation for cervical cancer. Failure to take these variations into account during the application of highly conformal external beam radiation techniques poses a theoretical risk of underdosing the target or overdosing adjacent critical structures.« less

What does postradiotherapy PSA nadir tell us about freedom from PSA failure and progression-free survival in patients with low and intermediate-risk localized prostate cancer?

PubMed

DeWitt, K D; Sandler, H M; Weinberg, V; McLaughlin, P W; Roach, M

2003-09-01

To determine whether the post-external beam radiotherapy (RT) prostate-specific antigen nadir (nPSA) improves our ability to predict freedom from PSA failure, progression-free survival (PFS), and overall survival. Controversy regarding the importance of nPSA after external beam RT as a prognostic indicator for patients with localized prostate cancer has continued. This analysis was based on the data from 748 patients with low and intermediate-risk localized prostate cancer treated with external beam RT alone. Patients were categorized by nPSA quartile groups with cutpoints of less than 0.3, 0.3 to less than 0.6, 0.6 to less than 1.2, and 1.2 ng/mL or greater. Both univariate and multivariate analyses were used to determine the significance of nPSA on PSA failure (American Society for Therapeutic Radiology Oncology consensus definition), PFS (death after PSA failure), and overall survival (death from any cause). Freedom from PSA failure was strongly associated with nadir quartile groups (P <0.0001). PFS was also significantly different statistically among nadir quartile groups (P = 0.02). No statistically significant difference was found in overall survival associated with nPSA at this point. nPSA is a strong independent predictor of freedom from PSA failure and PFS in patients with low and intermediate-risk localized prostate cancer treated with RT alone. Longer follow-up and larger patient numbers are required to confirm these observations.

Novel Parameter Predicting Grade 2 Rectal Bleeding After Iodine-125 Prostate Brachytherapy Combined With External Beam Radiation Therapy

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

Shiraishi, Yutaka, E-mail: shiraishi@rad.med.keio.ac.jp; Hanada, Takashi; Ohashi, Toshio

2013-09-01

Purpose: To propose a novel parameter predicting rectal bleeding on the basis of generalized equivalent uniform doses (gEUD) after {sup 125}I prostate brachytherapy combined with external beam radiation therapy and to assess the predictive value of this parameter. Methods and Materials: To account for differences among radiation treatment modalities and fractionation schedules, rectal dose–volume histograms (DVHs) of 369 patients with localized prostate cancer undergoing combined therapy retrieved from corresponding treatment planning systems were converted to equivalent dose-based DVHs. The gEUDs for the rectum were calculated from these converted DVHs. The total gEUD (gEUD{sub sum}) was determined by a summation ofmore » the brachytherapy and external-beam radiation therapy components. Results: Thirty-eight patients (10.3%) developed grade 2+ rectal bleeding. The grade 2+ rectal bleeding rate increased as the gEUD{sub sum} increased: 2.0% (2 of 102 patients) for <70 Gy, 10.3% (15 of 145 patients) for 70-80 Gy, 15.8% (12 of 76 patients) for 80-90 Gy, and 19.6% (9 of 46 patients) for >90 Gy (P=.002). Multivariate analysis identified age (P=.024) and gEUD{sub sum} (P=.000) as risk factors for grade 2+ rectal bleeding. Conclusions: Our results demonstrate gEUD to be a potential predictive factor for grade 2+ late rectal bleeding after combined therapy for prostate cancer.« less

Photovoltaic dependence of photorefractive grating on the externally applied dc electric field

NASA Astrophysics Data System (ADS)

Maurya, M. K.; Yadav, R. A.

2013-04-01

Photovoltaic dependence of photorefractive grating (i.e., space-charge field and phase-shift of the index grating) on the externally applied dc electric field in photovoltaic-photorefractive materials has been investigated. The influence of photovoltaic field (EPhN), diffusion field and carrier concentration ratio r (donor/acceptor impurity concentration ratio) on the space-charge field (SCF) and phase-shift of the index grating in the presence and absence of the externally applied dc electric field have also been studied in details. Our results show that, for a given value of EPhN and r, the magnitude of the SCF and phase-shift of the index grating can be enhanced significantly by employing the lower dc electric field (EON<10) across the photovoltaic-photorefractive crystal and higher value of diffusion field (EDN>40). Such an enhancement in the magnitude of the SCF and phase-shift of the index grating are responsible for the strongest beam coupling in photovoltaic-photorefractive materials. This sufficiently strong beam coupling increases the two-beam coupling gain that may be exceed the absorption and reflection losses of the photovoltaic-photorefractive sample, and optical amplification can occur. The higher value of optical amplification in photovoltaic-photorefractive sample is required for the every applications of photorefractive effect so that technology based on the photorefractive effect such as holographic storage devices, optical information processing, acousto-optic tunable filters, gyro-sensors, optical modulators, optical switches, photorefractive-photovoltaic solitons, biomedical applications, and frequency converters could be improved.

Security for a Smarter Planet

NASA Astrophysics Data System (ADS)

Nagaratnam, Nataraj

Bit by bit, our planet is getting smarter. By this, we mean the systems that run, the way we live and work as a society. Three things have brought this about - the world is becoming instrumented, interconnected and intelligent. Given the planet is becoming instrumented and interconnected, this opens up more risks that need to be managed. Escalating security and privacy concerns along with a renewed focus on organizational oversight are driving governance, risk management and compliance (GRC) to the forefront of the business. Compliance regulations have increasingly played a larger role by attempting to establish processes and controls that mitigate the internal and external risks organizations have today. To effectively meet the requirements of GRC, companies must prove that they have strong and consistent controls over who has access to critical applications and data.

Bariatric surgery and the financial reimbursement cycle.

PubMed

Schoenthal, Anna R; Getzen, Thomas E

2005-01-01

Financial reimbursement for new health care services tends to progress through a predictable cycle. Initially, requests for payment are often honored in full based on the assumption that generous reimbursement is necessary to bring about an expansion of supply, and that pioneering providers have incurred losses while the technology was developed and disseminated. As total third-party payments escalate, concerns regarding the relationship between costs and price are pushed to the fore. Allegations of profiteering, overuse, and abuse spread. These concerns often lead to a set of externally imposed restrictions on payment, with limits placed first on prices, and then usually on quantities and/or aggregate totals as well. In this article, we examine how one new technology, bariatric surgery, is progressing through the reimbursement cycle. Key words: bariatric surgery, obesity, reimbursement.

Design Considerations of a Novel Two-Beam Accelerator

NASA Astrophysics Data System (ADS)

Luginsland, John William

This thesis reports the design study of a new type of charged particle accelerator called the Twobetron. The accelerator consists of two beams of electrons traveling through a series of pillbox cavities. The power of a high current annular beam excites an electromagnetic mode in the cavities, which, in turn, drives a low current on-axis pencil beam to high energy. We focus on the design considerations that would make use of existing pulsed power systems, for a proof-of-principle experiment. Potential applications of this new device include radiotherapy, materials processing, and high energy accelerators. The first phase of the research involves analytic description of the accelerating process. This reveals the problem of phase slippage. Derbenev's proposed cure of beam radius modulation is analyzed. Further studies include the effect of initial phase and secondary beam loading. Scaling laws to characterize the Twobetron's performance are derived. Computer simulation is performed to produce a self-consistent analysis of the dynamics of the space charge and its interaction with the accelerator structure. Particle -in-cell simulations answer several questions concerning beam stability, cavity modes, and the nature of the structure. Specifically, current modulation on the primary beam is preserved in the simulations. However, these simulations also revealed that mode competition and significant cavity coupling are serious issues that need to be addressed. Also considered is non-axisymmetric instability on the driver beam of the Twobetron, in particular, the beam breakup instability (BBU), which is known to pose a serious threat to linear accelerators in general. We extend the classical analysis of BBU to annular beams. The effect of higher order non-axisymmetric modes is also examined. It is shown that annular beams are more stable than pencil beams to BBU in general. Our analysis also reveals that the rf magnetic field is more important than the rf electric field in contributing to BBU growth. We next address the issue of primary beam modulation. Both particle-in-cell and analytic investigation showed that the usual relativistic klystron amplifiers (RKA) mechanism cannot provide full beam modulation at convenient levels of external rf drive. However, the recent discovery at the Air Force Phillips Laboratory of the injection locked relativistic klystron oscillator suggests that electromagnetic feedback between the driver cavity and the booster cavity might significantly enhance the current modulation. A simple model is constructed to analyze this cavity coupling and its mutual interaction with the primary beam. Quantitative agreement is found between our model and the Phillips Laboratory experiments. This analysis suggests that significant current modulation on the primary beam may be achieved with low level external rf drive.

77 FR 42353 - Escalate Capital Partners SBIC I, L.P.; Notice Seeking Exemption Under Section 312 of the Small...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-18

... SMALL BUSINESS ADMINISTRATION [License No. 06/06-0335] Escalate Capital Partners SBIC I, L.P.; Notice Seeking Exemption Under Section 312 of the Small Business Investment Act, Conflicts of Interest Notice is hereby given that Escalate Capital Partners SBIC I, L.P., 300 West 6th Street, Suite 2250...

75 FR 71785 - Escalate Capital Partners SBIC I, L.P., License No. 06/06-0335; Notice Seeking Exemption Under...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

... SMALL BUSINESS ADMINISTRATION Escalate Capital Partners SBIC I, L.P., License No. 06/06-0335; Notice Seeking Exemption Under Section 312 of the Small Business Investment Act, Conflicts of Interest Notice is hereby given that Escalate Capital Partners, SBIC I, L.P., 300 W. 6th Street, Suite 2250...

76 FR 619 - Escalate Capital Partners SBIC I, L.P.; Notice Seeking Exemption Under Section 312 of the Small...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-05

... SMALL BUSINESS ADMINISTRATION [License No. 06/06-0335] Escalate Capital Partners SBIC I, L.P.; Notice Seeking Exemption Under Section 312 of the Small Business Investment Act, Conflicts of Interest Notice is hereby given that Escalate Capital Partners, SBIC I, L.P., 300 W. 6th Street, Suite 2250...

76 FR 68803 - Escalate Capital Partners SBIC I, L.P.; Notice Seeking Exemption Under Section 312 of the Small...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-07

... SMALL BUSINESS ADMINISTRATION [License No. 06/06-0335] Escalate Capital Partners SBIC I, L.P.; Notice Seeking Exemption Under Section 312 of the Small Business Investment Act, Conflicts of Interest Notice is hereby given that Escalate Capital Partners, SBIC I, L.P., 300 W. 6th Street, Suite 2250...

75 FR 45178 - Escalate Capital Partners SBIC I, L.P.; Notice Seeking Exemption Under Section 312 of the Small...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-02

... SMALL BUSINESS ADMINISTRATION Escalate Capital Partners SBIC I, L.P.; Notice Seeking Exemption Under Section 312 of the Small Business Investment Act, Conflicts of Interest Notice is hereby given that Escalate Capital Partners SBIC I, L.P., 300 W. 6th Street, Suite 2250, Austin, TX 78701, a Federal...

42 CFR 405.1106 - Where a request for review or escalation may be filed.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Where a request for review or escalation may be filed. 405.1106 Section 405.1106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... § 405.1016, the request for escalation must be filed with both the ALJ and the MAC. The appellant must...

42 CFR 405.1106 - Where a request for review or escalation may be filed.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Where a request for review or escalation may be filed. 405.1106 Section 405.1106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... § 405.1016, the request for escalation must be filed with both the ALJ and the MAC. The appellant must...

Determinants of escalating costs in low risk workers' compensation claims.

PubMed

Bernacki, Edward J; Yuspeh, Larry; Tao, Xuguang

2007-07-01

To identify and quantify attributes that lead to unanticipated cost escalation in workers' compensation claims. We constructed four claim categories: low initial reserve/low cost, migrated catastrophic (low initial reserve/high cost), high initial reserve/low cost, and catastrophic (high initial reserve/high cost). To assess the attributes associated with the increased cost of migrated catastrophic claims, we analyzed 36,329 Louisiana workers' compensation claims in the four categories over a 5-year period. In the 729 claims initially thought to be low-cost claims (migrated catastrophic), the most significant predictors for cost escalation were attorney involvement and claim duration, followed by low back disorder, married/single/divorced status, male gender, small company size, high premium, reporting delays, and older age. These injuries accounted for 2% of all claims but 32.3% of the costs. Accelerated escalation of costs occurred late in the claim cycle (2 years). Certain attributes, particularly attorney involvement and claim duration, are associated with unanticipated cost escalation in a small number of claims that drastically affect overall losses. The results of this study suggest that these cases may be identified and addressed before rapid escalation occurs.

Generalized Kapchinskij-Vladimirskij Distribution and Beam Matrix for Phase-Space Manipulations of High-Intensity Beams

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

Chung, Moses; Qin, Hong; Davidson, Ronald C.

In an uncoupled linear lattice system, the Kapchinskij-Vladimirskij (KV) distribution formulated on the basis of the single-particle Courant-Snyder invariants has served as a fundamental theoretical basis for the analyses of the equilibrium, stability, and transport properties of high-intensity beams for the past several decades. Recent applications of high-intensity beams, however, require beam phase-space manipulations by intentionally introducing strong coupling. Here in this Letter, we report the full generalization of the KV model by including all of the linear (both external and space-charge) coupling forces, beam energy variations, and arbitrary emittance partition, which all form essential elements for phase-space manipulations. Themore » new generalized KV model yields spatially uniform density profiles and corresponding linear self-field forces as desired. Finally, the corresponding matrix envelope equations and beam matrix for the generalized KV model provide important new theoretical tools for the detailed design and analysis of high-intensity beam manipulations, for which previous theoretical models are not easily applicable.« less

Generalized Kapchinskij-Vladimirskij Distribution and Beam Matrix for Phase-Space Manipulations of High-Intensity Beams

DOE PAGES

Chung, Moses; Qin, Hong; Davidson, Ronald C.; ...

2016-11-23

In an uncoupled linear lattice system, the Kapchinskij-Vladimirskij (KV) distribution formulated on the basis of the single-particle Courant-Snyder invariants has served as a fundamental theoretical basis for the analyses of the equilibrium, stability, and transport properties of high-intensity beams for the past several decades. Recent applications of high-intensity beams, however, require beam phase-space manipulations by intentionally introducing strong coupling. Here in this Letter, we report the full generalization of the KV model by including all of the linear (both external and space-charge) coupling forces, beam energy variations, and arbitrary emittance partition, which all form essential elements for phase-space manipulations. Themore » new generalized KV model yields spatially uniform density profiles and corresponding linear self-field forces as desired. Finally, the corresponding matrix envelope equations and beam matrix for the generalized KV model provide important new theoretical tools for the detailed design and analysis of high-intensity beam manipulations, for which previous theoretical models are not easily applicable.« less

Destined to die but not to wage war: how existential threat can contribute to escalation or de-escalation of violent intergroup conflict.

PubMed

Jonas, Eva; Fritsche, Immo

2013-10-01

War means threat to people's lives. Research derived from terror management theory (TMT) illustrates that the awareness of death leads people to defend cultural ingroups and their worldviews to attain a sense of symbolic immortality and thereby buffer existential anxiety. This can result in hostile effects of mortality salience (MS), such as derogation of outgroup members, prejudice, stereotyping, aggression, and racism, which, in turn, can lead to the escalation of violent intergroup conflict and, thus, the escalation of war. Yet, escalation of destructive conflict following MS is not automatic. Instead, research on TMT suggests that MS does not necessarily result in conflict and intolerance but can also foster positive tendencies, such as intergroup fairness or approval of pacifism, depending on how existential threat is perceived, whether the need for symbolic self-transcendence is satisfied, which social norms are salient, and how social situations are interpreted. In the present article, we review current TMT research with the aim of reconciling the seemingly contradictory findings of hostile and peaceful reactions to reminders of death. We present a terror management model of escalation and de-escalation of violent intergroup conflicts, which takes into account the interaction between threat salience and features of the social situation. We also discuss possible intervention strategies to override detrimental consequences of existential threat and argue that war is not the inevitable consequence of threat. PsycINFO Database Record (c) 2013 APA, all rights reserved

Continuous-wave dual-wavelength operation of a distributed feedback laser diode with an external cavity using a volume Bragg grating

NASA Astrophysics Data System (ADS)

Zheng, Yujin; Sekine, Takashi; Kurita, Takashi; Kato, Yoshinori; Kawashima, Toshiyuki

2018-03-01

We demonstrate continuous-wave dual-wavelength operation of a broad-area distributed feedback (DFB) laser diode with a single external-cavity configuration. This high-power DFB laser has a narrow bandwidth (<0.29 nm) and was used as a single-wavelength source. A volume Bragg grating was used as an output coupler for the external-cavity DFB laser to output another stable wavelength beam with a narrow bandwidth of 0.27 nm. A frequency difference for dual-wavelength operation of 0.88 THz was achieved and an output power of up to 415 mW was obtained. The external-cavity DFB laser showed a stable dual-wavelength operation over the practical current and temperature ranges.

Rigorous Model Reduction for a Damped-Forced Nonlinear Beam Model: An Infinite-Dimensional Analysis

NASA Astrophysics Data System (ADS)

Kogelbauer, Florian; Haller, George

2018-06-01

We use invariant manifold results on Banach spaces to conclude the existence of spectral submanifolds (SSMs) in a class of nonlinear, externally forced beam oscillations. SSMs are the smoothest nonlinear extensions of spectral subspaces of the linearized beam equation. Reduction in the governing PDE to SSMs provides an explicit low-dimensional model which captures the correct asymptotics of the full, infinite-dimensional dynamics. Our approach is general enough to admit extensions to other types of continuum vibrations. The model-reduction procedure we employ also gives guidelines for a mathematically self-consistent modeling of damping in PDEs describing structural vibrations.

Future directions for beam-foil spectroscopy

NASA Technical Reports Server (NTRS)

Bashkin, S.

1976-01-01

The beam-foil source has proved to be so useful for the study of atomic energy levels that it is almost trivial to propose a variety of new experiments involving new elements, higher energies, a broader wavelength range, shorter time intervals, pulsed beams, different targets, and new configurations in geometry or external fields. However, what is perhaps not so trivial is to propose experiments for which there is a specific purpose, experiments from which a novel kind of information might be expected. It is from this latter point of view that the author shall talk about experiments which seem to offer unusual opportunities to learn new things about atoms.

Focusing metasurface quantum-cascade laser with a near diffraction-limited beam

DOE PAGES

Xu, Luyao; Chen, Daguan; Itoh, Tatsuo; ...

2016-10-17

A terahertz vertical-external-cavity surface-emitting-laser (VECSEL) is demonstrated using an active focusing reflectarray metasurface based on quantum-cascade gain material. The focusing effect enables a hemispherical cavity with flat optics, which exhibits higher geometric stability than a plano-plano cavity and a directive and circular near-diffraction limited Gaussian beam with M 2 beam parameter as low as 1.3 and brightness of 1.86 × 10 6 Wsr –1m –2. As a result, this work initiates the potential of leveraging inhomogeneous metasurface and reflectarray designs to achieve high-power and high-brightness terahertz quantum-cascade VECSELs.

Phase II multi-institutional clinical trial on a new mixed beam RT scheme of IMRT on pelvis combined with a carbon ion boost for high-risk prostate cancer patients.

PubMed

Marvaso, Giulia; Jereczek-Fossa, Barbara A; Vischioni, Barbara; Ciardo, Delia; Giandini, Tommaso; Hasegawa, Azusa; Cattani, Federica; Carrara, Mauro; Ciocca, Mario; Bedini, Nice; Villa, Sergio; Morlino, Sara; Russo, Stefania; Zerini, Dario; Colangione, Sarah Pia; Panaino, Costanza Maria Vittoria; Fodor, Cristiana; Santoro, Luigi; Pignoli, Emanuele; Valvo, Francesca; Valdagni, Riccardo; De Cobelli, Ottavio; Orecchia, Roberto

2017-05-12

Definition of the optimal treatment schedule for high-risk prostate cancer is under debate. A combination of photon intensity modulated radiotherapy (IMRT) on pelvis with a carbon ion boost might be the optimal treatment scheme to escalate the dose on prostate and deliver curative dose with respect to normal tissue and quality of dose distributions. In fact, carbon ion beams offer the advantage to deliver hypofractionated radiotherapy (RT) using a significantly smaller number of fractions compared to conventional RT without increasing risks of late effects. This study is a prospective phase II clinical trial exploring safety and feasibility of a mixed beam scheme of carbon ion prostate boost followed by photon IMRT on pelvis. The study is designed to enroll 65 patients with localized high-risk prostate cancer at 3 different oncologic hospitals: Istituto Europeo di Oncologia, Fondazione IRCCS Istituto Nazionale dei Tumori, and Centro Nazionale di Adroterapia Oncologica. The primary endpoint is the evaluation of safety and feasibility with acute toxicity scored up to 1 month after the end of RT. Secondary endpoints are treatment early (3 months after the end of RT) and long-term tolerability, quality of life, and efficacy. The study is not yet recruiting; in silico studies are ongoing and we expect to start recruitment by 2017. The present clinical trial aims at improving the current treatment for high-risk prostate cancer, evaluating safety and feasibility of a new RT mixed-beam scheme including photons and carbon ions. Encouraging results are coming from carbon ion facilities worldwide on the treatment of different tumors including prostate cancers. Carbon ions combine physical properties allowing for high dose conformity and advantageous radiobiological characteristics. The proposed mixed beam treatment has the advantage to combine a photon high conformity standard of care IMRT phase with a hypofractionated carbon ion RT boost delivered in a short overall treatment time.

Slipping and tangential discontinuity instabilities in quasi-one-dimensional planar and cylindrical flows

NASA Astrophysics Data System (ADS)

Kuzelev, M. V.

2017-09-01

An analytical linear theory of instability of an electron beam with a nonuniform directional velocity (slipping instability) against perturbations with wavelengths exceeding the transverse beam size is offered. An analogy with hydrodynamic instabilities of tangential discontinuity of an incompressible liquid flow is drawn. The instability growth rates are calculated for particular cases and in a general form in planar and cylindrical geometries. The stabilizing effect of the external magnetic field is analyzed.

Recent Vertical External Cavity Surface Emitting Lasers (VECSELs) Developments for Sensor Applications (POSTPRINT)

DTIC Science & Technology

2013-02-01

edge-emitting strained InxGa1−xSb/AlyGa1−ySb quantum well struc- tures using solid-source molecular beam epitaxy (MBE) with varying barrier heights...intersubband quantum wells. The most common high-power edge-emitting semiconductor lasers suffter from poor beam quality, due primarily to the linewidth...reduces the power scalability of semiconductor lasers. In vertical cavity surface emitting lasers ( VCSELs ), light propagates parallel to the growth

Mechanical Behavior of Steel Fiber-Reinforced Concrete Beams Bonded with External Carbon Fiber Sheets

PubMed Central

Gribniak, Viktor; Tamulenas, Vytautas; Ng, Pui-Lam; Arnautov, Aleksandr K.; Gudonis, Eugenijus; Misiunaite, Ieva

2017-01-01

This study investigates the mechanical behavior of steel fiber-reinforced concrete (SFRC) beams internally reinforced with steel bars and externally bonded with carbon fiber-reinforced polymer (CFRP) sheets fixed by adhesive and hybrid jointing techniques. In particular, attention is paid to the load resistance and failure modes of composite beams. The steel fibers were used to avoiding the rip-off failure of the concrete cover. The CFRP sheets were fixed to the concrete surface by epoxy adhesive as well as combined with various configurations of small-diameter steel pins for mechanical fastening to form a hybrid connection. Such hybrid jointing techniques were found to be particularly advantageous in avoiding brittle debonding failure, by promoting progressive failure within the hybrid joints. The use of CFRP sheets was also effective in suppressing the localization of the discrete cracks. The development of the crack pattern was monitored using the digital image correlation method. As revealed from the image analyses, with an appropriate layout of the steel pins, brittle failure of the concrete-carbon fiber interface could be effectively prevented. Inverse analysis of the moment-curvature diagrams was conducted, and it was found that a simplified tension-stiffening model with a constant residual stress level at 90% of the strength of the SFRC is adequate for numerically simulating the deformation behavior of beams up to the debonding of the CFRP sheets. PMID:28773024

Using neutral beams as a light ion beam probe (invited)

DOE PAGES

Chen, Xi; Heidbrink, William W.; Van Zeeland, Michael A.; ...

2014-08-05

By arranging the particle first banana orbits to pass near a distant detector, the light ion beam probe (LIBP) utilizes orbital deflection to probe internal fields and field fluctuations. The LIBP technique takes advantage of 1) the in situ, known source of fast ions created by beam-injected neutral particles that naturally ionize near the plasma edge, and 2) various commonly available diagnostics as its detector. These born trapped particles can traverse the plasma core on their inner banana leg before returning to the plasma edge. Orbital displacements (the forces on fast ions) caused by internal instabilities or edge perturbing fieldsmore » appear as modulated signal at an edge detector. Adjustments in the q-profile and plasma shape that determine the first orbit, as well as the relative position of the source and detector, enable studies under a wide variety of plasma conditions. This diagnostic technique can be used to probe the impact on fast ions of various instabilities, e.g. Alfvén eigenmodes (AEs) and neoclassical tearing modes, and of externally-imposed 3D fields, e.g. magnetic perturbations. To date, displacements by AEs and by externally applied resonant magnetic perturbation fields have been measured using a fast ion loss detector. Comparisons with simulations are shown. Additionally, nonlinear interactions between fast ions and independent AE waves are revealed by this technique.« less

Using neutral beams as a light ion beam probe (invited)

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

Chen, Xi, E-mail: chenxi@fusion.gat.com; Heidbrink, W. W.; Van Zeeland, M. A.

By arranging the particle first banana orbits to pass near a distant detector, the light ion beam probe (LIBP) utilizes orbital deflection to probe internal fields and field fluctuations. The LIBP technique takes advantage of (1) the in situ, known source of fast ions created by beam-injected neutral particles that naturally ionize near the plasma edge and (2) various commonly available diagnostics as its detector. These born trapped particles can traverse the plasma core on their inner banana leg before returning to the plasma edge. Orbital displacements (the forces on fast ions) caused by internal instabilities or edge perturbing fieldsmore » appear as modulated signal at an edge detector. Adjustments in the q-profile and plasma shape that determine the first orbit, as well as the relative position of the source and detector, enable studies under a wide variety of plasma conditions. This diagnostic technique can be used to probe the impact on fast ions of various instabilities, e.g., Alfvén eigenmodes (AEs) and neoclassical tearing modes, and of externally imposed 3D fields, e.g., magnetic perturbations. To date, displacements by AEs and by externally applied resonant magnetic perturbation fields have been measured using a fast ion loss detector. Comparisons with simulations are shown. In addition, nonlinear interactions between fast ions and independent AE waves are revealed by this technique.« less

Using neutral beams as a light ion beam probe (invited)

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

Chen, Xi; Heidbrink, William W.; Van Zeeland, Michael A.

By arranging the particle first banana orbits to pass near a distant detector, the light ion beam probe (LIBP) utilizes orbital deflection to probe internal fields and field fluctuations. The LIBP technique takes advantage of 1) the in situ, known source of fast ions created by beam-injected neutral particles that naturally ionize near the plasma edge, and 2) various commonly available diagnostics as its detector. These born trapped particles can traverse the plasma core on their inner banana leg before returning to the plasma edge. Orbital displacements (the forces on fast ions) caused by internal instabilities or edge perturbing fieldsmore » appear as modulated signal at an edge detector. Adjustments in the q-profile and plasma shape that determine the first orbit, as well as the relative position of the source and detector, enable studies under a wide variety of plasma conditions. This diagnostic technique can be used to probe the impact on fast ions of various instabilities, e.g. Alfvén eigenmodes (AEs) and neoclassical tearing modes, and of externally-imposed 3D fields, e.g. magnetic perturbations. To date, displacements by AEs and by externally applied resonant magnetic perturbation fields have been measured using a fast ion loss detector. Comparisons with simulations are shown. Additionally, nonlinear interactions between fast ions and independent AE waves are revealed by this technique.« less

Mechanical Behavior of Steel Fiber-Reinforced Concrete Beams Bonded with External Carbon Fiber Sheets.

PubMed

Gribniak, Viktor; Tamulenas, Vytautas; Ng, Pui-Lam; Arnautov, Aleksandr K; Gudonis, Eugenijus; Misiunaite, Ieva

2017-06-17

This study investigates the mechanical behavior of steel fiber-reinforced concrete (SFRC) beams internally reinforced with steel bars and externally bonded with carbon fiber-reinforced polymer (CFRP) sheets fixed by adhesive and hybrid jointing techniques. In particular, attention is paid to the load resistance and failure modes of composite beams. The steel fibers were used to avoiding the rip-off failure of the concrete cover. The CFRP sheets were fixed to the concrete surface by epoxy adhesive as well as combined with various configurations of small-diameter steel pins for mechanical fastening to form a hybrid connection. Such hybrid jointing techniques were found to be particularly advantageous in avoiding brittle debonding failure, by promoting progressive failure within the hybrid joints. The use of CFRP sheets was also effective in suppressing the localization of the discrete cracks. The development of the crack pattern was monitored using the digital image correlation method. As revealed from the image analyses, with an appropriate layout of the steel pins, brittle failure of the concrete-carbon fiber interface could be effectively prevented. Inverse analysis of the moment-curvature diagrams was conducted, and it was found that a simplified tension-stiffening model with a constant residual stress level at 90% of the strength of the SFRC is adequate for numerically simulating the deformation behavior of beams up to the debonding of the CFRP sheets.

Strengthening of defected beam-column joints using CFRP.

PubMed

Mahmoud, Mohamed H; Afefy, Hamdy M; Kassem, Nesreen M; Fawzy, Tarek M

2014-01-01

This paper presents an experimental study for the structural performance of reinforced concrete (RC) exterior beam-column joints rehabilitated using carbon-fiber-reinforced polymer (CFRP). The present experimental program consists of testing 10 half-scale specimens divided into three groups covering three possible defects in addition to an adequately detailed control specimen. The considered defects include the absence of the transverse reinforcement within the joint core, insufficient bond length for the beam main reinforcement and inadequate spliced implanted column on the joint. Three different strengthening schemes were used to rehabilitate the defected beam-column joints including externally bonded CFRP strips and sheets in addition to near surface mounted (NSM) CFRP strips. The failure criteria including ultimate capacity, mode of failure, initial stiffness, ductility and the developed ultimate strain in the reinforcing steel and CFRP were considered and compared for each group for the control and the CFRP-strengthened specimens. The test results showed that the proposed CFRP strengthening configurations represented the best choice for strengthening the first two defects from the viewpoint of the studied failure criteria. On the other hand, the results of the third group showed that strengthening the joint using NSM strip technique enabled the specimen to outperform the structural performance of the control specimen while strengthening the joints using externally bonded CFRP strips and sheets failed to restore the strengthened joints capacity.

Optical speedup at transparency of the gain recovery in semiconductor optical amplifiers

NASA Astrophysics Data System (ADS)

Hessler, T. P.; Dupertuis, M.-A.; Deveaud, B.; Emery, J.-Y.; Dagens, B.

2002-10-01

Experimental demonstration of optical speedup at transparency (OSAT) has been performed on a 1 mm long semiconductor optical amplifiers (SOA). OSAT is a recently proposed scheme that decreases the recovery time of an SOA while maintaining the available gain. It is achieved by externally injecting into the SOA the beam of a separate high power laser at energies around the transparency point. Even though the experimental conditions were not optimal, a beam of 100 mW decreases the recovery time by a third when it is injected in the vicinity of the material transparency point of the device. This acceleration of the device response without detrimental reduction of the gain is found to be effective over a broad wavelength window of about 20 nm around transparency. The injection of the accelerating beam into the gain region is a less efficient solution not only because the gain is then strongly diminished but also because speeding is reduced. This originates from the reduction of the amplified spontaneous emission power in the device, which counterbalances the speeding capabilities of the external laser beam. Another advantage of the OSAT scheme is realized in relatively long SOAs, which suffer from gain overshoot under strong current injection. Simulations show that OSAT decreases the gain overshoot, which should enable us to use OSAT to further speedup the response of long SOAs.

Double-Referential Holography and Spatial Quadrature Amplitude Modulation

NASA Astrophysics Data System (ADS)

Zukeran, Keisuke; Okamoto, Atsushi; Takabayashi, Masanori; Shibukawa, Atsushi; Sato, Kunihiro; Tomita, Akihisa

2013-09-01

We proposed a double-referential holography (DRH) that allows phase-detection without external additional beams. In the DRH, phantom beams, prepared in the same optical path as signal beams and preliminary multiplexed in a recording medium along with the signal, are used to produce interference fringes on an imager for converting a phase into an intensity distribution. The DRH enables stable and high-accuracy phase detection independent of the fluctuations and vibrations of the optical system owing to medium shift and temperature variation. Besides, the collinear arrangement of the signal and phantom beams leads to the compactness of the optical data storage system. We conducted an experiment using binary phase modulation signals for verifying the DRH operation. In addition, 38-level spatial quadrature amplitude modulation signals were successfully reproduced with the DRH by numerical simulation. Furthermore, we verified that the distributed phase-shifting method moderates the dynamic range consumption for the exposure of phantom beams.

Photonic Crystal Microchip Laser

NASA Astrophysics Data System (ADS)

Gailevicius, Darius; Koliadenko, Volodymyr; Purlys, Vytautas; Peckus, Martynas; Taranenko, Victor; Staliunas, Kestutis

2016-09-01

The microchip lasers, being very compact and efficient sources of coherent light, suffer from one serious drawback: low spatial quality of the beam strongly reducing the brightness of emitted radiation. Attempts to improve the beam quality, such as pump-beam guiding, external feedback, either strongly reduce the emission power, or drastically increase the size and complexity of the lasers. Here it is proposed that specially designed photonic crystal in the cavity of a microchip laser, can significantly improve the beam quality. Experiments show that a microchip laser, due to spatial filtering functionality of intracavity photonic crystal, improves the beam quality factor M2 reducing it by a factor of 2, and increase the brightness of radiation by a factor of 3. This comprises a new kind of laser, the “photonic crystal microchip laser”, a very compact and efficient light source emitting high spatial quality high brightness radiation.

Photonic Crystal Microchip Laser

PubMed Central

Gailevicius, Darius; Koliadenko, Volodymyr; Purlys, Vytautas; Peckus, Martynas; Taranenko, Victor; Staliunas, Kestutis

2016-01-01

The microchip lasers, being very compact and efficient sources of coherent light, suffer from one serious drawback: low spatial quality of the beam strongly reducing the brightness of emitted radiation. Attempts to improve the beam quality, such as pump-beam guiding, external feedback, either strongly reduce the emission power, or drastically increase the size and complexity of the lasers. Here it is proposed that specially designed photonic crystal in the cavity of a microchip laser, can significantly improve the beam quality. Experiments show that a microchip laser, due to spatial filtering functionality of intracavity photonic crystal, improves the beam quality factor M2 reducing it by a factor of 2, and increase the brightness of radiation by a factor of 3. This comprises a new kind of laser, the “photonic crystal microchip laser”, a very compact and efficient light source emitting high spatial quality high brightness radiation. PMID:27683066

Two-dimensiosnal electron beam charging model for polymer films. M.S. Thesis; [spacecraft charging, geosynchronous satellites

NASA Technical Reports Server (NTRS)

Reeves, R. D.; Balmain, K. G.

1981-01-01

A two dimensional model was developed to describe the charging of thin polymer films exposed to a uniform mon-energetic electron beam. The study was motivated by observed anomalous behavior of geosynchronous satellites which was attributed to electrical discharges associated with the differential charging of satellite surfaces of magnetospheric electrons. Electric fields both internal and external to the irradiated specimen were calculated at steady state in order to identify regions of high electrical stress. Particular emphasis was placed on evaluating the charging characteristics near the material's edge. The model was used to identify and quantify the effects of some of the experimental parameters notably: beam energy; beam angle of incidence; beam current density; material thickness; and material width. Simulations of the following situations were also conducted: positive or negative precharging over part of the surface; a central gap in the material; and a discontinuity in the material's thickness.

The future of image-guided radiotherapy will be MR guided

PubMed Central

Wen, Zhifei; Sadagopan, Ramaswamy; Wang, Jihong; Ibbott, Geoffrey S

2017-01-01

Advances in image-guided radiotherapy (RT) have allowed for dose escalation and more precise radiation treatment delivery. Each decade brings new imaging technologies to help improve RT patient setup. Currently, the most frequently used method of three-dimensional pre-treatment image verification is performed with cone beam CT. However, more recent developments have provided RT with the ability to have on-board MRI coupled to the teleradiotherapy unit. This latest tool for treating cancer is known as MR-guided RT. Several varieties of these units have been designed and installed in centres across the globe. Their prevalence, history, advantages and disadvantages are discussed in this review article. In preparation for the next generation of image-guided RT, this review also covers where MR-guided RT might be heading in the near future. PMID:28256898

Temporally separating Cherenkov radiation in a scintillator probe exposed to a pulsed X-ray beam.

PubMed

Archer, James; Madden, Levi; Li, Enbang; Carolan, Martin; Petasecca, Marco; Metcalfe, Peter; Rosenfeld, Anatoly

2017-10-01

Cherenkov radiation is generated in optical systems exposed to ionising radiation. In water or plastic devices, if the incident radiation has components with high enough energy (for example, electrons or positrons with energy greater than 175keV), Cherenkov radiation will be generated. A scintillator dosimeter that collects optical light, guided by optical fibre, will have Cherenkov radiation generated throughout the length of fibre exposed to the radiation field and compromise the signal. We present a novel algorithm to separate Cherenkov radiation signal that requires only a single probe, provided the radiation source is pulsed, such as a linear accelerator in external beam radiation therapy. We use a slow scintillator (BC-444) that, in a constant beam of radiation, reaches peak light output after 1 microsecond, while the Cherenkov signal is detected nearly instantly. This allows our algorithm to separate the scintillator signal from the Cherenkov signal. The relative beam profile and depth dose of a linear accelerator 6MV X-ray field were reconstructed using the algorithm. The optimisation method improved the fit to the ionisation chamber data and improved the reliability of the measurements. The algorithm was able to remove 74% of the Cherenkov light, at the expense of only 1.5% scintillation light. Further characterisation of the Cherenkov radiation signal has the potential to improve the results and allow this method to be used as a simpler optical fibre dosimeter for quality assurance in external beam therapy. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Non-perturbative measurement of low-intensity charged particle beams

NASA Astrophysics Data System (ADS)

Fernandes, M.; Geithner, R.; Golm, J.; Neubert, R.; Schwickert, M.; Stöhlker, T.; Tan, J.; Welsch, C. P.

2017-01-01

Non-perturbative measurements of low-intensity charged particle beams are particularly challenging to beam diagnostics due to the low amplitude of the induced electromagnetic fields. In the low-energy antiproton decelerator (AD) and the future extra low energy antiproton rings at CERN, an absolute measurement of the beam intensity is essential to monitor the operation efficiency. Superconducting quantum interference device (SQUID) based cryogenic current comparators (CCC) have been used for measuring slow charged beams in the nA range, showing a very good current resolution. But these were unable to measure fast bunched beams, due to the slew-rate limitation of SQUID devices and presented a strong susceptibility to external perturbations. Here, we present a CCC system developed for the AD machine, which was optimised in terms of its current resolution, system stability, ability to cope with short bunched beams, and immunity to mechanical vibrations. This paper presents the monitor design and the first results from measurements with a low energy antiproton beam obtained in the AD in 2015. These are the first CCC beam current measurements ever performed in a synchrotron machine with both coasting and short bunched beams. It is shown that the system is able to stably measure the AD beam throughout the entire cycle, with a current resolution of 30 {nA}.

Development of Safety Analysis Code System of Beam Transport and Core for Accelerator Driven System

NASA Astrophysics Data System (ADS)

Aizawa, Naoto; Iwasaki, Tomohiko

2014-06-01

Safety analysis code system of beam transport and core for accelerator driven system (ADS) is developed for the analyses of beam transients such as the change of the shape and position of incident beam. The code system consists of the beam transport analysis part and the core analysis part. TRACE 3-D is employed in the beam transport analysis part, and the shape and incident position of beam at the target are calculated. In the core analysis part, the neutronics, thermo-hydraulics and cladding failure analyses are performed by the use of ADS dynamic calculation code ADSE on the basis of the external source database calculated by PHITS and the cross section database calculated by SRAC, and the programs of the cladding failure analysis for thermoelastic and creep. By the use of the code system, beam transient analyses are performed for the ADS proposed by Japan Atomic Energy Agency. As a result, the rapid increase of the cladding temperature happens and the plastic deformation is caused in several seconds. In addition, the cladding is evaluated to be failed by creep within a hundred seconds. These results have shown that the beam transients have caused a cladding failure.

Beam optical design of in-flight fragment separator for high-power heavy ion beam

NASA Astrophysics Data System (ADS)

Yun, C. C.; Kim, Mi-Jung; Kim, D. G.; Song, J. S.; Kim, Myeong-Jin; Kim, J. W.; Kim, J. R.; Wan, W.

2013-12-01

An in-flight fragment separator has been designed for the rare isotope science project (RISP) in Korea. A beam used for the design is 238U in the energy of 200 MeV/u with the maximum beam power of 400 kW. The use of high-power beam requires careful removal of the primary beam by pre-separator, for which its configuration was revised to employ four dipole magnets instead of two. Different configurations of the separator have been tested in search of optimal design in non-linear optics, which was complicated by the space needed for the target, beam dump and radiation shielding. Non-linear optical calculations have been carried out using GICOSY and COSY Infinity including the fringe fields of large-aperture quadrupole magnets. Correction of non-linear terms is made with multipole coils located inside the superconducting quadrupole magnets and by external multipole magnets. Beam simulations using LISE++ and MOCADI have been performed to consider the effects of multiple charge states of the primary and isotope beams produced at the target. Layout of the separator is being finalized, and detailed optics simulation will continue to refine its design.

Reply to: Mounting evidence indicates that escalating doses of allopurinol are unnecessary for cardiovascular protection.

PubMed

Coburn, Brian W; Michaud, Kaleb; Bergman, Debra A; Mikuls, Ted R

2018-05-08

We thank Dr. Bredemeier for his comments regarding our manuscript on allopurinol dose escalation and mortality. He raises important evidence to consider in support of an interesting hypothesis that dose escalation may be unnecessary for allopurinol's cardiovascular (CV) protection and may actually be related to adverse CV outcomes. While we agree that evidence exists suggesting that low doses of allopurinol may be sufficient for CV protection, we believe that the studies cited highlight a number of areas where knowledge gaps remain which preclude any definitive conclusions about the effect of dose escalation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Escalation: How Much is Enough?

NASA Technical Reports Server (NTRS)

Butts, Glenn

2007-01-01

Determining the escalation percentage to an estimate is often the subject of fierce debate. Cost increases are determined by dynamic relati onships between many factors, including acts of nature, interest rate s, oil prices, global commodity markets, wars, wage rates, and the ov erall health of the economy, as well as supply and demand for the required goods or services. How much escalation is enough? Are the recen t price increases temporary aberrations, or will they continue to pla gue us? This paper examines historical escalation rates, as well as i ndications of trends. Various analysis methods -- Monte Carlo simulations, neural networks, trend impact analysis, and the Delphi method -- are examined in an attempt to determine future trends.

Terahertz beam propagation measured through three-dimensional amplitude profile determination

NASA Astrophysics Data System (ADS)

Reiten, Matthew T.; Harmon, Stacee A.; Cheville, Richard Alan

2003-10-01

To determine the spatio-temporal field distribution of freely propagating terahertz bandwidth pulses, we measure the time-resolved electric field in two spatial dimensions with high resolution. The measured, phase-coherent electric-field distributions are compared with an analytic model in which the radiation from a dipole antenna near a dielectric interface is coupled to free space through a spherical lens. The field external to the lens is limited by reflection at the lens-air dielectric interface, which is minimized at Brewster's angle, leading to an annular field pattern. Field measurements compare favorably with theory. Propagation of terahertz beams is determined both by assuming a TEM0,0 Gaussian profile as well as expanding the beam into a superposition of Laguerre-Gauss modes. The Laguerre-Gauss model more accurately describes the beam profile for free-space propagation and after propagating through a simple optical system. The accuracy of both models for predicting far-field beam patterns depend upon accurately measuring complex field amplitudes of terahertz beams.

AMBER: a PIC slice code for DARHT

NASA Astrophysics Data System (ADS)

Vay, Jean-Luc; Fawley, William

1999-11-01

The accelerator for the second axis of the Dual Axis Radiographic Hydrodynamic Test (DARHT) facility will produce a 4-kA, 20-MeV, 2-μ s output electron beam with a design goal of less than 1000 π mm-mrad normalized transverse emittance and less than 0.5-mm beam centroid motion. In order to study the beam dynamics throughout the accelerator, we have developed a slice Particle-In-Cell code named AMBER, in which the beam is modeled as a time-steady flow, subject to self, as well as external, electrostatic and magnetostatic fields. The code follows the evolution of a slice of the beam as it propagates through the DARHT accelerator lattice, modeled as an assembly of pipes, solenoids and gaps. In particular, we have paid careful attention to non-paraxial phenomena that can contribute to nonlinear forces and possible emittance growth. We will present the model and the numerical techniques implemented, as well as some test cases and some preliminary results obtained when studying emittance growth during the beam propagation.

Application-Oriented Chemical Optimization of a Metakaolin Based Geopolymer.

PubMed

Ferone, Claudio; Colangelo, Francesco; Roviello, Giuseppina; Asprone, Domenico; Menna, Costantino; Balsamo, Alberto; Prota, Andrea; Cioffi, Raffaele; Manfredi, Gaetano

2013-05-10

In this study the development of a metakaolin based geopolymeric mortar to be used as bonding matrix for external strengthening of reinforced concrete beams is reported. Four geopolymer formulations have been obtained by varying the composition of the activating solution in terms of SiO₂/Na₂O ratio. The obtained samples have been characterized from a structural, microstructural and mechanical point of view. The differences in structure and microstructure have been correlated to the mechanical properties. A major issue of drying shrinkage has been encountered in the high Si/Al ratio samples. In the light of the characterization results, the optimal geopolymer composition was then applied to fasten steel fibers to reinforced concrete beams. The mechanical behavior of the strengthened reinforced beams was evaluated by four-points bending tests, which were performed also on reinforced concrete beams as they are for comparison. The preliminary results of the bending tests point out an excellent behavior of the geopolymeric mixture tested, with the failure load of the reinforced beams roughly twice that of the control beam.

Regrouping of the beam in the IHEP PS for the UNK p-p programs

NASA Astrophysics Data System (ADS)

Myae, E. A.; Nelipovich, E. S.; Pashkov, P. T.; Smirnov, A. V.

Possibilities to form particle bunches in the IHEP machine whose longitudinal parameters would satisfy the requirements imposed by the UNK p-p programs are analyzed. In the case of the 3 x 3 TeV p-p program the accelerated proton beam in the IHEP PS after preliminary quasiadiabatic debunching process will be recaptured into a stable oscillating mode at 33.3 MHz. The peculiarities of the RF system designed for these purposes with an account of strong beam loading are discussed. For the 0.4 x 3 TeV UNK colliding beam regime, it is necessary to compress the accelerated proton bunches in the IHEP PS so that their length will be 4 times less. The main difficulties arising during 'RF gymnastics' which is used for beam compressing, are caused by nonlinearities of the external accelerating field and also the fields induced in the RF cavities by the beam. The compensation of such effects with the help of the special RF system is discussed.

Calculation of external-internal flow fields for mixed-compression inlets

NASA Technical Reports Server (NTRS)

Chyu, W. J.; Kawamura, T.; Bencze, D. P.

1986-01-01

Supersonic inlet flows with mixed external-internal compressions were computed using a combined implicit-explicit (Beam-Warming-Steger/MacCormack) method for solving the three-dimensional unsteady, compressible Navier-Stokes equations in conservation form. Numerical calculations were made of various flows related to such inlet operations as the shock-wave intersections, subsonic spillage around the cowl lip, and inlet started versus unstarted conditions. Some of the computed results were compared with wind tunnel data.

Calculation of external-internal flow fields for mixed-compression inlets

NASA Technical Reports Server (NTRS)

Chyu, W. J.; Kawamura, T.; Bencze, D. P.

1987-01-01

Supersonic inlet flows with mixed external-internal compressions were computed using a combined implicit-explicit (Beam-Warming-Steger/MacCormack) method for solving the three-dimensional unsteady, compressible Navier-Stokes equations in conservation form. Numerical calculations were made of various flows related to such inlet operations as the shock-wave intersections, subsonic spillage around the cowl lip, and inlet started versus unstarted conditions. Some of the computed results were compared with wind tunnel data.

Study of low energy neutron beam formation based on GEANT4 simulations

NASA Astrophysics Data System (ADS)

Avagyan, R.; Avetisyan, R.; Ivanyan, V.; Kerobyan, I.

2017-07-01

The possibility of obtaining thermal/epithermal energy neutron beams using external protons from cyclotron C18/18 is studied based on GEANT4 simulations. This study will be the basis of the Beam Shaped Assembly (BSA) development for future Boron Neutron Capture Therapy (BNCT). Proton induced reactions on 9Be target are considered as a neutron source, and dependence of neutron yield on target thickness is investigated. The problem of reducing the ratio of gamma to neutron yields by inserting a lead sheet after the beryllium target is studied as well. By GEANT4 modeling the optimal thicknesses of 9Be target and lead absorber are determined and the design characteristics of beam shaping assembly, including the materials and thicknesses of reflector and moderator are considered.

Observation of acoustic valley vortex states and valley-chirality locked beam splitting

NASA Astrophysics Data System (ADS)

Ye, Liping; Qiu, Chunyin; Lu, Jiuyang; Wen, Xinhua; Shen, Yuanyuan; Ke, Manzhu; Zhang, Fan; Liu, Zhengyou

2017-05-01

We report an experimental observation of the classical version of valley polarized states in a two-dimensional hexagonal sonic crystal. The acoustic valley states, which carry specific linear momenta and orbital angular momenta, were selectively excited by external Gaussian beams and conveniently confirmed by the pressure distribution outside the crystal, according to the criterion of momentum conservation. The vortex nature of such intriguing bulk crystal states was directly characterized by scanning the phase profile inside the crystal. In addition, we observed a peculiar beam-splitting phenomenon, in which the separated beams are constructed by different valleys and locked to the opposite vortex chirality. The exceptional sound transport, encoded with valley-chirality locked information, may serve as the basis of designing conceptually interesting acoustic devices with unconventional functions.

Validation and testing of the Acceptability E-scale for Web-based patient-reported outcomes in cancer care

PubMed Central

Tariman, Joseph D.; Berry, Donna L.; Halpenny, Barbara; Wolpin, Seth; Schepp, Karen

2010-01-01

The performance of the Acceptability E-scale was tested in a sample of 627 adult and older adult patients from various oncology clinics who completed an electronic symptoms survey. The revised Acceptability E-scale has strong psychometric properties and can be useful in assessing the acceptability and usability of computerized health-related programs in oncology and other health population. PMID:20974066

Subthreshold depressive disorder in adolescents: predictors of escalation to full-syndrome depressive disorders.

PubMed

Klein, Daniel N; Shankman, Stewart A; Lewinsohn, Peter M; Seeley, John R

2009-07-01

Subthreshold depressive disorder is one of the best established risk factors for the onset of full-syndrome depressive disorders. However, many youths with subthreshold depressive disorder do not develop full-syndrome depression. We examined predictors of escalation to full-syndrome depressive disorders in a community sample of 225 adolescents with subthreshold depressive disorder. Criteria for subthreshold depressive disorder were an episode of depressed mood or loss of interest or pleasure lasting at least 1 week and at least two of the seven other DSM-IV-associated symptoms for major depression. Participants were assessed four times from mid-adolescence to age 30 years using semistructured diagnostic interviews. The estimated risk for escalation to full-syndrome depressive disorders was 67%. Five variables accounted for unique variance in predicting escalation: severity of depressive symptoms, medical conditions/symptoms, history of suicidal ideation, history of anxiety disorder, and familial loading for depression. Adolescents with three or more risk factors had an estimated 90% chance of escalating to full-syndrome depressive disorder, compared with 47% of adolescents with fewer than three risk factors. These data may be useful in identifying a subgroup of youths with subthreshold depressive disorder who are at especially high risk for escalating to full-syndrome depressive disorders.

Subthreshold Depressive Disorder in Adolescents: Predictors of Escalation to Full-Syndrome Depressive Disorders

PubMed Central

KLEIN, DANIEL N.; SHANKMAN, STEWART A.; LEWINSOHN, PETER M.; SEELEY, JOHN R.

2010-01-01

Objectives Subthreshold depressive disorder is one of the best established risk factors for the onset of full-syndrome depressive disorders. However, many youths with subthreshold depressive disorder do not develop full-syndrome depression. We examined predictors of escalation to full-syndrome depressive disorders in a community sample of 225 adolescents with subthreshold depressive disorder. Method Criteria for subthreshold depressive disorder were an episode of depressed mood or loss of interest or pleasure lasting at least 1 week and at least two of the seven other DSM-IV-associated symptoms for major depression. Participants were assessed four times from mid-adolescence to age 30 years using semistructured diagnostic interviews. Results The estimated risk for escalation to full-syndrome depressive disorders was 67%. Five variables accounted for unique variance in predicting escalation: severity of depressive symptoms, medical conditions/symptoms, history of suicidal ideation, history of anxiety disorder, and familial loading for depression. Adolescents with three or more risk factors had an estimated 90% chance of escalating to full-syndrome depressive disorder, compared with 47% of adolescents with fewer than three risk factors. Conclusions These data may be useful in identifying a subgroup of youths with subthreshold depressive disorder who are at especially high risk for escalating to full-syndrome depressive disorders. PMID:19465876

Conflict escalation in paediatric services: findings from a qualitative study

PubMed Central

Forbat, Liz; Teuten, Bea; Barclay, Sarah

2015-01-01

Objective To explore clinician and family experiences of conflict in paediatric services, in order to map the trajectory of conflict escalation. Design Qualitative interview study, employing extreme-case sampling. Interviews were analysed using an iterative thematic approach to identify common themes regarding the experience and escalation of conflict. Participants Thirty-eight health professionals and eight parents. All participants had direct experience of conflict, including physical assault and court proceedings, at the interface of acute and palliative care. Setting Two teaching hospitals, one district general hospital and two paediatric hospices in England, in 2011. Results Conflicts escalate in a predictable manner. Clearly identifiable behaviours by both clinicians and parents are defined as mild, moderate and severe. Mild describes features like the insensitive use of language and a history of unresolved conflict. Moderate involves a deterioration of trust, and a breakdown of communication and relationships. Severe marks disintegration of working relationships, characterised by behavioural changes including aggression, and a shift in focus from the child's best interests to the conflict itself. Though conflicts may remain at one level, those which escalated tended to move sequentially from one level to the next. Conclusions Understanding how conflicts escalate provides clinicians with a practical, evidence-based framework to identify the warning signs of conflict in paediatrics. PMID:25940425

Towards fluoroscopic respiratory gating for lung tumours without radiopaque markers

NASA Astrophysics Data System (ADS)

Berbeco, Ross I.; Mostafavi, Hassan; Sharp, Gregory C.; Jiang, Steve B.

2005-10-01

Due to the risk of pneumothorax, many clinicians are reluctant to implant radiopaque markers within patients' lungs for the purpose of radiographic or fluoroscopic tumour localization. We propose a method of gated therapy using fluoroscopic information without the implantation of radiopaque markers. The method presented here does not rely on any external motion signal either. Breathing phase information is found by analysing the fluoroscopic intensity fluctuations in the lung. As the lungs fill/empty, the radiological pathlength through them shortens/lengthens, giving brighter/darker fluoroscopic intensities. The phase information is combined with motion-enhanced template matching to turn the beam on when the tumour is in the desired location. A study based on patient data is presented to demonstrate the feasibility of this procedure. The resulting beam-on pattern is similar to that produced by an external gating system. The only discrepancies occur briefly and at the gate edges.

Secondary emission electron gun using external primaries

DOEpatents

Srinivasan-Rao, Triveni [Shoreham, NY; Ben-Zvi, Ilan [Setauket, NY

2009-10-13

An electron gun for generating an electron beam is provided, which includes a secondary emitter. The secondary emitter includes a non-contaminating negative-electron-affinity (NEA) material and emitting surface. The gun includes an accelerating region which accelerates the secondaries from the emitting surface. The secondaries are emitted in response to a primary beam generated external to the accelerating region. The accelerating region may include a superconducting radio frequency (RF) cavity, and the gun may be operated in a continuous wave (CW) mode. The secondary emitter includes hydrogenated diamond. A uniform electrically conductive layer is superposed on the emitter to replenish the extracted current, preventing charging of the emitter. An encapsulated secondary emission enhanced cathode device, useful in a superconducting RF cavity, includes a housing for maintaining vacuum, a cathode, e.g., a photocathode, and the non-contaminating NEA secondary emitter with the uniform electrically conductive layer superposed thereon.

Secondary emission electron gun using external primaries

DOEpatents

Srinivasan-Rao, Triveni [Shoreham, NY; Ben-Zvi, Ilan [Setauket, NY; Kewisch, Jorg [Wading River, NY; Chang, Xiangyun [Middle Island, NY

2007-06-05

An electron gun for generating an electron beam is provided, which includes a secondary emitter. The secondary emitter includes a non-contaminating negative-electron-affinity (NEA) material and emitting surface. The gun includes an accelerating region which accelerates the secondaries from the emitting surface. The secondaries are emitted in response to a primary beam generated external to the accelerating region. The accelerating region may include a superconducting radio frequency (RF) cavity, and the gun may be operated in a continuous wave (CW) mode. The secondary emitter includes hydrogenated diamond. A uniform electrically conductive layer is superposed on the emitter to replenish the extracted current, preventing charging of the emitter. An encapsulated secondary emission enhanced cathode device, useful in a superconducting RF cavity, includes a housing for maintaining vacuum, a cathode, e.g., a photocathode, and the non-contaminating NEA secondary emitter with the uniform electrically conductive layer superposed thereon.

Study of an External Neutron Source for an Accelerator-Driven System using the PHITS Code

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

Sugawara, Takanori; Iwasaki, Tomohiko; Chiba, Takashi

A code system for the Accelerator Driven System (ADS) has been under development for analyzing dynamic behaviors of a subcritical core coupled with an accelerator. This code system named DSE (Dynamics calculation code system for a Subcritical system with an External neutron source) consists of an accelerator part and a reactor part. The accelerator part employs a database, which is calculated by using PHITS, for investigating the effect related to the accelerator such as the changes of beam energy, beam diameter, void generation, and target level. This analysis method using the database may introduce some errors into dynamics calculations sincemore » the neutron source data derived from the database has some errors in fitting or interpolating procedures. In this study, the effects of various events are investigated to confirm that the method based on the database is appropriate.« less

A biomechanical approach for in vivo lung tumor motion prediction during external beam radiation therapy

NASA Astrophysics Data System (ADS)

Karami, Elham; Gaede, Stewart; Lee, Ting-Yim; Samani, Abbas

2015-03-01

Lung Cancer is the leading cause of cancer death in both men and women. Among various treatment methods currently being used in the clinic, External Beam Radiation Therapy (EBRT) is used widely not only as the primary treatment method, but also in combination with chemotherapy and surgery. However, this method may lack desirable dosimetric accuracy because of respiration induced tumor motion. Recently, biomechanical modeling of the respiratory system has become a popular approach for tumor motion prediction and compensation. This approach requires reasonably accurate data pertaining to thoracic pressure variation, diaphragm position and biomechanical properties of the lung tissue in order to predict the lung tissue deformation and tumor motion. In this paper, we present preliminary results of an in vivo study obtained from a Finite Element Model (FEM) of the lung developed to predict tumor motion during respiration.

Quality of life outcomes following treatment for localized prostate cancer: is there a clear winner?

PubMed

Parker, Walter R; Montgomery, Jeffery S; Wood, David P

2009-05-01

The majority of men treated for localized prostate cancer are cured of their disease. As a result, it is important to discuss long-term quality of life (QoL) expectations when counseling patients regarding treatment options. The varying QoL outcomes for radical prostatectomy, external beam radiotherapy, brachytherapy, and cryotherapy will be reviewed. Robotic and radical prostatectomy has similar outcomes with significant initial worsening of urinary continence and sexual function. External beam radiation has less impact on continence and sexual function but noteworthy bowel toxicity. Brachytherapy results in the most irritative urinary symptoms, with decreased sexual and bowel QoL as well. Cryotherapy greatly reduces sexual function. Every patient has unique pretreatment variables, priorities, and preferences. It is crucial to fully explain the range of oncologic and QoL implications when counseling patients regarding treatment for localized prostate cancer.

Modeling of capacitor charging dynamics in an energy harvesting system considering accurate electromechanical coupling effects

NASA Astrophysics Data System (ADS)

Bagheri, Shahriar; Wu, Nan; Filizadeh, Shaahin

2018-06-01

This paper presents an iterative numerical method that accurately models an energy harvesting system charging a capacitor with piezoelectric patches. The constitutive relations of piezoelectric materials connected with an external charging circuit with a diode bridge and capacitors lead to the electromechanical coupling effect and the difficulty of deriving accurate transient mechanical response, as well as the charging progress. The proposed model is built upon the Euler-Bernoulli beam theory and takes into account the electromechanical coupling effects as well as the dynamic process of charging an external storage capacitor. The model is validated through experimental tests on a cantilever beam coated with piezoelectric patches. Several parametric studies are performed and the functionality of the model is verified. The efficiency of power harvesting system can be predicted and tuned considering variations in different design parameters. Such a model can be utilized to design robust and optimal energy harvesting system.

High-power microwave amplifier based on overcritical relativistic electron beam without external magnetic field

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

Kurkin, S. A., E-mail: KurkinSA@gmail.com; Koronovskii, A. A.; Saratov State Technical University, Politechnicheskaja 77, Saratov 410028

2015-04-13

The high-power scheme for the amplification of powerful microwave signals based on the overcritical electron beam with a virtual cathode (virtual cathode amplifier) has been proposed and investigated numerically. General output characteristics of the virtual cathode amplifier including the dependencies of the power gain on the input signal frequency and amplitude have been obtained and analyzed. The possibility of the geometrical working frequency tuning over the range about 8%–10% has been shown. The obtained results demonstrate that the proposed virtual cathode amplifier scheme may be considered as the perspective high-power microwave amplifier with gain up to 18 dB, and with themore » following important advantages: the absence of external magnetic field, the simplicity of construction, the possibility of geometrical frequency tuning, and the amplification of relatively powerful microwave signals.« less

The role of external beam radiation therapy in well-differentiated thyroid cancer.

PubMed

Hamilton, Sarah N; Tran, Eric; Berthelet, Eric; Wu, Jonn

2017-10-01

This review article explores the use of external beam radiotherapy (EBRT) in well differentiated thyroid cancer. Areas covered: The published literature on EBRT for advanced pT4 disease and macroscopic unresectable disease to improve locoregional control is reviewed. EBRT techniques, volumes and doses are discussed in detail. The potential acute and late toxicities of EBRT are discussed in the context of the published literature. The use of EBRT for patients with metastatic disease is also described. Expert commentary: There is good retrospective evidence for EBRT in the setting of unresectable gross residual well-differentiated thyroid cancer as this can result in long-term local control. However, the benefit of EBRT in patients with locally advanced disease that is completely resected is less clear. The use of EBRT for these patients requires careful consideration of age, pathologic factors, comorbidities and patient preference, preferably by a multi-disciplinary team.

Radioactive iodine-125 implantation for cancer of the prostate.

PubMed

Nag, S

1985-01-01

Localized cancer of the prostate can be treated by radical prostatectomy, external beam irradiation, or radioactive implantation with similar survival results. Radical prostatectomy, however, almost universally results in impotency, although a new, nerve-sparing procedure may preserve potency in B1 patients. External beam irradiation radiates a large volume of tissue with significant rectal and bladder morbidity, 23-47% risk of impotency, and requires prolonged treatment (6-8 weeks). Radioactive implantation may be done suprapubically or transperineally using iodine-125, gold-198, or radon-222 permanent implantation techniques and iridium-192 or radium-226 removable implantation techniques. Interstitial iodine-125 implantation is frequently employed since it is a short procedure and limits the morbidity to a 7% incidence of impotency, 20% urinary complications, and 5% rectal complications. The overall 5-year survival of patients with iodine-125 is 79%, the survival rate decreasing with increasing T or N stage or increasing grade of tumor.

Recent developments of ion beam induced luminescence at the external scanning microbeam facility of the LABEC laboratory in Florence

NASA Astrophysics Data System (ADS)

Colombo, E.; Calusi, S.; Cossio, R.; Giuntini, L.; Giudice, A. Lo; Mandò, P. A.; Manfredotti, C.; Massi, M.; Mirto, F. A.; Vittone, E.

2008-04-01

A new ionoluminescence (IL) apparatus has been successfully installed at the external scanning microbeam facility of the 3 MV Tandetron accelerator of the INFN LABEC in Firenze; the apparatus for photon detection has been fully integrated in the existing ion beam analysis (IBA) set-up, for the simultaneous acquisition of IL and PIXE/PIGE/BS spectra and maps. The potential of the new set-up is illustrated in this paper by some results extracted by the analysis of art objects and advanced semiconductor materials. In particular, the adequacy of the new IBA set-up in the field of cultural heritage is pointed out by the coupled PIXE/IL micro-analysis of a lapis lazuli stone; concerning applications in material science, IL spectra from a N doped diamond sample were acquired and compared with CL analyses to evaluate the relevant sensitivities and the effect of ion damage.

[Bladder-conserving treatment for bladder cancer: potential of and developments in radiotherapy].

PubMed

Hulshof, Maarten C C M; Pieters, Bradley R; Koning, Caro C E

2013-01-01

The standard treatment for muscle-invasive bladder cancer is surgical removal of the bladder and construction of a neobladder. Recently, important improvements have been made in the potential for bladder-conserving treatment using radiotherapy. External beam radiotherapy has undergone technological improvements, as a result of which it is possible to radiate the tumour more precisely while decreasing radiation to healthy tissue. Radiochemotherapy improves local recurrence-free and overall survival compared with radiotherapy alone. The results of this combined treatment are comparable with those of surgery. Additionally, Dutch radiotherapy departments have collected data in a national database of 1040 selected patients with confined bladder cancer. These patients were treated with external beam radiation, limited surgery and brachytherapy. The 5-year local recurrence-free survival was 75%. Bladder conserving treatment options for muscle-invasive bladder cancer should be discussed during the multidisciplinary meeting.

Escalation to Major Depressive Disorder among Adolescents with Subthreshold Depressive Symptoms: Evidence of Distinct Subgroups at Risk

PubMed Central

Hill, Ryan M.; Pettit, Jeremy W.; Lewinsohn, Peter M.; Seeley, John R.; Klein, Daniel N.

2014-01-01

Background The presence of subthreshold depressive symptoms (SubD) in adolescence is associated with high prospective risk of developing Major Depressive Disorder (MDD). Little is known about variables that predict escalation from SubD to MDD. This study used a longitudinal prospective design in a community sample of adolescents to identify combinations of risk factors that predicted escalation from SubD to MDD. Methods Classification tree analysis was used to identify combinations of risk factors that improved the sensitivity and specificity of prediction of MDD onset among 424 adolescents with a lifetime history of SubD. Results Of the 424, 144 developed MDD during the follow-up period. Evidence for multiple subgroups was found: Among adolescents with poor friend support, the highest risk of escalation was among participants with lifetime histories of an anxiety or substance use disorder. Among adolescents with high friend support, those reporting multiple major life events in the past year or with a history of an anxiety disorder were at highest risk of escalation. Limitations Study findings may not inform prevention efforts for individuals who first develop SubD during adulthood. This study did not examine the temporal ordering of predictors involved in escalation from SubD to MDD. Conclusions Adolescents with a history of SubD were at highest risk of escalation to MDD in the presence of poor friend support and an anxiety or substance use disorder, or in the presence of better friend support, multiple major life events, and an anxiety disorder. Findings may inform case identification approaches for adolescent depression prevention programs. PMID:24655777

Change in Visual Field Progression Following Treatment Escalation in Primary Open-angle Glaucoma.

PubMed

Aptel, Florent; Bron, Alain M; Lachkar, Yves; Schweitzer, Cédric

2017-10-01

To evaluate the effect of treatment escalation on the rate of visual field progression in patients with primary open-angle glaucoma (POAG). Multicenter database study. We reviewed the electronic records of 171 patients with POAG under medical hypotensive treatment who underwent 5 consecutive visits 6 months apart before and after medical treatment escalation or additive laser trabeculoplasty. We calculated the rate of visual field progression (mean deviation change per year) before and after treatment escalation. The mean duration of follow-up was 5.1±0.5 years and the mean number of visual field examinations was 10.2±0.2. In 139 eyes with medical treatment escalation, the rate of progression was significantly reduced [from -0.57 to -0.29 dB/y; P=0.022; intraocular pressure (IOP) reduction 11.1%]. In detail, the rate of progression was significantly reduced after escalation from mono to dual therapy, dual to triple therapy, and from mono to triple therapy (-0.35 to -0.24 dB/y, P=0.018; -1.01 to -0.48 dB/y, P=0.038; -1.04 to -0.35 dB/y, P=0.020, respectively). In 32 eyes with additive laser trabeculoplasty, the rate of progression was significantly reduced (-0.60 to -0.24 dB/y; P=0.014; IOP reduction 9.4%). Medical treatment escalation or additive laser trabeculoplasty significantly reduced the rate of visual field progression in POAG. Larger IOP reduction has a greater probability of reducing glaucoma progression.

Developmental trends in alcohol use initiation and escalation from early- to middle-adolescence: Prediction by urgency and trait affect

PubMed Central

Spillane, Nichea S.; Merrill, Jennifer E.; Jackson, Kristina M.

2016-01-01

Studies on adolescent drinking have not always been able to distinguish between initiation and escalation of drinking, because many studies include samples in which initiation has already occurred; hence initiation and escalation are often confounded. The present study draws from a dual-process theoretical framework to investigate: if changes in the likelihood of drinking initiation and escalation are predicted by a tendency towards rash action when experiencing positive and negative emotions (positive and negative urgency); and whether trait positive and negative affect moderate such effects. Alcohol naïve adolescents (n=944; age: M=12.16, SD=.96; 52% female) completed 6 semi-annual assessments of trait urgency and affect (wave-1) and alcohol use (waves 2–6). A two-part random-effects model was used to estimate changes in the likelihood of any alcohol use vs. escalation in the volume of use amongst initiators. Main effects suggest a significant association between positive affect and change in level of alcohol use amongst initiators, such that lower positive affect predicted increased alcohol involvement. This main effect was qualified by a significant interaction between positive urgency and positive affect predicting changes in the escalation of drinking, such that the effect of positive urgency was augmented for those high on trait positive affect, though only at extremely high levels of positive affect. Results suggest risk factors in the development of drinking depend on whether initiation or escalation is investigated. A more nuanced understanding of the early developmental phases of alcohol involvement can inform prevention and intervention efforts. PMID:27031086

Care planning for aggression management in a specialist secure mental health service: An audit of user involvement.

PubMed

Hallett, Nutmeg; Huber, Jörg W; Sixsmith, Judith; Dickens, Geoffrey L

2016-12-01

This paper describes an audit of prevention and management of violence and aggression care plans and incident reporting forms which aimed to: (i) report the compliance rate of completion of care plans; (ii) identify the extent to which patients contribute to and agree with their care plan; (iii) describe de-escalation methods documented in care plans; and (iv) ascertain the extent to which the de-escalation methods described in the care plan are recorded as having been attempted in the event of an incident. Care plans and incident report forms were examined for all patients in men's and women's mental health care pathways who were involved in aggressive incidents between May and October 2012. In total, 539 incidents were examined, involving 147 patients and 121 care plans. There was no care plan in place at the time of 151 incidents giving a compliance rate of 72%. It was documented that 40% of patients had contributed to their care plans. Thematic analysis of de-escalation methods documented in the care plans revealed five de-escalation themes: staff interventions, interactions, space/quiet, activities and patient strategies/skills. A sixth category, coercive strategies, was also documented. Evidence of adherence to de-escalation elements of the care plan was documented in 58% of incidents. The reasons for the low compliance rate and very low documentation of patient involvement need further investigation. The inclusion of coercive strategies within de-escalation documentation suggests that some staff fundamentally misunderstand de-escalation. © 2016 Australian College of Mental Health Nurses Inc.

SU-C-BRB-02: Automatic Planning as a Potential Strategy for Dose Escalation for Pancreas SBRT?

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

Wang, S; Zheng, D; Ma, R

Purpose: Stereotactic body radiation therapy (SBRT) has been suggested to provide high rates of local control for locally advanced pancreatic cancer. However, the close proximity of highly radiosensitive normal tissues usually causes the labor-intensive planning process, and may impede further escalation of the prescription dose. The present study evaluates the potential of an automatic planning system as a dose escalation strategy. Methods: Ten pancreatic cancer patients treated with SBRT were studied retrospectively. SBRT was delivered over 5 consecutive fractions with 6 ∼ 8Gy/fraction. Two plans were generated by Pinnacle Auto-Planning with the original prescription and escalated prescription, respectively. Escalated prescriptionmore » adds 1 Gy/fraction to the original prescription. Manually-created planning volumes were excluded in the optimization goals in order to assess the planning efficiency and quality simultaneously. Critical organs with closest proximity were used to determine the plan normalization to ensure the OAR sparing. Dosimetric parameters including D100, and conformity index (CI) were assessed. Results: Auto-plans directly generate acceptable plans for 70% of the cases without necessity of further improvement, and two more iterations at most are necessary for the rest of the cases. For the pancreas SBRT plans with the original prescription, autoplans resulted in favorable target coverage and PTV conformity (D100 = 96.3% ± 1.48%; CI = 0.88 ± 0.06). For the plans with the escalated prescriptions, no significant target under-dosage was observed, and PTV conformity remains reasonable (D100 = 93.3% ± 3.8%, and CI = 0.84 ± 0.05). Conclusion: Automatic planning, without substantial human-intervention process, results in reasonable PTV coverage and PTV conformity on the premise of adequate OAR sparing for the pancreas SBRT plans with escalated prescription. The results highlight the potential of autoplanning as a dose escalation strategy for pancreas SBRT treatment planning. Further investigations with a larger number of patients are necessary. The project is partially supported by Philips Medical Systems.« less

Experimental assessment of out-of-field dose components in high energy electron beams used in external beam radiotherapy.

PubMed

Alabdoaburas, Mohamad M; Mege, Jean-Pierre; Chavaudra, Jean; Bezin, Jérémi Vũ; Veres, Atilla; de Vathaire, Florent; Lefkopoulos, Dimitri; Diallo, Ibrahima

2015-11-08

The purpose of this work was to experimentally investigate the out-of-field dose in a water phantom, with several high energy electron beams used in external beam radiotherapy (RT). The study was carried out for 6, 9, 12, and 18 MeV electron beams, on three different linear accelerators, each equipped with a specific applicator. Measurements were performed in a water phantom, at different depths, for different applicator sizes, and off-axis distances up to 70 cm from beam central axis (CAX). Thermoluminescent powder dosimeters (TLD-700) were used. For given cases, TLD measurements were compared to EBT3 films and parallel-plane ionization chamber measurements. Also, out-of-field doses at 10 cm depth, with and without applicator, were evaluated. With the Siemens applicators, a peak dose appears at about 12-15 cm out of the field edge, at 1 cm depth, for all field sizes and energies. For the Siemens Primus, with a 10 × 10 cm(²) applicator, this peak reaches 2.3%, 1%, 0.9% and 1.3% of the maximum central axis dose (Dmax) for 6, 9, 12 and 18 MeV electron beams, respectively. For the Siemens Oncor, with a 10 × 10 cm(²) applicator, this peak dose reaches 0.8%, 1%, 1.4%, and 1.6% of Dmax for 6, 9, 12, and 14 MeV, respectively, and these values increase with applicator size. For the Varian 2300C/D, the doses at 12.5 cm out of the field edge are 0.3%, 0.6%, 0.5%, and 1.1% of Dmax for 6, 9, 12, and 18 MeV, respectively, and increase with applicator size. No peak dose is evidenced for the Varian applicator for these energies. In summary, the out-of-field dose from electron beams increases with the beam energy and the applicator size, and decreases with the distance from the beam central axis and the depth in water. It also considerably depends on the applicator types. Our results can be of interest for the dose estimations delivered in healthy tissues outside the treatment field for the RT patient, as well as in studies exploring RT long-term effects.

Experimental assessment of out‐of‐field dose components in high energy electron beams used in external beam radiotherapy

PubMed Central

Alabdoaburas, Mohamad M.; Mege, Jean‐Pierre; Chavaudra, Jean; Bezin, Jérémi Vũ; Veres, Attila; de Vathaire, Florent; Lefkopoulos, Dimitri

2015-01-01

The purpose of this work was to experimentally investigate the out‐of‐field dose in a water phantom, with several high energy electron beams used in external beam radiotherapy (RT). The study was carried out for 6, 9, 12, and 18 MeV electron beams, on three different linear accelerators, each equipped with a specific applicator. Measurements were performed in a water phantom, at different depths, for different applicator sizes, and off‐axis distances up to 70 cm from beam central axis (CAX). Thermoluminescent powder dosimeters (TLD‐700) were used. For given cases, TLD measurements were compared to EBT3 films and parallel‐plane ionization chamber measurements. Also, out‐of‐field doses at 10 cm depth, with and without applicator, were evaluated. With the Siemens applicators, a peak dose appears at about 12–15 cm out of the field edge, at 1 cm depth, for all field sizes and energies. For the Siemens Primus, with a 10×10cm2 applicator, this peak reaches 2.3%, 1%, 0.9% and 1.3% of the maximum central axis dose (Dmax) for 6, 9, 12 and 18 MeV electron beams, respectively. For the Siemens Oncor, with a 10×10cm2 applicator, this peak dose reaches 0.8%, 1%, 1.4%, and 1.6% of Dmax for 6, 9, 12, and 14 MeV, respectively, and these values increase with applicator size. For the Varian 2300C/D, the doses at 12.5 cm out of the field edge are 0.3%, 0.6%, 0.5%, and 1.1% of Dmax for 6, 9, 12, and 18 MeV, respectively, and increase with applicator size. No peak dose is evidenced for the Varian applicator for these energies. In summary, the out‐of‐field dose from electron beams increases with the beam energy and the applicator size, and decreases with the distance from the beam central axis and the depth in water. It also considerably depends on the applicator types. Our results can be of interest for the dose estimations delivered in healthy tissues outside the treatment field for the RT patient, as well as in studies exploring RT long‐term effects. PACS number(s): 87.53.Bn, 87.56.bd, 87.56.J‐ PMID:26699572

Snakes, rotators, serpents and the octahedral group

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

Fieguth, T.

1986-04-01

Specific configurations of horizontal and vertical bending magnets are given that, when acting on the spin polarization vector of a particle beam, generate a group of 24 operators isomorphic to the group of rotational symmetries of a cube, known as the octahedral group. Some of these configurations have the feature of converting transversely polarized beams to longitudinally polarized beams (or vice versa) at the midpoint of the configuration for, in principle, all beam energies. Since the first order optical transfer matrix for each half of these configurations is nearly that of a drift region, the external geometry remains unchanged andmore » midpoint dispersion is not introduced. Changing field strengths and/or polarities allows a configuration to serve as either a Snake(1/sup st/ or 2/sup nd/ kind) or a Rotator, where in both cases the spin polarization is longitudinal at the midpoint. In this conceptualization, emphasis has been placed on electron beams and, indeed, for these beams some practical applications can be envisioned. However, due to the relatively high integrated field strengths required, application of these concepts to proton beams may be more promising.« less

Ion beam modification of zinc white pigment characterized by ex situ and in situ μ-Raman and XPS

NASA Astrophysics Data System (ADS)

Beck, L.; Gutiérrez, P. C.; Miro, S.; Miserque, F.

2017-10-01

Zinc oxide, known as zinc white, is one of the principal white pigments developed in the 18th century and was used by the Impressionist painters. ZnO as artists' pigment has occasionally been characterized by X-ray and ion beam techniques, but these studies are limited by the potential for visible radiation effect. Ion beam modifications of zinc oxide have extensively been investigated, but mainly for electronic and industrial applications. In this paper, we focus our investigation on ion beam modification of ZnO used as pigment. Two irradiation conditions have been used: an external 3 MeV proton micro-beam representative of PIXE analysis and 2 MeV H+ and 1.2 MeV Au + beams in vacuum to investigate irradiation modifications in electronic and nuclear energy loss regimes. Ion beam modification was characterized by ex situ and in situ micro-Raman spectrometry and XPS. The results shows that IBA of zinc white can be carried out safely in historical paintings with low current and dose.

Physics and applications of positron beams in an integrated PET/MR.

PubMed

Watson, Charles C; Eriksson, Lars; Kolb, Armin

2013-02-07

In PET/MR systems having the PET component within the uniform magnetic field interior to the MR, positron beams can be injected into the PET field of view (FOV) from unshielded emission sources external to it, as a consequence of the action of the Lorentz force on the transverse components of the positron's velocity. Such beams may be as small as a few millimeters in diameter, but extend 50 cm or more axially without appreciable divergence. Larger beams form 'phantoms' of annihilations in air that can be easily imaged, and that are essentially free of γ-ray attenuation and scatter effects, providing a unique tool for characterizing PET systems and reconstruction algorithms. Thin targets intersecting these beams can produce intense annihilation sources having the thickness of a sheet of paper, which are very useful for high resolution measurements, and difficult to achieve with conventional sources. Targeted beams can provide other point, line and surface sources for various applications, all without the need to have radioactivity within the FOV. In this paper we discuss the physical characteristics of positron beams in air and present examples of their applications.

Late complications of pelvic irradiation in 16 dogs.

PubMed

Anderson, Christine R; McNiel, Elizabeth A; Gillette, Edward L; Powers, Barbara E; LaRue, Susan M

2002-01-01

When external beam radiation therapy is administered to the pelvis, normal tissues irradiated may include the colon, small intestine, urethra, bladder, bone, and spinal cord. The objectives of this retrospective study were to determine the incidence and severity of late radiation effects following pelvic irradiation in dogs and to identify factors that increase the risk of these effects. Medical records of all dogs treated with curative intent external beam radiation therapy to the pelvic region between 1993 and 1999 were reviewed. Patients with follow-up longer than 9 months or any patient that developed late complications earlier than 9 months were evaluated. Sixteen dogs met criteria for inclusion in this study. All dogs were treated with a 6-MV linear accelerator with bilaterally opposed beams. Diseases treated included transitional cell carcinoma of the bladder, transitional cell carcinoma of the prostate, and anal sac apocrine gland adenocarcinoma. Four dose/fractionation schemes were used: 49.5 Gy in 3.3 Gy fractions, 54 Gy in 3.0 Gy fractions, 54 Gy in 2.7 Gy fractions, and 18 Gy intraoperative radiation therapy followed by 43 Gy external beam radiation therapy in 2.9 Gy fractions. Implantable chemotherapy in the form of an OPLA-Pt sponge was used in six dogs as a radiation potentiator. Colitis was the major late effect following pelvic irradiation, occurring in nine dogs (56%). Colitis was characterized as mild in three dogs, moderate in one dog, and severe in five dogs. Three of the dogs with severe effects suffered gastrointestinal perforation. All dogs with severe late effects received 3 or 3.3 Gy per fraction, and 80% received radiation potentiators. In the seven dogs that received 2.7 Gy or 2.9 Gy per fraction, late effects were classified as none (n = 5), mild colitis (n = 1), and moderate colitis (n = 1). Radiation therapy can be administered to the pelvic region with a minimal risk of late effects to the colon by giving smaller doses per fraction and avoiding systemic radiation potentiators.

Generation of powerful microwave pulses by channel power summation of two X-band phase-locked relativistic backward wave oscillators

NASA Astrophysics Data System (ADS)

Xiao, Renzhen; Deng, Yuqun; Chen, Changhua; Shi, Yanchao; Sun, Jun

2018-03-01

We demonstrate both theoretically and experimentally the possibility of the generation of powerful microwave pulses by channel power summation of two X-band phase-locked relativistic backward wave oscillators (RBWOs). A modulated electron beam induced by an external signal can lead the microwave field with an arbitrary initial phase to the same equilibrium phase, which is determined by the initial phase of the external signal. A high-current dual-beam accelerator was built to drive the two RBWOs. An external signal was divided into two channels with an adjusted relative phase and injected into the two RBWOs through two TE10-TEM mode converters. The generated microwaves were combined with a power combiner consisting of two TM01-TE11 serpentine mode converters with a common output. In the experiments, as the input power for each channel was 150 kW, the two RBWOs output 3.1 GW and 3.7 GW, respectively, the jitter of the relative phase of two output microwaves was about 20°, and the summation power from the power combiner is 6.2 GW, corresponding to a combination efficiency of 91%.