Silicone rubber selection for passive sampling of pesticides in water.

PubMed

Martin, A; Margoum, C; Randon, J; Coquery, M

2016-11-01

Silicone rubber can extract organic compounds with a broad range of polarities (logKow>2-3) from aqueous samples. Such compounds include substances of major concern in the protection of aquatic ecosystems and human health, e.g. pesticides. Silicone rubbers (SRs) with various characteristics have been successfully used in sorptive methods for water sample extraction in the laboratory (SPME, SBSE), and for passive sampling in aquatic environments. However, only few studies have evaluated variability in organic compound sorption due to the origin of SRs, particularly for pesticides. The aim of this study was to select an SR for the extraction of pesticides from water samples by passive sampling. To this end we measured the impact of seven SR formulations on sorption capacity, defined by the partition coefficient (Ksw). Kinetic experiments and sorption isotherms were performed to determine extraction recovery as a selection criterion for SRs, and pesticide partition coefficients. Very large differences in affinity for pesticides were found between two kinds of SRs: "Polymerized SR kits" and "Manufactured SRs". One SR was chosen among the "Manufactured SRs", and the Ksw values of 21 pesticides were determined, filling a gap in the literature (1.50

A Stimulated Raman Scattering CMOS Pixel Using a High-Speed Charge Modulator and Lock-in Amplifier.

PubMed

Lioe, De Xing; Mars, Kamel; Kawahito, Shoji; Yasutomi, Keita; Kagawa, Keiichiro; Yamada, Takahiro; Hashimoto, Mamoru

2016-04-13

A complementary metal-oxide semiconductor (CMOS) lock-in pixel to observe stimulated Raman scattering (SRS) using a high speed lateral electric field modulator (LEFM) for photo-generated charges and in-pixel readout circuits is presented. An effective SRS signal generated after the SRS process is very small and needs to be extracted from an extremely large offset due to a probing laser signal. In order to suppress the offset components while amplifying high-frequency modulated small SRS signal components, the lock-in pixel uses a high-speed LEFM for demodulating the SRS signal, resistor-capacitor low-pass filter (RC-LPF) and switched-capacitor (SC) integrator with a fully CMOS differential amplifier. AC (modulated) components remained in the RC-LPF outputs are eliminated by the phase-adjusted sampling with the SC integrator and the demodulated DC (unmodulated) components due to the SRS signal are integrated over many samples in the SC integrator. In order to suppress further the residual offset and the low frequency noise (1/f noise) components, a double modulation technique is introduced in the SRS signal measurements, where the phase of high-frequency modulated laser beam before irradiation of a specimen is modulated at an intermediate frequency and the demodulation is done at the lock-in pixel output. A prototype chip for characterizing the SRS lock-in pixel is implemented and a successful operation is demonstrated. The reduction effects of residual offset and 1/f noise components are confirmed by the measurements. A ratio of the detected small SRS to offset a signal of less than 10(-)⁵ is experimentally demonstrated, and the SRS spectrum of a Benzonitrile sample is successfully observed.

Radioactivity in smoke particulates from prescribed burns at the Savannah River Site and at selected southeastern United States forests.

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

Commodore, Adwoa, A.; Jannik, G. Timothy; Eddy, Teresa, P.

In this study we compare airborne radionuclide concentrations during prescribed burns at the Savannah River Site (SRS) and a sample of forests in the Southeastern United States. The spatial trends of airborne radionuclide concentrations from prescribed burn areas at SRS are also characterized. Total suspended particulate (TSP) samples were taken at three settings (subsequently termed burn sample populations): during prescribed burns at SRS (n = 34), on nonburn days at SRS (n = 12) and during prescribed burns at five offsite locations in the Southeastern United States (n = 2 per location). Mass concentrations of TSP were calculated and alpha,more » beta and gamma spectroscopy was performed to determine radionuclide activity concentrations. Spatial correlation in radionuclide concentration was assessed and ordinary kriging was used to create continuous surface maps across our study area. Median activity concentrations of natural radionuclides including {sup 40}K, thorium and uranium isotopes (n = 34) were higher in samples from SRS prescribed fires (p < 0.02) compared to offsite locations (n = 10) and nonburn days (n = 12). Median gross beta activity was also higher at SRS (p < 0.0001). Median concentrations of anthropogenic radionuclides did not significantly differ among burn sample populations except for {sup 238}Pu (p = 0.0022) and {sup 239,240}Pu (p = 0.014) with median concentrations of 8.41 x 10{sup -4} and 6.72 x 10{sup -5} pCi m{sup -3} at SRS compared to 1.55 x 10{sup -4} and -7.07 x 10{sup -6} pCi m{sup -3} (nonburn days) and 1.46 x 10{sup -4} and 2.78 x 10{sup -6} pCi m{sup 3} (offsite burns) respectively. Results from our spatial analysis found that only {sup 40}K demonstrated significant spatial correlation (X{sup 2} = 15.48, p = 0.0004) and spatial trends do not appear to directly link areas with higher activity concentrations with SRS facilities.« less

Gender Stereotypic Interest Patterns as Determinants of Cognitive Abilities in Transsexuals.

ERIC Educational Resources Information Center

Blanco, Mark R.; Heritage, Jeanette G.

The designation "transsexual" refers to those who persistently believe their gender to be incongruous with their anatomical morphology. This study involves a group of 21 female sexual reversal surgery (SRS) candidates and a group of 59 male SRS candidates to observe if transsexual cognitive ability patterns are correlated with levels of…

SITE SPECIFIC REFERENCE PERSON PARAMETERS AND DERIVED CONCENTRATION STANDARDS FOR THE SAVANNAH RIVER SITE

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

Jannik, T.

2013-03-14

The purpose of this report is twofold. The first is to develop a set of behavioral parameters for a reference person specific for the Savannah River Site (SRS) such that the parameters can be used to determine dose to members of the public in compliance with Department of Energy (DOE) Order 458.1 “Radiation Protection of the Public and the Environment.” A reference person is a hypothetical, gender and age aggregation of human physical and physiological characteristics arrived at by international consensus for the purpose of standardizing radiation dose calculations. DOE O 458.1 states that compliance with the annual dose limitmore » of 100 mrem (1 mSv) to a member of the public may be demonstrated by calculating the dose to the maximally exposed individual (MEI) or to a representative person. Historically, for dose compliance, SRS has used the MEI concept, which uses adult dose coefficients and adult male usage parameters. Beginning with the 2012 annual site environmental report, SRS will be using the representative person concept for dose compliance. The dose to a representative person will be based on 1) the SRS-specific reference person usage parameters at the 95th percentile of appropriate national or regional data, which are documented in this report, 2) the reference person (gender and age averaged) ingestion and inhalation dose coefficients provided in DOE Derived Concentration Technical Standard (DOE-STD-1196-2011), and 3) the external dose coefficients provided in the DC_PAK3 toolbox. The second purpose of this report is to develop SRS-specific derived concentration standards (DCSs) for all applicable food ingestion pathways, ground shine, and water submersion. The DCS is the concentration of a particular radionuclide in water, in air, or on the ground that results in a member of the public receiving 100 mrem (1 mSv) effective dose following continuous exposure for one year. In DOE-STD-1196-2011, DCSs were developed for the ingestion of water, inhalation of air and submersion in air pathways, only. These DCSs are required by DOE O 458.1 to be used at all DOE sites in the design and conduct of radiological environmental protection programs. In this report, DCSs for the following additional pathways were considered and documented: ingestion of meat, dairy, grains, produce (fruits and vegetables), seafood, submersion in water and ground shine. These additional DCSs were developed using the same methods as in DOE-STD-1196-2011 and will be used at SRS, where appropriate, as screening and reference values.« less

The Screening Accuracy of the Parent and Teacher-Reported Social Responsiveness Scale (SRS): Comparison with the 3Di and ADOS.

PubMed

Duvekot, Jorieke; van der Ende, Jan; Verhulst, Frank C; Greaves-Lord, Kirstin

2015-06-01

The screening accuracy of the parent and teacher-reported Social Responsiveness Scale (SRS) was compared with an autism spectrum disorder (ASD) classification according to (1) the Developmental, Dimensional, and Diagnostic Interview (3 Di), (2) the Autism Diagnostic Observation Schedule (ADOS), (3) both the 3 Di and ADOS, in 186 children referred to six mental health centers. The parent report showed excellent correspondence to an ASD classification according to the 3 Di and both the 3 Di and ADOS. The teacher report added significantly to the screening accuracy over and above the parent report when compared with the ADOS classification. Findings support the screening utility of the parent-reported SRS among clinically referred children and indicate that different informants may provide unique information relevant for ASD assessment.

Reporting of sources of funding in systematic reviews in periodontology and implant dentistry.

PubMed

Faggion, C M; Atieh, M; Zanicotti, D G

2014-02-01

Industry-supported clinical trials may present better outcomes than those supported by other sources. The aim of this paper was to assess whether systematic reviews (SRs) published in periodontology and implant dentistry report and discuss the influence of funding sources on study results. Two reviewers conducted a comprehensive search in PubMed and the Cochrane Database of Systematic Reviews independently and in duplicate to identify SRs published up to 11 November 2012. Speciality dental journals and the reference lists of included SRs were also scrutinised. Information on the reporting and discussion of funding sources of primary studies included in the SRs was extracted independently and in duplicate. Any disagreement regarding SR selection or data extraction was discussed until consensus was achieved. Of 146 SRs included in the assessment, only 45 (31%) reported the funding sources of primary studies. Fourteen (10%) SRs discussed the potential influence of funding sources on study results, that is, sponsorship bias. Funding sources are inadequately reported and discussed in SRs in periodontology and implant dentistry. Assessment, reporting, and critical appraisal of potential sponsorship bias of meta-analytic estimates are paramount to provide proper guidance for clinical treatments.

Long-Term Follow-Up of Individuals Undergoing Sex-Reassignment Surgery: Somatic Morbidity and Cause of Death.

PubMed

Simonsen, Rikke Kildevæld; Hald, Gert Martin; Kristensen, Ellids; Giraldi, Annamaria

2016-03-01

Studies of mortality and somatic well-being after sex-reassignment surgery (SRS) of transsexual individuals are equivocal. Accordingly, the present study investigated mortality and somatic morbidity using a sample of transsexual individuals who comprised 98% (n = 104) of all surgically reassigned transsexual individuals in Denmark. To investigate somatic morbidity before and after SRS and cause of death and its relation to somatic morbidity after SRS in Danish individuals who underwent SRS from 1978 through 2010. Somatic morbidity and mortality in 104 sex-reassigned individuals were identified retrospectively by data from the Danish National Health Register and the Cause of Death Register. Somatic morbidity and cause of death. Overall, 19.2% of the sample were registered with somatic morbidity before SRS and 23.1% after SRS (P = not significant). In total, 8.6% had somatic morbidity before and after SRS. The most common diagnostic category was cardiovascular disease, affecting 18 individuals, 9 before and 14 after SRS, and 5 of those 14 who were affected after SRS had cardiovascular disease before and after SRS. Ten individuals died after SRS at an average age of 53.5 ± 7.9 years (male to female) and 53.5 ± 7.3 years (female to male). Of 98% of all Danish transsexuals who officially underwent SRS from 1978 through 2010, one in three had somatic morbidity and approximately 1 in 10 had died. No significant differences in somatic morbidity or mortality were found between male-to-female and female-to-male individuals. Despite the young average age at death and the relatively larger number of individuals with somatic morbidity, the present study design does not allow for determination of casual relations between, for example, specific types of hormonal or surgical treatment received and somatic morbidity and mortality. Copyright © 2016. Published by Elsevier Inc.

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

King, W. D.

In order to appropriately model and predict the chemical integrity and performance of cementitious materials used for waste immobilization at the Savannah River Site (SRS), it is critical to understand the I-129 solubility and distribution within the tank farm. Iodine in radioactive waste and in environmental media is typically highly mobile and long lived. Iodine is ubiquitous in SRS tank waste and waste forms. The iodine is assumed to be soluble and present at low levels in Performance Assessments (PAs) for SRS Tank Farms, and is one of the dose drivers in the PAs for both the SRS Salt Disposalmore » Facility (SDF) and the H-Area Tank Farm (HTF). Analysis of tank waste samples is critical to understanding the Tank Farm iodine inventory and reducing disposal uncertainty. Higher than expected iodine levels have recently been observed in residual solids isolated from some SRS tanks prior to closure, indicating uncertainty regarding the chemical species involved. If the iodine inventory uncertainty is larger than anticipated, future work may be necessary to reduce the uncertainty. This memorandum satisfies a portion of the work scope identified in Task Plan SRNL-RP-2016-00651. A separate memorandum issued previously, reported historical unpublished I-129 data, a significant portion of which was below detectable analytical limits. This memorandum includes iodine and general chemical analysis results for six archived SRNL samples which were previously reported to have I-129 concentrations below detectable limits. Lower sample dilution factors were used for the current analyses in order to obtain concentrations above detection. The samples analyzed included surface and depth samples from SRS tanks 30, 32, and 39.« less

Entrainment sampling at the Savannah River Site (SRS) Savannah River water intakes (1991)

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

Paller, M.

1990-11-01

Cooling water for the Westinghouse Savannah River Company (WSRC) L-Reactor, K-Reactor, and makeup water for Par Pond is pumped from the Savannah River at the 1G, 3G, and 5G pumphouses. Ichthyoplankton (drifting fish larvae and eggs) from the river are entrained into the reactor cooling systems with the river water. They are passed through the reactor heat exchangers where temperatures may reach 70{degree}C during full power operation. Ichthyoplankton mortality under such conditions is presumably 100%. Apart from a small pilot study conducted in 1989, ichthyoplankton samples have not been collected from the vicinity of the SRS intake canals since 1985.more » The Department of Energy (DOE) has requested that the Environmental Sciences Section (ESS) of the Savannah River Laboratory (SRL) resume ichthyoplankton sampling for the purpose of assessing entrainment at the SRS Savannah River intakes. This request is due to the anticipated restart of several SRS reactors and the growing concern surrounding striped bass and American shad stocks in the Savannah River. The following scope of work presents a sampling plan that will collect information on the spatial and temporal distribution of fish eggs and larvae near the SRS intake canal mouths. This data will be combined with information on water movement patterns near the canal mouths in order to determine the percentage of ichthyoplankton that are removed from the Savannah River by the SRS intakes. The following sampling plan incorporates improvements in experimental design that resulted from the findings of the 1989 pilot study. 1 fig.« less

Preschool boys' development of emotional self-regulation strategies in a sample at risk for behavior problems.

PubMed

Supplee, Lauren H; Skuban, Emily Moye; Trentacosta, Christopher J; Shaw, Daniel S; Stoltz, Emilee

2011-01-01

Little longitudinal research has been conducted on changes in children's emotional self-regulation strategy (SRS) use after infancy, particularly for children at risk. In this study, the authors examined changes in boys' emotional SRS from toddlerhood through preschool. Repeated observational assessments using delay of gratification tasks at ages 2, 3, and 4 years were examined with both variable- and person-oriented analyses in a low-income sample of boys (N = 117) at risk for early problem behavior. Results were consistent with theory on emotional SRS development in young children. Children initially used more emotion-focused SRS (e.g., comfort seeking) and transitioned to greater use of planful SRS (e.g., distraction) by 4 years of age. Person-oriented analysis using trajectory analysis found similar patterns from 2 to 4 years, with small groups of boys showing delayed movement away from emotion-focused strategies or delay in the onset of regular use of distraction. The results provide a foundation for future researchers to examine the development of SRS in low-income young children.

Preschool Boys' Development of Emotional Self-regulation Strategies in a Sample At-risk for Behavior Problems

PubMed Central

Supplee, Lauren H.; Skuban, Emily Moye; Trentacosta, Christopher J.; Shaw, Daniel S.; Stoltz, Emilee

2011-01-01

Little longitudinal research has been conducted on changes in children's emotional self-regulation strategy (SRS) use after infancy, particularly for children at risk. The current study examined changes in boys' emotional SRS from toddlerhood through preschool. Repeated observational assessments using delay of gratification tasks at ages 2, 3, and 4 were examined with both variable- and person-oriented analyses in a low-income sample of boys (N = 117) at-risk for early problem behavior. Results were consistent with theory on emotional SRS development in young children. Children initially used more emotion-focused SRS (e.g., comfort seeking) and transitioned to greater use of planful SRS (e.g., distraction) by age 4. Person-oriented analysis using trajectory analysis found similar patterns from 2–4, with small groups of boys showing delayed movement away from emotion-focused strategies or delay in the onset of regular use of distraction. The results provide a foundation for future research to examine the development of SRS in low-income young children. PMID:21675542

Use of methodological tools for assessing the quality of studies in periodontology and implant dentistry: a systematic review.

PubMed

Faggion, Clovis M; Huda, Fahd; Wasiak, Jason

2014-06-01

To evaluate the methodological approaches used to assess the quality of studies included in systematic reviews (SRs) in periodontology and implant dentistry. Two electronic databases (PubMed and Cochrane Database of Systematic Reviews) were searched independently to identify SRs examining interventions published through 2 September 2013. The reference lists of included SRs and records of 10 specialty dental journals were searched manually. Methodological approaches were assessed using seven criteria based on the Cochrane Handbook for Systematic Reviews of Interventions. Temporal trends in methodological quality were also explored. Of the 159 SRs with meta-analyses included in the analysis, 44 (28%) reported the use of domain-based tools, 15 (9%) reported the use of checklists and 7 (4%) reported the use of scales. Forty-two (26%) SRs reported use of more than one tool. Criteria were met heterogeneously; authors of 15 (9%) publications incorporated the quality of evidence of primary studies into SRs, whereas 69% of SRs reported methodological approaches in the Materials/Methods section. Reporting of four criteria was significantly better in recent (2010-2013) than in previous publications. The analysis identified several methodological limitations of approaches used to assess evidence in studies included in SRs in periodontology and implant dentistry. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Is the evaluation of risk of bias in periodontology and implant dentistry comprehensive? A systematic review.

PubMed

Faggion, Clovis Mariano; Listl, Stefan; Alarcón, Marco Antonio

2015-05-01

The objective of this study was to assess how authors of systematic reviews (SRs) with meta-analyses published in periodontology and implant dentistry evaluate risk of bias (ROB) in primary studies included in these reviews. A literature search for SRs with meta-analyses was performed in PubMed and Cochrane library databases up to July 20th 2014. The reference lists of included articles were screened for further reviews. The standards of evaluating ROB in primary studies were evaluated by using a 14-item checklist based on the Cochrane approach for evaluating ROB. Standards in ROB evaluations in Cochrane and paper-based SRs were compared using the Fisher's exact test. All searches, data extraction and evaluations were performed independently and in duplicate. Seventy SRs were included (45 paper-based and 25 Cochrane SRs, respectively). The median percentage of items addressed was 58% (interquartile range 4-100%). Cochrane SRs more frequently included ROB assessments than paper-based reviews in terms of examiner blinding (p = 0.0026), selective outcome reporting (p = 0.0207) and other bias (p = 0.0241). The ROB evaluation in primary studies currently included in SRs with meta-analyses in periodontology and implant dentistry is not sufficiently comprehensive. Cochrane SRs have more comprehensive ROB evaluation than paper-based reviews. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Mammals of the Savannah River Site

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

Cothran, E.G.; Smith, M.H.; Wolff, J.O.

1991-12-31

This book is designed to be used as a field guide, reference book, bibliography, and introduction to the basic biology and ecology of the 54 mammal species that currently or potentially exist on or near the Savannah River Site (SRS). For 50 of these species, we present basic descriptions, distinguishing morphological features, distribution and habitat preferences, food habits, reproductive biology, social behavior, ecological relationships with other species, and economic importance to man. For those species that have been studied on the SRS, we summarize the results of these studies. Keys and illustrations are provided for whole body and skull identification.more » A selected glossary defines technical terminology. Illustrations of tracks of the more common larger mammals will assist in field identifications. We also summarize the results of two major long-term SRS studies, ``The Forbearer Census`` and ``White-tailed Deer Studies``. A cross-indexed list of over 300 SRS publications on mammals classifies each publication by 23 categories such as habitat, reproduction, genetics, etc., and also for each mammal species. The 149 Master`s theses and Ph.D. dissertations that have been conducted at the Savannah River Ecology Laboratory are provided as additional references.« less

Mammals of the Savannah River Site

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

Cothran, E.G.; Smith, M.H.; Wolff, J.O.

1991-01-01

This book is designed to be used as a field guide, reference book, bibliography, and introduction to the basic biology and ecology of the 54 mammal species that currently or potentially exist on or near the Savannah River Site (SRS). For 50 of these species, we present basic descriptions, distinguishing morphological features, distribution and habitat preferences, food habits, reproductive biology, social behavior, ecological relationships with other species, and economic importance to man. For those species that have been studied on the SRS, we summarize the results of these studies. Keys and illustrations are provided for whole body and skull identification.more » A selected glossary defines technical terminology. Illustrations of tracks of the more common larger mammals will assist in field identifications. We also summarize the results of two major long-term SRS studies, The Forbearer Census'' and White-tailed Deer Studies''. A cross-indexed list of over 300 SRS publications on mammals classifies each publication by 23 categories such as habitat, reproduction, genetics, etc., and also for each mammal species. The 149 Master's theses and Ph.D. dissertations that have been conducted at the Savannah River Ecology Laboratory are provided as additional references.« less

Impact of Inclusion of Industry Trial Results Registries as an Information Source for Systematic Reviews

PubMed Central

Potthast, Regine; Vervölgyi, Volker; McGauran, Natalie; Kerekes, Michaela F.; Wieseler, Beate; Kaiser, Thomas

2014-01-01

Background Clinical trial results registries may contain relevant unpublished information. Our main aim was to investigate the potential impact of the inclusion of reports from industry results registries on systematic reviews (SRs). Methods We identified a sample of 150 eligible SRs in PubMed via backward selection. Eligible SRs investigated randomized controlled trials of drugs and included at least 2 bibliographic databases (original search date: 11/2009). We checked whether results registries of manufacturers and/or industry associations had also been searched. If not, we searched these registries for additional trials not considered in the SRs, as well as for additional data on trials already considered. We reanalysed the primary outcome and harm outcomes reported in the SRs and determined whether results had changed. A “change” was defined as either a new relevant result or a change in the statistical significance of an existing result. We performed a search update in 8/2013 and identified a sample of 20 eligible SRs to determine whether mandatory results registration from 9/2008 onwards in the public trial and results registry ClinicalTrials.gov had led to its inclusion as a standard information source in SRs, and whether the inclusion rate of industry results registries had changed. Results 133 of the 150 SRs (89%) in the original analysis did not search industry results registries. For 23 (17%) of these SRs we found 25 additional trials and additional data on 31 trials already included in the SRs. This additional information was found for more than twice as many SRs of drugs approved from 2000 as approved beforehand. The inclusion of the additional trials and data yielded changes in existing results or the addition of new results for 6 of the 23 SRs. Of the 20 SRs retrieved in the search update, 8 considered ClinicalTrials.gov or a meta-registry linking to ClinicalTrials.gov, and 1 considered an industry results registry. Conclusion The inclusion of industry and public results registries as an information source in SRs is still insufficient and may result in publication and outcome reporting bias. In addition to an essential search in ClinicalTrials.gov, authors of SRs should consider searching industry results registries. PMID:24743113

Scale-Resolving simulations (SRS): How much resolution do we really need?

NASA Astrophysics Data System (ADS)

Pereira, Filipe M. S.; Girimaji, Sharath

2017-11-01

Scale-resolving simulations (SRS) are emerging as the computational approach of choice for many engineering flows with coherent structures. The SRS methods seek to resolve only the most important features of the coherent structures and model the remainder of the flow field with canonical closures. With reference to a typical Large-Eddy Simulation (LES), practical SRS methods aim to resolve a considerably narrower range of scales (reduced physical resolution) to achieve an adequate degree of accuracy at reasonable computational effort. While the objective of SRS is well-founded, the criteria for establishing the optimal degree of resolution required to achieve an acceptable level of accuracy are not clear. This study considers the canonical case of the flow around a circular cylinder to address the issue of `optimal' resolution. Two important criteria are developed. The first condition addresses the issue of adequate resolution of the flow field. The second guideline provides an assessment of whether the modeled field is canonical (stochastic) turbulence amenable to closure-based computations.

Methodological quality of systematic reviews referenced in clinical practice guidelines for the treatment of opioid use disorder.

PubMed

Ross, Andrew; Rankin, Justin; Beaman, Jason; Murray, Kelly; Sinnett, Philip; Riddle, Ross; Haskins, Jordan; Vassar, Matt

2017-01-01

With efforts to combat opioid use disorder, there is an increased interest in clinical practice guidelines (CPGs) for opioid use disorder treatments. No literature exists examining the quality of systematic reviews used in opioid use disorder CPGs. This study aims to describe the methodological quality and reporting clarity of systematic reviews (SRs) used to create CPGs for opioid use disorder. From June to July 2016 guideline clearinghouses and medical literature databases were searched for relevant CPGs used in the treatment of opioid use disorder. Included CPGs must have been recognized by a national organization. SRs from the reference section of each CPG was scored by using AMSTAR (a measurement tool to assess the methodological quality of systematic reviews) tool and PRISMA (preferred reporting items for systematic reviews and meta-analyses) checklist. Seventeen CPGs from 2006-2016 were included in the review. From these, 57 unique SRs were extracted. SRS comprised 0.28% to 17.92% of all references found in the CPGs. All SRs obtained moderate or high methodological quality score on the AMSTAR tool. All reviews met at least 70% of PRISMA criteria. In PRISMA, underperforming areas included accurate title labeling, protocol registration, and risk of bias. Underperforming areas in AMSTAR included conflicts of interest, funding, and publication bias. A positive correlation was found between AMSTAR and PRISMA scores (r = .79). Although the SRs in the CPGs were of good quality, there are still areas for improvement. Systematic reviewers should consult PRISMA and AMSTAR when conducting and reporting reviews. It is important for CPG developers to consider methodological quality as a factor when developing CPG recommendations, recognizing that the quality of systematic reviews underpinning guidelines does not necessarily correspond to the quality of the guideline itself.

The Screening Accuracy of the Parent and Teacher-Reported Social Responsiveness Scale (SRS): Comparison with the 3Di and ADOS

ERIC Educational Resources Information Center

Duvekot, Jorieke; van der Ende, Jan; Verhulst, Frank C.; Greaves-Lord, Kirstin

2015-01-01

The screening accuracy of the parent and teacher-reported Social Responsiveness Scale (SRS) was compared with an autism spectrum disorder (ASD) classification according to (1) the Developmental, Dimensional, and Diagnostic Interview (3Di), (2) the Autism Diagnostic Observation Schedule (ADOS), (3) both the 3Di and ADOS, in 186 children referred to…

Comparison of SSS and SRS calculated from normal databases provided by QPS and 4D-MSPECT manufacturers and from identical institutional normals.

PubMed

Knollmann, Daniela; Knebel, Ingrid; Koch, Karl-Christian; Gebhard, Michael; Krohn, Thomas; Buell, Ulrich; Schaefer, Wolfgang M

2008-02-01

There is proven evidence for the importance of myocardial perfusion-single-photon emission computed tomography (SPECT) with computerised determination of summed stress and rest scores (SSS/SRS) for the diagnosis of coronary artery disease (CAD). SSS and SRS can thereby be calculated semi-quantitatively using a 20-segment model by comparing tracer-uptake with values from normal databases (NDB). Four severity-degrees for SSS and SRS are normally used: <4, 4-8, 9-13, and > or =14. Manufacturers' NDBs (M-NDBs) often do not fit the institutional (I) settings. Therefore, this study compared SSS and SRS obtained with the algorithms Quantitative Perfusion SPECT (QPS) and 4D-MSPECT using M-NDB and I-NDB. I-NDBs were obtained using QPS and 4D-MSPECT from exercise stress data (450 MBq (99m)Tc-tetrofosmin, triple-head-camera, 30 s/view, 20 views/head) from 36 men with a low post-stress test CAD probability and visually normal SPECT findings. Patient group was 60 men showing the entire CAD-spectrum referred for routine perfusion-SPECT. Stress/rest results of automatic quantification of the 60 patients were compared to M-NDB and I-NDB. After reclassifying SSS/SRS into the four severity degrees, kappa values were calculated to objectify agreement. Mean values (vs M-NDB) were 9.4 +/- 10.3 (SSS) and 5.8 +/- 9.7 (SRS) for QPS and 8.2 +/- 8.7 (SSS) and 6.2 +/- 7.8 (SRS) for 4D-MSPECT. Thirty seven of sixty SSS classifications (kappa = 0.462) and 40/60 SRS classifications (kappa = 0.457) agreed. Compared to I-NDB, mean values were 10.2 +/- 11.6 (SSS) and 6.5 +/- 10.4 (SRS) for QPS and 9.2 +/- 9.3 (SSS) and 7.2 +/- 8.6 (SRS) for 4D-MSPECT. Forty four of sixty patients agreed in SSS and SRS (kappa = 0.621 resp. 0.58). Considerable differences between SSS/SRS obtained with QPS and 4D-MSPECT were found when using M-NDB. Even using identical patients and identical I-NDB, the algorithms still gave substantial different results.

Toxicodynamic modeling of 137Cs to estimate white-tailed deer background levels for the Department of Energy's Savannah River Site.

PubMed

Gaines, Karen F; Novak, James M; Bobryk, Christopher W; Blas, Susan A

2014-04-01

The U.S. Department of Energy's (USDOE) Savannah River Site (SRS) is a former nuclear weapon material production and current research facility adjacent to the Savannah River in South Carolina, USA. The purpose of this study was to determine the background radiocesium ((137)Cs) body burden (e.g., from global fallout) for white-tailed deer (Odocoileus virginianus) inhabiting the SRS. To differentiate what the background burden is for the SRS versus (137)Cs obtained from SRS nuclear activities, data were analyzed spatially, temporally and compared to other off-site hunting areas near the SRS. The specific objectives of this study were: to compare SRS and offsite deer herds based on time and space; to interpret comparisons based on how data were collected as well as the effect of environmental and anthropogenic influences; to determine what the ecological half-life/decay rate is for (137)Cs in the SRS deer herd; and to give a recommendation to what should be considered the background (137)Cs level in the SRS deer herd. Based on the available information and analyses, it is recommended that the determination of what is considered background for the SRS deer herd be derived from data collected from the SRS deer herd itself and not offsite collections for a variety of reasons. Offsite data show extreme variability most likely due to environmental factors such as soil type and land-use patterns (e.g., forest, agriculture, residential activities). This can be seen from results where samples from offsite military bases (Fort Jackson and Fort Stewart) without anthropogenic (137)Cs sources were much higher than both the SRS and a nearby (Sandhills) study site. Moreover, deer from private hunting grounds have the potential to be baited with corn, thus artificially lowering their (137)Cs body burdens compared to other free-ranging deer. Additionally, sample size for offsite collections were not robust enough to calculate a temporal decay curve with an upper confidence level to determine if the herds are following predicted radioactive decay rates like the SRS or if the variability is due to those points described above. Using mean yearly values, the ecological half-life for (137)Cs body burdens for SRS white-tailed deer was determined to be 28.79 years--very close to the 30.2 years physical half-life.

Methodological quality of systematic reviews analyzing the use of laser therapy in restorative dentistry.

PubMed

Salmos, Janaina; Gerbi, Marleny E M M; Braz, Rodivan; Andrade, Emanuel S S; Vasconcelos, Belmiro C E; Bessa-Nogueira, Ricardo V

2010-01-01

The purpose of this study was to identify systematic reviews (SRs) that compared laser with other dental restorative procedures and to evaluate their methodological quality. A search strategy was developed and implemented for MEDLINE, the Cochrane Library, LILACS, and the Brazilian Dentistry Bibliography (1966- 2007). Inclusion criteria were: the article had to be an SR (+/- meta-analysis); primary focus was the use of laser in restorative dentistry; published in English, Spanish, Portuguese, Italian, German. Two investigators independently selected and evaluated the SRs. The overview quality assessment questionnaire (OQAQ) was used to evaluate methodological quality, and the results were averaged. There were 145 references identified, of which seven were SRs that met the inclusion criteria (kappa=0.81). Of the SRs, 71.4% appraised lasers in dental caries diagnosis. The mean overall OQAQ score was 4.4 [95% confidence interval (CI) 2.4- 6.5]. Of the SRs, 57.1% had major flaws, scoring < or = 4. SR methodological quality is low; therefore, clinicians should critically appraise them prior to considering their recommendations to guide patient care.

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

Armstrong, Christopher R.; Brant, Heather A.; Nuessle, Patterson R.

Owing to the rich history of heavy element production in the unique high flux reactors that operated at the Savannah River Site, USA (SRS) decades ago, trace quantities of plutonium with highly unique isotopic characteristics still persist today in the SRS terrestrial environment. Development of an effective sampling, processing, and analysis strategy enables detailed monitoring of the SRS environment, revealing plutonium isotopic compositions, e.g., 244Pu, that reflect the unique legacy of plutonium production at SRS. This work describes the first long-term investigation of anthropogenic 244Pu occurrence in the environment. Environmental samples, consisting of collected foot borne debris, were taken atmore » SRS over an eleven year period, from 2003 to 2014. Separation and purification of trace plutonium was carried out followed by three stage thermal ionization mass spectrometry (3STIMS) measurements for plutonium isotopic content and isotopic ratios. Furthermore, significant 244Pu was measured in all of the years sampled with the highest amount observed in 2003. The 244Pu content, in femtograms (fg = 10 –15 g) per gram, ranged from 0.31 fg/g to 44 fg/g in years 2006 and 2003 respectively. In all years, the 244Pu/ 239Pu atom ratios were significantly higher than global fallout, ranging from 0.003 to 0.698 in years 2014 and 2003 respectively.« less

Radiosurgery alone for 5 or more brain metastases: expert opinion survey.

PubMed

Knisely, Jonathan P S; Yamamoto, Masaaki; Gross, Cary P; Castrucci, William A; Jokura, Hidefumi; Chiang, Veronica L S

2010-12-01

Oligometastatic brain metastases may be treated with stereotactic radiosurgery (SRS) alone, but no consensus exists as to when SRS alone would be appropriate. A survey was conducted at 2 radiosurgery meetings to determine which factors SRS practitioners emphasize in recommending SRS alone, and what physician characteristics are associated with recommending SRS alone for ≥ 5 metastases. All physicians attending the 8th Biennial Congress and Exhibition of the International Stereotactic Radiosurgery Society in June 2007 and the 18th Annual Meeting of the Japanese Society of Stereotactic Radiosurgery in July 2009 were asked to complete a questionnaire ranking 14 clinical factors on a 5-point Likert-type scale (ranging from 1 = not important to 5 = very important) to determine how much each factor might influence a decision to recommend SRS alone for brain metastases. Results were condensed into a single dichotomous outcome variable of "influential" (4-5) versus "not influential" (1-3). Respondents were also asked to complete the statement: "In general, a reasonable number of brain metastases treatable by SRS alone would be, at most, ___." The characteristics of physicians willing to recommend SRS alone for ≥ 5 metastases were assessed. Chi-square was used for univariate analysis, and logistic regression for multivariate analysis. The final study sample included 95 Gamma Knife and LINAC-using respondents (54% Gamma Knife users) in San Francisco and 54 in Sendai (48% Gamma Knife users). More than 70% at each meeting had ≥ 5 years experience with SRS. Sixty-five percent in San Francisco and 83% in Sendai treated ≥ 30 cases annually with SRS. The highest number of metastases considered reasonable to treat with SRS alone in both surveys was 50. In San Francisco, the mean and median numbers of metastases considered reasonable to treat with SRS alone were 6.7 and 5, while in Sendai they were 11 and 10. In the San Francisco sample, the clinical factors identified to be most influential in decision making were Karnofsky Performance Scale score (78%), presence/absence of mass effect (76%), and systemic disease control (63%). In Sendai, the most influential factors were the size of the metastases (78%), the Karnofsky Performance Scale score (70%), and metastasis location (68%). In San Francisco, 55% of respondents considered treating ≥ 5 metastases and 22% considered treating ≥ 10 metastases "reasonable." In Sendai, 83% of respondents considered treating ≥ 5 metastases and 57% considered treating ≥ 10 metastases "reasonable." In both groups, private practitioners, neurosurgeons, and Gamma Knife users were statistically significantly more likely to treat ≥ 5 metastases with SRS alone. Although there is no clear consensus for how many metastases are reasonable to treat with SRS alone, more than half of the radiosurgeons at 2 international meetings were willing to extend the use of SRS as an initial treatment for ≥ 5 brain metastases. Given the substantial variation in clinicians' approaches to SRS use, further research is required to identify patient characteristics associated with optimal SRS outcomes.

[How do authors of systematic reviews restrict their literature searches when only studies from Germany should be included?

PubMed

Pieper, Dawid; Mathes, Tim; Palm, Rebecca; Hoffmann, Falk

2016-11-01

The use of search filters (e. g. for study types) facilitates the process of literature searching. Regional limits might be helpful depending on the research question. Regional search filters are already available for some regions, but not for Germany. Our aim is to give an overview of applied search strategies in systematic reviews (SRs) focusing on Germany. We searched Medline (via Pubmed) applying a focused search strategy to identify SRs focusing on Germany in January 2016. Study selection and data extraction were performed by two reviewers independently. The search strategies with a focus on Germany were analyzed in terms of reasonableness and completeness relying on the Peer Review of Electronic Search Strategies (PRESS) criteria. A narrative evidence synthesis was performed. In total, 36 SRs (13 written in English) were included. 78% were published in 2012 or later. The majority (89%) of SRs utilized at least two different sources for their search with databases and checking references being the most common. 17 SRs did not use any truncations, ten SRs did not restrict their search to Germany, six SRs reported to have searched for German OR Germany. Only ten articles searched for the term Germany (occasionally jointly with the term Deutschland) without any use of an adjective such as German. There is a high interest in regionally focused SRs. The identified search strategies revealed a need for improvement. It would be helpful to develop a regional search filter for Germany that is able to identify studies performed in Germany. Copyright © 2016. Published by Elsevier GmbH.

Peripheral nervous system injury after high-dose single-fraction image-guided stereotactic radiosurgery for spine tumors.

PubMed

Stubblefield, Michael D; Ibanez, Katarzyna; Riedel, Elyn R; Barzilai, Ori; Laufer, Ilya; Lis, Eric; Yamada, Yoshiya; Bilsky, Mark H

2017-03-01

OBJECTIVE The object of this study was to determine the percentage of high-dose (1800-2600 cGy) single-fraction stereotactic radiosurgery (SF-SRS) treatments to the spine that result in peripheral nervous system (PNS) injury. METHODS All patients treated with SF-SRS for primary or metastatic spine tumors between January 2004 and May 2013 and referred to the Rehabilitation Medicine Service for evaluation and treatment of neuromuscular, musculoskeletal, or functional impairments or pain were retrospectively identified. RESULTS Five hundred fifty-seven SF-SRS treatments in 447 patients resulted in 14 PNS injuries in 13 patients. All injures resulted from SF-SRS delivered to the cervical or lumbosacral spine at 2400 cGy. The overall percentage of SF-SRS treatments resulting in PNS injury was 2.5%, increasing to 4.5% when the thoracic spine was excluded from analysis. The median time to symptom onset following SF-SRS was 10 months (range 4-32 months). The plexus (cervical, brachial, and/or lumbosacral) was affected clinically and/or electrophysiologically in 12 (86%) of 14 cases, the nerve root in 2 (14%) of 14, and both in 6 (43%) of 14 cases. All patients experienced pain and most (93%) developed weakness. Peripheral nervous system injuries were CTCAE Grade 1 in 14% of cases, 2 in 64%, and 3 in 21%. No dose relationship between SF-SRS dose and PNS injury was detected. CONCLUSIONS Single-fraction SRS to the spine can result in PNS injury with major implications for function and quality of life.

Production of refolded Toxoplasma gondii recombinant SAG1-related sequence 3 (SRS3) and its use for serodiagnosis of human toxoplasmosis.

PubMed

Mirzadeh, Abolfazl; Saadatnia, Geita; Golkar, Majid; Babaie, Jalal; Noordin, Rahmah

2017-05-01

SAG1-related sequence 3 (SRS3) is one of the major Toxoplasma gondii tachyzoite surface antigens and has been shown to be potentially useful for the detection of toxoplasmosis. This protein is highly conformational due to the presence of six disulfide bonds. To achieve solubility and antigenicity, SRS3 depends on proper disulfide bond formation. The aim of this study was to over-express the SRS3 protein with correct folding for use in serodiagnosis of the disease. To achieve this, a truncated SRS3 fusion protein (rtSRS3) was produced, containing six histidyl residues at both terminals and purified by immobilized metal affinity chromatography. The refolding process was performed through three methods, namely dialysis in the presence of chemical additives along with reduced/oxidized glutathione and drop-wise dilution methods with reduced/oxidized glutathione or reduced DTT/oxidized glutathione. Ellman's assay and ELISA showed that the protein folding obtained by the dialysis method was the most favorable, probably due to the correct folding. Subsequently, serum samples from individuals with chronic infection (n = 76), probable acute infection (n = 14), and healthy controls (n = 81) were used to determine the usefulness of the refolded rtSRS3 for Toxoplasma serodiagnosis. The results of the developed IgG-ELISA showed a diagnostic specificity of 91% and a sensitivity of 82.89% and 100% for chronic and acute serum samples, respectively. In conclusion, correctly folded rtSRS3 has the potential to be used as a soluble antigen for the detection of human toxoplasmosis. Copyright © 2017 Elsevier Inc. All rights reserved.

A Comparative Analysis Among the SRS M&M, NIS, and KID Databases for the Adolescent Idiopathic Scoliosis.

PubMed

Lee, Nathan J; Guzman, Javier Z; Kim, Jun; Skovrlj, Branko; Martin, Christopher T; Pugely, Andrew J; Gao, Yubo; Caridi, John M; Mendoza-Lattes, Sergio; Cho, Samuel K

2016-11-01

Retrospective cohort analysis. A growing number of publications have utilized the Scoliosis Research Society (SRS) Morbidity and Mortality (M&M) database, but none have compared it to other large databases. The objective of this study was to compare SRS complications with those in administrative databases. The Nationwide Inpatient Sample (NIS) and Kid's Inpatient Database (KID) captured a greater number of overall complications while the SRS M&M data provided a greater incidence of spine-related complications following adolescent idiopathic scoliosis (AIS) surgery. Chi-square was used to obtain statistical significance, with p < .05 considered significant. The SRS 2004-2007 (9,904 patients), NIS 2004-2007 (20,441 patients) and KID 2003-2006 (10,184 patients) databases were analyzed for AIS patients who underwent fusion. Comparable variables were queried in all three databases, including patient demographics, surgical variables, and complications. Patients undergoing AIS in the SRS database were slightly older (SRS 14.4 years vs. NIS 13.8 years, p < .0001; KID 13.9 years, p < .0001) and less likely to be male (SRS 18.5% vs. NIS 26.3%, p < .0001; KID 24.8%, p < .0001). Revision surgery (SRS 3.3% vs. NIS 2.4%, p < .0001; KID 0.9%, p < .0001) and osteotomy (SRS 8% vs. NIS 2.3%, p < .0001; KID 2.4%, p < .0001) were more commonly reported in the SRS database. The SRS database reported fewer overall complications (SRS 3.9% vs. NIS 7.3%, p < .0001; KID 6.6%, p < .0001). However, when respiratory complications (SRS 0.5% vs. NIS 3.7%, p < .0001; KID 4.4%, p < .0001) were excluded, medical complication rates were similar across databases. In contrast, SRS reported higher spine-specific complication rates. Mortality rates were similar between SRS versus NIS (p = .280) and SRS versus KID (p = .08) databases. There are similarities and differences between the three databases. These discrepancies are likely due to the varying data-gathering methods each organization uses to collect their morbidity data. Level IV. Copyright © 2016 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

BIOTIC INTEGRITY OF STREAMS IN THE SAVANNAH RIVER SITE INTEGRATOR OPERABLE UNITS, 1996 TO 2003

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

Paller, M; Susan Dyer, S

2004-11-08

The Savannah River Site (SRS) has been divided into six Integrator Operable Units (IOUs) that correspond to the watersheds of the five major streams on the SRS (Upper Three Runs, Fourmile Branch, Pen Branch, Steel Creek, and Lower Three Runs) and the portions of the Savannah River and Savannah River Swamp associated with the SRS. The streams are the primary integrators within each IOU because they potentially receive, through surface or subsurface drainage, soluble contaminants from all waste sites within their watersheds. If these contaminants reach biologically significant levels, they would be expected to effect the numbers, types, and healthmore » of stream organisms. In this study, biological sampling was conducted within each IOU as a measure of the cumulative ecological effects of the waste sites within the IOUs. The use of information from biological sampling to assess environmental quality is often termed bioassessment. The IOU bioassessment program included 38 sites in SRS streams and nine sites in the Savannah River. Sampling was conducted in 1996 to 1998, 2000, and 2003. Four bioassessment methods were used to evaluate ecological conditions in the IOU streams: the Index of Biotic Integrity, the Fish Health Assessment Index, measurement of fish tissue contaminant levels, and two benthic macroinvertebrate indices. The Index of Biotic Integrity (IBI) is an EPA supported method based on comparison of ecologically important and sensitive fish assemblage variables between potentially disturbed and reference (i.e., undisturbed) sites. It is designed to assess the ability of a stream to support a self-sustaining biological community and ecological processes typical of undisturbed, natural conditions. Since many types of contaminants can bioaccumulate, fish tissue contaminant data were used to determine the types of chemicals fish were exposed to and their relative magnitudes among IOUs. The Fish Health Assessment Index (HAI) is an EPA supported method for assessing the health and condition of individual fish based on dissection and internal examination. It helped to determine whether contaminant concentrations were high enough to adversely affect the health of individual fish. The benthic macroinvertebrate multimetric index (HDMI), used in 1997 to 2000, is a method for assessing stream health based on macroinvertebrate data collected with Hester-Dendy artificial substrates. In 2003 it was replaced with the Multiple Habitat Sampling protocol, a SCDHEC method for collecting and analyzing benthic macroinvertebrate data from natural substrate. These two macroinvertebrate based methods were used in conjunction with the fish based IBI to provide a more comprehensive assessment of ecological conditions. Lastly, habitat data were collected from each stream to assist in determining whether ecological integrity was compromised by physical factors (e.g., erosion) or chemical factors (e.g., discharge of toxic materials). Fish from many SRS streams exhibited evidence of contamination as a result of current or former SRS operations. The most prevalent radiological contaminants were cesium-137 (highest in fish from Lower Three Runs followed by Steel Creek and Fourmile Branch), tritium (highest in fish from Fourmile Branch followed by Pen Branch, and the Savannah River swamp), and strontium (highest in fish from Fourmile Branch followed by Pen Branch). Radiological contaminants were also found in fish collected from the Savannah River near the mouths of contaminated SRS streams; however, contaminant levels were substantially lower than in fish from the streams themselves. Mercury levels were moderately elevated in fish from some streams, particularly Lower Three Runs, and in fish from the Savannah River. Despite the occurrence of contaminants, most SRS streams exhibited comparatively high biotic integrity (based on IBI, HDMI, and MHSP scores) and minimal levels of pathology among individual fish (e.g., presence of tumors or extreme thinness), indicating that contaminant levels were generally insufficient to cause significant ecological degradation.« less

Complementary and alternative medicine for lowering blood lipid levels: A systematic review of systematic reviews.

PubMed

Posadzki, Paul; AlBedah, Abdullah M N; Khalil, Mohamed M K; AlQaed, Meshari S

2016-12-01

The aim of this article is to summarize and critically evaluate the evidence from systematic reviews (SRs) of complementary and alternative medicine (CAM) for lowering blood lipid levels (BLL). Eight electronic databases were searched until March 2016. Additionally, all the retrieved references were inspected manually for further relevant papers. Systematic reviews were considered eligible, if they included patients of any age and/or gender with elevated blood lipid levels using any type of CAM. We used the Oxman and AMSTAR criteria to critically appraise the methodological quality of the included SRs. Twenty-seven SRs were included in the analyses. The majority of the SRs were of high methodological quality (mean Oxman score=4.81, SD=4.88; and the mean AMSTAR score=7.22, SD=3.38). The majority of SRs (56%) arrived at equivocal conclusions (of these 8 were of high quality); 7 SRs (37%) arrived at positive conclusions (of these 6 were of high quality), and 2 (7%) arrived at negative conclusions (both were of high quality). There was conflicting evidence regarding the effectiveness of garlic; and promising evidence for yoga. To conclude, the evidence from SRs evaluating the effectiveness of CAM in lowering BLL is predominantly equivocal and confusing. Several limitations exist, such as variety of doses and preparations, confounding effects of diets and lifestyle factors, or heterogeneity of the primary trials among others. Copyright © 2016. Published by Elsevier Ltd.

The comparative recall of Google Scholar versus PubMed in identical searches for biomedical systematic reviews: a review of searches used in systematic reviews.

PubMed

Bramer, Wichor M; Giustini, Dean; Kramer, Bianca Mr; Anderson, Pf

2013-12-23

The usefulness of Google Scholar (GS) as a bibliographic database for biomedical systematic review (SR) searching is a subject of current interest and debate in research circles. Recent research has suggested GS might even be used alone in SR searching. This assertion is challenged here by testing whether GS can locate all studies included in 21 previously published SRs. Second, it examines the recall of GS, taking into account the maximum number of items that can be viewed, and tests whether more complete searches created by an information specialist will improve recall compared to the searches used in the 21 published SRs. The authors identified 21 biomedical SRs that had used GS and PubMed as information sources and reported their use of identical, reproducible search strategies in both databases. These search strategies were rerun in GS and PubMed, and analyzed as to their coverage and recall. Efforts were made to improve searches that underperformed in each database. GS' overall coverage was higher than PubMed (98% versus 91%) and overall recall is higher in GS: 80% of the references included in the 21 SRs were returned by the original searches in GS versus 68% in PubMed. Only 72% of the included references could be used as they were listed among the first 1,000 hits (the maximum number shown). Practical precision (the number of included references retrieved in the first 1,000, divided by 1,000) was on average 1.9%, which is only slightly lower than in other published SRs. Improving searches with the lowest recall resulted in an increase in recall from 48% to 66% in GS and, in PubMed, from 60% to 85%. Although its coverage and precision are acceptable, GS, because of its incomplete recall, should not be used as a single source in SR searching. A specialized, curated medical database such as PubMed provides experienced searchers with tools and functionality that help improve recall, and numerous options in order to optimize precision. Searches for SRs should be performed by experienced searchers creating searches that maximize recall for as many databases as deemed necessary by the search expert.

The comparative recall of Google Scholar versus PubMed in identical searches for biomedical systematic reviews: a review of searches used in systematic reviews

PubMed Central

2013-01-01

Background The usefulness of Google Scholar (GS) as a bibliographic database for biomedical systematic review (SR) searching is a subject of current interest and debate in research circles. Recent research has suggested GS might even be used alone in SR searching. This assertion is challenged here by testing whether GS can locate all studies included in 21 previously published SRs. Second, it examines the recall of GS, taking into account the maximum number of items that can be viewed, and tests whether more complete searches created by an information specialist will improve recall compared to the searches used in the 21 published SRs. Methods The authors identified 21 biomedical SRs that had used GS and PubMed as information sources and reported their use of identical, reproducible search strategies in both databases. These search strategies were rerun in GS and PubMed, and analyzed as to their coverage and recall. Efforts were made to improve searches that underperformed in each database. Results GS’ overall coverage was higher than PubMed (98% versus 91%) and overall recall is higher in GS: 80% of the references included in the 21 SRs were returned by the original searches in GS versus 68% in PubMed. Only 72% of the included references could be used as they were listed among the first 1,000 hits (the maximum number shown). Practical precision (the number of included references retrieved in the first 1,000, divided by 1,000) was on average 1.9%, which is only slightly lower than in other published SRs. Improving searches with the lowest recall resulted in an increase in recall from 48% to 66% in GS and, in PubMed, from 60% to 85%. Conclusions Although its coverage and precision are acceptable, GS, because of its incomplete recall, should not be used as a single source in SR searching. A specialized, curated medical database such as PubMed provides experienced searchers with tools and functionality that help improve recall, and numerous options in order to optimize precision. Searches for SRs should be performed by experienced searchers creating searches that maximize recall for as many databases as deemed necessary by the search expert. PMID:24360284

F-Area Acid/Caustic Basin groundwater monitoring report: Third quarter 1994

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

Not Available

1994-12-01

During third quarter 1994, samples from the FAC monitoring wells at the F-Area Acid/Caustic Basin were collected and analyzed for herbicides/pesticides, indicator parameters, metals, nitrate, radionuclide indicators, volatile organic compounds, and other constituents. Piezometer FAC 5P and monitoring well FAC 6 were dry and could not be sampled. New monitoring wells FAC 9C, 10C, 11C, and 12C were sampled for the first time during third quarter. Analytical results that exceeded final Primary Drinking Water Standards (PDWS), other Savannah River Site (SRS) Flag 2 criteria, or the SRS turbidity standard of 50 NTU during the quarter were as follows: gross alphamore » exceeded the final PDWS and aluminum, iron, manganese, and total alpha-emitting radium exceeded the SRS Flag 2 criteria in one or more of the FAC wells. Turbidity exceeded the SRS standard in wells FAC 3 and 10C. Groundwater flow direction and rate in the water table beneath the F-Area Acid/Caustic Basin were similar to past quarters.« less

3013/9975 Surveillance Program Interim Summary Report

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

Dunn, K.; Hackney, B.; McClard, J.

2011-06-22

The K-Area Materials Storage (KAMS) Documented Safety Analysis (DSA) requires a surveillance program to monitor the safety performance of 3013 containers and 9975 shipping packages stored in KAMS. The SRS surveillance program [Reference 1] outlines activities for field surveillance and laboratory tests that demonstrate the packages meet the functional performance requirements described in the DSA. The SRS program also supports the complexwide Integrated Surveillance Program (ISP) [Reference 2] for 3013 containers. The purpose of this report is to provide a summary of the SRS portion of the surveillance program activities through fiscal year 2010 (FY10) and formally communicate the interpretationmore » of these results by the Surveillance Program Authority (SPA). Surveillance for the initial 3013 container random sampling of the Innocuous bin and the Pressure bin has been completed and there has been no indication of corrosion or significant pressurization. The maximum pressure observed was less than 50 psig, which is well below the design pressure of 699 psig for the 3013 container [Reference 3]. The data collected during surveillance of these bins has been evaluated by the Materials Identification and Surveillance (MIS) Working Group and no additional surveillance is necessary for these bins at least through FY13. A decision will be made whether additional surveillance of these bins is needed during future years of storage and as additional containers are generated. Based on the data collected to date, the SPA concludes that 3013 containers in these bins can continue to be safely stored in KAMS. This year, 13 destructive examinations (DE) were performed on random samples from the Pressure & Corrosion bin. To date, DE has been completed for approximately 30% of the random samples from the Pressure & Corrosion bin. In addition, DE has been performed on 6 engineering judgment (EJ) containers, for a total of 17 to date. This includes one container that exceeded the 3013 Standard moisture limit which was opened at LANL. The container pieces and an oxide sample were sent to SRNL for examination in FY11. No significant pressurization has been observed for the Pressure & Corrosion bin containers. Relatively minor corrosion has been observed on some convenience containers and the inside of two inner containers. While the limited extent of corrosion does not jeopardize the integrity of the outer 3013 containers, it does highlight the importance of continuing to perform DE and the Shelf Life program to assure that the corrosion rate is not accelerating or changing to a different corrosion mechanism (e.g., stress corrosion cracking). Statistical sampling is currently scheduled to be completed in FY17, but there is a proposed reduction of the number of DE's per year for FY11 and beyond which may delay the completion date. Since 3013 containers are stored inside 9975 containers, surveillances of 9975 containers are performed in conjunction with 3013 container surveillances. Results of 9975 container nondestructive examinations (NDEs) and DEs indicate that the containers will provide adequate protection of the 3013 containers in K-Area storage for at least 15 years [Reference 4].« less

Benchmarking participation of Canadian university health sciences librarians in systematic reviews.

PubMed

Murphy, Susan A; Boden, Catherine

2015-04-01

This study describes the current state of Canadian university health sciences librarians' knowledge about, training needs for, and barriers to participating in systematic reviews (SRs). A convenience sample of Canadian librarians was surveyed. Over half of the librarians who had participated in SRs acknowledged participating in a traditional librarian role (e.g., search strategy developer); less than half indicated participating in any one nontraditional librarian role (e.g., data extractor). Lack of time and insufficient training were the most frequently reported barriers to participating in SRs. The findings provide a benchmark for tracking changes in Canadian university health sciences librarians' participation in SRs.

Benchmarking participation of Canadian university health sciences librarians in systematic reviews

PubMed Central

Murphy, Susan A.; Boden, Catherine

2015-01-01

This study describes the current state of Canadian university health sciences librarians' knowledge about, training needs for, and barriers to participating in systematic reviews (SRs). A convenience sample of Canadian librarians was surveyed. Over half of the librarians who had participated in SRs acknowledged participating in a traditional librarian role (e.g., search strategy developer); less than half indicated participating in any one nontraditional librarian role (e.g., data extractor). Lack of time and insufficient training were the most frequently reported barriers to participating in SRs. The findings provide a benchmark for tracking changes in Canadian university health sciences librarians' participation in SRs. PMID:25918485

Serum concentrations of brain-derived neurotrophic factor in patients diagnosed with gender dysphoria undergoing sex reassignment surgery.

PubMed

Schneider, Maiko A; Andreazza, Tahiana; Fontanari, Anna Martha V; Costa, Angelo B; Silva, Dhiordan C da; Aguiar, Bianca W de; Massuda, Raffael; Pedrini, Mariana; Gama, Clarissa S; Schwarz, Karine; Kauer-Sant'Anna, Marcia; Lobato, Maria Ines R

2017-01-01

Transsexualism (ICD-10) is a condition characterized by a strong and persistent dissociation with one's assigned gender. Sex reassignment surgery (SRS) and hormone therapy provide a means of allowing transsexual individuals to feel more congruent with their gender and have played a major role in treatment over the past 70 years. Brain-derived neurotrophic factor (BDNF) appears to play a key role in recovery from acute surgical trauma and environmentally mediated vulnerability to psychopathology. We hypothesize that BDNF may be a biomarker of alleviation of gender incongruence suffering. To measure preoperative and postoperative serum BDNF levels in transsexual individuals as a biomarker of alleviation of stress related to gender incongruence after SRS. Thirty-two male-to-female transsexual people who underwent both surgery and hormonal treatment were selected from our initial sample. BDNF serum levels were assessed before and after SRS with sandwich enzyme linked immunosorbent assay (ELISA). The time elapsed between the pre-SRS and post-SRS blood collections was also measured. No significant difference was found in pre-SRS or post-SRS BDNF levels or with relation to the time elapsed after SRS when BDNF levels were measured. Alleviation of the suffering related to gender incongruence after SRS cannot be assessed by BDNF alone. Surgical solutions may not provide a quick fix for psychological distress associated with transsexualism and SRS may serve as one step toward, rather than as the conclusion of, construction of a person's gender identity.

Anthropogenic plutonium-244 in the environment: Insights into plutonium’s longest-lived isotope

DOE PAGES

Armstrong, Christopher R.; Brant, Heather A.; Nuessle, Patterson R.; ...

2016-02-22

Owing to the rich history of heavy element production in the unique high flux reactors that operated at the Savannah River Site, USA (SRS) decades ago, trace quantities of plutonium with highly unique isotopic characteristics still persist today in the SRS terrestrial environment. Development of an effective sampling, processing, and analysis strategy enables detailed monitoring of the SRS environment, revealing plutonium isotopic compositions, e.g., 244Pu, that reflect the unique legacy of plutonium production at SRS. This work describes the first long-term investigation of anthropogenic 244Pu occurrence in the environment. Environmental samples, consisting of collected foot borne debris, were taken atmore » SRS over an eleven year period, from 2003 to 2014. Separation and purification of trace plutonium was carried out followed by three stage thermal ionization mass spectrometry (3STIMS) measurements for plutonium isotopic content and isotopic ratios. Furthermore, significant 244Pu was measured in all of the years sampled with the highest amount observed in 2003. The 244Pu content, in femtograms (fg = 10 –15 g) per gram, ranged from 0.31 fg/g to 44 fg/g in years 2006 and 2003 respectively. In all years, the 244Pu/ 239Pu atom ratios were significantly higher than global fallout, ranging from 0.003 to 0.698 in years 2014 and 2003 respectively.« less

Label-Free Biomedical Imaging Using High-Speed Lock-In Pixel Sensor for Stimulated Raman Scattering

PubMed Central

Mars, Kamel; Kawahito, Shoji; Yasutomi, Keita; Kagawa, Keiichiro; Yamada, Takahiro

2017-01-01

Raman imaging eliminates the need for staining procedures, providing label-free imaging to study biological samples. Recent developments in stimulated Raman scattering (SRS) have achieved fast acquisition speed and hyperspectral imaging. However, there has been a problem of lack of detectors suitable for MHz modulation rate parallel detection, detecting multiple small SRS signals while eliminating extremely strong offset due to direct laser light. In this paper, we present a complementary metal-oxide semiconductor (CMOS) image sensor using high-speed lock-in pixels for stimulated Raman scattering that is capable of obtaining the difference of Stokes-on and Stokes-off signal at modulation frequency of 20 MHz in the pixel before reading out. The generated small SRS signal is extracted and amplified in a pixel using a high-speed and large area lateral electric field charge modulator (LEFM) employing two-step ion implantation and an in-pixel pair of low-pass filter, a sample and hold circuit and a switched capacitor integrator using a fully differential amplifier. A prototype chip is fabricated using 0.11 μm CMOS image sensor technology process. SRS spectra and images of stearic acid and 3T3-L1 samples are successfully obtained. The outcomes suggest that hyperspectral and multi-focus SRS imaging at video rate is viable after slight modifications to the pixel architecture and the acquisition system. PMID:29120358

Label-Free Biomedical Imaging Using High-Speed Lock-In Pixel Sensor for Stimulated Raman Scattering.

PubMed

Mars, Kamel; Lioe, De Xing; Kawahito, Shoji; Yasutomi, Keita; Kagawa, Keiichiro; Yamada, Takahiro; Hashimoto, Mamoru

2017-11-09

Raman imaging eliminates the need for staining procedures, providing label-free imaging to study biological samples. Recent developments in stimulated Raman scattering (SRS) have achieved fast acquisition speed and hyperspectral imaging. However, there has been a problem of lack of detectors suitable for MHz modulation rate parallel detection, detecting multiple small SRS signals while eliminating extremely strong offset due to direct laser light. In this paper, we present a complementary metal-oxide semiconductor (CMOS) image sensor using high-speed lock-in pixels for stimulated Raman scattering that is capable of obtaining the difference of Stokes-on and Stokes-off signal at modulation frequency of 20 MHz in the pixel before reading out. The generated small SRS signal is extracted and amplified in a pixel using a high-speed and large area lateral electric field charge modulator (LEFM) employing two-step ion implantation and an in-pixel pair of low-pass filter, a sample and hold circuit and a switched capacitor integrator using a fully differential amplifier. A prototype chip is fabricated using 0.11 μm CMOS image sensor technology process. SRS spectra and images of stearic acid and 3T3-L1 samples are successfully obtained. The outcomes suggest that hyperspectral and multi-focus SRS imaging at video rate is viable after slight modifications to the pixel architecture and the acquisition system.

Anthropogenic plutonium-244 in the environment: Insights into plutonium’s longest-lived isotope

PubMed Central

Armstrong, Christopher R.; Brant, Heather A.; Nuessle, Patterson R.; Hall, Gregory; Cadieux, James R.

2016-01-01

Owing to the rich history of heavy element production in the unique high flux reactors that operated at the Savannah River Site, USA (SRS) decades ago, trace quantities of plutonium with highly unique isotopic characteristics still persist today in the SRS terrestrial environment. Development of an effective sampling, processing, and analysis strategy enables detailed monitoring of the SRS environment, revealing plutonium isotopic compositions, e.g., 244Pu, that reflect the unique legacy of plutonium production at SRS. This work describes the first long-term investigation of anthropogenic 244Pu occurrence in the environment. Environmental samples, consisting of collected foot borne debris, were taken at SRS over an eleven year period, from 2003 to 2014. Separation and purification of trace plutonium was carried out followed by three stage thermal ionization mass spectrometry (3STIMS) measurements for plutonium isotopic content and isotopic ratios. Significant 244Pu was measured in all of the years sampled with the highest amount observed in 2003. The 244Pu content, in femtograms (fg = 10−15 g) per gram, ranged from 0.31 fg/g to 44 fg/g in years 2006 and 2003 respectively. In all years, the 244Pu/239Pu atom ratios were significantly higher than global fallout, ranging from 0.003 to 0.698 in years 2014 and 2003 respectively. PMID:26898531

The Savannah River Site`s groundwater monitoring program. Third quarter 1990

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

Not Available

1991-05-06

The Environmental Protection Department/Environmental Monitoring Section (EPD/EMS) administers the Savannah River Site`s (SRS) Groundwater Monitoring Program. During third quarter 1990 (July through September) EPD/EMS conducted routine sampling of monitoring wells and drinking water locations. EPD/EMS established two sets of flagging criteria in 1986 to assist in the management of sample results. The flagging criteria do not define contamination levels; instead they aid personnel in sample scheduling, interpretation of data, and trend identification. The flagging criteria are based on detection limits, background levels in SRS groundwater, and drinking water standards. All analytical results from third quarter 1990 are listed in thismore » report, which is distributed to all site custodians. One or more analytes exceeded Flag 2 in 87 monitoring well series. Analytes exceeded Flat 2 for the first since 1984 in 14 monitoring well series. In addition to groundwater monitoring, EPD/EMS collected drinking water samples from SRS drinking water systems supplied by wells. The drinking water samples were analyzed for radioactive constituents.« less

The Savannah River Site's groundwater monitoring program

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

Not Available

1991-05-06

The Environmental Protection Department/Environmental Monitoring Section (EPD/EMS) administers the Savannah River Site's (SRS) Groundwater Monitoring Program. During third quarter 1990 (July through September) EPD/EMS conducted routine sampling of monitoring wells and drinking water locations. EPD/EMS established two sets of flagging criteria in 1986 to assist in the management of sample results. The flagging criteria do not define contamination levels; instead they aid personnel in sample scheduling, interpretation of data, and trend identification. The flagging criteria are based on detection limits, background levels in SRS groundwater, and drinking water standards. All analytical results from third quarter 1990 are listed in thismore » report, which is distributed to all site custodians. One or more analytes exceeded Flag 2 in 87 monitoring well series. Analytes exceeded Flat 2 for the first since 1984 in 14 monitoring well series. In addition to groundwater monitoring, EPD/EMS collected drinking water samples from SRS drinking water systems supplied by wells. The drinking water samples were analyzed for radioactive constituents.« less

Validation of a Japanese version of the Scoliosis Research Society-22 Patient Questionnaire among idiopathic scoliosis patients in Japan.

PubMed

Hashimoto, Hideki; Sase, Takeshi; Arai, Yasuhisa; Maruyama, Toru; Isobe, Keijirou; Shouno, Yasuhiro

2007-02-15

A cross-sectional observational study to determine the response distribution, internal consistency, and construct, concurrent, and discriminative validities of The Scoliosis Research Society-22 (SRS-22) Patient Questionnaire translated into Japanese as compared with the other language versions. To validate the Japanese version of SRS22. The SRS-22 was translated into several languages but yet not into Japanese. The Japanese SRS-22 and Medical Outcomes Study Short Form 36 were simultaneously administered to 114 adolescent idiopathic scoliosis patients. Exploratory factor analysis revealed a 4-factor structure, though several items were not loaded as theoretically expected. The originally constructed Japanese SRS-22 subscales and the English version showed similar response distribution. Internal consistency was fair but lower than that of the English version. The concurrent validity of the translated version, except for the self-image subscale, was supported using Medical Outcomes Study Short Form 36 subscales as a reference. The function scale differed significantly by curve angle magnitude and treatment status. The self-image score was the highest in patients under observation when curve angle was < 40 degrees, while postsurgical patients marked the highest scores when the angle > or = 40 degrees, respectively. The Japanese SRS-22 is valid and may be useful for clinical evaluation of Japanese scoliosis patients, though the self-image subscale may need further assessment.

Effects of nanostructuring on luminescence properties of SrS:Ce,Sm phosphor: An experimental and phenomenological study

NASA Astrophysics Data System (ADS)

Yazdanmehr, Mohsen; Sadeghi, Hossein; Tehrani, Masoud Kavosh; Hashemifar, Seyed Javad; Mahdavi, Mohammad

2018-01-01

In this work, we employ various experimental techniques to illustrate the effects of nanostructuring on improvement of the luminescence properties of the polycrystalline SrS co-activated by cerium and samarium dopants (SrS : Ce , Sm). The nano and microstructure SrS : Ce , Sm powders were synthesized by the co-precipitation and solid state diffusion methods, respectively, followed by the spark plasma sintering (SPS) process to densify powders into pellet shape. It is observed that the photo-luminescence (PL), radio-luminescence (RL), and optically stimulated luminescence (OSL) emission intensity of the nanostructure samples are significantly improved with respect to the microstructure samples. Moreover, by using an accurate photomultiplier tube, we measured the CW-OSL decay curves of the samples to demonstrate much higher and faster sensitivity of the nanostructure SrS : Ce , Sm for in-flight and online OSL radiation dosimetry. The obtained absorption and emission spectra are used for phenomenology of the electronic band structure of the SrS : Ce , Sm micro and nano-phosphors inside the band gap. The proposed phenomenological electronic structures are then used to clarify the role of Ce3+ and Sm3+ localized energy levels in the luminescence properties of the nano and microstructure samples. It is argued that electronic transitions from the 2T2g state of Ce3+ and the 4G5/2 state of Sm3+ have strong contribution to the PL and RL emission spectra, while in the OSL mechanism, the Sm3+ 4G5/2 state is mainly responsible for electrons trapping.

Identification and description of randomized controlled trials and systematic reviews on patient safety published in medical journals.

PubMed

Barajas-Nava, Leticia Andrea; Calvache, José Andrés; López-Alcalde, Jesús; Solà, Ivan; Cosp, Xavier Bonfill

2013-06-01

To identify and describe randomized controlled trials (RCTs) and systematic reviews (SRs) on patient safety published from 1973 onward. We handsearched a total of 12 medical journals published in English with contents related to patient safety to identify RCTs and SRs published between 1973 and the end of 2010. The results obtained from this search were complemented with an additional search in MEDLINE. The documents were classified by area of specialty or service in which the intervention was applied, level of preventive action, and type of patient safety incident, the latter in accordance with the International Classification for Patient Safety proposed by the World Health Organization (WHO). The main features of the identified studies are also described. A total of 787 issues of 12 journals published between 1973 and 2010 were handsearched. This procedure yielded 10,162 references, of which, 131 corresponded to RCTs and 127 to SRs. A parallel MEDLINE search identified only about two-thirds of these articles. Of all the studies identified, 83 RCTs and 64 SRs addressed interventions related to patient safety. The types of incident related to patient safety that were included most often in RCTs involved the clinical process, and for SRs, those related to resources/organizational management. On average, only 3.5 RCTs and 3.4 SRs were published per year, many of which had significant deficiencies in the reported information, such as, for instance, a lack of details on the methodology used. The number of RCTs and SRs on patient safety published in specialized journals is scarce. No studies on interventions to improve the safety of the handling of blood and derivatives, infections related to health care, nutrition, or infrastructure were identified as a result of our search. Handsearching plays a key role in the identification of all the clinical trials that could be included in SRs on patient safety interventions. Knowing the content of RCTs and SRs published on patient safety can better target future research.

Microbial Condition of Water Samples from Foreign Fuel Storage Facilities

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

Berry, C.J.; Fliermans, C.B.; Santo Domingo, J.

1997-10-30

In order to assess the microbial condition of foreign nuclear fuel storage facilities, fourteen different water samples were received from facilities outside the United States that have sent spent nuclear fuel to SRS for wet storage. Each water sample was analyzed for microbial content and activity as determined by total bacteria, viable aerobic bacteria, viable anaerobic bacteria, viable sulfate- reducing bacteria, viable acid-producing bacteria and enzyme diversity. The results for each water sample were then compared to other foreign samples and to data from the receiving basin for off- site fuel (RBOF) at SRS.

Geoscience laser altimeter system-stellar reference system

NASA Astrophysics Data System (ADS)

Millar, Pamela S.; Sirota, J. Marcos

1998-01-01

GLAS is an EOS space-based laser altimeter being developed to profile the height of the Earth's ice sheets with ~15 cm single shot accuracy from space under NASA's Mission to Planet Earth (MTPE). The primary science goal of GLAS is to determine if the ice sheets are increasing or diminishing for climate change modeling. This is achieved by measuring the ice sheet heights over Greenland and Antarctica to 1.5 cm/yr over 100 km×100 km areas by crossover analysis (Zwally 1994). This measurement performance requires the instrument to determine the pointing of the laser beam to ~5 urad (1 arcsecond), 1-sigma, with respect to the inertial reference frame. The GLAS design incorporates a stellar reference system (SRS) to relate the laser beam pointing angle to the star field with this accuracy. This is the first time a spaceborne laser altimeter is measuring pointing to such high accuracy. The design for the stellar reference system combines an attitude determination system (ADS) with a laser reference system (LRS) to meet this requirement. The SRS approach and expected performance are described in this paper.

F-Area Acid/Caustic Basin groundwater monitoring report. First quarter 1995

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

NONE

1995-06-01

During first quarter 1995, samples from the FAC monitoring wells at the F-Area Acid/Caustic Basin were collected and analyzed for herbicides/pesticides, indicator parameters, metals, nitrate, radionuclide indicators, volatile organic compounds, and other constituents. Piezometer FAC 5P and monitoring well FAC 6 were dry and could not be sampled. New monitoring wells FAC 9C, 10C, 11C, and 12C were completed in the Barnwell/McBean aquifer and were sampled for the first time during third quarter 1994 (first quarter 1995 is the third of four quarters of data required to support the closure of the basin). Analytical results that exceeded final Primary Drinkingmore » Water Standards (PDWS), other Savannah River Site (SRS) Flag 2 criteria, or the SRS turbidity standard of 50 NTU during the quarter were as follows: gross alpha exceeded the final PDWS and aluminum, iron, manganese, and total alpha-emitting radium exceeded the SRS Flag 2 criteria in one or more of the FAC wells. Turbidity exceeded the SRS standard (50 NTU) in wells FAC 3 and 11C. Groundwater flow direction and rate in the water table beneath the F-Area Acid/Caustic Basin were similar to past quarters.« less

Methodological quality and descriptive characteristics of prosthodontic-related systematic reviews.

PubMed

Aziz, T; Compton, S; Nassar, U; Matthews, D; Ansari, K; Flores-Mir, C

2013-04-01

Ideally, healthcare systematic reviews (SRs) should be beneficial to practicing professionals in making evidence-based clinical decisions. However, the conclusions drawn from SRs are directly related to the quality of the SR and of the included studies. The aim was to investigate the methodological quality and key descriptive characteristics of SRs published in prosthodontics. Methodological quality was analysed using the Assessment of Multiple Reviews (AMSTAR) tool. Several electronic resources (MEDLINE, EMBASE, Web of Science and American Dental Association's Evidence-based Dentistry website) were searched. In total 106 SRs were located. Key descriptive characteristics and methodological quality features were gathered and assessed, and descriptive and inferential statistical testing performed. Most SRs in this sample originated from the European continent followed by North America. Two to five authors conducted most SRs; the majority was affiliated with academic institutions and had prior experience publishing SRs. The majority of SRs were published in specialty dentistry journals, with implant or implant-related topics, the primary topics of interest for most. According to AMSTAR, most quality aspects were adequately fulfilled by less than half of the reviews. Publication bias and grey literature searches were the most poorly adhered components. Overall, the methodological quality of the prosthodontic-related systematic was deemed limited. Future recommendations would include authors to have prior training in conducting SRs and for journals to include a universal checklist that should be adhered to address all key characteristics of an unbiased SR process. © 2013 Blackwell Publishing Ltd.

Methodological systematic review identifies major limitations in prioritization processes for updating.

PubMed

Martínez García, Laura; Pardo-Hernandez, Hector; Superchi, Cecilia; Niño de Guzman, Ena; Ballesteros, Monica; Ibargoyen Roteta, Nora; McFarlane, Emma; Posso, Margarita; Roqué I Figuls, Marta; Rotaeche Del Campo, Rafael; Sanabria, Andrea Juliana; Selva, Anna; Solà, Ivan; Vernooij, Robin W M; Alonso-Coello, Pablo

2017-06-01

The aim of the study was to identify and describe strategies to prioritize the updating of systematic reviews (SRs), health technology assessments (HTAs), or clinical guidelines (CGs). We conducted an SR of studies describing one or more methods to prioritize SRs, HTAs, or CGs for updating. We searched MEDLINE (PubMed, from 1966 to August 2016) and The Cochrane Methodology Register (The Cochrane Library, Issue 8 2016). We hand searched abstract books, reviewed reference lists, and contacted experts. Two reviewers independently screened the references and extracted data. We included 14 studies. Six studies were classified as descriptive (6 of 14, 42.9%) and eight as implementation studies (8 of 14, 57.1%). Six studies reported an updating strategy (6 of 14, 42.9%), six a prioritization process (6 of 14, 42.9%), and two a prioritization criterion (2 of 14, 14.2%). Eight studies focused on SRs (8 of 14, 57.1%), six studies focused on CGs (6 of 14, 42.9%), and none were about HTAs. We identified 76 prioritization criteria that can be applied when prioritizing documents for updating. The most frequently cited criteria were as follows: available evidence (19 of 76, 25.0%), clinical relevance (10 of 76; 13.2%), and users' interest (10 of 76; 13.2%). There is wide variability and suboptimal reporting of the methods used to develop and implement processes to prioritize updating of SRs, HTAs, and CGs. Copyright © 2017 Elsevier Inc. All rights reserved.

A Multi-institutional Study of Factors Influencing the Use of Stereotactic Radiosurgery for Brain Metastases

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

Hodgson, David C., E-mail: David.Hodgson@rmp.uhn.on.ca; Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario

2013-02-01

Purpose: Stereotactic radiosurgery (SRS) for brain metastases is a relatively well-studied technology with established guidelines regarding patient selection, although its implementation is technically complex. We evaluated the extent to which local availability of SRS affected the treatment of patients with brain metastases. Methods and Materials: We identified 3030 patients who received whole-brain radiation therapy (WBRT) for brain metastases in 1 of 7 cancer centers in Ontario. Clinical data were abstracted for a random sample of 973 patients. Logistic regression analyses were performed to identify factors associated with the use of SRS as a boost within 4 months following WBRT ormore » at any time following WBRT. Results: Of 898 patients eligible for analysis, SRS was provided to 70 (7.8%) patients at some time during the course of their disease and to 34 (3.8%) patients as a boost following WBRT. In multivariable analyses, factors significantly associated with the use of SRS boost following WBRT were fewer brain metastases (odds ratio [OR] = 6.50), controlled extracranial disease (OR = 3.49), age (OR = 0.97 per year of advancing age), and the presence of an on-site SRS program at the hospital where WBRT was given (OR = 12.34; all P values were <.05). Similarly, availability of on-site SRS was the factor most predictive of the use of SRS at any time following WBRT (OR = 5.98). Among patients with 1-3 brain metastases, good/fair performance status, and no evidence of active extracranial disease, SRS was provided to 40.3% of patients who received WBRT in a hospital that had an on-site SRS program vs 3.0% of patients who received WBRT at a hospital without SRS (P<.01). Conclusions: The availability of on-site SRS is the factor most strongly associated with the provision of this treatment to patients with brain metastases and appears to be more influential than accepted clinical eligibility factors.« less

Long-Term Assessment of Critical Radionuclides and Associated Environmental Media at the Savannah River Site - 13038

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

Jannik, G.T.; Baker, R.A.; Lee, P.L.

2013-07-01

During the operational history of the Savannah River Site (SRS), many different radionuclides have been released from site facilities. However, only a relatively small number of the released radionuclides have been significant contributors to doses and risks to the public. At SRS dose and risk assessments indicate tritium oxide in air and surface water, and Cs-137 in fish and deer have been, and continue to be, the critical radionuclides and pathways. In this assessment, statistical analyses of the long-term trends of tritium oxide in atmospheric and surface water releases and Cs-137 concentrations in fish and deer are provided. Correlations alsomore » are provided with 1) operational changes and improvements, 2) geopolitical events (Cold War cessation), and 3) recent environmental remediation projects and decommissioning of excess facilities. For example, environmental remediation of the F- and H-Area Seepage Basins and the Solid Waste Disposal Facility have resulted in a measurable impact on the tritium oxide flux to the onsite Fourmile Branch stream. Airborne releases of tritium oxide have been greatly affected by operational improvements and the end of the Cold War in 1991. However, the effects of SRS environmental remediation activities and ongoing tritium operations on tritium concentrations in the environment are measurable and documented in this assessment. Controlled hunts of deer and feral hogs are conducted at SRS for approximately six weeks each year. Before any harvested animal is released to a hunter, SRS personnel perform a field analysis for Cs-137 concentrations to ensure the Hunter's dose does not exceed the SRS administrative game limit of 0.22 milli-sievert (22 mrem). However, most of the Cs-137 found in SRS onsite deer is not from site operations but is from nuclear weapons testing fallout from the 1950's and early 1960's. This legacy source term is trended in the SRS deer, and an assessment of the 'effective' half-life of Cs-137 in deer (including the physical decay half-life and the environmental dispersion half-life) is provided. The 'creek mouth' fisherman is the next most critical pathway at SRS. On an annual basis, three species of fish (panfish, catfish, and bass) are sampled from the mouths of the five SRS streams. Three composites of up to five fish of each species are analyzed from each sampling location. Long-term trending of the Cs-137 concentrations in fish and the subsequent doses from consumption of SRS fish is provided. (authors)« less

Long-Term Assessment of Critical Radionuclides and Associated Environmental Media at the Savannah River Site

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

Jannik, G. T.; Baker, R. A.; Lee, P. L.

2012-11-06

During the operational history of the Savannah River Site (SRS), many different radionuclides have been released from site facilities. However, only a relatively small number of the released radionuclides have been significant contributors to doses and risks to the public. At SRS dose and risk assessments indicate tritium oxide in air and surface water, and Cs-137 in fish and deer have been, and continue to be, the critical radionuclides and pathways. In this assessment, indepth statistical analyses of the long-term trends of tritium oxide in atmospheric and surface water releases and Cs-137 concentrations in fish and deer are provided. Correlationsmore » also are provided with 1) operational changes and improvements, 2) geopolitical events (Cold War cessation), and 3) recent environmental remediation projects and decommissioning of excess facilities. For example, environmental remediation of the F- and H-Area Seepage Basins and the Solid Waste Disposal Facility have resulted in a measurable impact on the tritium oxide flux to the onsite Fourmile Branch stream. Airborne releases of tritium oxide have been greatly affected by operational improvements and the end of the Cold War in 1991. However, the effects of SRS environmental remediation activities and ongoing tritium operations on tritium concentrations in the environment are measurable and documented in this assessment. Controlled hunts of deer and feral hogs are conducted at SRS for approximately six weeks each year. Before any harvested animal is released to a hunter, SRS personnel perform a field analysis for Cs-137 concentrations to ensure the hunter's dose does not exceed the SRS administrative game limit of 0.22 millisievert (22 mrem). However, most of the Cs-137 found in SRS onsite deer is not from site operations but is from nuclear weapons testing fallout from the 1950's and early 1960's. This legacy source term is trended in the SRS deer, and an assessment of the ''effective'' half-life of Cs-137 in deer (including the physical decay half-life and the environmental dispersion half-life) is provided. The ''creek mouth'' fisherman is the next most critical pathway at SRS. On an annual basis, three species of fish (panfish, catfish, and bass) are sampled from the mouths of the five SRS streams. Three composites of up to five fish of each species are analyzed from each sampling location. Long-term trending of the Cs-137 concentrations in fish and the subsequent doses from consumption of SRS fish is provided.« less

Stimulated Raman scattering microscopy by Nyquist modulation of a two-branch ultrafast fiber source.

PubMed

Riek, Claudius; Kocher, Claudius; Zirak, Peyman; Kölbl, Christoph; Fimpel, Peter; Leitenstorfer, Alfred; Zumbusch, Andreas; Brida, Daniele

2016-08-15

A highly stable setup for stimulated Raman scattering (SRS) microscopy is presented. It is based on a two-branch femtosecond Er:fiber laser operating at a 40 MHz repetition rate. One of the outputs is directly modulated at the Nyquist frequency with an integrated electro-optic modulator (EOM). This compact source combines a jitter-free pulse synchronization with a broad tunability and allows for shot-noise limited SRS detection. The performance of the SRS microscope is illustrated with measurements on samples from material science and cell biology.

Health effects of SRS non-radiological air emissions

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

Stewart, J.

1997-06-16

This report examines the potential health effects of non radiological emissions to the air resulting from operations at the Savannah River Site (SRS). The scope of this study was limited to the 55 air contaminants for which the US Environmental Protection Agency (EPA) has quantified risk by determining unit risk factors (excess cancer risks) and/or reference concentrations (deleterious non cancer risks). Potential health impacts have been assessed in relation to the maximally exposed individual. This is a hypothetical person who resides for a lifetime at the SRS boundary. The most recent (1994) quality assured SRS emissions data available were used.more » Estimated maximum site boundary concentrations of the air contaminants were calculated using air dispersion modeling and 24-hour and annual averaging times. For the emissions studied, the excess cancer risk was found to be less than the generally accepted risk level of 1 in 100,000 and, in most cases, was less than 1 in 1,000,000. Deleterious non cancer effects were also found to be very unlikely.« less

On the Shock-Response-Spectrum Recursive Algorithm of Kelly and Richman

NASA Technical Reports Server (NTRS)

Martin, Justin N.; Sinclair, Andrew J.; Foster, Winfred A.

2010-01-01

The monograph Principles and Techniques of Shock Data Analysis written by Kelly and Richman in 1969 has become a seminal reference on the shock response spectrum (SRS) [1]. Because of its clear physical descriptions and mathematical presentation of the SRS, it has been cited in multiple handbooks on the subject [2, 3] and research articles [4 10]. Because of continued interest, two additional versions of the monograph have been published: a second edition by Scavuzzo and Pusey in 1996 [11] and a reprint of the original edition in 2008 [12]. The main purpose of this note is to correct several typographical errors in the manuscript's presentation of a recursive algorithm for SRS calculations. These errors are consistent across all three editions of the monograph. The secondary purpose of this note is to present a Matlab implementation of the corrected algorithm.

ASD Screening Measures for High-Ability Youth with ASD: Examining the ASSQ and SRS

ERIC Educational Resources Information Center

Cederberg, Charles D.; Gann, Lianne C.; Foley-Nicpon, Megan; Sussman, Zachary

2018-01-01

High-ability youth diagnosed with autism spectrum disorder (ASD) historically have been neglected within samples validating ASD screening measures, and consensus for what constitutes high ability has not been established. The Autism Spectrum Screening Questionnaire (ASSQ) and Social Responsiveness Scale (SRS) are two common screening tools for ASD…

Mitigating budget constraints on visitation volume surveys: the case of U.S. National forests

Treesearch

Ashley E. Askew; Donald B.K. English; Stanley J. Zarnoch; Neelam C. Poudyal; J.M. Bowker

2014-01-01

Stratified random sampling (SRS) provides a scientifically based estimate of a population comprising mutually exclusive, homogenous subgroups. In the National Visitor Use Monitoring (NVUM) program, SRS is used to estimate recreation visitation and visitor characteristics across activities on National forests. However, with rising costs and declining budgets, carrying...

The association of psychological factors and healthcare use with the discrepancy between subjective and objective respiratory-health complaints in the general population.

PubMed

Selinheimo, Sanna; Vasankari, Tuula; Jokela, Markus; Kanervisto, Merja; Pirkola, Sami; Suvisaari, Jaana; Paunio, Tiina

2018-03-20

We examined the prevalence of self-perceived respiratory symptoms (SRS) in the absence of any objective findings of respiratory pathology, and the association of such prevalence with psychological factors and healthcare use in the general population. The study was conducted among a nationally representative sample of Finnish adults (BRIF8901). Respiratory functioning was measured by a spirometry test. Structured questionnaires were used to measure SRS, physician visits and psychological factors of alexithymia, sense of coherence, illness worry and common mental disorders. Individuals with a diagnosed respiratory disease or a severe psychiatric disorder, determined in a diagnostic interview, were excluded, giving a sample comprising 4544 participants. Twenty-six per cent of the general population and 36% of those with no diagnosed severe psychiatric disorder or respiratory disease experienced SRS despite a normal spirometry result. Psychological factors were associated with SRS (0.0001 < p < 0.032), and on the number of physician visit explaining 42.7% of the difference in visits between individuals with and without SRS, respectively. Illness worry was associated most strongly with SRS [odds ratio (OR) 1.29, 95% confidence interval (CI) 1.19-1.41, p < 0.0001] and higher numbers of physician visits (OR 1.35, CI 1.32-1.38, p < 0.00001), even after several adjustments. Respiratory symptoms without objective findings are common in the general population. The study results underline the role of psychological factors in the reporting of respiratory symptoms and the associated medical burden, thereby indicating the functional nature of the symptomatology.

Stereotactic radiosurgery vs. fractionated radiotherapy for tumor control in vestibular schwannoma patients: a systematic review.

PubMed

Persson, Oscar; Bartek, Jiri; Shalom, Netanel Ben; Wangerid, Theresa; Jakola, Asgeir Store; Förander, Petter

2017-06-01

Repeated controlled studies have revealed that stereotactic radiosurgery is better than microsurgery for patients with vestibular schwannoma (VS) <3 cm in need of intervention. In this systematic review we aimed to compare results from single-fraction stereotactic radiosurgery (SRS) to fractionated stereotactic radiotherapy (FSRT) for patients with VS. We systematically searched MEDLINE, Web of Science, Embase and Cochrane and screened relevant articles for references. Publications from 1995 through 2014 with a minimum of 50 adult (>18 years) patients with unilateral VS, followed for a median of >5 years, were eligible for inclusion. After screening titles and abstracts of the 1094 identified articles and systematically reviewing 98 of these articles, 19 were included. Patients with unilateral VS treated with radiosurgery were compared to patients treated with fractionated stereotactic radiotherapy. No randomized controlled trial (RCT) was identified. None of the identified controlled studies comparing SRS with FSRT were eligible according to the inclusion criteria. Nineteen case series on SRS (n = 17) and FSRT (n = 2) were included in the systematic review. Loss of tumor control necessitating a new VS-targeted intervention was found in an average of 5.0% of the patients treated with SRS and in 4.8% treated with FSRT. Mean deterioration ratio for patients with serviceable hearing before treatment was 49% for SRS and 45% for FSRT, respectively. The risk for facial nerve deterioration was 3.6% for SRS and 11.2% for FSRT and for trigeminal nerve deterioration 6.0% for SRS and 8.4% for FSRT. Since these results were obtained from case series, a regular meta-analysis was not attempted. SRS and FSRT are both noninvasive treatment alternatives for patients with VS with low rates of treatment failure in need of rescue therapy. In this selection of patients, the progression-free survival rates were on the order of 92-100% for both treatment options. There is a lack of high-quality studies comparing radiation therapy alternatives for patients with VS. Finally, 19 articles reported long-term tumor control after SRS, while only 2 articles reported long-term FSRT results, making effect estimates more uncertain for FSRT.

Recovery and Determination of Adsorbed Technetium on Savannah River Site Charcoal Stack Samples

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

Lahoda, Kristy G.; Engelmann, Mark D.; Farmer, Orville T.

2008-03-01

Experimental results are provided for the sample analyses for technetium (Tc) in charcoal samples placed in-line with a Savannah River Site (SRS) processing stack effluent stream as a part of an environmental surveillance program. The method for Tc removal from charcoal was based on that originally developed with high purity charcoal. Presented is the process that allowed for the quantitative analysis of 99Tc in SRS charcoal stack samples with and without 97Tc as a tracer. The results obtained with the method using the 97Tc tracer quantitatively confirm the results obtained with no tracer added. All samples contain 99Tc at themore » pg g-1 level.« less

Development of a High-Pressure Gaseous Burner for Calibrating Optical Diagnostic Techniques

NASA Technical Reports Server (NTRS)

Kojima, Jun; Nguyen, Quang-Viet

2003-01-01

In this work-in-progress report, we show the development of a unique high-pressure burner facility (up to 60 atm) that provides steady, reproducible premixed flames with high precision, while having the capability to use multiple fuel/oxidizer combinations. The highpressure facility has four optical access ports for applying different laser diagnostic techniques and will provide a standard reference flame for the development of a spectroscopic database in high-pressure/temperature conditions. Spontaneous Raman scattering (SRS) was the first diagnostic applied, and was used to successfully probe premixed hydrogen-air flames generated in the facility using a novel multi-jet micro-premixed array burner element. The SRS spectral data include contributions from H2, N2, O2, and H2O and were collected over a wide range of equivalence ratios ranging from 0.16 to 4.9 at an initial pressure of 10-atm via a spatially resolved point SRS measurement with a high-performance optical system. Temperatures in fuel-lean to stoichiometric conditions were determined from the ratio of the Stokes to anti-Stokes scattering of the Q-branch of N2, and those in fuel-rich conditions via the rotational temperature of H2. The SRS derived temperatures using both techniques were consistent and indicated that the flame temperature was approximately 500 K below that predicted by adiabatic equilibrium, indicating a large amount of heat-loss at the measurement zone. The integrated vibrational SRS signals show that SRS provides quantitative number density data in high-pressure H2-air flames.

Prenatal molecular testing for Beckwith–Wiedemann and Silver–Russell syndromes: a challenge for molecular analysis and genetic counseling

PubMed Central

Eggermann, Thomas; Brioude, Frédéric; Russo, Silvia; Lombardi, Maria P; Bliek, Jet; Maher, Eamonn R; Larizza, Lidia; Prawitt, Dirk; Netchine, Irène; Gonzales, Marie; Grønskov, Karen; Tümer, Zeynep; Monk, David; Mannens, Marcel; Chrzanowska, Krystyna; Walasek, Malgorzata K; Begemann, Matthias; Soellner, Lukas; Eggermann, Katja; Tenorio, Jair; Nevado, Julián; Moore, Gudrun E; Mackay, Deborah JG; Temple, Karen; Gillessen-Kaesbach, Gabriele; Ogata, Tsutomu; Weksberg, Rosanna; Algar, Elizabeth; Lapunzina, Pablo

2016-01-01

Beckwith–Wiedemann and Silver–Russell syndromes (BWS/SRS) are two imprinting disorders (IDs) associated with disturbances of the 11p15.5 chromosomal region. In BWS, epimutations and genomic alterations within 11p15.5 are observed in >70% of patients, whereas in SRS they are observed in about 60% of the cases. In addition, 10% of the SRS patients carry a maternal uniparental disomy of chromosome 7 11p15.5. There is an increasing demand for prenatal testing of these disorders owing to family history, indicative prenatal ultrasound findings or aberrations involving chromosomes 7 and 11. The complex molecular findings underlying these disorders are a challenge not only for laboratories offering these tests but also for geneticists counseling affected families. The scope of counseling must consider the range of detectable disturbances and their origin, the lack of precise quantitative knowledge concerning the inheritance and recurrence risks for the epigenetic abnormalities, which are hallmarks of these developmental disorders. In this paper, experts in the field of BWS and SRS, including members of the European network of congenital IDs (EUCID.net; www.imprinting-disorders.eu), put together their experience and work in the field of 11p15.5-associated IDs with a focus on prenatal testing. Altogether, prenatal tests of 160 fetuses (122 referred for BWS, 38 for SRS testing) from 5 centers were analyzed and reviewed. We summarize the current knowledge on BWS and SRS with respect to diagnostic testing, the consequences for prenatal genetic testing and counseling and our cumulative experience in dealing with these disorders. PMID:26508573

Evaluation of somatostatin receptors in large cell pulmonary neuroendocrine carcinoma with 99mTc-EDDA/HYNIC-TOC scintigraphy.

PubMed

Nocuń, Anna; Chrapko, Beata; Gołębiewska, Renata; Stefaniak, Bogusław; Czekajska-Chehab, Elżbieta

2011-06-01

Large cell pulmonary neuroendocrine carcinoma (LCNEC) is a poorly differentiated and high-grade neoplasm. It is positioned between an atypical carcinoid and small cell neuroendocrine carcinoma of the lung in a distinct family of pulmonary neuroendocrine tumors. The aim of our study was to detect somatostatin receptors in this uncommon malignancy and to evaluate the sensitivity of somatostatin receptor scintigraphy (SRS) in LCNEC staging. We analyzed data of 26 patients (mean age: 61.5±7.9 years) with histologically confirmed diagnosis of LCNEC, including 18 cases not treated surgically and eight patients after the resection of the primary tumor. SRS was carried out with technetium-99m ethylene diamine-diacetic acid/hydrazinonicotinyl-Tyr3-octreotide (Tc-TOC). A visual analysis of scintigraphic images was done with reference to conventional imaging modalities (computed tomography and bone sicintigraphy). SRS sensitivity for the detection of primary lesions, supradiaphragmatic metastases, and infradiaphragmatic metastases was 100, 83.3%, and 0%, respectively. Five out of 13 metastases to the liver appeared on SRS as photopenic foci, visible on the background of physiological hepatic activity. Only one of the nine metastases to the skeletal system was found by SRS with sensitivity as low as 11.1%. The overall SRS sensitivity for the detection of secondary lesions and of all lesions was 54.8 and 62.2%, respectively. Within a rather large series of LCNEC, the primary tumor showed an uptake of Tc-TOC in all cases, whereas some metastases did show Tc-TOC uptake and some others did not.

Quality of life and sexual health after sex reassignment surgery in transsexual men.

PubMed

Wierckx, Katrien; Van Caenegem, Eva; Elaut, Els; Dedecker, David; Van de Peer, Fleur; Toye, Kaatje; Weyers, Steven; Hoebeke, Piet; Monstrey, Stan; De Cuypere, Griet; T'Sjoen, Guy

2011-12-01

Although sexual health after genital surgery is an important outcome factor for many transsexual persons, little attention has been attributed to this subject. To provide data on quality of life and sexual health after sex reassignment surgery (SRS) in transsexual men. A single-center, cross-sectional study in 49 transsexual men (mean age 37 years) after long-term testosterone therapy and on average 8 years after SRS. Ninety-four percent of the participants had phalloplasty. Self-reported physical and mental health using the Dutch version of the Short Form-36 Health Survey; sexual functioning before and after SRS using a newly constructed specific questionnaire. Compared with a Dutch reference population of community-dwelling men, transsexual men scored well on self-perceived physical and mental health. The majority reported having been sexually active before hormone treatment, with more than a quarter having been vaginally penetrated frequently before starting hormone therapy. There was a tendency toward less vaginal involvement during hormone therapy and before SRS. Most participants reported an increase in frequency of masturbation, sexual arousal, and ability to achieve orgasm after testosterone treatment and SRS. Almost all participants were able to achieve orgasm during masturbation and sexual intercourse, and the majority reported a change in orgasmic feelings toward a more powerful and shorter orgasm. Surgical satisfaction was high, despite a relatively high complication rate. Results of the current study indicate transsexual men generally have a good quality of life and experience satisfactory sexual function after SRS. © 2011 International Society for Sexual Medicine.

Cortisol Predicts Behavioral Dysregulation and Length of Stay among Children Admitted for Psychiatric Inpatient Treatment

ERIC Educational Resources Information Center

Luebbe, Aaron M.; Elledge, L. Christian; Kiel, Elizabeth J.; Stoppelbein, Laura

2012-01-01

Individual differences in behavioral regulation system (BRS) and stress response system (SRS) functioning may reflect greater biological sensitivity to context. The current study tested whether children's cortisol, a measure of the SRS, was related to observed dysregulated behavior, an indicator of the BRS, in a sample of children admitted for…

Broad autism phenotype features of Chinese parents with autistic children and their associations with severity of social impairment in probands.

PubMed

Shi, Li-Juan; Ou, Jian-Jun; Gong, Jing-Bo; Wang, Su-Hong; Zhou, Yuan-Yue; Zhu, Fu-Rong; Liu, Xu-Dong; Zhao, Jing-Ping; Luo, Xue-Rong

2015-07-23

Parents of children with autism have higher rates of broad autism phenotype (BAP) features than parents of typically developing children (TDC) in Western countries. This study was designed to examine the rate of BAP features in parents of children with autism and the relationship between parental BAP and the social impairment of their children in a Chinese sample. A total of 299 families with autistic children and 274 families with TDC participated in this study. Parents were assessed using the Broad Autism Phenotype Questionnaire (BAPQ), which includes self-report, informant-report, and best-estimate versions. Children were assessed using the Chinese version of the Social Responsiveness Scale (SRS). Parents of children with autism were significantly more likely to have BAP features than were parents of TDC; mothers and fathers in families with autistic children had various BAP features. The total scores of the informant and best-estimate BAPQ versions for fathers were significantly associated with their children's SRS total scores in the autism group, whereas the total scores of the three BAPQ versions for mothers were significantly associated with their children's SRS total scores in the TDC group. In the autism group, the total SRS scores of children with "BAP present" parents (informant and best-estimate) were higher than the total SRS scores of children with"BAP absent" parents. In the TDC group, the total SRS scores of children with "BAP present" parents were higher than the total SRS scores of children with"BAP absent" parents (best-estimate). Parents of autistic children were found to have higher rates of BAP than parents of TDC in a sample of Chinese parents. The BAP features of parents are associated with their children's social functioning in both autism families and TDC families, but the patterns of the associations are different.

Re-examining the Evidence in Radiation Dermatitis Management Literature: An Overview and a Critical Appraisal of Systematic Reviews

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

Chan, Raymond Javan, E-mail: email.rchan@gmail.com; School of Nursing and Midwifery, University of Queensland, and Research Centre for Clinical and Community Practice Innovation, Griffith University; Larsen, Emily

2012-11-01

Purpose: To provide an overview and a critical appraisal of systematic reviews (SRs) of published interventions for the prevention/management of radiation dermatitis. Methods and Materials: We searched Medline, CINAHL, Embase, and the Cochrane Library. We also manually searched through individual reference lists of potentially eligible articles and a number of key journals in the topic area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using AMSTAR (the measurement tool for 'assessment of multiple systematic reviews'). Results: Of 1837 potential titles, 6 SRs were included. A numbermore » of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/nonsteroidal topical agents, systemic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews might create biases to the overall results or recommendations for clinical practice. Conclusions: An up-to-date high-quality SR in the prevention/management of radiation dermatitis is needed to guide practice and direction for future research. We recommend that clinicians or guideline developers critically evaluate the information of SRs in their decision making.« less

Experiences of Discrimination, Harassment, and Violence in a Sample of Italian Transsexuals Who Have Undergone Sex-Reassignment Surgery.

PubMed

Prunas, Antonio; Bandini, Elisa; Fisher, Alessandra D; Maggi, Mario; Pace, Valeria; Quagliarella, Luca; Todarello, Orlando; Bini, Maurizio

2018-07-01

The present study aims to provide an overview of experiences of discrimination, harassment, and violence in a sample of Italian transsexuals who have undergone sex-reassignment surgery (SRS). Lack of support for gender transition from family members was also assessed, before and after SRS. Data were collected in the context of a multicentric study (Milan, Florence, and Bari) on SRS outcome. Patients who underwent SRS were contacted and asked to fill out a questionnaire concerning experiences of discrimination, harassment, violence, and crime they might have experienced in previous years. Seventy-two participants took part in the research: 46 were male-to-female (MtF; 64%) and 26 were female-to-male (FtM; 36%). Thirty-six percent of the total sample (with no differences between MtF and FtM) experienced at least one episode of harassment, violence, or discrimination. The workplace was reported to be the social area with the highest risk of discrimination and harassment (22% of participants). Reports of more than one incident of discrimination, harassment, and violence characterized the majority of participants in the MtF sample. Compared with previous studies carried out in other countries, a much larger proportion of participants could count on a supportive family environment before and after transition. Our results show that Italian society at large is prejudiced against transsexuals, but at a more "micro" level, having a trans person as a family member might result in a protective and tolerant attitude.

Cognitive development in Silver-Russell syndrome: a sibling-controlled study.

PubMed

Noeker, Meinolf; Wollmann, Hartmut A

2004-05-01

This study examined cognitive development in Silver-Russell syndrome (SRS), a condition with intrauterine growth retardation, persisting short stature, and specific stigmata. Neuropsychological function and cognitive abilities were assessed in a sample of 36 children with SRS (21 males, 15 females; mean age 7 years 6 months, SD 2 years 8 months; age range 3 to 12 years) and 25 normally developing siblings (mean age 8 years 6 months, SD 2 years 7 months; age range 3 to 12 years) using the Kaufman Assessment Battery for Children. Special measures were taken to control for confounding factors and sample bias. Mean overall IQ score in the total SRS sample (95.7, SD 10.63), as measured by the Mental Processing Composite Scale, was significantly reduced (p=0.021) compared with test norms (IQ 100, SD 15), indicating a moderate cognitive impairment. Subscale analysis revealed some specific deficiencies. However, these cannot be attributed to an established category of specific learning disorder. The mean score in the Achievement Scale (91.25, SD 14.92), which is more sensitive to educational influences, showed stronger deficits (p=0.001). The sibling control group achieved a slightly better mean IQ score (104.20, SD 12.32) than test norms (p=0.10). Direct analysis of paired differences between the subsample of children with SRS and a sibling among the control group (n=25) revealed a significant mean difference of 8.08 IQ points (p=0.011). Risk factor analysis revealed that cognitive development is not associated with birth length (p=0.404), birthweight (p=0.820), growth hormone therapy (p=0.810), phenotypic severity (p=0.828), or sex (p=0.880). Two children with maternal uniparental disomy for the entire chromosome 7 had markedly lower IQ scores (81 and 84 respectively). In contrast to the few previous findings, children with SRS show only moderate, but significant, impairments in cognitive outcome, which are more striking in our sample when compared with siblings than with test norms.

Assessing Autistic Traits in a Taiwan Preschool Population: Cross-Cultural Validation of the Social Responsiveness Scale (SRS)

ERIC Educational Resources Information Center

Wang, Jessica; Lee, Li-Ching; Chen, Ying-Sheue; Hsu, Ju-Wei

2012-01-01

The cross-cultural validity of the Mandarin-adaptation of the social responsiveness scale (SRS) was examined in a sample of N = 307 participants in Taiwan, 140 typically developing and 167 with clinically-diagnosed developmental disorders. This scale is an autism assessment tool that provides a quantitative rather than categorical measure of…

Exploratory Factor Analysis of SRS-2 Teacher Ratings for Youth with ASD

ERIC Educational Resources Information Center

Nelson, Andrew T.; Lopata, Christopher; Volker, Martin A.; Thomeer, Marcus L.; Toomey, Jennifer A.; Dua, Elissa

2016-01-01

This study examined the factor structure and internal consistency of special education teaching staff ratings on the Social Responsiveness Scale-2 (SRS-2; Constantino and Gruber 2012), as well as the percentage of ratings falling above pre-established cut scores, for a sample of lower-functioning youth with autism spectrum disorder (ASD; n = 264).…

F-Area Acid/Caustic Basin groundwater monitoring report. Second quarter 1995

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

NONE

1995-09-01

During second quarter 1995, samples from the FAC monitoring wells at the F-Area Acid/Caustic Basin were collected and analyzed for herbicides/pesticides, indicator parameters, metals, nitrate, radionuclide indicators, volatile organic compounds, and other constituents. Piezometer FAC 5P and monitoring well FAC 6 were dry and could not be sampled. New monitoring wells FAC 9C, 10C, 11C, and 12C were completed in the Barnwell/McBean aquifer and were sampled for the first time during third quarter 1994 (second quarter 1995 is the fourth of four quarters of data required to support the closure of the basin). Analytical results that exceeded final Primary Drinkingmore » Water Standards (PDWS) or Savannah River Site (SRS) Flag 2 criteria such as the SRS turbidity standard of 50 NTU during the quarter were as follows: gross alpha exceeded the final PDWS and aluminum, iron, manganese, and radium-226 exceeded the SRS Flag 2 criteria in one or more of the FAC wells. Turbidity exceeded the SRS standard (50 NTU) in well FAC 3. Groundwater flow direction in the water table beneath the F-Area Acid/Caustic Basin was to the west at a rate of 1300 feet per year. Groundwater flow in the Barnwell/McBean was to the northeast at a rate of 50 feet per year.« less

Increased Butyrate Production During Long-Term Fermentation of In Vitro-Digested High Amylose Cornstarch Residues with Human Feces.

PubMed

Li, Li; Jiang, Hongxin; Kim, Hyun-Jung; Yum, Man-Yu; Campbell, Mark R; Jane, Jay-Lin; White, Pamela J; Hendrich, Suzanne

2015-09-01

An in vitro semi-continuous long-term (3 wk) anaerobic incubation system simulating lower gut fermentation was used to determine variability in gut microbial metabolism between 4 predigested high amylose-resistant starch residues (SR): SRV, SRVI, SRVII, and SRGEMS in human fecal samples. Subjects participated twice, 5 mo apart: 30 in Phase I (15 lean, 9 overweight and 6 obese), 29 in Phase II (15 lean, 9 overweight, 5 obese); 13 of 15 lean subjects participated in both phases. Of the 4 SRs, SRV displayed the highest gelatinization temperature, peak temperature, enthalpy changes, and the least digestibility compared with the other SRs. In both phases, compared with blank controls, all SRs increased butyrate ∼2-fold which stabilized at week 2 and only SRV caused greater propionate concentration (∼30%) after 3 wk which might have been partly mediated by its lesser digestibility. Fecal samples from lean and overweight/obese subjects incubated with SRs showed similar short-chain fatty acid production across both time points, which suggests that resistant starch may benefit individuals across BMIs. © 2015 Institute of Food Technologists®

Performance parameters of a liquid filled ionization chamber array

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

Poppe, B.; Stelljes, T. S.; Looe, H. K.

2013-08-15

Purpose: In this work, the properties of the two-dimensional liquid filled ionization chamber array Octavius 1000SRS (PTW-Freiburg, Germany) for use in clinical photon-beam dosimetry are investigated.Methods: Measurements were carried out at an Elekta Synergy and Siemens Primus accelerator. For measurements of stability, linearity, and saturation effects of the 1000SRS array a Semiflex 31013 ionization chamber (PTW-Freiburg, Germany) was used as a reference. The effective point of measurement was determined by TPR measurements of the array in comparison with a Roos chamber (type 31004, PTW-Freiburg, Germany). The response of the array with varying field size and depth of measurement was evaluatedmore » using a Semiflex 31010 ionization chamber as a reference. Output factor measurements were carried out with a Semiflex 31010 ionization chamber, a diode (type 60012, PTW-Freiburg, Germany), and the detector array under investigation. The dose response function for a single detector of the array was determined by measuring 1 cm wide slit-beam dose profiles and comparing them against diode-measured profiles. Theoretical aspects of the low pass properties and of the sampling frequency of the detector array were evaluated. Dose profiles measured with the array and the diode detector were compared, and an intensity modulated radiation therapy (IMRT) field was verified using the Gamma-Index method and the visualization of line dose profiles.Results: The array showed a short and long term stability better than 0.1% and 0.2%, respectively. Fluctuations in linearity were found to be within ±0.2% for the vendor specified dose range. Saturation effects were found to be similar to those reported in other studies for liquid-filled ionization chambers. The detector's relative response varied with field size and depth of measurement, showing a small energy dependence accounting for maximum signal deviations of ±2.6% from the reference condition for the setup used. The σ-values of the Gaussian dose response function for a single detector of the array were found to be (0.72 ± 0.25) mm at 6 MV and (0.74 ± 0.25) mm at 15 MV and the corresponding low pass cutoff frequencies are 0.22 and 0.21 mm{sup −1}, respectively. For the inner 5 × 5 cm{sup 2} region and the outer 11 × 11 cm{sup 2} region of the array the Nyquist theorem is fulfilled for maximum sampling frequencies of 0.2 and 0.1 mm{sup −1}, respectively. An IMRT field verification with a Gamma-Index analysis yielded a passing rate of 95.2% for a 3 mm/3% criterion with a TPS calculation as reference.Conclusions: This study shows the applicability of the Octavius 1000SRS in modern dosimetry. Output factor and dose profile measurements illustrated the applicability of the array in small field and stereotactic dosimetry. The high spatial resolution ensures adequate measurements of dose profiles in regular and intensity modulated photon-beam fields.« less

Evaluation of (68)Ga-DOTA-TOC PET/CT for the detection of duodenopancreatic neuroendocrine tumors in patients with MEN1.

PubMed

Morgat, Clément; Vélayoudom-Céphise, Fritz-Line; Schwartz, Paul; Guyot, Martine; Gaye, Delphine; Vimont, Delphine; Schulz, Jürgen; Mazère, Joachim; Nunes, Marie-Laure; Smith, Denis; Hindié, Elif; Fernandez, Philippe; Tabarin, Antoine

2016-07-01

Somatostatin receptor scintigraphy with (111)In-pentetreotide (SRS) is used to detect duodenopancreatic neuroendocrine tumors (dpNETs) in multiple endocrine neoplasia type 1 (MEN1). However, SRS has limited sensitivity for this purpose. Positron emission tomography/computed tomography (PET/CT) with (68)Ga-DOTA-TOC has a higher rate of sporadic dpNETs detection than SRS but there is little data for dpNETs detection in MEN1. To compare the performances of (68)Ga-DOTA-TOC PET/CT, SRS and contrast-enhanced computed tomography (CE-CT) to diagnose dpNETs in MEN1. Single-institution prospective comparative study Nineteen consecutive MEN1 patients (aged 47 ± 13 years) underwent (68)Ga-DOTA-TOC PET/CT, SRS, and CE-CT within 2 months in random order. Blinded readings of images were performed separately by experienced physicians. Unblinded analysis of CE-CT, combined with additional magnetic resonance imaging, endoscopic-ultrasound, (18)F-2-fluoro-deoxy-D-glucose ((18)F-FDG) PET/CT or histopathology results served as reference standard for dpNETs diagnosis. The sensitivity of (68)Ga-DOTA-TOC PET/CT, SRS, and CE-CT was 76, 20, and 60 %, respectively (p < 0.0001). All the true-positive lesions detected by SRS were also depicted on (68)Ga-DOTA-TOC PET/CT. (68)Ga-DOTA-TOC PET/CT detected lesions of smaller size than SRS (10.7 ± 7.6 and 15.2 ± 5.9 mm, respectively, p < 0.03). False negatives of (68)Ga-DOTA-TOC PET/CT included small dpNETs (<10 mm) and (18)F-FDG PET/CT positive aggressive dpNETs. No false positives were recorded. In addition, whole-body mapping with (68)Ga-DOTA-TOC PET/CT identified extra-abdominal MEN1-related tumors including one neuroendocrine thymic carcinoma identified by the three imaging procedures, one bronchial carcinoid undetected by CE-CT and three meningiomas undetected by SRS. Owing to higher diagnostic performance, (68)Ga-DOTA-TOC PET/CT (or alternative (68)Ga-labeled somatostatin analogues) should replace (111)In-pentetreotide in the investigation of MEN1 patients.

The Reliability and Validity of the Social Responsiveness Scale in a UK General Child Population

ERIC Educational Resources Information Center

Wigham, Sarah; McConachie, Helen; Tandos, Jonathan; Le Couteur, Ann S.

2012-01-01

This is the first UK study to report the reliability, validity, and factor structure of the Social Responsiveness Scale (SRS) in a general population sample. Parents of 500 children (aged 5-8 years) in North East England completed the SRS. Profiles of scores were similar to USA norms, and a single factor structure was identified. Good construct…

Modulated Raman spectroscopy for enhanced identification of bladder tumor cells in urine samples.

PubMed

Canetta, Elisabetta; Mazilu, Michael; De Luca, Anna Chiara; Carruthers, Antonia E; Dholakia, Kishan; Neilson, Sam; Sargeant, Harry; Briscoe, Tina; Herrington, C Simon; Riches, Andrew C

2011-03-01

Standard Raman spectroscopy (SRS) is a noninvasive technique that is used in the biomedical field to discriminate between normal and cancer cells. However, the presence of a strong fluorescence background detracts from the use of SRS in real-time clinical applications. Recently, we have reported a novel modulated Raman spectroscopy (MRS) technique to extract the Raman spectra from the background. In this paper, we present the first application of MRS to the identification of human urothelial cells (SV-HUC-1) and bladder cancer cells (MGH) in urine samples. These results are compared to those obtained by SRS. Classification using the principal component analysis clearly shows that MRS allows discrimination between Raman spectra of SV-HUC-1 and MGH cells with high sensitivity (98%) and specificity (95%). MRS is also used to distinguish between SV-HUC-1 and MGH cells after exposure to urine for up to 6 h. We observe a marked change in the MRS of SV-HUC-1 and MGH cells with time in urine, indicating that the conditions of sample collection will be important for the application of this methodology to clinical urine samples.

Botulinum toxin treatment for slipping rib syndrome: a case report.

PubMed

Pirali, Caterina; Santus, Gianna; Faletti, Sofia; De Grandis, Domenico

2013-10-01

Slipping rib syndrome (SRS) is a musculoskeletal cause of severe and recurrent thoracic or abdominal pain. The etiology of SRS is unknown, it seems to arise from costal hypermobility with a tendency of one of the ribs (usually from 8th to 10th but also 11th and 12th have been described) to slip under the superior adjacent rib. Its prevalence is underestimated because SRS is mainly a clinical diagnosis, frequently missed. The critical aspect of the diagnosis is knowledge of the condition itself, which, when lacking, often results in the patient being referred to many different specialists and exposed to unnecessary and costly investigations. The management of the condition includes conservative techniques such as manipulation, localized anesthetic, and steroid or anesthetic nerve block. However, where conservative therapy fails, surgical treatment, with excision of the rib, may be performed. In this paper we describe the case of a patient with persistent and debilitating flank pain who, after many investigations, was diagnosed with SRS. The usual conservative treatment failed, after which we treated the patient with injections of incobotulinumtoxin A into muscles inserting on the inferior side of the rib cage (quadratus lumborum muscle, muscle transversus abdomini, abdominal external oblique muscle, and recto abdomini) achieving a complete relief from pain. To our knowledge botulinum toxin has never been proposed before for the treatment of SRS. We believe that it should be considered as a therapeutic option, especially where other medical treatments have failed or as an intermediate step before surgical intervention.

Analysis of stimulated Raman backscatter and stimulated Brillouin backscatter in experiments performed on SG-III prototype facility with a spectral analysis code

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

Hao, Liang; Zhao, Yiqing; Hu, Xiaoyan

2014-07-15

Experiments about the observations of stimulated Raman backscatter (SRS) and stimulated Brillouin backscatter (SBS) in Hohlraum were performed on Shenguang-III (SG-III) prototype facility for the first time in 2011. In this paper, relevant experimental results are analyzed for the first time with a one-dimension spectral analysis code, which is developed to study the coexistent process of SRS and SBS in Hohlraum plasma condition. Spectral features of the backscattered light are discussed with different plasma parameters. In the case of empty Hohlraum experiments, simulation results indicate that SBS, which grows fast at the energy deposition region near the Hohlraum wall, ismore » the dominant instability process. The time resolved spectra of SRS and SBS are numerically obtained, which agree with the experimental observations. For the gas-filled Hohlraum experiments, simulation results show that SBS grows fastest in Au plasma and amplifies convectively in C{sub 5}H{sub 12} gas, whereas SRS mainly grows in the high density region of the C{sub 5}H{sub 12} gas. Gain spectra and the spectra of backscattered light are simulated along the ray path, which clearly show the location where the intensity of scattered light with a certain wavelength increases. This work is helpful to comprehend the observed spectral features of SRS and SBS. The experiments and relevant analysis provide references for the ignition target design in future.« less

Redundant systematic reviews on the same topic in surgery: a study protocol for a meta-epidemiological investigation.

PubMed

Katsura, Morihiro; Kuriyama, Akira; Tada, Masafumi; Yamamoto, Kazumichi; Furukawa, Toshi A

2017-08-21

We are witnessing an explosive increase in redundant and overlapping publications of systematic reviews and meta-analyses (SRs/MAs) on the same topic, which often present conflicting results and interpretations, in the current medical literature. They represent wasted efforts on the part of investigators and peer reviewers and may confuse and possibly mislead clinicians and policymakers. Here, we present a protocol for a meta-epidemiological investigation to describe how often there are overlapping SRs/MAs on the same topic, to assess the quality of these multiple publications, and to investigate the causes of discrepant results between multiple SRs/MAs in the field of major surgery. We will use MEDLINE/PubMed to identify all SRs/MAs of randomised controlled trials (RCTs) published in 2015 regarding major surgical interventions. After identifying the 'benchmark' SRs/MAs published in 2015, a process of screening in MEDLINE will be carried out to identify the previous SRs/MAs of RCTs on the same topic that were published within 5 years of the 'benchmark' SRs/MAs. We will tabulate the number of previous SRs/MAs on the same topic of RCTs, and then describe their variations in numbers of RCTs included, sample sizes, effect size estimates and other characteristics. We will also assess the differences in quality of each SR/MA using A Measurement Tool to Assess Systematic Reviews (AMSTAR) score. Finally, we will investigate the potential reasons to explain the discrepant results between multiple SRs/MAs. No formal ethical approval and informed consent are required because this study will not collect primary individual data. The intended audiences of the findings include clinicians, healthcare researchers and policymakers. We will publish our findings as a scientific report in a peer-reviewed journal. In PROSPERO CRD42017059077, March 2017. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Assessment of Geometrical Accuracy of Multimodal Images Used for Treatment Planning in Stereotactic Radiotherapy and Radiosurgery: CT, MRI and PET

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

Garcia-Garduno, O. A.; Larraga-Gutierrez, J. M.; Celis, M. A.

2006-09-08

An acrylic phantom was designed and constructed to assess the geometrical accuracy of CT, MRI and PET images for stereotactic radiotherapy (SRT) and radiosurgery (SRS) applications. The phantom was suited for each image modality with a specific tracer and compared with CT images to measure the radial deviation between the reference marks in the phantom. It was found that for MRI the maximum mean deviation is 1.9 {+-} 0.2 mm compared to 2.4 {+-} 0.3 mm reported for PET. These results will be used for margin outlining in SRS and SRT treatment planning.

Identification of problems in search strategies in Cochrane Reviews.

PubMed

Franco, Juan Víctor Ariel; Garrote, Virginia Laura; Escobar Liquitay, Camila Micaela; Vietto, Valeria

2018-05-15

Search strategies are essential for the adequate retrieval of studies in a systematic review (SR). Our objective was to identify problems in the design and reporting of search strategies in a sample of new Cochrane SRs first published in The Cochrane Library in 2015. We took a random sample of 70 new Cochrane SRs of interventions published in 2015. We evaluated their design and reporting of search strategies using the recommendations from the Cochrane Handbook for Systematic Reviews of Interventions, the Methodological Expectations of Cochrane Intervention Reviews, and the Peer Review of Electronic Search Strategies evidence-based guideline. Most reviews complied with the reporting standards in the Cochrane Handbook and the Methodological Expectations of Cochrane Intervention Reviews; however, 8 SRs did not search trials registers, 3 SRs included language restrictions, and there was inconsistent reporting of contact with individuals and searches of the gray literature. We found problems in the design of the search strategies in 73% of reviews (95% CI, 60-84%) and 53% of these contained problems (95% CI, 38-69%) that could limit both the sensitivity and precision of the search strategies. We found limitations in the design and reporting of search strategies. We consider that a greater adherence to the guidelines could improve their quality. Copyright © 2018 John Wiley & Sons, Ltd.

Understanding screen-related sedentary behavior and its contributing factors among school-aged children: a social-ecologic exploration.

PubMed

He, Meizi; Harris, Stewart; Piché, Leonard; Beynon, Charlene

2009-01-01

To explore the factors that contribute to children's screen-related sedentary (S-RS) behaviors. Elementary schools. A random sample of children in grades five and six and their parents. The outcome measure was children's S-RS activity level measured by a self-administered questionnaire. A full spectrum of potential contributing factors for children's S-RS behaviors was obtained through surveys. Multilevel linear regression methods were used to determine the associations between these factors and children's screen time (hours per day) and results were expressed as regression coefficients (g). Of 955 child-parent pairs in 14 participating schools, 508 pairs (53%) completed the surveys. At an intrapersonal level, protective factors included being a girl (g = -.71); belonging to a sports team inside (g = -.56) or outside (g = -.49) of school; having a negative attitude toward S-RS activities (g = -.13); and having a positive attitude toward physical activity (g = .48). At the interpersonal and social levels, parental leisure S-RS behaviors (g = .32) were positively associated, whereas strict parental rules on computer use (g = -.27) and family income (g = -.32) were inversely correlated with S-RS behavior. At the environmental level, the presence of TVs in children's bedrooms (g = .44) and owning videogame devices (g = .58) increased the risk of S-RS behaviors, whereas after school programs (g = - .86) and schools' participation in the Turn Off the Screen Week campaign (g = -.91) decreased the risk. Public health interventions should target multilevel factors, including increasing children's awareness, promoting parental involvement in healthy lifestyle pursuits, and creating less screenogenic environments.

AmeriFlux US-Skr Shark River Slough (Tower SRS-6) Everglades

DOE Data Explorer

Barr, Jordan G. [Everglades National Park; Fuentes, Jose [Pennsylvania State University

2016-01-01

This is the AmeriFlux version of the carbon flux data for the site US-Skr Shark River Slough (Tower SRS-6) Everglades. Site Description - The Florida Everglades Shark River Slough Mangrove Forest site is located along the Shark River in the western region of Everglades National Park. Also referred to as site SRS6 of the Florida Coastal Everglades LTER program, freshwater in the mangrove riverine floods the forest floor under a meter of water twice per day. Transgressive discharge of freshwater from the Shark river follows annual rainfall distributions between the wet and dry seasons. Hurricane Wilma struck the site in October of 2005 causing significant damage. The tower was offline until the following October in order to continue temporally consistent measurements. In post-hurricane conditions, ecosystem respiration rates and solar irradiance transfer increased. 2007- 2008 measurements indicate that these factors led to an decline in both annual -NEE and daily NEE from pre-hurricane conditions in 2004-2005.

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

Paller, M.; Blas, S.

The upper portion of Lower Three Runs includes several ponds, reservoirs, and canals that were formerly used as a cooling system for nuclear production reactors. This area was divided into nine exposure areas (EAs) for the assessment of environmental contamination resulting from past reactor operations and other industrial processes. A tiered screening process identified several contaminants of potential concern including aluminum, cyanide, lead, manganese, mercury, DDD, DDE, and DDT. Risks posed by these contaminants to ecological receptors (river otter, belted kingfisher, raccoon, and blue heron) were assessed using contaminant exposure models that estimated contaminant intake resulting from ingestion of food,more » water, and sediment/ soil and compared these intakes with toxicity reference values (TRVs). The contaminant exposure models showed that the TRVs were not exceeded in the otter model, exceeded by aluminum in EA 7 (Pond 2 and associated canals) in the raccoon model, and exceeded by mercury in EAs 2, 3 (Pond B), 6 (Par Pond), and 8 (Ponds 4 and 5 and Canal to Pond C) in both the kingfisher and blue heron models. Hazard quotients (total exposure dose divided by the TRV) were 2.8 for aluminum and 1.7- 3.6 for mercury. The primary route of exposure for aluminum was the ingestion of soil, and the primary route of exposure for mercury was the ingestion of mercury contaminated fish. Elevated levels of mercury in fish were at least partly the result of the aerial deposition of mercury onto Lower Three Runs and its watershed. The atmospheric deposition of mercury creates pervasive contamination in fish throughout the Savannah River basin. Another possible source of mercury was the discharge of mercury contaminated Savannah River water into the Lower Three Runs cooling ponds and canals during previous years of reactor operation. This contamination originated from industries located upstream of the SRS. The aluminum exceedance for the raccoon was likely the result of naturally high aluminum levels in SRS soils rather than SRS operations. Aluminum exceedances have previously been observed in relatively undisturbed background locations as well as areas affected by SRS operations. Aluminum exceedances are more likely with the raccoon than the other receptors because it consumes more soil as a result of its feeding habits. Sensitivity analysis showed that model uncertainty can be reduced by adequate sampling of key variables (e.g., fish and sediments). Although sediment samples were collected from all EAs, fish samples were not collected from three EAs and some analytes (pesticides and cyanide) were not measured in fish. Water-to-fish concentration ratios were used to estimate contaminant levels in fish when direct measurements from fish were unavailable; however, such estimates are potentially less accurate than direct measurements.« less

Age, Sex, and Blood Pressure-Related Influences on Reference Values of Left Atrial Deformation and Mechanics From a Large-Scale Asian Population.

PubMed

Liao, Jo-Nan; Chao, Tze-Fan; Kuo, Jen-Yuan; Sung, Kuo-Tzu; Tsai, Jui-Peng; Lo, Chi-In; Lai, Yau-Huei; Su, Cheng-Huang; Hung, Chung-Lieh; Yeh, Hung-I; Chen, Shih-Ann

2017-10-01

Left atrial (LA) function is tightly linked to several cardiovascular diseases and confers key prognostic information. Speckle tracking-based deformation as a feasible and sensitive LA mechanical assessment has proven its clinical significance beyond volume measures; however, the reference values remain largely unknown. We studied 4042 participants undergoing annual cardiovascular survey. Among them, 2812 healthy participants (65% men; mean age, 47.4±9.9 years) were eligible for speckle tracking analysis. Peak atrial longitudinal systolic strain and strain rate (SR) at systolic (SRs), early diastolic (SRe), and late diastolic atrial contraction phases (SRa) were analyzed by dedicated software (EchoPAC, GE) and compared in terms of age, sex, and blood pressure. Overall, women demonstrated higher peak atrial longitudinal systolic strain (39.34±7.99% versus 37.95±7.96%; P<0.001) and showed age-dependent more pronounced peak atrial longitudinal systolic strain functional decay than those of men (P value for interaction, <0.05), with men showing higher SRs and SRa, although lower SRe (all P<0.001). Both increasing age and higher blood pressure were independently associated with deteriorated peak atrial longitudinal systolic strain, SRs, and SRe, although augmented LA SRa, even after accounting for baseline clinical covariates in multivariable models that incorporated LA volume, NT-proBNP (N-terminal pro-B-type natriuretic peptide), or left ventricular E/e' (all P<0.001). Our findings suggest LA mechanical functional decays in association with increasing age and higher blood pressure, which seem to be compensated for by augmentation of atrial pump function. We have also provided age- and sex-stratified reference values for strain and SR based on a large-scale Asian population. © 2017 American Heart Association, Inc.

Effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of cardiovascular disease: protocol for an overview of systematic reviews.

PubMed

Studziński, Krzysztof; Tomasik, Tomasz; Krzyszton, Janusz; Jóźwiak, Jacek; Windak, Adam

2017-03-08

Major clinical practice guidelines recommend assessing risk of cardiovascular disease (CVD) using absolute/global/total CVD risk scores. However, the effectiveness of using them in clinical practice, despite publication of numerous randomised controlled trials (RCTs), is still poorly understood. To summarise and analyse current knowledge in this field, we will carry out an overview of existing systematic reviews (SRs). The objective of this overview will be to assess the effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of CVD compared with standard care. We will include SRs and meta-analyses which take into account RCTs and quasi-RCTs investigating the effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of CVD. SRs will be retrieved from 4 bibliographical databases and reference lists of identified reviews. Additionally, the PROSPERO database will be searched for unpublished, ongoing or recently completed SRs. 2 reviewers will assess the SRs independently for eligibility and bias. The data will be extracted to a special form. Any disagreement will be resolved by discussion. In case of lack of consensus, a third author will arbitrate. The overview of SRs will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Ethics approval is not required for overview of SRs. We will summarise evidence concerning whether use of the absolute/global/total CVD risk scoring tools in primary prevention of CVD is effective and supported with scientific data or not. If we face unsatisfactory confirmation, we will highlight a need for further research and advice on how to plan such a study. We will submit the results of our study for peer-review publication in a journal indexed in the international bibliographic database of biomedical information. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Testing of SRS and RFETS Nylon Bag Material

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

Laurinat, J.E.

1998-11-03

This report compares the effects of radiation and heating on nylon bagout materials used at the Savannah River Site (SRS) and the Rocky Flats Environmental Technology Site (RFETS). Recently, to simplify the processing of sand, slag, and crucible (SS and C), FB-Line has replaced the low-density polyethylene (LDPE) and polyvinyl chloride (PVC) bags normally used to package cans of plutonium-bearing material with nylon bags. LDPE and PVC are not soluble in the nitric acid dissolver solution used in F-Canyon, so cans bagged using these materials had to be repackaged before they were added to the dissolver. Because nylon dissolves inmore » nitric acid, cans bagged in nylon can be charged to the F-Canyon dissolvers without repackaging, thereby reducing handling requirements and personnel exposure. As part of a program to process RFETS SS and C at SRS, RFETS has also begun to use a nylon bagout material. The RFETS bag materials is made from a copolymer of nylon 6 and nylon 6.9, while the SRS material is made from a nylon 6 monomer. In addition, the SRS nylon has an anti-static agent added. The RFETS nylon is slightly softer than the SRS nylon, but does not appear to be as resistant to flex cracks initiated by contact with sharp corners of the inner can containing the SS and C.2 FB-Line Operations has asked for measurement of the effects of radiation and heating on these materials. Specifically, they have requested a comparison of the material properties of the plastics before and after irradiation, a measurement of the amount of outgassing when the plastics are heated, and a calculation of the amount of radiolytic gas generation. Testing was performed on samples taken from material that is currently used in FB-Line (color coded orange) and at RFETS. The requested tests are the same tests previously performed on the original and replacement nylon and LDPE bag materials.3,4,5. To evaluate the effect of irradiation on material properties, tensile stresses and elongations to break w ere compared for unirradiated and irradiated samples. A standard ASTM method for the measurement of tensile plastic properties6 was used. Properties were measured both parallel to the direction of machining (MD) and transverse to the direction of machining (TD). Tensile strength measurements showed that the ultimate strengths of the SRS replacement bag material decreased by 22 percent in the MD orientation and 17 percent in the TD orientation after irradiation with 5 x 106 rad, a dose equivalent to about 8-9 months exposure in a plutonium can. For the RFETS material, the decreases were 23 percent in the MD orientation and 56 percent in the TD orientation. Although the 5 x 106 dose significantly degraded the properties of both materials, their strengths remained superior to those previously measured for LDPE,4 even after irradiation. Elongations to break also decreased, especially for the SRS material. The decrease for the SRS material were 86 percent in the MD orientation and 95 percent in the TD orientation. For the RFETS material, elongations to break decreased at least 18 percent in the MD orientation and 29 percent in the TD orientation. When samples of both the SRS and RFETS materials were heated in a sealed container to the maximum expected storage can temperature of about 95 C, they outgassed at pressures ranging from 16 to 22 psig. These pressure increases would not cause a can to fail. Using a representative G value of 1.6 molecules/100 ev, the amount of outgassing due to radiolysis was calculated to be negligible. In conclusion, it may be stated that the results of the strength tests and the outgassing measurements and calculations demonstrate that the SRS and RFETS replacement bag materials are acceptable substitutes for LDPE with respect to mechanical properties.« less

In vivo and in vitro evidence of somatostatin receptors expression in a dedifferentiated retroperitoneal liposarcoma.

PubMed

Imperiale, Alessio; Chenard, Marie-Pierre; Rohr, Serge; Barlier, Anne; Goichot, Bernard

2014-10-01

A 62-year-old patient presented with mildly elevated catecholamines and an abdominal painless mass. Abdominal CT revealed an 18 × 12 cm tumor in the right retroperitoneum with intense contrast enhancement. Somatostatin receptor scintigraphy (SRS) showed pathologic uptake by the lesion. Given the suspicion of paraganglioma, the patient was referred to surgery for tumor removal. Surprisingly, the histopathological examination revealed a dedifferentiated liposarcoma. Somatostatin receptors of type 2 were identified and quantified by reverse transcription polymerase chain reaction. The unexpected presentation of our patient draws clinicians' attention when performing diagnostic procedure for retroperitoneal lesions, even though hormone secretion and positive SRS strongly suggest paraganglioma.

Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series.

PubMed

Abraha, Iosief; Rimland, Joseph M; Trotta, Fabiana Mirella; Dell'Aquila, Giuseppina; Cruz-Jentoft, Alfonso; Petrovic, Mirko; Gudmundsson, Adalsteinn; Soiza, Roy; O'Mahony, Denis; Guaita, Antonio; Cherubini, Antonio

2017-03-16

To provide an overview of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD). Systematic overview of reviews. PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL and PsycINFO (2009-March 2015). Systematic reviews (SRs) that included at least one comparative study evaluating any non-pharmacological intervention, to treat BPSD. Eligible studies were selected and data extracted independently by 2 reviewers.The AMSTAR checklist was used to assess the quality of the SRs. Extracted data were synthesised using a narrative approach. 38 SRs and 129 primary studies were identified, comprising the following categories of non-pharmacological interventions: (1) sensory stimulation interventions (25 SRs, 66 primary studies) that encompassed: shiatsu and acupressure, aromatherapy, massage/touch therapy, light therapy, sensory garden and horticultural activities, music/dance therapy, dance therapy, snoezelen multisensory stimulation therapy, transcutaneous electrical nerve stimulation; (2) cognitive/emotion-oriented interventions (13 SRs; 26 primary studies) that included cognitive stimulation, reminiscence therapy, validation therapy, simulated presence therapy; (3) behaviour management techniques (6 SRs; 22 primary studies); (4) Multicomponent interventions (3 SR; four primary studies); (5) other therapies (5 SRs, 15 primary studies) comprising exercise therapy, animal-assisted therapy, special care unit and dining room environment-based interventions. A large number of non-pharmacological interventions for BPSD were identified. The majority of the studies had great variation in how the same type of intervention was defined and applied, the follow-up duration, the type of outcome measured, usually with modest sample size. Overall, music therapy and behavioural management techniques were effective for reducing BPSD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The connection between mass, environment, and slow rotation in simulated galaxies

NASA Astrophysics Data System (ADS)

Lagos, Claudia del P.; Schaye, Joop; Bahé, Yannick; Van de Sande, Jesse; Kay, Scott T.; Barnes, David; Davis, Timothy A.; Dalla Vecchia, Claudio

2018-06-01

Recent observations from integral field spectroscopy (IFS) indicate that the fraction of galaxies that are slow rotators (SRs), FSR, depends primarily on stellar mass, with no significant dependence on environment. We investigate these trends and the formation paths of SRs using the EAGLE and HYDRANGEA hydrodynamical simulations. EAGLE consists of several cosmological boxes of volumes up to (100 Mpc)^3, while HYDRANGEA consists of 24 cosmological simulations of galaxy clusters and their environment. Together they provide a statistically significant sample in the stellar mass range 10^{9.5}-10^{12.3} M_{⊙}, of 16 358 galaxies. We construct IFS-like cubes and measure stellar spin parameters, λR, and ellipticities, allowing us to classify galaxies into slow/fast rotators as in observations. The simulations display a primary dependence of FSR on stellar mass, with a weak dependence on environment. At fixed stellar mass, satellite galaxies are more likely to be SRs than centrals. FSR shows a dependence on halo mass at fixed stellar mass for central galaxies, while no such trend is seen for satellites. We find that ≈70 per cent of SRs at z = 0 have experienced at least one merger with mass ratio ≥0.1, with dry mergers being at least twice more common than wet mergers. Individual dry mergers tend to decrease λR, while wet mergers mostly increase it. However, 30 per cent of SRs at z = 0 have not experienced mergers, and those inhabit haloes with median spins twice smaller than the haloes hosting the rest of the SRs. Thus, although the formation paths of SRs can be varied, dry mergers and/or haloes with small spins dominate.

Triterpene and Flavonoid Biosynthesis and Metabolic Profiling of Hairy Roots, Adventitious Roots, and Seedling Roots of Astragalus membranaceus.

PubMed

Park, Yun Ji; Thwe, Aye Aye; Li, Xiaohua; Kim, Yeon Jeong; Kim, Jae Kwang; Arasu, Mariadhas Valan; Al-Dhabi, Naif Abdullah; Park, Sang Un

2015-10-14

Astragalus membranaceus is an important traditional Chinese herb with various medical applications. Astragalosides (ASTs), calycosin, and calycosin-7-O-β-d-glucoside (CG) are the primary metabolic components in A. membranaceus roots. The dried roots of A. membranaceus have various medicinal properties. The present study aimed to investigate the expression levels of genes related to the biosynthetic pathways of ASTs, calycosin, and CG to investigate the differences between seedling roots (SRs), adventitious roots (ARs), and hairy roots (HRs) using quantitative real-time polymerase chain reaction (qRT-PCR). qRT-PCR study revealed that the transcription level of genes involved in the AST biosynthetic pathway was lowest in ARs and showed similar patterns in HRs and SRs. Moreover, most genes involved in the synthesis of calycosin and CG exhibited the highest expression levels in SRs. High-performance liquid chromatography (HPLC) analysis indicated that the expression level of the genes correlated with the content of ASTs, calycosin, and CG in the three different types of roots. ASTs were the most abundant in SRs. CG accumulation was greater than calycosin accumulation in ARs and HRs, whereas the opposite was true in SRs. Additionally, 40 metabolites were identified using gas chromatography-time-of-flight mass spectrometry (GC-TOF-MS). Principal component analysis (PCA) documented the differences among SRs, ARs, and HRs. PCA comparatively differentiated among the three samples. The results of PCA showed that HRs were distinct from ARs and SRs on the basis of the dominant amounts of sugars and clusters derived from closely similar biochemical pathways. Also, ARs had a higher concentration of phenylalanine, a precursor for the phenylpropanoid biosynthetic pathway, as well as CG. TCA cycle intermediates levels including succinic acid and citric acid indicated a higher amount in SRs than in the others.

Methodological quality of systematic reviews on treatments for depression: a cross-sectional study.

PubMed

Chung, V C H; Wu, X Y; Feng, Y; Ho, R S T; Wong, S Y S; Threapleton, D

2017-05-02

Depression is one of the most common mental disorders and identifying effective treatment strategies is crucial for the control of depression. Well-conducted systematic reviews (SRs) and meta-analyses can provide the best evidence for supporting treatment decision-making. Nevertheless, the trustworthiness of conclusions can be limited by lack of methodological rigour. This study aims to assess the methodological quality of a representative sample of SRs on depression treatments. A cross-sectional study on the bibliographical and methodological characteristics of SRs published on depression treatments trials was conducted. Two electronic databases (the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects) were searched for potential SRs. SRs with at least one meta-analysis on the effects of depression treatments were considered eligible. The methodological quality of included SRs was assessed using the validated AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool. The associations between bibliographical characteristics and scoring on AMSTAR items were analysed using logistic regression analysis. A total of 358 SRs were included and appraised. Over half of included SRs (n = 195) focused on non-pharmacological treatments and harms were reported in 45.5% (n = 163) of all studies. Studies varied in methods and reporting practices: only 112 (31.3%) took the risk of bias among primary studies into account when formulating conclusions; 245 (68.4%) did not fully declare conflict of interests; 93 (26.0%) reported an 'a priori' design and 104 (29.1%) provided lists of both included and excluded studies. Results from regression analyses showed: more recent publications were more likely to report 'a priori' designs [adjusted odds ratio (AOR) 1.31, 95% confidence interval (CI) 1.09-1.57], to describe study characteristics fully (AOR 1.16, 95% CI 1.06-1.28), and to assess presence of publication bias (AOR 1.13, 95% CI 1.06-1.19), but were less likely to list both included and excluded studies (AOR 0.86, 95% CI 0.81-0.92). SRs published in journals with higher impact factor (AOR 1.14, 95% CI 1.04-1.25), completed by more review authors (AOR 1.12, 95% CI 1.01-1.24) and SRs on non-pharmacological treatments (AOR 1.62, 95% CI 1.01-2.59) were associated with better performance in publication bias assessment. The methodological quality of included SRs is disappointing. Future SRs should strive to improve rigour by considering of risk of bias when formulating conclusions, reporting conflict of interests and authors should explicitly describe harms. SR authors should also use appropriate methods to combine the results, prevent language and publication biases, and ensure timely updates.

Prevalence of Axis II disorders in a sample of clients undertaking psychiatric evaluation for sex reassignment surgery.

PubMed

Madeddu, Fabio; Prunas, Antonio; Hartmann, Diamante

2009-12-01

The aim of the present study is to assess the prevalence of Axis II disorders (DSM-IV-TR) in a sample of clients requesting sex reassignment surgery (SRS), consecutively admitted to a Gender Identity Disorder (GID) psychiatric unit. Fifty clients self-referred as transsexuals (34 biological males and 16 biological females; mean age = 31.74 +/- 7.06 years) were assessed through the SCID-II after a preliminary evaluation to exclude current major psychiatric disorders. Prevalence of any Axis II disorder was 52% (N = 26), with no significant differences related to biological sex. The most frequent personality disorders were Cluster B PDs (22% of total sample), followed by Cluster C (12%) and Cluster A PDs (2%). A significant prevalence of NOS PD (16%) was also found. Our data offers prevalence estimates slightly higher than those found in previous studies and does not provide evidence for any differences in the psychopathological profile and severity between MtF and FtM transsexuals.

Surface Complexation Modeling of U(VI) Adsorption onto Savannah River Site Sediments

NASA Astrophysics Data System (ADS)

Dong, W.; Wan, J.; Tokunaga, T. K.; Denham, M.; Davis, J.; Hubbard, S. S.

2011-12-01

The Savannah River Site (SRS) was a U.S. Department of Energy facility for plutonium production during the Cold War. Waste plumes containing low-level radioactivity and acidic waste solutions were discharged to a series of unlined seepage basins in the F-Area of the SRS from 1955 to 1988. Although the site has undergone many years of active remediation, the groundwater remains acidic, and the concentrations of U and other radionuclides are still significantly higher than their Maximum Contaminant Levels (MCLs). The objective of this effort is to understand and predict U(VI) mobility in acidic waste plumes through developing surface complexation models (SCMs). Laboratory batch experiments were conducted to evaluate U adsorption behavior over the pH range of 3.0 to 9.5. Ten sorbent samples were selected including six contaminated sediment samples from three boreholes drilled within the plume and along the groundwater flow direction, two uncontaminated (pristine) sediment samples from a borehole outside of the plume, and two reference minerals, goethite and kaolinite (identified as the dominant minerals in the clay size fraction of the F-Area sediments). The results show that goethite and kaolinite largely control U partitioning behavior. In comparison with the pristine sediment, U(VI) adsorption onto contaminated sediments exhibits adsorption edges shifted toward lower pH by about 1.0 unit (e.g., from pH≈4.5 to pH≈3.5). We developed a SCMs based component additivity (CA) approach, which can successfully predict U(VI) adsorption onto uncontaminated SRS sediments. However, application of the same SCMs based CA approach to contaminated sediments resulted in underestimates of U(VI) adsorption at acidic pH conditions. The model sensitivity analyses indicate that both goethite and kaolinite surfaces co-contributed to U(VI) adsorption under acidic pH conditions. In particular, the exchange sites of clay minerals might play an important role in adsorption of U(VI) at pH < 5.0. These results suggested that the contaminated sediments might either contain other more reactive clay minerals such as smectite, or that the long-term acid-leaching process might have altered the surface reactivity of the original sediments. Further studies are needed to identify more reactive mineral facies and understand the effects of acid leaching on the surface reactivity of the sediments.

Patient Motivation and Long-Term Satisfaction with Treatment Choice in Vestibular Schwannoma.

PubMed

Carlson, Matthew L; Tveiten, Øystein Vesterli; Lund-Johansen, Morten; Tombers, Nicole M; Lohse, Christine M; Link, Michael J

2018-06-01

To ascertain primary motivation and long-term satisfaction with treatment selection in patients with vestibular schwannoma. A multicenter, cross-sectional survey was performed. Patients with small- to medium-sized sporadic vestibular schwannoma who underwent stereotactic radiosurgery (SRS; n = 247), microsurgery (n = 144), or observation (n = 148) between 1998 and 2008 were surveyed regarding their motivation behind treatment selection and hindsight satisfaction with their choice of management. "Physician recommendation" was the most commonly stated reason for modality selection in all 3 groups. The second and third most common reasons for selecting SRS included "less invasive option than surgery" in 80 patients (32%) and "less recovery time than surgery" in 16 patients (6%). The second and third most common reasons for selecting observation included "to avoid side-effects of treatment" in 25 patients (17%) and "symptoms not severe enough to warrant intervention" in 22 patients (15%). The second and third most common reasons for selecting microsurgery included "do not want tumor in head" in 35 patients (24%) and "most definitive treatment" in 15 patients (10%). Overall, 232 patients (96%) treated with SRS, 141 observed patients (97%), and 121 patients (85%) who underwent microsurgical treatment were satisfied with their original decision (P < 0.001). Motivation behind treatment selection varies between individuals. Those who select observation and SRS commonly reference less invasiveness and lower risk, whereas those who select microsurgery are commonly motivated by having their tumor physically removed and the more definitive nature of treatment. Posttreatment satisfaction is highest in patients who undergo SRS and observation, although all 3 groups report high levels of satisfaction. Copyright © 2018 Elsevier Inc. All rights reserved.

Expression of the Broad Autism Phenotype in Simplex Autism Families from the Simons Simplex Collection

ERIC Educational Resources Information Center

Davidson, Julie; Goin-Kochel, Robin P.; Green-Snyder, Lee Anne; Hundley, Rachel J.; Warren, Zachary; Peters, Sarika U.

2014-01-01

The broad autism phenotype (BAP) refers to the phenotypic expression of an underlying genetic liability to autism, manifest in non-autistic relatives. This study examined the relationship among the "Broad Autism Phenotype Questionnaire" (BAPQ), "Social Responsiveness Scale: Adult Research Version" (SRS:ARV), and "Family…

Boxcar detection for high-frequency modulation in stimulated Raman scattering microscopy

NASA Astrophysics Data System (ADS)

Fimpel, P.; Riek, C.; Ebner, L.; Leitenstorfer, A.; Brida, D.; Zumbusch, A.

2018-04-01

Stimulated Raman scattering (SRS) microscopy is an important non-linear optical technique for the investigation of unlabeled samples. The SRS signal manifests itself as a small intensity exchange between the laser pulses involved in coherent excitation of Raman modes. Usually, high-frequency modulation is applied in one pulse train, and the signal is then detected on the other pulse train via lock-in amplification. While allowing shot-noise limited detection sensitivity, lock-in detection, which corresponds to filtering the signal in the frequency domain, is not the most efficient way of using the excitation light. In this manuscript, we show that boxcar averaging, which is equivalent to temporal filtering, is better suited for the detection of low-duty-cycle signals as encountered in SRS microscopy. We demonstrate that by employing suitable gating windows, the signal-to-noise ratios achievable with lock-in detection can be realized in shorter time with boxcar averaging. Therefore, high-quality images are recorded at a faster rate and lower irradiance which is an important factor, e.g., for minimizing degradation of biological samples.

Person-Generated Health Data in Simulated Rehabilitation Using Kinect for Stroke: Literature Review.

PubMed

Dimaguila, Gerardo Luis; Gray, Kathleen; Merolli, Mark

2018-05-08

Person- or patient-generated health data (PGHD) are health, wellness, and clinical data that people generate, record, and analyze for themselves. There is potential for PGHD to improve the efficiency and effectiveness of simulated rehabilitation technologies for stroke. Simulated rehabilitation is a type of telerehabilitation that uses computer technologies and interfaces to allow the real-time simulation of rehabilitation activities or a rehabilitation environment. A leading technology for simulated rehabilitation is Microsoft's Kinect, a video-based technology that uses infrared to track a user's body movements. This review attempts to understand to what extent Kinect-based stroke rehabilitation systems (K-SRS) have used PGHD and to what benefit. The review is conducted in two parts. In part 1, aspects of relevance for PGHD were searched for in existing systematic reviews on K-SRS. The following databases were searched: IEEE Xplore, Association of Computing Machinery Digital Library, PubMed, Biomed Central, Cochrane Library, and Campbell Collaboration. In part 2, original research papers that presented or used K-SRS were reviewed in terms of (1) types of PGHD, (2) patient access to PGHD, (3) PGHD use, and (4) effects of PGHD use. The search was conducted in the same databases as part 1 except Cochrane and Campbell Collaboration. Reference lists on K-SRS of the reviews found in part 1 were also included in the search for part 2. There was no date restriction. The search was closed in June 2017. The quality of the papers was not assessed, as it was not deemed critical to understanding PGHD access and use in studies that used K-SRS. In part 1, 192 papers were identified, and after assessment only 3 papers were included. Part 1 showed that previous reviews focused on technical effectiveness of K-SRS with some attention on clinical effectiveness. None of those reviews reported on home-based implementation or PGHD use. In part 2, 163 papers were identified and after assessment, 41 papers were included. Part 2 showed that there is a gap in understanding how PGHD use may affect patients using K-SRS and a lack of patient participation in the design of such systems. This paper calls specifically for further studies of K-SRS-and for studies of technologies that allow patients to generate their own health data in general-to pay more attention to how patients' own use of their data may influence their care processes and outcomes. Future studies that trial the effectiveness of K-SRS outside the clinic should also explore how patients and carers use PGHD in home rehabilitation programs. ©Gerardo Luis Dimaguila, Kathleen Gray, Mark Merolli. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 08.05.2018.

Single Broadband Phase-Shaped Pulse Stimulated Raman Spectroscopy for Standoff Trace Explosive Detection.

PubMed

Glenn, Rachel; Dantus, Marcos

2016-01-07

Recent success with trace explosives detection based on the single ultrafast pulse excitation for remote stimulated Raman scattering (SUPER-SRS) prompts us to provide new results and a Perspective that describes the theoretical foundation of the strategy used for achieving the desired sensitivity and selectivity. SUPER-SRS provides fast and selective imaging while being blind to optical properties of the substrate such as color, texture, or laser speckle. We describe the strategy of combining coherent vibrational excitation with a reference pulse in order to detect stimulated Raman gain or loss. A theoretical model is used to reproduce experimental spectra and to determine the ideal pulse parameters for best sensitivity, selectivity, and resolution when detecting one or more compounds simultaneously.

Development and validation of an item response theory-based Social Responsiveness Scale short form.

PubMed

Sturm, Alexandra; Kuhfeld, Megan; Kasari, Connie; McCracken, James T

2017-09-01

Research and practice in autism spectrum disorder (ASD) rely on quantitative measures, such as the Social Responsiveness Scale (SRS), for characterization and diagnosis. Like many ASD diagnostic measures, SRS scores are influenced by factors unrelated to ASD core features. This study further interrogates the psychometric properties of the SRS using item response theory (IRT), and demonstrates a strategy to create a psychometrically sound short form by applying IRT results. Social Responsiveness Scale analyses were conducted on a large sample (N = 21,426) of youth from four ASD databases. Items were subjected to item factor analyses and evaluation of item bias by gender, age, expressive language level, behavior problems, and nonverbal IQ. Item selection based on item psychometric properties, DIF analyses, and substantive validity produced a reduced item SRS short form that was unidimensional in structure, highly reliable (α = .96), and free of gender, age, expressive language, behavior problems, and nonverbal IQ influence. The short form also showed strong relationships with established measures of autism symptom severity (ADOS, ADI-R, Vineland). Degree of association between all measures varied as a function of expressive language. Results identified specific SRS items that are more vulnerable to non-ASD-related traits. The resultant 16-item SRS short form may possess superior psychometric properties compared to the original scale and emerge as a more precise measure of ASD core symptom severity, facilitating research and practice. Future research using IRT is needed to further refine existing measures of autism symptomatology. © 2017 Association for Child and Adolescent Mental Health.

Network Sampling with Memory: A proposal for more efficient sampling from social networks.

PubMed

Mouw, Ted; Verdery, Ashton M

2012-08-01

Techniques for sampling from networks have grown into an important area of research across several fields. For sociologists, the possibility of sampling from a network is appealing for two reasons: (1) A network sample can yield substantively interesting data about network structures and social interactions, and (2) it is useful in situations where study populations are difficult or impossible to survey with traditional sampling approaches because of the lack of a sampling frame. Despite its appeal, methodological concerns about the precision and accuracy of network-based sampling methods remain. In particular, recent research has shown that sampling from a network using a random walk based approach such as Respondent Driven Sampling (RDS) can result in high design effects (DE)-the ratio of the sampling variance to the sampling variance of simple random sampling (SRS). A high design effect means that more cases must be collected to achieve the same level of precision as SRS. In this paper we propose an alternative strategy, Network Sampling with Memory (NSM), which collects network data from respondents in order to reduce design effects and, correspondingly, the number of interviews needed to achieve a given level of statistical power. NSM combines a "List" mode, where all individuals on the revealed network list are sampled with the same cumulative probability, with a "Search" mode, which gives priority to bridge nodes connecting the current sample to unexplored parts of the network. We test the relative efficiency of NSM compared to RDS and SRS on 162 school and university networks from Add Health and Facebook that range in size from 110 to 16,278 nodes. The results show that the average design effect for NSM on these 162 networks is 1.16, which is very close to the efficiency of a simple random sample (DE=1), and 98.5% lower than the average DE we observed for RDS.

Network Sampling with Memory: A proposal for more efficient sampling from social networks

PubMed Central

Mouw, Ted; Verdery, Ashton M.

2013-01-01

Techniques for sampling from networks have grown into an important area of research across several fields. For sociologists, the possibility of sampling from a network is appealing for two reasons: (1) A network sample can yield substantively interesting data about network structures and social interactions, and (2) it is useful in situations where study populations are difficult or impossible to survey with traditional sampling approaches because of the lack of a sampling frame. Despite its appeal, methodological concerns about the precision and accuracy of network-based sampling methods remain. In particular, recent research has shown that sampling from a network using a random walk based approach such as Respondent Driven Sampling (RDS) can result in high design effects (DE)—the ratio of the sampling variance to the sampling variance of simple random sampling (SRS). A high design effect means that more cases must be collected to achieve the same level of precision as SRS. In this paper we propose an alternative strategy, Network Sampling with Memory (NSM), which collects network data from respondents in order to reduce design effects and, correspondingly, the number of interviews needed to achieve a given level of statistical power. NSM combines a “List” mode, where all individuals on the revealed network list are sampled with the same cumulative probability, with a “Search” mode, which gives priority to bridge nodes connecting the current sample to unexplored parts of the network. We test the relative efficiency of NSM compared to RDS and SRS on 162 school and university networks from Add Health and Facebook that range in size from 110 to 16,278 nodes. The results show that the average design effect for NSM on these 162 networks is 1.16, which is very close to the efficiency of a simple random sample (DE=1), and 98.5% lower than the average DE we observed for RDS. PMID:24159246

A multi-method approach to the molecular diagnosis of overt and borderline 11p15.5 defects underlying Silver-Russell and Beckwith-Wiedemann syndromes.

PubMed

Russo, Silvia; Calzari, Luciano; Mussa, Alessandro; Mainini, Ester; Cassina, Matteo; Di Candia, Stefania; Clementi, Maurizio; Guzzetti, Sara; Tabano, Silvia; Miozzo, Monica; Sirchia, Silvia; Finelli, Palma; Prontera, Paolo; Maitz, Silvia; Sorge, Giovanni; Calcagno, Annalisa; Maghnie, Mohamad; Divizia, Maria Teresa; Melis, Daniela; Manfredini, Emanuela; Ferrero, Giovanni Battista; Pecile, Vanna; Larizza, Lidia

2016-01-01

Multiple (epi)genetic defects affecting the expression of the imprinted genes within the 11p15.5 chromosomal region underlie Silver-Russell (SRS) and Beckwith-Wiedemann (BWS) syndromes. The molecular diagnosis of these opposite growth disorders requires a multi-approach flowchart to disclose known primary and secondary (epi)genetic alterations; however, up to 20 and 30 % of clinically diagnosed BWS and SRS cases remain without molecular diagnosis. The complex structure of the 11p15 region with variable CpG methylation and low-rate mosaicism may account for missed diagnoses. Here, we demonstrate the relevance of complementary techniques for the assessment of different CpGs and the importance of testing multiple tissues to increase the SRS and BWS detection rate. Molecular testing of 147 and 450 clinically diagnosed SRS and BWS cases provided diagnosis in 34 SRS and 185 BWS patients, with 9 SRS and 21 BWS cases remaining undiagnosed and herein referred to as "borderline." A flowchart including complementary techniques and, when applicable, the analysis of buccal swabs, allowed confirmation of the molecular diagnosis in all borderline cases. Comparison of methylation levels by methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) in borderline and control cases defined an interval of H19/IGF2:IG-DMR loss of methylation that was distinct between "easy to diagnose" and "borderline" cases, which were characterized by values ≤mean -3 standard deviations (SDs) compared to controls. Values ≥mean +1 SD at H19/IGF2: IG-DMR were assigned to borderline hypermethylated BWS cases and those ≤mean -2 SD at KCNQ1OT1: TSS-DMR to hypomethylated BWS cases; these were supported by quantitative pyrosequencing or Southern blot analysis. Six BWS cases suspected to carry mosaic paternal uniparental disomy of chromosome 11 were confirmed by SNP array, which detected mosaicism till 10 %. Regarding the clinical presentation, borderline SRS were representative of the syndromic phenotype, with exception of one patient, whereas BWS cases showed low frequency of the most common features except hemihyperplasia. A conclusive molecular diagnosis was reached in borderline methylation cases, increasing the detection rate by 6 % for SRS and 5 % for BWS cases. The introduction of complementary techniques and additional tissue analyses into routine diagnostic work-up should facilitate the identification of cases undiagnosed because of mosaicism, a distinctive feature of epigenetic disorders.

The Savannah River Site`s Groundwater Monitoring Program, first quarter 1989

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

Not Available

The Environmental Monitoring Section of the Environmental and Health Protection (EHP) Department administers the Savannah River Site`s Groundwater Monitoring Program. During first quarter 1989 (January--March), EHP conducted routine sampling of monitoring wells and drinking water locations. EHP collected the drinking water samples from Savannah River Site (SRS) drinking water systems supplied by wells. EHP established two sets of flagging criteria in 1986 to assist in the management of sample results. The flagging criteria aid personnel in sample scheduling, interpretation of data, and trend identification. The flagging criteria are based on detection limits, background levels in SRS groundwater, and drinking watermore » standards. An explanation of flagging criteria for the first quarter is presented in the Flagging Criteria section of this document. All analytical results from first quarter 1989 are listed in this report, which is distributed to all waste-site custodians.« less

The Savannah River Site`s Groundwater Monitoring Program, third quarter 1989

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

Not Available

The Environmental Monitoring Section of the Environmental and Health Protection (EHP) Department administers the Savannah River Site`s Groundwater Monitoring Program. During third quarter 1989 (July--September), EHP conducted routine sampling of monitoring wells and drinking water locations. EHP collected the drinking water samples from Savannah River Site (SRS) drinking water systems supplied by wells. EHP established two sets of flagging criteria in 1986 to assist in the management of sample results. The flagging criteria do not define contamination levels; instead they aid personnel in sample scheduling, interpretation of data, and trend identification. The flagging criteria are based on detection limits, backgroundmore » levels in SRS groundwater, and drinking water standards. An explanation of flagging criteria for the third quarter is presented in the Flagging Criteria section of this document. All analytical results from third quarter 1989 are listed in this report, which is distributed to all waste-site custodians.« less

The Savannah River Site's Groundwater Monitoring Program, third quarter 1989

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

Not Available

The Environmental Monitoring Section of the Environmental and Health Protection (EHP) Department administers the Savannah River Site's Groundwater Monitoring Program. During third quarter 1989 (July--September), EHP conducted routine sampling of monitoring wells and drinking water locations. EHP collected the drinking water samples from Savannah River Site (SRS) drinking water systems supplied by wells. EHP established two sets of flagging criteria in 1986 to assist in the management of sample results. The flagging criteria do not define contamination levels; instead they aid personnel in sample scheduling, interpretation of data, and trend identification. The flagging criteria are based on detection limits, backgroundmore » levels in SRS groundwater, and drinking water standards. An explanation of flagging criteria for the third quarter is presented in the Flagging Criteria section of this document. All analytical results from third quarter 1989 are listed in this report, which is distributed to all waste-site custodians.« less

The Savannah River Site's Groundwater Monitoring Program, first quarter 1989

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

Not Available

The Environmental Monitoring Section of the Environmental and Health Protection (EHP) Department administers the Savannah River Site's Groundwater Monitoring Program. During first quarter 1989 (January--March), EHP conducted routine sampling of monitoring wells and drinking water locations. EHP collected the drinking water samples from Savannah River Site (SRS) drinking water systems supplied by wells. EHP established two sets of flagging criteria in 1986 to assist in the management of sample results. The flagging criteria aid personnel in sample scheduling, interpretation of data, and trend identification. The flagging criteria are based on detection limits, background levels in SRS groundwater, and drinking watermore » standards. An explanation of flagging criteria for the first quarter is presented in the Flagging Criteria section of this document. All analytical results from first quarter 1989 are listed in this report, which is distributed to all waste-site custodians.« less

Local control of brain metastases after stereotactic radiosurgery: the impact of whole brain radiotherapy and treatment paradigm

PubMed Central

Black, Paul J.; Page, Brandi R.; Lucas, John T.; Qasem, Shadi A.; Watabe, Kounosuke; Ruiz, Jimmy; Laxton, Adrian W.; Tatter, Stephen B.; Debinski, Waldemar; Chan, Michael D.

2016-01-01

Purpose We investigate clinical, pathologic, and treatment paradigm-related factors affecting local control of brain metastases after stereotactic radiosurgery (SRS) with or without whole brain radiotherapy (WBRT). Methods and materials Patients with brain metastases treated with SRS alone, before or after WBRT were considered to determine predictors of local failure (LF), time to failure and survival. Results Among 137 patients, 411 brain metastases were analyzed. 23% of patients received SRS alone, 51% received WBRT prior to SRS, and 26% received SRS followed by WBRT. LF occurred in 125 metastases: 63% after SRS alone, 20% after WBRT then SRS, and 22% after SRS then WBRT. Median time to local failure was significantly less after SRS alone compared to WBRT then SRS (12.1 v. 22.7 months, p=0.003). Tumor volume was significantly associated with LF (HR:5.2, p<0.001, 95% CI:3.4-7.8). Conclusions WBRT+SRS results in reduced LF. Local control was not significantly different after SRS as salvage therapy versus upfront SRS. PMID:29296433

Psychosocial Adjustment to Sex Reassignment Surgery: A Qualitative Examination and Personal Experiences of Six Transsexual Persons in Croatia

PubMed Central

Jokić-Begić, Nataša; Jurin, Tanja

2014-01-01

In Croatia, transgender individuals face numerous social and medical obstacles throughout the process of transition. The aim of this study was to depict the factors contributing to the psychosocial adjustment of six transsexual individuals living in Croatia following sex reassignment surgery (SRS). A combination of quantitative and qualitative self-report methods was used. Due to the specificity of the sample, the data were collected online. Standardized questionnaires were used to assess mental health and quality of life alongside a series of open-ended questions divided into 4 themes: the decision-making process regarding SRS; social and medical support during the SRS process; experience of discrimination and stigmatizing behaviors; psychosocial adjustment after SRS. Despite the unfavorable circumstances in Croatian society, participants demonstrated stable mental, social, and professional functioning, as well as a relative resilience to minority stress. Results also reveal the role of pretransition factors such as high socioeconomic status, good premorbid functioning, and high motivation for SRS in successful psychosocial adjustment. During and after transition, participants reported experiencing good social support and satisfaction with the surgical treatment and outcomes. Any difficulties reported by participants are related to either sexual relationships or internalized transphobia. The results also demonstrate the potentially protective role that a lengthier process of transition plays in countries such as Croatia. PMID:24790589

The effectiveness of combined bracing and exercise in adolescent idiopathic scoliosis based on SRS and SOSORT criteria: a prospective study.

PubMed

Negrini, Stefano; Donzelli, Sabrina; Lusini, Monia; Minnella, Salvatore; Zaina, Fabio

2014-08-06

Recently an RCT confirmed brace efficacy in adolescent idiopathic scoliosis (AIS) patients. Previously, a Cochrane review suggested also producing studies according to the Scoliosis Research Society (SRS) criteria on the effectiveness of bracing for AIS. Even if the SRS criteria propose a prospective design, until now only one out of 6 published studies was prospective. Our purpose was to evaluate the effects of bracing plus exercises following the SRS and the international Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) criteria for AIS conservative treatment. prospective cohort study nested in a clinical database of all outpatients of a clinic specialized in scoliosis conservative treatment. seventy-three patients (60 females), age 12 years 10 months ±17 months, 34.4±4.4 Cobb degrees, who satisfied SRS criteria were included out of 3,883 patients at first evaluation. Cobb angle at the end of treatment according to SRS criteria : (unchanged; worsened 6° or more, over 45° and surgically treated, and rate of improvement of 6° or more).Braces were prescribed for 18-23 hours/day according to curves magnitude and actual international guidelines. Weaning was gradual after Risser 3. All patients performed exercises and were managed according to SOSORT criteria. Results in all patients were analyzed according to intent-to-treat at the end of the treatment. Funding and Conflict of Interest: no. Overall 34 patients (52.3%) improved. Seven patients (9.6%) worsened, of which 1 patient progressed beyond 45° and was fused. Referred compliance was assessed during a mean period of 3 years 4 months ±20 months; the median adherence was 99.1% (range 22.2-109.2%). Employing intent-to-treat analysis, there were failures in 11 patients (15.1%). At start, these patients had statistically significant low BMI and kyphosis, high thoracic rotation and higher Cobb angles. Drop-outs showed reduced compliance and years of treatment; their average scoliosis at discontinuation was low: 22.7° (range 16-35°) at Risser 1.3 ± 1. Bracing in patients with AIS who satisfy SRS criteria is effective. Combining bracing with exercise according to SOSORT criteria shows better results than the current literature.

Bidirectional reflectance distribution function of diffuse extreme ultraviolet scatterers and extreme ultraviolet baffle materials.

PubMed

Newell, M P; Keski-Kuha, R A

1997-08-01

Bidirectional reflectance distribution function (BRDF) measurements of a number of diffuse extreme ultraviolet (EUV) scatterers and EUV baffle materials have been performed with the Goddard EUV scatterometer. BRDF data are presented for white Spectralon SRS-99 at 121.6 nm; the data exhibit a non-Lambertian nature and a total hemispherical reflectance lower than 0.15. Data are also presented for an evaporated Cu black sample, a black Spectralon SRS-02 sample, and a Martin Optical Black sample at wavelengths of 58.4 and 121.6 nm and for angles of incidence of 15 degrees and 45 degrees. Overall Martin Optical Black exhibited the lowest BRDF characteristic, with a total hemispherical reflectance of the order of 0.01 and measured BRDF values as low as 2 x 10(-3) sr(-1).

Combination Therapy with Anti-PD-1, Anti-TIM-3, and Focal Radiation Results in Regression of Murine Gliomas.

PubMed

Kim, Jennifer E; Patel, Mira A; Mangraviti, Antonella; Kim, Eileen S; Theodros, Debebe; Velarde, Esteban; Liu, Ann; Sankey, Eric W; Tam, Ada; Xu, Haiying; Mathios, Dimitrios; Jackson, Christopher M; Harris-Bookman, Sarah; Garzon-Muvdi, Tomas; Sheu, Mary; Martin, Allison M; Tyler, Betty M; Tran, Phuoc T; Ye, Xiaobu; Olivi, Alessandro; Taube, Janis M; Burger, Peter C; Drake, Charles G; Brem, Henry; Pardoll, Drew M; Lim, Michael

2017-01-01

Checkpoint molecules like programmed death-1 (PD-1) and T-cell immunoglobulin mucin-3 (TIM-3) are negative immune regulators that may be upregulated in the setting of glioblastoma multiforme. Combined PD-1 blockade and stereotactic radiosurgery (SRS) have been shown to improve antitumor immunity and produce long-term survivors in a murine glioma model. However, tumor-infiltrating lymphocytes (TIL) can express multiple checkpoints, and expression of ≥2 checkpoints corresponds to a more exhausted T-cell phenotype. We investigate TIM-3 expression in a glioma model and the antitumor efficacy of TIM-3 blockade alone and in combination with anti-PD-1 and SRS. C57BL/6 mice were implanted with murine glioma cell line GL261-luc2 and randomized into 8 treatment arms: (i) control, (ii) SRS, (iii) anti-PD-1 antibody, (iv) anti-TIM-3 antibody, (v) anti-PD-1 + SRS, (vi) anti-TIM-3 + SRS, (vii) anti-PD-1 + anti-TIM-3, and (viii) anti-PD-1 + anti-TIM-3 + SRS. Survival and immune activation were assessed. Dual therapy with anti-TIM-3 antibody + SRS or anti-TIM-3 + anti-PD-1 improved survival compared with anti-TIM-3 antibody alone. Triple therapy resulted in 100% overall survival (P < 0.05), a significant improvement compared with other arms. Long-term survivors demonstrated increased immune cell infiltration and activity and immune memory. Finally, positive staining for TIM-3 was detected in 7 of 8 human GBM samples. This is the first preclinical investigation on the effects of dual PD-1 and TIM-3 blockade with radiation. We also demonstrate the presence of TIM-3 in human glioblastoma multiforme and provide preclinical evidence for a novel treatment combination that can potentially result in long-term glioma survival and constitutes a novel immunotherapeutic strategy for the treatment of glioblastoma multiforme. Clin Cancer Res; 23(1); 124-36. ©2016 AACR. ©2016 American Association for Cancer Research.

ENTERPRISE SRS: LEVERAGING ONGOING OPERATIONS TO ADVANCE RADIOACTIVE WASTE MANAGEMENT TECHNOLOGIES

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

Murray, A.; Wilmarth, W.; Marra, J.

2013-05-16

The Savannah River Site (SRS) is repurposing its vast array of assets to solve future national issues regarding environmental stewardship, national security, and clean energy. The vehicle for this transformation is Enterprise SRS which presents a new, strategic view of SRS as a united endeavor for “all things nuclear” as opposed to a group of distinct and separate entities with individual missions and organizations. Key among the Enterprise SRS strategic initiatives is the integration of research into facilities in conjunction with ongoing missions to provide researchers from other national laboratories, academic institutions, and commercial entities the opportunity to demonstrate theirmore » technologies in a relevant environment and scale prior to deployment. To manage that integration of research demonstrations into site facilities, The DOE Savannah River Operations Office, Savannah River Nuclear Solutions, and the Savannah River National Laboratory (SRNL) have established a center for applied nuclear materials processing and engineering research (hereafter referred to as the Center). The key objective of this initiative is to bridge the gap between promising transformational nuclear materials management advancements and large-scale deployment of the technology by using SRS assets (e.g. facilities, staff, and property) for those critical engineering-scale demonstrations necessary to assure the successful deployment of new technologies. The Center will coordinate the demonstration of R&D technologies and serve as the interface between the engineering-scale demonstration and the R&D programs, essentially providing cradle-to-grave support to the R&D team during the demonstration. While the initial focus of the Center will be on the effective use of SRS assets for these demonstrations, the Center also will work with research teams to identify opportunities to perform R&D demonstrations at other facilities. Unique to this approach is the fact that these SRS assets will continue to accomplish DOE’s critical nuclear material missions (e.g., processing in H-Canyon and plutonium storage in K-Area). These demonstrations can be accomplished in a more cost-effective manner through the use of existing facilities in conjunction with ongoing missions. Essentially, the R&D program would not need to pay the full operational cost of a facility, just the incremental cost of performing the demonstration. Current Center activities have been focused on integrating advanced safeguards monitoring technology demonstrations into the SRS H-Canyon and advanced location technology demonstrations into K-Area Materials Storage. These demonstrations are providing valuable information to researchers and program owners. In addition these demonstrations are providing the Center with an improved protocol for demonstration management that can be exercised across the entire SRS (and to offsite venues) to ensure that future demonstrations are done efficiently and provide an opportunity to use these unique assets for multiple purposes involving national laboratories, academia, and commercial entities. Key among the envisioned future use of SRS assets is the demonstration of new radioactive waste management technologies critical for advancing the mission needs of the DOE-EM program offices in their efforts to cleanup 107 sites across the United States. Of particular interest is the demonstration of separations technologies in H-Canyon. Given the modular design of H-Canyon, those demonstrations would be accomplished using a process frame. The demonstration equipment would be installed on the process frame and that frame would then be positioned into an H-Canyon cell so that the demonstration is performed in a radiological environment involving prototypic nuclear materials.« less

Enterprise SRS: leveraging ongoing operations to advance radioactive waste management technologies

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

Murray, Alice M.; Wilmarth, William; Marra, John E.

2013-07-01

The Savannah River Site (SRS) is re-purposing its vast array of assets to solve future national issues regarding environmental stewardship, national security, and clean energy. The vehicle for this transformation is Enterprise SRS which presents a new, strategic view of SRS as a united endeavor for 'all things nuclear' as opposed to a group of distinct and separate entities with individual missions and organizations. Key among the Enterprise SRS strategic initiatives is the integration of research into facilities in conjunction with ongoing missions to provide researchers from other national laboratories, academic institutions, and commercial entities the opportunity to demonstrate theirmore » technologies in a relevant environment and scale prior to deployment. To manage that integration of research demonstrations into site facilities, The DOE Savannah River Operations Office, Savannah River Nuclear Solutions, and the Savannah River National Laboratory (SRNL) have established a center for applied nuclear materials processing and engineering research (hereafter referred to as the Center). The key objective of this initiative is to bridge the gap between promising transformational nuclear materials management advancements and large-scale deployment of the technology by using SRS assets (e.g. facilities, staff, and property) for those critical engineering-scale demonstrations necessary to assure the successful deployment of new technologies. The Center will coordinate the demonstration of R and D technologies and serve as the interface between the engineering-scale demonstration and the R and D programs, essentially providing cradle-to-grave support to the R and D team during the demonstration. While the initial focus of the Center will be on the effective use of SRS assets for these demonstrations, the Center also will work with research teams to identify opportunities to perform R and D demonstrations at other facilities. Unique to this approach is the fact that these SRS assets will continue to accomplish DOE's critical nuclear material missions (e.g., processing in H-Canyon and plutonium storage in K-Area). These demonstrations can be accomplished in a more cost-effective manner through the use of existing facilities in conjunction with ongoing missions. Essentially, the R and D program would not need to pay the full operational cost of a facility, just the incremental cost of performing the demonstration. Current Center activities have been focused on integrating advanced safeguards monitoring technology demonstrations into the SRS H-Canyon and advanced location technology demonstrations into K-Area Materials Storage. These demonstrations are providing valuable information to researchers and program owners. In addition these demonstrations are providing the Center with an improved protocol for demonstration management that can be exercised across the entire SRS (and to offsite venues) to ensure that future demonstrations are done efficiently and provide an opportunity to use these unique assets for multiple purposes involving national laboratories, academia, and commercial entities. Key among the envisioned future use of SRS assets is the demonstration of new radioactive waste management technologies critical for advancing the mission needs of the DOE-EM program offices in their efforts to cleanup 107 sites across the United States. Of particular interest is the demonstration of separations technologies in H-Canyon. Given the modular design of H-Canyon, those demonstrations would be accomplished using a process frame. The demonstration equipment would be installed on the process frame and that frame would then be positioned into an H-Canyon cell so that the demonstration is performed in a radiological environment involving prototypic nuclear materials. (authors)« less

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

Smith, C.; Brigmon, R.

Legionnaires disease is a pneumonia caused by the inhalation of the bacterium Legionella pneumophila. The majority of illnesses have been associated with cooling towers since these devices can harbor and disseminate the bacterium in the aerosolized mist generated by these systems. Historically, Savannah River Site (SRS) cooling towers have had occurrences of elevated levels of Legionella in all seasons of the year and in patterns that are difficult to predict. Since elevated Legionella in cooling tower water are a potential health concern a question has been raised as to the best control methodology. In this work we analyze available chemical,more » biological, and atmospheric data to determine the best method or key parameter for control. The SRS 4Q Industrial Hygiene Manual, 4Q-1203, 1 - G Cooling Tower Operation and the SRNL Legionella Sampling Program, states that 'Participation in the SRNL Legionella Sampling Program is MANDATORY for all operating cooling towers'. The resulting reports include L. pneumophila concentration information in cells/L. L. pneumophila concentrations >10{sup 7} cells/L are considered elevated and unsafe so action must be taken to reduce these densities. These remedial actions typically include increase biocide addition or 'shocking'. Sometimes additional actions are required if the problem persists including increase tower maintenance (e.g. cleaning). Evaluation of 14 SRS cooling towers, seven water quality parameters, and five Legionella serogroups over a three-plus year time frame demonstrated that cooling tower water Legionella densities varied widely though out this time period. In fact there was no one common consistent significant variable across all towers. The significant factors that did show up most frequently were related to suspended particulates, conductivity, pH, and dissolved oxygen, not chlorine or bromine as might be expected. Analyses of atmospheric data showed that there were more frequent significant elevated Legionella concentrations when the dew point temperature was high--a summertime occurrence. However, analysis of the three years of Legionella monitoring data of the 14 different SRS Cooling Towers demonstrated that elevated concentrations are observed at all temperatures and seasons. The objective of this study is to evaluate the ecology of L. pneumophila including serogroups and population densities, chemical, and atmospheric data, on cooling towers at SRS to determine whether relationships exist among water chemistry, and atmospheric conditions. The goal is to more fully understand the conditions which inhibit or encourage L. pneumophila growth and supply this data and associated recommendations to SRS Cooling Tower personnel for improved management of operation. Hopefully this information could then be used to help control L. pneumophila growth more effectively in SRS cooling tower water.« less

Rapid Bioassessment Methods for Assessing Stream Macroinvertebrate Community on the Savannah River Site

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

Specht, W.L.

Macroinvertebrate sampling was performed at 16 locations in the Savannah River Site (SRS) streams using Hester-Dendy multiplate samplers and EPA Rapid Bioassessment Protocols (RBP). Some of the sampling locations were unimpacted, while other locations had been subject to various forms of perturbation by SRS activities. In general, the data from the Hester-Dendy multiplate samplers were more sensitive at detecting impacts than were the RBP data. We developed a Biotic Index for the Hester-Dendy data which incorporated eight community structure, function, and balance parameters. when tested using a data set that was unrelated to the data set that was used inmore » developing the Biotic Index, the index was very successful at detecting impact.« less

Enterprise SRS: Leveraging Ongoing Operations To Advance Nuclear Fuel Cycles Research And Development Programs

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

Murray, Alice M.; Marra, John E.; Wilmarth, William R.

2013-07-03

The Savannah River Site (SRS) is repurposing its vast array of assets to solve future national issues regarding environmental stewardship, national security, and clean energy. The vehicle for this transformation is Enterprise SRS which presents a new, radical view of SRS as a united endeavor for ''all things nuclear'' as opposed to a group of distinct and separate entities with individual missions and organizations. Key among the Enterprise SRS strategic initiatives is the integration of research into facilities in conjunction with on-going missions to provide researchers from other national laboratories, academic institutions, and commercial entities the opportunity to demonstrate theirmore » technologies in a relevant environment and scale prior to deployment. To manage that integration of research demonstrations into site facilities, The Department of Energy, Savannah River Operations Office, Savannah River Nuclear Solutions, the Savannah River National Laboratory (SRNL) have established a center for applied nuclear materials processing and engineering research (hereafter referred to as the Center). The key proposition of this initiative is to bridge the gap between promising transformational nuclear fuel cycle processing discoveries and large commercial-scale-technology deployment by leveraging SRS assets as facilities for those critical engineering-scale demonstrations necessary to assure the successful deployment of new technologies. The Center will coordinate the demonstration of R&D technologies and serve as the interface between the engineering-scale demonstration and the R&D programs, essentially providing cradle-to-grave support to the research team during the demonstration. While the initial focus of the Center will be on the effective use of SRS assets for these demonstrations, the Center also will work with research teams to identify opportunities to perform research demonstrations at other facilities. Unique to this approach is the fact that these SRS assets will continue to accomplish DOE's critical nuclear material missions (e.g., processing in H-Canyon and plutonium storage in K-Area). Thus, the demonstration can be accomplished by leveraging the incremental cost of performing demonstrations without needing to cover the full operational cost of the facility. Current Center activities have been focused on integrating advanced safeguards monitoring technologies demonstrations into the SRS H-Canyon and advanced location technologies demonstrations into K-Area Materials Storage. These demonstrations are providing valuable information to researchers and customers as well as providing the Center with an improved protocol for demonstration management that can be exercised across the entire SRS (as well as to offsite venues) so that future demonstrations can be done more efficiently and provide an opportunity to utilize these unique assets for multiple purposes involving national laboratories, academia, and commercial entities. Key among the envisioned future demonstrations is the use of H-Canyon to demonstrate new nuclear materials separations technologies critical for advancing the mission needs DOE-Nuclear Energy (DOE-NE) to advance the research for next generation fuel cycle technologies. The concept is to install processing equipment on frames. The frames are then positioned into an H-Canyon cell and testing in a relevant radiological environment involving prototypic radioactive materials can be performed.« less

A descriptive analysis of oral health systematic reviews published 1991-2012: cross sectional study.

PubMed

Saltaji, Humam; Cummings, Greta G; Armijo-Olivo, Susan; Major, Michael P; Amin, Maryam; Major, Paul W; Hartling, Lisa; Flores-Mir, Carlos

2013-01-01

To identify all systematic reviews (SRs) published in the domain of oral health research and describe them in terms of their epidemiological and descriptive characteristics. Cross sectional, descriptive study. An electronic search of seven databases was performed from inception through May 2012; bibliographies of relevant publications were also reviewed. Studies were considered for inclusion if they were oral health SRs defined as therapeutic or non-therapeutic investigations that studied a topic or an intervention related to dental, oral or craniofacial diseases/disorders. Data were extracted from all the SRs based on a number of epidemiological and descriptive characteristics. Data were analysed descriptively for all the SRs, within each of the nine dental specialities, and for Cochrane and non-Cochrane SRs separately. 1,188 oral health (126 Cochrane and 1062 non-Cochrane) SRs published from 1991 through May 2012 were identified, encompassing the nine dental specialties. Over half (n = 676; 56.9%) of the SRs were published in specialty oral health journals, with almost all (n = 1,178; 99.2%) of the SRs published in English and almost none of the non-Cochrane SRs (n = 11; 0.9%) consisting of updates of previously published SRs. 75.3% of the SRs were categorized as therapeutic, with 64.5% examining non-drug interventions, while approximately half (n = 150/294; 51%) of the non-therapeutic SRs were classified as epidemiological SRs. The SRs included a median of 15 studies, with a meta-analysis conducted in 43.6%, in which a median of 9 studies/1 randomized trial were included in the largest meta-analysis conducted. Funding was received for 25.1% of the SRs, including nearly three-quarters (n = 96; 76.2%) of the Cochrane SRs. Epidemiological and descriptive characteristics of the 1,188 oral health SRs varied across the nine dental specialties and by SR category (Cochrane vs. non-Cochrane). There is a clear need for more updates of SRs in all the dental specialties.

Mining association patterns of drug-interactions using post marketing FDA's spontaneous reporting data.

PubMed

Ibrahim, Heba; Saad, Amr; Abdo, Amany; Sharaf Eldin, A

2016-04-01

Pharmacovigilance (PhV) is an important clinical activity with strong implications for population health and clinical research. The main goal of PhV is the timely detection of adverse drug events (ADEs) that are novel in their clinical nature, severity and/or frequency. Drug interactions (DI) pose an important problem in the development of new drugs and post marketing PhV that contribute to 6-30% of all unexpected ADEs. Therefore, the early detection of DI is vital. Spontaneous reporting systems (SRS) have served as the core data collection system for post marketing PhV since the 1960s. The main objective of our study was to particularly identify signals of DI from SRS. In addition, we are presenting an optimized tailored mining algorithm called "hybrid Apriori". The proposed algorithm is based on an optimized and modified association rule mining (ARM) approach. A hybrid Apriori algorithm has been applied to the SRS of the United States Food and Drug Administration's (U.S. FDA) adverse events reporting system (FAERS) in order to extract significant association patterns of drug interaction-adverse event (DIAE). We have assessed the resulting DIAEs qualitatively and quantitatively using two different triage features: a three-element taxonomy and three performance metrics. These features were applied on two random samples of 100 interacting and 100 non-interacting DIAE patterns. Additionally, we have employed logistic regression (LR) statistic method to quantify the magnitude and direction of interactions in order to test for confounding by co-medication in unknown interacting DIAE patterns. Hybrid Apriori extracted 2933 interacting DIAE patterns (including 1256 serious ones) and 530 non-interacting DIAE patterns. Referring to the current knowledge using four different reliable resources of DI, the results showed that the proposed method can extract signals of serious interacting DIAEs. Various association patterns could be identified based on the relationships among the elements which composed a pattern. The average performance of the method showed 85% precision, 80% negative predictive value, 81% sensitivity and 84% specificity. The LR modeling could provide the statistical context to guard against spurious DIAEs. The proposed method could efficiently detect DIAE signals from SRS data as well as, identifying rare adverse drug reactions (ADRs). Copyright © 2016 Elsevier Inc. All rights reserved.

Cost-effectiveness of stereotactic radiosurgery versus whole-brain radiation therapy for up to 10 brain metastases.

PubMed

Lester-Coll, Nataniel H; Dosoretz, Arie P; Magnuson, William J; Laurans, Maxwell S; Chiang, Veronica L; Yu, James B

2016-12-01

OBJECTIVE The JLGK0901 study found that stereotactic radiosurgery (SRS) is a safe and effective treatment option for treating up to 10 brain metastases. The purpose of this study is to determine the cost-effectiveness of treating up to 10 brain metastases with SRS, whole-brain radiation therapy (WBRT), or SRS and immediate WBRT (SRS+WBRT). METHODS A Markov model was developed to evaluate the cost effectiveness of SRS, WBRT, and SRS+WBRT in patients with 1 or 2-10 brain metastases. Transition probabilities were derived from the JLGK0901 study and modified according to the recurrence rates observed in the Radiation Therapy Oncology Group (RTOG) 9508 and European Organization for Research and Treatment of Cancer (EORTC) 22952-26001 studies to simulate the outcomes for patients who receive WBRT. Costs are based on 2015 Medicare reimbursements. Health state utilities were prospectively collected using the Standard Gamble method. End points included cost, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). The willingness-to-pay (WTP) threshold was $100,000 per QALY. One-way and probabilistic sensitivity analyses explored uncertainty with regard to the model assumptions. RESULTS In patients with 1 brain metastasis, the ICERs for SRS versus WBRT, SRS versus SRS+WBRT, and SRS+WBRT versus WBRT were $117,418, $51,348, and $746,997 per QALY gained, respectively. In patients with 2-10 brain metastases, the ICERs were $123,256, $58,903, and $821,042 per QALY gained, respectively. On the sensitivity analyses, the model was sensitive to the cost of SRS and the utilities associated with stable post-SRS and post-WBRT states. In patients with 2-10 brain metastases, SRS versus WBRT becomes cost-effective if the cost of SRS is reduced by $3512. SRS versus WBRT was also cost effective at a WTP of $200,000 per QALY on the probabilistic sensitivity analysis. CONCLUSIONS The most cost-effective strategy for patients with up to 10 brain metastases is SRS alone relative to SRS+WBRT. SRS alone may also be cost-effective relative to WBRT alone, but this depends on WTP, the cost of SRS, and patient preferences.

Postoperative Perfection: Ceiling Effects and Lack of Discrimination With Both SRS-22 and -24 Outcomes Instruments in Patients With Adolescent Idiopathic Scoliosis.

PubMed

Bastrom, Tracey P; Bartley, Carrie; Marks, Michelle C; Yaszay, Burt; Newton, Peter O

2015-12-01

Review of a prospective database registry. To compare the Scoliosis Research Society (SRS)-22 and SRS-24 outcomes instruments in terms of scores, rate of ceiling effects, and discriminant ability in patients with pre- and postoperative adolescent idiopathic scoliosis. Despite improvements noted with the SRS-22, the SRS-24 is still occasionally used prospectively and for comparisons with previous studies reporting SRS-24 scores. Previous work has demonstrated that postoperative scores from the 2 versions are not interchangeable. A multicenter prospective registry of patients who underwent surgical correction of adolescent idiopathic scoliosis was queried for preoperative and 2-year postoperative SRS-22 and SRS-24 scores. Scores were compared between versions and ceiling effects were identified. Groups of deformity severity were created to evaluate discriminant ability. 829 patients were identified. The SRS-22 scores for pain and general function were significantly greater than SRS-24 scores (P < 0.001), whereas the SRS-22 scores were significantly lower than the SRS-24 for self-image (P < 0.001). Preoperative ceiling effect was only noted in 1 domain each. Both versions were able to discriminate between large (80°+) and small (<45°) preoperative curves in all domains and total scores (P < 0.05). Postoperatively, the SRS-22 scores for all shared domains and total score were significantly greater than SRS-24 scores (P < 0.001). Ceiling effects in 5 of 5 domain scores were noted postoperatively for SRS-22 and in 4 of 7 for SRS-24. With a smaller range of deformity postoperatively, only the SRS-22 self-image domain was able to discriminate between large (29°+) and small (≤11°) residual curves (P < 0.05). Scores obtained by the SRS-22 and the SRS-24 are not translatable despite shared domains. Whereas both versions demonstrated preoperative discriminant ability, postoperative discrimination of residual deformity is lacking in both. Patient-reported outcomes of treatment are crucial in advancing treatment, and improvement in the ability to assess subjective outcomes is essential. 3.

Stereotactic radiosurgery (SRS) in the modern management of patients with brain metastases

PubMed Central

Soliman, Hany; Das, Sunit; Larson, David A.; Sahgal, Arjun

2016-01-01

Stereotactic radiosurgery (SRS) is an established non-invasive ablative therapy for brain metastases. Early clinical trials with SRS proved that tumor control rates are superior to whole brain radiotherapy (WBRT) alone. As a result, WBRT plus SRS was widely adopted for patients with a limited number of brain metastases (“limited number” customarily means 1-4). Subsequent trials focused on answering whether WBRT upfront was necessary at all. Based on current randomized controlled trials (RCTs) and meta-analyses comparing SRS alone to SRS plus WBRT, adjuvant WBRT results in better intracranial control; however, at the expense of neurocognitive functioning and quality of life. These adverse effects of WBRT may also negatively impact on survival in younger patients. Based on the results of these studies, treatment has shifted to SRS alone in patients with a limited number of metastases. Additionally, RCTs are evaluating the role of SRS alone in patients with >4 brain metastases. New developments in SRS include fractionated SRS for large tumors and the integration of SRS with targeted systemic therapies that cross the blood brain barrier and/or stimulate an immune response. We present in this review the current high level evidence and rationale supporting SRS as the standard of care for patients with limited brain metastases, and emerging applications of SRS. PMID:26848525

Wrapping SRS with CORBA: from textual data to distributed objects.

PubMed

Coupaye, T

1999-04-01

Biological data come in very different shapes. Databanks are maintained and used by distinct organizations. Text is the de facto Standard exchange format. The SRS system can integrate heterogeneous textual databanks but it was lacking a way to structure the extracted data. This paper presents a CORBA interface to the SRS system which manages databanks in a flat file format. SRS Object Servers are CORBA wrappers for SRS. They allow client applications (visualisation tools, data mining tools, etc.) to access and query SRS servers remotely through an Object Request Broker (ORB). They provide loader objects that contain the information extracted from the databanks by SRS. Loader objects are not hard-coded but generated in a flexible way by using loader specifications which allow SRS administrators to package data coming from distinct databanks. The prototype may be available for beta-testing. Please contact the SRS group (http://srs.ebi.ac.uk).

Growth in coculture stimulates metabolism of the phenylurea herbicide isoproturon by Sphingomonas sp. strain SRS2.

PubMed

Sørensen, Sebastian R; Ronen, Zeev; Aamand, Jens

2002-07-01

Metabolism of the phenylurea herbicide isoproturon by Sphingomonas sp. strain SRS2 was significantly enhanced when the strain was grown in coculture with a soil bacterium (designated strain SRS1). Both members of this consortium were isolated from a highly enriched isoproturon-degrading culture derived from an agricultural soil previously treated regularly with the herbicide. Based on analysis of the 16S rRNA gene, strain SRS1 was assigned to the beta-subdivision of the proteobacteria and probably represents a new genus. Strain SRS1 was unable to degrade either isoproturon or its known metabolites 3-(4-isopropylphenyl)-1-methylurea, 3-(4-isopropylphenyl)-urea, or 4-isopropyl-aniline. Pure culture studies indicate that Sphingomonas sp. SRS2 is auxotrophic and requires components supplied by association with other soil bacteria. A specific mixture of amino acids appeared to meet these requirements, and it was shown that methionine was essential for Sphingomonas sp. SRS2. This suggests that strain SRS1 supplies amino acids to Sphingomonas sp. SRS2, thereby leading to rapid metabolism of (14)C-labeled isoproturon to (14)CO(2) and corresponding growth of strain SRS2. Proliferation of strain SRS1 suggests that isoproturon metabolism by Sphingomonas sp. SRS2 provides unknown metabolites or cell debris that supports growth of strain SRS1. The role of strain SRS1 in the consortium was not ubiquitous among soil bacteria; however, the indigenous soil microflora and some strains from culture collections also stimulate isoproturon metabolism by Sphingomonas sp. strain SRS2 to a similar extent.

Growth in Coculture Stimulates Metabolism of the Phenylurea Herbicide Isoproturon by Sphingomonas sp. Strain SRS2

PubMed Central

Sørensen, Sebastian R.; Ronen, Zeev; Aamand, Jens

2002-01-01

Metabolism of the phenylurea herbicide isoproturon by Sphingomonas sp. strain SRS2 was significantly enhanced when the strain was grown in coculture with a soil bacterium (designated strain SRS1). Both members of this consortium were isolated from a highly enriched isoproturon-degrading culture derived from an agricultural soil previously treated regularly with the herbicide. Based on analysis of the 16S rRNA gene, strain SRS1 was assigned to the β-subdivision of the proteobacteria and probably represents a new genus. Strain SRS1 was unable to degrade either isoproturon or its known metabolites 3-(4-isopropylphenyl)-1-methylurea, 3-(4-isopropylphenyl)-urea, or 4-isopropyl-aniline. Pure culture studies indicate that Sphingomonas sp. SRS2 is auxotrophic and requires components supplied by association with other soil bacteria. A specific mixture of amino acids appeared to meet these requirements, and it was shown that methionine was essential for Sphingomonas sp. SRS2. This suggests that strain SRS1 supplies amino acids to Sphingomonas sp. SRS2, thereby leading to rapid metabolism of 14C-labeled isoproturon to 14CO2 and corresponding growth of strain SRS2. Proliferation of strain SRS1 suggests that isoproturon metabolism by Sphingomonas sp. SRS2 provides unknown metabolites or cell debris that supports growth of strain SRS1. The role of strain SRS1 in the consortium was not ubiquitous among soil bacteria; however, the indigenous soil microflora and some strains from culture collections also stimulate isoproturon metabolism by Sphingomonas sp. strain SRS2 to a similar extent. PMID:12089031

Cost-effectiveness of stereotactic radiosurgery with and without whole-brain radiotherapy for the treatment of newly diagnosed brain metastases.

PubMed

Hall, Matthew D; McGee, James L; McGee, Mackenzie C; Hall, Kevin A; Neils, David M; Klopfenstein, Jeffrey D; Elwood, Patrick W

2014-12-01

Stereotactic radiosurgery (SRS) alone is increasingly used in patients with newly diagnosed brain metastases. Stereotactic radiosurgery used together with whole-brain radiotherapy (WBRT) reduces intracranial failure rates, but this combination also causes greater neurocognitive toxicity and does not improve survival. Critics of SRS alone contend that deferring WBRT results in an increased need for salvage therapy and in higher costs. The authors compared the cost-effectiveness of treatment with SRS alone, SRS and WBRT (SRS+WBRT), and surgery followed by SRS (S+SRS) at the authors' institution. The authors retrospectively reviewed the medical records of 289 patients in whom brain metastases were newly diagnosed and who were treated between May 2001 and December 2007. Overall survival curves were plotted using the Kaplan-Meier method. Multivariate proportional hazards analysis (MVA) was used to identify factors associated with overall survival. Survival data were complete for 96.2% of patients, and comprehensive data on the resource use for imaging, hospitalizations, and salvage therapies were available from the medical records. Treatment costs included the cost of initial and all salvage therapies for brain metastases, hospitalizations, management of complications, and imaging. They were computed on the basis of the 2007 Medicare fee schedule from a payer perspective. Average treatment cost and average cost per month of median survival were compared. Sensitivity analysis was performed to examine the impact of variations in key cost variables. No significant differences in overall survival were observed among patients treated with SRS alone, SRS+WBRT, or S+SRS with respective median survival of 9.8, 7.4, and 10.6 months. The MVA detected a significant association of overall survival with female sex, Karnofsky Performance Scale (KPS) score, primary tumor control, absence of extracranial metastases, and number of brain metastases. Salvage therapy was required in 43% of SRS-alone and 26% of SRS+WBRT patients (p < 0.009). Despite an increased need for salvage therapy, the average cost per month of median survival was $2412 per month for SRS alone, $3220 per month for SRS+WBRT, and $4360 per month for S+SRS (p < 0.03). Compared with SRS+WBRT, SRS alone had an average incremental cost savings of $110 per patient. Sensitivity analysis confirmed that the average treatment cost of SRS alone remained less than or was comparable to SRS+WBRT over a wide range of costs and treatment efficacies. Despite an increased need for salvage therapy, patients with newly diagnosed brain metastases treated with SRS alone have similar overall survival and receive more cost-effective care than those treated with SRS+WBRT. Compared with SRS+WBRT, initial management with SRS alone does not result in a higher average cost.

SRS-sensor 13C/12C isotops measurements for detecting Helicobacter Pylori

NASA Astrophysics Data System (ADS)

Grishkanich, Aleksandr; Chubchenko, Yan; Elizarov, Valentin; Zhevlakov, Aleksandr; Konopelko, Leonid

2018-02-01

We developed SRS-sensor 13C/12C isotops measurements detecting Helicobacter Pylori for medical diagnostics of human health. Measuring of absolute 13C/12C isotope amount ratios allows to explore the topical problems of the modern world, alcoholic beverages and tobacco, medical diagnostics of human health. SRS method is used to measure the ratio of carbon isotopes in the exhaled carbon dioxide, which is used to diagnose the human infection of Helicobacter pylori and the influence of the Helicobacter pylori bacterium on the occurrence of gastritis, gastric and duodenal ulcers. A method for the analysis of human infection with Helicobacter pylori was developed on the basis of measurements of the ratio of 13C / 12C carbon isotopes in human exhaled air with a high level of measurement accuracy. The article reviews the work in the field of provision comparability of absolute 13C/12C isotope amount ratios in the environment and food. The analysis of the technical and metrological characteristics of traditional and perspective instruments for measuring isotope ratios is presented. The provision of comparability of absolute 13C/12C isotope amount ratios is carried by gravimetrically prepared reference standards. The key features and emerging issues are discussed.

SRS stainless steel beneficial reuse program

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

Boettinger, W.L.

1997-02-01

The US Department of Energy`s (DOE) Savannah River Site (SRS) has thousands of tons of stainless steel radioactive scrap metal (RSNI). Much of the metal is volumetrically contaminated. There is no {open_quotes}de minimis{close_quotes} free release level for volumetric material, and therefore no way to recycle the metal into the normal commercial market. If declared waste, the metal would qualify as low level radioactive waste (LLW) and ultimately be dispositioned through shallow land buried at a cost of millions of dollars. The metal however could be recycled in a {open_quotes}controlled release{close_quote} manner, in the form of containers to hold other typesmore » of radioactive waste. This form of recycle is generally referred to as {open_quotes}Beneficial Reuse{close_quotes}. Beneficial reuse reduces the amount of disposal space needed and reduces the need for virgin containers which would themselves become contaminated. Stainless steel is particularly suited for long term storage because of its resistance to corrosion. To assess the practicality of stainless steel RSM recycle the SRS Benficial Reuse Program began a demonstration in 1994, funded by the DOE Office of Science and Technology. This paper discusses the experiences gained in this program.« less

Improving the measurement of health-related quality of life in adolescent with idiopathic scoliosis: the SRS-7, a Rasch-developed short form of the SRS-22 questionnaire.

PubMed

Caronni, Antonio; Zaina, Fabio; Negrini, Stefano

2014-04-01

Scoliosis Research Society-22 (SRS-22) questionnaire was developed to evaluate health-related quality of life (HRQL) in adolescent idiopathic scoliosis (AIS) patients. Rasch analysis (RA) is a statistical procedure which turns questionnaire ordinal scores into interval measures. Measures from Rasch-compatible questionnaires can be used, similar to body temperature or blood pressure, to quantify disease severity progression and treatment efficacy. Purpose of the current work is to present Rasch analysis (RA) of the SRS-22 questionnaire and to develop an SRS-22 Rasch-approved short form. 300 SRS-22 were randomly collected from 2447 consecutive IS adolescents at their first evaluation (229 females; 13.9 ± 1.9 years; 26.9 ± 14.7 Cobb°) in a scoliosis outpatient clinic. RA showed both disordered thresholds and overall misfit of the SRS-22. Sixteen items were re-scored and two misfitting items (6 and 14) removed to obtain a Rasch-compatible questionnaire. Participants HRQL measured too high with the rearranged questionnaire, indicating a severe SRS-22 ceiling effect. RA also highlighted SRS-22 multidimensionality, with pain/function not merging with self-image/mental health items. Item 3 showed differential item functioning (DIF) for both curve and hump amplitude. A 7-item questionnaire (SRS-7) was prepared by selecting single items from the original SRS-22. SRS-7 showed fit to the model, unidimensionality and no DIF. Compared with the SRS-22, the short form scale shows better targeting of the participants' population. RA shows that SRS-22 has poor clinimetric properties; moreover, when used with AIS at first evaluation, SRS-22 is affected by a severe ceiling effect. SRS-7, an SRS-22 7-item short form questionnaire, provides an HRQL interval measure better tailored to these participants. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evaluation of the polyurethane foam (PUF) disk passive air sampler: Computational modeling and experimental measurements

NASA Astrophysics Data System (ADS)

May, Andrew A.; Ashman, Paul; Huang, Jiaoyan; Dhaniyala, Suresh; Holsen, Thomas M.

2011-08-01

Computational fluid dynamics (CFD) simulations coupled with wind tunnel-experiments were used to determine the sampling rate (SR) of the widely used polyurethane foam (PUF) disk passive sampler. In the wind-tunnel experiments, water evaporation rates from a water saturated PUF disk installed in the sampler housing were determined by measuring weight loss over time. In addition, a modified passive sampler designed to collect elemental mercury (Hg 0) with gold-coated filters was used. Experiments were carried out at different wind speeds and various sampler angles. The SRs obtained from wind-tunnel experiments were compared to those obtained from the field by scaling the values by the ratios of air diffusivities. Three-dimensional (3D) CFD simulations were also used to generate SRs for both polychlorinated biphenyls (PCBs) and Hg 0. Overall, the modeled and measured SRs agree well and are consistent with the values obtained from field studies. As previously observed, the SRs increased linearly with increasing wind speed. In addition, it was determined that the SR was strongly dependent on the angle of the ambient wind. The SRs increased when the base was tilted up pointing into the wind and when the base was tilted down (i.e., such that the top of the sampler was facing the wind) the SR decreased initially and then increased. The results suggest that there may be significant uncertainty in concentrations obtained from passive sampler measurements without knowledge of wind speed and wind angle relative to the sampler.

Results of Macroinvertebrate Sampling Conducted at 33 SRS Stream Locations, July--August 1993

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

Specht, W.L.

1994-12-01

In order to assess the health of the macroinvertebrate communities of SRS streams, the macroinvertebrate communities at 30 stream locations on SRS were sampled during the summer of 1993, using Hester-Dendy multiplate samplers. In addition, three off-site locations in the Upper Three Runs drainage were sampled in order to assess the potential for impact from off-site activities. In interpreting the data, it is important to recognize that these data were from a single set of collections. Macroinvertebrate communities often undergo considerable temporal variation, and are also greatly influenced by such factors as water depth, water velocity, and available habitat. Thesemore » stations were selected with the intent of developing an on-going sampling program at a smaller number of stations, with the selection of the stations to be based largely upon the results of this preliminary sampling program. When stations within a given stream showed similar results, fewer stations would be sampled in the future. Similarly, if a stream appeared to be perturbed, additional stations or chemical analyses might be added so that the source of the perturbation could be identified. In general, unperturbed streams will contain more taxa than perturbed streams, and the distribution of taxa among orders or families will differ. Some groups of macroinvertebrates, such as Ephemeroptera (mayflies), Plecoptera (stoneflies) and Trichoptera (caddisflies), which are collectively called EPT taxa, are considered to be relatively sensitive to most kinds of stream perturbation; therefore a reduced number of EPT taxa generally indicates that the stream has been subject to chemical or physical stressors. In coastal plain streams, EPT taxa are generally less dominant than in streams with rocky substrates, while Chironomidae (midges) are more abundant. (Abstract Truncated)« less

Vegetation survey of Pen Branch and Four Mile Creek wetlands

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

Not Available

One hundred-fifty plots were recently sampled (vegetational sampling study) at the Savannah River Site (SRS). An extensive characterization of the vascular flora, in four predetermined strata (overstory, Understory, shrub layer, and ground cover), was undertaken to determine dominance, co-dominance, and the importance value (I.V.) of each species. These results will be used by the Savannah River Laboratory (SRL) to evaluate the environmental status of Four Mile Creek, Pen Branch, and two upland pine stands. Objectives of this study were to: Describe in detail the plant communities previously mapped with reference to the topography and drainage, including species of plants present:more » Examine the successional trends within each sampling area and describe the extent to which current vegetation communities have resulted from specific earlier vegetation disturbances (e.g., logging and grazing); describe in detail the botanical field techniques used to sample the flora; describe the habitat and location of protected and/or rare species of plants; and collect and prepare plant species as herbarium quality specimens. Sampling was conducted at Four Mile Creek and Pen Branch, and in two upland pine plantations of different age growth.« less

Vegetation survey of Pen Branch and Four Mile Creek wetlands

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

Not Available

1992-01-01

One hundred-fifty plots were recently sampled (vegetational sampling study) at the Savannah River Site (SRS). An extensive characterization of the vascular flora, in four predetermined strata (overstory, Understory, shrub layer, and ground cover), was undertaken to determine dominance, co-dominance, and the importance value (I.V.) of each species. These results will be used by the Savannah River Laboratory (SRL) to evaluate the environmental status of Four Mile Creek, Pen Branch, and two upland pine stands. Objectives of this study were to: Describe in detail the plant communities previously mapped with reference to the topography and drainage, including species of plants present:more » Examine the successional trends within each sampling area and describe the extent to which current vegetation communities have resulted from specific earlier vegetation disturbances (e.g., logging and grazing); describe in detail the botanical field techniques used to sample the flora; describe the habitat and location of protected and/or rare species of plants; and collect and prepare plant species as herbarium quality specimens. Sampling was conducted at Four Mile Creek and Pen Branch, and in two upland pine plantations of different age growth.« less

A Descriptive Analysis of Oral Health Systematic Reviews Published 1991–2012: Cross Sectional Study

PubMed Central

Saltaji, Humam; Cummings, Greta G.; Armijo-Olivo, Susan; Major, Michael P.; Amin, Maryam; Major, Paul W.; Hartling, Lisa; Flores-Mir, Carlos

2013-01-01

Objectives To identify all systematic reviews (SRs) published in the domain of oral health research and describe them in terms of their epidemiological and descriptive characteristics. Design Cross sectional, descriptive study. Methods An electronic search of seven databases was performed from inception through May 2012; bibliographies of relevant publications were also reviewed. Studies were considered for inclusion if they were oral health SRs defined as therapeutic or non-therapeutic investigations that studied a topic or an intervention related to dental, oral or craniofacial diseases/disorders. Data were extracted from all the SRs based on a number of epidemiological and descriptive characteristics. Data were analysed descriptively for all the SRs, within each of the nine dental specialities, and for Cochrane and non-Cochrane SRs separately. Results 1,188 oral health (126 Cochrane and 1062 non-Cochrane) SRs published from 1991 through May 2012 were identified, encompassing the nine dental specialties. Over half (n = 676; 56.9%) of the SRs were published in specialty oral health journals, with almost all (n = 1,178; 99.2%) of the SRs published in English and almost none of the non-Cochrane SRs (n = 11; 0.9%) consisting of updates of previously published SRs. 75.3% of the SRs were categorized as therapeutic, with 64.5% examining non-drug interventions, while approximately half (n = 150/294; 51%) of the non-therapeutic SRs were classified as epidemiological SRs. The SRs included a median of 15 studies, with a meta-analysis conducted in 43.6%, in which a median of 9 studies/1 randomized trial were included in the largest meta-analysis conducted. Funding was received for 25.1% of the SRs, including nearly three-quarters (n = 96; 76.2%) of the Cochrane SRs. Conclusion Epidemiological and descriptive characteristics of the 1,188 oral health SRs varied across the nine dental specialties and by SR category (Cochrane vs. non-Cochrane). There is a clear need for more updates of SRs in all the dental specialties. PMID:24098657

The role of imaging specialists as authors of systematic reviews on diagnostic and interventional imaging and its impact on scientific quality: report from the EuroAIM Evidence-based Radiology Working Group.

PubMed

Sardanelli, Francesco; Bashir, Humayun; Berzaczy, Dominik; Cannella, Guglielmo; Espeland, Ansgar; Flor, Nicola; Helbich, Thomas; Hunink, Myriam; Malone, Dermot E; Mann, Ritse; Muzzupappa, Claudia; Petersen, Lars J; Riklund, Katrine; Sconfienza, Luca M; Serafin, Zbigniew; Spronk, Sandra; Stoker, Jaap; van Beek, Edwin J R; Vorwerk, Dierk; Di Leo, Giovanni

2014-08-01

To evaluate the inclusion of radiologists or nuclear medicine physicians (imaging specialists) as authors of systematic reviews (SRs) on imaging and imaging-guided diagnostic procedures and to determine the impact of imaging specialists' presence as authors on the overall quality of the reviews. A MEDLINE and EMBASE search was performed for SRs of diagnostic and interventional image-guided procedures that were published from January 2001 to December 2010. SRs about procedures primarily performed by nonimaging specialists were excluded. The inclusion of imaging specialists among the SR authors and the frequency of publication in imaging journals were evaluated. The quality of a subset of 200 SRs (100 most recent SRs with imaging specialists as authors and 100 most recent SRs without imaging specialists as authors) was rated by using a 12-item modified assessment of multiple SRs (AMSTAR) evaluation tool. Spearman, χ(2), and Mann-Whitney statistics were used. From among 3258 retrieved citations, 867 SRs were included in the study. Neuroimaging had the largest number of SRs (28% [241 of 867]), 41% (354 of 867) of SRs concerned diagnostic performance, and 26% (228 of 867) of SRs were published in imaging journals. Imaging specialists were authors (in any position) in 330 (38%) of 867 SRs; they were first authors of 176 SRs and last authors of 161 SRs. SRs with imaging specialists as authors were more often published in imaging journals than in nonimaging journals (54% [179 of 330] vs 9% [49 of 537]; P < .001). The median number of modified AMSTAR quality indicators was nine in SRs with imaging specialists as authors, while that in SRs without imaging specialists as authors was seven (P = .003). Only 38% (330 of 867) of SRs on radiology or nuclear medicine-related imaging published from January 2001 to December 2010 included imaging specialists as authors. However, the inclusion of imaging specialists as authors was associated with a significant increase in the scientific quality (as judged by using a modified AMSTAR scale) of the SR.

Multi-species attributes as the condition for adaptive sampling of rare species using two-stage sequential sampling with an auxiliary variable

USGS Publications Warehouse

Panahbehagh, B.; Smith, D.R.; Salehi, M.M.; Hornbach, D.J.; Brown, D.J.; Chan, F.; Marinova, D.; Anderssen, R.S.

2011-01-01

Assessing populations of rare species is challenging because of the large effort required to locate patches of occupied habitat and achieve precise estimates of density and abundance. The presence of a rare species has been shown to be correlated with presence or abundance of more common species. Thus, ecological community richness or abundance can be used to inform sampling of rare species. Adaptive sampling designs have been developed specifically for rare and clustered populations and have been applied to a wide range of rare species. However, adaptive sampling can be logistically challenging, in part, because variation in final sample size introduces uncertainty in survey planning. Two-stage sequential sampling (TSS), a recently developed design, allows for adaptive sampling, but avoids edge units and has an upper bound on final sample size. In this paper we present an extension of two-stage sequential sampling that incorporates an auxiliary variable (TSSAV), such as community attributes, as the condition for adaptive sampling. We develop a set of simulations to approximate sampling of endangered freshwater mussels to evaluate the performance of the TSSAV design. The performance measures that we are interested in are efficiency and probability of sampling a unit occupied by the rare species. Efficiency measures the precision of population estimate from the TSSAV design relative to a standard design, such as simple random sampling (SRS). The simulations indicate that the density and distribution of the auxiliary population is the most important determinant of the performance of the TSSAV design. Of the design factors, such as sample size, the fraction of the primary units sampled was most important. For the best scenarios, the odds of sampling the rare species was approximately 1.5 times higher for TSSAV compared to SRS and efficiency was as high as 2 (i.e., variance from TSSAV was half that of SRS). We have found that design performance, especially for adaptive designs, is often case-specific. Efficiency of adaptive designs is especially sensitive to spatial distribution. We recommend that simulations tailored to the application of interest are highly useful for evaluating designs in preparation for sampling rare and clustered populations.

Nutrient Digestibility, Ruminal Fermentation Activities, Serum Parameters and Milk Production and Composition of Lactating Goats Fed Diets Containing Rice Straw Treated with Pleurotus ostreatus.

PubMed

Kholif, A E; Khattab, H M; El-Shewy, A A; Salem, A Z M; Kholif, A M; El-Sayed, M M; Gado, H M; Mariezcurrena, M D

2014-03-01

The study evaluated replacement of Egyptian berseem clover (BC, Trifolium alexandrinum) with spent rice straw (SRS) of Pleurotus ostreatus basidiomycete in diets of lactating Baladi goats. Nine lactating homo-parity Baladi goats (average BW 23.8±0.4 kg) at 7 d postpartum were used in a triplicate 3×3 Latin square design with 30 d experimental periods. Goats were fed a basal diet containing 0 (Control), 0.25 (SRS25) and 0.45 (SRS45) (w/w, DM basis) of SRS. The Control diet was berseem clover and concentrate mixture (1:1 DM basis). The SRS45 had lowered total feed intake and forages intake compared to Control. The SRS25 and SRS45 rations had the highest digestibilities of DM (p = 0.0241) and hemicellulose (p = 0.0021) compared to Control which had higher (p<0.01) digestibilities of OM (p = 0.0002) and CP (p = 0.0005) than SRS25 and SRS45. Ruminal pH and microbial protein synthesis were higher (p<0.0001) for SRS25 and SRS45 than Control, which also had the highest (p<0.0001) concentration of TVFA, total proteins, non-protein N, and ammonia-N. All values of serum constituents were within normal ranges. The Control ration had higher serum globulin (p = 0.0148), creatinine (p = 0.0150), glucose (p = 0.0002) and cholesterol (p = 0.0016). Both Control and SRS25 groups had the highest (p<0.05) milk (p = 0.0330) and energy corrected milk (p = 0.0290) yields. Fat content was higher (p = 0.0373) with SRS45 and SRS25 groups compared with Control. Replacement of BC with SRS in goat rations increased milk levels of conjugated linoleic acid and unsaturated fatty acids compared with Control. It was concluded that replacing 50% of Egyptian berseem clover with SRS in goat rations improved their productive performance without marked effects on metabolic indicators health.

Comparison of the Current Center of Site Annual Neshap Dose Modeling at the Savannah River Site with Other Assessment Methods.

PubMed

Minter, Kelsey M; Jannik, G Timothy; Stagich, Brooke H; Dixon, Kenneth L; Newton, Joseph R

2018-04-01

The U.S. Environmental Protection Agency (EPA) requires the use of the model CAP88 to estimate the total effective dose (TED) to an offsite maximally exposed individual (MEI) for demonstrating compliance with 40 CFR 61, Subpart H: The National Emission Standards for Hazardous Air Pollutants (NESHAP) regulations. For NESHAP compliance at the Savannah River Site (SRS), the EPA, the U.S. Department of Energy (DOE), South Carolina's Department of Health and Environmental Control, and SRS approved a dose assessment method in 1991 that models all radiological emissions as if originating from a generalized center of site (COS) location at two allowable stack heights (0 m and 61 m). However, due to changes in SRS missions, radiological emissions are no longer evenly distributed about the COS. An area-specific simulation of the 2015 SRS radiological airborne emissions was conducted to compare to the current COS method. The results produced a slightly higher dose estimate (2.97 × 10 mSv vs. 2.22 × 10 mSv), marginally changed the overall MEI location, and noted that H-Area tritium emissions dominated the dose. Thus, an H-Area dose model was executed as a potential simplification of the area-specific simulation by adopting the COS methodology and modeling all site emissions from a single location in H-Area using six stack heights that reference stacks specific to the tritium production facilities within H-Area. This "H-Area Tritium Stacks" method produced a small increase in TED estimates (3.03 × 10 mSv vs. 2.97 × 10 mSv) when compared to the area-specific simulation. This suggests that the current COS method is still appropriate for demonstrating compliance with NESHAP regulations but that changing to the H-Area Tritium Stacks assessment method may now be a more appropriate representation of operations at SRS.

USING A RISK-BASED METHODOLOGY FOR THE TRANSFER OF RADIOACTIVE MATERIAL WITHIN THE SAVANNAH RIVER SITE BOUNDARY

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

Loftin, B; Watkins, R; Loibl, M

2010-06-03

Shipment of radioactive materials (RAM) is discussed in the Code of Federal Regulations in parts of both 49 CFR and 10 CFR. The regulations provide the requirements and rules necessary for the safe shipment of RAM across public highways, railways, waterways, and through the air. These shipments are sometimes referred to as in-commerce shipments. Shipments of RAM entirely within the boundaries of Department of Energy sites, such as the Savannah River Site (SRS), can be made using methodology allowing provisions to maintain equivalent safety while deviating from the regulations for in-commerce shipments. These onsite shipments are known as transfers atmore » the SRS. These transfers must follow the requirements approved in a site-specific Transportation Safety Document (TSD). The TSD defines how the site will transfer materials so that they have equivalence to the regulations. These equivalences are documented in an Onsite Safety Assessment (OSA). The OSA can show how a particular packaging used onsite is equivalent to that which would be used for an in-commerce shipment. This is known as a deterministic approach. However, when a deterministic approach is not viable, the TSD allows for a risk-based OSA to be written. These risk-based assessments show that if a packaging does not provide the necessary safety to ensure that materials are not released (during normal or accident conditions) then the worst-case release of materials does not result in a dose consequence worse than that defined for the SRS. This paper will discuss recent challenges and successes using this methodology at the SRS.« less

Compaction behavior and deformation mechanism of directly compressible textured mannitol in a rotary tablet press simulator.

PubMed

Tarlier, Nicolas; Soulairol, Ian; Bataille, Bernard; Baylac, Gilles; Ravel, Patrice; Nofrerias, Isaac; Lefèvre, Philippe; Sharkawi, Tahmer

2015-11-10

Textured mannitol powder is widely used as a pharmaceutical excipient for tablet compaction. In order to choose the right tableting parameters, it is necessary to understand its mechanical behavior during deformation under industrial tableting conditions. The aim of this study was to evaluate the mechanical behavior during deformation of a textured mannitol using a rotary tablet press simulator. Mean yield pressure (Py) obtained by Heckel modeling, Walker coefficients (W) and Stress Rate Sensitivity (SRS) were compared to reference excipients, known for either their plastic (microcrystalline cellulose) or fragmentary (lactose and dibasic calcium phosphate) deformation behavior. Py, W and SRS values showed that the studied textured mannitol has a fragmentary deformation mechanism. Furthermore, this mechanical behavior was not sensitive to lubrication, which is characteristic of fragmentary excipients. Copyright © 2015 Elsevier B.V. All rights reserved.

The Development of a Manhole Access Pipe-Crawler System

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

Collins, M.

2000-09-19

The Savannah River Site's (SRS) Environmental Restoration Division (ERD) is in the process of reconditioning and decommissioning potentially contaminated facilities. Many of these facilities require inspection prior to remediation tasks. Remote inspections are necessary to reduce hazards and ensure the health and safety of workers and the public. To aid in ERD's efforts, the Remote and Specialty Equipment Systems (RSES) section developed a remote inspection vehicle referred to as the Manhole Access Pipecrawler System (MAPS). The MAPS is comprised of a battery-powered mobile vehicle, a portable control console, a cable reel enclosing 300 feet of tethered cable, and a deployment/retrievalmore » system. The components used in MAPS are predominantly standard off-the-shelf items to reduce fabrication costs. Parts were chosen based on size and durability to satisfy SRS operating conditions.« less

Converting Scoliosis Research Society-24 to Scoliosis Research Society-22r in a Surgical-Range, Medical/Interventional Adolescent Idiopathic Scoliosis Patient Cohort.

PubMed

Chen, Antonia F; Bi, Wenzhu; Singhabahu, Dilrukshika; Londino, Joanne; Hohl, Justin; Ward, Maeve; Ward, W Timothy

2013-03-01

Prospective questionnaire administration study. To assess the ability to translate total and domain scores from Scoliosis Research Society (SRS)-24 to SRS-22r in a surgical-range, medical/interventional adolescent idiopathic scoliosis (AIS) patient population. Conversion of SRS-24 to SRS-22r is demonstrated in an operative cohort of patients with AIS, but not in a medical/interventional patient population. We simultaneously administered SRS-24 and SRS-22r questionnaires to 75 surgical-range, medical/interventional AIS patients and compared them. We performed analysis by regression modeling to produce conversion equations from SRS-24 to SRS-22r. The total SRS-24 score for these medical/interventional AIS patients was 92.5 ± 9.45 (mean, 3.9 ± 0.39), and the total SRS-22r score was 93.5 ± 9.63 (mean, 4.3 ± 0.44). The correlation between these 2 groups was fair (R 2 = 0.77) and improved to good when mental health or recall questions were removed. The correlation was also fair for total pain domains (R 2 = 0.73). However, there was poor correlation for general self-image (R 2 = 0.6) and unacceptable for post-treatment self-image (R 2 = 0.01), general function (R 2 = 0.52), activity function (R 2 = 0.56), and satisfaction (R 2 = 0.53). Compared with a published population of operative AIS patients, R 2 values for total SRS-24 scores, pain, general self-image, activity function, and satisfaction were similar (p > .05). The R 2 values for general function and combined general and activity function were significantly different between the operative and medical/interventional cohorts. Scoliosis Research Society-24 can be converted to SRS-22r scores with fair accuracy in the surgical-range, medical/interventional AIS patient population for total score, and total pain domains. The SRS-24 translates unacceptably to the SRS-22r in self-image, function, and satisfaction domains. The SRS-24 to SRS-22r conversion equations are similar to operative AIS patients, except for the function domain. Caution should be used when interpreting results based on translation of SRS-24 to SRS-22r values. Copyright © 2013 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series

PubMed Central

Rimland, Joseph M; Trotta, Fabiana Mirella; Dell'Aquila, Giuseppina; Cruz-Jentoft, Alfonso; Petrovic, Mirko; Gudmundsson, Adalsteinn; Soiza, Roy; O'Mahony, Denis; Guaita, Antonio; Cherubini, Antonio

2017-01-01

Objective To provide an overview of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD). Design Systematic overview of reviews. Data sources PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL and PsycINFO (2009–March 2015). Eligibility criteria Systematic reviews (SRs) that included at least one comparative study evaluating any non-pharmacological intervention, to treat BPSD. Data extraction Eligible studies were selected and data extracted independently by 2 reviewers. The AMSTAR checklist was used to assess the quality of the SRs. Data analysis Extracted data were synthesised using a narrative approach. Results 38 SRs and 142 primary studies were identified, comprising the following categories of non-pharmacological interventions: (1) sensory stimulation interventions (12 SRs, 27 primary studies) that encompassed: acupressure, aromatherapy, massage/touch therapy, light therapy and sensory garden; (2) cognitive/emotion-oriented interventions (33 SRs; 70 primary studies) that included cognitive stimulation, music/dance therapy, dance therapy, snoezelen, transcutaneous electrical nerve stimulation, reminiscence therapy, validation therapy, simulated presence therapy; (3) behaviour management techniques (6 SRs; 32 primary studies) and (4) other therapies (5 SRs, 12 primary studies) comprising exercise therapy, animal-assisted therapy, special care unit and dining room environment-based interventions. Music therapy was effective in reducing agitation (SMD, −0.49; 95% CI −0.82 to −0.17; p=0.003), and anxiety (SMD, −0.64; 95% CI −1.05 to −0.24; p=0.002). Home-based behavioural management techniques, caregiver-based interventions or staff training in communication skills, person-centred care or dementia care mapping with supervision during implementation were found to be effective for symptomatic and severe agitation. Conclusions A large number of non-pharmacological interventions for BPSD were identified. The majority of the studies had great variation in how the same type of intervention was defined and applied, the follow-up duration, the type of outcome measured, usually with modest sample size. Overall, music therapy and behavioural management techniques were effective for reducing BPSD. PMID:28302633

Nutrient Digestibility, Ruminal Fermentation Activities, Serum Parameters and Milk Production and Composition of Lactating Goats Fed Diets Containing Rice Straw Treated with Pleurotus ostreatus

PubMed Central

Kholif, A. E.; Khattab, H. M.; El-Shewy, A. A.; Salem, A. Z. M.; Kholif, A. M.; El-Sayed, M. M.; Gado, H. M.; Mariezcurrena, M. D.

2014-01-01

The study evaluated replacement of Egyptian berseem clover (BC, Trifolium alexandrinum) with spent rice straw (SRS) of Pleurotus ostreatus basidiomycete in diets of lactating Baladi goats. Nine lactating homo-parity Baladi goats (average BW 23.8±0.4 kg) at 7 d postpartum were used in a triplicate 3×3 Latin square design with 30 d experimental periods. Goats were fed a basal diet containing 0 (Control), 0.25 (SRS25) and 0.45 (SRS45) (w/w, DM basis) of SRS. The Control diet was berseem clover and concentrate mixture (1:1 DM basis). The SRS45 had lowered total feed intake and forages intake compared to Control. The SRS25 and SRS45 rations had the highest digestibilities of DM (p = 0.0241) and hemicellulose (p = 0.0021) compared to Control which had higher (p<0.01) digestibilities of OM (p = 0.0002) and CP (p = 0.0005) than SRS25 and SRS45. Ruminal pH and microbial protein synthesis were higher (p<0.0001) for SRS25 and SRS45 than Control, which also had the highest (p<0.0001) concentration of TVFA, total proteins, non-protein N, and ammonia-N. All values of serum constituents were within normal ranges. The Control ration had higher serum globulin (p = 0.0148), creatinine (p = 0.0150), glucose (p = 0.0002) and cholesterol (p = 0.0016). Both Control and SRS25 groups had the highest (p<0.05) milk (p = 0.0330) and energy corrected milk (p = 0.0290) yields. Fat content was higher (p = 0.0373) with SRS45 and SRS25 groups compared with Control. Replacement of BC with SRS in goat rations increased milk levels of conjugated linoleic acid and unsaturated fatty acids compared with Control. It was concluded that replacing 50% of Egyptian berseem clover with SRS in goat rations improved their productive performance without marked effects on metabolic indicators health. PMID:25049962

Proposed Site Treatment Plan (PSTP). Volumes 1 and 2 and Reference Document

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

Helmich, E.; Noller, D.K.; Wierzbicki, K.S.

1994-12-22

The Compliance Plan Volume provides overall schedules with target dates for achieving compliance with the land disposal restrictions (LDR) and contains procedures to establish milestones to be enforced under the Order. Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume and is provided for informational purposes only.

Effect of Risk of Bias on the Effect Size of Meta-Analytic Estimates in Randomized Controlled Trials in Periodontology and Implant Dentistry.

PubMed

Faggion, Clovis Mariano; Wu, Yun-Chun; Scheidgen, Moritz; Tu, Yu-Kang

2015-01-01

Risk of bias (ROB) may threaten the internal validity of a clinical trial by distorting the magnitude of treatment effect estimates, although some conflicting information on this assumption exists. The objective of this study was evaluate the effect of ROB on the magnitude of treatment effect estimates in randomized controlled trials (RCTs) in periodontology and implant dentistry. A search for Cochrane systematic reviews (SRs), including meta-analyses of RCTs published in periodontology and implant dentistry fields, was performed in the Cochrane Library in September 2014. Random-effect meta-analyses were performed by grouping RCTs with different levels of ROBs in three domains (sequence generation, allocation concealment, and blinding of outcome assessment). To increase power and precision, only SRs with meta-analyses including at least 10 RCTs were included. Meta-regression was performed to investigate the association between ROB characteristics and the magnitudes of intervention effects in the meta-analyses. Of the 24 initially screened SRs, 21 SRs were excluded because they did not include at least 10 RCTs in the meta-analyses. Three SRs (two from periodontology field) generated information for conducting 27 meta-analyses. Meta-regression did not reveal significant differences in the relationship of the ROB level with the size of treatment effect estimates, although a trend for inflated estimates was observed in domains with unclear ROBs. In this sample of RCTs, high and (mainly) unclear risks of selection and detection biases did not seem to influence the size of treatment effect estimates, although several confounders might have influenced the strength of the association.

Use of diffusion-weighted MRI to modify radiosurgery planning in brain metastases may reduce local recurrence.

PubMed

Zakaria, Rasheed; Pomschar, Andreas; Jenkinson, Michael D; Tonn, Jörg-Christian; Belka, Claus; Ertl-Wagner, Birgit; Niyazi, Maximilian

2017-02-01

Stereotactic radiosurgery (SRS) is an effective and well tolerated treatment for selected brain metastases; however, local recurrence still occurs. We investigated the use of diffusion weighted MRI (DWI) as an adjunct for SRS treatment planning in brain metastases. Seventeen consecutive patients undergoing complete surgical resection of a solitary brain metastasis underwent image analysis retrospectively. SRS treatment plans were generated based on standard 3D post-contrast T1-weighted sequences at 1.5T and then separately using apparent diffusion coefficient (ADC) maps in a blinded fashion. Control scans immediately post operation confirmed complete tumour resection. Treatment plans were compared to one another and with volume of local recurrence at progression quantitatively and qualitatively by calculating the conformity index (CI), the overlapping volume as a proportion of the total combined volume, where 1 = identical plans and 0 = no conformation whatsoever. Gross tumour volumes (GTVs) using ADC and post-contrast T1-weighted sequences were quantitatively the same (related samples Wilcoxon signed rank test = -0.45, p = 0.653) but showed differing conformations (CI 0.53, p < 0.001). The diffusion treatment volume (DTV) obtained by combining the two target volumes was significantly greater than the treatment volume based on post contrast T1-weighted MRI alone, both quantitatively (median 13.65 vs. 9.52 cm 3 , related samples Wilcoxon signed rank test p < 0.001) and qualitatively (CI 0.74, p = 0.001). This DTV covered a greater volume of subsequent tumour recurrence than the standard plan (median 3.53 cm 3 vs. 3.84 cm 3 , p = 0.002). ADC maps may be a useful tool in addition to the standard post-contrast T1-weighted sequence used for SRS planning.

SRS environmental air surveillance program 1954-2015: General trends

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

Abbott, K.; Jannik, T.

The radiological monitoring program at SRS was established under the DuPont Company in June 1951 and was used as a measurement of the effectiveness of plant controls and as an authoritative record of environmental conditions surrounding the plant. It also served as a method of demonstrating compliance with applicable federal regulations and guidance. This document serves as a general summary of changes made specifically to the environmental air monitoring program since its inception, and a discussion of the general trends seen in the air monitoring program at SRS from 1954 to 2015. Initially, the environmental air surveillance program focused notmore » only on releases from SRS but also on fallout from various weapons testing performed through the end of 1978. Flypaper was used to measure the amount of fallout in the atmosphere during this period, and was present at each of the 10 monitoring stations. By 1959, all site stacks were included in the air monitoring program to determine their contribution to the airborne radioactivity onsite, and the number of air surveillance samplers rose to 18. This trend of an increased number of sampling locations continued to a peak of 35 sampling locations before shifting to a downward trend in the mid-1990s. In 1962, 4 outer-range samplers were placed in Savannah and Macon, GA, and in Greenville and Columbia, SC. Until 1976, air samplers were simply placed around the perimeter of the various operation locations (after 1959, this included stacks to determine their contribution to the airborne radioactivity), with the intent of creating as representative a distribution as possible of the air surrounding operations.« less

Single-Fraction Versus Multifraction (3 × 9 Gy) Stereotactic Radiosurgery for Large (>2 cm) Brain Metastases: A Comparative Analysis of Local Control and Risk of Radiation-Induced Brain Necrosis

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

Minniti, Giuseppe, E-mail: gminniti@ospedalesantandrea.it; IRCCS Neuromed, Pozzilli; Scaringi, Claudia

Purpose: To investigate the local control and radiation-induced brain necrosis in patients with brain metastases >2 cm in size who received single-fraction or multifraction stereotactic radiosurgery (SRS); factors associated with clinical outcomes and the development of brain radionecrosis were assessed. Methods and Materials: Two hundred eighty-nine consecutive patients with brain metastases >2.0 cm who received SRS as primary treatment at Sant'Andrea Hospital, University of Rome Sapienza, Rome, Italy, were analyzed. Cumulative incidence analysis was used to compare local control and radiation-induced brain necrosis between groups from the time of SRS. To achieve a balanced distribution of baseline covariates between treatment groups, amore » propensity score analysis was used. Results: The 1-year cumulative local control rates were 77% in the single-fraction SRS (SF-SRS) group and 91% in the multifraction SRS (MF-SRS) group (P=.01). Recurrences occurred in 25 and 11 patients who received SF-SRS or MF-SRS (P=.03), respectively. Thirty-one patients (20%) undergoing SF-SRS and 11 (8%) subjected to MF-SRS experienced brain radionecrosis (P=.004); the 1-year cumulative incidence rate of radionecrosis was 18% and 9% (P=.01), respectively. Significant differences between the 2 groups in terms of local control and risk of radionecrosis were maintained after propensity score adjustment. Conclusions: Multifraction SRS at a dose of 27 Gy in 3 daily fractions seems to be an effective treatment modality for large brain metastases, associated with better local control and a reduced risk of radiation-induced radionecrosis as compared with SF-SRS.« less

Salvage whole brain radiotherapy or stereotactic radiosurgery after initial stereotactic radiosurgery for 1-4 brain metastases.

PubMed

Liu, Yufei; Alexander, Brian M; Chen, Yu-Hui; Horvath, Margaret C; Aizer, Ayal A; Claus, Elizabeth B; Dunn, Ian F; Golby, Alexandra J; Johnson, Mark D; Friesen, Scott; Mannarino, Edward G; Wagar, Matthew; Hacker, Fred L; Arvold, Nils D

2015-09-01

Patients with limited brain metastases are often candidates for stereotactic radiosurgery (SRS) or whole brain radiotherapy (WBRT). Among patients who receive SRS, the likelihood and timing of salvage WBRT or SRS remains unclear. We examined rates of salvage WBRT or SRS among 180 patients with 1-4 newly diagnosed brain metastases who received index SRS from 2008-2013. Competing risks multivariable analysis was used to examine factors associated with time to WBRT. Patients had non-small cell lung (53 %), melanoma (23 %), breast (10 %), renal (6 %), or other (8 %) cancers. Median age was 62 years. Patients received index SRS to 1 (60 %), 2 (21 %), 3 (13 %), or 4 (7 %) brain metastases. Median survival after SRS was 9.7 months (range, 0.3-67.6 months). No further brain-directed radiotherapy was delivered after index SRS in 55 % of patients. Twenty-seven percent of patients ever received salvage WBRT, and 30 % ever received salvage SRS; 12 % of patients received both salvage WBRT and salvage SRS. Median time to salvage WBRT or salvage SRS were 5.6 and 6.1 months, respectively. Age ≤60 years (adjusted hazard ratio [AHR] = 2.80; 95 % CI 1.05-7.51; P = 0.04) and controlled/absent extracranial disease (AHR = 6.76; 95 % CI 1.60-28.7; P = 0.01) were associated with shorter time to salvage WBRT. Isolated brain progression caused death in only 11 % of decedents. In summary, most patients with 1-4 brain metastases receiving SRS never require salvage WBRT or SRS, and the remainder do not require salvage treatment for a median of 6 months.

Comparison of stereotactic radiosurgery and fractionated stereotactic radiotherapy of acoustic neurinomas according to 3-D tumor volume shrinkage and quality of life.

PubMed

Henzel, Martin; Hamm, Klaus; Sitter, Helmut; Gross, Markus W; Surber, Gunnar; Kleinert, Gabriele; Engenhart-Cabillic, Rita

2009-09-01

Stereotactic radiosurgery (SRS) and also fractionated stereotactic radiotherapy (SRT) offer high local control (LC) rates (> 90%). This study aimed to evaluate three-dimensional (3-D) tumor volume (TV) shrinkage and to assess quality of life (QoL) after SRS/SRT. From 1999 to 2005, 35/74 patients were treated with SRS, and 39/74 with SRT. Median age was 60 years. Treatment was delivered by a linear accelerator. Median single dose was 13 Gy (SRS) or 54 Gy (SRT). Patients were followed up > or = 12 months after SRS/SRT. LC and toxicity were evaluated by clinical examinations and magnetic resonance imaging. 3-D TV shrinkage was evaluated with the planning system. QoL was assessed using the questionnaire Short Form-36. Median follow-up was 50/36 months (SRS/SRT). Actuarial 5-year freedom from progression/overall survival was 88.1%/100% (SRS), and 87.5%/87.2% (SRT). TV shrinkage was 15.1%/40.7% (SRS/SRT; p = 0.01). Single dose (< 13 Gy) was the only determinant factor for TV shrinkage after SRS (p = 0.001). Age, gender, initial TV, and previous operations did not affect TV shrinkage. Acute or late toxicity (> or = grade 3) was never seen. Concerning QoL, no significant differences were observed after SRS/SRT. Previous operations and gender did not affect QoL (p > 0.05). Compared with the German normal population, patients had worse values for all domains except for mental health. TV shrinkage was significantly higher after SRT than after SRS. Main symptoms were not affected by SRS/SRT. Retrospectively, QoL was neither affected by SRS nor by SRT.

Final Scientific/Technical Report for DE-FG02-07ER64500 Study of Lignocellulosic Material Degradation with CARS Microscopy

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

Xie, Xiaoliang Sunney; Ding, Shi-You

2013-09-30

The program of research undertaken by our Harvard group, in collaboration with Dr. Ding at the National Renewable Energy Laboratory (NREL) in Golden, CO, seeks to introduce, validate and apply a new analytical technique to study the conversion of lignocellulosic biomass into ethanol. This conversion process has been the subject of intense interest over the past few years because of its potential to provide a clean, renewable source of energy to meet increasing global demand. During the funding period, we have clearly demonstrated visualization of lignin and cellulose using intrinsic vibrational contrast with simulated Raman scattering (SRS) microscopy, developed atmore » Harvard. Our approach offers high spatial resolution and time resolution that is sufficient to capture the kinetics of a pre‐treatment process. This is reflected by the publications listed below, as well as the use of SRS microscopy at NREL as a routine analysis tool for research on lignocellulosic biomass. In our original proposal, we envisioned moving to near‐field CARS imaging in order to perform chemical mapping at the nanoscale. However, given the dramatic progress made by our group in SRS imaging, we concentrated our efforts on using multi‐component SRS (lignin, cellulose, lipid, water, protein, deuterated metabolites, etc.) to quantitatively understand the spatially dispersed kinetics in a variety of plant samples under a variety of conditions. In addition, we built a next generation laser system based on fiber laser technology that allowed rugged and portable instrumentation for SRS microscopy. We also pursued new imaging approaches to improve the acquisition speed of SRS imaging of lignocellulose without sacrificing signal‐to‐noise ratio. This allowed us to image larger volumes of tissue with higher time resolution to get a more comprehensive picture of the heterogeneity of this chemical process from the submicron up to the centimeter scale.« less

Customized Noise-Stimulation Intensity for Bipedal Stability and Unipedal Balance Deficits Associated With Functional Ankle Instability

PubMed Central

Ross, Scott E.; Linens, Shelley W.; Wright, Cynthia J.; Arnold, Brent L.

2013-01-01

Context: Stochastic resonance stimulation (SRS) administered at an optimal intensity could maximize the effects of treatment on balance. Objective: To determine if a customized optimal SRS intensity is better than a traditional SRS protocol (applying the same percentage sensory threshold intensity for all participants) for improving double- and single-legged balance in participants with or without functional ankle instability (FAI). Design: Case-control study with an embedded crossover design. Setting: Laboratory. Patients or Other Participants: Twelve healthy participants (6 men, 6 women; age = 22 ± 2 years, height = 170 ± 7 cm, mass = 64 ± 10 kg) and 12 participants (6 men, 6 women; age = 23 ± 3 years, height = 174 ± 8 cm, mass = 69 ± 10 kg) with FAI. Intervention(s): The SRS optimal intensity level was determined by finding the intensity from 4 experimental intensities at the percentage sensory threshold (25% [SRS25], 50% [SRS50], 75% [SRS75], 90% [SRS90]) that produced the greatest improvement in resultant center-of-pressure velocity (R-COPV) over a control condition (SRS0) during double-legged balance. We examined double- and single-legged balance tests, comparing optimal SRS (SRSopt1) and SRS0 using a battery of center-of-pressure measures in the frontal and sagittal planes. Main Outcome Measure(s): Anterior-posterior (A-P) and medial-lateral (M-L) center-of-pressure velocity (COPV) and center-of-pressure excursion (COPE), R-COPV, and 95th percentile center-of-pressure area ellipse (COPA-95). Results: Data were organized into bins that represented optimal (SRSopt1), second (SRSopt2), third (SRSopt3), and fourth (SRSopt4) improvement over SRS0. The SRSopt1 enhanced R-COPV (P ≤ .05) over SRS0 and other SRS conditions (SRS0 = 0.94 ± 0.32 cm/s, SRSopt1 = 0.80 ± 0.19 cm/s, SRSopt2 = 0.88 ± 0.24 cm/s, SRSopt3 = 0.94 ± 0.25 cm/s, SRSopt4 = 1.00 ± 0.28 cm/s). However, SRS did not improve R-COPV over SRS0 when data were categorized by sensory threshold. Furthermore, SRSopt1 improved double-legged balance over SRS0 from 11% to 25% in all participants for the center-of-pressure frontal- and sagittal-plane assessments (P ≤ .05). The SRSopt1 also improved single-legged balance over SRS0 from 10% to 17% in participants with FAI for the center-of-pressure frontal- and sagittal-plane assessments (P ≤ .05). The SRSopt1 did not improve single-legged balance in participants with stable ankles. Conclusions: The SRSopt1 improved double-legged balance and transfers to enhancing single-legged balance deficits associated with FAI. PMID:23724774

Atomistic simulations of the effect of embedded hydrogen and helium on the tensile properties of monocrystalline and nanocrystalline tungsten

NASA Astrophysics Data System (ADS)

Chen, Zhe; Kecskes, Laszlo J.; Zhu, Kaigui; Wei, Qiuming

2016-12-01

Uniaxial tensile properties of monocrystalline tungsten (MC-W) and nanocrystalline tungsten (NC-W) with embedded hydrogen and helium atoms have been investigated using molecular dynamics (MD) simulations in the context of radiation damage evolution. Different strain rates have been imposed to investigate the strain rate sensitivity (SRS) of the samples. Results show that the plastic deformation processes of MC-W and NC-W are dominated by different mechanisms, namely dislocation-based for MC-W and grain boundary-based activities for NC-W, respectively. For MC-W, the SRS increases and a transition appears in the deformation mechanism with increasing embedded atom concentration. However, no obvious embedded atom concentration dependence of the SRS has been observed for NC-W. Instead, in the latter case, the embedded atoms facilitate GB sliding and intergranular fracture. Additionally, a strong strain enhanced He cluster growth has been observed. The corresponding underlying mechanisms are discussed.

Importance of patient-reported individualized goals when assessing outcomes for adult spinal deformity (ASD): initial experience with a Patient Generated Index (PGI).

PubMed

Scheer, Justin K; Keefe, Malla; Lafage, Virginie; Kelly, Michael P; Bess, Shay; Burton, Douglas C; Hart, Robert A; Jain, Amit; Lonner, Baron S; Protopsaltis, Themistocles S; Hostin, Richard; Shaffrey, Christopher I; Smith, Justin S; Schwab, Frank; Ames, Christopher P

2017-10-01

Current metrics to assess patients' health-related quality of life (HRQOL) may not reflect a true change in the patients' specific perception of what is most important to them. This study aimed to describe the initial experience of a Patient Generated Index (PGI) in which patients create their own outcome domains. This is a single-center prospective study. Patients with adult spinal deformity (ASD) comprise the study sample. Oswestry Disability Index (ODI), Short Form-36 (SF-36 Physical Component Score [PCS] and Mental Component Score [MCS]), Scoliosis Research Society-22r (SRS-22r), and PGI. Oswestry Disability Index, SF-36, SRS-22r, and PGI were administered preoperatively and postoperatively at 6 weeks, 3 months, 6 months, and 1 and 2 years. PGI correlations with ODI, SF-36, SRS total score, free-text frequency analysis of PGI exact response with text in ODI and SRS-22r questionnaires, and the responsiveness (effect size [ES]) of the HRQOL metrics were analyzed. No funding was used for this study and there are no conflicts of interest. A total of 59 patients with 209 clinical encounters produced 370 PGI written response topics that included affect or emotions, relationships, activities of daily life, personal care, work, and hobbies. Mean preoperative PGI score was 18.6±13.5 (0-71.7 out of 100 [best]), and mean scores significantly improved at every postoperative time point (p<.05). Preoperative PGI scores significantly correlated with preoperative ODI (r=-0.28, p=.03), MCS (r=0.48, p<.01), and SRS total (r=0.57, p<.01). Postoperative PGI scores correlated with all HRQOL measures (p<.0001): ODI (r=-0.65), PCS (r=0.50), MCS (r=0.55), and SRS total (r=0.63). PGI responses exactly matched ODI and SRS-22r text at 47.8% and 35.4%, respectively, and at 63.2% and 58.9%, respectively, for categories. Patient Generated Index ES at a minimum of 1-year follow-up was -2.39, indicating substantial responsiveness (|ES|>0.8). Effect sizes for ODI, SRS-22r total, SF-36 PCS, and SF-36 MCS were 2.16, -2.06, -2.05, and -0.80, respectively. The PGI is easy to administer and offers additional information about the patients' perspective not captured in standard HRQOL metrics. Patient Generated Index scores correlated with all of the standard HRQOL scores and were more responsive than ODI, SF-36, and SRS-22r, suggesting that the PGI may be a step closer to one HRQOL measure that better encompasses concerns and goals of the individual patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Teaching with Student Response Systems (SRS): Teacher-Centric Aspects that Can Negatively Affect Students' Experience of Using SRS

ERIC Educational Resources Information Center

Nielsen, Kjetil L.; Hansen, Gabrielle; Stav, John B.

2013-01-01

In this article, we describe and discuss the most significant teacher-centric aspects of student response systems (SRS) that we have found to negatively affect students' experience of using SRS in lecture settings. By doing so, we hope to increase teachers' awareness of how they use SRS and how seemingly trivial choices or aspects when using SRS…

Effect of Radiosurgery Alone vs Radiosurgery With Whole Brain Radiation Therapy on Cognitive Function in Patients With 1 to 3 Brain Metastases

PubMed Central

Brown, Paul D.; Jaeckle, Kurt; Ballman, Karla V.; Farace, Elana; Cerhan, Jane H.; Anderson, S. Keith; Carrero, Xiomara W.; Barker, Fred G.; Deming, Richard; Burri, Stuart H.; Ménard, Cynthia; Chung, Caroline; Stieber, Volker W.; Pollock, Bruce E.; Galanis, Evanthia; Buckner, Jan C.; Asher, Anthony L.

2017-01-01

IMPORTANCE Whole brain radiotherapy (WBRT) significantly improves tumor control in the brain after stereotactic radiosurgery (SRS), yet because of its association with cognitive decline, its role in the treatment of patients with brain metastases remains controversial. OBJECTIVE To determine whether there is less cognitive deterioration at 3 months after SRS alone vs SRS plus WBRT. DESIGN, SETTING, AND PARTICIPANTS At 34 institutions in North America, patients with 1 to 3 brain metastases were randomized to receive SRS or SRS plus WBRT between February 2002 and December 2013. INTERVENTIONS The WBRT dose schedule was 30 Gy in 12 fractions; the SRS dose was 18 to 22 Gy in the SRS plus WBRT group and 20 to 24 Gy for SRS alone. MAIN OUTCOMES AND MEASURES The primary end point was cognitive deterioration (decline >1 SD from baseline on at least 1 cognitive test at 3 months) in participants who completed the baseline and 3-month assessments. Secondary end points included time to intracranial failure, quality of life, functional independence, long-term cognitive status, and overall survival. RESULTS There were 213 randomized participants (SRS alone, n = 111; SRS plus WBRT, n = 102) with a mean age of 60.6 years (SD, 10.5 years); 103 (48%) were women. There was less cognitive deterioration at 3 months after SRS alone (40/63 patients [63.5%]) than when combined with WBRT (44/48 patients [91.7%]; difference, −28.2%; 90% CI, −41.9% to −14.4%; P < .001). Quality of life was higher at 3 months with SRS alone, including overall quality of life (mean change from baseline, −0.1 vs −12.0 points; mean difference, 11.9; 95% CI, 4.8–19.0 points; P = .001). Time to intracranial failure was significantly shorter for SRS alone compared with SRS plus WBRT (hazard ratio, 3.6; 95% CI, 2.2–5.9; P < .001). There was no significant difference in functional independence at 3 months between the treatment groups (mean change from baseline, −1.5 points for SRS alone vs −4.2 points for SRS plus WBRT; mean difference, 2.7 points; 95% CI, −2.0 to 7.4 points; P = .26). Median overall survival was 10.4 months for SRS alone and 7.4 months for SRS plus WBRT (hazard ratio, 1.02; 95% CI, 0.75–1.38; P = .92). For long-term survivors, the incidence of cognitive deterioration was less after SRS alone at 3 months (5/11 [45.5%] vs 16/17 [94.1%]; difference, −48.7%; 95% CI, −87.6% to −9.7%; P = .007) and at 12 months (6/10 [60%] vs 17/18 [94.4%]; difference, −34.4%; 95% CI, −74.4% to 5.5%; P = .04). CONCLUSIONS AND RELEVANCE Among patients with 1 to 3 brain metastases, the use of SRS alone, compared with SRS combined with WBRT, resulted in less cognitive deterioration at 3 months. In the absence of a difference in overall survival, these findings suggest that for patients with 1 to 3 brain metastases amenable to radiosurgery, SRS alone may be a preferred strategy. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00377156 PMID:27458945

Effect of Radiosurgery Alone vs Radiosurgery With Whole Brain Radiation Therapy on Cognitive Function in Patients With 1 to 3 Brain Metastases: A Randomized Clinical Trial.

PubMed

Brown, Paul D; Jaeckle, Kurt; Ballman, Karla V; Farace, Elana; Cerhan, Jane H; Anderson, S Keith; Carrero, Xiomara W; Barker, Fred G; Deming, Richard; Burri, Stuart H; Ménard, Cynthia; Chung, Caroline; Stieber, Volker W; Pollock, Bruce E; Galanis, Evanthia; Buckner, Jan C; Asher, Anthony L

2016-07-26

Whole brain radiotherapy (WBRT) significantly improves tumor control in the brain after stereotactic radiosurgery (SRS), yet because of its association with cognitive decline, its role in the treatment of patients with brain metastases remains controversial. To determine whether there is less cognitive deterioration at 3 months after SRS alone vs SRS plus WBRT. At 34 institutions in North America, patients with 1 to 3 brain metastases were randomized to receive SRS or SRS plus WBRT between February 2002 and December 2013. The WBRT dose schedule was 30 Gy in 12 fractions; the SRS dose was 18 to 22 Gy in the SRS plus WBRT group and 20 to 24 Gy for SRS alone. The primary end point was cognitive deterioration (decline >1 SD from baseline on at least 1 cognitive test at 3 months) in participants who completed the baseline and 3-month assessments. Secondary end points included time to intracranial failure, quality of life, functional independence, long-term cognitive status, and overall survival. There were 213 randomized participants (SRS alone, n = 111; SRS plus WBRT, n = 102) with a mean age of 60.6 years (SD, 10.5 years); 103 (48%) were women. There was less cognitive deterioration at 3 months after SRS alone (40/63 patients [63.5%]) than when combined with WBRT (44/48 patients [91.7%]; difference, -28.2%; 90% CI, -41.9% to -14.4%; P < .001). Quality of life was higher at 3 months with SRS alone, including overall quality of life (mean change from baseline, -0.1 vs -12.0 points; mean difference, 11.9; 95% CI, 4.8-19.0 points; P = .001). Time to intracranial failure was significantly shorter for SRS alone compared with SRS plus WBRT (hazard ratio, 3.6; 95% CI, 2.2-5.9; P < .001). There was no significant difference in functional independence at 3 months between the treatment groups (mean change from baseline, -1.5 points for SRS alone vs -4.2 points for SRS plus WBRT; mean difference, 2.7 points; 95% CI, -2.0 to 7.4 points; P = .26). Median overall survival was 10.4 months for SRS alone and 7.4 months for SRS plus WBRT (hazard ratio, 1.02; 95% CI, 0.75-1.38; P = .92). For long-term survivors, the incidence of cognitive deterioration was less after SRS alone at 3 months (5/11 [45.5%] vs 16/17 [94.1%]; difference, -48.7%; 95% CI, -87.6% to -9.7%; P = .007) and at 12 months (6/10 [60%] vs 17/18 [94.4%]; difference, -34.4%; 95% CI, -74.4% to 5.5%; P = .04). Among patients with 1 to 3 brain metastases, the use of SRS alone, compared with SRS combined with WBRT, resulted in less cognitive deterioration at 3 months. In the absence of a difference in overall survival, these findings suggest that for patients with 1 to 3 brain metastases amenable to radiosurgery, SRS alone may be a preferred strategy. clinicaltrials.gov Identifier: NCT00377156.

Acceptance of a systematic review as a thesis: survey of biomedical doctoral programs in Europe.

PubMed

Puljak, Livia; Sapunar, Damir

2017-12-12

Systematic reviews (SRs) have been proposed as a type of research methodology that should be acceptable for a graduate research thesis. The aim of this study was to analyse whether PhD theses in European biomedical graduate programs can be partly or entirely based on SRs. In 2016, we surveyed individuals in charge of European PhD programs from 105 institutions. The survey asked about acceptance of SRs as the partial or entire basis for a PhD thesis, their attitude towards such a model for PhD theses, and their knowledge about SR methodology. We received responses from 86 individuals running PhD programs in 68 institutions (institutional response rate of 65%). In 47% of the programs, SRs were an acceptable study design for a PhD thesis. However, only 20% of participants expressed a personal opinion that SRs meet the criteria for a PhD thesis. The most common reasons for not accepting SRs as the basis for PhD theses were that SRs are 'not a result of a PhD candidate's independent work, but more of a team effort' and that SRs 'do not produce enough new knowledge for a dissertation'. The majority of participants were not familiar with basic concepts related to SRs; questions about meta-analyses and the type of plots frequently used in SRs were correctly answered by only one third of the participants. Raising awareness about the importance of SRs and their methodology could contribute to higher acceptance of SRs as a type of research that forms the basis of a PhD thesis.

Report on inspection of compliance with DOE Order 2030.4B at the Savannah River Site

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

NONE

1997-03-01

The purpose of this inspection was to evaluate contractor compliance at the Savannah River Site (SRS) with Department of Energy (DOE) Order 2030.4B, {open_quotes}Reporting Fraud, Waste, And Abuse To The Office Of Inspector General.{close_quotes} The specific objective was to determine if the SRS management and operating (M&O) contractors were complying with the requirements in Paragraph 6.c. of DOE Order 2030.4B. These requirements are: (1) annual notification to employees of their duty to report allegations of fraud, waste, abuse, corruption, or mismanagement; (2) display and publish the DOE Office of Inspector General (OIG) Hotline telephone number in common areas of buildings;more » (3) display and publish the DOE OIG Hotline number in telephone books and newsletters; and (4) notify the OIG cases referred to other law enforcement entities.« less

Management of Spent and Disused Sealed Radioactive Sources in the Czech Republic - 12124

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

Podlaha, J.

2012-07-01

The Czech Republic is a country with a well-developed peaceful utilization of nuclear energy and ionizing radiation. Sealed Radioactive Sources (further also SRS) are broadly used in many areas in the Czech Republic, e.g. in research, industry, medicine, education, agriculture, etc. Legislation in the field of ionizing radiation source utilization has been fully harmonized with European Community legislation. SRS utilization demands a proper system which must ensure the safe use of SRS, including the management of disused (spent) and orphaned SRS. In the Czech Republic, a comprehensive system of SRS management has been established that is comparable with systems inmore » other developed countries. The system covers both legal and institutional aspects. The Central Register of Ionizing Radiation Sources is an important part of the system. It is a tracking system that covers all activities related to SRS, from their production or import to the end of their use (recycling or disposal). Many spent SRS are recycled and can be used for other purposes after inspection, repacking or reprocessing. When the disused SRS are not intended for further use, they are managed as radioactive waste (RAW). The system of SRS management also ensures the suitable resolution of situations connected with improper SRS handling (in the case of orphaned sources, accidents, etc.). (author)« less

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

Seger, Tona

This guidebook is a resource to help field personnel (nonbotanists) identify plants on the Savannah River Site (SRS) premises. Although not a complete flora guide, this publication contains information about 123 plant species found on the SRS. Plants are listed by their common names and arranged by the color of the flower. The SRS supports a diverse array of plant communities. Land use history, the establishment of the SRS, and current land management practices have shaped the flora presently found on the SRS. Located south of Aiken, SC, SRS spans 198,344 acres with land covering Aiken, Allendale, and Barnwell Counties.more » Situated on the Upper Coastal Plain and Sandhills physiographic provinces, the SRS has more than 50 distinct soil types. The topography is rolling to flat with elevation ranges from 50 to 400 feet above sea level.« less

Bovine immune response to inoculation with Neospora caninum surface antigen SRS2 lipopeptides mimics immune response to infection with live parasites.

PubMed

Baszler, Timothy V; Shkap, Varda; Mwangi, Waithaka; Davies, Christopher J; Mathison, Bruce A; Mazuz, Monica; Resnikov, Dror; Fish, Lea; Leibovitch, Benjamin; Staska, Lauren M; Savitsky, Igor

2008-04-01

Infection of cattle with Neospora caninum protozoa, the causative agent of bovine protozoal abortion, results in robust cellular and humoral immune responses, particularly CD4(+) T-lymphocyte activation and gamma interferon (IFN-gamma) secretion. In the present study, N. caninum SRS2 (NcSRS2) T-lymphocyte-epitope-bearing subunits were incorporated into DNA and peptide preparations to assess CD4(+) cell proliferation and IFN-gamma T-lymphocyte-secretion immune responses in cattle with predetermined major histocompatibility complex (MHC) genotypes. In order to optimize dendritic-cell processing, NcSRS2 DNA vaccine was delivered with granulocyte macrophage-colony-stimulating factor and Flt3 ligand adjuvant. The synthesized NcSRS2 peptides were coupled with a palmitic acid molecule (lipopeptide) and delivered with Freund's adjuvant. Cattle vaccinated with NcSRS2 DNA vaccine alone did not induce T-lymphocyte activation or IFN-gamma secretion, whereas subsequent booster inoculation with NcSRS2-lipopeptides induced robust NcSRS2-specific immune responses. Compared to the response in control animals, NcSRS2-lipopeptide-immunized cattle had significantly increased NcSRS2-specific T-lymphocyte proliferation, numbers of IFN-gamma-secreting peripheral blood mononuclear cells, and immunoglobulin G1 (IgG1) and IgG2a antibody levels. The findings show that N. caninum NcSRS2 subunits bearing T-lymphocyte epitopes induced cell-mediated immune responses similar to the protective immune responses previously described against live parasite infection, namely T-lymphocyte activation and IFN-gamma secretion. The findings support the investigation of NcSRS2 immunogens for protection against N. caninum-induced fetal infection and abortion in cattle.

SISGR: Room Temperature Single-Molecule Detection and Imaging by Stimulated Emission Microscopy

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

Xie, Xiaoliang Sunney

Single-molecule spectroscopy has made considerable impact on many disciplines including chemistry, physics, and biology. To date, most single-molecule spectroscopy work is accomplished by detecting fluorescence. On the other hand, many naturally occurring chromophores, such as retinal, hemoglobin and cytochromes, do not have detectable fluorescence. There is an emerging need for single-molecule spectroscopy techniques that do not require fluorescence. In the last proposal period, we have successfully demonstrated stimulated emission microscopy, single molecule absorption, and stimulated Raman microscopy based on a high-frequency modulation transfer technique. These first-of-a- kind new spectroscopy/microscopy methods tremendously improved our ability to observe molecules that fluorescence weakly,more » even to the limit of single molecule detection for absorption measurement. All of these methods employ two laser beams: one (pump beam) excites a single molecule to a real or virtual excited state, and the other (probe beam) monitors the absorption/emission property of the single. We extract the intensity change of the probe beam with high sensitivity by implementing a high-frequency phase-sensitive detection scheme, which offers orders of magnitude improvement in detection sensitivity over direct absorption/emission measurement. However, single molecule detection based on fluorescence or absorption is fundamentally limited due to their broad spectral response. It is important to explore other avenues in single molecule detection and imaging which provides higher molecular specificity for studying a wide variety of heterogeneous chemical and biological systems. This proposal aimed to achieve single-molecule detection sensitivity with near resonance stimulated Raman scattering (SRS) microscopy. SRS microscopy was developed in our lab as a powerful technique for imaging heterogeneous samples based on their intrinsic vibrational contrasts, which provides much higher molecular specificity than absorption and fluorescence. Current sensitivity limit of SRS microscopy has not yet reached single molecule detection. We proposed to capitalize on our state-of-the-art SRS microscopy and develop near-resonance enhanced SRS for single molecule detection of carotenoids and heme proteins. The specific aims we pursued are: (1) building the next SRS generation microscope that utilizes near resonance enhancement to allow detection and imaging of single molecules with undetectable fluorescence, such as -carotene. (2) using near-resonance SRS as a contrast mechanism to study dye-sensitize semiconductor interface, elucidating the heterogeneous electron ejection kinetics with high spatial and temporal resolution. (3) studying the binding and unbinding of oxygen in single hemoglobin molecules in order to gain molecular level understanding of the long-standing issue of cooperativity. The new methods developed in the fund period of this grant have advanced the detection sensitivity in many aspects. Near-resonance SRS improved the signal by using shorter wavelengths for SRS microscopy. Frequency modulation and multi-color SRS target the reduction of background to improve the chemical specificity of SRS while maintaining the high imaging speed. Time-domain coherent Raman scattering microscopy targets to reduce the noise floor of coherent Raman microscopy. These methods have already demonstrated first-of-a-kind new applications in biology and medical research. However, we are still one order of magnitude away from single molecule limit. It is important to continue to improve the laser specification and develop new imaging methods to finally achieve label-free single molecule microscopy.« less

Decision Analysis of Stereotactic Radiation Surgery Versus Stereotactic Radiation Surgery and Whole-Brain Radiation Therapy for 1 to 3 Brain Metastases

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

Lester-Coll, Nataniel H., E-mail: nataniel.lester-coll@yale.edu; Dosoretz, Arie P.; Yu, James B.

Purpose: Although whole-brain radiation therapy (WBRT) is effective for controlling intracranial disease, it is also associated with neurocognitive side effects. It is unclear whether a theoretically improved quality of life after stereotactic radiation surgery (SRS) alone relative to that after SRS with adjuvant WBRT would justify the omission of WBRT, given the higher risk of intracranial failure. This study compares SRS alone with SRS and WBRT, to evaluate the theoretical benefits of intracranial tumor control with adjuvant WBRT against its possible side effects, using quality-adjusted life expectancy (QALE) as a primary endpoint. Methods and Materials: A Markov decision analysis modelmore » was used to compare QALE in a cohort of patients with 1 to 3 brain metastases and Karnofsky performance status of at least 70. Patients were treated with SRS alone or with SRS immediately followed by WBRT. Patients treated with SRS alone underwent surveillance magnetic resonance imaging and received salvage WBRT if they developed intracranial relapse. All patients whose cancer relapsed after WBRT underwent simulation as dying of intracranial progression. Model parameters were estimated from published literature. Results: Treatment with SRS yielded 6.2 quality-adjusted life months (QALMs). The addition of initial WBRT reduced QALE by 1.2 QALMs. On one-way sensitivity analysis, the model was sensitive only to a single parameter, the utility associated with the state of no evidence of disease after SRS alone. At values greater than 0.51, SRS alone was preferred. Conclusions: In general, SRS alone is suggested to have improved quality of life in patients with 1 to 3 brain metastases compared to SRS and immediate WBRT. Our results suggest that immediate treatment with WBRT after SRS can be reserved for patients who would have a poor performance status regardless of treatment. These findings are stable under a wide range of assumptions.« less

Srs2 prevents Rad51 filament formation by repetitive motion on DNA.

PubMed

Qiu, Yupeng; Antony, Edwin; Doganay, Sultan; Koh, Hye Ran; Lohman, Timothy M; Myong, Sua

2013-01-01

Srs2 dismantles presynaptic Rad51 filaments and prevents its re-formation as an anti-recombinase. However, the molecular mechanism by which Srs2 accomplishes these tasks remains unclear. Here we report a single-molecule fluorescence study of the dynamics of Rad51 filament formation and its disruption by Srs2. Rad51 forms filaments on single-stranded DNA by sequential binding of primarily monomers and dimers in a 5'-3' direction. One Rad51 molecule binds to three nucleotides, and six monomers are required to achieve a stable nucleation cluster. Srs2 exhibits ATP-dependent repetitive motion on single-stranded DNA and this activity prevents re-formation of the Rad51 filament. The same activity of Srs2 cannot prevent RecA filament formation, indicating its specificity for Rad51. Srs2's DNA-unwinding activity is greatly suppressed when Rad51 filaments form on duplex DNA. Taken together, our results reveal an exquisite and highly specific mechanism by which Srs2 regulates the Rad51 filament formation.

Systematic random sampling of the comet assay.

PubMed

McArt, Darragh G; Wasson, Gillian R; McKerr, George; Saetzler, Kurt; Reed, Matt; Howard, C Vyvyan

2009-07-01

The comet assay is a technique used to quantify DNA damage and repair at a cellular level. In the assay, cells are embedded in agarose and the cellular content is stripped away leaving only the DNA trapped in an agarose cavity which can then be electrophoresed. The damaged DNA can enter the agarose and migrate while the undamaged DNA cannot and is retained. DNA damage is measured as the proportion of the migratory 'tail' DNA compared to the total DNA in the cell. The fundamental basis of these arbitrary values is obtained in the comet acquisition phase using fluorescence microscopy with a stoichiometric stain in tandem with image analysis software. Current methods deployed in such an acquisition are expected to be both objectively and randomly obtained. In this paper we examine the 'randomness' of the acquisition phase and suggest an alternative method that offers both objective and unbiased comet selection. In order to achieve this, we have adopted a survey sampling approach widely used in stereology, which offers a method of systematic random sampling (SRS). This is desirable as it offers an impartial and reproducible method of comet analysis that can be used both manually or automated. By making use of an unbiased sampling frame and using microscope verniers, we are able to increase the precision of estimates of DNA damage. Results obtained from a multiple-user pooled variation experiment showed that the SRS technique attained a lower variability than that of the traditional approach. The analysis of a single user with repetition experiment showed greater individual variances while not being detrimental to overall averages. This would suggest that the SRS method offers a better reflection of DNA damage for a given slide and also offers better user reproducibility.

Effect of Risk of Bias on the Effect Size of Meta-Analytic Estimates in Randomized Controlled Trials in Periodontology and Implant Dentistry

PubMed Central

Faggion, Clovis Mariano; Wu, Yun-Chun; Scheidgen, Moritz; Tu, Yu-Kang

2015-01-01

Background Risk of bias (ROB) may threaten the internal validity of a clinical trial by distorting the magnitude of treatment effect estimates, although some conflicting information on this assumption exists. Objective The objective of this study was evaluate the effect of ROB on the magnitude of treatment effect estimates in randomized controlled trials (RCTs) in periodontology and implant dentistry. Methods A search for Cochrane systematic reviews (SRs), including meta-analyses of RCTs published in periodontology and implant dentistry fields, was performed in the Cochrane Library in September 2014. Random-effect meta-analyses were performed by grouping RCTs with different levels of ROBs in three domains (sequence generation, allocation concealment, and blinding of outcome assessment). To increase power and precision, only SRs with meta-analyses including at least 10 RCTs were included. Meta-regression was performed to investigate the association between ROB characteristics and the magnitudes of intervention effects in the meta-analyses. Results Of the 24 initially screened SRs, 21 SRs were excluded because they did not include at least 10 RCTs in the meta-analyses. Three SRs (two from periodontology field) generated information for conducting 27 meta-analyses. Meta-regression did not reveal significant differences in the relationship of the ROB level with the size of treatment effect estimates, although a trend for inflated estimates was observed in domains with unclear ROBs. Conclusion In this sample of RCTs, high and (mainly) unclear risks of selection and detection biases did not seem to influence the size of treatment effect estimates, although several confounders might have influenced the strength of the association. PMID:26422698

Modulation of the formation and release of bovine SRS-A in vitro by several anti-anaphylactic drugs.

PubMed

Burka, J F; Eyre, P

1975-01-01

Slow-reacting substance of anaphylaxis (SRS-A) is released immunologically from bovine lung in vitro. Various drugs known to protect calves and other animals during anaphylaxis were tested to investigate their modulation of the formation and release of SRS-A. The anti-inflammatory drugs, meclofenamate and aspirin, potentiated SRS-A release. Chlorphenesin and diethylcarbamazine citrate at high concentrations both inhibited SRS-A release. Two new anti-anaphylactic drugs, PR-D-92-EA and M&B 22,948, were particularly effective in inhibiting SRS-A release at low concentrations. The possible modes of actions of these drugs are discussed.

Survival was Significantly Better with Surgical/Medical/Radiation Co-interventions in a Single-Institution Practice Audit of Frameless Stereotactic Radiosurgery.

PubMed

Taggar, Amandeep; MacKenzie, Joanna; Li, Haocheng; Lau, Harold; Lim, Gerald; Nordal, Robert; Hudson, Alana; Khan, Rao; Spencer, David; Voroney, Jon-Paul

2016-05-17

To audit outcomes after introducing frameless stereotactic radiosurgery (SRS) for brain metastases, including co-interventions: neurosurgery, systemic therapy, and whole brain radiotherapy (WBRT). We report median overall survival (MS), local failure, and distant brain failure. We hypothesized patients treated with SRS would have clinically meaningful improved MS compared with historic institutional values. We further hypothesized that patients treated with co-interventions would have clinically meaningful improved MS compared with patients treated with SRS alone. One hundred twenty patients (N = 120) with limited intracranial disease underwent 130 frameless SRS sessions from April 2010 to May 2013. Median follow-up was 11 months. MS was measured from brain metastases diagnosis, local failure, and distant brain failure from the time of first SRS. Practice pattern during the first year of the study favored upfront WBRT (79%) over SRS (21%) while upfront SRS (45%) was almost as common as upfront WBRT (55%) in the last year of the study. MS was 18 months; 37% received SRS alone as initial radiotherapy (MS 12 months); 63% received WBRT prior to SRS (MS 19 months); 50% received systemic therapy post-SRS (MS 21 months); and 26% had tumor resection then SRS to the surgical cavity (MS 42 months). Local failure occurred in 10% of lesions and radio-necrosis occurred in 4%. Differences in distant brain failure among patients treated with upfront SRS (40% rate), WBRT followed by SRS (33% rate) or systemic therapy post-SRS (37% rate) were not statistically significant. Frameless SRS effectively treats surgical cavities, persistent tumors post-WBRT, and can be used as an upfront treatment of brain metastases. Surgery, systemic therapy, and WBRT are associated with longer MS. Patients can live for years while receiving multiple therapies. Systemic therapy for patients with brain metastases is increasingly common, palliative care occurs earlier and improves survival, and WBRT use is not routine. Modern series sometimes produce unexpectedly good results. Classification and treatment protocols are evolving. This practice audit is note-worthy for (i) high median overall survival, (ii) systemic therapy after radiosurgery for patients with tumors treated by radiosurgery, (iii) distant brain failure not significantly related to WBRT, and (iv) neurosurgery, systemic therapy, and WBRT are independently associated with improved MS.

SU-F-T-640: Feasibility of Using a Commercially Available Surface Guided Radiotherapy System with An Open-Face SRS Immobilization System

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

Chinsky, B; Patel, R; Roeske, J

Purpose: To evaluate the inherent accuracy of using a surface guided radiotherapy system (SGRT) in the setup and monitoring of patients receiving stereotactic radiosurgery with an open-face SRS immobilization system. Methods: An anthropomorphic head phantom was set up using the Qfix Encompass SRS Immobilization System on a Varian Edge with OSMS and Varian TrueBeam with AlignRT. The phantom was positioned at 0° gantry and couch. A reference image was acquired using the SGRT system and an ROI was created over the mask opening. The couch and gantry were rotated to different combinations focusing on clinically used SRS gantry/couch combinations andmore » those blocking the SGRT cameras. Perceived surface deviation by the SGRT system from the reference image was recorded. A Winston-Lutz test was performed on couch angles tested and used to exclude couch walkout. The deviation magnitude was calculated using translational values and rotational raw values were recorded. Results: The maximum couch walkouts were: 0.4mm (Edge) and 0.5mm (TB). Solely rotating the gantry resulted in a median couch deviation of 0.2mm and range of 0.1–0.3mm for both linacs. Only rotating the couch (0° gantry) resulted in median deviations of 0.6mm and 0.5mm with ranges of 0.3–1.0mm and 0.3–0.7mm for the Edge and TB, respectively. Combining gantry and couch rotations, the median deviations were 0.7mm and 0.9mm with ranges of 0.3–1.1mm and 0.2–1.9mm for the Edge and TB, respectively. Including all combinations, rotation, roll, and pitch median deviations ranged from 0.1–0.3° with pitch demonstrating consistently higher values and a maximum deviation of 1.0° (both linacs). Conclusion: SGRT is a reliable monitoring tool, though taking into account system fluctuations, 1mm is too restrictive a site tolerance to use with the Qfix Encompass mask. Gantry rotation has little effect on system fluctuation even with camera blockage, whereas couch rotation has a larger effect.« less

Evaluation of the reliability, usability, and applicability of AMSTAR, AMSTAR 2, and ROBIS: protocol for a descriptive analytic study.

PubMed

Gates, Allison; Gates, Michelle; Duarte, Gonçalo; Cary, Maria; Becker, Monika; Prediger, Barbara; Vandermeer, Ben; Fernandes, Ricardo M; Pieper, Dawid; Hartling, Lisa

2018-06-13

Systematic reviews (SRs) of randomised controlled trials (RCTs) can provide the best evidence to inform decision-making, but their methodological and reporting quality varies. Tools exist to guide the critical appraisal of quality and risk of bias in SRs, but evaluations of their measurement properties are limited. We will investigate the interrater reliability (IRR), usability, and applicability of A MeaSurement Tool to Assess systematic Reviews (AMSTAR), AMSTAR 2, and Risk Of Bias In Systematic reviews (ROBIS) for SRs in the fields of biomedicine and public health. An international team of researchers at three collaborating centres will undertake the study. We will use a random sample of 30 SRs of RCTs investigating therapeutic interventions indexed in MEDLINE in February 2014. Two reviewers at each centre will appraise the quality and risk of bias in each SR using AMSTAR, AMSTAR 2, and ROBIS. We will record the time to complete each assessment and for the two reviewers to reach consensus for each SR. We will extract the descriptive characteristics of each SR, the included studies, participants, interventions, and comparators. We will also extract the direction and strength of the results and conclusions for the primary outcome. We will summarise the descriptive characteristics of the SRs using means and standard deviations, or frequencies and proportions. To test for interrater reliability between reviewers and between the consensus agreements of reviewer pairs, we will use Gwet's AC 1 statistic. For comparability to previous evaluations, we will also calculate weighted Cohen's kappa and Fleiss' kappa statistics. To estimate usability, we will calculate the mean time to complete the appraisal and to reach consensus for each tool. To inform applications of the tools, we will test for statistical associations between quality scores and risk of bias judgments, and the results and conclusions of the SRs. Appraising the methodological and reporting quality of SRs is necessary to determine the trustworthiness of their conclusions. Which tool may be most reliably applied and how the appraisals should be used is uncertain; the usability of newly developed tools is unknown. This investigation of common (AMSTAR) and newly developed (AMSTAR 2, ROBIS) tools will provide empiric data to inform their application, interpretation, and refinement.

Grey literature in systematic reviews: a cross-sectional study of the contribution of non-English reports, unpublished studies and dissertations to the results of meta-analyses in child-relevant reviews.

PubMed

Hartling, Lisa; Featherstone, Robin; Nuspl, Megan; Shave, Kassi; Dryden, Donna M; Vandermeer, Ben

2017-04-19

Systematic reviews (SRs) are an important source of information about healthcare interventions. A key component of a well-conducted SR is a comprehensive literature search. There is limited evidence on the contribution of non-English reports, unpublished studies, and dissertations and their impact on results of meta-analyses. Our sample included SRs from three Cochrane Review Groups: Acute Respiratory Infections (ARI), Infectious Diseases (ID), Developmental Psychosocial and Learning Problems (DPLP) (n = 129). Outcomes included: 1) proportion of reviews that searched for and included each study type; 2) proportion of relevant studies represented by each study type; and 3) impact on results and conclusions of the primary meta-analysis for each study type. Most SRs searched for non-English studies; however, these were included in only 12% of reviews and represented less than 5% of included studies. There was a change in results in only four reviews (total sample = 129); in two cases the change did not have an impact on the statistical or clinical significance of results. Most SRs searched for unpublished studies but the majority did not include these (only 6%) and they represented 2% of included studies. In most cases the impact of including unpublished studies was small; a substantial impact was observed in one case that relied solely on unpublished data. Few reviews in ARI (9%) and ID (3%) searched for dissertations compared to 65% in DPLP. Overall, dissertations were included in only nine SRs and represented less than 2% of included studies. In the majority of cases the change in results was negligible or small; in the case where a large change was noted, the estimate was more conservative without dissertations. The majority of SRs searched for non-English and unpublished studies; however, these represented a small proportion of included studies and rarely impacted the results and conclusions of the review. Inclusion of these study types may have an impact in situations where there are few relevant studies, or where there are questionable vested interests in the published literature. We found substantial variation in whether SRs searched for dissertations; in most reviews that included dissertations, these had little impact on results.

Cost-effectiveness Analysis of Stereotactic Radiosurgery Alone Versus Stereotactic Radiosurgery with Upfront Whole Brain Radiation Therapy for Brain Metastases.

PubMed

Kim, H; Rajagopalan, M S; Beriwal, S; Smith, K J

2017-10-01

Stereotactic radiosurgery (SRS) alone or upfront whole brain radiation therapy (WBRT) plus SRS are the most commonly used treatment options for one to three brain oligometastases. The most recent randomised clinical trial result comparing SRS alone with upfront WBRT plus SRS (NCCTG N0574) has favoured SRS alone for neurocognitive function, whereas treatment options remain controversial in terms of cognitive decline and local control. The aim of this study was to conduct a cost-effectiveness analysis of these two competing treatments. A Markov model was constructed for patients treated with SRS alone or SRS plus upfront WBRT based on largely randomised clinical trials. Costs were based on 2016 Medicare reimbursement. Strategies were compared using the incremental cost-effectiveness ratio (ICER) and effectiveness was measured in quality-adjusted life years (QALYs). One-way and probabilistic sensitivity analyses were carried out. Strategies were evaluated from the healthcare payer's perspective with a willingness-to-pay threshold of $100 000 per QALY gained. In the base case analysis, the median survival was 9 months for both arms. SRS alone resulted in an ICER of $9917 per QALY gained. In one-way sensitivity analyses, results were most sensitive to variation in cognitive decline rates for both groups and median survival rates, but the SRS alone remained cost-effective for most parameter ranges. Based on the current available evidence, SRS alone was found to be cost-effective for patients with one to three brain metastases compared with upfront WBRT plus SRS. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Enterprise.SRS = Business for Success at SRS

ScienceCinema

Wilson, Dwayne; Moody, David; Michalske, Terry; Bush, Byron; Sprague, Leslie; Worrell, Timothy

2017-12-09

Goals and accomplishments of SRS. The debut of enterprise.srs, a strategic vision that will refocus site talents and efforts on developing future missions by broadening its impact in existing and new areas of national service. An expansion of people and facility in 3 areas: National Security, Clean Energy, and Environmental Stewardship.

Prevalence of Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Infections Among Transgender Persons Referred to an Italian Center for Total Sex Reassignment Surgery.

PubMed

Luzzati, Roberto; Zatta, Marta; Pavan, Nicola; Serafin, Maurizia; Maurel, Cristina; Trombetta, Carlo; Barbone, Fabio

2016-07-01

The burden of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in transgender population is an underestimated issue. We performed a study to evaluate the prevalence of such infections in transgender persons addressed our center for total sex reassignment surgery (SRS). All transgender persons undergoing SRS from 2000 to 2014 were evaluated retrospectively. Participant characteristics and results of HIV, HBV, and HCV testing were collected. Exact Fisher test, Cochran-Armitage tests for trend and correct prevalence ratios were estimated. Among 498 transgender persons, 243 had confirmed serological data. Of them, 25 were female-to-male and 218 male-to-female (MtF) subjects. The prevalence of HIV, HBV and HCV infections was 0%, 4.0%, and 8.0% in female-to-male, and 12.1%, 4.6%, and 3.7% in MtF. Among MtF, younger age and earlier year of SRS were associated with lower HIV prevalence. From the multivariate model, the mutually adjustment prevalence ratios were 1.9 (95% confidence interval [95% CI], 1.2-3.1) for SRS in 2005-2010 and 3.6 (95% CI, 1.3-9.4) in 2010-2014, as compared with SRS in 2000-2004; and 4.7 (95% CI, 2.4-9.4) for South Americans as compared with others. Among the HCV-positive MtF, 57.1% were also HIV-positive. Regarding HBV, the immunity was 38.5% and, after mutual adjustment, the prevalence ratios were 2.1 (95% CI, 1.3-3.4) for South Americans versus others and 2.2 (95% CI, 1.6-3.1) for year of birth ≥ 1980. The prevalence of HBV and HCV infections among our transgender persons overlaps that reported in the general population, but HCV prevalence was much higher in HIV-infected MtF. The high burden of HIV infection among MtF and its recent incremented prevalence points out that social and medical support should be strongly promoted in such population.

SRS in the single molecule limit (Conference Presentation)

NASA Astrophysics Data System (ADS)

Potma, Eric O.; Crampton, Kevin T.; Fast, Alexander; Apkarian, Vartkess A.

2017-02-01

We present combined surface-enhanced stimulated Raman scattering (SE-SRS) and surface-enhanced coherent anti-Stokes Raman scattering (SE-CARS) measurements on individual plasmonic antennas dressed with bipyridyl-ethylene molecules. By carefully optimizing the conditions for performing SE-SRS experiments, we have obtained stable and reproducible molecular surface-enhanced SRS spectra from single nano-antennas. Using surface-enhanced Raman scattering (SERS) and transmission electron microscopy of the same antennas, we confirm that the observed SE-SRS signals originate from only one or a few molecules. We highlight the physics of surface enhancement in the context of coherent Raman scattering and derive sensitivity parameters under the relevant conditions. The implications of single molecule SRS measurements are discussed.

Hyperspectral stimulated Raman scattering and multiphoton imaging for digital pathology of colonic disease

NASA Astrophysics Data System (ADS)

Wang, Zi; Zheng, Wei; Lin, Jian; Huang, Zhiwei

2016-03-01

Histopathology examinations of H&E stained biopsied tissues is the golden standard for colonic diseases (e.g., polyps, adenoma, and adenocarcinoma) diagnosis. However, staining effect of sample and doctor's expertise degree may greatly influence the diagnosis results. The information provided by the H&E stained sample is also limited to the morphological and PH information and no quantative information is available. In this paper, we report the development of a unique multimodal nonlinear optical microscopy (i.e., hyperspectral stimulated Raman scattering (hsSRS), second-harmonic generation (SHG), third-harmonic generation (THG), two-photon excitation fluorescence (TPEF)) platform for the diagnosis and characterization of colonic diseases. HsSRS in both fingerprint (800-1800 cm-1) and high-wavenumber (2800-3600 cm-1) regions allows us to discriminate different constituents with tiny difference in the Raman spectra. The increase of proteins and reduction of lipids could be observed with the progress of colonic cancer. SHG shows the distribution of collagen, which is found to aggregate for adenocarcinoma. TPEF provides the cell morphological and can reflect the damage inside glands caused by the diseases. THG shows the increase of optical heterogeneity related to cancer process. This work shows that the integrated hsSRS and TPEF/SHG/THG imaging technique can be an effective method for digital pathology of colonic diseases at the molecular and sub-cellular levels.

Ichthyoplankton entrainment study at the SRS Savannah River water intakes for Westinghouse Savannah River Company

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

Paller, M.

1992-03-26

Cooling water for L and K Reactors and makeup water for Par Pond is pumped from the Savannah River at the 1G, 3G, and 5G pump houses. Ichthyoplankton (drifting fish larvae and eggs) from the river are entrained into the reactor cooling systems with the river water and passed through the reactor's heat exchangers where temperatures may reach 70[degrees]C during full power operation. Ichthyoplankton mortality under such conditions is assumed to be 100 percent. The number of ichthyoplankton entrained into the cooling system depends on a variety of variables, including time of year, density and distribution of ichthyoplankton in themore » river, discharge levels in the river, and the volume of water withdrawn by the pumps. Entrainment at the 1 G pump house, which is immediately downstream from the confluence of Upper Three Runs Creek and the Savannah River, is also influenced by discharge rates and ichthyoplankton densities in Upper Three Runs Creek. Because of the anticipated restart of several SRS reactors and the growing concern surrounding striped bass and American shad stocks in the Savannah River, the Department of Energy requested that the Environmental Sciences Section (ESS) of the Savannah River Laboratory sample ichthyoplankton at the SRS Savannah River intakes. Dams Moore, Inc., under a contract with Westinghouse Savannah River Company performed the sampling and data analysis for the ESS.« less

Actinomyces spp. gene expression in root caries lesions

PubMed Central

Dame-Teixeira, Naile; Parolo, Clarissa Cavalcanti Fatturi; Maltz, Marisa; Tugnait, Aradhna; Devine, Deirdre; Do, Thuy

2016-01-01

Background The studies of the distribution of Actinomyces spp. on carious and non-carious root surfaces have not been able to confirm the association of these bacteria with root caries, although they were extensively implicated as a prime suspect in root caries. Objective The aim of this study was to observe the gene expression of Actinomyces spp. in the microbiota of root surfaces with and without caries. Design The oral biofilms from exposed sound root surface (SRS; n=10) and active root caries (RC; n=30) samples were collected. The total bacterial RNA was extracted, and the mRNA was isolated. Samples with low RNA concentration were pooled, yielding a final sample size of SRS=10 and RC=9. Complementary DNA (cDNA) libraries were prepared and sequenced on an Illumina® HiSeq 2500 system. Sequence reads were mapped to eight Actinomyces genomes. Count data were normalized using DESeq2 to analyse differential gene expression applying the Benjamini-Hochberg correction (false discovery rate [FDR]<0.001). Results Actinomyces spp. had similar numbers of reads (Mann-Whitney U-test; p>0.05), except for Actinomyces OT178 (p=0.001) and Actinomyces gerencseriae (p=0.004), which had higher read counts in the SRS. Genes that code for stress proteins (clp, dnaK, and groEL), enzymes of glycolysis pathways (including enolase and phosphoenolpyruvate carboxykinase), adhesion (Type-2 fimbrial and collagen-binding protein), and cell growth (EF-Tu) were highly – but not differentially (p>0.001) – expressed in both groups. Genes with the most significant upregulation in RC were those coding for hypothetical proteins and uracil DNA glycosylase (p=2.61E-17). The gene with the most significant upregulation in SRS was a peptide ABC transporter substrate-binding protein (log2FC=−6.00, FDR=2.37E-05). Conclusion There were similar levels of Actinomyces gene expression in both sound and carious root biofilms. These bacteria can be commensal in root surface sites but may be cariogenic due to survival mechanisms that allow them to exist in acid environments and to metabolize sugars, saving energy. PMID:27640531

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

Trifiletti, Daniel M., E-mail: daniel.trifiletti@gmail.com; Lee, Cheng-Chia; Kano, Hideyuki

Purpose: To pool data across multiple institutions internationally and report on the cumulative experience of brainstem stereotactic radiosurgery (SRS). Methods and Materials: Data on patients with brainstem metastases treated with SRS were collected through the International Gamma Knife Research Foundation. Clinical, radiographic, and dosimetric characteristics were compared for factors prognostic for local control (LC) and overall survival (OS) using univariate and multivariate analyses. Results: Of 547 patients with 596 brainstem metastases treated with SRS, treatment of 7.4% of tumors resulted in severe SRS-induced toxicity (grade ≥3, increased odds with increasing tumor volume, margin dose, and whole-brain irradiation). Local control at 12 monthsmore » after SRS was 81.8% and was improved with increasing margin dose and maximum dose. Overall survival at 12 months after SRS was 32.7% and impacted by age, gender, number of metastases, tumor histology, and performance score. Conclusions: Our study provides additional evidence that SRS has become an option for patients with brainstem metastases, with an excellent benefit-to-risk ratio in the hands of experienced clinicians. Prior whole-brain irradiation increases the risk of severe toxicity in brainstem metastasis patients undergoing SRS.« less

Yeast Srs2 Helicase Promotes Redistribution of Single-Stranded DNA-Bound RPA and Rad52 in Homologous Recombination Regulation.

PubMed

De Tullio, Luisina; Kaniecki, Kyle; Kwon, Youngho; Crickard, J Brooks; Sung, Patrick; Greene, Eric C

2017-10-17

Srs2 is a super-family 1 helicase that promotes genome stability by dismantling toxic DNA recombination intermediates. However, the mechanisms by which Srs2 remodels or resolves recombination intermediates remain poorly understood. Here, single-molecule imaging is used to visualize Srs2 in real time as it acts on single-stranded DNA (ssDNA) bound by protein factors that function in recombination. We demonstrate that Srs2 is highly processive and translocates rapidly (∼170 nt per second) in the 3'→5' direction along ssDNA saturated with replication protein A (RPA). We show that RPA is evicted from DNA during the passage of Srs2. Remarkably, Srs2 also readily removes the recombination mediator Rad52 from RPA-ssDNA and, in doing so, promotes rapid redistribution of both Rad52 and RPA. These findings have important mechanistic implications for understanding how Srs2 and related nucleic acid motor proteins resolve potentially pathogenic nucleoprotein intermediates. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Stereotactic Radiosurgery in the Management of Patients With Brain Metastases of Non-Small Cell Lung Cancer: Indications, Decision Tools and Future Directions

PubMed Central

Hartgerink, Dianne; van der Heijden, Britt; De Ruysscher, Dirk; Postma, Alida; Ackermans, Linda; Hoeben, Ann; Anten, Monique; Lambin, Philippe; Terhaag, Karin; Jochems, Arthur; Dekker, Andre; Schoenmaekers, Janna; Hendriks, Lizza; Zindler, Jaap

2018-01-01

Brain metastases (BM) frequently occur in non-small cell lung cancer (NSCLC) patients. Most patients with BM have a limited life expectancy, measured in months. Selected patients may experience a very long progression-free survival, for example, patients with a targetable driver mutation. Traditionally, whole-brain radiotherapy (WBRT) has been the cornerstone of the treatment, but its indication is a matter of debate. A randomized trial has shown that for patients with a poor prognosis, WBRT does not add quality of life (QoL) nor survival over the best supportive care. In recent decades, stereotactic radiosurgery (SRS) has become an attractive non-invasive treatment for patients with BM. Only the BM is irradiated to an ablative dose, sparing healthy brain tissue. Intracranial recurrence rates decrease when WBRT is administered following SRS or resection but does not improve overall survival and comes at the expense of neurocognitive function and QoL. The downside of SRS compared with WBRT is a risk of radionecrosis (RN) and a higher risk of developing new BM during follow-up. Currently, SRS is an established treatment for patients with a maximum of four BM. Several promising strategies are currently being investigated to further improve the indication and outcome of SRS for patients with BM: the effectivity and safety of SRS in patients with more than four BM, combining SRS with systemic therapy such as targeted agents or immunotherapy, shared decision-making with SRS as a treatment option, and individualized isotoxic dose prescription to mitigate the risk of RN and further enhance local control probability of SRS. This review discusses the current indications of SRS and future directions of treatment for patients with BM of NSCLC with focus on the value of SRS.

Comparison of stereotactic radiosurgery (SRS) alone and whole brain radiotherapy (WBRT) plus a stereotactic boost (WBRT+SRS) for one to three brain metastases.

PubMed

Rades, Dirk; Kueter, Jan-Dirk; Hornung, Dagmar; Veninga, Theo; Hanssens, Patrick; Schild, Steven E; Dunst, Juergen

2008-12-01

The best available treatment of patients with one to three brain metastases is still unclear. This study compared the results of stereotactic radiosurgery (SRS) alone and whole brain radiotherapy (WBRT) plus SRS (WBRT+SRS). Survival (OS), intracerebral control (IC), and local control of treated metastases (LC) were retrospectively analyzed in 144 patients receiving SRS alone (n=93) or WBRT+SRS (n=51). Eight additional potential prognostic factors were evaluated: age, gender, Eastern Cooperative Oncology Group performance score (ECOG-PS), tumor type, number of brain metastases, extracerebral metastases, recursive partitioning analysis (RPA) class, and interval from tumor diagnosis to irradiation. Subgroup analyses were performed for RPA class I and II patients. 1-year-OS was 53% after SRS and 56% after WBRT+SRS (p=0.24). 1-year-IC rates were 51% and 66% (p=0.015), respectively. 1-year-LC rates were 66% and 87% (p=0.003), respectively. On multivariate analyses, OS was associated with age (p=0.004), ECOG-PS (p=0.005), extracerebral metastases (p<0.001), RPA class (p<0.001), and interval from tumor diagnosis to irradiation (p<0.001). IC was associated with interval from tumor diagnosis to irradiation (p=0.004) and almost with treatment (p=0.09), and LC with treatment (p=0.026) and almost with interval (p=0.08). The results of the subgroup analyses were similar to those of the entire cohort. The increase in IC was stronger in RPA class I patients. WBRT+SRS resulted in better IC and LC but not better OS than SRS alone. Because also IC and LC are important end-points, additional WBRT appears justified in patients with one to three brain metastases, in particular in RPA class I patients.

Stereotactic Radiosurgery: Treatment of Brain Metastasis Without Interruption of Systemic Therapy

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

Shen, Colette J.; Kummerlowe, Megan N.; Redmond, Kristin J.

Purpose: To evaluate the prevalence, outcomes, and toxicities of concurrent delivery of systemic therapy with stereotactic radiosurgery (SRS) for treatment of brain metastases. Methods and Materials: We conducted a retrospective review of 193 patients treated at our institution with SRS without prior whole-brain radiation therapy (WBRT) for brain metastases between 2009 and 2014. Outcome metrics included administration of concurrent systemic therapy, myelosuppression, neurotoxicity, and survival. Results: One hundred ninety-three patients with a median age of 61 years underwent a total of 291 SRS treatments. Thirty-seven percent of SRS treatments were delivered concurrently with systemic therapy, of which 46% were with conventional myelosuppressivemore » chemotherapy, and 54% with targeted and immune therapy agents. Myelosuppression was minimal after treatment with both systemic therapy and SRS, with 14% grade 3-4 toxicity for lymphopenia and 4-9% for leukopenia, neutropenia, anemia, and thrombocytopenia. Neurotoxicity was also minimal after combined therapy, with no grade 4 and <5% grade 3 toxicity, 34% dexamethasone requirement, and 4% radiation necrosis, all similar to treatments with SRS alone. Median overall survival was similar after SRS alone (14.4 months) versus SRS with systemic therapy (12.9 months). In patients with a new diagnosis of primary cancer with brain metastasis, early treatment with concurrent systemic therapy and SRS correlated with improved survival versus SRS alone (41.6 vs 21.5 months, P<.05). Conclusions: Systemic therapy can be safely given concurrently with SRS for brain metastases: our results suggest minimal myelosuppression and neurotoxicity. Concurrent therapy is an attractive option for patients who have both intracranial and extracranial metastatic disease and may be particularly beneficial in patients with a new diagnosis of primary cancer with brain metastasis.« less

A prospective study validating a clinical scoring system and demonstrating phenotypical-genotypical correlations in Silver-Russell syndrome

PubMed Central

Azzi, Salah; Salem, Jennifer; Thibaud, Nathalie; Chantot-Bastaraud, Sandra; Lieber, Eli; Netchine, Irène; Harbison, Madeleine D

2015-01-01

Background Multiple clinical scoring systems have been proposed for Silver-Russell syndrome (SRS). Here we aimed to test a clinical scoring system for SRS and to analyse the correlation between (epi)genotype and phenotype. Subjects and methods Sixty-nine patients were examined by two physicians. Clinical scores were generated for all patients, with a new, six-item scoring system: (1) small for gestational age, birth length and/or weight ≤−2SDS, (2) postnatal growth retardation (height ≤−2SDS), (3) relative macrocephaly at birth, (4) body asymmetry, (5) feeding difficulties and/or body mass index (BMI) ≤−2SDS in toddlers; (6) protruding forehead at the age of 1–3 years. Subjects were considered to have likely SRS if they met at least four of these six criteria. Molecular investigations were performed blind to the clinical data. Results The 69 patients were classified into two groups (Likely-SRS (n=60), Unlikely-SRS (n=9)). Forty-six Likely-SRS patients (76.7%) displayed either 11p15 ICR1 hypomethylation (n=35; 58.3%) or maternal UPD of chromosome 7 (mUPD7) (n=11; 18.3%). Eight Unlikely-SRS patients had neither ICR1 hypomethylation nor mUPD7, whereas one patient had mUPD7. The clinical score and molecular results yielded four groups that differed significantly overall and for individual scoring system factors. Further molecular screening led identifying chromosomal abnormalities in Likely-SRS-double-negative and Unlikely-SRS groups. Four Likely-SRS-double negative patients carried a DLK1/GTL2 IG-DMR hypomethylation, a mUPD16; a mUPD20 and a de novo 1q21 microdeletion. Conclusions This new scoring system is very sensitive (98%) for the detection of patients with SRS with demonstrated molecular abnormalities. Given its clinical and molecular heterogeneity, SRS could be considered as a spectrum. PMID:25951829

Genetic heterogeneity of patients with suspected Silver-Russell syndrome: genome-wide copy number analysis in 82 patients without imprinting defects.

PubMed

Inoue, Takanobu; Nakamura, Akie; Fuke, Tomoko; Yamazawa, Kazuki; Sano, Shinichiro; Matsubara, Keiko; Mizuno, Seiji; Matsukura, Yoshika; Harashima, Chie; Hasegawa, Tatsuji; Nakajima, Hisakazu; Tsumura, Kumi; Kizaki, Zenro; Oka, Akira; Ogata, Tsutomu; Fukami, Maki; Kagami, Masayo

2017-01-01

Silver-Russell syndrome (SRS) is a rare congenital disorder characterized by pre- and postnatal growth failure and dysmorphic features. Recently, pathogenic copy number variations (PCNVs) and imprinting defects other than hypomethylation of the H19 -differentially methylated region (DMR) and maternal uniparental disomy chromosome 7 have been reported in patients with the SRS phenotype. This study aimed to clarify the frequency and clinical features of patients with SRS phenotype caused by PCNVs. We performed array comparative genomic hybridization analysis using a catalog array for 54 patients satisfying the Netchine-Harbison clinical scoring system (NH-CSS) (SRS-compatible) and for 28 patients presenting with three NH-CSS items together with triangular face and/or fifth finger clinodactyly and/or brachydactyly (SRS-like) without abnormal methylation levels of 9 DMRs related to known imprinting disorders. We then investigated the clinical features of patients with PCNVs. Three of the 54 SRS-compatible patients (5.6%) and 2 of the 28 SRS-like patients (7.1%) had PCNVs. We detected 3.5 Mb deletion in 4p16.3, mosaic trisomy 18, and 3.77-4.00 Mb deletion in 19q13.11-12 in SRS-compatible patients, and 1.41-1.97 Mb deletion in 7q11.23 in both SRS-like patients. Congenital heart diseases (CHDs) were identified in two patients and moderate to severe global developmental delay was observed in four patients. Of the patients in our study, 5.6% of SRS-compatible and 7.1% of SRS-like patients had PCNVs. All PCNVs have been previously reported for genetic causes of contiguous deletion syndromes or mosaic trisomy 18. Our study suggests patients with PCNVs, who have a phenotype resembling SRS, show a high tendency towards CHDs and/or apparent developmental delay.

Systematic review adherence to methodological or reporting quality.

PubMed

Pussegoda, Kusala; Turner, Lucy; Garritty, Chantelle; Mayhew, Alain; Skidmore, Becky; Stevens, Adrienne; Boutron, Isabelle; Sarkis-Onofre, Rafael; Bjerre, Lise M; Hróbjartsson, Asbjørn; Altman, Douglas G; Moher, David

2017-07-19

Guidelines for assessing methodological and reporting quality of systematic reviews (SRs) were developed to contribute to implementing evidence-based health care and the reduction of research waste. As SRs assessing a cohort of SRs is becoming more prevalent in the literature and with the increased uptake of SR evidence for decision-making, methodological quality and standard of reporting of SRs is of interest. The objective of this study is to evaluate SR adherence to the Quality of Reporting of Meta-analyses (QUOROM) and PRISMA reporting guidelines and the A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Overview Quality Assessment Questionnaire (OQAQ) quality assessment tools as evaluated in methodological overviews. The Cochrane Library, MEDLINE®, and EMBASE® databases were searched from January 1990 to October 2014. Title and abstract screening and full-text screening were conducted independently by two reviewers. Reports assessing the quality or reporting of a cohort of SRs of interventions using PRISMA, QUOROM, OQAQ, or AMSTAR were included. All results are reported as frequencies and percentages of reports and SRs respectively. Of the 20,765 independent records retrieved from electronic searching, 1189 reports were reviewed for eligibility at full text, of which 56 reports (5371 SRs in total) evaluating the PRISMA, QUOROM, AMSTAR, and/or OQAQ tools were included. Notable items include the following: of the SRs using PRISMA, over 85% (1532/1741) provided a rationale for the review and less than 6% (102/1741) provided protocol information. For reports using QUOROM, only 9% (40/449) of SRs provided a trial flow diagram. However, 90% (402/449) described the explicit clinical problem and review rationale in the introduction section. Of reports using AMSTAR, 30% (534/1794) used duplicate study selection and data extraction. Conversely, 80% (1439/1794) of SRs provided study characteristics of included studies. In terms of OQAQ, 37% (499/1367) of the SRs assessed risk of bias (validity) in the included studies, while 80% (1112/1387) reported the criteria for study selection. Although reporting guidelines and quality assessment tools exist, reporting and methodological quality of SRs are inconsistent. Mechanisms to improve adherence to established reporting guidelines and methodological assessment tools are needed to improve the quality of SRs.

Evaluation of AMSTAR to assess the methodological quality of systematic reviews in overviews of reviews of healthcare interventions.

PubMed

Pollock, Michelle; Fernandes, Ricardo M; Hartling, Lisa

2017-03-23

Overviews of reviews (overviews) compile information from multiple systematic reviews (SRs) to provide a single synthesis of relevant evidence for decision-making. It is recommended that authors assess and report the methodological quality of SRs in overviews-for example, using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). Currently, there is variation in whether and how overview authors assess and report SR quality, and limited guidance is available. Our objectives were to: examine methodological considerations involved in using AMSTAR to assess the quality of Cochrane and non-Cochrane SRs in overviews of healthcare interventions; identify challenges (and develop potential decision rules) when using AMSTAR in overviews; and examine the potential impact of considering methodological quality when making inclusion decisions in overviews. We selected seven overviews of healthcare interventions and included all SRs meeting each overview's inclusion criteria. For each SR, two reviewers independently conducted AMSTAR assessments with consensus and discussed challenges encountered. We also examined the correlation between AMSTAR assessments and SR results/conclusions. Ninety-five SRs were included (30 Cochrane, 65 non-Cochrane). Mean AMSTAR assessments (9.6/11 vs. 5.5/11; p < 0.001) and inter-rater reliability (AC1 statistic: 0.84 vs. 0.69; "almost perfect" vs. "substantial" using the Landis & Koch criteria) were higher for Cochrane compared to non-Cochrane SRs. Four challenges were identified when applying AMSTAR in overviews: the scope of the SRs and overviews often differed; SRs examining similar topics sometimes made different methodological decisions; reporting of non-Cochrane SRs was sometimes poor; and some non-Cochrane SRs included other SRs as well as primary studies. Decision rules were developed to address each challenge. We found no evidence that AMSTAR assessments were correlated with SR results/conclusions. Results indicate that the AMSTAR tool can be used successfully in overviews that include Cochrane and non-Cochrane SRs, though decision rules may be useful to circumvent common challenges. Findings support existing recommendations that quality assessments of SRs in overviews be conducted independently, in duplicate, with a process for consensus. Results also suggest that using methodological quality to guide inclusion decisions (e.g., to exclude poorly conducted and reported SRs) may not introduce bias into the overview process.

Three-beam double stimulated Raman scatterings: Cascading configuration

NASA Astrophysics Data System (ADS)

Rao, B. Jayachander; Cho, Minhaeng

2018-03-01

Two-beam stimulated Raman scattering (SRS) has been used in diverse label-free spectroscopy and imaging applications of live cells, biological tissues, and functional materials. Recently, we developed a theoretical framework for the three-beam double SRS processes that involve pump, Stokes, and depletion beams, where the pump-Stokes and pump-depletion SRS processes compete with each other. It was shown that the net Stokes gain signal can be suppressed by increasing the depletion beam intensity. The theoretical prediction has been experimentally confirmed recently. In the previous scheme for a selective suppression of one SRS by making it compete with another SRS, the two SRS processes occur in a parallel manner. However, there is another possibility of three-beam double SRS scheme that can be of use to suppress either Raman gain of the Stokes beam or Raman loss of the pump beam by depleting the Stokes photons with yet another SRS process induced by the pair of Stokes and another (second) Stokes beam. This three-beam double SRS process resembles a cascading energy transfer process from the pump beam to the first Stokes beam (SRS-1) and subsequently from the first Stokes beam to the second Stokes beam (SRS-2). Here, the two stimulated Raman gain-loss processes are associated with two different Raman-active vibrational modes of solute molecule. In the present theory, both the radiation and the molecules are treated quantum mechanically. We then show that the cascading-type three-beam double SRS can be described by coupled differential equations for the photon numbers of the pump and Stokes beams. From the approximate solutions as well as exact numerical calculation results for the coupled differential equations, a possibility of efficiently suppressing the stimulated Raman loss of the pump beam by increasing the second Stokes beam intensity is shown and discussed. To further prove a potential use of this scheme for developing a super-resolution SRS microscopy, we present a theoretical expression and numerical simulation results for the full-width-at-half-maximum of SRS imaging point spread function, assuming that the pump and Stokes beam profiles are Gaussian and the second Stokes beam has a doughnut-shaped spatial profile. It is clear that the spatial resolution with the present 3-beam cascading SRS method can be enhanced well beyond the diffraction limit. We anticipate that the present work will provide a theoretical framework for a super-resolution stimulated Raman scattering microscopy that is currently under investigation.

Dose Comparisons for a Site-specific Representative Person Using the Age-dependent Dose Coefficients in CAP88-PC Version 4.

PubMed

Stagich, Brooke H; Moore, Kelsey R; Newton, Joseph R; Dixon, Kenneth L; Jannik, G Timothy

2017-04-01

Most U.S. Department of Energy (DOE) facilities with radiological airborne releases use the U.S. Environmental Protection Agency's (EPA) environmental dosimetry code CAP88-PC to demonstrate compliance with regulations in 40CFR61, subpart H [National Emission Standards for Hazardous Air Pollutants: Radiological (NESHAP)]. In 2015, EPA released Version 4 of CAP88-PC, which included significant modifications that improved usability and age-dependent dose coefficients and usage factors for six age groups (infant, 1 y, 5 y, 10 y, 15 y, and adult). However, EPA has not yet provided specific guidance on how to use these age-dependent factors. For demonstrating compliance with DOE public dose regulations, the Savannah River Site (SRS) recently changed from using the maximally exposed individual (MEI) concept (adult male) to the representative person concept (age- and gender-averaged reference person). In this study, dose comparisons are provided between the MEI and a SRS-specific representative person using the age-specific dose coefficients and usage factors in CAP88-PC V.4. Dose comparisons also are provided for each of the six age groups using five radionuclides of interest at SRS (tritium oxide, Cs, Sr, Pu, and I). In general, the total effective dose increases about 11% for the representative person as compared to the current NESHAP MEI because of the inclusion of the more radiosensitive age groups.

Land and Water Use Characteristics and Human Health Input Parameters for use in Environmental Dosimetry and Risk Assessments at the Savannah River Site. 2016 Update

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

Jannik, G. Tim; Hartman, Larry; Stagich, Brooke

Operations at the Savannah River Site (SRS) result in releases of small amounts of radioactive materials to the atmosphere and to the Savannah River. For regulatory compliance purposes, potential offsite radiological doses are estimated annually using computer models that follow U.S. Nuclear Regulatory Commission (NRC) regulatory guides. Within the regulatory guides, default values are provided for many of the dose model parameters, but the use of applicant site-specific values is encouraged. Detailed surveys of land-use and water-use parameters were conducted in 1991 and 2010. They are being updated in this report. These parameters include local characteristics of meat, milk andmore » vegetable production; river recreational activities; and meat, milk and vegetable consumption rates, as well as other human usage parameters required in the SRS dosimetry models. In addition, the preferred elemental bioaccumulation factors and transfer factors (to be used in human health exposure calculations at SRS) are documented. The intent of this report is to establish a standardized source for these parameters that is up to date with existing data, and that is maintained via review of future-issued national references (to evaluate the need for changes as new information is released). These reviews will continue to be added to this document by revision.« less

Land and Water Use Characteristics and Human Health Input Parameters for use in Environmental Dosimetry and Risk Assessments at the Savannah River Site 2017 Update

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

Jannik, T.; Stagich, B.

Operations at the Savannah River Site (SRS) result in releases of relatively small amounts of radioactive materials to the atmosphere and to the Savannah River. For regulatory compliance purposes, potential offsite radiological doses are estimated annually using computer models that follow U.S. Nuclear Regulatory Commission (NRC) regulatory guides. Within the regulatory guides, default values are provided for many of the dose model parameters, but the use of site-specific values is encouraged. Detailed surveys of land-use and water-use parameters were conducted in 1991, 2008, 2010, and 2016 and are being concurred with or updated in this report. These parameters include localmore » characteristics of meat, milk, and vegetable production; river recreational activities; and meat, milk, and vegetable consumption rates, as well as other human usage parameters required in the SRS dosimetry models. In addition, the preferred elemental bioaccumulation factors and transfer factors (to be used in human health exposure calculations at SRS) are documented. The intent of this report is to establish a standardized source for these parameters that is up to date with existing data, and that is maintained via review of future-issued national references (to evaluate the need for changes as new information is released). These reviews will continue to be added to this document by revision.« less

Thermal and Physical Property Determinations for Ionsiv IE-911 Crystalline Silicotitanate and Savannah River Site Waste Simulant Solutions

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

Bostick, D.T.; Steele, W.V.

1999-08-01

This document describes physical and thermophysical property determinations that were made in order to resolve questions associated with the decontamination of Savannah River Site (SRS) waste streams using ion exchange on crystalline silicotitanate (CST). The research will aid in the understanding of potential issues associated with cooling of feed streams within SRS waste treatment processes. Toward this end, the thermophysical properties of engineered CST, manufactured under the trade name, Ionsive{reg_sign} IE-911 by UOP, Mobile, AL, were determined. The heating profiles of CST samples from several manufacturers' production runs were observed using differential scanning calorimetric (DSC) measurements. DSC data were obtainedmore » over the region of 10 to 215 C to check for the possibility of a phase transition or any other enthalpic event in that temperature region. Finally, the heat capacity, thermal conductivity, density, viscosity, and salting-out point were determined for SRS waste simulants designated as Average, High NO{sub 3}{sup {minus}} and High OH{sup {minus}} simulants.« less

Investigating the Clinical Usefulness of the Social Responsiveness Scale (SRS) in a Tertiary Level, Autism Spectrum Disorder Specific Assessment Clinic

ERIC Educational Resources Information Center

Aldridge, Fiona J.; Gibbs, Vicki M.; Schmidhofer, Katherine; Williams, Megan

2012-01-01

The Social Responsiveness Scale (SRS; Constantino and Gruber in Social Responsiveness Scale (SRS). Western Psychological Services, Los Angeles, 2005) is a commonly used screening tool for identifying children with possible autism spectrum disorder (ASD). This study investigated the relationship between SRS scores and eventual diagnostic outcome…

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

Wells, D.

The SRS Interim Sanitary Landfill opened in Mid-1992 and operated until 1998 under Domestic Waste Permit No. 025500-1120. Several contaminants have been detected in the groundwater beneath the unit.The well sampling and analyses were conducted in accordance with Procedure 3Q5, Hydrogeologic Data Collection.

Hypopituitarism after stereotactic radiosurgery for pituitary adenomas.

PubMed

Xu, Zhiyuan; Lee Vance, Mary; Schlesinger, David; Sheehan, Jason P

2013-04-01

Studies of new-onset Gamma Knife stereotactic radiosurgery (SRS)-induced hypopituitarism in large cohort of pituitary adenoma patients with long-term follow-up are lacking. We investigated the outcomes of SRS for pituitary adenoma patients with regard to newly developed hypopituitarism. This was a retrospective review of patients treated with SRS at the University of Virginia between 1994 and 2006. A total of 262 patients with a pituitary adenoma treated with SRS were reviewed. Thorough endocrine assessment was performed immediately before SRS and in regular follow-ups. Assessment consisted of 24-hour urine free cortisol (patients with Cushing disease), serum adrenocorticotropic hormone, cortisol, follicle-stimulating hormone, luteinizing hormone, insulin-like growth factor-1, growth hormone, testosterone (men), prolactin, thyroid-stimulating hormone, and free T(4). Endocrine remission occurred in 144 of 199 patients with a functioning adenoma. Tumor control rate was 89%. Eighty patients experienced at least 1 axis of new-onset SRS-induced hypopituitarism. The new hypopituitarism rate was 30% based on endocrine follow-up ranging from 6 to 150 months; the actuarial rate of new pituitary hormone deficiency was 31.5% at 5 years after SRS. On univariate and multivariate analyses, variables regarding the increased risk of hypopituitarism included suprasellar extension and higher radiation dose to the tumor margin; there were no correlations among tumor volume, prior transsphenoidal adenomectomy, prior radiation therapy, and age at SRS. SRS provides an effective and safe treatment option for patients with a pituitary adenoma. Higher margin radiation dose to the adenoma and suprasellar extension were 2 independent predictors of SRS-induced hypopituitarism.

Differential Impact of Whole-Brain Radiotherapy Added to Radiosurgery for Brain Metastases

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

Kong, Doo-Sik; Lee, Jung-Il, E-mail: jilee@skku.ed; Im, Yong-Seok

2010-10-01

Purpose: The authors investigated whether the addition of whole-brain radiotherapy (WBRT) to stereotactic radiosurgery (SRS) provided any therapeutic benefit according to recursive partitioning analysis (RPA) class. Methods and Materials: Two hundred forty-five patients with 1 to 10 metastases who underwent SRS between January 2002 and December 2007 were included in the study. Of those, 168 patients were treated with SRS alone and 77 patients received SRS followed by WBRT. Actuarial curves were estimated using the Kaplan-Meier method regarding overall survival (OS), distant brain control (DC), and local brain control (LC) stratified by RPA class. Analyses for known prognostic variables weremore » performed using the Cox proportional hazards model. Results: Univariate and multivariate analysis revealed that control of the primary tumor, small number of brain metastases, Karnofsky performance scale (KPS) > 70, and initial treatment modalities were significant predictors for survival. For RPA class 1, SRS plus WBRT was associated with a longer survival time compared with SRS alone (854 days vs. 426 days, p = 0.042). The SRS plus WBRT group also showed better LC rate than did the SRS-alone group (p = 0.021), although they did not show a better DC rate (p = 0.079). By contrast, for RPA class 2 or 3, no significant difference in OS, LC, or DC was found between the two groups. Conclusions: These results suggest that RPA classification should determine whether or not WBRT is added to SRS. WBRT may be recommended to be added to SRS for patients in whom long-term survival is expected on the basis of RPA classification.« less

Repeat Courses of Stereotactic Radiosurgery (SRS), Deferring Whole-Brain Irradiation, for New Brain Metastases After Initial SRS

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

Shultz, David B.; Modlin, Leslie A.; Jayachandran, Priya

Purpose: To report the outcomes of repeat stereotactic radiosurgery (SRS), deferring whole-brain radiation therapy (WBRT), for distant intracranial recurrences and identify factors associated with prolonged overall survival (OS). Patients and Methods: We retrospectively identified 652 metastases in 95 patients treated with 2 or more courses of SRS for brain metastases, deferring WBRT. Cox regression analyzed factors predictive for OS. Results: Patients had a median of 2 metastases (range, 1-14) treated per course, with a median of 2 courses (range, 2-14) of SRS per patient. With a median follow-up after first SRS of 15 months (range, 3-98 months), the median OS from the timemore » of the first and second course of SRS was 18 (95% confidence interval [CI] 15-24) and 11 months (95% CI 6-17), respectively. On multivariate analysis, histology, graded prognostic assessment score, aggregate tumor volume (but not number of metastases), and performance status correlated with OS. The 1-year cumulative incidence, with death as a competing risk, of local failure was 5% (95% CI 4-8%). Eighteen (24%) of 75 deaths were from neurologic causes. Nineteen patients (20%) eventually received WBRT. Adverse radiation events developed in 2% of SRS sites. Conclusion: Multiple courses of SRS, deferring WBRT, for distant brain metastases after initial SRS, seem to be a safe and effective approach. The graded prognostic assessment score, updated at each course, and aggregate tumor volume may help select patients in whom the deferral of WBRT might be most beneficial.« less

Epidemiology, methodological and reporting characteristics of systematic reviews of nursing interventions published in China.

PubMed

Shi, Chunhu; Zhu, Lin; Wang, Xue; Qin, Chunxia; Xu, Qi; Tian, Jinhui

2014-12-01

The importance of systematic reviews (SRs) of nursing interventions' impact on practice makes their methodological quality and reporting characteristics especially important as it directly influence their utility for clinicians, patients and policy makers.The study aims to assess the methodological quality and reporting characteristics of SRs of nursing interventions in Chinese nursing journals. Three Chinese databases were searched for SRs of nursing interventions from inception to October 2011. The assessment of multiple systematic reviews (AMSTAR) and Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statements were used to assess methodological quality and reporting characteristics. Seventy-four SRs were included. The proportion of SRs complying with AMSTAR checklist items ranged from 0% to 82.4%. No SRs reported an 'a priori' design or conflict of interest. Only four items were found to be reported in more than 50% of the SRs: a list of included and excluded studies, the scientific quality of included studies, the appropriate use of methods to combine findings, and formulating conclusions appropriately. The majority of SRs of nursing interventions in China had major methodological and reporting flaws that limited their value to guide decisions. Chinese authors and journals should adopt and keep up with the AMSTAR and PRISMA statements to improve the quality of SRs in this field. © 2014 Wiley Publishing Asia Pty Ltd.

Tank 30 and 37 Supernatant Sample Cross-Check and Evaporator Feed Qualification Analysis-2012

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

Oji, L. N.

2013-03-07

This report summarizes the analytical data reported by the F/H and Savannah River National Laboratories for the 2012 cross-check analysis for high level waste supernatant liquid samples from SRS Tanks 30 and 37. The intent of this Tank 30 and 37 sample analyses was to perform cross-checks against routine F/H Laboratory analyses (corrosion and evaporator feed qualification programs) using samples collected at the same time from both tanks as well as split samples from the tanks.

A simple method of measuring the effective SRS coefficient in single-mode optical fibres and the range of its applicability

NASA Astrophysics Data System (ADS)

Shikhaliev, I. I.; Gainov, V. V.; Dorozhkin, A. N.; Nanii, O. E.; Konyshev, V. A.; Treshchikov, V. N.

2017-11-01

This paper describes techniques for measuring the SRS coefficient in a wide spectral range, including the region of small Stokes shifts. A simple, approximate method is proposed for evaluating the SRS coefficient near a gain peak. Spectral dependences of the SRS coefficient are presented for various telecom fibres.

Brief Report: The Social Responsiveness Scale for Adults (SRS-A)-- Initial Results in a German Cohort

ERIC Educational Resources Information Center

Bolte, Sven

2012-01-01

The Social Responsiveness Scale (SRS) is a tool for quantitative autism assessment in children and adolescents. The SRS-A addresses social responsiveness in adulthood. Reliability and validity using the German adaptation of the SRS-A was examined in 20 adults with Autism Spectrum Disorder (ASD), 62 with other mental disorders (CLIN) and 163…

Preoperative Vs Postoperative Radiosurgery For Resected Brain Metastases: A Review.

PubMed

Prabhu, Roshan S; Patel, Kirtesh R; Press, Robert H; Soltys, Scott G; Brown, Paul D; Mehta, Minesh P; Asher, Anthony L; Burri, Stuart H

2018-05-16

Patients who undergo surgical resection of brain metastases are at significant risk of cavity local recurrence without additional radiation therapy. Postoperative stereotactic radiosurgery (SRS) is a method of focal treatment to the cavity to maximize local control while minimizing the risk of neurocognitive detriment associated with whole brain radiation therapy. Recently published randomized trials have demonstrated the benefit of postoperative SRS in terms of cavity tumor control and preserving neurocognition. However, there are several potential drawbacks with postoperative SRS including a possible increase in symptomatic radiation necrosis because of the need for cavity margin expansion due to target delineation uncertainty, the variable postoperative clinical course and potential delay in administering postoperative SRS, and the theoretical risk of tumor spillage into cerebrospinal fluid at the time of surgery. Preoperative SRS is an alternative paradigm wherein SRS is delivered prior to surgical resection, which may effectively address some of these potential drawbacks. The goal of this review is to examine the rationale, technique, outcomes, evidence, and future directions for the use of SRS as an adjunct to surgical resection. This can be delivered as either preoperative or postoperative SRS with potential advantages and disadvantages to both approaches that will be discussed.

Srs2 overexpression reveals a helicase-independent role at replication forks that requires diverse cell functions

PubMed Central

León Ortiz, Ana María; Reid, Robert J. D.; Dittmar, John C.; Rothstein, Rodney; Nicolas, Alain

2011-01-01

Srs2 is a 3’ to 5’ DNA helicase that regulates many aspects of DNA metabolism in Saccharomyces cerevisiae. It is best known for its ability to counteract homologous recombination by dismantling Rad51 filaments, but is also involved in checkpoint activation, adaptation and recovery, and in resolution of late recombination intermediates. To further address its biological roles and uncover new genetic interactions, we examined the consequences of overexpressing SRS2 as well as two helicase-dead mutants, srs2-K41A and srs2-K41R, in the collection of 4827 yeast haploid deletion mutants. We identified 274 genes affecting a large variety of cellular functions that are required for cell growth when SRS2 or its mutants are overexpressed. Further analysis of these interactions reveals that Srs2 acts independently of its helicase function at replication forks likely through its recruitment by the sumoylated PCNA replication clamp. This helicase-independent function is responsible for the negative interactions with DNA metabolism genes and for the toxicity of SRS2 overexpression in many of the diverse cellular pathways revealed in our screens. PMID:21459050

SRS: Site ranking system for hazardous chemical and radioactive waste

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

Rechard, R.P.; Chu, M.S.Y.; Brown, S.L.

1988-05-01

This report describes the rationale and presents instructions for a site ranking system (SRS). SRS ranks hazardous chemical and radioactive waste sites by scoring important and readily available factors that influence risk to human health. Using SRS, sites can be ranked for purposes of detailed site investigations. SRS evaluates the relative risk as a combination of potentially exposed population, chemical toxicity, and potential exposure of release from a waste site; hence, SRS uses the same concepts found in a detailed assessment of health risk. Basing SRS on the concepts of risk assessment tends to reduce the distortion of results foundmore » in other ranking schemes. More importantly, a clear logic helps ensure the successful application of the ranking procedure and increases its versatility when modifications are necessary for unique situations. Although one can rank sites using a detailed risk assessment, it is potentially costly because of data and resources required. SRS is an efficient approach to provide an order-of-magnitude ranking, requiring only readily available data (often only descriptive) and hand calculations. Worksheets are included to make the system easier to understand and use. 88 refs., 19 figs., 58 tabs.« less

The species recognition system: a new corollary for the human fetoembryonic defense system hypothesis.

PubMed

Clark, G F; Dell, A; Morris, H R; Patankar, M S; Easton, R L

2001-01-01

We have previously suggested that the human fetus is protected during human development by a system of both soluble and cell surface associated glycoconjugates that utilize their carbohydrate sequences as functional groups to enable them to evoke tolerance. The proposed model has been referred to as the human fetoembryonic defense system hypothesis (hu-FEDS). In this paradigm, it has previously been proposed that similar oligosaccharides are used to mediate crucial recognition events required during both human sperm-egg binding and immune-inflammatory cell interactions. This vertical integration suggested to us that the sperm-egg binding itself is related to universal recognition events that occur between immune and inflammatory cells, except that in this case recognition of 'species' rather than recognition of 'self' is being manifested. In this paper, we have designated this component of hu-FEDS as the species recognition system (SRS). We propose that the SRS is an integral component of the hu-FEDS used to enable sperm-egg recognition and protection of the gametes from potential immune responses. Recent structural data indicates that the glycan sequences implicated in mediating murine gamete recognition are also expressed on CD45 in activated murine T lymphocytes and cytotoxic T lymphocytes. This overlap supports our contention that there is an overlap between the immune and gamete recognition systems. Therefore the hu-FEDS paradigm may be a subset of a larger model that also applies to other placental mammals. We therefore propose that the hu-FEDS model for protection should in the future be referred to as the eutherian fetoembryonic defense system hypothesis (eu-FEDS) to account for this extension. The possibility exists that the SRS component of eu-FEDS could predate eutherians and extend to all sexually reproducing organisms. Future investigation of the interactions between the immune and gamete recognition system will be required to determine the degree of overlap. Copyright 2001 S. Karger AG, Basel

Spodumene, α-LiAlSi2O6 - A new natural SRS-active crystal with three χ(3)-promoting vibrational modes

NASA Astrophysics Data System (ADS)

Kaminskii, Alexander A.; Bohatý, Ladislav; Libowitzky, Eugen; Rhee, Hanjo; Lux, Oliver; Eichler, Hans J.; Kleinschrodt, Reiner; Yoneda, Hitoki; Shirakawa, Akira; Becker, Petra

2018-04-01

α-LiAlSi2O6, known as mineral spodumene, is introduced as a novel SRS-active crystal with monoclinic symmetry C2/c. Under picosecond laser excitation Raman-induced steady-state χ(3)-nonlinear generation in the visible and near-IR is observed in the crystals. All recorded Stokes and anti-Stokes high-order lasing components are identified and correspond to three SRS-promoting phonon modes with ωSRS1 ≈ 709 cm-1, ωSRS2 ≈ 357 cm-1 and ωSRS3 ≈ 1074 cm-1. On the basis of the results of a spontaneous Raman scattering study they were assigned to vibrations of the tetrahedral [SiO4] groups of the silicate chains and lattice modes of Li-O or Al-O of the crystal structure. A brief review in tabular form of so far known SRS-active natural crystals (minerals) is given as well.

Enterprise SRS: leveraging ongoing operations to advance nuclear fuel cycles research and development programs

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

Murray, A.M.; Marra, J.E.; Wilmarth, W.R.

2013-07-01

The Savannah River Site (SRS) is re-purposing its vast array of assets (including H Canyon - a nuclear chemical separation plant) to solve issues regarding advanced nuclear fuel cycle technologies, nuclear materials processing, packaging, storage and disposition. The vehicle for this transformation is Enterprise SRS which presents a new, radical view of SRS as a united endeavor for 'all things nuclear' as opposed to a group of distinct and separate entities with individual missions and organizations. Key among the Enterprise SRS strategic initiatives is the integration of research into SRS facilities but also in other facilities in conjunction with on-goingmore » missions to provide researchers from other national laboratories, academic institutions, and commercial entities the opportunity to demonstrate their technologies in a relevant environment and scale prior to deployment. To manage that integration of research demonstrations into site facilities, a center for applied nuclear materials processing and engineering research has been established in SRS.« less

Genetic labelling and application of the isoproturon-mineralizing Sphingomonas sp. strain SRS2 in soil and rhizosphere.

PubMed

Kristensen, K E; Jacobsen, C S; Hansen, L H; Aamand, J; Morgan, J A W; Sternberg, C; Sørensen, S R

2006-09-01

To construct a luxAB-labelled Sphingomonas sp. strain SRS2 maintaining the ability to mineralize the herbicide isoproturon and usable for monitoring the survival and distribution of strain SRS2 on plant roots in laboratory systems. We inserted the mini-Tn5-luxAB marker into strain SRS2 using conjugational mating. In the transconjugant mutants luciferase was produced in varying levels. The mutants showed significant differences in their ability to degrade isoproturon. One luxAB-labelled mutant maintained the ability to mineralize isoproturon and was therefore selected for monitoring colonization of barley roots. We successfully constructed a genetically labelled isoproturon-mineralizing-strain SRS2 and demonstrated its ability to survive in soil and its colonization of rhizosphere. The construction of a luxAB-labelled strain SRS2 maintaining the degradative ability, provides a powerful tool for ecological studies serving as the basis for evaluating SRS2 as a bioremediation agent.

A model for successful use of student response systems.

PubMed

Klein, Kathleen; Kientz, Mary

2013-01-01

This article presents a model developed to assist teachers in selecting, implementing, and assessing student response system (SRS) use in the classroom. Research indicates that SRS technology is effective in achieving desired outcomes in higher education settings. Studies indicate that effective SRS use promotes greater achievement of learning outcomes, increased student attention, improved class participation, and active engagement. The model offered in this article is based on best practices described in the literature and several years of SRS use in a traditional higher education classroom setting. Student feedback indicates increased class participation and engagement with SRS technology. Teacher feedback indicates opportunities for contingent teaching. The model described in this article provides a process to assist teachers in the successful selection, implementation, and assessment of SRS technology in the classroom.

First follow-up radiographic response is one of the predictors of local tumor progression and radiation necrosis after stereotactic radiosurgery for brain metastases.

PubMed

Sharma, Mayur; Jia, Xuefei; Ahluwalia, Manmeet; Barnett, Gene H; Vogelbaum, Michael A; Chao, Samuel T; Suh, John H; Murphy, Erin S; Yu, Jennifer S; Angelov, Lilyana; Mohammadi, Alireza M

2017-09-01

Local progression (LP) and radiation necrosis (RN) occur in >20% of cases following stereotactic radiosurgery (SRS) for brain metastases (BM). Expected outcomes following SRS for BM include tumor control/shrinkage, local progression and radiation necrosis. 1427 patients with 4283 BM lesions were treated using SRS at Cleveland Clinic from 2000 to 2012. Clinical, imaging and radiosurgery data were collected from the database. Local tumor progression and RN were the primary end points and correlated with patient and tumor-related variables. 5.7% of lesions developed radiographic RN and 3.6% showed local progression at 6 months. Absence of new extracranial metastasis (P < 0.001), response to SRS at first follow-up scan (local progression versus stable size (P < 0.001), partial resolution versus complete resolution at first follow up [P = 0.009]), prior SRS to the same lesion (P < 0.001), IDL% (≤55; P < 0.001), maximum tumor diameter (>0.9 cm; P < 0.001) and MD/PD gradient index (≤1.8, P < 0.001) were independent predictors of high risk of local tumor progression. Absence of systemic metastases (P = 0.029), good neurological function at 1st follow-up (P ≤ 0.001), no prior SRS to other lesion (P = 0.024), low conformity index (≤1.9) (P = 0.009), large maximum target diameter (>0.9 cm) (P = 0.003) and response to SRS (tumor progression vs. stable size following SRS [P < 0.001]) were independent predictors of high risk of radiographic RN. Complete tumor response at first follow-up, maximum tumor diameter <0.9 cm, tumor volume <2.4 cc and no prior SRS to the index lesion are good prognostic factors with reduced risk of LP following SRS. Complete tumor response to SRS, poor neurological function at first follow-up, prior SRS to other lesions and high conformity index are favorable factors for not developing RN. Stable or partial response at first follow-up after SRS have same impact on local progression and RN compared to those with complete resolution or progression. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

A prospective study validating a clinical scoring system and demonstrating phenotypical-genotypical correlations in Silver-Russell syndrome.

PubMed

Azzi, Salah; Salem, Jennifer; Thibaud, Nathalie; Chantot-Bastaraud, Sandra; Lieber, Eli; Netchine, Irène; Harbison, Madeleine D

2015-07-01

Multiple clinical scoring systems have been proposed for Silver-Russell syndrome (SRS). Here we aimed to test a clinical scoring system for SRS and to analyse the correlation between (epi)genotype and phenotype. Sixty-nine patients were examined by two physicians. Clinical scores were generated for all patients, with a new, six-item scoring system: (1) small for gestational age, birth length and/or weight ≤-2SDS, (2) postnatal growth retardation (height ≤-2SDS), (3) relative macrocephaly at birth, (4) body asymmetry, (5) feeding difficulties and/or body mass index (BMI) ≤-2SDS in toddlers; (6) protruding forehead at the age of 1-3 years. Subjects were considered to have likely SRS if they met at least four of these six criteria. Molecular investigations were performed blind to the clinical data. The 69 patients were classified into two groups (Likely-SRS (n=60), Unlikely-SRS (n=9)). Forty-six Likely-SRS patients (76.7%) displayed either 11p15 ICR1 hypomethylation (n=35; 58.3%) or maternal UPD of chromosome 7 (mUPD7) (n=11; 18.3%). Eight Unlikely-SRS patients had neither ICR1 hypomethylation nor mUPD7, whereas one patient had mUPD7. The clinical score and molecular results yielded four groups that differed significantly overall and for individual scoring system factors. Further molecular screening led identifying chromosomal abnormalities in Likely-SRS-double-negative and Unlikely-SRS groups. Four Likely-SRS-double negative patients carried a DLK1/GTL2 IG-DMR hypomethylation, a mUPD16; a mUPD20 and a de novo 1q21 microdeletion. This new scoring system is very sensitive (98%) for the detection of patients with SRS with demonstrated molecular abnormalities. Given its clinical and molecular heterogeneity, SRS could be considered as a spectrum. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Stereotactic Radiosurgery for Melanoma Brain Metastases in Patients Receiving Ipilimumab: Safety Profile and Efficacy of Combined Treatment

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

Kiess, Ana P.; Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York; Wolchok, Jedd D.

2015-06-01

Purpose: Ipilimumab (Ipi), a monoclonal antibody against cytotoxic T-lymphocyte antigen-4, has been shown to improve survival in patients with metastatic melanoma. In this single-institution study, we investigated the safety and efficacy of stereotactic radiosurgery (SRS) for patients with melanoma brain metastases (BMs) who also received Ipi. Methods and Materials: From 2005 to 2011, 46 patients with melanoma received Ipi and underwent single-fraction SRS for BMs. A total of 113 BMs (91% intact, 9% postoperative) were treated with a median dose of 21 Gy (range, 15-24 Gy). Ipi was given at 3 mg/kg (54%) or 10 mg/kg (46%) for a median of 4 doses (range,more » 1-21). Adverse events were recorded with the use of the Common Terminology Criteria for Adverse Events 3.0. Kaplan-Meier methods were used to estimate survival, and Cox regression was used to investigate associations. Results: Fifteen patients received SRS during Ipi, 19 received SRS before Ipi, and 12 received SRS after Ipi. Overall survival (OS) was significantly associated with the timing of SRS/Ipi (P=.035) and melanoma-specific graded prognostic assessment (P=.013). Patients treated with SRS during or before Ipi had better OS and less regional recurrence than did those treated with SRS after Ipi (1-year OS 65% vs 56% vs 40%, P=.008; 1-year regional recurrence 69% vs 64% vs 92%, P=.003). SRS during Ipi also yielded a trend toward less local recurrence than did SRS before or after Ipi (1-year local recurrence 0% vs 13% vs 11%, P=.21). On magnetic resonance imaging, an increase in BM diameter to >150% was seen in 50% of patients treated during or before Ipi but in only 13% of patients treated after Ipi. Grade 3 to 4 toxicities were seen in 20% of patients. Conclusion: Overall, the combination of Ipi and SRS appears to be well tolerated. Concurrent delivery of Ipi and SRS is associated with favorable locoregional control and possibly longer survival. It may also cause a temporary increase in tumor size, possibly because of an enhanced immunomodulatory effect.« less

The Savannah River Site's Groundwater Monitoring Program, third quarter 1991

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

Not Available

The Environmental Protection Department/Environmental Monitoring Section (EPD/EMS) administers the Savannah River Site's (SRS) Groundwater Monitoring Program. During third quarter 1991, EPD/EMS conducted extensive sampling of monitoring wells. Analytical results from third quarter 1991 are listed in this report.

Mapping Systematic Reviews on Atopic Eczema—An Essential Resource for Dermatology Professionals and Researchers

PubMed Central

Futamura, Masaki; Thomas, Kim S.; Grindlay, Douglas J. C.; Doney, Elizabeth J.; Torley, Donna; Williams, Hywel C.

2013-01-01

Background Many research studies have been published on atopic eczema and these are often summarised in systematic reviews (SRs). Identifying SRs can be time-consuming for health professionals, and researchers. In order to facilitate the identification of important research, we have compiled an on-line resource that includes all relevant eczema reviews published since 2000. Methods SRs were searched for in MEDLINE (Ovid), EMBASE (Ovid), PubMed, the Cochrane Database of Systematic Reviews, DARE and NHS Evidence. Selected SRs were assessed against the pre-defined eligibility criteria and relevant articles were grouped by treatment category for the included interventions. All identified systematic reviews are included in the Global Resource of EczemA Trials (GREAT) database (www.greatdatabase.org.uk) and key clinical messages are summarised here. Results A total of 128 SRs reviews were identified, including three clinical guidelines. Of these, 46 (36%) were found in the Cochrane Library. No single database contained all of the SRs found. The number of SRs published per year has increased substantially over the last thirteen years, and reviews were published in a variety of clinical journals. Of the 128 SRs, 1 (1%) was on mechanism, 37 (29%) were on epidemiology, 40 (31%) were on eczema prevention, 29 (23%) were on topical treatments, 31 (24%) were on systemic treatments, and 24 (19%) were on other treatments. All SRs included searches of MEDLINE in their search methods. One hundred six SRs (83%) searched more than one electronic database. There were no language restrictions reported in the search methods of 52 of the SRs (41%). Conclusions This mapping of atopic eczema reviews is a valuable resource. It will help healthcare practitioners, guideline writers, information specialists, and researchers to quickly identify relevant up-to-date evidence in the field for improving patient care. PMID:23505516

A Phase 3 Trial of Whole Brain Radiation Therapy and Stereotactic Radiosurgery Alone Versus WBRT and SRS With Temozolomide or Erlotinib for Non-Small Cell Lung Cancer and 1 to 3 Brain Metastases: Radiation Therapy Oncology Group 0320

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

Sperduto, Paul W., E-mail: psperduto@mropa.com; Wang, Meihua; Robins, H. Ian

2013-04-01

Background: A phase 3 Radiation Therapy Oncology Group (RTOG) study subset analysis demonstrated improved overall survival (OS) with the addition of stereotactic radiosurgery (SRS) to whole brain radiation therapy (WBRT) in non-small cell lung cancer (NSCLC) patients with 1 to 3 brain metastases. Because temozolomide (TMZ) and erlotinib (ETN) cross the blood-brain barrier and have documented activity in NSCLC, a phase 3 study was designed to test whether these drugs would improve the OS associated with WBRT + SRS. Methods and Materials: NSCLC patients with 1 to 3 brain metastases were randomized to receive WBRT (2.5 Gy × 15 tomore » 37.5 Gy) and SRS alone, versus WBRT + SRS + TMZ (75 mg/m{sup 2}/day × 21 days) or ETN (150 mg/day). ETN (150 mg/day) or TMZ (150-200 mg/m{sup 2}/day × 5 days/month) could be continued for as long as 6 months after WBRT + SRS. The primary endpoint was OS. Results: After 126 patients were enrolled, the study closed because of accrual limitations. The median survival times (MST) for WBRT + SRS, WBRT + SRS + TMZ, and WBRT + SRS + ETN were qualitatively different (13.4, 6.3, and 6.1 months, respectively), although the differences were not statistically significant. Time to central nervous system progression and performance status at 6 months were better in the WBRT + SRS arm. Grade 3 to 5 toxicity was 11%, 41%, and 49% in arms 1, 2, and 3, respectively (P<.001). Conclusion: The addition of TMZ or ETN to WBRT + SRS in NSCLC patients with 1 to 3 brain metastases did not improve survival and possibly had a deleterious effect. Because the analysis is underpowered, these data suggest but do not prove that increased toxicity was the cause of inferior survival in the drug arms.« less

A Phase 3 Trial of Whole Brain Radiation Therapy and Stereotactic Radiosurgery Alone Versus WBRT and SRS With Temozolomide or Erlotinib for Non-Small Cell Lung Cancer and 1 to 3 Brain Metastases: Radiation Therapy Oncology Group 0320.

PubMed Central

Sperduto, Paul W.; Wang, Meihua; Robins, H. Ian; Schell, Michael C.; Werner-Wasik, Maria; Komaki, Ritsuko; Souhami, Luis; Buyyounouski, Mark K.; Khuntia, Deepak; Demas, William; Shah, Sunjay A.; Nedzi, Lucien A.; Perry, Gad; Suh, John H.; Mehta, Minesh P.

2013-01-01

Background A phase 3 Radiation Therapy Oncology Group (RTOG) study subset analysis demonstrated improved overall survival (OS) with the addition of stereotactic radiosurgery (SRS) to whole brain radiation therapy (WBRT) in non-small cell lung cancer (NSCLC) patients with 1 to 3 brain metastases. Because temozolomide (TMZ) and erlotinib (ETN) cross the bloodbrain barrier and have documented activity in NSCLC, a phase 3 study was designed to test whether these drugs would improve the OS associated with WBRT + SRS. Methods and Materials NSCLC patients with 1 to 3 brain metastases were randomized to receive WBRT (2.5 Gy×15 to 37.5 Gy) and SRS alone, versus WBRT + SRS + TMZ (75 mg/m2/day× 21 days) or ETN (150 mg/day). ETN (150 mg/day) or TMZ (150–200 mg/m2/day ×5 days/month) could be continued for as long as 6 months after WBRT þ SRS. The primary endpoint was OS. Results After 126 patients were enrolled, the study closed because of accrual limitations. The median survival times (MST) for WBRT + SRS, WBRT + SRS + TMZ, and WBRT + SRS + ETN were qualitatively different (13.4, 6.3, and 6.1 months, respectively), although the differences were not statistically significant. Time to central nervous system progression and performance status at 6 months were better in the WBRT þ SRS arm. Grade 3 to 5 toxicity was 11%, 41%, and 49% in arms 1, 2, and 3, respectively (P<.001). Conclusion The addition of TMZ or ETN to WBRT + SRS in NSCLC patients with 1 to 3 brain metastases did not improve survival and possibly had a deleterious effect. Because the analysis is underpowered, these data suggest but do not prove that increased toxicity was the cause of inferior survival in the drug arms. PMID:23391814

A phase 3 trial of whole brain radiation therapy and stereotactic radiosurgery alone versus WBRT and SRS with temozolomide or erlotinib for non-small cell lung cancer and 1 to 3 brain metastases: Radiation Therapy Oncology Group 0320.

PubMed

Sperduto, Paul W; Wang, Meihua; Robins, H Ian; Schell, Michael C; Werner-Wasik, Maria; Komaki, Ritsuko; Souhami, Luis; Buyyounouski, Mark K; Khuntia, Deepak; Demas, William; Shah, Sunjay A; Nedzi, Lucien A; Perry, Gad; Suh, John H; Mehta, Minesh P

2013-04-01

A phase 3 Radiation Therapy Oncology Group (RTOG) study subset analysis demonstrated improved overall survival (OS) with the addition of stereotactic radiosurgery (SRS) to whole brain radiation therapy (WBRT) in non-small cell lung cancer (NSCLC) patients with 1 to 3 brain metastases. Because temozolomide (TMZ) and erlotinib (ETN) cross the blood-brain barrier and have documented activity in NSCLC, a phase 3 study was designed to test whether these drugs would improve the OS associated with WBRT + SRS. NSCLC patients with 1 to 3 brain metastases were randomized to receive WBRT (2.5 Gy × 15 to 37.5 Gy) and SRS alone, versus WBRT + SRS + TMZ (75 mg/m(2)/day × 21 days) or ETN (150 mg/day). ETN (150 mg/day) or TMZ (150-200 mg/m(2)/day × 5 days/month) could be continued for as long as 6 months after WBRT + SRS. The primary endpoint was OS. After 126 patients were enrolled, the study closed because of accrual limitations. The median survival times (MST) for WBRT + SRS, WBRT + SRS + TMZ, and WBRT + SRS + ETN were qualitatively different (13.4, 6.3, and 6.1 months, respectively), although the differences were not statistically significant. Time to central nervous system progression and performance status at 6 months were better in the WBRT + SRS arm. Grade 3 to 5 toxicity was 11%, 41%, and 49% in arms 1, 2, and 3, respectively (P<.001). The addition of TMZ or ETN to WBRT + SRS in NSCLC patients with 1 to 3 brain metastases did not improve survival and possibly had a deleterious effect. Because the analysis is underpowered, these data suggest but do not prove that increased toxicity was the cause of inferior survival in the drug arms. Copyright © 2013 Elsevier Inc. All rights reserved.

Technique of Whole-Sellar Stereotactic Radiosurgery for Cushing Disease: Results from a Multicenter, International Cohort Study.

PubMed

Shepard, Matthew J; Mehta, Gautam U; Xu, Zhiyuan; Kano, Hideyuki; Sisterson, Nathaniel; Su, Yan-Hua; Krsek, Michal; Nabeel, Ahmed M; El-Shehaby, Amr; Kareem, Khaled A; Martinez-Moreno, Nuria; Mathieu, David; McShane, Brendan J; Blas, Kevin; Kondziolka, Douglas; Grills, Inga; Lee, John Y; Martinez-Alvarez, Roberto; Reda, Wael A; Liscak, Roman; Lee, Cheng-Chia; Lunsford, L Dade; Lee Vance, Mary; Sheehan, Jason P

2018-05-18

Stereotactic radiosurgery (SRS) is used to manage patients with Cushing disease (CD) who have failed surgical/medical management. Because many patients with recurrent/persistent CD lack an identifiable adenoma on neuroimaging, whole-sellar SRS has been increasingly used. Thus, we sought to define the outcomes of patients undergoing whole-sellar SRS. An international, multicenter, retrospective cohort design was used to define clinical/endocrine outcomes for patients undergoing whole-sellar SRS for CD. Propensity-score matching was used to compare patients undergoing whole-sellar SRS and patients who underwent discreet adenoma-targeted SRS. A total of 68 patients underwent whole-sellar SRS, with a mean endocrine follow-up of 5.3 years. The mean treatment volume was 2.6 cm 3 , and the mean margin dose was 22.4 Gy. The 5-year actuarial remission rate was 75.9%, and the median time to remission was 12-months. Treatment volumes >1.6 cm 3 were associated with shorter times to remission (P < 0.05). The 5-year recurrence-free survival rate was 86.0%. Decreased margin and maximum treatment doses were associated with recurrence (P < 0.05). New pituitary hormone deficiency occurred in 15 patients (22.7%). An additional 210 patients were identified who underwent adenoma-targeted SRS. There was no difference in remission rate, time to remission, recurrence-free survival or new endocrinopathy development between patients who underwent whole-sellar SRS and those who underwent discreet adenoma-targeted SRS. Whole-sellar GKRS is effective in controlling CD when an adenoma is not clearly defined on imaging or when an invasive adenoma is suspected at the time of initial surgery. Patients who undergo whole-sellar SRS have outcomes and rates of new pituitary hormone deficiency similar to those of patients who undergo discrete adenoma-targeted GKRS. Copyright © 2018 Elsevier Inc. All rights reserved.

Leukoencephalopathy After Stereotactic Radiosurgery for Brain Metastases

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

Trifiletti, Daniel M., E-mail: daniel.trifiletti@gmail.com; Lee, Cheng-Chia; Schlesinger, David

Purpose: Although the use of stereotactic radiosurgery (SRS) in the treatment of multiple brain metastases has increased dramatically during the past decade to avoid the neurocognitive dysfunction induced by whole brain radiation therapy (WBRT), the cumulative neurocognitive effect of numerous SRS sessions remains unknown. Because leukoencephalopathy is a sensitive marker for radiation-induced central nervous system damage, we studied the clinical and dosimetric predictors of SRS-induced leukoencephalopathy. Methods and Materials: Patients treated at our institution with at least 2 sessions of SRS for brain metastases from 2007 to 2013 were reviewed. The pre- and post-SRS magnetic resonance imaging sequences were reviewedmore » and graded for white matter changes associated with radiation leukoencephalopathy using a previously validated scale. Patient characteristics and SRS dosimetric parameters were reviewed for factors that contributed to leukoencephalopathy using Cox proportional hazards modeling. Results: A total of 103 patients meeting the inclusion criteria were identified. The overall incidence of leukoencephalopathy was 29% at year 1, 38% at year 2, and 53% at year 3. Three factors were associated with radiation-induced leukoencephalopathy: (1) the use of WBRT (P=.019); (2) a higher SRS integral dose to the cranium (P=.036); and (3) the total number of intracranial metastases (P=.003). Conclusions: Our results have established that WBRT plus SRS produces leukoencephalopathy at a much higher rate than SRS alone. In addition, for patients who did not undergo WBRT before SRS, the integral dose was associated with the development of leukoencephalopathy. As the survival of patients with central nervous system metastases increases and as the neurotoxicity of chemotherapeutic and targeted agents becomes established, these 3 potential risk factors will be important to consider.« less

Self-organized coherent bursts of stimulated Raman scattering and speckle interaction in multi-speckled laser beams

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

Yin, L.; Albright, B. J.; Rose, H. A.

2013-01-15

Nonlinear physics governing the kinetic behavior of stimulated Raman scattering (SRS) in multi-speckled laser beams has been identified in the trapping regime over a wide range of k{lambda}{sub D} values (here k is the wave number of the electron plasma waves and {lambda}{sub D} is the Debye length) in homogeneous and inhomogeneous plasmas. Hot electrons from intense speckles, both forward and side-loss hot electrons produced during SRS daughter electron plasma wave bowing and filamentation, seed and enhance the growth of SRS in neighboring speckles by reducing Landau damping. Trapping-enhanced speckle interaction through transport of hot electrons, backscatter, and sidescatter SRSmore » light waves enable the system of speckles to self-organize and exhibit coherent, sub-ps SRS bursts with more than 100% instantaneous reflectivity, resulting in an SRS transverse coherence width much larger than a speckle width and a SRS spectrum that peaks outside the incident laser cone. SRS reflectivity is found to saturate above a threshold laser intensity at a level of reflectivity that depends on k{lambda}{sub D}: higher k{lambda}{sub D} leads to lower SRS and the reflectivity scales as {approx}(k{lambda}{sub D}){sup -4}. As k{lambda}{sub D} and Landau damping increase, speckle interaction via sidescattered light and side-loss hot electrons decreases and the occurrence of self-organized events becomes infrequent, leading to the reduction of time-averaged SRS reflectivity. It is found that the inclusion of a moderately strong magnetic field in the laser direction can effectively control SRS by suppressing transverse speckle interaction via hot electron transport.« less

Concordance between results of somatostatin receptor scintigraphy with 111In-DOTA-DPhe 1-Tyr 3-octreotide and chromogranin A assay in patients with neuroendocrine tumours.

PubMed

Rodrigues, Margarida; Gabriel, Michael; Heute, Dirk; Putzer, Daniel; Griesmacher, Andrea; Virgolini, Irene

2008-10-01

Somatostatin receptor scintigraphy (SRS) and chromogranin A (CgA) assay have successfully been implemented in the clinical work-up and management of neuroendocrine tumour (NET) patients. However, there is still a lack of studies comparing results in these patients. Our aim was to compare directly in NET patients SRS and CgA assay results with special regard to tumour features such as grade of malignancy, primary origin, disease extent and function. One hundred twenty consecutive patients with histological confirmed NETs were investigated with (111)In-DOTA-DPhe(1)-Tyr(3)-octreotide ((111)In-DOTA-TOC) SRS and CgA immunoradiometric assay. Tumours were classified by cell characteristics [well-differentiated NETs, well-differentiated neuroendocrine carcinomas, poorly differentiated neuroendocrine carcinomas (PDNECs)], primary origin (foregut, midgut, hindgut, undetermined), disease extent (limited disease, metastases, primary tumour and metastases) and functionality (secretory, nonsecretory). SRS was positive in 107 (89%) patients; CgA levels were increased in 95 (79%) patients. Overall, concordance between SRS and CgA results was found in 84 patients. Positive SRS but normal CgA level were found in 24 patients, with higher prevalence (p<0.05) in patients with nonsecretory tumours. Conversely, negative SRS but CgA level increased were seen in 12 patients, with higher proportion (p<0.05) in patients with PDNECs and tumours of hindgut origin. Overall, (111)In-DOTA-TOC SRS proved to be more sensitive than CgA in NETs patients. Tumour differentiation, disease extent and presence of liver metastases impact both SRS and CgA results, whereas nonsecretory activity is a negative predictor of only CgA increase. PDNECs and hindgut origin of tumours predispose to discrepancies with negative SRS but increased CgA levels.

A flood tide of systematic reviews on endodontic posts: methodological assessment using of R-AMSTAR.

PubMed

Schmitter, M; Sterzenbach, G; Faggion, C M; Krastl, G

2013-06-01

To help the dental practitioner solve a specific clinical problem, systematic reviews (SRs) are seen as the best guide. In addition to the unmanageable quantity of SRs, however, one should be aware of their variable quality. The present review describes the methodological quality of SRs on postendodontic restorations to work out the value of these reviews for the dental practitioner. SRs were searched in April 2012, independently and in triplicate. Post survival was used as measure of outcome. The methodological quality of included SRs was assessed with the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) checklist. Kappa statistics were used to assess reviewer agreement. Three hundred sixty-three papers were retrieved from the initial search. Ten SRs were included. One SR achieved a high R-AMSTAR score, whereas the other nine SRs achieved scores that indicate a substantial lack of methodological quality. Especially the items "grey literature," "combination of findings," "likelihood of publication bias," and conflict of interest" showed low R-AMSTAR scores. The three reviews with the highest R-AMSTAR scores tended to conclude that fewer failures occurred when using nonmetal posts. The reviewer agreement was excellent (kappa ranged from 0.79 to 0.85) in the R-AMSTAR classification. The approach presented revealed a lack of SRs with high methodological quality. Thus, no decisive conclusion can be drawn with respect to this topic. It appears that there is a trend for the superiority of fiber-reinforced posts. SRs must be of high methodological quality. This can be achieved by taking into consideration the results of this review. Improved methodological quality would make SRs more supportive for the general practitioner.

Clinical outcomes of patients treated with a second course of stereotactic radiosurgery for locally or regionally recurrent brain metastases after prior stereotactic radiosurgery.

PubMed

Kim, Daniel H; Schultheiss, Timothy E; Radany, Eric H; Badie, Behnam; Pezner, Richard D

2013-10-01

Patients with metastatic disease are living longer and may be confronted with locally or regionally recurrent brain metastases (BM) after prior stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT). This study analyzes outcomes in patients without prior whole brain radiotherapy (WBRT) who were treated with a second course of SRS/FSRT for locally or regionally recurrent BM. We identified 32 patients at our institution who were treated with a second course of SRS/FSRT after initial SRS/FSRT for newly diagnosed BM. We report clinical outcomes including local control, survival, and toxicities. Control rates and survival were calculated using Kaplan-Meier analysis and the multivariate proportional hazards model. The Kaplan-Meier estimate of local control at 6 months was 77 % for targets treated by a second course of SRS/FSRT with 11/71 (15 %) targets experiencing local failure. Multivariate analysis shows that upon re-treatment, local recurrences were more likely to fail than regional recurrences (OR 8.8, p = 0.02). Median survival for all patients from first SRS/FSRT was 14.6 months (5.3-72.2 months) and 7.9 months (0.7-61.1 months) from second SRS/FSRT. Thirty-eight percent of patients ultimately received WBRT as salvage therapy after the second SRS/FSRT. Seventy-one percent of patients died without active neurologic symptoms. The present study demonstrates that the majority of patients who progress after SRS/FSRT for newly diagnosed BM are candidates for salvage SRS/FSRT. By reserving WBRT for later salvage, we believe that a significant proportion of patients can avoid WBRT all together, thus putting fewer patients at risk for neurocognitive toxicity.

Differences in Clinical Results After LINAC-Based Single-Dose Radiosurgery Versus Fractionated Stereotactic Radiotherapy for Patients With Vestibular Schwannomas

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

Combs, Stephanie E., E-mail: Stephanie.Combs@med.uni-heidelberg.d; Welzel, Thomas; Schulz-Ertner, Daniela

2010-01-15

Purpose: To evaluate the outcomes of patients with vestibular schwannoma (VS) treated with fractionated stereotactic radiotherapy (FSRT) vs. those treated with stereotactic radiosurgery (SRS). Methods and Materials: This study is based on an analysis of 200 patients with 202 VSs treated with FSRT (n = 172) or SRS (n = 30). Patients with tumor progression and/or progression of clinical symptoms were selected for treatment. In 165 out of 202 VSs (82%), RT was performed as the primary treatment for VS, and for 37 VSs (18%), RT was conducted for tumor progression after neurosurgical intervention. For patients receiving FSRT, a medianmore » total dose of 57.6 Gy was prescribed, with a median fractionation of 5 x 1.8 Gy per week. For patients who underwent SRS, a median single dose of 13 Gy was prescribed to the 80% isodose. Results: FSRT and SRS were well tolerated. Median follow-up time was 75 months. Local control was not statistically different for both groups. The probability of maintaining the pretreatment hearing level after SRS with doses of <=13 Gy was comparable to that of FSRT. The radiation dose for the SRS group (<=13 Gy vs. >13 Gy) significantly influenced hearing preservation rates (p = 0.03). In the group of patients treated with SRS doses of <=13 Gy, cranial nerve toxicity was comparable to that of the FSRT group. Conclusions: FSRT and SRS are both safe and effective alternatives for the treatment of VS. Local control rates are comparable in both groups. SRS with doses of <=13 Gy is a safe alternative to FSRT. While FSRT can be applied safely for the treatment of VSs of all sizes, SRS should be reserved for smaller lesions.« less

Relapsed or refractory primary central nervous system lymphoma radiosurgery: Report of the International Gamma Knife Research Foundation.

PubMed

Shin, Samuel M; Silverman, Joshua S; Bowden, Greg; Mathieu, David; Yang, Huai-Che; Lee, Cheng-Chia; Tam, Moses; Szelemej, Paul; Kaufmann, Anthony M; Cohen-Inbar, Or; Sheehan, Jason; Niranjan, Ajay; Lunsford, L Dade; Kondziolka, Douglas

2017-01-01

Stereotactic radiosurgery (SRS) can be used as part of multimodality management for patients with primary central nervous system lymphoma (PCNSL). The objective of this study is to evaluate outcomes of SRS for this disease. The International Gamma Knife Research Foundation identified 23 PCNSL patients who underwent SRS for either relapsed (intracerebral in-field or out-of-field tumor recurrences) or refractory disease from 1995-2014. All 23 patients presented with RPA Class I or II PCNSL, and were initially treated with a median of 7 cycles of methotrexate-based chemotherapy regimens (range, 3-26 cycles). Ten received prior whole brain radiation (WBRT) to a median dose of 43 Gy (range, 24-55 Gy). Sixteen presented with relapsed PCNSL, and seven presented with refractory disease. Twenty-three received 26 procedures of SRS. The median tumor volume was 4 cm 3 (range, 0.1-26 cm 3 ), and the median margin dose was 15 Gy (range, 8-20 Gy). Median follow-up from SRS was 11 months (interquartile range, 5.7-33.2 months). Twenty presented with treatment response to twenty-three tumors (12 complete, 11 partial). Fourteen patients relapsed or were refractory to salvage SRS, and local control was 95%, 91%, and 75% at 3, 6, and 12 months post SRS. Intracranial (in-field and out-of-field) and distant (systemic) PFS was 86%, 81%, and 55% at 3, 6, and 12 months post SRS. Toxicity of SRS was low, with one developing an adverse radiation effect requiring no additional intervention. Although methotrexate-based chemotherapy regimens with or without WBRT is the first-line management option for PCNSL, SRS may be used as an alternative option in properly selected patients with smaller relapsed or refractory PCNSL tumors.

Long-term Outcomes With Planned Multistage Reduced Dose Repeat Stereotactic Radiosurgery for Treatment of Inoperable High-Grade Arteriovenous Malformations: An Observational Retrospective Cohort Study.

PubMed

Marciscano, Ariel E; Huang, Judy; Tamargo, Rafael J; Hu, Chen; Khattab, Mohamed H; Aggarwal, Sameer; Lim, Michael; Redmond, Kristin J; Rigamonti, Daniele; Kleinberg, Lawrence R

2017-07-01

There is no consensus regarding the optimal management of inoperable high-grade arteriovenous malformations (AVMs). This long-term study of 42 patients with high-grade AVMs reports obliteration and adverse event (AE) rates using planned multistage repeat stereotactic radiosurgery (SRS). To evaluate the efficacy and safety of multistage SRS with treatment of the entire AVM nidus at each treatment session to achieve complete obliteration of high-grade AVMs. Patients with high-grade Spetzler-Martin (S-M) III-V AVMs treated with at least 2 multistage SRS treatments from 1989 to 2013. Clinical outcomes of obliteration rate, minor/major AEs, and treatment characteristics were collected. Forty-two patients met inclusion criteria (n = 26, S-M III; n = 13, S-M IV; n = 3, S-M V) with a median follow-up was 9.5 yr after first SRS. Median number of SRS treatment stages was 2, and median interval between stages was 3.5 yr. Twenty-two patients underwent pre-SRS embolization. Complete AVM obliteration rate was 38%, and the median time to obliteration was 9.7 yr. On multivariate analysis, higher S-M grade was significantly associated ( P = .04) failure to achieve obliteration. Twenty-seven post-SRS AEs were observed, and the post-SRS intracranial hemorrhage rate was 0.027 events per patient year. Treatment of high-grade AVMs with multistage SRS achieves AVM obliteration in a meaningful proportion of patients with acceptable AE rates. Lower obliteration rates were associated with higher S-M grade and pre-SRS embolization. This approach should be considered with caution, as partial obliteration does not protect from hemorrhage. Copyright © 2017 by the Congress of Neurological Surgeons

SOARCA Peach Bottom Atomic Power Station Long-Term Station Blackout Uncertainty Analysis: Convergence of the Uncertainty Results

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

Bixler, Nathan E.; Osborn, Douglas M.; Sallaberry, Cedric Jean-Marie

2014-02-01

This paper describes the convergence of MELCOR Accident Consequence Code System, Version 2 (MACCS2) probabilistic results of offsite consequences for the uncertainty analysis of the State-of-the-Art Reactor Consequence Analyses (SOARCA) unmitigated long-term station blackout scenario at the Peach Bottom Atomic Power Station. The consequence metrics evaluated are individual latent-cancer fatality (LCF) risk and individual early fatality risk. Consequence results are presented as conditional risk (i.e., assuming the accident occurs, risk per event) to individuals of the public as a result of the accident. In order to verify convergence for this uncertainty analysis, as recommended by the Nuclear Regulatory Commission’s Advisorymore » Committee on Reactor Safeguards, a ‘high’ source term from the original population of Monte Carlo runs has been selected to be used for: (1) a study of the distribution of consequence results stemming solely from epistemic uncertainty in the MACCS2 parameters (i.e., separating the effect from the source term uncertainty), and (2) a comparison between Simple Random Sampling (SRS) and Latin Hypercube Sampling (LHS) in order to validate the original results obtained with LHS. Three replicates (each using a different random seed) of size 1,000 each using LHS and another set of three replicates of size 1,000 using SRS are analyzed. The results show that the LCF risk results are well converged with either LHS or SRS sampling. The early fatality risk results are less well converged at radial distances beyond 2 miles, and this is expected due to the sparse data (predominance of “zero” results).« less

A Bayesian network meta-analysis of whole brain radiotherapy and stereotactic radiotherapy for brain metastasis.

PubMed

Yuan, Xi; Liu, Wen-Jie; Li, Bing; Shen, Ze-Tian; Shen, Jun-Shu; Zhu, Xi-Xu

2017-08-01

This study was conducted to compare the effects of whole brain radiotherapy (WBRT) and stereotactic radiotherapy (SRS) in treatment of brain metastasis.A systematical retrieval in PubMed and Embase databases was performed for relative literatures on the effects of WBRT and SRS in treatment of brain metastasis. A Bayesian network meta-analysis was performed by using the ADDIS software. The effect sizes included odds ratio (OR) and 95% confidence interval (CI). A random effects model was used for the pooled analysis for all the outcome measures, including 1-year distant control rate, 1-year local control rate, 1-year survival rate, and complication. The consistency was tested by using node-splitting analysis and inconsistency standard deviation. The convergence was estimated according to the Brooks-Gelman-Rubin method.A total of 12 literatures were included in this meta-analysis. WBRT + SRS showed higher 1-year distant control rate than SRS. WBRT + SRS was better for the 1-year local control rate than WBRT. SRS and WBRT + SRS had higher 1-year survival rate than the WBRT. In addition, there was no difference in complication among the three therapies.Comprehensively, WBRT + SRS might be the choice of treatment for brain metastasis.

Ichthyoplankton entrainment study at the SRS Savannah River water intakes for Westinghouse Savannah River Company. Final report

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

Paller, M.

1992-03-26

Cooling water for L and K Reactors and makeup water for Par Pond is pumped from the Savannah River at the 1G, 3G, and 5G pump houses. Ichthyoplankton (drifting fish larvae and eggs) from the river are entrained into the reactor cooling systems with the river water and passed through the reactor`s heat exchangers where temperatures may reach 70{degrees}C during full power operation. Ichthyoplankton mortality under such conditions is assumed to be 100 percent. The number of ichthyoplankton entrained into the cooling system depends on a variety of variables, including time of year, density and distribution of ichthyoplankton in themore » river, discharge levels in the river, and the volume of water withdrawn by the pumps. Entrainment at the 1 G pump house, which is immediately downstream from the confluence of Upper Three Runs Creek and the Savannah River, is also influenced by discharge rates and ichthyoplankton densities in Upper Three Runs Creek. Because of the anticipated restart of several SRS reactors and the growing concern surrounding striped bass and American shad stocks in the Savannah River, the Department of Energy requested that the Environmental Sciences Section (ESS) of the Savannah River Laboratory sample ichthyoplankton at the SRS Savannah River intakes. Dams & Moore, Inc., under a contract with Westinghouse Savannah River Company performed the sampling and data analysis for the ESS.« less

Monoclinic β-BaY2F8—a novel crystal simultaneously active for SRS and Ln3+-ion lasing

NASA Astrophysics Data System (ADS)

Kaminskii, A. A.; Lux, O.; Hanuza, J.; Rhee, H.; Eichler, H. J.; Zhang, J.; Tang, D.; Shen, D.; Yu, H.; Wang, J.; Yoneda, H.; Shirakawa, A.

2015-01-01

This paper presents the first investigation of stimulated Raman scattering (SRS) in the monoclinic fluoride crystal β-BaY2F8, which is known as a promising host-material for trivalent lanthanide (Ln3+) lasant ions. Picosecond laser excitation in the visible and near-IR spectral range at room temperature revealed the manifestation of nine SRS-promoting phonon modes, which are related to Ag and Bg vibrations of the crystal. Besides multi-phonon Stokes and anti-Stokes generation, we observed cross-cascaded χ(3) ↔ χ(3) processes involving different pairs of SRS-active phonons. A comparative estimation of the first Stokes steady-state Raman gain coefficients, both in the visible and near-IR region related to the most active SRS-phonon mode ωSRS1 ≈ 208 cm-1 of β-BaY2F8, was also performed. Furthermore, a brief review of the pioneering papers on laser action of Ln3+-ions doped in β-BaY2F8 single crystals and other known SRS-active fluoride crystals is given in tabular form.

The Savannah River Site`s Groundwater Monitoring Program, third quarter 1991

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

Not Available

The Environmental Protection Department/Environmental Monitoring Section (EPD/EMS) administers the Savannah River Site`s (SRS) Groundwater Monitoring Program. During third quarter 1991, EPD/EMS conducted extensive sampling of monitoring wells. Analytical results from third quarter 1991 are listed in this report.

Classification of epileptic EEG signals based on simple random sampling and sequential feature selection.

PubMed

Ghayab, Hadi Ratham Al; Li, Yan; Abdulla, Shahab; Diykh, Mohammed; Wan, Xiangkui

2016-06-01

Electroencephalogram (EEG) signals are used broadly in the medical fields. The main applications of EEG signals are the diagnosis and treatment of diseases such as epilepsy, Alzheimer, sleep problems and so on. This paper presents a new method which extracts and selects features from multi-channel EEG signals. This research focuses on three main points. Firstly, simple random sampling (SRS) technique is used to extract features from the time domain of EEG signals. Secondly, the sequential feature selection (SFS) algorithm is applied to select the key features and to reduce the dimensionality of the data. Finally, the selected features are forwarded to a least square support vector machine (LS_SVM) classifier to classify the EEG signals. The LS_SVM classifier classified the features which are extracted and selected from the SRS and the SFS. The experimental results show that the method achieves 99.90, 99.80 and 100 % for classification accuracy, sensitivity and specificity, respectively.

Near-Infrared Spatially Resolved Spectroscopy for Tablet Quality Determination.

PubMed

Igne, Benoît; Talwar, Sameer; Feng, Hanzhou; Drennen, James K; Anderson, Carl A

2015-12-01

Near-infrared (NIR) spectroscopy has become a well-established tool for the characterization of solid oral dosage forms manufacturing processes and finished products. In this work, the utility of a traditional single-point NIR measurement was compared with that of a spatially resolved spectroscopic (SRS) measurement for the determination of tablet assay. Experimental designs were used to create samples that allowed for calibration models to be developed and tested on both instruments. Samples possessing a poor distribution of ingredients (highly heterogeneous) were prepared by under-blending constituents prior to compaction to compare the analytical capabilities of the two NIR methods. The results indicate that SRS can provide spatial information that is usually obtainable only through imaging experiments for the determination of local heterogeneity and detection of abnormal tablets that would not be detected with single-point spectroscopy, thus complementing traditional NIR measurement systems for in-line, and in real-time tablet analysis. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association.

Spinal appearance questionnaire: factor analysis, scoring, reliability, and validity testing.

PubMed

Carreon, Leah Y; Sanders, James O; Polly, David W; Sucato, Daniel J; Parent, Stefan; Roy-Beaudry, Marjolaine; Hopkins, Jeffrey; McClung, Anna; Bratcher, Kelly R; Diamond, Beverly E

2011-08-15

Cross sectional. This study presents the factor analysis of the Spinal Appearance Questionnaire (SAQ) and its psychometric properties. Although the SAQ has been administered to a large sample of patients with adolescent idiopathic scoliosis (AIS) treated surgically, its psychometric properties have not been fully evaluated. This study presents the factor analysis and scoring of the SAQ and evaluates its psychometric properties. The SAQ and the Scoliosis Research Society-22 (SRS-22) were administered to AIS patients who were being observed, braced or scheduled for surgery. Standard demographic data and radiographic measures including Lenke type and curve magnitude were also collected. Of the 1802 patients, 83% were female; with a mean age of 14.8 years and mean initial Cobb angle of 55.8° (range, 0°-123°). From the 32 items of the SAQ, 15 loaded on two factors with consistent and significant correlations across all Lenke types. There is an Appearance (items 1-10) and an Expectations factor (items 12-15). Responses are summed giving a range of 5 to 50 for the Appearance domain and 5 to 20 for the Expectations domain. The Cronbach's α was 0.88 for both domains and Total score with a test-retest reliability of 0.81 for Appearance and 0.91 for Expectations. Correlations with major curve magnitude were higher for the SAQ Appearance and SAQ Total scores compared to correlations between the SRS Appearance and SRS Total scores. The SAQ and SRS-22 Scores were statistically significantly different in patients who were scheduled for surgery compared to those who were observed or braced. The SAQ is a valid measure of self-image in patients with AIS with greater correlation to curve magnitude than SRS Appearance and Total score. It also discriminates between patients who require surgery from those who do not.

Using ontology-based semantic similarity to facilitate the article screening process for systematic reviews.

PubMed

Ji, Xiaonan; Ritter, Alan; Yen, Po-Yin

2017-05-01

Systematic Reviews (SRs) are utilized to summarize evidence from high quality studies and are considered the preferred source of evidence-based practice (EBP). However, conducting SRs can be time and labor intensive due to the high cost of article screening. In previous studies, we demonstrated utilizing established (lexical) article relationships to facilitate the identification of relevant articles in an efficient and effective manner. Here we propose to enhance article relationships with background semantic knowledge derived from Unified Medical Language System (UMLS) concepts and ontologies. We developed a pipelined semantic concepts representation process to represent articles from an SR into an optimized and enriched semantic space of UMLS concepts. Throughout the process, we leveraged concepts and concept relations encoded in biomedical ontologies (SNOMED-CT and MeSH) within the UMLS framework to prompt concept features of each article. Article relationships (similarities) were established and represented as a semantic article network, which was readily applied to assist with the article screening process. We incorporated the concept of active learning to simulate an interactive article recommendation process, and evaluated the performance on 15 completed SRs. We used work saved over sampling at 95% recall (WSS95) as the performance measure. We compared the WSS95 performance of our ontology-based semantic approach to existing lexical feature approaches and corpus-based semantic approaches, and found that we had better WSS95 in most SRs. We also had the highest average WSS95 of 43.81% and the highest total WSS95 of 657.18%. We demonstrated using ontology-based semantics to facilitate the identification of relevant articles for SRs. Effective concepts and concept relations derived from UMLS ontologies can be utilized to establish article semantic relationships. Our approach provided a promising performance and can easily apply to any SR topics in the biomedical domain with generalizability. Copyright © 2017 Elsevier Inc. All rights reserved.

Dental caries imaging using hyperspectral stimulated Raman scattering microscopy

NASA Astrophysics Data System (ADS)

Wang, Zi; Zheng, Wei; Jian, Lin; Huang, Zhiwei

2016-03-01

We report the development of a polarization-resolved hyperspectral stimulated Raman scattering (SRS) imaging technique based on a picosecond (ps) laser-pumped optical parametric oscillator system for label-free imaging of dental caries. In our imaging system, hyperspectral SRS images (512×512 pixels) in both fingerprint region (800-1800 cm-1) and high-wavenumber region (2800-3600 cm-1) are acquired in minutes by scanning the wavelength of OPO output, which is a thousand times faster than conventional confocal micro Raman imaging. SRS spectra variations from normal enamel to caries obtained from the hyperspectral SRS images show the loss of phosphate and carbonate in the carious region. While polarization-resolved SRS images at 959 cm-1 demonstrate that the caries has higher depolarization ratio. Our results demonstrate that the polarization resolved-hyperspectral SRS imaging technique developed allows for rapid identification of the biochemical and structural changes of dental caries.

Emerging Trends in the Management of Brain Metastases from Non-small Cell Lung Cancer.

PubMed

Churilla, Thomas M; Weiss, Stephanie E

2018-05-07

To summarize current approaches in the management of brain metastases from non-small cell lung cancer (NSCLC). Local treatment has evolved from whole-brain radiotherapy (WBRT) to increasing use of stereotactic radiosurgery (SRS) alone for patients with limited (1-4) brain metastases. Trials have established post-operative SRS as an alternative to adjuvant WBRT following resection of brain metastases. Second-generation TKIs for ALK rearranged NSCLC have demonstrated improved CNS penetration and activity. Current brain metastasis trials are focused on reducing cognitive toxicity: hippocampal sparing WBRT, SRS for 5-15 metastases, pre-operative SRS, and use of systemic targeted agents or immunotherapy. The role for radiotherapy in the management of brain metastases is becoming better defined with local treatment shifting from WBRT to SRS alone for limited brain metastases and post-operative SRS for resected metastases. Further trials are warranted to define the optimal integration of newer systemic agents with local therapies.

Physiological and Comparative Genomic Analysis of Arthrobacter sp. SRS-W-1-2016 Provides Insights on Niche Adaptation for Survival in Uraniferous Soils

PubMed Central

Chauhan, Ashvini; Pathak, Ashish; Jaswal, Rajneesh; Edwards, Bobby; Chappell, Demario; Ball, Christopher; Garcia-Sillas, Reyna; Stothard, Paul; Seaman, John

2018-01-01

Arthrobacter sp. strain SRS-W-1-2016 was isolated on high concentrations of uranium (U) from the Savannah River Site (SRS) that remains co-contaminated by radionuclides, heavy metals, and organics. SRS is located on the northeast bank of the Savannah River (South Carolina, USA), which is a U.S. Department of Energy (DOE) managed ecosystem left historically contaminated from decades of nuclear weapons production activities. Predominant contaminants within the impacted SRS environment include U and Nickel (Ni), both of which can be transformed microbially into less toxic forms via metal complexation mechanisms. Strain SRS-W-1-2016 was isolated from the uraniferous SRS soils on high concentrations of U (4200 μM) and Ni (8500 μM), but rapid growth was observed at much lower concentrations of 500 μM U and 1000 μM Ni, respectively. Microcosm studies established with strain SRS-W-1-2016 revealed a rapid decline in the concentration of spiked U such that it was almost undetectable in the supernatant by 72 h of incubation. Conversely, Ni concentrations remained unchanged, suggesting that the strain removed U but not Ni under the tested conditions. To obtain a deeper understanding of the metabolic potential, a draft genome sequence of strain SRS-W-1-2016 was obtained at a coverage of 90×, assembling into 93 contigs with an N50 contig length of 92,788 bases. The genomic size of strain SRS-W-1-2016 was found to be 4,564,701 bases with a total number of 4327 putative genes. An in-depth, genome-wide comparison between strain SRS-W-1-2016 and its four closest taxonomic relatives revealed 1159 distinct genes, representing 26.7% of its total genome; many associating with metal resistance proteins (e.g., for cadmium, cobalt, and zinc), transporter proteins, stress proteins, cytochromes, and drug resistance functions. Additionally, several gene homologues coding for resistance to metals were identified in the strain, such as outer membrane efflux pump proteins, peptide/nickel transport substrate and ATP-binding proteins, a high-affinity nickel-transport protein, and the spoT gene, which was recently implicated in bacterial resistance towards U. Detailed genome mining analysis of strain SRS-W-1-2016 also revealed the presence of a plethora of secondary metabolite biosynthetic gene clusters likely facilitating resistance to antibiotics, biocides, and metals. Additionally, several gene homologous for the well-known oxygenase enzyme system were also identified, potentially functioning to generate energy via the breakdown of organic compounds and thus enabling the successful colonization and natural attenuation of contaminants by Arthrobacter sp. SRS-W-1-2016 at the SRS site. PMID:29324691

Physiological and Comparative Genomic Analysis of Arthrobacter sp. SRS-W-1-2016 Provides Insights on Niche Adaptation for Survival in Uraniferous Soils.

PubMed

Chauhan, Ashvini; Pathak, Ashish; Jaswal, Rajneesh; Edwards, Bobby; Chappell, Demario; Ball, Christopher; Garcia-Sillas, Reyna; Stothard, Paul; Seaman, John

2018-01-11

Arthrobacter sp. strain SRS-W-1-2016 was isolated on high concentrations of uranium (U) from the Savannah River Site (SRS) that remains co-contaminated by radionuclides, heavy metals, and organics. SRS is located on the northeast bank of the Savannah River (South Carolina, USA), which is a U.S. Department of Energy (DOE) managed ecosystem left historically contaminated from decades of nuclear weapons production activities. Predominant contaminants within the impacted SRS environment include U and Nickel (Ni), both of which can be transformed microbially into less toxic forms via metal complexation mechanisms. Strain SRS-W-1-2016 was isolated from the uraniferous SRS soils on high concentrations of U (4200 μM) and Ni (8500 μM), but rapid growth was observed at much lower concentrations of 500 μM U and 1000 μM Ni, respectively. Microcosm studies established with strain SRS-W-1-2016 revealed a rapid decline in the concentration of spiked U such that it was almost undetectable in the supernatant by 72 h of incubation. Conversely, Ni concentrations remained unchanged, suggesting that the strain removed U but not Ni under the tested conditions. To obtain a deeper understanding of the metabolic potential, a draft genome sequence of strain SRS-W-1-2016 was obtained at a coverage of 90×, assembling into 93 contigs with an N50 contig length of 92,788 bases. The genomic size of strain SRS-W-1-2016 was found to be 4,564,701 bases with a total number of 4327 putative genes. An in-depth, genome-wide comparison between strain SRS-W-1-2016 and its four closest taxonomic relatives revealed 1159 distinct genes, representing 26.7% of its total genome; many associating with metal resistance proteins (e.g., for cadmium, cobalt, and zinc), transporter proteins, stress proteins, cytochromes, and drug resistance functions. Additionally, several gene homologues coding for resistance to metals were identified in the strain, such as outer membrane efflux pump proteins, peptide/nickel transport substrate and ATP-binding proteins, a high-affinity nickel-transport protein, and the spoT gene, which was recently implicated in bacterial resistance towards U. Detailed genome mining analysis of strain SRS-W-1-2016 also revealed the presence of a plethora of secondary metabolite biosynthetic gene clusters likely facilitating resistance to antibiotics, biocides, and metals. Additionally, several gene homologous for the well-known oxygenase enzyme system were also identified, potentially functioning to generate energy via the breakdown of organic compounds and thus enabling the successful colonization and natural attenuation of contaminants by Arthrobacter sp. SRS-W-1-2016 at the SRS site.

ALK-FISH borderline cases in non-small cell lung cancer: Implications for diagnostics and clinical decision making.

PubMed

von Laffert, Maximilian; Stenzinger, Albrecht; Hummel, Michael; Weichert, Wilko; Lenze, Dido; Warth, Arne; Penzel, Roland; Herbst, Hermann; Kellner, Udo; Jurmeister, Philipp; Schirmacher, Peter; Dietel, Manfred; Klauschen, Frederick

2015-12-01

Fluorescence in-situ hybridization (FISH) for the detection of ALK-rearrangements in non-small cell lung cancer (NSCLC) is based on at first sight clear cut-off criteria (≥15% of tumor cells) for split signals (SS) and single red signals (SRS). However, NSCLC with SS-counts around the cut-off may cause interpretation problems. Tissue microarrays containing 753 surgically resected NSCLCs were independently tested for ALK-alterations by FISH and immunohistochemistry (IHC). Our analysis focused on samples with SS/SRS in the range between 10% and 20% (ALK-FISH borderline group). To better understand the role of these samples in routine diagnostics, we performed statistical analyses to systematically estimate the probability of ALK-FISH-misclassification (false negative or positive) for different numbers of evaluated tumor cell nuclei (30, 50, 100, and 200). 94.3% (710/753) of the cases were classified as unequivocally (<10% or ≥20%) ALK-FISH-negative (93%; 700/753) or positive (1.3%; 10/753) and showed concordant IHC results. 5.7% (43/753) of the samples showed SS/SRS between 10% and 20% of the tumor cells. Out of these, 7% (3/43; ALK-FISH: 14%, 18% and 20%) were positive by ALK-IHC, while 93% (40/43) had no detectable expression of the ALK-protein. Statistical analysis showed that ALK-FISH misclassifications occur frequently for samples with rearrangements between 10% and 20% if ALK-characterization is based on a sharp cut-off point (15%). If results in this interval are defined as equivocal (borderline), statistical sampling-related ALK-FISH misclassifications will occur in less than 1% of the cases if 100 tumor cells are evaluated. While ALK status can be determined robustly for the majority of NSCLC by FISH our analysis showed that ∼6% of the cases belong to a borderline group for which ALK-FISH evaluation has only limited reliability due to statistical sampling effects. These cases should be considered equivocal and therapy decisions should include additional tests and clinical considerations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Gamma Knife radiosurgery for hemangioma of the cavernous sinus.

PubMed

Lee, Cheng-Chia; Sheehan, Jason P; Kano, Hideyuki; Akpinar, Berkcan; Martinez-Alvarez, Roberto; Martinez-Moreno, Nuria; Guo, Wan-Yuo; Lunsford, L Dade; Liu, Kang-Du

2017-05-01

OBJECTIVE Cavernous sinus hemangiomas (CSHs) are rare vascular tumors. A direct microsurgical approach usually results in massive hemorrhage and incomplete tumor resection. Although stereotactic radiosurgery (SRS) has emerged as a therapeutic alternative to microsurgery, outcome studies are few. Authors of the present study evaluated the role of SRS for CSH. METHODS An international multicenter study was conducted to review outcome data in 31 patients with CSH. Eleven patients had initial microsurgery before SRS, and the other 20 patients (64.5%) underwent Gamma Knife SRS as the primary management for their CSH. Median age at the time of radiosurgery was 47 years, and 77.4% of patients had cranial nerve dysfunction before SRS. Patients received a median tumor margin dose of 12.6 Gy (range 12-19 Gy) at a median isodose of 55%. RESULTS Tumor regression was confirmed by imaging in all 31 patients, and all patients had greater than 50% reduction in tumor volume at 6 months post-SRS. No patient had delayed tumor growth, new cranial neuropathy, visual function deterioration, adverse radiation effects, or hypopituitarism after SRS. Twenty-four patients had presented with cranial nerve disorders before SRS, and 6 (25%) of them had gradual improvement. Four (66.7%) of the 6 patients with orbital symptoms had symptomatic relief at the last follow-up. CONCLUSIONS Stereotactic radiosurgery was effective in reducing the volume of CSH and attaining long-term tumor control in all patients at a median of 40 months. The authors' experience suggests that SRS is a reasonable primary and adjuvant treatment modality for patients in whom a CSH is diagnosed.

Microsurgery Versus Stereotactic Radiosurgery for Brain Arteriovenous Malformations: A Matched Cohort Study.

PubMed

Chen, Ching-Jen; Ding, Dale; Wang, Tony R; Buell, Thomas J; Ilyas, Adeel; Ironside, Natasha; Lee, Cheng-Chia; Kalani, M Yashar; Park, Min S; Liu, Kenneth C; Sheehan, Jason P

2018-05-12

Microsurgery (MS) and stereotactic radiosurgery (SRS) remain the preferred interventions for the curative treatment of brain arteriovenous malformations (AVM), but their relative efficacy remains incompletely defined. To compare the outcomes of MS to SRS for AVMs through a retrospective, matched cohort study. We evaluated institutional databases of AVM patients who underwent MS and SRS. MS-treated patients were matched, in a 1:1 ratio based on patient and AVM characteristics, to SRS-treated patients. Statistical analyses were performed to compare outcomes data between the 2 cohorts. The primary outcome was defined as AVM obliteration without a new permanent neurological deficit. The matched MS and SRS cohorts were each comprised of 59 patients. Both radiological (85 vs 11 mo; P < .001) and clinical (92 vs 12 mo; P < .001) follow-up were significantly longer for the SRS cohort. The primary outcome was achieved in 69% of each cohort. The MS cohort had a significantly higher obliteration rate (98% vs 72%; P = .001), but also had a significantly higher rate of new permanent deficit (31% vs 10%; P = .011). The posttreatment hemorrhage rate was significantly higher for the SRS cohort (10% for SRS vs 0% for MS; P = .027). In subgroup analyses of ruptured and unruptured AVMs, no significant differences between the primary outcomes were observed. For patients with comparable AVMs, MS and SRS afford similar rates of deficit-free obliteration. Nidal obliteration is more frequently achieved with MS, but this intervention also incurs a greater risk of new permanent neurological deficit.

Why SRS Matters - Introduction

ScienceCinema

Hunt, Paul

2018-01-16

A video series presenting an overview of the Savannah River Site's (SRS) mission and operations. Each episode features a specific area/operation and how it contributes to help make the world safer. This episode provides an introduction to the SRS mission and operations.

A superparticle on the super Riemann surface

NASA Astrophysics Data System (ADS)

Matsumoto, Shuji; Uehara, Shozo; Yasui, Yukinori

1990-02-01

The free motion of a nonrelativistic superparticle on the super Riemann surface (SRS) of genus h≥2 is investigated. Geodesics or classical paths are given explicitly on the super Poincaré upper half-plane SH, a universal covering space of the SRS, and the paths with some suitable initial conditions yield periodic orbits on the SRS. The periodic orbits are unstable and the system is chaotic. Quantum mechanics is solved on the universal covering space SH and the heat kernel is given on the SRS. This leads to a superanalog of the Selberg trace formula. The Selberg super zeta function is introduced whose zero points and poles determine the energy spectrum on the SRS.

A field evaluation of a satellite microwave rainfall sensor network

NASA Astrophysics Data System (ADS)

Caridi, Andrea; Caviglia, Daniele D.; Colli, Matteo; Delucchi, Alessandro; Federici, Bianca; Lanza, Luca G.; Pastorino, Matteo; Randazzo, Andrea; Sguerso, Domenico

2017-04-01

An innovative environmental monitoring system - Smart Rainfall System (SRS) - that estimates rainfall in real-time by means of the analysis of the attenuation of satellite signals (DVB-S in the microwave Ku band) is presented. Such a system consists in a set of peripheral microwave sensors placed on the field of interest, and connected to a central processing and analysis node. It has been developed jointly by the University of Genoa, with its departments DITEN and DICCA and the Genoese SME "Darts Engineering Srl". This work discusses the rainfall intensity measurements accuracy and sensitivity performance of SRS, based on preliminary results from a field comparison experiment at the urban scale. The test-bed is composed by a set of preliminary measurement sites established from Autumn 2016 in the Genoa (Italy) municipality and the data collected from the sensors during a selection of rainfall events is studied. The availability of point-scale rainfall intensity measurements made by traditional tipping-bucket rain gauges and radar areal observations allows a comparative analysis of the SRS performance. The calibration of the reference rain gauges has been carried out at the laboratories of DICCA using a rainfall simulator and the measurements have been processed taking advantage of advanced algorithms to reduce counting errors. The experimental set-up allows a fine tuning of the retrieval algorithm and a full characterization of the accuracy of the rainfall intensity estimates from the microwave signal attenuation as a function of different precipitation regimes.

99mTc-EDDA/HYNIC-octreotate in detection of atypical bronchial carcinoid.

PubMed

Hubalewska-Dydejczyk, A; Fröss-Baron, K; Gołkowski, F; Sowa-Staszczak, A; Mikołajczak, R; Huszno, B

2007-01-01

Pulmonary carcinoids cause serious difficulties in imaging diagnostics in all stages of the disease. SRS holds great promise for detecting occult primary tu and metastatic lesions. (99m)Tc-EDDA/HYNIC-octreotate, a new scintigraphic agent, should significantly improve sensitivity of the diagnostics of carcinoids due to better affinity to SSR2 than (111)In-Octreoscan and the higher count rate obtained from (99m)Tc over (111)In. We present a case of a 40-year-old women operated on because of lung carcinoid tumour in 2002. The symptoms did not resolve after the operation and 5-OHIAA was still elevated. The thorax spiral CT revealed the focal lesion beneath carina. (111)In-Octreoscan and (99m)Tc-EDDA/HYNIC-octreotate SRS revealed two focal lesions in the mediastinum. (99m)Tc-EDDA/HYNIC-octreotate detected two additional lesions in the lower part of the right lung. Target/non-target count ratios of the lesions were as follows: (99m)Tc-EDDA/HYNIC-octreotate scans - 2,9, (111)In-Octreoscan- 2,1. PET-FDG examination revealed no pathology. Owing to severe bone pains and carcinoid symptoms the patient was referred for the 90Y-DOTA-octreotate treatment. SRS with a new 99mTc marked somatostatin analogue - octreotate allows for a more sensitive detection of metastatic leasions in carcinoid tumours. The usefulness of 18F-FDG PET, widely used as a powerful imaging technique in clinical oncology, is limited in detection of carcinoid tumours due to the low proliferative activity.

Stereotactic radiosurgery for patients with multiple brain metastases: a case-matched study comparing treatment results for patients with 2-9 versus 10 or more tumors.

PubMed

Yamamoto, Masaaki; Kawabe, Takuya; Sato, Yasunori; Higuchi, Yoshinori; Nariai, Tadashi; Watanabe, Shinya; Kasuya, Hidetoshi

2014-12-01

Although stereotactic radiosurgery (SRS) alone is not a standard treatment for patients with 4-5 tumors or more, a recent trend has been for patients with 5 or more, or even 10 or more, tumors to undergo SRS alone. The aim of this study was to reappraise whether the treatment results for SRS alone for patients with 10 or more tumors differ from those for patients with 2-9 tumors. This was an institutional review board-approved, retrospective cohort study that gathered data from the Katsuta Hospital Mito GammaHouse prospectively accumulated database. Data were collected for 2553 patients who consecutively had undergone Gamma Knife SRS alone, without whole-brain radiotherapy (WBRT), for newly diagnosed (mostly) or recurrent (uncommonly) brain metastases during 1998-2011. Of these 2553 patients, 739 (28.9%) with a single tumor were excluded, leaving 1814 with multiple metastases in the study. These 1814 patients were divided into 2 groups: those with 2-9 tumors (Group A, 1254 patients) and those with 10 or more tumors (Group B, 560 patients). Because of considerable bias in pre-SRS clinical factors between groups A and B, a case-matched study, which used the propensity score matching method, was conducted for clinical factors (i.e., age, sex, primary tumor state, extracerebral metastases, Karnofsky Performance Status, neurological symptoms, prior procedures [surgery and WBRT], volume of the largest tumor, and peripheral doses). Ultimately, 720 patients (360 in each group) were selected. The standard Kaplan-Meier method was used to determine post-SRS survival times and post-SRS neurological death-free survival times. Competing risk analysis was applied to estimate cumulative incidence for local recurrence, repeat SRS for new lesions, neurological deterioration, and SRS-induced complications. Post-SRS median survival times did not differ significantly between the 2 groups (6.8 months for Group A vs 6.0 months for Group B; hazard ratio [HR] 1.133, 95% CI 0.974-1.319, p = 0.10). Furthermore, rates of neurological death were very similar: 10.0% for group A and 9.4% for group B (p = 0.89); neurological death-free survival times did not differ significantly between the 2 groups (HR 1.073, 95% CI 0.649-1.771, p = 0.78). The cumulative incidence of local recurrence (HR 0.425, 95% CI 0.0.181-0.990, p = 0.04) and repeat SRS for new lesions (HR 0.732, 95% CI 0.554-0.870, p = 0.03) were significantly lower for Group B than for Group A patients. No significant differences between the groups were found for cumulative incidence for neurological deterioration (HR 0.994, 95% CI 0.607-1.469, p = 0.80) or SRS-related complications (HR 0.541, 95% CI 0.138-2.112, p = 0.38). Post-SRS treatment results (i.e., median survival time; neurological death-free survival times; and cumulative incidence for local recurrence, repeat SRS for new lesions, neurological deterioration, and SRS-related complications) were not inferior (neither less effective nor less safe) for patients in Group B than for those in Group A. We conclude that carefully selected patients with 10 or more tumors are not unfavorable candidates for SRS alone. A randomized controlled trial should be conducted to test this hypothesis.

Management of Brain Metastases in Tyrosine Kinase Inhibitor-Naïve Epidermal Growth Factor Receptor-Mutant Non-Small-Cell Lung Cancer: A Retrospective Multi-Institutional Analysis.

PubMed

Magnuson, William J; Lester-Coll, Nataniel H; Wu, Abraham J; Yang, T Jonathan; Lockney, Natalie A; Gerber, Naamit K; Beal, Kathryn; Amini, Arya; Patil, Tejas; Kavanagh, Brian D; Camidge, D Ross; Braunstein, Steven E; Boreta, Lauren C; Balasubramanian, Suresh K; Ahluwalia, Manmeet S; Rana, Niteshkumar G; Attia, Albert; Gettinger, Scott N; Contessa, Joseph N; Yu, James B; Chiang, Veronica L

2017-04-01

Purpose Stereotactic radiosurgery (SRS), whole-brain radiotherapy (WBRT), and epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are treatment options for brain metastases in patients with EGFR-mutant non-small-cell lung cancer (NSCLC). This multi-institutional analysis sought to determine the optimal management of patients with EGFR-mutant NSCLC who develop brain metastases and have not received EGFR-TKI. Materials and Methods A total of 351 patients from six institutions with EGFR-mutant NSCLC developed brain metastases and met inclusion criteria for the study. Exclusion criteria included prior EGFR-TKI use, EGFR-TKI resistance mutation, failure to receive EGFR-TKI after WBRT/SRS, or insufficient follow-up. Patients were treated with SRS followed by EGFR-TKI, WBRT followed by EGFR-TKI, or EGFR-TKI followed by SRS or WBRT at intracranial progression. Overall survival (OS) and intracranial progression-free survival were measured from the date of brain metastases. Results The median OS for the SRS (n = 100), WBRT (n = 120), and EGFR-TKI (n = 131) cohorts was 46, 30, and 25 months, respectively ( P < .001). On multivariable analysis, SRS versus EGFR-TKI, WBRT versus EGFR-TKI, age, performance status, EGFR exon 19 mutation, and absence of extracranial metastases were associated with improved OS. Although the SRS and EGFR-TKI cohorts shared similar prognostic features, the WBRT cohort was more likely to have a less favorable prognosis ( P = .001). Conclusion This multi-institutional analysis demonstrated that the use of upfront EGFR-TKI, and deferral of radiotherapy, is associated with inferior OS in patients with EGFR-mutant NSCLC who develop brain metastases. SRS followed by EGFR-TKI resulted in the longest OS and allowed patients to avoid the potential neurocognitive sequelae of WBRT. A prospective, multi-institutional randomized trial of SRS followed by EGFR-TKI versus EGFR-TKI followed by SRS at intracranial progression is urgently needed.

Utilizing the right mix of environmental cleanup technologies

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

Whitaker, Wade; Bergren, Chris; Flora, Mary

2007-07-01

The Savannah River Site (SRS) is a 310-square-mile United States Department of Energy nuclear facility located along the Savannah River near Aiken, South Carolina. During operations, which started in 1951, hazardous substances (chemicals and radionuclides) were released to the environment. The releases occurred as a result of inadvertent spills and waste disposal in unlined pits and basins which was common practice before environmental regulations existed. The hazardous substances have migrated to the vadose zone and groundwater in many areas of the SRS, resulting in 515 waste units that are required by environmental regulations, to undergo characterization and, if needed, remediation.more » In the initial years of the SRS environmental cleanup program (early 1990's), the focus was to use common technologies (such as pump and treat, air stripping, excavation and removal) that actively and tangibly removed contamination. Exclusive use of these technologies required continued and significant funding while often failing to meet acceptable clean-up goals and objectives. Recognizing that a more cost-effective approach was needed, SRS implemented new and complementary remediation methods focused on active and passive technologies targeted to solve specific remediation problems. Today, SRS uses technologies such as chemical / pH-adjusting injection, phyto-remediation, underground cutoff walls, dynamic underground stripping, soil fracturing, microbial degradation, baro-balls, electrical resistance heating, soil vapor extraction, and micro-blowers to more effectively treat contamination at lower costs. Additionally, SRS's remediation approach cost effectively maximizes cleanup as SRS works pro-actively with multiple regulatory agencies. Using GIS, video, animation, and graphics, SRS is able to provide an accurate depiction of the evolution of SRS groundwater and vadose zone cleanup activities to convince stakeholders and regulators of the effectiveness of various cleanup technologies. Remediating large, complex groundwater plumes using state of-the art technologies and approaches is a hallmark of years of experience and progress. Environmental restoration at SRS continues to be a challenging and dynamic process as new cleanup technologies and approaches are adopted. (authors)« less

Does Stereotactic Radiosurgery Have a Role in the Management of Patients Presenting With 4 or More Brain Metastases?

PubMed

Soike, Michael H; Hughes, Ryan T; Farris, Michael; McTyre, Emory R; Cramer, Christina K; Bourland, J D; Chan, Michael D

2018-06-01

Stereotactic radiosurgery (SRS) and whole brain radiation therapy (WBRT) are effective treatments for management of brain metastases. Prospective trials comparing the 2 modalities in patients with fewer than 4 brain metastases demonstrate that overall survival (OS) is similar. Intracranial failure is more common after SRS, while WBRT is associated with neurocognitive decline. As technology has advanced, fewer technical obstacles remain for treating patients with 4 or more brain metastases with SRS, but level I data supporting its use are lacking. Observational prospective studies and retrospective series indicate that in patients with 4 or more brain metastases, performance status, total volume of intracranial disease, histology, and rate of development of new brain metastases predict outcomes more accurately than the number of brain metastases. It may be reasonable to initially offer SRS to some patients with 4 or more brain metastases. Initiating therapy with SRS avoids the acute and late sequelae of WBRT. Multiple phase III trials of SRS vs WBRT, both currently open or under development, are directly comparing quality of life and OS for patients with 4 or more brain metastases to help answer the question of SRS appropriateness for these patients.

Intracranial stereotactic radiosurgery with an adapted linear accelerator vs. robotic radiosurgery: Comparison of dosimetric treatment plan quality.

PubMed

Treuer, Harald; Hoevels, Moritz; Luyken, Klaus; Visser-Vandewalle, Veerle; Wirths, Jochen; Kocher, Martin; Ruge, Maximilian

2015-06-01

Stereotactic radiosurgery with an adapted linear accelerator (linac-SRS) is an established therapy option for brain metastases, benign brain tumors, and arteriovenous malformations. We intended to investigate whether the dosimetric quality of treatment plans achieved with a CyberKnife (CK) is at least equivalent to that for linac-SRS with circular or micromultileaf collimators (microMLC). A random sample of 16 patients with 23 target volumes, previously treated with linac-SRS, was replanned with CK. Planning constraints were identical dose prescription and clinical applicability. In all cases uniform optimization scripts and inverse planning objectives were used. Plans were compared with respect to coverage, minimal dose within target volume, conformity index, and volume of brain tissue irradiated with ≥ 10 Gy. Generating the CK plan was unproblematic with simple optimization scripts in all cases. With the CK plans, coverage, minimal target volume dosage, and conformity index were significantly better, while no significant improvement could be shown regarding the 10 Gy volume. Multiobjective comparison for the irradiated target volumes was superior in the CK plan in 20 out of 23 cases and equivalent in 3 out of 23 cases. Multiobjective comparison for the treated patients was superior in the CK plan in all 16 cases. The results clearly demonstrate the superiority of the irradiation plan for CK compared to classical linac-SRS with circular collimators and microMLC. In particular, the average minimal target volume dose per patient, increased by 1.9 Gy, and at the same time a 14% better conformation index seems to be an improvement with clinical relevance.

The feasibility and benefits of using volumetric arc therapy in patients with brain metastases: a systematic review.

PubMed

Andrevska, Adriana; Knight, Kellie A; Sale, Charlotte A

2014-12-01

Radiotherapy management of patients with brain metastases most commonly involve a whole-brain radiation therapy (WBRT) regime, as well as newer techniques such as stereotactic radiosurgery (SRS) and intensity modulated radiotherapy (IMRT). The long treatment times incurred by these techniques indicates the need for a novel technique that has shorter treatment times, whilst still producing highly conformal treatment with the potential to deliver escalated doses to the target area. Volumetric modulated arc therapy (VMAT) is a dynamic, highly conformal technique that may deliver high doses of radiation through a single gantry arc and reduce overall treatment times. The aim of this systematic review is to determine the feasibility and benefits of VMAT treatment in regard to overall survival rates and local control in patients with brain metastases, in comparison with patients treated with WBRT, SRS and IMRT. A search of the literature identified 23 articles for the purpose of this review. Articles were included on the basis they were human-based studies, with sample sizes of more than five patients who were receiving treatment for 1-10 metastatic brain lesions. VMAT was found to be highly conformal, have a reduced treatment delivery time and incurred no significant toxicities in comparison with WBRT, SRS and IMRT. Compared to other treatment techniques, VMAT proved to have fewer toxicities than conventional WBRT, shorter treatment times than SRS and similar dose distributions to IMRT plans. Future prospective studies are needed to accurately assess the prognostic benefits of VMAT as well as the occurrence of late toxicities.

Assessment of the quality of reporting in abstracts of systematic reviews with meta-analyses in periodontology and implant dentistry.

PubMed

Faggion, C M; Liu, J; Huda, F; Atieh, M

2014-04-01

Proper scientific reporting is necessary to ensure the correct interpretation of study results by readers. The main objective of this study was to assess the quality of reporting in abstracts of systematic reviews (SRs) with meta-analyses in periodontology and implant dentistry. Differences in reporting of abstracts in Cochrane and paper-based reviews were also assessed. The PubMed electronic database and the Cochrane database for SRs were searched on November 11, 2012, independently and in duplicate, for SRs with meta-analyses related to interventions in periodontology and implant dentistry. Assessment of the quality of reporting was performed independently and in duplicate, taking into account items related to the effect direction, numerical estimates of effect size, measures of precision, probability and consistency. We initially screened 433 papers and included 146 (127 paper-based and 19 Cochrane reviews, respectively). The direction of evidence was reported in two-thirds of the abstracts while strength of evidence and measure of precision (i.e., confidence interval) were reported in less than half the selected abstracts. Measures of consistency such as I(2) statistics were reported in only 5% of the selected sample of abstracts. Cochrane abstracts reported the limitations of evidence and precision better than paper-based ones. Two items ("meta-analysis" in title and abstract, respectively), were nevertheless better reported in paper-based abstracts. Abstracts of SRs with meta-analyses in periodontology and implant dentistry currently have no uniform standard of reporting, which may hinder readers' understanding of study outcomes. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Factors influencing intentions to use social recommender systems: a social exchange perspective.

PubMed

Chang, Tsung-Sheng; Hsiao, Wei-Hung

2013-05-01

This study employs the perspective of social exchange theory and seeks to understand users' intentions to use social recommender systems (SRS) through three psychological factors: trust, shared values, and reputation. We use structural equation modeling to analyze 221 valid questionnaires. The results show that trust has a direct positive influence on the intention to use SRS, followed by shared values, whereas reputation has an indirect influence on SRS use. We further discuss specific recommendations concerning these factors for developing SRS.

Optimal sampling design for estimating spatial distribution and abundance of a freshwater mussel population

USGS Publications Warehouse

Pooler, P.S.; Smith, D.R.

2005-01-01

We compared the ability of simple random sampling (SRS) and a variety of systematic sampling (SYS) designs to estimate abundance, quantify spatial clustering, and predict spatial distribution of freshwater mussels. Sampling simulations were conducted using data obtained from a census of freshwater mussels in a 40 X 33 m section of the Cacapon River near Capon Bridge, West Virginia, and from a simulated spatially random population generated to have the same abundance as the real population. Sampling units that were 0.25 m 2 gave more accurate and precise abundance estimates and generally better spatial predictions than 1-m2 sampling units. Systematic sampling with ???2 random starts was more efficient than SRS. Estimates of abundance based on SYS were more accurate when the distance between sampling units across the stream was less than or equal to the distance between sampling units along the stream. Three measures for quantifying spatial clustering were examined: Hopkins Statistic, the Clumping Index, and Morisita's Index. Morisita's Index was the most reliable, and the Hopkins Statistic was prone to false rejection of complete spatial randomness. SYS designs with units spaced equally across and up stream provided the most accurate predictions when estimating the spatial distribution by kriging. Our research indicates that SYS designs with sampling units equally spaced both across and along the stream would be appropriate for sampling freshwater mussels even if no information about the true underlying spatial distribution of the population were available to guide the design choice. ?? 2005 by The North American Benthological Society.

Methodological quality evaluation of systematic reviews or meta-analyses on ERCC1 in non-small cell lung cancer: a systematic review.

PubMed

Tao, Huan; Zhang, Yueyuan; Li, Qian; Chen, Jin

2017-11-01

To assess the methodological quality of systematic reviews (SRs) or meta-analysis concerning the predictive value of ERCC1 in platinum chemotherapy of non-small cell lung cancer. We searched the PubMed, EMbase, Cochrane library, international prospective register of systematic reviews, Chinese BioMedical Literature Database, China National Knowledge Infrastructure, Wan Fang and VIP database for SRs or meta-analysis. The methodological quality of included literatures was evaluated by risk of bias in systematic review (ROBIS) scale. Nineteen eligible SRs/meta-analysis were included. The most frequently searched databases were EMbase (74%), PubMed, Medline and CNKI. Fifteen SRs did additional retrieval manually, but none of them retrieved the registration platform. 47% described the two-reviewers model in the screening for eligible original articles, and seven SRs described the two reviewers to extract data. In methodological quality assessment, inter-rater reliability Kappa was 0.87 between two reviewers. Research question were well related to all SRs in phase 1 and the eligibility criteria was suitable for each SR, and rated as 'low' risk bias. But the 'high' risk bias existed in all the SRs regarding methods used to identify and/or select studies, and data collection and study appraisal. More than two-third of SRs or meta-analysis were finished with high risk of bias in the synthesis, findings and the final phase. The study demonstrated poor methodological quality of SRs/meta-analysis assessing the predictive value of ERCC1 in chemotherapy among the NSCLC patients, especially the high performance bias. Registration or publishing the protocol is recommended in future research.

Immunotherapy safety: a prospective multi-centric monitoring study of biologically standardized therapeutic vaccines for allergic diseases.

PubMed

Moreno, C; Cuesta-Herranz, J; Fernández-Távora, L; Alvarez-Cuesta, E

2004-04-01

The fear of side-effects has led to strict regulations preventing a more widespread use of specific immunotherapy (SIT) in some countries, in spite of the low risk of systemic reactions (SRs) reported in well-controlled studies. The goal of the study was to carry out a prospective and multi-centric trial to evaluate the safety, risk factors and compliance degree of commercially available SIT. The study was carried out in 14 allergy departments from Spain. Four-hundred and eighty-eight patients with rhinitis and/or asthma were submitted to treatment with biologically standardized allergen extracts commercially available. They were administered following the European Academy of Allergy and Clinical Immunology guidelines. Four hundred and twenty-three patients (86.7%) completed the treatment and remained under control at the end of the trial. Out of 17,526 administered doses, 17,368 doses (99.1%) were not associated with a reaction. Eighteen patients (3.7%) experienced 53 (0.3% of the doses) SRs. All immediate SRs were mild or moderate and responded well to ordinary treatment measures. There were no fatal reactions, anaphylactic shock or life-threatening reactions. A higher ratio of SRs was found among asthmatic and dust mite allergic patients, although multi-variable logistic analysis did not demonstrate any risk factor associated with SRs. There was also a subgroup of patients at risk for recurrent reactions, and therefore 40% of SRs had been avoided if the maximal number of SRs had been previously limited to only three SRs. This multi-centric study showed that SIT was a safe treatment with a very good compliance. Future guidelines of SIT should limit the maximal number of SRs.

Critical Assessment of Search Strategies in Systematic Reviews in Endodontics.

PubMed

Yaylali, Ibrahim Ethem; Alaçam, Tayfun

2016-06-01

The aim of this study was to perform an overview of literature search strategies in systematic reviews (SRs) published in 2 endodontic journals, Journal of Endodontics and International Endodontic Journal. A search was done by using the MEDLINE (PubMed interface) database to retrieve the articles published between January 1, 2000 and December 31, 2015. The last search was on January 10, 2016. All the SRs published in the 2 journals were retrieved and screened. Eligible SRs were assessed by using 11 questions about search strategies in the SRs that were adapted from 2 guidelines (ie, AMSTAR checklist and the Cochrane Handbook). A total of 83 SRs were retrieved by electronic search. Of these, 55 were from the Journal of Endodontics, and 28 were from the International Endodontic Journal. After screening, 2 SRs were excluded, and 81 SRs were included in the study. Some issues, such as search of grey literature and contact with study authors, were not fully reported (30% and 25%, respectively). On the other hand, some issues, such as the use of index terms and key words and search in at least 2 databases, were reported in most of the SRs (97% and 95%, respectively). The overall quality of the search strategy in both journals was 61%. No significant difference was found between the 2 journals in terms of evaluation criteria (P > .05). There exist areas for improving the quality of reporting of search strategies in SRs; for example, grey literature should be searched for unpublished studies, no language limitation should be applied to databases, and authors should make an attempt to contact the authors of included studies to obtain further relevant information. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Cost-effectiveness analysis of neurocognitive-sparing treatments for brain metastases.

PubMed

Savitz, Samuel T; Chen, Ronald C; Sher, David J

2015-12-01

Decisions regarding how to treat patients who have 1 to 3 brain metastases require important tradeoffs between controlling recurrences, side effects, and costs. In this analysis, the authors compared novel treatments versus usual care to determine the incremental cost-effectiveness ratio from a payer's (Medicare) perspective. Cost-effectiveness was evaluated using a microsimulation of a Markov model for 60 one-month cycles. The model used 4 simulated cohorts of patients aged 65 years with 1 to 3 brain metastases. The 4 cohorts had a median survival of 3, 6, 12, and 24 months to test the sensitivity of the model to different prognoses. The treatment alternatives evaluated included stereotactic radiosurgery (SRS) with 3 variants of salvage after recurrence (whole-brain radiotherapy [WBRT], hippocampal avoidance WBRT [HA-WBRT], SRS plus WBRT, and SRS plus HA-WBRT). The findings were tested for robustness using probabilistic and deterministic sensitivity analyses. Traditional radiation therapies remained cost-effective for patients in the 3-month and 6-month cohorts. In the cohorts with longer median survival, HA-WBRT and SRS plus HA-WBRT became cost-effective relative to traditional treatments. When the treatments that involved HA-WBRT were excluded, either SRS alone or SRS plus WBRT was cost-effective relative to WBRT alone. The deterministic and probabilistic sensitivity analyses confirmed the robustness of these results. HA-WBRT and SRS plus HA-WBRT were cost-effective for 2 of the 4 cohorts, demonstrating the value of controlling late brain toxicity with this novel therapy. Cost-effectiveness depended on patient life expectancy. SRS was cost-effective in the cohorts with short prognoses (3 and 6 months), whereas HA-WBRT and SRS plus HA-WBRT were cost-effective in the cohorts with longer prognoses (12 and 24 months). © 2015 American Cancer Society.

Genome-wide methylation analysis in Silver-Russell syndrome patients

PubMed Central

Böhm, S; Frost, JM; Puszyk, W; Abu-Amero, S; Stanier, P; Schulz, R; Moore, GE; Oakey, RJ

2015-01-01

Silver-Russell Syndrome (SRS) is a clinically heterogeneous disorder characterised by severe in utero growth restriction and poor postnatal growth, body asymmetry, irregular craniofacial features and several additional minor malformations. The aetiology of SRS is complex and current evidence strongly implicates imprinted genes. Approximately half of all patients exhibit DNA hypomethylation at the H19/IGF2 imprinted domain, and around 10% have maternal uniparental disomy of chromosome 7. We measured DNA methylation in 18 SRS patients at >485,000 CpG sites using DNA methylation microarrays. Using a novel bioinformatics methodology specifically designed to identify subsets of patients with a shared epimutation, we analysed methylation changes genome-wide as well as at known imprinted regions to identify SRS-associated epimutations. Our analysis identifies epimutations at the previously characterised domains of H19/IGF2 and at imprinted regions on chromosome 7, providing proof of principle that our methodology can detect DNA methylation changes at imprinted loci. In addition we discovered two novel epimutations associated with SRS and located at imprinted loci previously linked to relevant mouse and human phenotypes. We identify RB1 as an additional imprinted locus associated with SRS, with a region near the RB1 DMR hypermethylated in 13/18 (~70 %) patients. We also report 6/18 (~33 %) patients were hypermethylated at a CpG island near the ANKRD11 gene. We do not observe consistent cooccurrence of epimutations at multiple imprinted loci in single SRS individuals. SRS is clinically heterogeneous and the absence of multiple imprinted loci epimutations reflects the heterogeneity at the molecular level. Further stratification of SRS patients by molecular phenotypes might aid the identification of disease causes. PMID:25563730

Reliability and validity of the French-Canadian version of the scoliosis research society 22 questionnaire in France.

PubMed

Lonjon, Guillaume; Ilharreborde, Brice; Odent, Thierry; Moreau, Sébastien; Glorion, Christophe; Mazda, Keyvan

2014-01-01

Outcome study to determine the internal consistency, reproducibility, and concurrent validity of the French-Canadian version of the Scoliosis Research Society 22 (SRS-22 fcv) patient questionnaire in France. To determine whether the SRS-22 fcv can be used in a population from France. The SRS-22 has been translated and validated in multiple countries, notably in the French-Canadian language in Quebec, Canada. Use of SRS-22 fcv seems appropriate for evaluating adolescent idiopathic scoliosis in France. However, French-Canadian French is noticeably different from the French spoken in France, and no study has investigated the use of a French-Canadian version of a health-quality questionnaire in another French population. The methods used for validating the SRS-22 fcv in Quebec were adopted for use with a group of 200 adolescents with idiopathic scoliosis and 60 healthy adolescents in France. Reliability and reproducibility were measured by the Cronbach α and intraclass correlation coefficient (ICC), construct validity by factorial analysis, concurrent validity by the Short-Form of the survey, and discriminant validity by analysis of variance and multivariate linear regression. In France, the SRS-22 fcv showed good global internal consistency (Cronbach α = 0.87, intraclass correlation coefficient = 0.92), a coherent factorial structure, and high correlation coefficients between the SRS-22 fcv and Short-Form of the survey (P < 0.001). However, reliability and validity were slightly less than that for the instrument's original validation and the validation of the SRS-22 fcv in Quebec. These differences could be explained by language and cultural differences. The SRS-22 fcv is relevant for use in France, but further development and validation of a specific French questionnaire remain necessary to improve the assessment of functional outcomes of adolescents with scoliosis in France. N/A.

Tolerance and outcomes of stereotactic radiosurgery combined with anti-programmed cell death-1 (pembrolizumab) for melanoma brain metastases.

PubMed

Nardin, Charlee; Mateus, Christine; Texier, Mathieu; Lanoy, Emilie; Hibat-Allah, Salima; Ammari, Samy; Robert, Caroline; Dhermain, Frederic

2018-04-01

Anti-programmed cell death-1 (anti-PD1) antibodies are currently the first-line treatment for patients with metastatic BRAF wild-type melanoma, alone or combined with the anti-CTLA4 monoclonal antibody, ipilimumab. To date, data on safety and the outcomes of patients treated with the anti-PD1 monoclonal antibodies, pembrolizumab (PB), or nivolumab, combined with stereotactic radiosurgery (SRS), for melanoma brain metastases (MBM) are scarce. We retrospectively reviewed all patients with MBM treated with PB combined with SRS between 2012 and 2015. The primary endpoint was neurotoxicity. The secondary endpoints were local, distant intracranial controls and overall survival (OS). Among 74 patients with MBM treated with SRS, 25 patients with a total of 58 MBM treated with PB combined with SRS within 6 months were included. Radiation necrosis, occurring within a median time of 6.5 months, was observed for four MBM (6.8%) in four patients. No other significant SRS-related adverse event was observed. After a median follow-up of 8.4 months, local control was achieved in 46 (80%) metastases and 17 (68%) patients. Perilesional oedema and intratumour haemorrhage appearing or increasing after SRS were associated with local progression (P<0.001). The median OS was 15.3 months (95% confidence interval: 4.6-26). The timing between SRS and PB administration did not seem to influence the risk of radiation necrosis, intracranial control or OS. SRS combined with PB was well tolerated and achieved local control in 80% of the lesions. Prolonged OS was observed compared with that currently yielded in this population of patients. Prospective studies are required to explore further the optimal ways to combine immunotherapy and SRS.

Discordances originated by multiple meta-analyses on interventions for myocardial infarction: a systematic review.

PubMed

Lucenteforte, Ersilia; Moja, Lorenzo; Pecoraro, Valentina; Conti, Andrea A; Conti, Antonio; Crudeli, Elena; Galli, Alessio; Gensini, Gian Franco; Minnelli, Martina; Mugelli, Alessandro; Proietti, Riccardo; Shtylla, Jonida; D'Amico, Roberto; Parmelli, Elena; Virgili, Gianni

2015-03-01

To clarify the impact of multiple (covering the same population, intervention, control, and outcomes) systematic reviews (SRs) on interventions for myocardial infarction (MI). Clinical Evidence (BMJ Group) sections and related search strategies regarding MI were used to identify multiple SRs published between 1997 and 2007. Multiple SRs were classified as discordant if they featured conflicting results or interpretation of them. Thirty-six SRs (23.5% of 153 on the treatment or prevention of MI) were classified as multiple and grouped in 16 clusters [ie, at least two SRs with the same PICO (population, condition/disease, intervention, control) and at least one common outcome] exploring angioplasty, angiotensin-converting enzyme inhibitors, anticoagulants, antiplatelets, β-blockers, and stents. Complete agreement on statistically significant differences between interventions was found in 7 of 10 clusters with a shared composite outcome. Agreement was reduced when single outcomes were considered. Despite substantial variation and limited agreement in reporting of major outcomes, SRs agreed in their conclusions on the superiority of either the intervention or control in 14 of 16 clusters. Sources of minor discrepancies were found in terms of study and outcome selection, subgroup analyses, and interpretation of findings. Multiple SRs agreed in their qualitative conclusions but not on reporting and on analyses of hard outcomes. Discordance on significance of treatment effects was due to a combination of variation in design with inclusion of different studies and lack of precision for single hard outcomes compared with a composite outcome. Such inconsistencies among SRs could potentially slow the translation of SRs' results to clinical and public health decision making and suggest the need for a broader methodological and clinical agreement on their design. Copyright © 2015 Elsevier Inc. All rights reserved.

Stereotactic Radiosurgery With or Without Whole-Brain Radiotherapy for Brain Metastases: Secondary Analysis of the JROSG 99-1 Randomized Clinical Trial.

PubMed

Aoyama, Hidefumi; Tago, Masao; Shirato, Hiroki

2015-07-01

It remains uncertain whether treatment with stereotactic radiosurgery (SRS) alone can be safely applied to all patient populations with 1 to 4 brain metastases (BMs) exhibiting heterogeneous prognoses. To investigate the feasibility of SRS alone for patients with different prognoses determined by the diagnosis-specific Graded Prognostic Assessment (DS-GPA). A secondary analysis (performed in September 2014) of the Japanese Radiation Oncology Study Group (JROSG) 99-1, a phase 3 randomized trial, comparing SRS alone and whole-brain radiotherapy (WBRT) + SRS conducted in 1999 to 2003. Among a total of 132 patients, 88 with non-small-cell lung cancer (NSCLC) and 1 to 4 BMs were included and poststratified by DS-GPA scores to avoid potential bias from BMs from different primary cancer types. The median follow-up time was 8.05 months. The WBRT schedule was 30 Gy in 10 fractions over 2 to 2.5 weeks. The mean SRS dose was 21.9 Gy in SRS alone and 16.6 Gy in WBRT + SRS. The primary end point was overall survival (OS), and the secondary end points included brain tumor recurrence (BTR), salvage treatment, and radiation toxic effects. Forty-seven patients had a favorable prognosis, with DS-GPA scores of 2.5 to 4.0 (26 SRS-alone and 21 WBRT + SRS [DS-GPA 2.5-4.0 group]), and 41 had an unfavorable prognosis, with DS-GPA scores of 0.5 to 2.0 (19 SRS-alone and 22 WBRT + SRS [DS-GPA 0.5-2.0 group]). Significantly better OS was observed in the DS-GPA 2.5-4.0 group in WBRT + SRS vs the SRS alone, with a median survival time of 16.7 (95% CI, 7.5-72.9) months vs 10.6 (95% CI, 7.7-15.5) months (P = .04) (hazard ratio [HR], 1.92; 95% CI, 1.01-3.78). However, no such difference was observed in the DS-GPA 0.5-2.0 group (HR, 1.05; 95% CI, 0.55-1.99) (P = .86). This benefit could be explained by the differing BTR rates, in that the prevention against BTR by WBRT had a more significant impact in the DS-GPA 2.5-4.0 group (HR, 8.31; 95% CI, 3.05-29.13) (P < .001) vs the DS-GPA 0.5-2.0 group (HR, 3.57; 95% CI, 1.02-16.49) (P = .04). Despite the current trend of using SRS alone, the important role of WBRT for patients with BMs from NSCLC with a favorable prognosis should be considered. Our findings should be validated through appropriately designed prospective studies. umin.ac.jp/ctr Identifier: C000000412.

Test plan for the soils facility demonstration: A petroleum contaminated soil bioremediation facility

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

Lombard, K.H.

1994-08-01

The objectives of this test plan are to show the value added by using bioremediation as an effective and environmentally sound method to remediate petroleum contaminated soils (PCS) by: demonstrating bioremediation as a permanent method for remediating soils contaminated with petroleum products; establishing the best operating conditions for maximizing bioremediation and minimizing volatilization for SRS PCS during different seasons; determining the minimum set of analyses and sampling frequency to allow efficient and cost-effective operation; determining best use of existing site equipment and personnel to optimize facility operations and conserve SRS resources; and as an ancillary objective, demonstrating and optimizing newmore » and innovative analytical techniques that will lower cost, decrease time, and decrease secondary waste streams for required PCS assays.« less

Plutonium Isotopes in the Terrestrial Environment at the Savannah River Site, USA. A Long-Term Study

DOE PAGES

Armstrong, Christopher R.; Nuessle, Patterson R.; Brant, Heather A.; ...

2015-01-16

This work presents the findings of a long term plutonium study at Savannah River Site (SRS) conducted between 2003 and 2013. Terrestrial environmental samples were obtained at Savannah River National Laboratory (SRNL) in A-area. Plutonium content and isotopic abundances were measured over this time period by alpha spectrometry and three stage thermal ionization mass spectrometry (3STIMS). Here we detail the complete sample collection, radiochemical separation, and measurement procedure specifically targeted to trace plutonium in bulk environmental samples. Total plutonium activities were determined to be not significantly above atmospheric global fallout. However, the 238Pu/ 239+240Pu activity ratios attributed to SRS aremore » above atmospheric global fallout ranges. The 240Pu/ 239Pu atom ratios are reasonably consistent from year to year and are lower than fallout, while the 242Pu/ 239Pu atom ratios are higher than fallout values. Overall, the plutonium signatures obtained in this study reflect a mixture of weapons-grade, higher burn-up, and fallout material. This study provides a blue print for long term low level monitoring of plutonium in the environment.« less

Time-dependent classification accuracy curve under marker-dependent sampling.

PubMed

Zhu, Zhaoyin; Wang, Xiaofei; Saha-Chaudhuri, Paramita; Kosinski, Andrzej S; George, Stephen L

2016-07-01

Evaluating the classification accuracy of a candidate biomarker signaling the onset of disease or disease status is essential for medical decision making. A good biomarker would accurately identify the patients who are likely to progress or die at a particular time in the future or who are in urgent need for active treatments. To assess the performance of a candidate biomarker, the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) are commonly used. In many cases, the standard simple random sampling (SRS) design used for biomarker validation studies is costly and inefficient. In order to improve the efficiency and reduce the cost of biomarker validation, marker-dependent sampling (MDS) may be used. In a MDS design, the selection of patients to assess true survival time is dependent on the result of a biomarker assay. In this article, we introduce a nonparametric estimator for time-dependent AUC under a MDS design. The consistency and the asymptotic normality of the proposed estimator is established. Simulation shows the unbiasedness of the proposed estimator and a significant efficiency gain of the MDS design over the SRS design. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Choosing the right journal for your systematic review.

PubMed

Betini, Marluci; Volpato, Enilze S N; Anastácio, Guilherme D J; de Faria, Renata T B G; El Dib, Regina

2014-12-01

The importance of systematic reviews (SRs) as an aid to decision making in health care has led to an increasing interest in the development of this type of study. When selecting a target journal for publication, authors generally seek out higher impact factor journals. This study aimed to determine the percentage of scientific medical journals that publish SRs according to their impact factors (>2.63) and to determine whether those journals require tools that aim to improve SR reporting and meta-analyses. In our cross-sectional study showing how to choose the right journal for a SR, we selected and analysed scientific journals available in a digital library with a minimum Institute for Scientific Information impact factor of 2.63. We analysed 622 scientific journals, 435 (69.94%) of which publish SRs. Of those 435 journals, 135 (21.60%) provide instructions for authors that mention SRs. Three hundred journals (48.34%) do not discuss criteria for article acceptance in the instructions for authors section, but do publish SRs. Only 118 (27.00%) scientific journals require items to be reported in accordance with the specific SR reporting forms. The majority of the journals do not mention the acceptance of SRs in the instructions for authors section. Only a few journals require that SRs meet specific reporting guidelines, making interpretation of their findings across studies challenging. There is no correlation between the impact factor of the journal and its acceptance of SRs for publication. © 2014 John Wiley & Sons, Ltd.

Effects of Different Student Response Modes on Science Learning

ERIC Educational Resources Information Center

Kho, Lee Sze; Chen, Chwen Jen

2017-01-01

Student response systems (SRSs) are wireless answering devices that enable students to provide simple real-time feedback to instructors. This study aims to evaluate the effects of different SRS interaction modes on elementary school students' science learning. Three interaction modes which include SRS Individual, SRS Collaborative, and Classroom…

NONLINEAR OPTICAL PHENOMENA Intracavity SRS conversion in diode-pumpedmultifunctional Nd3+:SrMoO4 laser crystal

NASA Astrophysics Data System (ADS)

Basiev, Tasoltan T.; Smetanin, Sergei N.; Fedin, Aleksandr V.; Shurygin, Anton S.

2010-10-01

Lasing of a miniature all-solid-state SRS laser based on a Nd3+:SrMoO4 crystal with a LiF:F2--passive Q-switch is studied. The dependences of the laser and SRS self-conversion parameters on the initial transmission of the passive Q-switch are studied experimentally and theoretically. Simulation of the lasing kinetics has shown the possibility of nonlinear cavity dumping upon highly efficient SRS self-conversion of laser radiation. An increase in the active medium length from 1 to 3mm resulted in an increase in the energy of the output 1.17-μm SRS radiation from 20 μJ to record-high 60 μJ at the absorbed multimode diode pump energy of 3.7 mJ.

Most systematic reviews of high methodological quality on psoriasis interventions are classified as high risk of bias using ROBIS tool.

PubMed

Gómez-García, Francisco; Ruano, Juan; Gay-Mimbrera, Jesus; Aguilar-Luque, Macarena; Sanz-Cabanillas, Juan Luis; Alcalde-Mellado, Patricia; Maestre-López, Beatriz; Carmona-Fernández, Pedro Jesús; González-Padilla, Marcelino; García-Nieto, Antonio Vélez; Isla-Tejera, Beatriz

2017-12-01

No gold standard exists to assess methodological quality of systematic reviews (SRs). Although Assessing the Methodological Quality of Systematic Reviews (AMSTAR) is widely accepted for analyzing quality, the ROBIS instrument has recently been developed. This study aimed to compare the capacity of both instruments to capture the quality of SRs concerning psoriasis interventions. Systematic literature searches were undertaken on relevant databases. For each review, methodological quality and bias risk were evaluated using the AMSTAR and ROBIS tools. Descriptive and principal component analyses were conducted to describe similarities and discrepancies between both assessment tools. We classified 139 intervention SRs as displaying high/moderate/low methodological quality and as high/low risk of bias. A high risk of bias was detected for most SRs classified as displaying high or moderate methodological quality by AMSTAR. When comparing ROBIS result profiles, responses to domain 4 signaling questions showed the greatest differences between bias risk assessments, whereas domain 2 items showed the least. When considering SRs published about psoriasis, methodological quality remains suboptimal, and the risk of bias is elevated, even for SRs exhibiting high methodological quality. Furthermore, the AMSTAR and ROBIS tools may be considered as complementary when conducting quality assessment of SRs. Copyright © 2017 Elsevier Inc. All rights reserved.

PRISMA and AMSTAR Show Systematic Reviews of Health Literacy and Cancer Screening are Good Quality.

PubMed

Sharma, Sakshi; Oremus, Mark

2018-04-11

To evaluate the reporting and methodological quality of systematic reviews (SRs) in health literacy and cancer screening; to investigate factors that may influence overall quality. A review of SRs published between 2009 and 2017. We calculated indices to represent the included SRs' adherence to PRISMA and AMSTAR. To assess possible determinants of SR quality, we regressed the index scores on year and region of publication, journal impact factor, authors' reported use of PRISMA, and presence of funding statements. We included 19 SRs and median index scores were 0.86 for PRISMA (interquartile range [IQR] = 0.11; range = 0.32 to 1.00) and 0.67 for AMSTAR (IQR = 0.30; range = 0.22 to 1.00). Methodological and reporting problems pertained to protocol registration or publication, number of raters used, gray literature searches, excluded article lists, and unintegrated discussions of risk of bias and efficacy. Only journal impact factor was statistically significantly associated (positively) with PRISMA and AMSTAR index scores. The quality of SRs in health literacy and cancer screening was generally good. Systematic reviewers should register or publish their protocols, include PRISMA and AMSTAR checklists when submitting SRs to journals, and self-evaluate their SRs before submission. Copyright © 2018. Published by Elsevier Inc.

Whole brain radiotherapy plus stereotactic radiosurgery (WBRT+SRS) versus surgery plus whole brain radiotherapy (OP+WBRT) for 1-3 brain metastases: results of a matched pair analysis.

PubMed

Rades, Dirk; Kueter, Jan-Dirk; Veninga, Theo; Gliemroth, Jan; Schild, Steven E

2009-02-01

This study is the first one to compare WBRT+SRS to OP+WBRT for 1-3 brain metastases. Survival (OS), intracerebral control (IC) and local control (LC) of the treated metastases were retrospectively evaluated in 52 patients undergoing WBRT+SRS and in 52 patients undergoing OP+WBRT. Both groups were matched for WBRT schedule, age, gender, performance status, tumour, number of brain metastases, extracerebral metastases, RPA class and interval from tumour diagnosis to WBRT. One-year OS was 56% after WBRT+SRS and 47% after OP+WBRT (p=0.034). One-year IC was 66% and 50% (p=0.003). One-year LC was 82% and 66% (p=0.006). On multivariate analyses, it was found that improved OS was associated with younger age (p=0.044), no extracerebral metastases (p<0.001), RPA class 1 (p<0.001) and longer interval from tumour diagnosis to WBRT (p=0.001). IC was associated with younger age (p=0.002) and longer interval (p=0.004); WBRT+SRS achieved borderline significance (p=0.052). Improved LC was associated with longer interval (p=0.017); WBRT+SRS showed a trend (p=0.09). WBRT+SRS appears at least as effective as OP+WBRT.

TU-A-BRB-00: PANEL DISCUSSION: SBRT/SRS Case Studies - Brain and Spine

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

NONE

Brain stereotactic radiosurgery (SRS) and spine stereotactic body radiation therapy (SBRT) are commonly treated by a multidisciplinary team of neurosurgeons, radiation oncologists, and medical physicists. However the treatment objectives, constraints, and technical considerations involved can be quite different between the two techniques. In this interactive session an expert panel of speakers will present clinical brain SRS and spine SBRT cases in order to demonstrate real-world considerations for ensuring safe and accurate treatment delivery and to highlight the significant differences in approach for each treatment site. The session will include discussion of topic such as clinical indications, immobilization, target definition, normalmore » tissue tolerance limits, and beam arrangements. Learning Objectives: Understand the differences in indications and dose/fractionation strategies for intracranial SRS and spine SBRT. Describe the different treatment modalities which can be used to deliver intracranial SRS and spine SBRT. Cite the major differences in treatment setup and delivery principles between intracranial and spine treatments. Identify key critical structures and clinical dosimetric tolerance levels for spine SBRT and intracranial SRS. Understand areas of ongoing work to standardize intracranial SRS and spine SBRT procedures. Schlesinger: Research support: Elekta Instruments, AB; D. Schlesinger, Elekta Instruments, AB - research support; B. Winey, No relevant external funding for this subject.« less

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

Wike, L; Doug Martin, D; Eric Nelson, E

The SRS Ecology Environmental Information Document (EEID) provides a source of information on the ecology of Savannah River Site (SRS). The SRS is a U.S. Department of Energy (DOE)--owned property on the upper Atlantic Coastal Plain of South Carolina, centered approximately 40 kilometers (25 miles) southeast of Augusta, Georgia. The entire site was designated a National Environmental Research Park in 1972 by the Atomic Energy Commission, the predecessor of DOE. This document summarizes and synthesizes ecological research and monitoring conducted on the three main types of ecosystems found at SRS: terrestrial, wetland and aquatic. It also summarizes the available informationmore » on the threatened and endangered species found on the Savannah River Site. SRS is located along the Savannah River and encompasses an area of 80,267 hectares (310 square miles) in three South Carolina counties. It contains diverse habitats, flora, and fauna. Habitats include upland terrestrial areas, wetlands, streams, reservoirs, and the adjacent Savannah River. These diverse habitats support a variety of plants and animals, including many commercially or recreationally valuable species and several rare, threatened, or endangered species. Soils are the basic terrestrial resource, influencing the development of terrestrial biological communities. Many different soils exist on the SRS, from hydric to well-drained, and from sand to clay. In general, SRS soils are predominantly well-drained loamy sands.« less

Sequence-dependent catalytic regulation of the SpoIIIE motor activity ensures directionality of DNA translocation.

PubMed

Chara, Osvaldo; Borges, Augusto; Milhiet, Pierre-Emmanuel; Nöllmann, Marcelo; Cattoni, Diego I

2018-03-27

Transport of cellular cargo by molecular motors requires directionality to ensure proper biological functioning. During sporulation in Bacillus subtilis, directionality of chromosome transport is mediated by the interaction between the membrane-bound DNA translocase SpoIIIE and specific octameric sequences (SRS). Whether SRS regulate directionality by recruiting and orienting SpoIIIE or by simply catalyzing its translocation activity is still unclear. By using atomic force microscopy and single-round fast kinetics translocation assays we determined the localization and dynamics of diffusing and translocating SpoIIIE complexes on DNA with or without SRS. Our findings combined with mathematical modelling revealed that SpoIIIE directionality is not regulated by protein recruitment to SRS but rather by a fine-tuned balance among the rates governing SpoIIIE-DNA interactions and the probability of starting translocation modulated by SRS. Additionally, we found that SpoIIIE can start translocation from non-specific DNA, providing an alternative active search mechanism for SRS located beyond the exploratory length defined by 1D diffusion. These findings are relevant in vivo in the context of chromosome transport through an open channel, where SpoIIIE can rapidly explore DNA while directionality is modulated by the probability of translocation initiation upon interaction with SRS versus non-specific DNA.

Methods For Collecting , Culturing And Performing Toxicity Tests With Daphnia ambigua

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

Specht, Winona L.

2005-07-01

Toxicity tests conducted on water collected from impacted locations in SRS streams often failed chronic toxicity tests and sometimes failed acute toxicity tests (Specht 1995). These findings prompted SRS to determine the cause of the failures. Some SRS NPDES outfalls were also failing chronic toxicity tests, even though no toxicant could be identified and when TIEs were performed, none of the TIE treatments removed the toxicity. Ultimately, it was determined that the failures were due to the low hardness of SRS surface waters, rather than to the presence of a toxicant. The species of cladoceran that the EPA recommends formore » toxicity testing, Ceriodaphnia dubia, is stressed by the very low hardness of SRS waters. SRS developed an alternate species toxicity test that is similar to the EPA test, but uses an indigenous cladoceran, Daphnia ambigua (Specht and Harmon, 1997; Harmon et al., 2003). In 2001, SCDHEC approved the use of D. ambigua for toxicity testing at SRS, contingent upon approval by EPA Region 4. In 2002, EPA Region 4 approved the use of this species for compliance toxicity testing at SRS. Ultimately, the use of this species demonstrated that SRS effluents were not toxic, and most toxicity testing requirements were removed from the NPDES permit that was issued in December 2003, with the exception of one round of chronic definitive testing on outfalls A-01, A-11, and G-10 just before the next NPDES permit application is submitted to SCDHEC. Although the alternate species test was developed at SRS (1996-1998), the culture was transferred to a contract toxicity testing lab (ETT Environmental) located in Greer, SC in 1998. ETT Environmental became certified by SCDHEC to perform toxicity tests using D. ambigua in 2002, and at this time is the only laboratory certified by SCDHEC to perform tests with this species. Because of the expense associated with maintaining the D. ambigua culture for several years when no toxicity testing is required, SRS decided to suspend financial support associated with maintaining the cultures until testing is needed. The purpose of this document is to provide guidance on how to establish a laboratory culture of D. ambigua so that a culture can be restarted when needed.« less

Experimental Determination and Thermodynamic Modeling of Electrical Conductivity of SRS Waste Tank Supernate

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

Pike, J.; Reboul, S.

2015-06-01

SRS High Level Waste Tank Farm personnel rely on conductivity probes for detection of incipient overflow conditions in waste tanks. Minimal information is available concerning the sensitivity that must be achieved such that that liquid detection is assured. Overly sensitive electronics results in numerous nuisance alarms for these safety-related instruments. In order to determine the minimum sensitivity required of the probe, Tank Farm Engineering personnel need adequate conductivity data to improve the existing designs. Little or no measurements of liquid waste conductivity exist; however, the liquid phase of the waste consists of inorganic electrolytes for which the conductivity may bemore » calculated. Savannah River Remediation (SRR) Tank Farm Facility Engineering requested SRNL to determine the conductivity of the supernate resident in SRS waste Tank 40 experimentally as well as computationally. In addition, SRNL was requested to develop a correlation, if possible, that would be generally applicable to liquid waste resident in SRS waste tanks. A waste sample from Tank 40 was analyzed for composition and electrical conductivity as shown in Table 4-6, Table 4-7, and Table 4-9. The conductivity for undiluted Tank 40 sample was 0.087 S/cm. The accuracy of OLI Analyzer™ was determined using available literature data. Overall, 95% of computed estimates of electrical conductivity are within ±15% of literature values for component concentrations from 0 to 15 M and temperatures from 0 to 125 °C. Though the computational results are generally in good agreement with the measured data, a small portion of literature data deviates as much as ±76%. A simplified model was created that can be used readily to estimate electrical conductivity of waste solution in computer spreadsheets. The variability of this simplified approach deviates up to 140% from measured values. Generally, this model can be applied to estimate the conductivity within a factor of two. The comparison of the simplified model to pure component literature data suggests that the simplified model will tend to under estimate the electrical conductivity. Comparison of the computed Tank 40 conductivity with the measured conductivity shows good agreement within the range of deviation identified based on pure component literature data.« less

Prospective comparison of long-term pain relief rates after first-time microvascular decompression and stereotactic radiosurgery for trigeminal neuralgia.

PubMed

Wang, Doris D; Raygor, Kunal P; Cage, Tene A; Ward, Mariann M; Westcott, Sarah; Barbaro, Nicholas M; Chang, Edward F

2018-01-01

OBJECTIVE Common surgical treatments for trigeminal neuralgia (TN) include microvascular decompression (MVD), stereotactic radiosurgery (SRS), and radiofrequency ablation (RFA). Although the efficacy of each procedure has been described, few studies have directly compared these treatment modalities on pain control for TN. Using a large prospective longitudinal database, the authors aimed to 1) directly compare long-term pain control rates for first-time surgical treatments for idiopathic TN, and 2) identify predictors of pain control. METHODS The authors reviewed a prospectively collected database for all patients who underwent treatment for TN between 1997 and 2014 at the University of California, San Francisco. Standardized collection of data on preoperative clinical characteristics, surgical procedure, and postoperative outcomes was performed. Data analyses were limited to those patients who received a first-time procedure for treatment of idiopathic TN with > 1 year of follow-up. RESULTS Of 764 surgical procedures performed at the University of California, San Francisco, for TN (364 SRS, 316 MVD, and 84 RFA), 340 patients underwent first-time treatment for idiopathic TN (164 MVD, 168 SRS, and 8 RFA) and had > 1 year of follow-up. The analysis was restricted to patients who underwent MVD or SRS. Patients who received MVD were younger than those who underwent SRS (median age 63 vs 72 years, respectively; p < 0.001). The mean follow-up was 59 ± 35 months for MVD and 59 ± 45 months for SRS. Approximately 38% of patients who underwent MVD or SRS had > 5 years of follow-up (60 of 164 and 64 of 168 patients, respectively). Immediate or short-term (< 3 months) postoperative pain-free rates (Barrow Neurological Institute Pain Intensity score of I) were 96% for MVD and 75% for SRS. Percentages of patients with Barrow Neurological Institute Pain Intensity score of I at 1, 5, and 10 years after MVD were 83%, 61%, and 44%, and the corresponding percentages after SRS were 71%, 47%, and 27%, respectively. The median time to pain recurrence was 94 months (25th-75th quartiles: 57-131 months) for MVD and 53 months (25th-75th quartiles: 37-69 months) for SRS (p = 0.006). A subset of patients who had MVD also underwent partial sensory rhizotomy, usually in the setting of insignificant vascular compression. Compared with MVD alone, those who underwent MVD plus partial sensory rhizotomy had shorter pain-free intervals (median 45 months vs no median reached; p = 0.022). Multivariable regression demonstrated that shorter preoperative symptom duration (HR 1.005, 95% CI 1.001-1.008; p = 0.006) was associated with favorable outcome for MVD and that post-SRS sensory changes (HR 0.392, 95% CI 0.213-0.723; p = 0.003) were associated with favorable outcome for SRS. CONCLUSIONS In this longitudinal study, patients who received MVD had longer pain-free intervals compared with those who underwent SRS. For patients who received SRS, postoperative sensory change was predictive of favorable outcome. However, surgical decision making depends upon many factors. This information can help physicians counsel patients with idiopathic TN on treatment selection.

Salvage Radiosurgery for Brain Metastases: Prognostic Factors to Consider in Patient Selection

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

Kurtz, Goldie; Zadeh, Gelareh; Gingras-Hill, Geneviève

2014-01-01

Purpose: Stereotactic radiosurgery (SRS) is offered to patients for recurrent brain metastases after prior brain radiation therapy (RT), but few studies have evaluated the efficacy of salvage SRS or factors to consider in selecting patients for this treatment. This study reports overall survival (OS), intracranial progression-free survival (PFS), and local control (LC) after salvage SRS, and factors associated with outcomes. Methods and Materials: This is a retrospective review of patients treated from 2009 to 2011 with salvage SRS after prior brain RT for brain metastases. Survival from salvage SRS and from initial brain metastases diagnosis (IBMD) was calculated. Univariate andmore » multivariable (MVA) analyses included age, performance status, recursive partitioning analysis (RPA) class, extracranial disease control, and time from initial RT to salvage SRS. Results: There were 106 patients included in the analysis with a median age of 56.9 years (range 32.5-82 years). A median of 2 metastases were treated per patient (range, 1-12) with a median dose of 21 Gy (range, 12-24) prescribed to the 50% isodose. With a median follow-up of 10.5 months (range, 0.1-68.2), LC was 82.8%, 60.1%, and 46.8% at 6 months, 1 year, and 3 years, respectively. Median PFS was 6.2 months (95% confidence interval [CI] = 4.9-7.6). Median OS was 11.7 months (95% CI = 8.1-13) from salvage SRS, and 22.1 months from IBMD (95% CI = 18.4-26.8). On MVA, age (P=.01; hazard ratio [HR] = 1.04; 95% CI = 1.01-1.07), extracranial disease control (P=.004; HR = 0.46; 95% CI = 0.27-0.78), and interval from initial RT to salvage SRS of at least 265 days (P=.001; HR = 2.46; 95% CI = 1.47-4.09) were predictive of OS. Conclusions: This study demonstrates that patients can have durable local control and survival after salvage SRS for recurrent brain metastases. In particular, younger patients with controlled extracranial disease and a durable response to initial brain RT are likely to benefit from salvage SRS.« less

Stereotactic Radiosurgery for Trigeminal Neuralgia in Patients With Multiple Sclerosis: A Multicenter Study.

PubMed

Xu, Zhiyuan; Mathieu, David; Heroux, France; Abbassy, Mahmoud; Barnett, Gene; Mohammadi, Alireza M; Kano, Hideyuki; Caruso, James; Shih, Han-Hsun; Grills, Inga S; Lee, Kuei; Krishnan, Sandeep; Kaufmann, Anthony M; Lee, John Y K; Alonso-Basanta, Michelle; Kerr, Marie; Pierce, John; Kondziolka, Douglas; Hess, Judith A; Gerrard, Jason; Chiang, Veronica; Lunsford, L Dade; Sheehan, Jason P

2018-04-23

Facial pain response (PR) to various surgical interventions in patients with multiple sclerosis (MS)-related trigeminal neuralgia (TN) is much less optimal. No large patient series regarding stereotactic radiosurgery (SRS) has been published. To evaluate the clinical outcomes of MS-related TN treated with SRS. This is a retrospective cohort study. A total of 263 patients contributed by 9 member tertiary referral Gamma Knife centers (2 in Canada and 7 in USA) of the International Gamma Knife Research Consortium (IGKRF) constituted this study. The median latency period of PR after SRS was 1 mo. Reasonable pain control (Barrow Neurological Institute [BNI] Pain Scores I-IIIb) was achieved in 232 patients (88.2%). The median maintenance period from SRS was 14.1 months (range, 10 days to 10 years). The actuarial reasonable pain control maintenance rates at 1 yr, 2 yr, and 4 yr were 54%, 35%, and 24%, respectively. There was a correlation between the status of achieving BNI-I and the maintenance of facial pain recurrence-free rate. The median recurrence-free rate was 36 mo and 12.2 mo in patients achieving BNI-I and BNI > I, respectively (P = .046). Among 210 patients with known status of post-SRS complications, the new-onset of facial numbness (BNI-I or II) after SRS occurred in 21 patients (10%). In this largest series SRS offers a reasonable benefit to risk profile for patients who have exhausted medical management. More favorable initial response to SRS may predict a long-lasting pain control.

Male Prison Inmates With Gender Dysphoria: When Is Sex Reassignment Surgery Appropriate?

PubMed

Osborne, Cynthia S; Lawrence, Anne A

2016-10-01

Gender dysphoria (GD), a feeling of persistent discomfort with one's biologic sex or assigned gender, is estimated to be more prevalent in male prison inmates than in nonincarcerated males; there may be 3000-4000 male inmates with GD in prisons in the United States. An increasing number of U.S. prison systems now offer gender dysphoric inmates diagnostic evaluation, psychotherapy, cross-sex hormone therapy, and opportunities, albeit limited, to enact their preferred gender role. Sex reassignment surgery (SRS), however, has not been offered to inmates except in response to litigation. In the first case of its kind, the California Department of Corrections and Rehabilitation recently agreed to provide SRS to an inmate and developed policy guidelines for its future provision. In other recent cases, U.S. courts have ruled that male inmates with GD are entitled to SRS when it is medically necessary. Although these decisions may facilitate the provision of SRS to inmates in the future, many U.S. prison systems will probably remain reluctant to offer SRS unless legally compelled to do so. In this review, we address the medical necessity of SRS for male inmates with GD. We also discuss eligibility criteria and the practical considerations involved in providing SRS to inmates. We conclude by offering recommendations for physicians, mental health professionals, and prison administrators, designed to facilitate provision of SRS to inmates with GD in a manner that provides humane treatment, maximizes the likelihood of successful outcomes, minimizes risk of regret, and generates data that can help inform future decisions.

Whole brain radiotherapy and stereotactic radiosurgery for patients with recursive partitioning analysis I and lesions <5 cm(3): A matched pair analysis.

PubMed

Viani, Gustavo Arruda; Godoi da Silva, Lucas Bernardes; Viana, Bruno Silveira; Rossi, Bruno Tiago; Suguikawa, Elton; Zuliani, Gisele

2016-01-01

The intention of this study is to compare whole brain radiotherapy and stereotactic radiosurgery (WBRT + SRS) with WBRT in patients with 1-4 brain metastases to find a subgroup of patients that have a great benefit with aggressive treatment. Between December 2002 and December 2013, 60 patients with 1-4 brain metastases were treated by WBRT + SRS. In this period, 60 patients treated with WBRT were matched with patients treated with WBRT + SRS. The median survival for the entire cohort was 8.3 months. In the univariate analysis, WBRT + SRS (0.031), the presence of extracranial disease (P = 0.02), Karnofsky performance score <70 (P = 0.0001), and age >65 (P = 0.001) years were significant factors for survival. In the entire cohort, the median survival for recursive partitioning analysis (RPA) classes I, II, and III was 11, 7, and 3 months, respectively (P = 0.0001). In a stratified analysis, only RPA class I achieved statistical significance for 1-year survival between the groups (WBRT + SRS = 51% and WBRT = 23%, P = 0.03). Cox regression analysis revealed WBRT + SRS, age >65 years, and extracranial disease as independent prognostic factors. In the univariate analysis, lesion volume ≤5 cm 3 (P = 0.002) and WBRT + SRS (P = 0.003) were the significant factors associated with better brain control. WBRT plus SRS was an independent prognostic factor for survival. However, the combined treatment appears to be justified only in patients with RPA I and lesion volume ≤5 cm 3, independently of the number of lesions.

Do the SRS-22 self-image and mental health domain scores reflect the degree of asymmetry of the back in adolescent idiopathic scoliosis?

PubMed

Cheshire, James; Gardner, Adrian; Berryman, Fiona; Pynsent, Paul

2017-01-01

Patient-reported outcomes are becoming increasingly recognised in the management of patients with adolescent idiopathic scoliosis (AIS). Integrated Shape Imaging System 2 (ISIS2) surface topography is a validated tool to assess AIS. Previous studies have failed to demonstrate strong correlations between AIS and patient-reported outcomes highlighting the need for additional objective surface parameters to define the deformities associated with AIS. The aim of this study was to examine whether the Scoliosis Research Society-22 (SRS-22) outcome questionnaire reflects the degree of measurable external asymmetry of the back in AIS and thus is a measure of patient outcome for external appearance. A total of 102 pre-operative AIS patients were identified retrospectively. Objective parameters were measured using ISIS2 surface topography. The associations between these parameters and the self-image and mental health domains of the SRS-22 questionnaire were investigated using correlation coefficients. All correlations between the parameters of asymmetry and SRS-22 self-image score were of weak strength. Similarly, all correlations between the parameters of asymmetry and SRS-22 mental health score were of weak strength. The SRS-22 mental health and self-image domains correlate poorly with external measures of deformity. This demonstrates that the assessment of mental health and self-image by the SRS-22 has little to do with external torso shape. Whilst the SRS-22 assesses the patient as a whole, it provides little information about objective measures of deformity over which a surgeon has control.

Impact of preexisting tumor necrosis on the efficacy of stereotactic radiosurgery in the treatment of brain metastases in women with breast cancer.

PubMed

Xu, Zhiyuan; Marko, Nicholas F; Angelov, Lilyana; Barnett, Gene H; Chao, Samuel T; Vogelbaum, Michael A; Suh, John H; Weil, Robert J

2012-03-01

Breast cancer is the second most common source of brain metastasis. Stereotactic radiosurgery (SRS) can be an effective treatment for some patients with brain metastasis (BM). Necrosis is a common feature of many brain tumors, including BM; however, the influence of tumor necrosis on treatment efficacy of SRS in women with breast cancer metastatic to the brain is unknown. A cohort of 147 women with breast cancer and BM treated consecutively with SRS over 10 years were studied. Of these, 80 (54.4%) had necrosis identified on pretreatment magnetic resonance images and 67 (46.4%) did not. Survival times were computed using the Kaplan-Meier method. Log-rank tests were used to compare groups with respect to survival times, Cox proportional hazards regression models were used to perform univariate and multivariate analyses, and chi-square and Fisher exact tests were used to compare clinicopathologic covariates. Neurological survival (NS) and survival after SRS were decreased in BM patients with necrosis at the time of SRS compared with patients without necrosis by 32% and 27%, respectively (NS median survival, 25 vs 17 months [log-rank test, P = .006]; SRS median survival, 15 vs 11 months [log-rank test, P = .045]). On multivariate analysis, HER2 amplification status and necrosis influenced NS and SRS after adjusting for standard clinical features, including BM number, size, and volume as well as Karnofsky performance status. Neuroimaging evidence of necrosis at the time of SRS significantly diminished the efficacy of therapy and was a potent prognostic marker. Copyright © 2011 American Cancer Society.

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

Benedict, Stanley H.; Bova, Frank J.; Clark, Brenda

This article is a tribute to the pioneering medical physicists over the last 50 years who have participated in the research, development, and commercialization of stereotactic radiosurgery (SRS) and stereotactic radiotherapy utilizing a wide range of technology. The authors have described the evolution of SRS through the eyes of physicists from its beginnings with the Gamma Knife in 1951 to proton and charged particle therapy; modification of commercial linacs to accommodate high precision SRS setups; the multitude of accessories that have enabled fine tuning patients for relocalization, immobilization, and repositioning with submillimeter accuracy; and finally the emerging technology of SBRT.more » A major theme of the article is the expanding role of the medical physicist from that of advisor to the neurosurgeon to the current role as a primary driver of new technology that has already led to an adaptation of cranial SRS to other sites in the body, including, spine, liver, and lung. SRS continues to be at the forefront of the impetus to provide technological precision for radiation therapy and has demonstrated a host of downstream benefits in improving delivery strategies for conventional therapy as well. While this is not intended to be a comprehensive history, and the authors could not delineate every contribution by all of those working in the pursuit of SRS development, including physicians, engineers, radiobiologists, and the rest of the therapy and dosimetry staff in this important and dynamic radiation therapy modality, it is clear that physicists have had a substantial role in the development of SRS and theyincreasingly play a leading role in furthering SRS technology.« less

Assessment of Residual Stresses in 3013 Inner and Outer Containers and Teardrop Samples

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

Stroud, Mary Ann; Prime, Michael Bruce; Veirs, Douglas Kirk

2015-12-08

This report is an assessment performed by LANL that examines packaging for plutonium-bearing materials and the resilience of its design. This report discusses residual stresses in the 3013 outer, the SRS/Hanford and RFETS/LLNL inner containers, and teardrop samples used in studies to assess the potential for SCC in 3013 containers. Residual tensile stresses in the heat affected zones of the closure welds are of particular concern.

The Development and Validation of the Student Response System Benefit Scale

ERIC Educational Resources Information Center

Hooker, J. F.; Denker, K. J.; Summers, M. E.; Parker, M.

2016-01-01

Previous research into the benefits student response systems (SRS) that have been brought into the classroom revealed that SRS can contribute positively to student experiences. However, while the benefits of SRS have been conceptualized and operationalized into a widely cited scale, the validity of this scale had not been tested. Furthermore,…

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

Hussain, Aamir; Brown, Paul D.; Stafford, Scott L.

Purpose: Patients with brainstem metastases have limited treatment options. In this study, we reviewed outcomes after stereotactic radiosurgery (SRS) in the management of patients with brainstem metastases. Methods and Materials: Records were reviewed of 22 consecutive patients presenting with brainstem metastases who underwent SRS. The most frequent primary malignancy was the lung (n = 11), followed by breast (n = 3) and kidney (n = 2). Three patients (14%) also underwent whole-brain radiation therapy (WBRT). The median tumor volume was 0.9 mL (range, 0.1-3.3 mL); the median tumor margin dose was 16 Gy (range, 14-23 Gy). Results: Median survival timemore » after SRS was 8.5 months. Although local tumor control was achieved in all patients with imaging follow-up (n = 19), 5 patients died from development and progression of new brain metastases. Two patients (9%) had symptom improvement after SRS, whereas 1 patient (5%) developed a new hemiparesis after SRS. Conclusions: Radiosurgery is safe and provides a high local tumor control rate for patients with small brainstem metastases. Patients with limited systemic disease and good performance status should be strongly considered for SRS.« less

Student Response Systems and Learning: Perceptions of the Student.

PubMed

Benson, Jeryl D; Szucs, Kimberly A; Taylor, Meredith

2016-10-01

To assess student perception of learning and use of a student response system (SRS) as a teaching/learning strategy. Survey methods were used to explore student perceptions of learning and use of student response systems as a pedagogical strategy. Fifty-nine graduate students participated in the survey post completion of two graduate intervention courses. Overall, there was a positive response to the use of SRS's in the classroom. All of the students (100%) recommended the continued use of the clickers for various reasons. The primary benefit reported by students related to providing immediate feedback, the opportunity to manipulate and revisit the content, and the ability to check for understanding within a class session. Students recommended the continued use of the SRS in classes to support acquisition of content and exam preparation. The student reported technology difficulties as the only the negative to SRS use in the classroom. Instructor perception was that the addition of the SRS devices added a new way to interact with the students. Suggestions for incorporating the use of a SRS devices into classroom instruction are offered.

Srs2 promotes synthesis-dependent strand annealing by disrupting DNA polymerase δ-extending D-loops

PubMed Central

Liu, Jie; Ede, Christopher; Wright, William D; Gore, Steven K; Jenkins, Shirin S; Freudenthal, Bret D; Todd Washington, M; Veaute, Xavier; Heyer, Wolf-Dietrich

2017-01-01

Synthesis-dependent strand annealing (SDSA) is the preferred mode of homologous recombination in somatic cells leading to an obligatory non-crossover outcome, thus avoiding the potential for chromosomal rearrangements and loss of heterozygosity. Genetic analysis identified the Srs2 helicase as a prime candidate to promote SDSA. Here, we demonstrate that Srs2 disrupts D-loops in an ATP-dependent fashion and with a distinct polarity. Specifically, we partly reconstitute the SDSA pathway using Rad51, Rad54, RPA, RFC, DNA Polymerase δ with different forms of PCNA. Consistent with genetic data showing the requirement for SUMO and PCNA binding for the SDSA role of Srs2, Srs2 displays a slight but significant preference to disrupt extending D-loops over unextended D-loops when SUMOylated PCNA is present, compared to unmodified PCNA or monoubiquitinated PCNA. Our data establish a biochemical mechanism for the role of Srs2 in crossover suppression by promoting SDSA through disruption of extended D-loops. DOI: http://dx.doi.org/10.7554/eLife.22195.001 PMID:28535142

Complementary deoxyribonucleic acid cloning of spermatogonial stem cell renewal factor.

PubMed

Miura, Takeshi; Ohta, Takashi; Miura, Chiemi I; Yamauchi, Kohei

2003-12-01

Spermatogonial mitosis can be subdivided into two processes: spermatogonial stem cell renewal and spermatogonial proliferation toward meiosis. Recently it has been indicated that estrogen, estradiol-17beta, is involved in regulating the renewal of spermatogonial stem cells in eel. To determine the genes that directly regulate this process, we used expression screening to identify genes whose expression is regulated by estradiol-17beta in testes. We detected a previously unidentified cDNA clone that is up-regulated by estradiol-17beta stimulation and named it eel spermatogenesis-related substances 34 (eSRS34) cDNA. Homology searching showed that eSRS34 shares amino acid sequence similarity with human platelet-derived endothelial cell growth factor. We examined the function of eSRS34 using several in vitro systems. Recombinant eSRS34 produced by a baculovirus system induced spermatogonial mitosis in testicular organ culture. Furthermore, the addition of an antibody specific for eSRS34 prevented spermatogonial mitosis induced by estradiol-17beta stimulation in a germ cell/somatic cell coculture system. We therefore conclude that eSRS34 is a "spermatogonial stem cell renewal factor."

Results of Toxicity Studies Conducted on Ceriodaphnia dubia and Daphnia ambigua in Support of an Alternate Species Demonstration, January - June 2000

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

Specht, W.L.

2003-01-14

In 1997, the Savannah River Site completed toxicity testing studies on an alternate species, Daphnia ambigua, that we have proposed for use as a toxicity testing organism at SRS. We demonstrated that this species could be cultured in the laboratory and that it was at least as sensitive as Ceriodaphnia dubia to a broad range of toxicants (Specht and Harmon, 1997; Harmon, 1998; Harmon and Specht, 1998; Harmon, Specht and Chandler, 1999). However, it performed better that C. dubia in very soft water, which is representative of many SRS effluents and receiving waters. In January 2000, representatives from SRS metmore » with representatives from U.S. EPA Region 4 and SCDHEC to discuss data needs related to EPA's consideration of SRS's request to use the alternate species (D. ambigua) for routine toxicity testing at SRS. SRS contends that the very low water hardness of some of its effluents is responsible for toxicity failures because the species recommended by the EPA (C. dubia) does not reproduce well in waters that have very low hardness.« less

SRS Computer Animation and Drive Train System

NASA Technical Reports Server (NTRS)

Arthun, Daniel; Schachner, Christian

2001-01-01

The spinning rocket simulator (SRS) is an ongoing project at Oral Roberts University. The goal of the SRS is to gather crucial data concerning a spinning rocket under thrust for the purpose of analysis and correction of the coning motion experienced by this type of spacecraft maneuver. The computer animation simulates a virtual, scale model of the component of the SRS that represents the spacecraft itself. This component is known as the (VSM), or virtual spacecraft model. During actual physical simulation, this component of the SRS will experience a coning. The goal of the animation is to cone the VSM within that range to accurately represent the motion of the actual simulator. The drive system of the SRS is the apparatus that turns the actual simulator. It consists of a drive motor, motor mount and chain to power the simulator into motion. The motor mount is adjustable and rigid for high torque application. A digital stepper motor controller actuates the main drive motor for linear acceleration. The chain transfers power from the motor to the simulator via sprockets on both ends.

An in-depth cognitive examination of individuals with superior face recognition skills.

PubMed

Bobak, Anna K; Bennetts, Rachel J; Parris, Benjamin A; Jansari, Ashok; Bate, Sarah

2016-09-01

Previous work has reported the existence of "super-recognisers" (SRs), or individuals with extraordinary face recognition skills. However, the precise underpinnings of this ability have not yet been investigated. In this paper we examine (a) the face-specificity of super recognition, (b) perception of facial identity in SRs, (c) whether SRs present with enhancements in holistic processing and (d) the consistency of these findings across different SRs. A detailed neuropsychological investigation into six SRs indicated domain-specificity in three participants, with some evidence of enhanced generalised visuo-cognitive or socio-emotional processes in the remaining individuals. While superior face-processing skills were restricted to face memory in three of the SRs, enhancements to facial identity perception were observed in the others. Notably, five of the six participants showed at least some evidence of enhanced holistic processing. These findings indicate cognitive heterogeneity in the presentation of superior face recognition, and have implications for our theoretical understanding of the typical face-processing system and the identification of superior face-processing skills in applied settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reliability and validity of the adapted Dutch version of the revised Scoliosis Research Society 22-item questionnaire.

PubMed

Schlösser, Tom P C; Stadhouder, Agnita; Schimmel, Janneke J P; Lehr, A Mechteld; van der Heijden, Geert J M G; Castelein, René M

2014-08-01

As in other fields of medicine, there is an increasing interest among orthopedic surgeons to measure health-related quality of life in adolescent idiopathic scoliosis patients and to evaluate the burden of disease and the effectiveness of different treatment strategies. The development of the revised Scoliosis Research Society 22-item patient questionnaire (SRS-22r) enabled a comprehensive evaluation of health-related quality of life of these patients. Over the years, the SRS-22r gained wide acceptance and has been used in several different countries, languages, and cultures. The SRS-22r has not been translated into Dutch to date. To translate the SRS-22r into Dutch and adapt it cross-culturally as outlined by international guidelines and to test its psychometric properties to measure health-related quality of life of adolescent idiopathic scoliosis patients in the Netherlands. A cross-sectional, multicenter validation study. A total of 135 adolescent idiopathic scoliosis patients (mean age 15.1 years old) of three major scoliosis centers in the Netherlands were enrolled in this study. Ninety-two (68%) subjects completed the Dutch SRS-22r, Child Health Questionnaire (CHQ)-CF87 (golden standard for adolescents), and Short Form (SF)-36 (golden standard for adults). Two weeks later, 73 (79%) of 92 respondents returned a second SRS-22r. Demographics, curve type, Risser stage, and treatment status were documented. Floor and ceiling effects, internal consistency, reproducibility, concurrent validity, and discriminative ability of the Dutch version of the SRS-22r questionnaire. For content analysis, SRS-22r domain scores (function, pain, self-image, mental health, and satisfaction with management) were explored and floor and ceiling effects were determined. Cronbach's α was calculated for internal consistency of each domain of the questionnaires and reproducibility was assessed by test-retest reliability analysis. Using Pearson's correlation coefficient, comparison of the domains of the Dutch SRS-22r with the domains of the SF-36 and Child Health Questionnaire-CF87 assessed the concurrent validity. Differences in SRS-22r domain scores between untreated patients with different curve severity determined the discriminative ability of the questionnaire. The SRS-22r domains as well as the SF-36 and CHQ-CF87 domains demonstrated no floor effects, but the function, pain, and satisfaction with management domains had ceiling effects, indicating the proportion of subjects with the maximum score between 19.6% and 33.0%. Internal consistency was very satisfactory for all SRS-22r domains: Cronbach's α was between 0.718 and 0.852. By omitting question 15, the internal consistency of the function domain increased from 0.746 to 0.827. Test-retest reliability was ≥0.799 for all SRS-22r domains. The function, pain, mental health, and self-image domains correlated under the 0.001 significance level with the corresponding CHQ-CF87 and SF-36 domains. The satisfaction with management domain did not correlate with the other questionnaires. The SRS-22r had the ability to detect differences between groups with different curve severity; patients with a severe scoliotic curvature had significantly lower pain and self-image domain scores than patients with relatively mild scoliosis. The Dutch SRS-22r had the properties needed for the measurement of patient perceived health-related quality of life of adolescent idiopathic scoliosis patients in the Netherlands. The Dutch SRS-22r could be used for the longitudinal follow-up of adolescent idiopathic scoliosis patients from adolescence to adulthood and for establishing the effects of conservative or invasive surgical treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

Applied environmental technology development at the Savannah River Site: A retrospective on the last half of the 20th century

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

Looney, B.B.

2000-03-13

Fifty years ago, the Savannah River Site (SRS) was built to produce nuclear materials. These operations impacted air, soil, groundwater, ecology and the local environment. Throughout its history, SRS has addressed these contamination issues directly and has maintained a strong commitment to environmental stewardship. The site boasts many environmental firsts. Notably, SRS was the first major DOE facility to perform a baseline ecological assessment. This pioneering effort, by Ruth Patrick and the Philadelphia Academy of Sciences, was performed during SRS planning and construction in the early 1950's. This unique early example sets the stage for subsequent efforts. Since that time,more » the scientists and engineers at SRS have proactively identified environmental problems as they occurred and have skillfully developed elegant and efficient solutions.« less

Validation of the Self-Regulation Scale in Chinese Children

ERIC Educational Resources Information Center

Zhou, Ying; Bullock, Amanda; Liu, Junsheng; Fu, Rui; Coplan, Robert J.; Cheah, Charissa S. L.

2016-01-01

Psychometric properties of the Chinese version of the Self-Regulation Scale (C-SRS) were examined in a sample of 1,458 third- to eighth-grade students in China. Children completed self-reports of self-regulation, loneliness, depression, and self-esteem, and teachers rated children's school adjustment. Results showed a stable three-factor model…

Salvage stereotactic radiosurgery for breast cancer brain metastases: outcomes and prognostic factors.

PubMed

Kelly, Paul J; Lin, Nancy U; Claus, Elizabeth B; Quant, Eudocia C; Weiss, Stephanie E; Alexander, Brian M

2012-04-15

Salvage stereotactic radiosurgery (SRS) is often considered in breast cancer patients previously treated for brain metastases. The goal of this study was to analyze clinical outcomes and prognostic factors for survival in the salvage setting. The authors retrospectively examined 79 consecutive breast cancer patients who received salvage SRS (interval of >3 months after initial therapy), 76 of whom (96%) received prior whole-brain radiation therapy. Overall survival (OS) and central nervous system (CNS) progression-free survival rates were calculated from the date of SRS using the Kaplan-Meier method. Prognostic factors were evaluated using the Cox proportional hazards model. Median age was 50.5 years. Fifty-eight percent of this population was estrogen receptor positive, 62% was HER2 positive, and 10% was triple negative. At the time of SRS, 95% had extracranial metastases, with 81% of extracranial metastases at other visceral sites (lung/pleura/liver). Forty-eight percent had stable extracranial disease. Median interval from initial brain metastases therapy to SRS was 8.4 months. Median CNS progression-free survival after SRS was 5.7 months (interquartile range [IQR], 3.6-11 months), and median OS was 9.8 months (IQR, 3.8-18 months). Eighty-two percent of evaluable patients received further systemic therapy after SRS. HER2 status (adjusted hazard ratio [HR], 2.4; P = .008) and extracranial disease status (adjusted HR, 2.7; P = .004) were significant prognostic factors for survival on multivariate analysis. In patients with good Karnofsky performance status, salvage SRS for breast cancer brain metastases is a reasonable treatment option, given an associated median survival in excess of 9 months. Furthermore, patients with HER2-positive tumors at diagnosis or stable extracranial disease at the time of SRS have an improved clinical course, with median survival of >1 year. Copyright © 2011 American Cancer Society.

Prognostic Factors for Survival in Patients Treated With Stereotactic Radiosurgery for Recurrent Brain Metastases After Prior Whole Brain Radiotherapy

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

Caballero, Jorge A.; Sneed, Penny K., E-mail: psneed@radonc.ucsf.edu; Lamborn, Kathleen R.

2012-05-01

Purpose: To evaluate prognostic factors for survival after stereotactic radiosurgery (SRS) for new, progressive, or recurrent brain metastases (BM) after prior whole brain radiotherapy (WBRT). Methods and Materials: Patients treated between 1991 and 2007 with Gamma Knife SRS for BM after prior WBRT were retrospectively reviewed. Potential prognostic factors were analyzed overall and by primary site using univariate and stepwise multivariate analyses and recursive partitioning analysis, including age, Karnofsky performance status (KPS), primary tumor control, extracranial metastases, number of BM treated, total SRS target volume, and interval from WBRT to SRS. Results: A total of 310 patients were analyzed, includingmore » 90 breast, 113 non-small-cell lung, 31 small-cell lung, 42 melanoma, and 34 miscellaneous patients. The median age was 56, KPS 80, number of BM treated 3, and interval from WBRT to SRS 8.1 months; 76% had controlled primary tumor and 60% had extracranial metastases. The median survival was 8.4 months overall and 12.0 vs. 7.9 months for single vs. multiple BM treated (p = 0.001). There was no relationship between number of BM and survival after excluding single-BM patients. On multivariate analysis, favorable prognostic factors included age <50, smaller total target volume, and longer interval from WBRT to SRS in breast cancer patients; smaller number of BM, KPS >60, and controlled primary in non-small-cell lung cancer patients; and smaller total target volume in melanoma patients. Conclusions: Among patients treated with salvage SRS for BM after prior WBRT, prognostic factors appeared to vary by primary site. Although survival time was significantly longer for patients with a single BM, the median survival time of 7.9 months for patients with multiple BM seems sufficiently long for salvage SRS to appear to be worthwhile, and no evidence was found to support the use of a cutoff for number of BM appropriate for salvage SRS.« less

Comparing pre-operative stereotactic radiosurgery (SRS) to post-operative whole brain radiation therapy (WBRT) for resectable brain metastases: a multi-institutional analysis.

PubMed

Patel, Kirtesh R; Burri, Stuart H; Boselli, Danielle; Symanowski, James T; Asher, Anthony L; Sumrall, Ashley; Fraser, Robert W; Press, Robert H; Zhong, Jim; Cassidy, Richard J; Olson, Jeffrey J; Curran, Walter J; Shu, Hui-Kuo G; Crocker, Ian R; Prabhu, Roshan S

2017-02-01

Pre-operative stereotactic radiosurgery (pre-SRS) has been shown as a viable treatment option for resectable brain metastases (BM). The aim of this study is to compare oncologic outcomes and toxicities for pre-SRS and post-operative WBRT (post-WBRT) for resectable BM. We reviewed records of consecutive patients who underwent resection of BM and either pre-SRS or post-WBRT between 2005 and 2013 at two institutions. Overall survival (OS) was calculated using the Kaplan-Meier method. Cumulative incidence was used for intracranial outcomes. Multivariate analysis (MVA) was performed using the Cox and Fine and Gray models, respectively. Overall, 102 patients underwent surgical resection of BM; 66 patients with 71 lesions received pre-SRS while 36 patients with 42 cavities received post-WBRT. Baseline characteristics were similar except for the pre-SRS cohort having more single lesions (65.2% vs. 38.9%, p = 0.001) and smaller median lesion volume (8.3 cc vs. 15.3 cc, p = 0.006). 1-year OS was similar between cohorts (58% vs. 56%, respectively) (p = 0.43). Intracranial outcomes were also similar (2-year outcomes, pre-SRS vs. post-WBRT): local recurrence: 24.5% vs. 25% (p = 0.81), distant brain failure (DBF): 53.2% vs. 45% (p = 0.66), and leptomeningeal disease (LMD) recurrence: 3.5% vs. 9.0% (p = 0.66). On MVA, radiation cohort was not independently associated with OS or any intracranial outcome. Crude rates of symptomatic radiation necrosis were 5.6 and 0%, respectively. OS and intracranial outcomes were similar for patients treated with pre-SRS or post-WBRT for resected BM. Pre-SRS is a viable alternative to post-WBRT for resected BM. Further confirmatory studies with neuro-cognitive outcomes comparing these two treatment paradigms are needed.

Stereotactic radiosurgery for arteriovenous malformations after Onyx embolization: a case-control study.

PubMed

Lee, Cheng-Chia; Chen, Ching-Jen; Ball, Benjamin; Schlesinger, David; Xu, Zhiyuan; Yen, Chun-Po; Sheehan, Jason

2015-07-01

Onyx, an ethylene-vinyl alcohol copolymer mixed in a dimethyl sulfoxide solvent, is currently one of the most widely used liquid materials for embolization of intracranial arteriovenous malformations (AVMs). The goal of this study was to define the risks and benefits of stereotactic radiosurgery (SRS) for patients who have previously undergone partial AVM embolization with Onyx. Among a consecutive series of 199 patients who underwent SRS between January 2007 and December 2012 at the University of Virginia, 25 patients had Onyx embolization prior to SRS (the embolization group). To analyze the obliteration rates and complications, 50 patients who underwent SRS without prior embolization (the no-embolization group) were matched by propensity score method. The matched variables included age, sex, nidus volume before SRS, margin dose, Spetzler-Martin grade, Virginia Radiosurgery AVM Scale score, and median imaging follow-up period. After Onyx embolization, 18 AVMs were reduced in size. Total obliteration was achieved in 6 cases (24%) at a median of 27.5 months after SRS. In the no-embolization group, total obliteration was achieved in 20 patients (40%) at a median of 22.4 months after SRS. Kaplan-Meier analysis demonstrated obliteration rates of 17.7% and 34.1% in the embolization group at 2 and 4 years, respectively. In the no-embolization group, the corresponding obliteration rates were 27.0% and 55.9%. The between-groups difference in obliteration rates after SRS did not achieve statistical significance. The difference in complications, including adverse radiation effects, hemorrhage episodes, seizure control, and patient mortality also did not reach statistical significance. Onyx embolization can effectively reduce the size of many AVMs. This case-control study did not show any statistically significant difference in the rates of embolization or complications after SRS in patients who had previously undergone Onyx embolization and those who had not.

Assessing the dosimetric and geometric accuracy of stereotactic radiosurgery

NASA Astrophysics Data System (ADS)

Dimitriadis, Alexis

Stereotactic radiosurgery (SRS) is a non-invasive treatment predominantly used for the management of malignant and benign brain tumours. The treatment can be delivered by various platforms in a single fraction where a high dose of radiation is delivered to the target whilst the surrounding healthy tissue is spared. This requires a high degree of accuracy in terms of the dose level delivered but also in terms of geometric precision. The purpose of this work was to identify the variations of SRS practice in the UK and develop a novel method compatible with all practices, capable of assessing the accuracy of delivery. The motivation behind this effort was to contribute to safety in SRS delivery, provide confidence through a quality assurance audit and form a basis to support standardisation in SRS. A national survey was performed to investigate SRS practices in the UK and to help guide the methodology of this thesis. This resulted to the development of a method for an end-to-end audit of SRS. This was based on an anthropomorphic head phantom with a medium sized target located centrally in the brain, in close proximity to the brainstem. This realistic patient scenario was presented to all 26 radiosurgery centres in the UK who were asked to treat it with SRS. The dose delivered was assessed using two novel commercially available radiation detectors, a plastic scintillator and radiochromic film. These detectors were characterised for measuring the dose delivered in SRS. Another established dosimetry system, alanine, was also used alongside these detectors to assess the accuracy of each delivery. The results allowed the assessment of SRS practices in the UK and the comparison of all centres that participated in the audit. The results were also used to evaluate the performance of the dosimeters used for the purposes of quality assurance measurements and audit.

TU-FG-201-07: Development of SRS Conical Collimator Collision Prediction Software for Radiation Treatment Safety

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

Gutti, V; Morrow, A; Kim, S

Purpose: Stereotactic radiosurgery (SRS) treatments using conical collimators can potentially result in gantry collision with treatment table due to limited collision-clear spaces. An in-house software was developed to help the SRS treatment planner mitigate potential SRS conical collimator (Varian Medical System, Palo Alto, CA) collisions with the treatment table. This software was designed to remove treatment re-planning secondary to unexpected collisions. Methods: A BrainLAB SRS ICT Frameless Extension used for SRS treatments in our clinic was mathematically modelled using surface points registered to the 3D co-ordinate space of the couch extension. The surface points are transformed based on the treatmentmore » isocenter point and potential collisions are determined in 3D space for couch and gantry angle combinations. The distance between the SRS conical collimators and LINAC isocenter is known. The collision detection model was programmed in MATLAB (Mathwork, Natick, MA) to display graphical plots of the calculations, and the plotted data is used to avoid the gantry and couch angle combinations that would likely result in a collision. We have utilized the cone collision tool for 23 SRS cone treatment plans (8 retrospective and 15 prospective for 10 patients). Results: Twenty one plans strongly agreed with the software tool prediction for collision. However, in two plans, a collision was observed with a 0.5 cm margin when the software predicted no collision. Therefore, additional margins were added to the clearance criteria in the program to achieve a lower risk of actual collisions. Conclusion: Our in-house developed collision check software successfully avoided SRS cone re-planning by 91.3% due to a reduction in cone collisions with the treatment table. Future developments to our software will include a CT image data set based collision prediction model as well as a beam angle optimization tool to avoid normal critical tissues as well as previously treated lesions.« less

Towards frameless maskless SRS through real-time 6DoF robotic motion compensation.

PubMed

Belcher, Andrew H; Liu, Xinmin; Chmura, Steven; Yenice, Kamil; Wiersma, Rodney D

2017-11-13

Stereotactic radiosurgery (SRS) uses precise dose placement to treat conditions of the CNS. Frame-based SRS uses a metal head ring fixed to the patient's skull to provide high treatment accuracy, but patient comfort and clinical workflow may suffer. Frameless SRS, while potentially more convenient, may increase uncertainty of treatment accuracy and be physiologically confining to some patients. By incorporating highly precise robotics and advanced software algorithms into frameless treatments, we present a novel frameless and maskless SRS system where a robot provides real-time 6DoF head motion stabilization allowing positional accuracies to match or exceed those of traditional frame-based SRS. A 6DoF parallel kinematics robot was developed and integrated with a real-time infrared camera in a closed loop configuration. A novel compensation algorithm was developed based on an iterative closest-path correction approach. The robotic SRS system was tested on six volunteers, whose motion was monitored and compensated for in real-time over 15 min simulated treatments. The system's effectiveness in maintaining the target's 6DoF position within preset thresholds was determined by comparing volunteer head motion with and without compensation. Comparing corrected and uncorrected motion, the 6DoF robotic system showed an overall improvement factor of 21 in terms of maintaining target position within 0.5 mm and 0.5 degree thresholds. Although the system's effectiveness varied among the volunteers examined, for all volunteers tested the target position remained within the preset tolerances 99.0% of the time when robotic stabilization was used, compared to 4.7% without robotic stabilization. The pre-clinical robotic SRS compensation system was found to be effective at responding to sub-millimeter and sub-degree cranial motions for all volunteers examined. The system's success with volunteers has demonstrated its capability for implementation with frameless and maskless SRS treatments, potentially able to achieve the same or better treatment accuracies compared to traditional frame-based approaches.

Safety and utility of kyphoplasty prior to spine stereotactic radiosurgery for metastatic tumors: a clinical and dosimetric analysis.

PubMed

Barzilai, Ori; DiStefano, Natalie; Lis, Eric; Yamada, Yoshiya; Lovelock, D Michael; Fontanella, Andrew N; Bilsky, Mark H; Laufer, Ilya

2018-01-01

OBJECTIVE The aim of this study was to evaluate the safety and efficacy of kyphoplasty treatment prior to spine stereotactic radiosurgery (SRS) in patients with spine metastases. METHODS A retrospective review of charts, radiology reports, and images was performed for all patients who received SRS (single fraction; either standalone or post-kyphoplasty) at a large tertiary cancer center between January 2012 and July 2015. Patient and tumor variables were documented, as well as treatment planning data and dosimetry. To measure the photon scatter due to polymethyl methacrylate, megavolt photon beam attenuation was determined experimentally as it passed through a kyphoplasty cement phantom. Corrected electron density values were recalculated and compared with uncorrected values. RESULTS Of 192 treatment levels in 164 unique patients who underwent single-fraction SRS, 17 (8.8%) were treated with kyphoplasty prior to radiation delivery to the index level. The median time from kyphoplasty to SRS was 22 days. Four of 192 treatments (2%) demonstrated local tumor recurrence or progression at the time of analysis. Of the 4 local failures, 1 patient had kyphoplasty prior to SRS. This recurrence occurred 18 months after SRS in the setting of widespread systemic disease and spinal tumor progression. Dosimetric review demonstrated a lower than average treatment dose for this case compared with the rest of the cohort. There were no significant differences in dosimetry analysis between the group of patients who underwent kyphoplasty prior to SRS and the remaining patients in the cohort. A preliminary analysis of polymethyl methacrylate showed that dosimetric errors due to uncorrected electron density values were insignificant. CONCLUSIONS In cases without epidural spinal cord compression, stabilization with cement augmentation prior to SRS is safe and does not alter the efficacy of the radiation or preclude physicians from adhering to SRS planning and contouring guidelines.

Towards frameless maskless SRS through real-time 6DoF robotic motion compensation

NASA Astrophysics Data System (ADS)

Belcher, Andrew H.; Liu, Xinmin; Chmura, Steven; Yenice, Kamil; Wiersma, Rodney D.

2017-12-01

Stereotactic radiosurgery (SRS) uses precise dose placement to treat conditions of the CNS. Frame-based SRS uses a metal head ring fixed to the patient’s skull to provide high treatment accuracy, but patient comfort and clinical workflow may suffer. Frameless SRS, while potentially more convenient, may increase uncertainty of treatment accuracy and be physiologically confining to some patients. By incorporating highly precise robotics and advanced software algorithms into frameless treatments, we present a novel frameless and maskless SRS system where a robot provides real-time 6DoF head motion stabilization allowing positional accuracies to match or exceed those of traditional frame-based SRS. A 6DoF parallel kinematics robot was developed and integrated with a real-time infrared camera in a closed loop configuration. A novel compensation algorithm was developed based on an iterative closest-path correction approach. The robotic SRS system was tested on six volunteers, whose motion was monitored and compensated for in real-time over 15 min simulated treatments. The system’s effectiveness in maintaining the target’s 6DoF position within preset thresholds was determined by comparing volunteer head motion with and without compensation. Comparing corrected and uncorrected motion, the 6DoF robotic system showed an overall improvement factor of 21 in terms of maintaining target position within 0.5 mm and 0.5 degree thresholds. Although the system’s effectiveness varied among the volunteers examined, for all volunteers tested the target position remained within the preset tolerances 99.0% of the time when robotic stabilization was used, compared to 4.7% without robotic stabilization. The pre-clinical robotic SRS compensation system was found to be effective at responding to sub-millimeter and sub-degree cranial motions for all volunteers examined. The system’s success with volunteers has demonstrated its capability for implementation with frameless and maskless SRS treatments, potentially able to achieve the same or better treatment accuracies compared to traditional frame-based approaches.

Linear accelerator-based stereotactic radiosurgery for brainstem metastases: the Dana-Farber/Brigham and Women's Cancer Center experience.

PubMed

Kelly, Paul J; Lin, Yijie Brittany; Yu, Alvin Y C; Ropper, Alexander E; Nguyen, Paul L; Marcus, Karen J; Hacker, Fred L; Weiss, Stephanie E

2011-09-01

To review the safety and efficacy of linear accelerator-based stereotactic radiosurgery (SRS) for brainstem metastases. We reviewed all patients with brain metastases treated with SRS at DF/BWCC from 2001 to 2009 to identify patients who had SRS to a single brainstem metastasis. Overall survival and freedom-from-local failure rates were calculated from the date of SRS using the Kaplan-Meier method. Prognostic factors were evaluated using the log-rank test and Cox proportional hazards model. A total of 24 consecutive patients with brainstem metastases had SRS. At the time of SRS, 21/24 had metastatic lesions elsewhere within the brain. 23/24 had undergone prior WBRT. Primary diagnoses included eight NSCLC, eight breast cancer, three melanoma, three renal cell carcinoma and two others. Median dose was 13 Gy (range, 8-16). One patient had fractionated SRS 5 Gy ×5. Median target volume was 0.2 cc (range, 0.02-2.39). The median age was 57 years (range, 42-92). Follow-up information was available in 22/24 cases. At the time of analysis, 18/22 patients (82%) had died. The median overall survival time was 5.3 months (range, 0.8-21.1 months). The only prognostic factor that trended toward statistical significance for overall survival was the absence of synchronous brain metastasis at the time of SRS; 1-year overall survival was 31% with versus 67% without synchronous brain metastasis (log rank P = 0.11). Non-significant factors included primary tumor histology and status of extracranial disease (progressing vs. stable/absent). Local failure occurred in 4/22 cases (18%). Actuarial freedom from local failure for all cases was 78.6% at 1 year. RTOG grade 3 toxicities were recorded in two patients (ataxia, confusion). Linac-based SRS for small volume brainstem metastases using a median dose of 13 Gy is associated with acceptable local control and low morbidity.

Quality of search strategies reported in systematic reviews published in stereotactic radiosurgery.

PubMed

Faggion, Clovis M; Wu, Yun-Chun; Tu, Yu-Kang; Wasiak, Jason

2016-06-01

Systematic reviews require comprehensive literature search strategies to avoid publication bias. This study aimed to assess and evaluate the reporting quality of search strategies within systematic reviews published in the field of stereotactic radiosurgery (SRS). Three electronic databases (Ovid MEDLINE(®), Ovid EMBASE(®) and the Cochrane Library) were searched to identify systematic reviews addressing SRS interventions, with the last search performed in October 2014. Manual searches of the reference lists of included systematic reviews were conducted. The search strategies of the included systematic reviews were assessed using a standardized nine-question form based on the Cochrane Collaboration guidelines and Assessment of Multiple Systematic Reviews checklist. Multiple linear regression analyses were performed to identify the important predictors of search quality. A total of 85 systematic reviews were included. The median quality score of search strategies was 2 (interquartile range = 2). Whilst 89% of systematic reviews reported the use of search terms, only 14% of systematic reviews reported searching the grey literature. Multiple linear regression analyses identified publication year (continuous variable), meta-analysis performance and journal impact factor (continuous variable) as predictors of higher mean quality scores. This study identified the urgent need to improve the quality of search strategies within systematic reviews published in the field of SRS. This study is the first to address how authors performed searches to select clinical studies for inclusion in their systematic reviews. Comprehensive and well-implemented search strategies are pivotal to reduce the chance of publication bias and consequently generate more reliable systematic review findings.

Absolute quantification methods in tissue near-infrared spectroscopy

NASA Astrophysics Data System (ADS)

Matcher, Steven J.; Kirkpatrick, Peter J.; Nahid, K.; Cope, Mark; Delpy, David T.

1995-05-01

Recent work aimed at providing an absolute measurement of tissue haemoglobin saturation and a new instrument development, the spatially resolved spectrometer (SRS), are discussed. The theoretical basis of operation of this device and its hardware implementation are described and the results of validation studies on tissue simulating phantoms are presented as are preliminary measurements on human volunteers and observations on patients undergoing neurosurgery. In its present form the instrument appears to produce absolute haemoglobin saturation values for resting human skeletal muscle and the normally perfused human head which are rather low based on physiological expectations. However, we obtained a tight correlation between the saturation values measured by the SRS instrument and those obtained from blood-gas analysis of samples drawn from a jugular bulb catheter in one neurosurgery subject during clamping of the right carotid arteries.

Improvements to the Hunter Dose tracking system

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

Whiteside, T. S.; Aucott, T. J.; Brand, A. D.

Since 1965, the Savannah River Site (SRS) has conducted deer hunts which are open to the general public. SRS performs field monitoring for cesium-137 (Cs-137) of each harvested animal to determine whether the animal may be released to the hunter. A new field system for measuring Cs-137 in the harvested animals has been developed. The system incorporates numerous enhancements compared to the original system. The original system was composed of two Ludlum Measurements scalar-driven 2 inch x 2 inch sodium iodide counters, while the new system is based on a single Ametek Ortec Digibase-driven 2 inch x 4 inch xmore » 16 inch sodium iodide gamma spectrometer. The new system includes a series of easy-to-assemble stainless steel encapsulated lead shields. The combination of the larger detector size and lead shielding improved the detection limit of the new system by a factor of approximately three compared to the original system. This lower detection limit allows for a larger number of measurements to be directly compared to the laboratory results, in cases where animal portions have been sampled. The results from developing and using this system are presented as well as recommendations on improvements to the overall field monitoring of the SRS hunts.« less

The Geoscience Laser Altimeter System (GLAS) for the ICESAT Mission

NASA Technical Reports Server (NTRS)

Abshire, James B.; Sun, Xiao-Li; Ketchum, Eleanor A.; Afzal, Robert S.; Millar, Pamela S.

1999-01-01

Accurate measurements of surface heights and atmospheric backscatter have been demonstrated with the SLA, MOLA and LITE space lidar. Recent MOLA measurements of the Mars surface have 40 cm resolution and have reduced the global uncertainty in Mars topography from a few km to approx. 10 m. GLAS is a next generation lidar being developed as part of NASA's Icesat Mission for Earth orbit . The GLAS design combines a 10 cm precision surface lidar with a sensitive dual wavelength cloud and aerosol lidar. GLAS will precisely measure the heights of the Earth's polar ice sheets, determine the height profiles of the Earth's land topography, and profile the vertical backscatter of clouds and aerosols on a global scale. GLAS will fly on a small dedicated spacecraft in a polar orbit at 598 km altitude with an inclination of 94 degrees. GLAS is scheduled to launch in summer 2001 and to operate continuously for a minimum of 3 years with a goal of 5 years. The primary mission for GLAS is to measure the seasonal and annual changes in the heights of the Greenland and Antarctic ice sheets. GLAS will measure the vertical distance to the ice sheet from orbit with 1064 nm pulses from a Nd:Yag laser at 40 Hz. Each 5 nsec wide laser pulse is used for a single range measurement. When over land GLAS will profile the heights of the topography and vegetation. The GLAS receiver uses a I m diameter telescope and a Si APD detector. The detector signal is sampled by an all digital receiver which records each surface echo waveform with I nsec resolution and a stored echo record lengths of either 200, 400, or 600 samples. Analysis of the echo waveforms within the instrument permits discrimination between cloud and surface echoes. Ground based echo analysis permits precise ranging, determining the roughness or slopes of the surface as well as the vertical distributions of vegetation illuminated by the laser, Errors in knowledge of the laser beam pointing angle can bias height measurements of sloped surfaces. For surfaces with 2 deg. slopes, knowledge of pointing angle of the beam centroid to about 8 urad is required to achieve 10 cm height accuracy. GLAS uses a stellar reference system (SRS) to determine the pointing angle of each laser firing relative to inertial space. The SRS uses a high precision star camera oriented toward local zenith whose measurements are combined with a gyroscope to determine the inertial orientation of the SRS optical bench. The far field pattern of each laser pulse is measured with a laser reference system (LRS). Optically measuring each laser far field pattern relative to the star camera and gyroscope permits the angular offsets of each laser pulse to be determined. GLAS will also determine the vertical distributions of clouds and aerosols by measuring atmospheric backscatter profiles at both 1064 and 532 nm. The 1064 nm measurements use an analog detector and profile the height and vertical structure of thicker clouds. Measurements at 532 nm use new highly sensitive photon counting detectors, and measure the height distributions of very thin clouds and aerosol layers. With averaging these can be used to determine the height of the planetary boundary layer. The instrument design and expected performance will be discussed.

Effects of variables upon pyrotechnically induced shock response spectra

NASA Technical Reports Server (NTRS)

Smith, J. L.

1986-01-01

Throughout the aerospace industry, large variations of 50 percent (6 dB) or more are continually noted for linear shaped charge (LSC) generated shock response spectra (SRS) from flight data (from the exact same location on different flights) and from plate tests (side by side measurements on the same test). A research program was developed to investigate causes of these large SRS variations. A series of ball drop calibration tests to verify calibration of accelerometers and a series of plate tests to investigate charge and assembly variables were performed. The resulting data were analyzed to determine if and to what degree manufacturing and assembly variables, distance from the shock source, data acquisition instrumentation, and shock energy propagation affect the SRS. LSC variables consisted of coreload, standoff, and apex angle. The assembly variable was the torque on the LSC holder. Other variables were distance from source of accelerometers, accelerometer mounting methods, and joint effects. Results indicated that LSC variables did not affect SRS as long as the plate was severed. Accelerometers mounted on mounting blocks showed significantly lower levels above 5000 Hz. Lap joints did not affect SRS levels. The test plate was mounted in an almost free-free state; therefore, distance from the source did not affect the SRS. Several varieties and brands of accelerometers were used, and all but one demonstrated very large variations in SRS.

Red laser based on intra-cavity Nd:YAG/CH4 frequency doubled Raman lasers

NASA Astrophysics Data System (ADS)

Wang, Yanchao; Wang, Pengyuan; Liu, Jinbo; Liu, Wanfa; Guo, Jingwei

2017-01-01

Stimulated Raman scattering (SRS) is a powerful tool for the extension of the spectral range of lasers. To obtain efficient Raman conversion in SRS, many researchers have studied different types of Raman laser configurations. Among these configurations, the intra-cavity type is particularly attractive. Intra-cavity SRS has the advantages of high intra-cavity laser intensity, low-SRS threshold, and high Raman conversion efficiency. In this paper, An Q-switched intra-cavity Nd: YAG/CH4 frequency-doubled Raman lasers is reported. A negative branch confocal resonator with M= 1.25 is used for the frequency-doubling of Nd: YAG laser. The consequent 532nm light is confined in intra- cavity SRS with travelling wave resonator, and the focal of one mirror of cavity is overlap with the center of the other mirror of the cavity. We found this design is especially efficient to reduce the threshold of SRS, and increase conversion efficiency. The threshold is measured to be 0.62 MW, and at the pump energy of 16.1 mJ, the conversion efficiency is 34%. With the smaller magnification M, the threshold could further decrease, and the conversion efficiency could be improved further. This is a successful try to extend the spectral range of a laser to the shorter wavelength by SRS, and this design may play an important role in the fulfillment of high power red lasers.

Label-free biomolecular characterization of human breast cancer tissue with stimulated Raman scattering (SRS) spectral imaging (Conference Presentation)

NASA Astrophysics Data System (ADS)

Lu, Fa-Ke F.; Calligaris, David; Suo, Yuanzhen; Santagata, Sandro; Golby, Alexandra J.; Xie, X. Sunney; Mallory, Melissa A.; Golshan, Mehra; Dillon, Deborah A.; Agar, Nathalie Y. R.

2017-02-01

Stimulated Raman scattering (SRS) microscopy has been used for rapid label-free imaging of various biomolecules and drugs in living cells and tissues (Science, doi:10.1126/science.aaa8870). Our recent work has demonstrated that lipid and protein mapping of cancer tissue renders pathology-like images, providing essential histopathological information with subcellular resolution of the entire specimen (Cancer Research, doi: 10.1158/0008-5472.CAN-16-027). We have also established the first SRS imaging Atlas of human brain tumors (Harvard Dataverse, doi: (doi:10.7910/DVN/EZW4EK). SRS imaging of tissue could provide invaluable information for cancer diagnosis and surgical guidance in two aspects: rapid surgical pathology and quantitative biomolecular characterization. In this work, we present the use of SRS microscopy for characterization of a few essential biomolecules in breast cancer. Human breast cancer tissue specimens at the tumor core, tumor margin and normal area (5 cm away from the tumor) from surgical cases will be imaged with SRS at multiple Raman shifts, including the peaks for lipid, protein, blood (absorption), collagen, microcalcification (calcium phosphates and calcium oxalate) and carotenoids. Most of these Raman shifts have relatively strong Raman cross sections, which ensures high-quality and fast imaging. This proof-of-principle study is sought to demonstrate the feasibility and potential of SRS imaging for ambient diagnosis and surgical guidance of breast cancer.

Emile: Software-Realized Scaffolding for Science Learners Programming in Mixed Media

NASA Astrophysics Data System (ADS)

Guzdial, Mark Joseph

Emile is a computer program that facilitates students using programming to create models of kinematics (physics of motion without forces) and executing these models as simulations. Emile facilitates student programming and model-building with software-realized scaffolding (SRS). Emile integrates a range of SRS and provides mechanisms to fade (or diminish) most scaffolding. By fading Emile's SRS, students can adapt support to their individual needs. Programming in Emile involves graphic and text elements (as compared with more traditional text-based programming). For example, students create graphical objects which can be dragged on the screen, and when dropped, fall as if in a gravitational field. Emile supports a simplified, HyperCard-like mixed media programming framework. Scaffolding is defined as support which enables student performance (called the immediate benefit of scaffolding) and which facilitates student learning (called the lasting benefit of scaffolding). Scaffolding provides this support through three methods: Modeling, coaching, and eliciting articulation. For example, Emile has tools to structure the programming task (modeling), menus identify the next step in the programming and model-building process (coaching), and prompts for student plans and predictions (eliciting articulation). Five students used Emile in a summer workshop (45 hours total) focusing on creating kinematics simulations and multimedia demonstrations. Evaluation of Emile's scaffolding addressed use of scaffolding and the expected immediate and lasting benefits. Emile created records of student interactions (log files) which were analyzed to determine how students used Emile's SRS and how they faded that scaffolding. Student projects and articulations about those projects were analyzed to assess success of student's model-building and programming activities. Clinical interviews were conducted before and after the workshop to determine students' conceptualizations of kinematics and programming and how they changed. The results indicate that students were successful at model-building and programming, learned physics and programming, and used and faded Emile's scaffolding over time. These results are from a small sample who were self -selected and highly-motivated. Nonetheless, this study provides a theory and operationalization for SRS, an example of a successful model-building environment, and a description of student use of mixed media programming.

Long-term monitoring of fleshy fruit and hard mast production and seasonal bird distribution at the Savannah River Site, South Carolina.

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

Greenberg, Cathryn, H.; Levey, Douglas J.

2009-06-15

A final report of Fruit and hard mast production in five habitat types at SRS with a comparison of fruit consumption by fledgling versus adult birds at SRS and Relative importance of fruit, seeds, and insects in the diets of overwintering birds at SRS.

Environmental Stewardship at the Savannah River Site: Generations of Success - 13212

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

Looney, Brian B.; Bergren, Christopher L.; Gaughan, Thomas F.

2013-07-01

Approximately sixty years ago, the Savannah River Site (SRS) was built to produce nuclear materials. SRS production operations impacted air, soil, groundwater, ecology, and the local environment. Throughout its history, SRS has addressed these contamination issues directly and has maintained a commitment to environmental stewardship. The Site boasts many environmental firsts. Notably, SRS was the first major Department of Energy (DOE) facility to perform a baseline ecological assessment. This pioneering effort, by Ruth Patrick and the Philadelphia Academy of Sciences, was performed during SRS planning and construction in the early 1950's. This unique early generation of work set the stagemore » for subsequent efforts. Since that time, the scientists and engineers at SRS pro-actively identified environmental problems and developed and implemented effective and efficient environmental management and remediation solutions. This second generation, spanning the 1980's through the 2000's, is exemplified by numerous large and small cleanup actions to address metals and radionuclides, solvents and hydrocarbons, facility and area decommissioning, and ecological restoration. Recently, a third generation of environmental management was initiated as part of Enterprise SRS. This initiative to 'Develop and Deploy Next Generation Cleanup Technologies' formalizes and organizes the major technology matching, development, and implementation processes associated with historical SRS cleanup success as a resource to support future environmental management missions throughout DOE. The four elements of the current, third generation, effort relate to: 1) transition from active to passive cleanup, 2) in situ decommissioning of large nuclear facilities, 3) new long term monitoring paradigms, and 4) a major case study related to support for recovery and restoration of the Japanese Fukushima-Daiichi nuclear power plant and surrounding environment. (authors)« less

Use of Stereotactic Radiosurgery for Brain Metastases From Non-Small Cell Lung Cancer in the United States

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

Halasz, Lia M., E-mail: lhalasz@uw.edu; Harvard Radiation Oncology Program, Harvard Medical School, Boston, Massachusetts; Weeks, Jane C.

2013-02-01

Purpose: The indications for treatment of brain metastases from non-small cell lung cancer (NSCLC) with stereotactic radiosurgery (SRS) remain controversial. We studied patterns, predictors, and cost of SRS use in elderly patients with NSCLC. Methods and Materials: Using the Surveillance, Epidemiology, and End Results-Medicare (SEER-Medicare) database, we identified patients with NSCLC who were diagnosed with brain metastases between 2000 and 2007. Our cohort included patients treated with radiation therapy and not surgical resection as initial treatment for brain metastases. Results: We identified 7684 patients treated with radiation therapy within 2 months after brain metastases diagnosis, of whom 469 (6.1%) casesmore » had billing codes for SRS. Annual SRS use increased from 3.0% in 2000 to 8.2% in 2005 and varied from 3.4% to 12.5% by specific SEER registry site. After controlling for clinical and sociodemographic characteristics, we found SRS use was significantly associated with increasing year of diagnosis, specific SEER registry, higher socioeconomic status, admission to a teaching hospital, no history of participation in low-income state buy-in programs (a proxy for Medicaid eligibility), no extracranial metastases, and longer intervals from NSCLC diagnosis. The average cost per patient associated with radiation therapy was 2.19 times greater for those who received SRS than for those who did not. Conclusions: The use of SRS in patients with metastatic NSCLC increased almost 3-fold from 2000 to 2005. In addition, we found significant variations in SRS use across SEER registries and socioeconomic quartiles. National practice patterns in this study suggested both a lack of consensus and an overall limited use of the approach among elderly patients before 2008.« less

A case-matched study of stereotactic radiosurgery for patients with brain metastases: comparing treatment results for those with versus without neurological symptoms.

PubMed

Koiso, Takao; Yamamoto, Masaaki; Kawabe, Takuya; Watanabe, Shinya; Sato, Yasunori; Higuchi, Yoshinori; Yamamoto, Tetsuya; Matsumura, Akira; Kasuya, Hidetoshi; Barfod, Bierta E

2016-12-01

We aimed to reappraise whether post-stereotactic radiosurgery (SRS) results for brain metastases differ between patients with and without neurological symptoms. This was an institutional review board-approved, retrospective cohort study using our prospectively accumulated database including 2825 consecutive BM patients undergoing gamma knife SRS alone during the 15-year period since July 1998. The 2825 patients were divided into two groups; neurologically asymptomatic [group A, 1374 patients (48.6 %)] and neurologically symptomatic [group B, 1451 (51.4 %)]. Because there was considerable bias in pre-SRS clinical factors between groups A and B, a case-matched study was conducted. Ultimately, 1644 patients (822 in each group) were selected. The standard Kaplan-Meier method was used to determine post-SRS survival. Competing risk analysis was applied to estimate cumulative incidences of neurological death, neurological deterioration, local recurrence, re-SRS for new lesions and SRS-induced complications. Post-SRS median survival times (MSTs) did not differ between the two groups; 7.8 months in group A versus 7.4 months in group B patients (HR 1.064, 95 % CI 0.963-1.177, p = 0.22). However, cumulative incidences of neurological death (HR 1.637, 95 % CI 1.174-2.281, p = 0.0036) and neurological deterioration (HR 1.425, 95 % CI 1.073-1.894, p = 0.014) were significantly lower in the group A than in the group B patients. Neurologically asymptomatic patients undergoing SRS for BM had better results than symptomatic patients in terms of both maintenance of good neurological state and prolonged neurological survival. Thus, we conclude that screening computed tomography/magnetic resonance imaging is highly beneficial for managing cancer patients.

Inception of a national multidisciplinary registry for stereotactic radiosurgery.

PubMed

Sheehan, Jason P; Kavanagh, Brian D; Asher, Anthony; Harbaugh, Robert E

2016-01-01

Stereotactic radiosurgery (SRS) represents a multidisciplinary approach to the delivery of ionizing high-dose radiation to treat a wide variety of disorders. Much of the radiosurgical literature is based upon retrospective single-center studies along with a few randomized controlled clinical trials. More timely and effective evidence is needed to enhance the consistency and quality of and clinical outcomes achieved with SRS. The authors summarize the creation and implementation of a national SRS registry. The American Association of Neurological Surgeons (AANS) through NeuroPoint Alliance, Inc., started a successful registry effort with its lumbar spine initiative. Following a similar approach, the AANS and NeuroPoint Alliance collaborated with corporate partners and the American Society for Radiation Oncology to devise a data dictionary for an SRS registry. Through administrative and financial support from professional societies and corporate partners, a framework for implementation of the registry was created. Initial plans were devised for a 3-year effort encompassing 30 high-volume SRS centers across the country. Device-specific web-based data-extraction platforms were built by the corporate partners. Data uploaders were then used to port the data to a common repository managed by Quintiles, a national and international health care trials company. Audits of the data for completeness and veracity will be undertaken by Quintiles to ensure data fidelity. Data governance and analysis are overseen by an SRS board comprising equal numbers of representatives from the AANS and NeuroPoint Alliance. Over time, quality outcome assessments and post hoc research can be performed to advance the field of SRS. Stereotactic radiosurgery offers a high-technology approach to treating complex intracranial disorders. Improvements in the consistency and quality of care delivered to patients who undergo SRS should be afforded by the national registry effort that is underway.

Stereotactic Radiosurgery in the Management of Limited (1-4) Brain Metasteses: Systematic Review and International Stereotactic Radiosurgery Society Practice Guideline.

PubMed

Chao, Samuel T; De Salles, Antonio; Hayashi, Motohiro; Levivier, Marc; Ma, Lijun; Martinez, Roberto; Paddick, Ian; Régis, Jean; Ryu, Samuel; Slotman, Ben J; Sahgal, Arjun

2017-11-03

Guidelines regarding stereotactic radiosurgery (SRS) for brain metastases are missing recently published evidence. To conduct a systematic review and provide an objective summary of publications regarding SRS in managing patients with 1 to 4 brain metastases. Using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was conducted using PubMed and Medline up to November 2016. A separate search was conducted for SRS for larger brain metastases. Twenty-seven prospective studies, critical reviews, meta-analyses, and published consensus guidelines were reviewed. Four key points came from these studies. First, there is no detriment to survival by withholding whole brain radiation (WBRT) in the upfront management of brain metastases with SRS. Second, while SRS on its own provides a high rate of local control (LC), WBRT may provide further increase in LC. Next, WBRT does provide distant brain control with less need for salvage therapy. Finally, the addition of WBRT does affect neurocognitive function and quality of life more than SRS alone. For larger brain metastases, surgical resection should be considered, especially when factoring lower LC with single-session radiosurgery. There is emerging data showing good LC and/or decreased toxicity with multisession radiosurgery. A number of well-conducted prospective and meta-analyses studies demonstrate good LC, without compromising survival, using SRS alone for patients with a limited number of brain metastases. Some also demonstrated less impact on neurocognitive function with SRS alone. Practice guidelines were developed using these data with International Stereotactic Radiosurgery Society consensus. Copyright © 2017 by the Congress of Neurological Surgeons

Place of Gamma Knife Stereotactic Radiosurgery in Grade 4 Vestibular Schwannoma Based on Case Series of 86 Patients with Long-Term Follow-Up.

PubMed

Lefranc, Michel; Da Roz, Leila Maria; Balossier, Anne; Thomassin, Jean Marc; Roche, Pierre Hugue; Regis, Jean

2018-06-01

Grade IV vestibular schwannoma (Koos classification) is generally considered to be an indication for microsurgical resection or combined radiosurgery-microsurgery. However, the place of Gamma Knife stereotactic surgery (GK-SRS), either as first-line treatment or when progression of residual tumor compresses the brainstem, has not been clearly evaluated. This article reports the results of a large case series of patients with grade 4 vestibular schwannoma treated by GK-SRS. All consecutive patients with grade IV vestibular schwannoma treated by GK-SRS in our department between 1996 and 2011 with a minimum follow-up of 3 years were included in this study. 86 patients were treated by GK-SRS with a minimum follow-up of 3 years. Mean follow-up was 6.2 years (3-16 years). The mean age of the patients at the time of GK-SRS was 54.6 years (range: 23-84) and the sex ratio was 0.6. At the time of radiosurgery, no patient presented brainstem dysfunction prior to GK-SRS. 38 patients had functional hearing before treatment. One patient presented mild trigeminal neuralgia before GK-SRS. Tumor control with no clinical deterioration was obtained in 78 patients (90.7%). No radiation-induced brainstem or cranial nerve toxicity was observed in any of these patients. Functional hearing was maintained in 25 patients. 8 (9.3%) patients presented tumor growth and required microsurgical resection in 7 cases and ventricular shunt in 1 case. On the basis of this large series, GK-SRS appears to be a safe and effective treatment option for grade IV vestibular schwannoma for patients with no signs of brainstem dysfunction. Copyright © 2018 Elsevier Inc. All rights reserved.

Single-Dose Versus Fractionated Stereotactic Radiotherapy for Brain Metastases

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

Kim, Yeon-Joo; Cho, Kwan Ho, E-mail: kwancho@ncc.re.kr; Kim, Joo-Young

2011-10-01

Purpose: To evaluate the efficacy of stereotactic radiotherapy in patients with brain metastases by comparing two different treatment regimens, single-dose radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT). Methods and Materials: Between November 2003 and December 2008, 98 patients with brain metastases were included. Fifty-eight patients were treated with SRS, and forty were treated with FSRT. Fractionated stereotactic radiotherapy was used for large lesions or lesions located near critical structures. The median doses were 20 Gy for the SRS group and 36 Gy in 6 fractions for the FSRT group. Results: With a median follow-up period of 7 months, the medianmore » survival was 7 months for all patients, with a median of 6 months for the SRS group and 8 months for the FSRT group (p = 0.89). Local progression-free survival (LPFS) rates at 6 months and 1 year were 81% and 71%, respectively, for the SRS group and 97% and 69%, respectively, for the FSRT group (p = 0.31). Despite the fact that FSRT was used for large lesions and lesions in adverse locations, LPFS was not inferior to SRS. Toxicity was more frequently observed in the SRS group than in the FSRT group (17% vs. 5%, p = 0.05). Conclusions: Because patients treated with FSRT exhibited similar survival times and LPFS rates with a lower risk of toxicity in comparison to those treated with SRS, despite the fact that FSRT was used for large lesions and lesions in adverse locations, we find that FSRT can particularly be beneficial for patients with large lesions or lesions located near critical structures. Further investigation is warranted to determine the optimal dose/fractionation.« less

Three or More Courses of Stereotactic Radiosurgery for Patients with Multiply Recurrent Brain Metastases.

PubMed

Kotecha, Rupesh; Damico, Nicholas; Miller, Jacob A; Suh, John H; Murphy, Erin S; Reddy, Chandana A; Barnett, Gene H; Vogelbaum, Michael A; Angelov, Lilyana; Mohammadi, Alireza M; Chao, Samuel T

2017-06-01

Although patients with brain metastasis are treated with primary stereotactic radiosurgery (SRS), the use of salvage therapies and their consequence remains understudied. To study the intracranial recurrence patterns and salvage therapies for patients who underwent multiple SRS courses. A retrospective review was performed of 59 patients with brain metastases who underwent ≥3 SRS courses for new lesions. Cox regression analyzed factors predictive for overall survival. The median age at diagnosis was 52 years. Over time, patients underwent a median of 3 courses of SRS (range: 3-8) to a total of 765 different brain metastases. The 6-month risk of distant intracranial recurrence after the first SRS treatment was 64% (95% confidence interval: 52%-77%). Overall survival was 40% (95% confidence interval: 28%-53%) at 24 months. Only 24 patients (41%) had a decline in their Karnofsky Performance Status ≤70 at last office visit. Quality of life was preserved among 77% of patients at 12 months, with 45% experiencing clinically significant improvement during clinical follow-up. Radiation necrosis developed in 10 patients (17%). On multivariate analysis, gender (males, Hazard Ratio [HR]: 2.0, P < .05), Karnofsky Performance Status ≤80 (HR 3.2, P < .001), extracranial metastases (HR: 3.6, P < .001), and a distant intracranial recurrence ≤3 months from initial to repeat SRS (HR: 3.8, P < .001) were associated with a poorer survival. In selected patients, performing ≥3 SRS courses controls intracranial disease. Patients may need salvage SRS for distant intracranial relapse, but focal retreatments are associated with modest toxicity, do not appear to negatively affect a patient's performance status, and help preserve quality of life. Copyright © 2017 by the Congress of Neurological Surgeons

Simulating adverse event spontaneous reporting systems as preferential attachment networks: application to the Vaccine Adverse Event Reporting System.

PubMed

Scott, J; Botsis, T; Ball, R

2014-01-01

Spontaneous Reporting Systems [SRS] are critical tools in the post-licensure evaluation of medical product safety. Regulatory authorities use a variety of data mining techniques to detect potential safety signals in SRS databases. Assessing the performance of such signal detection procedures requires simulated SRS databases, but simulation strategies proposed to date each have limitations. We sought to develop a novel SRS simulation strategy based on plausible mechanisms for the growth of databases over time. We developed a simulation strategy based on the network principle of preferential attachment. We demonstrated how this strategy can be used to create simulations based on specific databases of interest, and provided an example of using such simulations to compare signal detection thresholds for a popular data mining algorithm. The preferential attachment simulations were generally structurally similar to our targeted SRS database, although they had fewer nodes of very high degree. The approach was able to generate signal-free SRS simulations, as well as mimicking specific known true signals. Explorations of different reporting thresholds for the FDA Vaccine Adverse Event Reporting System suggested that using proportional reporting ratio [PRR] > 3.0 may yield better signal detection operating characteristics than the more commonly used PRR > 2.0 threshold. The network analytic approach to SRS simulation based on the principle of preferential attachment provides an attractive framework for exploring the performance of safety signal detection algorithms. This approach is potentially more principled and versatile than existing simulation approaches. The utility of network-based SRS simulations needs to be further explored by evaluating other types of simulated signals with a broader range of data mining approaches, and comparing network-based simulations with other simulation strategies where applicable.

Early Radiosurgery Improves Hearing Preservation in Vestibular Schwannoma Patients With Normal Hearing at the Time of Diagnosis

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

Akpinar, Berkcan; Mousavi, Seyed H., E-mail: mousavish@upmc.edu; McDowell, Michael M.

Purpose: Vestibular schwannomas (VS) are increasingly diagnosed in patients with normal hearing because of advances in magnetic resonance imaging. We sought to evaluate whether stereotactic radiosurgery (SRS) performed earlier after diagnosis improved long-term hearing preservation in this population. Methods and Materials: We queried our quality assessment registry and found the records of 1134 acoustic neuroma patients who underwent SRS during a 15-year period (1997-2011). We identified 88 patients who had VS but normal hearing with no subjective hearing loss at the time of diagnosis. All patients were Gardner-Robertson (GR) class I at the time of SRS. Fifty-seven patients underwent earlymore » (≤2 years from diagnosis) SRS and 31 patients underwent late (>2 years after diagnosis) SRS. At a median follow-up time of 75 months, we evaluated patient outcomes. Results: Tumor control rates (decreased or stable in size) were similar in the early (95%) and late (90%) treatment groups (P=.73). Patients in the early treatment group retained serviceable (GR class I/II) hearing and normal (GR class I) hearing longer than did patients in the late treatment group (serviceable hearing, P=.006; normal hearing, P<.0001, respectively). At 5 years after SRS, an estimated 88% of the early treatment group retained serviceable hearing and 77% retained normal hearing, compared with 55% with serviceable hearing and 33% with normal hearing in the late treatment group. Conclusions: SRS within 2 years after diagnosis of VS in normal hearing patients resulted in improved retention of all hearing measures compared with later SRS.« less

SSME Bearing and Seal Tester Data Compilation, Analysis and Reporting; and Refinement of the Cryogenic Bearing Analysis Mathematical Model

NASA Technical Reports Server (NTRS)

Moore, James; Marty, Dave; Cody, Joe

2000-01-01

SRS and NASA/MSFC have developed software with unique capabilities to couple bearing kinematic modeling with high fidelity thermal modeling. The core thermomechanical modeling software was developed by SRS and others in the late 1980's and early 1990's under various different contractual efforts. SRS originally developed software that enabled SHABERTH (Shaft Bearing Thermal Model) and SINDA (Systems Improved Numerical Differencing Analyzer) to exchange data and autonomously allowing bearing component temperature effects to propagate into the steady state bearing mechanical model. A separate contract was issued in 1990 to create a personal computer version of the software. At that time SRS performed major improvements to the code. Both SHABERTH and SINDA were independently ported to the PC and compiled. SRS them integrated the two programs into a single program that was named SINSHA. This was a major code improvement.

SSME Bearing and Seal Tester Data Compilation, Analysis, and Reporting; and Refinement of the Cryogenic Bearing Analysis Mathematical Model

NASA Technical Reports Server (NTRS)

Moore, James; Marty, Dave; Cody, Joe

2000-01-01

SRS and NASA/MSFC have developed software with unique capabilities to couple bearing kinematic modeling with high fidelity thermal modeling. The core thermomechanical modeling software was developed by SRS and others in the late 1980's and early 1990's under various different contractual efforts. SRS originally developed software that enabled SHABERTH (Shaft Bearing Thermal Model) and SINDA (Systems Improved Numerical Differencing Analyzer) to exchange data and autonomously allowing bearing component temperature effects to propagate into the steady state bearing mechanical model. A separate contract was issued in 1990 to create a personal computer version of the software. At that time SRS performed major improvements to the code. Both SHABERTH and SINDA were independently ported to the PC and compiled. SRS them integrated the two programs into a single program that was named SINSHA. This was a major code improvement.

Linear accelerator radiosurgery for arteriovenous malformations: Updated literature review.

PubMed

Yahya, S; Heyes, G; Nightingale, P; Lamin, S; Chavda, S; Geh, I; Spooner, D; Cruickshank, G; Sanghera, P

2017-04-01

Arteriovenous malformations (AVMs) are the leading causing of intra-cerebral haemorrhage. Stereotactic radiosurgery (SRS) is an established treatment for arteriovenous malformations (AVM) and commonly delivered using Gamma Knife within dedicated radiosurgery units. Linear accelerator (LINAC) SRS is increasingly available however debate remains over whether it offers an equivalent outcome. The aim of this project is to evaluate the outcomes using LINAC SRS for AVMs used within a UK neurosciences unit and review the literature to aid decision making across various SRS platforms. Results have shown comparability across platforms and strongly supports that an adapted LINAC based SRS facility within a dynamic regional neuro-oncology department delivers similar outcomes (in terms of obliteration and toxicity) to any other dedicated radio-surgical platform. Locally available facilities can facilitate discussion between options however throughput will inevitably be lower than centrally based dedicated national radiosurgery units. Copyright © 2016. Published by Elsevier Ltd.

Trigonal LaF3: a novel SRS-active crystal

NASA Astrophysics Data System (ADS)

Kaminskii, A. A.; Lux, O.; Hanuza, J.; Rhee, H.; Eichler, H. J.; Zhang, J.; Tang, D.; Shen, D.; Yoneda, H.; Shirakawa, A.

2014-12-01

Trigonal fluoride LaF3, widely known as a host crystal for Ln3+-lasants, was found to be an attractive many-phonon Raman material and a subject for the investigation of different χ(3)-nonlinear optical effects. We present the manifestation of photon-phonon interactions related to stimulated Raman scattering (SRS) and Raman-induced four-wave mixing (RFWM) processes, initiated by picosecond exсitation at room temperature. Sesqui-octave-spanning Stokes and anti-Stokes frequency comb generation as well as many-step cascaded and cross-cascaded up-conversion χ(3)-nonlinear processes have been observed. The recorded spectral lines originated by SRS and RFWM are identified and attributed to the three observed SRS-promoting phonon modes. The lower limit of the steady-state Raman gain coefficient for near-IR first Stokes generation was estimated. Moreover, a brief review of known Ln3+ : LaF3 laser crystals and SRS-active fluorides is given.

Waste Determination Equivalency - 12172

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

Freeman, Rebecca D.

2012-07-01

The Savannah River Site (SRS) is a Department of Energy (DOE) facility encompassing approximately 800 square kilometers near Aiken, South Carolina which began operations in the 1950's with the mission to produce nuclear materials. The SRS contains fifty-one tanks (2 stabilized, 49 yet to be closed) distributed between two liquid radioactive waste storage facilities at SRS containing carbon steel underground tanks with storage capacities ranging from 2,800,000 to 4,900,000 liters. Treatment of the liquid waste from these tanks is essential both to closing older tanks and to maintaining space needed to treat the waste that is eventually vitrified or disposedmore » of onsite. Section 3116 of the Ronald W. Reagan National Defense Authorization Act of Fiscal Year 2005 (NDAA) provides the Secretary of Energy, in consultation with the Nuclear Regulatory Commission (NRC), a methodology to determine that certain waste resulting from prior reprocessing of spent nuclear fuel are not high-level radioactive waste if it can be demonstrated that the waste meets the criteria set forth in Section 3116(a) of the NDAA. The Secretary of Energy, in consultation with the NRC, signed a determination in January 2006, pursuant to Section 3116(a) of the NDAA, for salt waste disposal at the SRS Saltstone Disposal Facility. This determination is based, in part, on the Basis for Section 3116 Determination for Salt Waste Disposal at the Savannah River Site and supporting references, a document that describes the planned methods of liquid waste treatment and the resulting waste streams. The document provides descriptions of the proposed methods for processing salt waste, dividing them into 'Interim Salt Processing' and later processing through the Salt Waste Processing Facility (SWPF). Interim Salt Processing is separated into Deliquification, Dissolution, and Adjustment (DDA) and Actinide Removal Process/Caustic Side Solvent Extraction Unit (ARP/MCU). The Waste Determination was signed by the Secretary of Energy in January of 2006 based on proposed processing techniques with the expectation that it could be revised as new processing capabilities became viable. Once signed, however, it became evident that any changes would require lengthy review and another determination signed by the Secretary of Energy. With the maturation of additional salt removal technologies and the extension of the SWPF start-up date, it becomes necessary to define 'equivalency' to the processes laid out in the original determination. For the purposes of SRS, any waste not processed through Interim Salt Processing must be processed through SWPF or an equivalent process, and therefore a clear statement of the requirements for a process to be equivalent to SWPF becomes necessary. (authors)« less

TH-C-BRC-02: A Review of Emerging Technologies in Robotic SRS/SBRT Delivery

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

Wang, L.

The delivery techniques for SRS/SBRT have been under rapid developments in recent years, which pose new challenges to medical physicists ranging from planning and quality assurance to imaging and motion management. This educational course will provide a general overview of the latest delivery techniques in SRS/SBRT, and discuss the clinical processes to address the challenges of each technique with special emphasis on dedicated gamma-ray based device, robotic x-band linac-based system and conventional C-arm s-band linac-based SRS systems. (1). Gamma-ray based SRS/SRT: This is the gold standard of intracranial SRS. With the advent of precision imaging guidance and frameless patient positioningmore » capabilities, novel stereoscopic CBCT and automatic dose adaption solution are introduced to the Gamma-ray based SRS for the first time. The first North American system has been approved by the US regulatory for patient treatments in the spring of 2016. (2). Robotic SRS/SBRT system: A number of technological milestones have been developed in the past few years, including variable aperture collimator, sequential optimization technique, and the time reduction technique. Recently, a new robotic model allows the option of a multi-leaf collimator. These technological advances have reduced the treatment time and improved dose conformity significantly and could potentially expand the application of radiosurgery for the treatment of targets not previously suitable for robotic SRS/SBRT or fractionated stereotactic radiotherapy. These technological advances have created new demanding mandates on hardware and patient quality assurance (QA) tasks, as well as the need for updating/educating the physicists in the community on these requirements. (3). Conventional Linac based treatments: Modulated arc therapy (MAT) has gained wide popularities in Linac-based treatments in recent years due to its high delivery efficiency and excellent dose conformities. Recently, MAT has been introduced to deliver highly conformal radiosurgery treatments to multiple targets simultaneously via a single isocenter to replace the conventional multi-iso multi-plan treatments. It becomes important to understand the advantages and limitations of this technique, and the pitfalls for implementing this technique in clinical practice. The planning process of single-iso multi-target MAT will be described, and its plan quality and delivery efficiency will be compared with multi-iso plans. The QA process for verifying such complex plans will be illustrated, and pitfalls in imaging and patient set up will be discussed. Overall, this session will focus on the following areas: 1) Update on the emerging technology in current SRS/SBRT delivery. 2) New developments in treatment planning and Quality Assurance program. 3) Imaging guidance and motion management. Learning Objectives: To understand the SRS/SBRT principles and its clinical applications, and gain knowledge on the emerging technologies in SRS/SBRT. To review planning concepts and useful tips in treatment planning. To learn about the imaging guidance procedures and the quality assurance program in SRS/SBRT. National Institutes of Health, Varian Medical System; L. Ren, The presenter is funded by National Institutes of Health and Varian Medical System.« less

TH-C-BRC-01: An Overview of Emerging Technologies in SRS/SBRT Delivery

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

Ma, L.

2016-06-15

The delivery techniques for SRS/SBRT have been under rapid developments in recent years, which pose new challenges to medical physicists ranging from planning and quality assurance to imaging and motion management. This educational course will provide a general overview of the latest delivery techniques in SRS/SBRT, and discuss the clinical processes to address the challenges of each technique with special emphasis on dedicated gamma-ray based device, robotic x-band linac-based system and conventional C-arm s-band linac-based SRS systems. (1). Gamma-ray based SRS/SRT: This is the gold standard of intracranial SRS. With the advent of precision imaging guidance and frameless patient positioningmore » capabilities, novel stereoscopic CBCT and automatic dose adaption solution are introduced to the Gamma-ray based SRS for the first time. The first North American system has been approved by the US regulatory for patient treatments in the spring of 2016. (2). Robotic SRS/SBRT system: A number of technological milestones have been developed in the past few years, including variable aperture collimator, sequential optimization technique, and the time reduction technique. Recently, a new robotic model allows the option of a multi-leaf collimator. These technological advances have reduced the treatment time and improved dose conformity significantly and could potentially expand the application of radiosurgery for the treatment of targets not previously suitable for robotic SRS/SBRT or fractionated stereotactic radiotherapy. These technological advances have created new demanding mandates on hardware and patient quality assurance (QA) tasks, as well as the need for updating/educating the physicists in the community on these requirements. (3). Conventional Linac based treatments: Modulated arc therapy (MAT) has gained wide popularities in Linac-based treatments in recent years due to its high delivery efficiency and excellent dose conformities. Recently, MAT has been introduced to deliver highly conformal radiosurgery treatments to multiple targets simultaneously via a single isocenter to replace the conventional multi-iso multi-plan treatments. It becomes important to understand the advantages and limitations of this technique, and the pitfalls for implementing this technique in clinical practice. The planning process of single-iso multi-target MAT will be described, and its plan quality and delivery efficiency will be compared with multi-iso plans. The QA process for verifying such complex plans will be illustrated, and pitfalls in imaging and patient set up will be discussed. Overall, this session will focus on the following areas: 1) Update on the emerging technology in current SRS/SBRT delivery. 2) New developments in treatment planning and Quality Assurance program. 3) Imaging guidance and motion management. Learning Objectives: To understand the SRS/SBRT principles and its clinical applications, and gain knowledge on the emerging technologies in SRS/SBRT. To review planning concepts and useful tips in treatment planning. To learn about the imaging guidance procedures and the quality assurance program in SRS/SBRT. National Institutes of Health, Varian Medical System; L. Ren, The presenter is funded by National Institutes of Health and Varian Medical System.« less

TH-C-BRC-00: Emerging Technologies in SRS/SBRT Delivery

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

NONE

2016-06-15

The delivery techniques for SRS/SBRT have been under rapid developments in recent years, which pose new challenges to medical physicists ranging from planning and quality assurance to imaging and motion management. This educational course will provide a general overview of the latest delivery techniques in SRS/SBRT, and discuss the clinical processes to address the challenges of each technique with special emphasis on dedicated gamma-ray based device, robotic x-band linac-based system and conventional C-arm s-band linac-based SRS systems. (1). Gamma-ray based SRS/SRT: This is the gold standard of intracranial SRS. With the advent of precision imaging guidance and frameless patient positioningmore » capabilities, novel stereoscopic CBCT and automatic dose adaption solution are introduced to the Gamma-ray based SRS for the first time. The first North American system has been approved by the US regulatory for patient treatments in the spring of 2016. (2). Robotic SRS/SBRT system: A number of technological milestones have been developed in the past few years, including variable aperture collimator, sequential optimization technique, and the time reduction technique. Recently, a new robotic model allows the option of a multi-leaf collimator. These technological advances have reduced the treatment time and improved dose conformity significantly and could potentially expand the application of radiosurgery for the treatment of targets not previously suitable for robotic SRS/SBRT or fractionated stereotactic radiotherapy. These technological advances have created new demanding mandates on hardware and patient quality assurance (QA) tasks, as well as the need for updating/educating the physicists in the community on these requirements. (3). Conventional Linac based treatments: Modulated arc therapy (MAT) has gained wide popularities in Linac-based treatments in recent years due to its high delivery efficiency and excellent dose conformities. Recently, MAT has been introduced to deliver highly conformal radiosurgery treatments to multiple targets simultaneously via a single isocenter to replace the conventional multi-iso multi-plan treatments. It becomes important to understand the advantages and limitations of this technique, and the pitfalls for implementing this technique in clinical practice. The planning process of single-iso multi-target MAT will be described, and its plan quality and delivery efficiency will be compared with multi-iso plans. The QA process for verifying such complex plans will be illustrated, and pitfalls in imaging and patient set up will be discussed. Overall, this session will focus on the following areas: 1) Update on the emerging technology in current SRS/SBRT delivery. 2) New developments in treatment planning and Quality Assurance program. 3) Imaging guidance and motion management. Learning Objectives: To understand the SRS/SBRT principles and its clinical applications, and gain knowledge on the emerging technologies in SRS/SBRT. To review planning concepts and useful tips in treatment planning. To learn about the imaging guidance procedures and the quality assurance program in SRS/SBRT. National Institutes of Health, Varian Medical System; L. Ren, The presenter is funded by National Institutes of Health and Varian Medical System.« less

TH-C-BRC-03: Emerging Linac Based SRS/SBRT Technologies with Modulated Arc Delivery

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

Ren, L.

2016-06-15

The delivery techniques for SRS/SBRT have been under rapid developments in recent years, which pose new challenges to medical physicists ranging from planning and quality assurance to imaging and motion management. This educational course will provide a general overview of the latest delivery techniques in SRS/SBRT, and discuss the clinical processes to address the challenges of each technique with special emphasis on dedicated gamma-ray based device, robotic x-band linac-based system and conventional C-arm s-band linac-based SRS systems. (1). Gamma-ray based SRS/SRT: This is the gold standard of intracranial SRS. With the advent of precision imaging guidance and frameless patient positioningmore » capabilities, novel stereoscopic CBCT and automatic dose adaption solution are introduced to the Gamma-ray based SRS for the first time. The first North American system has been approved by the US regulatory for patient treatments in the spring of 2016. (2). Robotic SRS/SBRT system: A number of technological milestones have been developed in the past few years, including variable aperture collimator, sequential optimization technique, and the time reduction technique. Recently, a new robotic model allows the option of a multi-leaf collimator. These technological advances have reduced the treatment time and improved dose conformity significantly and could potentially expand the application of radiosurgery for the treatment of targets not previously suitable for robotic SRS/SBRT or fractionated stereotactic radiotherapy. These technological advances have created new demanding mandates on hardware and patient quality assurance (QA) tasks, as well as the need for updating/educating the physicists in the community on these requirements. (3). Conventional Linac based treatments: Modulated arc therapy (MAT) has gained wide popularities in Linac-based treatments in recent years due to its high delivery efficiency and excellent dose conformities. Recently, MAT has been introduced to deliver highly conformal radiosurgery treatments to multiple targets simultaneously via a single isocenter to replace the conventional multi-iso multi-plan treatments. It becomes important to understand the advantages and limitations of this technique, and the pitfalls for implementing this technique in clinical practice. The planning process of single-iso multi-target MAT will be described, and its plan quality and delivery efficiency will be compared with multi-iso plans. The QA process for verifying such complex plans will be illustrated, and pitfalls in imaging and patient set up will be discussed. Overall, this session will focus on the following areas: 1) Update on the emerging technology in current SRS/SBRT delivery. 2) New developments in treatment planning and Quality Assurance program. 3) Imaging guidance and motion management. Learning Objectives: To understand the SRS/SBRT principles and its clinical applications, and gain knowledge on the emerging technologies in SRS/SBRT. To review planning concepts and useful tips in treatment planning. To learn about the imaging guidance procedures and the quality assurance program in SRS/SBRT. National Institutes of Health, Varian Medical System; L. Ren, The presenter is funded by National Institutes of Health and Varian Medical System.« less

Airbus windshear warning and guidance system

NASA Technical Reports Server (NTRS)

Bonafe, J. L.

1990-01-01

From its first designed airplane, Airbus considered mandatory a help in the crew's decision-making process to initiate an escape maneuver and help to successfully realize it. All the Airbus airplanes designed since 1975 included an alpha-floor function and a speed reference control law imbedded in the speed reference system (SRS) box for A 300 and FAC and FCC for A 310, A300/600 and the A 320. Alpha-Floor function takes into account the airplane energy situation considering angle of attack and observed longitudinal situation in order to apply immediately the full power without any pilot action. Speed reference managers control airspeed and/or ground speed in order to survive a maximum in shear situation. In order to comply with the new FAA regulation: Aerospatiale and Airbus developed more efficient systems. A comparison between 1975 and a newly developed system is given. It is explained how the new system improves the situation.

Effectiveness of Student Response Systems in Terms of Learning Environment, Attitudes and Achievement

ERIC Educational Resources Information Center

Cohn, Stephen T.; Fraser, Barry J.

2016-01-01

In order to investigate the effectiveness of using Student Response Systems (SRS) among grade 7 and 8 science students in New York, the How Do You Feel About This Class? (HDYFATC) questionnaire was administered to 1097 students (532 students did use SRS and 565 students who did not use SRS). Data analyses attested to the sound factorial validity…

SRS modeling in high power CW fiber lasers for component optimization

NASA Astrophysics Data System (ADS)

Brochu, G.; Villeneuve, A.; Faucher, M.; Morin, M.; Trépanier, F.; Dionne, R.

2017-02-01

A CW kilowatt fiber laser numerical model has been developed taking into account intracavity stimulated Raman scattering (SRS). It uses the split-step Fourier method which is applied iteratively over several cavity round trips. The gain distribution is re-evaluated after each iteration with a standard CW model using an effective FBG reflectivity that quantifies the non-linear spectral leakage. This model explains why spectrally narrow output couplers produce more SRS than wider FBGs, as recently reported by other authors, and constitute a powerful tool to design optimized and innovative fiber components to push back the onset of SRS for a given fiber core diameter.

A flexible and rapid frequency selective scheme for SRS microscopy

NASA Astrophysics Data System (ADS)

Li, Jingting; Yue, Yuankai; Shih, Wei-Chuan

2017-02-01

Stimulated Raman scattering (SRS) is a label-free imaging technique suitable for studying biological systems. Due to stimulated nature by ultrafast laser pulses, SRS microscopy has the advantage of significantly higher sensitivity but often reduced spectroscopic information. In this paper, we present a newly constructed femtosecond SRS microscope with a high-speed dynamic micromirror device based pulse shaper to achieve flexible and rapid frequency selection within the C-H stretch region near 2800 to 3100 cm-1 with spectral width of 30 cm-1. This technique is applicable to lipid profiling such as cell activity mapping, lipid distribution mapping and distinction among subclasses.

Enhanced stimulated Raman scattering by femtosecond ultraviolet plasma grating in water

NASA Astrophysics Data System (ADS)

Liu, Fengjiang; Yuan, Shuai; He, Boqu; Nan, Junyi; Khan, Abdul Qayyum; Ding, Liang'en; Zeng, Heping

2018-02-01

Efficient forward stimulated Raman scattering (SRS) was observed along 400-nm femtosecond (fs) laser filaments in water. SRS conversion dominated over self-phase modulation induced continuum generation as the input pulse energy was above 4 μJ (˜30 Pcr), implying that plasma in the aqueous filamentation channel played an important role in compensating for the group velocity walk-off between the pump and Stokes pulses. By overlapping two synchronous fs 400-nm filaments to form plasma grating in water, significant enhancement of SRS conversion was observed. Such a SRS enhancement originated from the ultrahigh plasma density in the intersection region of the preformed plasma grating.

Interventions for tic disorders: An overview of systematic reviews and meta analyses.

PubMed

Yang, Chunsong; Hao, Zilong; Zhu, Cairong; Guo, Qin; Mu, Dezhi; Zhang, Lingli

2016-04-01

We conducted a comprehensive search and the overview included 22 systematic reviews (SRs) for treating tic disorders (TDs). Three SRs indicated typical antipsychotics (i.e., haloperidol, pimozide) were efficacious in the reduction of tic severity compared with placebo but with poor tolerability. Six SRs assessed the efficacy of atypical antipsychotics and indicated that atypical antipsychotics (i.e., risperidone, aripiprazole) could significantly improved tic symptoms compared with placebo or typical antipsychotics with less AEs. Four SRs indicated alpha adrenergic agonists (i.e., clonidine, guanfacine) could improve tic symptoms. Two SRs assessed the efficacy of antiepileptic drugs and indicated topiramate was a promising therapy. Six SRs evaluated the efficacy of behavior therapy and showed habit reversal therapy (HRT) and exposure and response prevention (ERP) were effective. One SR evaluated the efficacy deep brain stimulation (DBS) and indicated DBS is a promising treatment option for severe cases of TS. In conclusion, RCTs directly comparing different pharmacological treatment options are scarce. In practice, typical and atypical antipsychotics are often considered firstly while other pharmacological medications are suggested as alternatives in the case of treatment failure or contradictory outcomes. Behavioral therapies can be used either alone or in combination with medication. Copyright © 2016. Published by Elsevier Ltd.

The comparison of SRs' variation affected by solar events observed in America and in China

NASA Astrophysics Data System (ADS)

Yu, H.; Williams, E.

2017-12-01

Schumann Resonances(SRs) are the electromagnetic resonance wave propagating in the earth-ionosphere cavity. Its characteristic of propagation are modified by the variation of ionosphere. So SRs can be the tools of monitoring the ionosphere which is often perturbed by solar events, x-ray emission and some other space-weather events (Roldugin et.al., 2004, De et al., 2010; Satori et.al., 2015). In present work, the amplitude and intrinsic frequencies of SRs observed at RID station in America and YSH station in China are compared. The variation of SRs during the solar flare on Feb. 15, 2011 are analyzed. Two-Dimensional Telegraph Equation(TDTE) method is used to simulate the perturbation of ionosphere by solar proton events. From the simulation and observation, the asymmetric construction of ionoshphere which is perturbed by the solar event will affect the amplitudes and frequencies of SRs. Due to the interfere influence of forward and backward propagation of electromagnetic field, the SR amplitude on different station will present different variation. The distance among the lightning source, observer and perturbed area will produce the different variation of amplitude and frequency for different station' SR.

Role of stereotactic radiosurgery in patients with more than four brain metastases

PubMed Central

Jairam, Vikram; Chiang, Veronica LS; Yu, James B; Knisely, Jonathan PS

2013-01-01

SUMMARY For patients presenting with brain metastases, two methods of radiation treatment currently exist: stereotactic radiosurgery (SRS) and whole-brain radiation therapy (WBRT). SRS is a minimally invasive to noninvasive technique that delivers a high dose of ionizing radiation to a precisely defined focal target volume, whereas WBRT involves multiple smaller doses of radiation delivered to the whole brain. Evidence exists from randomized controlled trials for SRS in the treatment of patients with one to four brain metastases. Patients with more than four brain metastases generally receive WBRT, which can effectively treat undetected metastases and protect against intracranial relapse. However, WBRT has been associated with an increased potential for toxic neurocognitive side effects, including memory loss and early dementia, and does not provide 100% protection against relapse. For this reason, physicians at many medical centers are opting to use SRS as first-line treatment for patients with more than four brain metastases, despite evidence showing an increased rate of intracranial relapse compared with WBRT. In light of the evolving use of SRS, this review will examine the available reports on institutional trials and outcomes for patients with more than four brain metastases treated with SRS alone as first-line therapy. PMID:24273642

High proportion of smaller ranged hummingbird species coincides with ecological specialization across the Americas

PubMed Central

Martín González, Ana M.; Maruyama, Pietro K.; Sandel, Brody; Vizentin-Bugoni, Jeferson; Schleuning, Matthias; Abrahamczyk, Stefan; Alarcón, Ruben; Araujo, Andréa C.; Araújo, Francielle P.; Mendes de Azevedo, Severino; Baquero, Andrea C.; Cotton, Peter A.; Ingversen, Tanja Toftemark; Kohler, Glauco; Lara, Carlos; Guedes Las-Casas, Flor Maria; Machado, Adriana O.; Machado, Caio Graco; Maglianesi, María Alejandra; Moura, Alan Cerqueira; Nogués-Bravo, David; Oliveira, Genilda M.; Oliveira, Paulo E.; Ornelas, Juan Francisco; Rodrigues, Licléia da Cruz; Rosero-Lasprilla, Liliana; Rui, Ana Maria; Sazima, Marlies; Timmermann, Allan; Varassin, Isabela Galarda; Wang, Zhiheng; Watts, Stella; Fjeldså, Jon; Svenning, Jens-Christian; Rahbek, Carsten; Dalsgaard, Bo

2016-01-01

Ecological communities that experience stable climate conditions have been speculated to preserve more specialized interspecific associations and have higher proportions of smaller ranged species (SRS). Thus, areas with disproportionally large numbers of SRS are expected to coincide geographically with a high degree of community-level ecological specialization, but this suggestion remains poorly supported with empirical evidence. Here, we analysed data for hummingbird resource specialization, range size, contemporary climate, and Late Quaternary climate stability for 46 hummingbird–plant mutualistic networks distributed across the Americas, representing 130 hummingbird species (ca 40% of all hummingbird species). We demonstrate a positive relationship between the proportion of SRS of hummingbirds and community-level specialization, i.e. the division of the floral niche among coexisting hummingbird species. This relationship remained strong even when accounting for climate, furthermore, the effect of SRS on specialization was far stronger than the effect of specialization on SRS, suggesting that climate largely influences specialization through species' range-size dynamics. Irrespective of the exact mechanism involved, our results indicate that communities consisting of higher proportions of SRS may be vulnerable to disturbance not only because of their small geographical ranges, but also because of their high degree of specialization. PMID:26842573

Thematic orders and the comprehension of subject-extracted relative clauses in Mandarin Chinese

PubMed Central

Lin, Chien-Jer Charles

2015-01-01

This study investigates the comprehension of three kinds of subject-extracted relative clauses (SRs) in Mandarin Chinese: standard SRs, relative clauses involving the disposal ba construction (“disposal SRs”), and relative clauses involving the long passive bei constructions (“passive SRs”). In a self-paced reading experiment, the regions before the relativizer (where the sentential fragments are temporarily ambiguous) showed reading patterns consistent with expectation-based incremental processing: standard SRs, with the highest constructional frequency and the least complex syntactic structure, were processed faster than the other two variants. However, in the regions after the relativizer and the head noun where the existence of a relative clause is unambiguously indicated, a top-down global effect of thematic ordering was observed: passive SRs, whose thematic role order conforms to the canonical thematic order of Chinese, were read faster than both the standard SRs and the disposal SRs. Taken together, these results suggest that two expectation-based processing factors are involved in the comprehension of Chinese relative clauses, including both the structural probabilities of pre-relativizer constituents and the overall surface thematic orders in the relative clauses. PMID:26441697

Stereotactic radiosurgery for deep intracranial arteriovenous malformations, part 1: Brainstem arteriovenous malformations.

PubMed

Cohen-Inbar, Or; Ding, Dale; Chen, Ching-Jen; Sheehan, Jason P

2016-02-01

The management of brainstem arteriovenous malformations (AVM) are one of the greatest challenges encountered by neurosurgeons. Brainstem AVM have a higher risk of hemorrhage compared to AVM in other locations, and rupture of these lesions commonly results in devastating neurological morbidity and mortality. The potential morbidity associated with currently available treatment modalities further compounds the complexity of decision making for affected patients. Stereotactic radiosurgery (SRS) has an important role in the management of brainstem AVM. SRS offers acceptable obliteration rates with lower risks of hemorrhage occurring during the latency period. Complex nidal architecture requires a multi-disciplinary treatment approach. Nidi partly involving subpial/epipial regions of the dorsal midbrain or cerebellopontine angle should be considered for a combination of endovascular embolization, micro-surgical resection and SRS. Considering the fact that incompletely obliterated lesions (even when reduced in size) could still cause lethal hemorrhages, additional treatment, including repeat SRS and surgical resection should be considered when complete obliteration is not achieved by first SRS. Patients with brainstem AVM require continued clinical and radiological observation and follow-up after SRS, well after angiographic obliteration has been confirmed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Enzymologic and pharmacologic profile of loxoprofen sodium and its metabolites.

PubMed

Noguchi, Masahiro; Kimoto, Aishi; Gierse, James Kevin; Walker, Mark Crossfield; Zweifel, Ben Scott; Nozaki, Kazutoshi; Sasamata, Masao

2005-11-01

We investigated the mechanism of inhibition of loxoprofen sodium, a non-steroidal anti-inflammatory drug (NSAID), and its active metabolite (loxoprofen-SRS) on cyclooxygenase (COX). In in vitro assays, loxoprofen sodium appeared inactive against recombinant human COX-1 and COX-2, whereas loxoprofen-SRS inhibited both. In the investigation of kinetic behavior, loxoprofen-SRS showed time-dependent inhibition for both isozymes. Human whole blood assay also showed that loxoprofen-SRS possesses the profile of a non-selective inhibitor for COX. In a rat air pouch model, oral administration of loxoprofen sodium lowered prostaglandin (PG) E2 in both fluid exudates of the inflammatory pouch and stomach tissue with ED50 values of 2.0 and 2.1 mg/kg, respectively. Additionally, platelet thromboxane B2 production was also inhibited by loxoprofen sodium (ED50 of 0.34 mg/kg). In a rat carrageenan-induced paw edema model, loxoprofen sodium dose-dependently reduced the paw edema, accompanied by a decrease in PGE2 content in inflamed paw exudates. These findings suggest that the COX inhibitory activity of loxoprofen sodium is attributable to its active metabolite, loxoprofen-SRS, and that loxoprofen-SRS shows non-selective inhibition for COX.

Cranial Stereotactic Radiosurgery: Current Status of the Initial Paradigm Shifter

PubMed Central

Sheehan, Jason P.; Yen, Chun-Po; Lee, Cheng-Chia; Loeffler, Jay S.

2014-01-01

The concept of stereotactic radiosurgery (SRS) was first described by Lars Leksell in 1951. It was proposed as a noninvasive alternative to open neurosurgical approaches to manage a variety of conditions. In the following decades, SRS emerged as a unique discipline involving a collegial partnership among neurosurgeons, radiation oncologists, and medical physicists. SRS relies on the precisely guided delivery of high-dose ionizing radiation to an intracranial target. The focused convergence of multiple beams yields a potent therapeutic effect on the target and a steep dose fall-off to surrounding structures, thereby minimizing the risk of collateral damage. SRS is typically administered in a single session but can be given in as many as five sessions or fractions. By providing an ablative effect noninvasively, SRS has altered the treatment paradigms for benign and malignant intracranial tumors, functional disorders, and vascular malformations. Literature on extensive intracranial radiosurgery has unequivocally demonstrated the favorable benefit-to-risk profile that SRS affords for appropriately selected patients. In a departure from conventional radiotherapeutic strategies, radiosurgical principles have recently been extended to extracranial indications such as lung, spine, and liver tumors. The paradigm shift resulting from radiosurgery continues to alter the landscape of related fields. PMID:25113762

Cells resembling intraventricular macrophages are present in the subretinal space of human foetal eyes.

PubMed

McMenamin, P G; Loeffler, K U

1990-06-01

The subretinal spaces (SRS) in 17 human foetal eyes were investigated by light microscopy and scanning and transmission electron microscopy. A hitherto undocumented group of pleomorphic cells was detected on the apical surface of the retinal pigment epithelium (RPE) and on the undersurface of the neural retina. These cells formed a regularly spaced array in the peripheral SRS, particularly in the most anterior portion nearest the ciliary body anlage. The morphology of the SRS cells ranged from a small round or ovoid form with a few short basal pseudopodia to an extremely flattened dendritic form. Ultrastructural features, such as large melanophagolysosomes, consistent with a phagocytic function, were observed in some cells. These SRS cells bore remarkable resemblance to epiplexus and supraependymal cells, considered to be the resident population of macrophages on the ventricular surfaces of the brain. This morphological parallelism, together with the anatomically homologous location, is strong evidence that SRS cells represent a normal population of macrophages in the developing human eye. No features consistent with an RPE or neuronal origin were observed. The possible role of these cells as transient phagocytes in the SRS with a possible destiny as retinal microglia is discussed.

A systematic assessment of Cochrane reviews and systematic reviews published in high-impact medical journals related to cancer.

PubMed

Goldkuhle, Marius; Narayan, Vikram M; Weigl, Aaron; Dahm, Philipp; Skoetz, Nicole

2018-03-25

To compare cancer-related systematic reviews (SRs) published in the Cochrane Database of SRs (CDSR) and high-impact journals, with respect to type, content, quality and citation rates. Methodological SR with assessment and comparison of SRs and meta-analyses. Two authors independently assessed methodological quality using an Assessment of Multiple Systematic Reviews (AMSTAR)-based extraction form. Both authors independently screened search results, extracted content-relevant characteristics and retrieved citation numbers of the included reviews using the Clarivate Analytics Web of Science database. Cancer-related SRs were retrieved from the CDSR, as well as from the 10 journals which publish oncological SRs and had the highest impact factors, using a comprehensive search in both the CDSR and MEDLINE. We included all cancer-related SRs and meta-analyses published from January 2011 to May 2016. Methodological SRs were excluded. We included 346 applicable Cochrane reviews and 215 SRs from high-impact journals. Cochrane reviews consistently met more individual AMSTAR criteria, notably with regard to an a priori design (risk ratio (RR) 3.89; 95% CI 3.10 to 4.88), inclusion of the grey literature and trial registries (RR 3.52; 95% CI 2.84 to 4.37) in their searches, and the reporting of excluded studies (RR 8.80; 95% CI 6.06 to 12.78). Cochrane reviews were less likely to address questions of prognosis (RR 0.04; 95% CI 0.02 to 0.09), use individual patient data (RR 0.03; 95% CI 0.01 to 0.09) or be based on non-randomised controlled trials (RR 0.04; 95% CI 0.02 to 0.09). Citation rates of Cochrane reviews were notably lower than those for high-impact journals (Cochrane reviews: mean number of citations 6.52 (range 0-143); high-impact journal SRs: 74.45 (0-652)). When comparing cancer-related SRs published in the CDSR versus those published in high-impact medical journals, Cochrane reviews were consistently of higher methodological quality, but cited less frequently. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Research on subgroups is not research on equity attributes: Evidence from an overview of systematic reviews on vaccination.

PubMed

Bosch-Capblanch, Xavier; Zuske, Meike-Kathrin; Auer, Christian

2017-06-07

Equity remains a priority in the international health development agenda. However, major inequities in vaccination coverage jeopardise the achievement of the Sustainable Development Goals. We aim at comprehensively describing how research has addressed equity issues related to vaccination. We carried out an overview of systematic reviews (SRs) that explicitly explored the effects of interventions to improve vaccination in any context; for any vaccine and, in any language. We followed standard research synthesis methods to systematically search for SR, assess them for inclusion and extracting relevant data, particularly on vaccination related outcomes. To gather evidence on equity issues addressed in the SR, we used the PROGRESS-plus framework. Our search obtained 2,003 hits which resulted in 54 included SRs, published between 1994 and 2014. The quality of SRs was generally poor, with less than half complying with most of the quality criteria. Reported vaccines included, by order of frequency, influenza and Expanded Programme on Immunisation vaccines. The types of interventions more frequently reported were related to vaccination delivery strategies, financial support and information, education and communication. Most of the SRs suggested effects favouring intervention groups as opposed to comparison groups. The most frequently reported equity attribute was 'place of residence' and the least reported equity attributes were sexual orientation and religion. Very few estimates of effects actually measured differences or changes between groups having those attributes and all of them referred to the place of residence. No data was found about reducing equity gaps for vulnerable groups or minorities, or attributes such as sexual orientation, education or specific religious groups. Although research on vulnerable populations as a subgroup is abundant, it fails to report on the interventions that will actually reduce inequities and consider how redistribution of health care resources could shrink the gap between the privileged and most vulnerable groups including minorities. Research, if aiming at being responsive to global health policy trends, needs to report not only on specific attributes but also on how a better redistribution of health care resources could contribute to alleviating the unjust situation of the most vulnerable populations.

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

Li, Winnie; Cho, Young-Bin; Department of Radiation Oncology, University of Toronto, Toronto, Ontario

Purpose: The present study used cone beam computed tomography (CBCT) to measure the inter- and intrafraction uncertainties for intracranial stereotactic radiosurgery (SRS) using the Leksell Gamma Knife (GK). Methods and Materials: Using a novel CBCT system adapted to the GK radiosurgery treatment unit, CBCT images were acquired immediately before and after treatment for each treatment session within the context of a research ethics board–approved prospective clinical trial. Patients were immobilized in the Leksell coordinate frame (LCF) for both volumetric CBCT imaging and GK-SRS delivery. The relative displacement of the patient's skull to the stereotactic reference (interfraction motion) was measured formore » each CBCT scan. Differences between the pre- and post-treatment CBCT scans were used to determine the intrafraction motion. Results: We analyzed 20 pre- and 17 post-treatment CBCT scans in 20 LCF patients treated with SRS. The mean translational pretreatment setup error ± standard deviation in the left-right, anteroposterior, and craniocaudal directions was −0.19 ± 0.32, 0.06 ± 0.27, and −0.23 ± 0.2 mm, with a maximum of −0.74, −0.53, and −0.68 mm, respectively. After an average time between the pre- and post-treatment CBCT scans of 82 minutes (range 27-170), the mean intrafraction error ± standard deviation for the LCF was −0.03 ± 0.05, −0.03 ± 0.18, and −0.03 ± 0.12 mm in the left-right, anteroposterior, and craniocaudual direction, respectively. Conclusions: Using CBCT on a prototype image guided GK Perfexion unit, we were able to measure the inter- and intrafraction positional changes for GK-SRS using the invasive frame. In the era of image guided radiation therapy, the use of CBCT image guidance for both frame- and non–frame-based immobilization systems could serve as a useful quality assurance tool. Our preliminary measurements can guide the application of achievable thresholds for inter- and intrafraction discrepancy when moving to a frameless approach.« less

The Use of Cone Beam Computed Tomography for Image Guided Gamma Knife Stereotactic Radiosurgery: Initial Clinical Evaluation.

PubMed

Li, Winnie; Cho, Young-Bin; Ansell, Steve; Laperriere, Normand; Ménard, Cynthia; Millar, Barbara-Ann; Zadeh, Gelareh; Kongkham, Paul; Bernstein, Mark; Jaffray, David A; Chung, Caroline

2016-09-01

The present study used cone beam computed tomography (CBCT) to measure the inter- and intrafraction uncertainties for intracranial stereotactic radiosurgery (SRS) using the Leksell Gamma Knife (GK). Using a novel CBCT system adapted to the GK radiosurgery treatment unit, CBCT images were acquired immediately before and after treatment for each treatment session within the context of a research ethics board-approved prospective clinical trial. Patients were immobilized in the Leksell coordinate frame (LCF) for both volumetric CBCT imaging and GK-SRS delivery. The relative displacement of the patient's skull to the stereotactic reference (interfraction motion) was measured for each CBCT scan. Differences between the pre- and post-treatment CBCT scans were used to determine the intrafraction motion. We analyzed 20 pre- and 17 post-treatment CBCT scans in 20 LCF patients treated with SRS. The mean translational pretreatment setup error ± standard deviation in the left-right, anteroposterior, and craniocaudal directions was -0.19 ± 0.32, 0.06 ± 0.27, and -0.23 ± 0.2 mm, with a maximum of -0.74, -0.53, and -0.68 mm, respectively. After an average time between the pre- and post-treatment CBCT scans of 82 minutes (range 27-170), the mean intrafraction error ± standard deviation for the LCF was -0.03 ± 0.05, -0.03 ± 0.18, and -0.03 ± 0.12 mm in the left-right, anteroposterior, and craniocaudual direction, respectively. Using CBCT on a prototype image guided GK Perfexion unit, we were able to measure the inter- and intrafraction positional changes for GK-SRS using the invasive frame. In the era of image guided radiation therapy, the use of CBCT image guidance for both frame- and non-frame-based immobilization systems could serve as a useful quality assurance tool. Our preliminary measurements can guide the application of achievable thresholds for inter- and intrafraction discrepancy when moving to a frameless approach. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

HRQoL assessment by SRS-30 for Chinese patients with surgery for Adolescent Idiopathic Scoliosis (AIS).

PubMed

Ng, Bobby Kin Wah; Chau, Wai-Wang; Hui, Chak-Na; Cheng, Po-Yin; Wong, Chau-Yuet; Wang, Bin; Cheng, Jack Chun Yiu; Lam, Tsz Ping

2015-01-01

Health-related quality of life (HRQoL) outcome questionnaire, Scoliosis Research Society (SRS)-30, had been well received since its establishment in 2003. Literatures from Asia on the use of SRS-30 mainly focused on the translation process and validation process, but not on measuring outcomes, particularly in the Chinese community. We carried out a prospective cohort study to evaluate the HRQoL of Chinese AIS adolescents with severe scoliosis after surgery. One hundred and four Chinese AIS patients with severe scoliosis undergoing posterior spinal fusion between 2009 and 2013 were recruited in this study. They completed SRS-30 questions before surgery, before hospital discharge, and at follow-up. Mean scores and percentages of individual scores in different domains, and composite scores in terms of subtotal and total scores were calculated referring to the scoring system. Gender-specific and period-specific descriptive analyses were described. Correlation of mean domain scores at the three time points were explored to look for any time-specific relationship. Linear regression analysis looking for potential risk factors on domain scores at different time points by gender were also carried out. Mean age was 16.28 at surgery, and 83.6% were female. Significant correlations between pre-op scores and scores after surgery were observed in function/activity domain (p=0.05) in males, and pain (p=0.04) and satisfaction with management (p=0.04) domains in females. No gender difference in all 5 domain scores at the 3 time points was found. Pre-op maximum Cobb angle and corrected angle were found to be risk factors on self-image, as well as satisfaction with management, in male and female patients. This is the first report on the evaluation of the clinical HRQoL outcomes of Chinese AIS patients with severe scoliosis after surgery. Medical professionals should pay attention to take care of the difference in personal perceptions of feelings between boys and girls. Special care should also be allocated to AIS patients, and try to arrange earlier surgical intervention.

Multiresolution molecular mechanics: Surface effects in nanoscale materials

NASA Astrophysics Data System (ADS)

Yang, Qingcheng; To, Albert C.

2017-05-01

Surface effects have been observed to contribute significantly to the mechanical response of nanoscale structures. The newly proposed energy-based coarse-grained atomistic method Multiresolution Molecular Mechanics (MMM) (Yang, To (2015), [57]) is applied to capture surface effect for nanosized structures by designing a surface summation rule SRS within the framework of MMM. Combined with previously proposed bulk summation rule SRB, the MMM summation rule SRMMM is completed. SRS and SRB are consistently formed within SRMMM for general finite element shape functions. Analogous to quadrature rules in finite element method (FEM), the key idea to the good performance of SRMMM lies in that the order or distribution of energy for coarse-grained atomistic model is mathematically derived such that the number, position and weight of quadrature-type (sampling) atoms can be determined. Mathematically, the derived energy distribution of surface area is different from that of bulk region. Physically, the difference is due to the fact that surface atoms lack neighboring bonding. As such, SRS and SRB are employed for surface and bulk domains, respectively. Two- and three-dimensional numerical examples using the respective 4-node bilinear quadrilateral, 8-node quadratic quadrilateral and 8-node hexahedral meshes are employed to verify and validate the proposed approach. It is shown that MMM with SRMMM accurately captures corner, edge and surface effects with less 0.3% degrees of freedom of the original atomistic system, compared against full atomistic simulation. The effectiveness of SRMMM with respect to high order element is also demonstrated by employing the 8-node quadratic quadrilateral to solve a beam bending problem considering surface effect. In addition, the introduced sampling error with SRMMM that is analogous to numerical integration error with quadrature rule in FEM is very small.

An update: improvements in imaging perfluorocarbon-mounted plant leaves with implications for studies of plant pathology, physiology, development and cell biology

PubMed Central

Littlejohn, George R.; Mansfield, Jessica C.; Christmas, Jacqueline T.; Witterick, Eleanor; Fricker, Mark D.; Grant, Murray R.; Smirnoff, Nicholas; Everson, Richard M.; Moger, Julian; Love, John

2014-01-01

Plant leaves are optically complex, which makes them difficult to image by light microscopy. Careful sample preparation is therefore required to enable researchers to maximize the information gained from advances in fluorescent protein labeling, cell dyes and innovations in microscope technologies and techniques. We have previously shown that mounting leaves in the non-toxic, non-fluorescent perfluorocarbon (PFC), perfluorodecalin (PFD) enhances the optical properties of the leaf with minimal impact on physiology. Here, we assess the use of the PFCs, PFD, and perfluoroperhydrophenanthrene (PP11) for in vivo plant leaf imaging using four advanced modes of microscopy: laser scanning confocal microscopy (LSCM), two-photon fluorescence microscopy, second harmonic generation microscopy, and stimulated Raman scattering (SRS) microscopy. For every mode of imaging tested, we observed an improved signal when leaves were mounted in PFD or in PP11, compared to mounting the samples in water. Using an image analysis technique based on autocorrelation to quantitatively assess LSCM image deterioration with depth, we show that PP11 outperformed PFD as a mounting medium by enabling the acquisition of clearer images deeper into the tissue. In addition, we show that SRS microscopy can be used to image PFCs directly in the mesophyll and thereby easily delimit the “negative space” within a leaf, which may have important implications for studies of leaf development. Direct comparison of on and off resonance SRS micrographs show that PFCs do not to form intracellular aggregates in live plants. We conclude that the application of PFCs as mounting media substantially increases advanced microscopy image quality of living mesophyll and leaf vascular bundle cells. PMID:24795734

Male-female differences in Scoliosis Research Society-30 scores in adolescent idiopathic scoliosis.

PubMed

Roberts, David W; Savage, Jason W; Schwartz, Daniel G; Carreon, Leah Y; Sucato, Daniel J; Sanders, James O; Richards, Benjamin Stephens; Lenke, Lawrence G; Emans, John B; Parent, Stefan; Sarwark, John F

2011-01-01

Longitudinal cohort study. To compare functional outcomes between male and female patients before and after surgery for adolescent idiopathic scoliosis (AIS). There is no clear consensus in the existing literature with respect to sex differences in functional outcomes in the surgical treatment of AIS. A prospective, consecutive, multicenter database of patients who underwent surgical correction for adolescent idiopathic scoliosis was analyzed retrospectively. All patients completed Scoliosis Research Society-30 (SRS-30) questionnaires before and 2 years after surgery. Patients with previous spine surgery were excluded. Data were collected for sex, age, Risser grade, previous bracing history, maximum preoperative Cobb angle, curve correction at 2 years, and SRS-30 domain scores. Paired sample t tests were used to compare preoperative and postoperative scores within each sex. Independent sample t tests were used to compare scores between sexes. A P value of <0.05 was considered statistically significant. Seven hundred forty-four patients (621 females and 123 males) were included. On average, males were 1 year older than females. There were no differences between sexes in Risser grade, bracing history, maximum curve magnitude, or correction after surgery. Both males and females had similar improvement in all SRS-30 domains after surgery. Self-image/appearance had the greatest relative improvement. Males had better self-image/appearance scores preoperatively, better pain scores at 2 years, and better mental health and total scores both preoperatively and at 2 years. Both males and females were similarly satisfied with surgery. Males treated with surgery for AIS report better preoperative self-image, less postoperative pain, and better mental health than females. These differences may be clinically significant. For both males and females, the most beneficial effect of surgery is improved self-image/appearance. Overall, the benefits of surgery for AIS are similar for both sexes.

Evaluating turbidity and suspended-sediment concentration relations from the North Fork Toutle River basin near Mount St. Helens, Washington; annual, seasonal, event, and particle size variations - a preliminary analysis.

USGS Publications Warehouse

Uhrich, Mark A.; Spicer, Kurt R.; Mosbrucker, Adam; Christianson, Tami

2015-01-01

Regression of in-stream turbidity with concurrent sample-based suspended-sediment concentration (SSC) has become an accepted method for producing unit-value time series of inferred SSC (Rasmussen et al., 2009). Turbidity-SSC regression models are increasingly used to generate suspended-sediment records for Pacific Northwest rivers (e.g., Curran et al., 2014; Schenk and Bragg, 2014; Uhrich and Bragg, 2003). Recent work developing turbidity-SSC models for the North Fork Toutle River in Southwest Washington (Uhrich et al., 2014), as well as other studies (Landers and Sturm, 2013, Merten et al., 2014), suggests that models derived from annual or greater datasets may not adequately reflect shorter term changes in turbidity-SSC relations, warranting closer inspection of such relations. In-stream turbidity measurements and suspended-sediment samples have been collected from the North Fork Toutle River since 2010. The study site, U.S. Geological Survey (USGS) streamgage 14240525 near Kid Valley, Washington, is 13 river km downstream of the debris avalanche emplaced by the 1980 eruption of Mount St. Helens (Lipman and Mullineaux, 1981), and 2 river km downstream of the large sediment retention structure (SRS) built from 1987–1989 to mitigate the associated sediment hazard. The debris avalanche extends roughly 25 km down valley from the edifice of the volcano and is the primary source of suspended sediment moving past the streamgage (NF Toutle-SRS). Other significant sources are debris flow events and sand deposits upstream of the SRS, which are periodically remobilized and transported downstream. Also, finer material often is derived from the clay-rich original debris avalanche deposit, while coarser material can derive from areas such as fluvially reworked terraces.

Characterizing spatial uncertainty when integrating social data in conservation planning.

PubMed

Lechner, A M; Raymond, C M; Adams, V M; Polyakov, M; Gordon, A; Rhodes, J R; Mills, M; Stein, A; Ives, C D; Lefroy, E C

2014-12-01

Recent conservation planning studies have presented approaches for integrating spatially referenced social (SRS) data with a view to improving the feasibility of conservation action. We reviewed the growing conservation literature on SRS data, focusing on elicited or stated preferences derived through social survey methods such as choice experiments and public participation geographic information systems. Elicited SRS data includes the spatial distribution of willingness to sell, willingness to pay, willingness to act, and assessments of social and cultural values. We developed a typology for assessing elicited SRS data uncertainty which describes how social survey uncertainty propagates when projected spatially and the importance of accounting for spatial uncertainty such as scale effects and data quality. These uncertainties will propagate when elicited SRS data is integrated with biophysical data for conservation planning and may have important consequences for assessing the feasibility of conservation actions. To explore this issue further, we conducted a systematic review of the elicited SRS data literature. We found that social survey uncertainty was commonly tested for, but that these uncertainties were ignored when projected spatially. Based on these results we developed a framework which will help researchers and practitioners estimate social survey uncertainty and use these quantitative estimates to systematically address uncertainty within an analysis. This is important when using SRS data in conservation applications because decisions need to be made irrespective of data quality and well characterized uncertainty can be incorporated into decision theoretic approaches. © 2014 Society for Conservation Biology.

Initial description of a quantitative, cross-species (chimpanzee-human) social responsiveness measure

PubMed Central

Marrus, Natasha; Faughn, Carley; Shuman, Jeremy; Petersen, Steve; Constantino, John; Povinelli, Daniel; Pruett, John R.

2011-01-01

Objective Comparative studies of social responsiveness, an ability that is impaired in autistic spectrum disorders, can inform our understanding of both autism and the cognitive architecture of social behavior. Because there is no existing quantitative measure of social responsiveness in chimpanzees, we generated a quantitative, cross-species (human-chimpanzee) social responsiveness measure. Method We translated the Social Responsiveness Scale (SRS), an instrument that quantifies human social responsiveness, into an analogous instrument for chimpanzees. We then retranslated this "Chimp SRS" into a human "Cross-Species SRS" (XSRS). We evaluated three groups of chimpanzees (n=29) with the Chimp SRS and typical and autistic spectrum disorder (ASD) human children (n=20) with the XSRS. Results The Chimp SRS demonstrated strong inter-rater reliability at the three sites (ranges for individual ICCs: .534–.866 and mean ICCs: .851–.970). As has been observed in humans, exploratory principal components analysis of Chimp SRS scores supports a single factor underlying chimpanzee social responsiveness. Human subjects' XSRS scores were fully concordant with their SRS scores (r=.976, p=.001) and distinguished appropriately between typical and ASD subjects. One chimpanzee known for inappropriate social behavior displayed a significantly higher score than all other chimpanzees at its site, demonstrating the scale's ability to detect impaired social responsiveness in chimpanzees. Conclusion Our initial cross-species social responsiveness scale proved reliable and discriminated differences in social responsiveness across (in a relative sense) and within (in a more objectively quantifiable manner) humans and chimpanzees. PMID:21515200

Radiobiological basis of SBRT and SRS.

PubMed

Song, Chang W; Kim, Mi-Sook; Cho, L Chinsoo; Dusenbery, Kathryn; Sperduto, Paul W

2014-08-01

Stereotactic body radiation therapy (SBRT) and stereotactic radiosurgery (SRS) have been demonstrated to be highly effective for a variety of tumors. However, the radiobiological principles of SBRT and SRS have not yet been clearly defined. It is well known that newly formed tumor blood vessels are fragile and extremely sensitive to ionizing radiation. Various lines of evidence indicate that irradiation of tumors with high dose per fraction, i.e. >10 Gy per fraction, not only kills tumor cells but also causes significant damage in tumor vasculatures. Such vascular damage and ensuing deterioration of the intratumor environment then cause ischemic or indirect/secondary tumor cell death within a few days after radiation exposure, indicating that vascular damage plays an important role in the response of tumors to SBRT and SRS. Indications are that the extensive tumor cell death due to the direct effect of radiation on tumor cells and the secondary effect through vascular damage may lead to massive release of tumor-associated antigens and various pro-inflammatory cytokines, thereby triggering an anti-tumor immune response. However, the precise role of immune assault on tumor cells in SBRT and SRS has not yet been clearly defined. The "4 Rs" for conventional fractionated radiotherapy do not include indirect cell death and thus 4 Rs cannot account for the effective tumor control by SBRT and SRS. The linear-quadratic model is for cell death caused by DNA breaks and thus the usefulness of this model for ablative high-dose SBRT and SRS is limited.

Comparative Transcriptome Analysis Reveals Critical Function of Sucrose Metabolism Related-Enzymes in Starch Accumulation in the Storage Root of Sweet Potato

PubMed Central

Zhang, Kai; Wu, Zhengdan; Tang, Daobin; Luo, Kai; Lu, Huixiang; Liu, Yingying; Dong, Jie; Wang, Xin; Lv, Changwen; Wang, Jichun; Lu, Kun

2017-01-01

The starch properties of the storage root (SR) affect the quality of sweet potato (Ipomoea batatas (L.) Lam.). Although numerous studies have analyzed the accumulation and properties of starch in sweet potato SRs, the transcriptomic variation associated with starch properties in SR has not been quantified. In this study, we measured the starch and sugar contents and analyzed the transcriptome profiles of SRs harvested from sweet potatoes with high, medium, and extremely low starch contents, at five developmental stages [65, 80, 95, 110, and 125 days after transplanting (DAP)]. We found that differences in both water content and starch accumulation in the dry matter affect the starch content of SRs in different sweet potato genotypes. Based on transcriptome sequencing data, we assembled 112336 unigenes, and identified several differentially expressed genes (DEGs) involved in starch and sucrose metabolism, and revealed the transcriptional regulatory network controlling starch and sucrose metabolism in sweet potato SRs. Correlation analysis between expression patterns and starch and sugar contents suggested that the sugar–starch conversion steps catalyzed by sucrose synthase (SuSy) and UDP-glucose pyrophosphorylase (UGPase) may be essential for starch accumulation in the dry matter of SRs, and IbβFRUCT2, a vacuolar acid invertase, might also be a key regulator of starch content in the SRs. Our results provide valuable resources for future investigations aimed at deciphering the molecular mechanisms determining the starch properties of sweet potato SRs. PMID:28690616

Phase Stability Determinations of DWPF Waste Glasses

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

Marra, S.L.

1999-10-22

Liquid high-level nuclear waste will be immobilized at the Savannah River Site (SRS) by vitrification in borosilicate glass. To fulfill this requirement, glass samples were heat treated at various times and temperatures. These results will provide guidance to the repository program about conditions to be avoided during shipping, handling and storage of DWPF canistered waste forms.

Experiences with Use of Various Pedagogical Methods Utilizing a Student Response System -- Motivation and Learning Outcome

ERIC Educational Resources Information Center

Arnesen, Ketil; Korpas, Guri Sivertsen; Hennissen, Jon Eirik; Stav, John Birger

2013-01-01

This paper describes use of an online Student Response System (SRS) in a pre-qualification course for engineering studies in Norway. The SRS in use, where students answer quizzes using handheld mobile devices like Smartphones, PADs, iPods etc., has been developed at Sor-Trondelag University College. The development of the SRS was co-funded by the …

Cargo Movement Operations System (CMOS). Software Requirements Specification, Increment 1, Change 02

DTIC Science & Technology

1990-05-24

COMMENT: YES [ ] NO [ ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ CLOSED [ ] ORIGINATOR CONTROL NUMBER: SRS2-0002 PROGRAM OFFICE CONTROL NUMBER: DATA...ACCEPTS COMMENT: YES ( J NO [ ) COMMENT DISPOSITION: COMMENT STATUS: OPEN [ J CLOSED [ ] ORIGINATOR CONTROL NUMBER: SRS2-0003 PROGRAM OFFICE CONTROL...NO [ ] ERCI ACCEPTS COMMENT: YES [ ] NO ( ] COMMENT DISPOSITION: COMMENT STATUS: OPEN [ ] CLOSED [ J ORIGINATOR CONTROL NUMBER: SRS2-0004 PROGRAM

Use of existing systematic reviews for evidence assessments in infectious disease prevention: a comparative case study.

PubMed

Harder, Thomas; Remschmidt, Cornelius; Haller, Sebastian; Eckmanns, Tim; Wichmann, Ole

2016-10-11

Given limited resources and time constraints, the use of existing systematic reviews (SR) for the development of evidence-based public health recommendations has become increasingly important. Recently, a five-step approach for identifying, analyzing, appraising and using existing SRs based on recent guidance by the US Agency for Healthcare Research and Quality (AHRQ) was proposed within the Project on a Framework for Rating Evidence in Public Health (PRECEPT). However, case studies are needed to test whether this approach is useful, what challenges arise and how problems can be solved. In two case studies, the five-step approach was applied to integrate existing SRs in the development of evidence-based public health recommendations. Case study A focused on the role of neonatal sepsis as a risk factor for adverse neurodevelopmental outcome. Case study B examined the efficacy, effectiveness and safety of influenza vaccination during pregnancy. For each step, we report the approach of the review team, discuss challenges and describe solutions. For case study A, one existing SR was identified, while in case study B four SRs were eligible for analysis. We found that comparison of inclusion criteria alone was sufficient to judge on relevance of SRs in case study A, but not B. Although methodological quality of all identified SRs was acceptable, risk of bias assessments of individual studies included in the SRs had to be repeated in both case studies. Particular challenges appeared in case study B where multiple SRs addressed the same research question. With the help of spreadsheets comparing the characteristics of the existing SR we decided to use the most comprehensive one for our evidence synthesis and supplemented the results with those from the other SRs. In both case studies using the complete SR was not possible. The five-step approach provided useful and structured guidance and should be routinely applied when using existing SRs as a basis for evidence-based recommendations in public health. In situations where more than one SR has to be considered, the development of spreadsheets comparing characteristics, inclusion criteria, risk of bias, included studies and outcomes seems useful.

Endorsement of PRISMA statement and quality of systematic reviews and meta-analyses published in nursing journals: a cross-sectional study

PubMed Central

Tam, Wilson W S; Lo, Kenneth K H; Khalechelvam, Parames

2017-01-01

Objective Systematic reviews (SRs) often poorly report key information, thereby diminishing their usefulness. Previous studies evaluated published SRs and determined that they failed to meet explicit criteria or characteristics. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was recommended as a reporting guideline for SR and meta-analysis (MA), but previous studies showed that adherence to the statement was not high for SRs published in different medical fields. Thus, the aims of this study are twofold: (1) to investigate the number of nursing journals that have required or recommended the use of the PRISMA statement for reporting SR, and (2) to examine the adherence of SRs and/or meta-analyses to the PRISMA statement published in nursing journals. Design A cross-sectional study. Methods Nursing journals listed in the ISI journal citation report were divided into 2 groups based on the recommendation of PRISMA statement in their ‘Instruction for Authors’. SRs and meta-analyses published in 2014 were searched in 3 databases. 37 SRs and meta-analyses were randomly selected in each group. The adherence of each item to the PRISMA was examined and summarised using descriptive statistics. The quality of the SRs was assessed by Assessing the Methodological Quality of Systematic Reviews. The differences between the 2 groups were compared using the Mann-Whitney U test. Results Out of 107 nursing journals, 30 (28.0%) recommended or required authors to follow the PRISMA statement when they submit SRs or meta-analyses. The median rates of adherence to the PRISMA statement for reviews published in journals with and without PRISMA endorsement were 64.9% (IQR: 17.6–92.3%) and 73.0% (IQR: 59.5–94.6%), respectively. No significant difference was observed in any of the items between the 2 groups. Conclusions The median adherence of SRs and meta-analyses in nursing journals to PRISMA is low at 64.9% and 73.0%, respectively. Nonetheless, the adherence level of nursing journals to the PRISMA statement does not significantly vary whether they endorse or recommend such a guideline. PMID:28174224

SU-F-T-638: Is There A Need For Immobilization in SRS?

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

Masterova, K; Sethi, A; Anderson, D

2016-06-15

Purpose: Frameless Stereotactic radiosurgery (SRS) is increasingly used in the clinic. Cone-Beam CT (CBCT) to simulation-CT match has replaced the 3-dimensional coordinate based set up using a stereotactic localizing frame. The SRS frame however served as both a localizing and immobilizing device. We seek to measure the quality of frameless (mask based) and frame based immobilization and evaluate its impact on target dose. Methods: Each SRS patient was set up by kV on-board imaging (OBI) and then fine-tuned with CBCT. A second CBCT was done at treatment-end to ascertain intrafraction motion. We compared pre- vs post-treatment CBCT shifts for bothmore » frameless and frame based SRS patients. CBCT to sim-CT fusion was repeated for each patient off-line to assess systematic residual image registration error. Each patient was re-planned with measured shifts to assess effects on target dose. Results: We analyzed 11 patients (12 lesions) treated with frameless SRS and 6 patients (11 lesions) with a fixed frame system. Average intra-fraction iso-center positioning errors for frameless and frame-based treatments were 1.24 ± 0.57 mm and 0.28 ± 0.08 mm (mean ± s.d.) respectively. Residual error in CBCT registration was 0.24 mm. The frameless positioning uncertainties led to target dose errors in Dmin and D95 of 15.5 ± 18.4% and 6.6 ± 9.1% respectively. The corresponding errors in fixed frame SRS were much lower with Dmin and D95 reduced by 4.2 ± 6.5% and D95 2.5 ± 3.8% respectively. Conclusion: Frameless mask provides good immobilization with average patient motion of 1.2 mm during treatment. This exceeds MRI voxel dimensions (∼0.43mm) used for target delineation. Frame-based SRS provides superior patient immobilization with measureable movement no greater than the background noise of the CBCT registration. Small lesions requiring submm precision are better served with a frame based SRS.« less

Backscatter spectra measurements of the two beams on the same cone on Shenguang-III laser facility

NASA Astrophysics Data System (ADS)

Zha, Weiyi; Yang, Dong; Xu, Tao; Liu, Yonggang; Wang, Feng; Peng, Xiaoshi; Li, Yulong; Wei, Huiyue; Liu, Xiangming; Mei, Yu; Yan, Yadong; He, Junhua; Li, Zhichao; Li, Sanwei; Jiang, Xiaohua; Guo, Liang; Xie, Xufei; Pan, Kaiqiang; Liu, Shenye; Jiang, Shaoen; Zhang, Baohan; Ding, Yongkun

2018-01-01

In laser driven hohlraums, laser beams on the same incident cone may have different beam and plasma conditions, causing beam-to-beam backscatter difference and subsequent azimuthal variations in the x-ray drive on the capsule. To elucidate the large variation of backscatter proportion from beam to beam in some gas-filled hohlraum shots on Shenguang-III, two 28.5° beams have been measured with the Stimulated Raman Scattering (SRS) time-resolved spectra. A bifurcated fiber is used to sample two beams and then coupled to a spectrometer and streak camera combination to reduce the cost. The SRS spectra, characterized by a broad wavelength, were further corrected considering the temporal distortion and intensity modulation caused by components along the light path. This measurement will improve the understanding of the beam propagation inside the hohlraum and related laser plasma instabilities.

Preliminary Tests For Development Of A Non-Pertechnetate Analysis Method

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

Diprete, D.; McCabe, D.

2016-09-28

The objective of this task was to develop a non-pertechnetate analysis method that 222-S lab could easily implement. The initial scope involved working with 222-S laboratory personnel to adapt the existing Tc analytical method to fractionate the non-pertechnetate and pertechnetate. SRNL then developed and tested a method using commercial sorbents containing Aliquat ® 336 to extract the pertechnetate (thereby separating it from non-pertechnetate), followed by oxidation, extraction, and stripping steps, and finally analysis by beta counting and Mass Spectroscopy. Several additional items were partially investigated, including impacts of a 137Cs removal step. The method was initially tested on SRS tankmore » waste samples to determine its viability. Although SRS tank waste does not contain non-pertechnetate, testing with it was useful to investigate the compatibility, separation efficiency, interference removal efficacy, and method sensitivity.« less

Elevated Autism Spectrum Disorder Traits in Young Children with OCD.

PubMed

Stewart, Elyse; Cancilliere, Mary Kathryn; Freeman, Jennifer; Wellen, Brianna; Garcia, Abbe; Sapyta, Jeffrey; Franklin, Martin

2016-12-01

Studies have shown a high prevalence of autistic spectrum traits in both children and adults with psychiatric disorders; however the prevalence rate has not yet been investigated in young children with OCD. The aim of the current study was to (1) determine whether ASD traits indicated by the Social Communication Questionnaire (SCQ) and the Social Responsiveness Scale (SRS) were elevated in young children with OCD who do not have a specific ASD diagnosis and (2) determine if ASD traits were associated with OCD severity. Participants (N = 127) were children ages 5-8 years enrolled in the pediatric obsessive-compulsive disorder treatment study for young children (POTS Jr.). Results indicated that the SRS showed elevated autistic traits in the sample and was associated with OCD severity whereas the SCQ did not indicate heightened ASD symptoms. Implications of these results are discussed.

Geoscience Laser Altimeter System (GLAS) for the ICESat Mission

NASA Technical Reports Server (NTRS)

Abshire, James B.; Sun, Xiaoli; Ketchum, Eleanor A.; Millar, Pamela S.; Riris, Haris

2002-01-01

The Geoscience Laser Altimeter System (GLAS) is a new generation lidar and is the primary science payload for NASA's ICESat Mission. The GLAS design combines a 10 cm precision surface lidar with a sensitive dual wavelength cloud and aerosol lidar. GLAS will precisely measure the heights of the Earth's polar ice sheets, establish a grid of accurate height profiles of the Earth's land topography, and profile the vertical distribution of clouds and aerosols on a global scale. GLAS will be integrated onto a small spacecraft built by Ball Aerospace, and will be launched into a polar orbit with a 590-630 km altitude at an inclination of 94 degrees. ICESat is is currently planned to launch in winter 2002/03 and GLAS is designed to operate continuously in space for a minimum of 3 years. GLAS will measure the vertical distance from orbit to the Earth's surface with pulses from a ND:YAG laser at a 40 Hz rate. Each 6 nsec wide 1064 nm laser pulse is used to produce a single range measurement. On the surface, the laser footprints have 66 m diameter and approx. 170 m center-center spacings. The GLAS receiver uses a I m diameter telescope to detect laser backscatter and a Si APD to detect the 1064 nm signals. The detector's output is sampled by a digital ranging receiver, which records each transmitted pulse and surface echo waveform with 1 nsec (15 cm) resolution. Each echo pulse is digitized and is reported to ground with a record length of from 200 to 544 samples, depending on the spacecraft's location . The GLAS location and epoch times are measured by a precision GPS receiver carried on the ICESat spacecraft. Initial processing of the echo waveforms within GLAS permits discrimination between cloud and surface echoes for selecting appropriate waveform samples. This selection is guided by an on-board DEM which is used to set the boundaries for the echo pulse search algorithm. Subsequent ground-based echo pulse analysis, along with GPS-based clock frequency estimates, permit final determination of the range to the surface, degree of pulse spreading, and vertical distribution of any vegetation illuminated by the laser. Accurate knowledge of the laser beam's pointing angle is needed to prevent height biases when measuring over tilted surfaces, such as near the boundaries of ice sheets. For surfaces with 2 deg. slopes, knowledge of pointing angle of the beam's centroid angle to better than 10 urad is needed. GLAS uses a stellar reference system (SRS) to measure the pointing angle of each laser firing relative to inertial space. The SRS uses a high precision star camera oriented toward local zenith and a gyroscope to determine the inertial orientation of the SRS optical bench. The far field pattern of each laser is measured pulse relative to the star camera with a laser reference system (LRS). GLAS will also measure the vertical distributions of clouds and aerosols by recording the vertical profiles of laser pulse backscatter at both 1064 and 532 nm. The 1064 rim measurements use the Si APD detector and will be used to measure the height and echo pulse shape from thicker clouds. The lidar receiver at 532 nm uses a narrow bandwidth etalon filter and highly sensitive photon counting detectors. The 532 nm backscatter profiles will be used to measure the vertical extent of thinner clouds and the atmospheric boundary layer. The GLAS instrument component development is complete and the instrument is undergoing final testing and qualification at NASA-Goddard. The GLAS "as-built" characteristics and its expected measurement performance will be discussed.

Best of the Radiosurgery Society® Scientific Meeting 2014: stereotactic radiosurgery/stereotactic body radiotherapy treatment of extracranial and intracranial lesions.

PubMed

Mahadevan, Anand; Bucholz, Richard; Gaya, Andrew M; Kresl, John J; Mantz, Constantine; Minnich, Douglas J; Muacevic, Alexander; Medbery, Clinton; Yang, Jun; Caglar, Hale Basak; Davis, Joanne N

2014-12-01

The SRS/SBRT Scientific Meeting 2014, Minneapolis, MN, USA, 7-10 May 2014. The Radiosurgery Society(®), a professional medical society dedicated to advancing the field of stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT), held the international Radiosurgery Society Scientific Meeting, from 7-10 May 2014 in Minneapolis (MN, USA). This year's conference attracted over 400 attendants from around the world and featured over 100 presentations (46 oral) describing the role of SRS/SBRT for the treatment of intracranial and extracranial malignant and nonmalignant lesions. This article summarizes the meeting highlights for SRS/SBRT treatments, both intracranial and extracranial, in a concise review.

RandomSpot: A web-based tool for systematic random sampling of virtual slides.

PubMed

Wright, Alexander I; Grabsch, Heike I; Treanor, Darren E

2015-01-01

This paper describes work presented at the Nordic Symposium on Digital Pathology 2014, Linköping, Sweden. Systematic random sampling (SRS) is a stereological tool, which provides a framework to quickly build an accurate estimation of the distribution of objects or classes within an image, whilst minimizing the number of observations required. RandomSpot is a web-based tool for SRS in stereology, which systematically places equidistant points within a given region of interest on a virtual slide. Each point can then be visually inspected by a pathologist in order to generate an unbiased sample of the distribution of classes within the tissue. Further measurements can then be derived from the distribution, such as the ratio of tumor to stroma. RandomSpot replicates the fundamental principle of traditional light microscope grid-shaped graticules, with the added benefits associated with virtual slides, such as facilitated collaboration and automated navigation between points. Once the sample points have been added to the region(s) of interest, users can download the annotations and view them locally using their virtual slide viewing software. Since its introduction, RandomSpot has been used extensively for international collaborative projects, clinical trials and independent research projects. So far, the system has been used to generate over 21,000 sample sets, and has been used to generate data for use in multiple publications, identifying significant new prognostic markers in colorectal, upper gastro-intestinal and breast cancer. Data generated using RandomSpot also has significant value for training image analysis algorithms using sample point coordinates and pathologist classifications.

Radiosurgery with photons or protons for benign and malignant tumours of the skull base: a review.

PubMed

Amichetti, Maurizio; Amelio, Dante; Minniti, Giuseppe

2012-12-14

Stereotactic radiosurgery (SRS) is an important treatment option for intracranial lesions. Many studies have shown the effectiveness of photon-SRS for the treatment of skull base (SB) tumours; however, limited data are available for proton-SRS.Several photon-SRS techniques, including Gamma Knife, modified linear accelerators (Linac) and CyberKnife, have been developed and several studies have compared treatment plan characteristics between protons and photons.The principles of classical radiobiology are similar for protons and photons even though they differ in terms of physical properties and interaction with matter resulting in different dose distributions.Protons have special characteristics that allow normal tissues to be spared better than with the use of photons, although their potential clinical superiority remains to be demonstrated.A critical analysis of the fundamental radiobiological principles, dosimetric characteristics, clinical results, and toxicity of proton- and photon-SRS for SB tumours is provided and discussed with an attempt of defining the advantages and limits of each radiosurgical technique.

Coherent Raman scattering microscopy for label-free imaging of live amphioxus

NASA Astrophysics Data System (ADS)

Yu, Zhilong; Chen, Tao; Zhang, Xiannian; Shen, Jie; Chen, Junyuan; Huang, Yanyi

2012-03-01

The existence of notochord distinguishes chordates from other phyla. Amphioxus is the only animal that keeps notochord during the whole life. Notochord is a unique organ for amphioxus, with its vertically arranged muscular notochordal plates, which is different from notochords in embryos of other chordates. We use stimulated Raman scattering (SRS) microscopy as a non-invasive technique to image the chemical components in amphioxus notochord. SRS provides chemical specificity as spontaneous Raman does and offers a higher sensitivity for fast acquisition. Unlike coherent anti- Stokes Raman scattering (CARS) microscopy, SRS microscopy doesn't have non-resonant background and can better differentiate different components in the specimen. We verify that the notochord is a protein-rich organ, which agrees well with the result of conventional staining methods. Detailed structures in notochordal plates and notochordal sheath are revealed by SRS microscopy with diffraction limited resolution. Our experiment shows that SRS microscopy is an excellent imaging tool for biochemical research with its intrinsic chemical selectivity, high spatiotemporal resolution and native 3D optical sectioning ability.

Overexpression of Brassica rapa SHI-RELATED SEQUENCE genes suppresses growth and development in Arabidopsis thaliana.

PubMed

Hong, Joon Ki; Kim, Jin A; Kim, Jung Sun; Lee, Soo In; Koo, Bon Sung; Lee, Yeon-Hee

2012-08-01

S HI-R ELATED SEQUENCE (SRS) genes are plant-specific transcription factors containing a zinc-binding RING finger motif, which play a critical role in plant growth and development. We have characterized six SRS genes in Brassica rapa. Overexpression of the SRSs BrSTY1, BrSRS7, and BrLRP1 induced dwarf and compact plants, and significantly decreased primary root elongation and lateral root formation. Additionally, the transgenic plants had upward-curled leaves of narrow widths and with short petioles, and had shorter siliques and low fertility. In stems, hypocotyls, and styles, epidermal cell lengths were also significantly reduced in transgenic plants. RT-PCR analysis of transgenic plants revealed that BrSTY1, BrSRS7, and BrLRP1 regulate expression of several gibberellin (GA)- and auxin-related genes involved in morphogenesis in shoot apical regions. We conclude that BrSTY1, BrSRS7, and BrLRP1 regulate plant growth and development by regulating expression of GA- and auxin-related genes.

Herb–drug interactions: an overview of systematic reviews

PubMed Central

Posadzki, Paul; Watson, Leala; Ernst, Edzard

2013-01-01

OBJECTIVES The aim of this overview of systematic reviews (SRs) is to evaluate critically the evidence regarding interactions between herbal medicinal products (HMPs) and synthetic drugs. METHODS Four electronic databases were searched to identify relevant SRs. RESULTS Forty‐six SRs of 46 different HMPs met our inclusion criteria. The vast majority of SRs were of poor methodological quality. The majority of these HMPs were not associated with severe herb–drug interactions. Serious herb–drug interactions were noted for Hypericum perforatum and Viscum album. The most severe interactions resulted in transplant rejection, delayed emergence from anaesthesia, cardiovascular collapse, renal and liver toxicity, cardiotoxicity, bradycardia, hypovolaemic shock, inflammatory reactions with organ fibrosis and death. Moderately severe interactions were noted for Ginkgo biloba, Panax ginseng, Piper methysticum, Serenoa repens and Camellia sinensis. The most commonly interacting drugs were antiplatelet agents and anticoagulants. CONCLUSION The majority of the HMPs evaluated in SRs were not associated with drug interactions with serious consequences. However, the poor quality and the scarcity of the primary data prevent firm conclusions. PMID:22670731

Radiosurgery with photons or protons for benign and malignant tumours of the skull base: a review

PubMed Central

2012-01-01

Stereotactic radiosurgery (SRS) is an important treatment option for intracranial lesions. Many studies have shown the effectiveness of photon-SRS for the treatment of skull base (SB) tumours; however, limited data are available for proton-SRS. Several photon-SRS techniques, including Gamma Knife, modified linear accelerators (Linac) and CyberKnife, have been developed and several studies have compared treatment plan characteristics between protons and photons. The principles of classical radiobiology are similar for protons and photons even though they differ in terms of physical properties and interaction with matter resulting in different dose distributions. Protons have special characteristics that allow normal tissues to be spared better than with the use of photons, although their potential clinical superiority remains to be demonstrated. A critical analysis of the fundamental radiobiological principles, dosimetric characteristics, clinical results, and toxicity of proton- and photon-SRS for SB tumours is provided and discussed with an attempt of defining the advantages and limits of each radiosurgical technique. PMID:23241206

ANALYSIS OF SAMPLES FROM TANK 5F CHEMICAL CLEANING

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

Poirier, M.; Fink, S.

2011-03-07

The Savannah River Site (SRS) is preparing Tank 5F for closure. The first step in preparing the tank for closure is mechanical sludge removal. Following mechanical sludge removal, SRS performed chemical cleaning with oxalic acid to remove the sludge heel. Personnel are currently assessing the effectiveness of the chemical cleaning. SRS personnel collected liquid samples during chemical cleaning and submitted them to Savannah River National Laboratory (SRNL) for analysis. Following chemical cleaning, they collected a solid sample (also known as 'process sample') and submitted it to SRNL for analysis. The authors analyzed these samples to assess the effectiveness of themore » chemical cleaning process. The conclusions from this work are: (1) With the exception of iron, the dissolution of sludge components from Tank 5F agreed with results from the actual waste demonstration performed in 2007. The fraction of iron removed from Tank 5F by chemical cleaning was significantly less than the fraction removed in the SRNL demonstrations. The likely cause of this difference is the high pH following the first oxalic acid strike. (2) Most of the sludge mass remaining in the tank is iron and nickel. (3) The remaining sludge contains approximately 26 kg of barium, 37 kg of chromium, and 37 kg of mercury. (4) Most of the radioactivity remaining in the residual material is beta emitters and {sup 90}Sr. (5) The chemical cleaning removed more than {approx} 90% of the uranium isotopes and {sup 137}Cs. (6) The chemical cleaning removed {approx} 70% of the neptunium, {approx} 83% of the {sup 90}Sr, and {approx} 21% of the {sup 60}Co. (7) The chemical cleaning removed less than 10% of the plutonium, americium, and curium isotopes. (8) The chemical cleaning removed more than 90% of the aluminium, calcium, and sodium from the tank. (9) The cleaning operations removed 61% of lithium, 88% of non-radioactive strontium, and 65% of zirconium. The {sup 90}Sr and non-radioactive strontium were measured by different methods, and the differences in the fraction removed are not statistically significant. (10) Chemical cleaning removed 10-50% of the barium, chromium, iron, magnesium, manganese, and silicon. (11) Chemical cleaning removed only {approx}1% of the nickel.« less

Sex Ratio Elasticity Influences the Selection of Sex Ratio Strategy.

PubMed

Wang, Yaqiang; Wang, Ruiwu; Li, Yaotang; Sam Ma, Zhanshan

2016-12-23

There are three sex ratio strategies (SRS) in nature-male-biased sex ratio, female-biased sex ratio and, equal sex ratio. It was R. A. Fisher who first explained why most species in nature display a sex ratio of ½. Consequent SRS theories such as Hamilton's local mate competition (LMC) and Clark's local resource competition (LRC) separately explained the observed deviations from the seemingly universal 1:1 ratio. However, to the best of our knowledge, there is not yet a unified theory that accounts for the mechanisms of the three SRS. Here, we introduce the price elasticity theory in economics to define sex ratio elasticity (SRE), and present an analytical model that derives three SRSs based on the following assumption: simultaneously existing competitions for both resources A and resources B influence the level of SRE in both sexes differently. Consequently, it is the difference (between two sexes) in the level of their sex ratio elasticity that leads to three different SRS. Our analytical results demonstrate that the elasticity-based model not only reveals a highly plausible mechanism that explains the evolution of SRS in nature, but also offers a novel framework for unifying two major classical theories (i.e., LMC &LRC) in the field of SRS research.

TU-A-BRB-03: Panel Member

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

Winey, B.

2016-06-15

Brain stereotactic radiosurgery (SRS) and spine stereotactic body radiation therapy (SBRT) are commonly treated by a multidisciplinary team of neurosurgeons, radiation oncologists, and medical physicists. However the treatment objectives, constraints, and technical considerations involved can be quite different between the two techniques. In this interactive session an expert panel of speakers will present clinical brain SRS and spine SBRT cases in order to demonstrate real-world considerations for ensuring safe and accurate treatment delivery and to highlight the significant differences in approach for each treatment site. The session will include discussion of topic such as clinical indications, immobilization, target definition, normalmore » tissue tolerance limits, and beam arrangements. Learning Objectives: Understand the differences in indications and dose/fractionation strategies for intracranial SRS and spine SBRT. Describe the different treatment modalities which can be used to deliver intracranial SRS and spine SBRT. Cite the major differences in treatment setup and delivery principles between intracranial and spine treatments. Identify key critical structures and clinical dosimetric tolerance levels for spine SBRT and intracranial SRS. Understand areas of ongoing work to standardize intracranial SRS and spine SBRT procedures. Schlesinger: Research support: Elekta Instruments, AB; D. Schlesinger, Elekta Instruments, AB - research support; B. Winey, No relevant external funding for this subject.« less

TU-A-BRB-02: Panel Member

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

Ma, L.

2016-06-15

Brain stereotactic radiosurgery (SRS) and spine stereotactic body radiation therapy (SBRT) are commonly treated by a multidisciplinary team of neurosurgeons, radiation oncologists, and medical physicists. However the treatment objectives, constraints, and technical considerations involved can be quite different between the two techniques. In this interactive session an expert panel of speakers will present clinical brain SRS and spine SBRT cases in order to demonstrate real-world considerations for ensuring safe and accurate treatment delivery and to highlight the significant differences in approach for each treatment site. The session will include discussion of topic such as clinical indications, immobilization, target definition, normalmore » tissue tolerance limits, and beam arrangements. Learning Objectives: Understand the differences in indications and dose/fractionation strategies for intracranial SRS and spine SBRT. Describe the different treatment modalities which can be used to deliver intracranial SRS and spine SBRT. Cite the major differences in treatment setup and delivery principles between intracranial and spine treatments. Identify key critical structures and clinical dosimetric tolerance levels for spine SBRT and intracranial SRS. Understand areas of ongoing work to standardize intracranial SRS and spine SBRT procedures. Schlesinger: Research support: Elekta Instruments, AB; D. Schlesinger, Elekta Instruments, AB - research support; B. Winey, No relevant external funding for this subject.« less

TU-A-BRB-01: Panel Member

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

Schlesinger, D.

2016-06-15

Brain stereotactic radiosurgery (SRS) and spine stereotactic body radiation therapy (SBRT) are commonly treated by a multidisciplinary team of neurosurgeons, radiation oncologists, and medical physicists. However the treatment objectives, constraints, and technical considerations involved can be quite different between the two techniques. In this interactive session an expert panel of speakers will present clinical brain SRS and spine SBRT cases in order to demonstrate real-world considerations for ensuring safe and accurate treatment delivery and to highlight the significant differences in approach for each treatment site. The session will include discussion of topic such as clinical indications, immobilization, target definition, normalmore » tissue tolerance limits, and beam arrangements. Learning Objectives: Understand the differences in indications and dose/fractionation strategies for intracranial SRS and spine SBRT. Describe the different treatment modalities which can be used to deliver intracranial SRS and spine SBRT. Cite the major differences in treatment setup and delivery principles between intracranial and spine treatments. Identify key critical structures and clinical dosimetric tolerance levels for spine SBRT and intracranial SRS. Understand areas of ongoing work to standardize intracranial SRS and spine SBRT procedures. Schlesinger: Research support: Elekta Instruments, AB; D. Schlesinger, Elekta Instruments, AB - research support; B. Winey, No relevant external funding for this subject.« less

Sex Ratio Elasticity Influences the Selection of Sex Ratio Strategy

NASA Astrophysics Data System (ADS)

Wang, Yaqiang; Wang, Ruiwu; Li, Yaotang; (Sam) Ma, Zhanshan

2016-12-01

There are three sex ratio strategies (SRS) in nature—male-biased sex ratio, female-biased sex ratio and, equal sex ratio. It was R. A. Fisher who first explained why most species in nature display a sex ratio of ½. Consequent SRS theories such as Hamilton’s local mate competition (LMC) and Clark’s local resource competition (LRC) separately explained the observed deviations from the seemingly universal 1:1 ratio. However, to the best of our knowledge, there is not yet a unified theory that accounts for the mechanisms of the three SRS. Here, we introduce the price elasticity theory in economics to define sex ratio elasticity (SRE), and present an analytical model that derives three SRSs based on the following assumption: simultaneously existing competitions for both resources A and resources B influence the level of SRE in both sexes differently. Consequently, it is the difference (between two sexes) in the level of their sex ratio elasticity that leads to three different SRS. Our analytical results demonstrate that the elasticity-based model not only reveals a highly plausible mechanism that explains the evolution of SRS in nature, but also offers a novel framework for unifying two major classical theories (i.e., LMC & LRC) in the field of SRS research.

Citizen Contributions to the Closure of High-Level Waste (HLW) Tanks 18 and 19 at the Department of Energy's (DOE) Savannah River Site (SRS) - 13448

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

Lawless, W.F.

2013-07-01

Citizen involvement in DOE's decision-making for the environmental cleanup from DOE's management of its nuclear wastes across the DOE complex has had a positive effect on the cleanup of its SRS site, characterized by an acceleration of cleanup not only for the Transuranic wastes at SRS, but also for DOE's first two closures of HLW tanks, both of which occurred at SRS. The Citizens around SRS had pushed successfully for the closures of Tanks 17 and 20 in 1997, becoming the first closures of HLW tanks under regulatory guidance in the USA. However, since then, HLW tank closures ceased duemore » to a lawsuit, the application of new tank clean-up technology, interagency squabbling between DOE and NRC over tank closure criteria, and finally and almost fatally, from budget pressures. Despite an agreement with its regulators for the closure of Tanks 18 and 19 by the end of calendar year 2012, the outlook in Fall 2011 to close these two tanks had dimmed. It was at this point that the citizens around SRS became reengaged with tank closures, helping DOE to reach its agreed upon milestone. (authors)« less

High proportion of smaller ranged hummingbird species coincides with ecological specialization across the Americas.

PubMed

Sonne, Jesper; Martín González, Ana M; Maruyama, Pietro K; Sandel, Brody; Vizentin-Bugoni, Jeferson; Schleuning, Matthias; Abrahamczyk, Stefan; Alarcón, Ruben; Araujo, Andréa C; Araújo, Francielle P; Mendes de Azevedo, Severino; Baquero, Andrea C; Cotton, Peter A; Ingversen, Tanja Toftemark; Kohler, Glauco; Lara, Carlos; Guedes Las-Casas, Flor Maria; Machado, Adriana O; Machado, Caio Graco; Maglianesi, María Alejandra; Moura, Alan Cerqueira; Nogués-Bravo, David; Oliveira, Genilda M; Oliveira, Paulo E; Ornelas, Juan Francisco; Rodrigues, Licléia da Cruz; Rosero-Lasprilla, Liliana; Rui, Ana Maria; Sazima, Marlies; Timmermann, Allan; Varassin, Isabela Galarda; Wang, Zhiheng; Watts, Stella; Fjeldså, Jon; Svenning, Jens-Christian; Rahbek, Carsten; Dalsgaard, Bo

2016-02-10

Ecological communities that experience stable climate conditions have been speculated to preserve more specialized interspecific associations and have higher proportions of smaller ranged species (SRS). Thus, areas with disproportionally large numbers of SRS are expected to coincide geographically with a high degree of community-level ecological specialization, but this suggestion remains poorly supported with empirical evidence. Here, we analysed data for hummingbird resource specialization, range size, contemporary climate, and Late Quaternary climate stability for 46 hummingbird-plant mutualistic networks distributed across the Americas, representing 130 hummingbird species (ca 40% of all hummingbird species). We demonstrate a positive relationship between the proportion of SRS of hummingbirds and community-level specialization, i.e. the division of the floral niche among coexisting hummingbird species. This relationship remained strong even when accounting for climate, furthermore, the effect of SRS on specialization was far stronger than the effect of specialization on SRS, suggesting that climate largely influences specialization through species' range-size dynamics. Irrespective of the exact mechanism involved, our results indicate that communities consisting of higher proportions of SRS may be vulnerable to disturbance not only because of their small geographical ranges, but also because of their high degree of specialization. © 2016 The Author(s).

Cranial stereotactic radiosurgery: current status of the initial paradigm shifter.

PubMed

Sheehan, Jason P; Yen, Chun-Po; Lee, Cheng-Chia; Loeffler, Jay S

2014-09-10

The concept of stereotactic radiosurgery (SRS) was first described by Lars Leksell in 1951. It was proposed as a noninvasive alternative to open neurosurgical approaches to manage a variety of conditions. In the following decades, SRS emerged as a unique discipline involving a collegial partnership among neurosurgeons, radiation oncologists, and medical physicists. SRS relies on the precisely guided delivery of high-dose ionizing radiation to an intracranial target. The focused convergence of multiple beams yields a potent therapeutic effect on the target and a steep dose fall-off to surrounding structures, thereby minimizing the risk of collateral damage. SRS is typically administered in a single session but can be given in as many as five sessions or fractions. By providing an ablative effect noninvasively, SRS has altered the treatment paradigms for benign and malignant intracranial tumors, functional disorders, and vascular malformations. Literature on extensive intracranial radiosurgery has unequivocally demonstrated the favorable benefit-to-risk profile that SRS affords for appropriately selected patients. In a departure from conventional radiotherapeutic strategies, radiosurgical principles have recently been extended to extracranial indications such as lung, spine, and liver tumors. The paradigm shift resulting from radiosurgery continues to alter the landscape of related fields. © 2014 by American Society of Clinical Oncology.

99mTc-EDDA/HYNIC-TOC in management of patients with head and neck somatostatin receptor positive tumors.

PubMed

Trogrlic, Mate; Tezak, Stanko

2016-01-01

Aim of this study was to determine the value of technetium-99m-hydrazinonicotinyl-Tyr3-octreotide (99mTc-ED-DA/HYNIC-TOC) in patients with somatostatin receptor (SSR) positive tumors of head and neck region. A total number of 16 patients were enrolled in this study. Planar whole body (WB) and single photon emission computed tomography (SPECT) images were acquired at 2 and 4 hours after the injection of approximately 670 MBq of 99mTc-EDDA/HYNIC-TOC. Additional single photon emission computed tomography/computed tomography (SPECT/CT) images of the head and neck region were acquired at 4h post tracer injection. Clinical and imaging follow up were taken as the reference standard. There were 10 female and 6 male patients of age 57.7 ± 12.9 years (58.5; 32-78) years. 99mTc-EDDA/HYNIC-TOC somatostatin receptor scintigraphy (SRS) was TP in 13 patients, TN in two and FP in one. Follow up period for SRS was 31.1 ± 19.4 (29; 2-63) months. 99mTc-EDDA/HYNIC-TOC scintigraphy provided additional information in 50% of patients, with impact on patient management in the same percentage of patients. Distant metastases were found in nine out of 16 patients (56%). 99mTc-EDDA/HYNIC-TOC SRS had sensitivity of 100% (75.3-100%), specificity of 66.7% (9.4-99.2%), accuracy of 93.7%, positive predictive value of 92.9% (66.1-99.8%), and negative predictive value of 100% (15.8-100%). Somatostatin receptor scintigraphy using 99mTc-EDDA/HYNIC-TOC is very useful imaging method in the evalu-ation of patients with SSR positive tumors of head and neck region.

Long-term assessment of the physical, mental, and sexual health among transsexual women.

PubMed

Weyers, Steven; Elaut, Els; De Sutter, Petra; Gerris, Jan; T'Sjoen, Guy; Heylens, Gunter; De Cuypere, Griet; Verstraelen, Hans

2009-03-01

Transsexualism is the most extreme form of gender identity disorder and most transsexuals eventually pursue sex reassignment surgery (SRS). In transsexual women, this comprises removal of the male reproductive organs, creation of a neovagina and clitoris, and often implantation of breast prostheses. Studies have shown good sexual satisfaction after transition. However, long-term follow-up data on physical, mental and sexual functioning are lacking. To gather information on physical, mental, and sexual well-being, health-promoting behavior and satisfaction with gender-related body features of transsexual women who had undergone SRS. Fifty transsexual women who had undergone SRS >or=6 months earlier were recruited. Self-reported physical and mental health using the Dutch version of the Short-Form-36 (SF-36) Health Survey; sexual functioning using the Dutch version of the Female Sexual Function Index (FSFI). Satisfaction with gender-related bodily features as well as with perceived female appearance; importance of sex, relationship quality, necessity and advisability of gynecological exams, as well as health concerns and feelings of regret concerning transition were scored. Compared with reference populations, transsexual women scored good on physical and mental level (SF-36). Gender-related bodily features were shown to be of high value. Appreciation of their appearance as perceived by others, as well as their own satisfaction with their self-image as women obtained a good score (8 and 9, respectively). However, sexual functioning as assessed through FSFI was suboptimal when compared with biological women, especially the sublevels concerning arousal, lubrication, and pain. Superior scores concerning sexual function were obtained in those transsexual women who were in a relationship and in heterosexuals. Transsexual women function well on a physical, emotional, psychological and social level. With respect to sexuality, they suffer from specific difficulties, especially concerning arousal, lubrication, and pain.

Next Generation Solvent (NGS): Development for Caustic-Side Solvent Extraction of Cesium

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

Moyer, Bruce A.; Birdwell, Jr, Joseph F.; Bonnesen, Peter V.

This report summarizes the FY 2010 and 2011 accomplishments at Oak Ridge National Laboratory (ORNL) in developing the Next Generation Caustic-Side Solvent Extraction (NG-CSSX) process, referred to commonly as the Next Generation Solvent (NGS), under funding from the U.S. Department of Energy, Office of Environmental Management (DOE-EM), Office of Technology Innovation and Development. The primary product of this effort is a process solvent and preliminary flowsheet capable of meeting a target decontamination factor (DF) of 40,000 for worst-case Savannah River Site (SRS) waste with a concentration factor of 15 or higher in the 18-stage equipment configuration of the SRS Modularmore » Caustic-Side Solvent Extraction Unit (MCU). In addition, the NG-CSSX process may be readily adapted for use in the SRS Salt Waste Processing Facility (SWPF) or in supplemental tank-waste treatment at Hanford upon appropriate solvent or flowsheet modifications. Efforts in FY 2010 focused on developing a solvent composition and process flowsheet for MCU implementation. In FY 2011 accomplishments at ORNL involved a wide array of chemical-development activities and testing up through single-stage hydraulic and mass-transfer tests in 5-cm centrifugal contactors. Under subcontract from ORNL, Argonne National Laboratory (ANL) designed a preliminary flowsheet using ORNL cesium distribution data, and Tennessee Technological University confirmed a chemical model for cesium distribution ratios (DCs) as a function of feed composition. Interlaboratory efforts were coordinated with complementary engineering tests carried out (and reported separately) by personnel at Savannah River National Laboratory (SRNL) and Savannah River Remediation (SRR) with helpful advice by Parsons Engineering and General Atomics on aspects of possible SWPF implementation.« less

Next Generation Solvent Development for Caustic-Side Solvent Extraction of Cesium

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

Moyer, Bruce A.; Birdwell, Joseph F.; Bonnesen, Peter V.

This report summarizes the FY 2010 and 2011 accomplishments at Oak Ridge National Laboratory (ORNL) in developing the Next Generation Caustic-Side Solvent Extraction (NG-CSSX) process, referred to commonly as the Next Generation Solvent (NGS), under funding from the U.S. Department of Energy, Office of Environmental Management (DOE-EM), Office of Technology Innovation and Development. The primary product of this effort is a process solvent and preliminary flowsheet capable of meeting a target decontamination factor (DF) of 40,000 for worst-case Savannah River Site (SRS) waste with a concentration factor of 15 or higher in the 18-stage equipment configuration of the SRS Modularmore » Caustic-Side Solvent Extraction Unit (MCU). In addition, the NG-CSSX process may be readily adapted for use in the SRS Salt Waste Processing Facility (SWPF) or in supplemental tank-waste treatment at Hanford upon appropriate solvent or flowsheet modifications. Efforts in FY 2010 focused on developing a solvent composition and process flowsheet for MCU implementation. In FY 2011 accomplishments at ORNL involved a wide array of chemical-development activities and testing up through single-stage hydraulic and mass-transfer tests in 5-cm centrifugal contactors. Under subcontract from ORNL, Argonne National Laboratory (ANL) designed a preliminary flowsheet using ORNL cesium distribution data, and Tennessee Technological University confirmed a chemical model for cesium distribution ratios (DCs) as a function of feed composition. Inter laboratory efforts were coordinated with complementary engineering tests carried out (and reported separately) by personnel at Savannah River National Laboratory (SRNL) and Savannah River Remediation (SRR) with helpful advice by Parsons Engineering and General Atomics on aspects of possible SWPF implementation.« less

Association of Left Atrial Function and Left Atrial Enhancement in Patients with Atrial Fibrillation: A Cardiac Magnetic Resonance Study

PubMed Central

Habibi, Mohammadali; Lima, Joao A.C.; Khurram, Irfan M.; Zimmerman, Stefan L.; Zipunnikov, Vadim; Fukumoto, Kotaro; Spragg, David; Ashikaga, Hiroshi; Rickard, John; Marine, Joseph E.; Calkins, Hugh; Nazarian, Saman

2015-01-01

Background Atrial fibrillation (AF) is associated with left atrial (LA) structural and functional changes. Cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) and feature-tracking are capable of noninvasive quantification of LA fibrosis and myocardial motion, respectively. We sought to examine the association of phasic LA function with LA enhancement in patients with AF. Methods and Results LA structure and function was measured in 90 AF patients (age 61 ± 10 years, 76% male) referred for ablation and 14 healthy volunteers. Peak global longitudinal LA strain (PLAS), LA systolic strain rate (SR-s), and early (SR-ed) and late diastolic (SR-ld) strain rates were measured using cine-CMR images acquired during sinus rhythm. The degree of LGE was quantified. Compared to patients with paroxysmal AF (60% of cohort), those with persistent AF had larger maximum LA volume index (LAVImax, 56 ± 17ml/m2 versus 49 ± 13ml/m2 p=0.036), and increased LGE (27.1± 11.7% versus 36.8 ± 14.8% p<0.001). Aside from LA active emptying fraction, all LA parameters (passive emptying fraction, PLAS, SR-s, SR-ed and SR-ld) were lower in patients with persistent AF (p< 0.05 for all). Healthy volunteers had less LGE and higher LA functional parameters compared to AF patients (p<0.05 for all). In multivariable analysis, increased LGE was associated with lower LA passive emptying fraction, PLAS, SR-s, SR-ed, and SR-ld (p<0.05 for all). Conclusions Increased LA enhancement is associated with decreased LA reservoir, conduit, and booster pump functions. Phasic measurement of LA function using feature-tracking CMR may add important information regarding the physiological importance of LA fibrosis. PMID:25652181

Canadian Neurosurgery Educators' Views on Stereotactic Radiosurgery in Residency Training.

PubMed

Samuel, Nardin; Philteos, Justine; Alotaibi, Naif M; Ahuja, Christopher; Mansouri, Alireza; Kulkarni, Abhaya V

2018-04-01

Despite the increasing prominence of stereotactic radiosurgery (SRS) in treating intracranial and spinal pathologies, there is currently a dearth of exposure to this modality in the neurosurgical residency. To address this gap, the aim of this study is to assess neurosurgery educators' views regarding the current state of SRS exposure, and to identify potential approaches to improve residency education in this domain. Qualitative thematic analysis and constructivist grounded theory methodology were employed. Semistructured telephone-based interviews were conducted with current or past residency program directors, as well as current departmental chairs across neurosurgical departments in Canada. Interviews were transcribed and subjected to thematic analysis using open and axial coding. Of the 34 eligible participants, the overall response rate was 41.1% (14/34), with a 35.3% participation rate (12/34). Participants represented 9 of the 12 Canadian institutions surveyed. The majority of participants were current program directors (n = 8), followed by past program directors (n = 2), and departmental chairs (n = 2). Most respondents 75% (9/12) view an increasing role for SRS in neurosurgery. Unanimously, respondents endorse greater exposure to SRS during residency through formal residency rotations and engagement in interdisciplinary tumor boards to facilitate involvement in clinical decision-making. This is the first study to systematically collate neurosurgery educators' views on SRS in residency in Canada and demonstrates recognition of the discordance between SRS in practice and residency training. Neurosurgery educators broadly endorse increased exposure to this modality. Future work is needed to delineate the requirements necessary to achieve adequate competency in SRS. Copyright © 2018 Elsevier Inc. All rights reserved.

SWS: accessing SRS sites contents through Web Services.

PubMed

Romano, Paolo; Marra, Domenico

2008-03-26

Web Services and Workflow Management Systems can support creation and deployment of network systems, able to automate data analysis and retrieval processes in biomedical research. Web Services have been implemented at bioinformatics centres and workflow systems have been proposed for biological data analysis. New databanks are often developed by taking into account these technologies, but many existing databases do not allow a programmatic access. Only a fraction of available databanks can thus be queried through programmatic interfaces. SRS is a well know indexing and search engine for biomedical databanks offering public access to many databanks and analysis tools. Unfortunately, these data are not easily and efficiently accessible through Web Services. We have developed 'SRS by WS' (SWS), a tool that makes information available in SRS sites accessible through Web Services. Information on known sites is maintained in a database, srsdb. SWS consists in a suite of WS that can query both srsdb, for information on sites and databases, and SRS sites. SWS returns results in a text-only format and can be accessed through a WSDL compliant client. SWS enables interoperability between workflow systems and SRS implementations, by also managing access to alternative sites, in order to cope with network and maintenance problems, and selecting the most up-to-date among available systems. Development and implementation of Web Services, allowing to make a programmatic access to an exhaustive set of biomedical databases can significantly improve automation of in-silico analysis. SWS supports this activity by making biological databanks that are managed in public SRS sites available through a programmatic interface.

Initial description of a quantitative, cross-species (chimpanzee-human) social responsiveness measure.

PubMed

Marrus, Natasha; Faughn, Carley; Shuman, Jeremy; Petersen, Steve E; Constantino, John N; Povinelli, Daniel J; Pruett, John R

2011-05-01

Comparative studies of social responsiveness, an ability that is impaired in autism spectrum disorders, can inform our understanding of both autism and the cognitive architecture of social behavior. Because there is no existing quantitative measure of social responsiveness in chimpanzees, we generated a quantitative, cross-species (human-chimpanzee) social responsiveness measure. We translated the Social Responsiveness Scale (SRS), an instrument that quantifies human social responsiveness, into an analogous instrument for chimpanzees. We then retranslated this "Chimpanzee SRS" into a human "Cross-Species SRS" (XSRS). We evaluated three groups of chimpanzees (n = 29) with the Chimpanzee SRS and typical and human children with autism spectrum disorder (ASD; n = 20) with the XSRS. The Chimpanzee SRS demonstrated strong interrater reliability at the three sites (ranges for individual ICCs: 0.534 to 0.866; mean ICCs: 0.851 to 0.970). As has been observed in human beings, exploratory principal components analysis of Chimpanzee SRS scores supports a single factor underlying chimpanzee social responsiveness. Human subjects' XSRS scores were fully concordant with their SRS scores (r = 0.976, p = .001) and distinguished appropriately between typical and ASD subjects. One chimpanzee known for inappropriate social behavior displayed a significantly higher score than all other chimpanzees at its site, demonstrating the scale's ability to detect impaired social responsiveness in chimpanzees. Our initial cross-species social responsiveness scale proved reliable and discriminated differences in social responsiveness across (in a relative sense) and within (in a more objectively quantifiable manner) human beings and chimpanzees. Copyright © 2011 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2017-08-01

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

Development of SRS.php, a Simple Object Access Protocol-based library for data acquisition from integrated biological databases.

PubMed

Barbosa-Silva, A; Pafilis, E; Ortega, J M; Schneider, R

2007-12-11

Data integration has become an important task for biological database providers. The current model for data exchange among different sources simplifies the manner that distinct information is accessed by users. The evolution of data representation from HTML to XML enabled programs, instead of humans, to interact with biological databases. We present here SRS.php, a PHP library that can interact with the data integration Sequence Retrieval System (SRS). The library has been written using SOAP definitions, and permits the programmatic communication through webservices with the SRS. The interactions are possible by invoking the methods described in WSDL by exchanging XML messages. The current functions available in the library have been built to access specific data stored in any of the 90 different databases (such as UNIPROT, KEGG and GO) using the same query syntax format. The inclusion of the described functions in the source of scripts written in PHP enables them as webservice clients to the SRS server. The functions permit one to query the whole content of any SRS database, to list specific records in these databases, to get specific fields from the records, and to link any record among any pair of linked databases. The case study presented exemplifies the library usage to retrieve information regarding registries of a Plant Defense Mechanisms database. The Plant Defense Mechanisms database is currently being developed, and the proposal of SRS.php library usage is to enable the data acquisition for the further warehousing tasks related to its setup and maintenance.

Risk factors for systemic reactions to bee venom in British beekeepers.

PubMed

Richter, Alex G; Nightingale, Peter; Huissoon, Aarnoud P; Krishna, Mamidipudi T

2011-02-01

There is a high incidence of systemic reactions (SRs) to bee stings in beekeepers, but the factors predisposing individuals to such responses are not well understood. To identify factors that predispose British beekeepers to SRs and to investigate how beekeepers access specialist services after SRs to bee venom. A link to an online survey was published in the bimonthly magazine and on the Web site of the British Beekeepers Association. The demographic results are presented using descriptive analysis, and a logistic regression model was used to determine risk factors for SRs. There were 852 responses to the questionnaire of which 63% were from male beekeepers; the most common age range was 51 to 60 years. Twenty-eight percent of all responders had experienced a large local reaction and 21% had experienced a SR. Factors that predisposed beekeepers to SRs included female sex, having a family member with bee venom allergy, more than 2 years of beekeeping before a SR, and premedication with an antihistamine before attending the hives. A total of 44% of beekeepers with SRs attended the emergency department because of their symptoms, 16.6% were reviewed by an allergy specialist, and only 18% carried an adrenaline autoinjector. Logistic regression analysis identified a number of novel factors to be associated with the development of SRs. Rates of attendance at the emergency department, allergy specialist review, and carriage of adrenaline were low, highlighting a need for education in the beekeeping community and among health care professionals. Copyright © 2011 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Stereotactic Radiosurgery for Patients With Brain Metastases From Small Cell Lung Cancer

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

Wegner, Rodney E.; Olson, Adam C.; Kondziolka, Douglas

2011-11-01

Background: Patients with small-cell lung cancer have a high likelihood of developing brain metastases. Many of these patients will have prophylactic cranial irradiation (PCI) or eventually undergo whole brain radiation therapy (WBRT). Despite these treatments, a large number of these patients will have progression of their intracranial disease and require additional local therapy. Stereotactic radiosurgery (SRS) is an important treatment option for such patients. Methods: We retrospectively reviewed the charts of 44 patients with brain metastases from small-cell lung cancer treated with gamma knife SRS. Multivariate analysis was used to determine significant prognostic factors influencing survival. Results: The median follow-upmore » from SRS in this patient population was 9 months (1-49 months). The median overall survival (OS) was 9 months after SRS. Karnofsky performance status (KPS) and combined treatment involving WBRT and SRS within 4 weeks were the two factors identified as being significant predictors of increased OS (p = 0.033 and 0.040, respectively). When comparing all patients, patients treated with a combined approach had a median OS of 14 months compared to 6 months if SRS was delivered alone. We also compared the OS times from the first definitive radiation: WBRT, WBRT and SRS if combined therapy was used, and SRS if the patient never received WBRT. The median survival for those groups was 12, 14, and 13 months, respectively, p = 0.19. Seventy percent of patients had follow-up magnetic resonance imaging available for review. Actuarial local control at 6 months and 12 months was 90% and 86%, respectively. Only 1 patient (2.2%) had symptomatic intracranial swelling related to treatment, which responded to a short course of steroids. New brain metastases outside of the treated area developed in 61% of patients at a median time of 7 months; 81% of these patients had received previous WBRT. Conclusions: Stereotactic radiosurgery for small-cell lung carcinoma brain metastases provided safe and effective local tumor control in the majority of patients.« less

Reliability and Validity Study of the Finnish Adaptation of Scoliosis Research Society Questionnaire Version SRS-30.

PubMed

Kyrölä, Kati; Järvenpää, Salme; Ylinen, Jari; Mecklin, Jukka-Pekka; Repo, Jussi Petteri; Häkkinen, Arja

2017-06-15

A prospective clinical study to test and adapt a Finnish version of the Scoliosis Research Society 30 (SRS-30) questionnaire. The aim of this study was to perform cross-cultural adaptation and evaluate the validity of the adapted Finnish version of the SRS-30 questionnaire. The SRS-30 questionnaire has proved to be a valid instrument in evaluating health-related quality of life (HRQoL) in adolescent and adult population with spine deformities in the United States. Multinational availability requires cross-cultural and linguistic adaptation and validation of the instrument. The SRS-30 was translated into Finnish using accepted methods for translation of quality-of-life questionnaires. A total of 274 adult patients with degenerative radiographic sagittal spinal disorder answered the questionnaire with sociodemographic data, RAND 36-item health survey questionnaire (RAND Corp. Health, Santa Monica, CA, US), Oswestry disability index, DEPS depression scale, and Visual Analog Scale (VAS) back and leg pain scales within 2 weeks' interval. The cohort included patients with and without previous spine surgery. Internal consistency and validity were tested with Cronbach α, intraclass correlation (ICC), standard error of measurement, and Spearman correlation coefficient with 95% confidence intervals (CIs). The internal consistency of SRS-30 was good in both surgery and nonsurgery groups, with Cronbach α 0.853 (95% CI, 0.670 to 0.960) and 0.885 (95% CI, 0.854 to 0.911), respectively. The test-retest reproducibility ICC of the SRS-30 total and subscore domains of patients with stable symptoms was 0.905 (95% CI, 0.870-0.930) and 0.904 (95% CI, 0.871-0.929), respectively. The questionnaire had discriminative validity in the pain, self-image, and satisfaction with management domains compared with other questionnaires. The SRS-30 questionnaire proved to be valid and applicable in evaluating HRQoL in Finnish adult spinal deformity patients. It has two domains related to deformity that are not covered by other generally used questionnaires. 3.

Clinical outcomes of gastrointestinal brain metastases treated with radiotherapy.

PubMed

Sanghvi, Samrat M; Lischalk, Jonathan W; Cai, Ling; Collins, Sean; Nair, Mani; Collins, Brain; Unger, Keith

2017-02-28

Brain metastases of gastrointestinal origin are a rare occurrence. Radiation therapy (RT) in the form of stereotactic radiosurgery (SRS) or whole brain radiation therapy (WBRT) is an effective established treatment modality in either the definitive or adjuvant setting. The aim of this study is to assess the long-term clinical outcomes of patients with gastrointestinal (GI) brain metastases treated with SRS or WBRT. In this single institutional retrospective review, we detail the outcomes of patients diagnosed with metastatic brain tumors from an adenocarcinoma gastrointestinal primary. Patients were treated using stereotactic radiosurgery or whole brain radiation therapy. Initial site control (defined as lesions visualized on imaging at time of treatment), new site control (defined as new intracranial lesions visualized on follow-up imaging), and overall survival were calculated using the Kaplan-Meier method. Thirty-three patients were treated from August 2008 to December 2015. Primary malignancy locations were as follows: 18 colon, 6 esophagus, 4 rectum, 5 other. Median total dose delivered was 25 Gy (18-35 Gy) in a median of 4 fractions for SRS and 30 Gy (10.8-40 Gy) in 10 fractions for WBRT. Crude initial site control at last radiographic follow-up was 64.3% after SRS and 41.7% after WBRT. Eleven of the 28 brain lesions (39.3%) treated with SRS had resection of the SRS-treated lesion prior to radiation therapy. Five of the twelve patients (41.7%) undergoing WBRT underwent cranial resection prior to radiation therapy. Crude new site control at last radiographic follow-up was 46.4% after SRS and 83.3% after WBRT. Kaplan-Meier analysis of overall survival did not show any statistically significant difference between WBRT and SRS (p = 0.424). Median overall survival for SRS patients was 5.2 months (0.5-57.5) and for WBRT patients 4.4 months (0-15). Kaplan-Meier analysis of new site control was significantly improved with WBRT versus SRS (p = 0.017). Total dose, treatment with WBRT, and active extracranial disease were statistically significant on multivariate analysis for new site control (p < 0.05). Survival and intracranial disease control are poor following RT for brain metastases from GI primaries. In this small series, outcomes are worse than published series for other primary malignancies metastatic to the brain and further research into methods of local control improvement is warranted. Future studies should explore the utility of dose escalation or radiosensitization in this patient population.

Alternative Chemical Cleaning Methods for High Level Waste Tanks: Actual Waste Testing with SRS Tank 5F Sludge

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

King, William D.; Hay, Michael S.

Solubility testing with actual High Level Waste tank sludge has been conducted in order to evaluate several alternative chemical cleaning technologies for the dissolution of sludge residuals remaining in the tanks after the exhaustion of mechanical cleaning and sludge sluicing efforts. Tests were conducted with archived Savannah River Site (SRS) radioactive sludge solids that had been retrieved from Tank 5F in order to determine the effectiveness of an optimized, dilute oxalic/nitric acid cleaning reagent toward dissolving the bulk non-radioactive waste components. Solubility tests were performed by direct sludge contact with the oxalic/nitric acid reagent and with sludge that had beenmore » pretreated and acidified with dilute nitric acid. For comparison purposes, separate samples were also contacted with pure, concentrated oxalic acid following current baseline tank chemical cleaning methods. One goal of testing with the optimized reagent was to compare the total amounts of oxalic acid and water required for sludge dissolution using the baseline and optimized cleaning methods. A second objective was to compare the two methods with regard to the dissolution of actinide species known to be drivers for SRS tank closure Performance Assessments (PA). Additionally, solubility tests were conducted with Tank 5 sludge using acidic and caustic permanganate-based methods focused on the “targeted” dissolution of actinide species.« less

The effect of methylphenidate treatment on suspiciousness in children with ADHD alone or comorbid with ODD.

PubMed

Golubchik, Pavel; Weizman, Abraham

2018-06-01

To assess the level of the suspiciousness in children with attention deficit/hyperactivity disorder (ADHD) and comorbid oppositional defiant disorder (ODD) in comparison to ADHD alone and the response of suspiciousness symptoms to methylphenidate (MPH) treatment. In this open-label comparative study, children with DSM-IV-TR ADHD, aged 8-18 years, with (N = 30) or without (N = 30) ODD received MPH treatment for 12 weeks. The severity of ODD symptoms was assessed by the Kiddie-Schedule for Affective Disorders and Schizophrenia. The severity of ADHD symptoms was assessed by the ADHD-Rating-Scale-IV and suspiciousness was assessed at baseline and at endpoint by a scale designed especially for assessment of suspiciousness and named Suspiciousness Rating Scale (SRS). Significant reductions in SRS scores were detected in both groups following MPH treatment (before and after: p = .0012 and p = .0273, respectively). Only in the ADHD/ODD group a significant correlation was found between the rate of improvement in ADHD, as assessed by the ADHD-RS, and the reduction in suspiciousness, as assessed by the SRS (Spearman r = 0.48, p =  .0066). In addition to the beneficial effect of MPH treatment on ADHD and ODD symptoms it also diminishes suspiciousness. However, due to the small sample size further studies are needed to confirm the present results.

Residual Stresses and Other Properties of Teardrops

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

Stroud, Mary Ann; Veirs, Douglas Kirk; Berg, John M.

The Department of Energy’s 3013 Standard for packaging plutonium-bearing materials for storage up to fifty years specifies a minimum of two individually welded, nested containers herein referred to as the 3013 outer and the 3013 inner.1 Stress corrosion cracking (SCC) is a potential failure mechanism for 3013 inner containers.2,3 The bagless transfer container (BTC), a 3013 inner container used by Hanford and Savanna River Site (SRS) made from 304L stainless steel (SS), poses the greatest concern for SCC.4,5 The Surveillance and Monitoring Program (SMP) use stressed metal samples known as teardrops as screening tools in SCC studies to evaluate factorsmore » that could result in cracks in the 3013 containers.6,7 This report provides background information on the teardrops used in the Los Alamos National Laboratory (LANL) SMP studies including method of construction, composition and variability. In addition, the report discusses measurements of residual stresses in teardrops and compares the results with residual stresses in BTCs reported previously.4 Factors affecting residual stresses, including teardrop dimensions and surface finish, are also discussed.« less

Estimating the pressure of laser-induced plasma shockwave by stimulated Raman shift of lattice translational modes

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

Li Zhanlong; College of Physics, Jilin University, Changchun 130012; Shan Xiaoning

2012-07-09

The current paper investigates stimulated Raman scattering (SRS) when laser-induced plasma is formed in heavy water by focusing an intense pulsed 532 nm Nd:YAG laser beam at room temperature. An unexpected low-frequency SRS line attributed to the lattice translational modes of ice-VII (D{sub 2}O) is observed. The pressure of the plasma shockwave is estimated using low-frequency SRS line shift.

Utilization of SRS pond ash in controlled low strength material. Technical report

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

Langton, C.A.; Rajendran, N.

1995-12-01

Design mixes for Controlled Low Strength Material (CLSM) were developed which incorporate pond ashes (fly ashes) from the A-Area Ash Pile, the old F-Area Ash Basin and the D-Area Ash Basin. CLSM is a pumpable, flowable, excavatable backfill used in a variety of construction applications at SRS. Results indicate that CLSM which meets all of the SRS design specifications for backfill, can be made with the A-, D-, and F-Area pond ashes. Formulations for the design mixes are provided in this report. Use of the pond ashes may result in a cost savings for CLSM used at SRS and willmore » utilize a by-product waste material, thereby decreasing the amount of material requiring disposal.« less

Epigenetic and genetic diagnosis of Silver-Russell syndrome.

PubMed

Eggermann, Thomas; Spengler, Sabrina; Gogiel, Magdalena; Begemann, Matthias; Elbracht, Miriam

2012-06-01

Silver-Russell syndrome (SRS) is a congenital imprinting disorder characterized by intrauterine and postnatal growth restriction and further characteristic features. SRS is genetically heterogenous: 7-10% of patients carry a maternal uniparental disomy of chromosome 7; >38% show a hypomethylation in imprinting control region 1 in 11p15; and a further class of mutations are copy number variations affecting different chromosomes, but mainly 11p15 and 7. The diagnostic work-up should thus aim to detect these three molecular subtypes. Numerous techniques are currently applied in genetic SRS testing, but none of them covers all known (epi)mutations, and they should therefore be used synergistically. However, future next-generation sequencing approaches will allow a comprehensive analysis of all types of alterations in SRS.

Performance Evaluation of Speech Recognition Systems as a Next-Generation Pilot-Vehicle Interface Technology

NASA Technical Reports Server (NTRS)

Arthur, Jarvis J., III; Shelton, Kevin J.; Prinzel, Lawrence J., III; Bailey, Randall E.

2016-01-01

During the flight trials known as Gulfstream-V Synthetic Vision Systems Integrated Technology Evaluation (GV-SITE), a Speech Recognition System (SRS) was used by the evaluation pilots. The SRS system was intended to be an intuitive interface for display control (rather than knobs, buttons, etc.). This paper describes the performance of the current "state of the art" Speech Recognition System (SRS). The commercially available technology was evaluated as an application for possible inclusion in commercial aircraft flight decks as a crew-to-vehicle interface. Specifically, the technology is to be used as an interface from aircrew to the onboard displays, controls, and flight management tasks. A flight test of a SRS as well as a laboratory test was conducted.

The impact of decompression with instrumentation on local failure following spine stereotactic radiosurgery.

PubMed

Miller, Jacob A; Balagamwala, Ehsan H; Berriochoa, Camille A; Angelov, Lilyana; Suh, John H; Benzel, Edward C; Mohammadi, Alireza M; Emch, Todd; Magnelli, Anthony; Godley, Andrew; Qi, Peng; Chao, Samuel T

2017-10-01

OBJECTIVE Spine stereotactic radiosurgery (SRS) is a safe and effective treatment for spinal metastases. However, it is unknown whether this highly conformal radiation technique is suitable at instrumented sites given the potential for microscopic disease seeding. The authors hypothesized that spinal decompression with instrumentation is not associated with increased local failure (LF) following SRS. METHODS A 2:1 propensity-matched retrospective cohort study of patients undergoing SRS for spinal metastasis was conducted. Patients with less than 1 month of radiographic follow-up were excluded. Each SRS treatment with spinal decompression and instrumentation was propensity matched to 2 controls without decompression or instrumentation on the basis of demographic, disease-related, dosimetric, and treatment-site characteristics. Standardized differences were used to assess for balance between matched cohorts. The primary outcome was the 12-month cumulative incidence of LF, with death as a competing risk. Lesions demonstrating any in-field progression were considered LFs. Secondary outcomes of interest were post-SRS pain flare, vertebral compression fracture, instrumentation failure, and any Grade ≥ 3 toxicity. Cumulative incidences analysis was used to estimate LF in each cohort, which were compared via Gray's test. Multivariate competing-risks regression was then used to adjust for prespecified covariates. RESULTS Of 650 candidates for the control group, 166 were propensity matched to 83 patients with instrumentation. Baseline characteristics were well balanced. The median prescription dose was 16 Gy in each cohort. The 12-month cumulative incidence of LF was not statistically significantly different between cohorts (22.8% [instrumentation] vs 15.8% [control], p = 0.25). After adjusting for the prespecified covariates in a multivariate competing-risks model, decompression with instrumentation did not contribute to a greater risk of LF (HR 1.21, 95% CI 0.74-1.98, p = 0.45). The incidences of post-SRS pain flare (11% vs 14%, p = 0.55), vertebral compression fracture (12% vs 22%, p = 0.04), and Grade ≥ 3 toxicity (1% vs 1%, p = 1.00) were not increased at instrumented sites. No instrumentation failures were observed. CONCLUSIONS In this propensity-matched analysis, LF and toxicity were similar among cohorts, suggesting that decompression with instrumentation does not significantly impact the efficacy or safety of spine SRS. Accordingly, spinal instrumentation may not be a contraindication to SRS. Future studies comparing SRS to conventional radiotherapy at instrumented sites in matched populations are warranted.

Comparison of methodological quality rating of systematic reviews on neuropathic pain using AMSTAR and R-AMSTAR.

PubMed

Dosenovic, Svjetlana; Jelicic Kadic, Antonia; Vucic, Katarina; Markovina, Nikolina; Pieper, Dawid; Puljak, Livia

2018-05-08

Systematic reviews (SRs) in the field of neuropathic pain (NeuP) are increasingly important for decision-making. However, methodological flaws in SRs can reduce the validity of conclusions. Hence, it is important to assess the methodological quality of NeuP SRs critically. Additionally, it remains unclear which assessment tool should be used. We studied the methodological quality of SRs published in the field of NeuP and compared two assessment tools. We systematically searched 5 electronic databases to identify SRs of randomized controlled trials of interventions for NeuP available up to March 2015. Two independent reviewers assessed the methodological quality of the studies using the Assessment of Multiple Systematic Reviews (AMSTAR) and the revised AMSTAR (R-AMSTAR) tools. The scores were converted to percentiles and ranked into 4 grades to allow comparison between the two checklists. Gwet's AC1 coefficient was used for interrater reliability assessment. The 97 included SRs had a wide range of methodological quality scores (AMSTAR median (IQR): 6 (5-8) vs. R-AMSTAR median (IQR): 30 (26-35)). The overall agreement score between the 2 raters was 0.62 (95% CI 0.39-0.86) for AMSTAR and 0.62 (95% CI 0.53-0.70) for R-AMSTAR. The 31 Cochrane systematic reviews (CSRs) were consistently ranked higher than the 66 non-Cochrane systematic reviews (NCSRs). The analysis of individual domains showed the best compliance in a comprehensive literature search (item 3) on both checklists. The results for the domain that was the least compliant differed: conflict of interest (item 11) was the item most poorly reported on AMSTAR vs. publication bias assessment (item 10) on R-AMSTAR. A high positive correlation between the total AMSTAR and R-AMSTAR scores for all SRs, as well as for CSRs and NCSRs, was observed. The methodological quality of analyzed SRs in the field of NeuP was not optimal, and CSRs had a higher quality than NCSRs. Both AMSTAR and R-AMSTAR tools produced comparable quality ratings. Our results point out to weaknesses in the methodology of existing SRs on interventions for the management NeuP and call for future improvement by better adherence to analyzed quality checklists, either AMSTAR or R-AMSTAR.

Endorsement of PRISMA statement and quality of systematic reviews and meta-analyses published in nursing journals: a cross-sectional study.

PubMed

Tam, Wilson W S; Lo, Kenneth K H; Khalechelvam, Parames

2017-02-07

Systematic reviews (SRs) often poorly report key information, thereby diminishing their usefulness. Previous studies evaluated published SRs and determined that they failed to meet explicit criteria or characteristics. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was recommended as a reporting guideline for SR and meta-analysis (MA), but previous studies showed that adherence to the statement was not high for SRs published in different medical fields. Thus, the aims of this study are twofold: (1) to investigate the number of nursing journals that have required or recommended the use of the PRISMA statement for reporting SR, and (2) to examine the adherence of SRs and/or meta-analyses to the PRISMA statement published in nursing journals. A cross-sectional study. Nursing journals listed in the ISI journal citation report were divided into 2 groups based on the recommendation of PRISMA statement in their 'Instruction for Authors'. SRs and meta-analyses published in 2014 were searched in 3 databases. 37 SRs and meta-analyses were randomly selected in each group. The adherence of each item to the PRISMA was examined and summarised using descriptive statistics. The quality of the SRs was assessed by Assessing the Methodological Quality of Systematic Reviews. The differences between the 2 groups were compared using the Mann-Whitney U test. Out of 107 nursing journals, 30 (28.0%) recommended or required authors to follow the PRISMA statement when they submit SRs or meta-analyses. The median rates of adherence to the PRISMA statement for reviews published in journals with and without PRISMA endorsement were 64.9% (IQR: 17.6-92.3%) and 73.0% (IQR: 59.5-94.6%), respectively. No significant difference was observed in any of the items between the 2 groups. The median adherence of SRs and meta-analyses in nursing journals to PRISMA is low at 64.9% and 73.0%, respectively. Nonetheless, the adherence level of nursing journals to the PRISMA statement does not significantly vary whether they endorse or recommend such a guideline. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Identification of Scoliosis Research Society-22r Health-Related Quality of Life questionnaire domains using factor analysis methodology.

PubMed

Lai, Sue-Min; Asher, Marc A; Burton, Douglas C; Carlson, Brandon B

2010-05-20

Cross-sectional mail questionnaire. Examination of the underlying construct validity of the Scoliosis Research Society-22r (SRS-22r) Health-Related Quality of Life (HRQoL) Questionnaire using factor analysis. The original SRS-24 HRQoL questionnaire has undergone a series of modifications in an effort to further improve its psychometric properties and validate its use in patients from 10 years of age until well into adulthood. The SRS-22r questionnaire is the result of this effort. To date, the underlying construct validity of the original English version has not been analyzed by factor analysis. A questionnaire including all questions on the SRS-24, -23, -22, and -22r questionnaires (49 total questions) was mailed to a consecutive series of 235 patients who had received primary posterior or anterior instrumentation and arthrodesis. Domain structure of the SRS-22r questions was analyzed using iterated principal factor analysis with orthogonal rotation. One hundred twenty-one (51%) of the patients, age 23.34 +/- 4.52 years (range, 14.16-34.57 years), returned the questionnaire at 8.63 +/- 4.00 years (range, 2.32-15.94 years) following surgery. Factor analysis using all 22 questions resulted in 3 factors with many shared items because of significant collinearity of the satisfaction/dissatisfaction with management questions with the others. After 18 iterations, factor analysis using the 20 nonmanagement questions revealed 4 factors that explained 98% of the variance. These factors parallel the assigned domains of the SRS-22r questionnaire. Three questions (2 self-image and 1 function) were identified that had high loading in 2 factors. However, internal consistency was best when 2 of the questions (1 self-image and 1 function) were retained in their assigned SRS-22r domains and the third decreased self-image internal consistency by only 0.01%. The internal consistencies (Cronbach alpha) of the assigned SRS-22r nonmanagement domains were excellent or very good: function 0.83, pain 0.87, self-image 0.80, and mental health 0.90. For the management domain it was good: 0.73. Factor analysis of the SRS-22r HRQoL confirms placement of the 20 nonmanagement domain questions in the assigned 4 domains, all with excellent or very good internal consistency.

The reliability and concurrent validity of the Scoliosis Research Society-22r patient questionnaire compared with the Child Health Questionnaire-CF87 patient questionnaire for adolescent spinal deformity.

PubMed

Glattes, R Christopher; Burton, Douglas C; Lai, Sue Min; Frasier, Elizabeth; Asher, Marc A

2007-07-15

This is a clinic-based cross-sectional study involving 2 health-related quality-of-life (HRQL) questionnaires. To compare the score distribution and reliability of the spinal deformity specific Scoliosis Research Society-22r (SRS-22r) questionnaire and the established generic Child Health Questionnaire-CF87 (CHQ-CF87), and to assess the concurrent validity of the SRS-22r using the CHQ-CF87 in an adolescent spine deformity population. Different questionnaires are commonly thought to be necessary to assess the HRQL of adolescent and adult populations. But since spinal deformities usually begin in the second decade of life, longitudinal follow-up with the same HRQL is desirable. The SRS-22r HRQL has recently been validated for score distribution and internal consistency in a spinal deformity population ranging in age from 7 to 78 years. The SRS-22r and CHQ-CF87 HRQLs were completed by 70 orthopedic spinal deformity outpatients 8 to 18 years of age, of whom 54 returned mailed retest questionnaires at an average of 24 days later. The ceiling effect averaged 27% for the SRS-22r and 36% for the CHQ-CF87. Respective values for internal consistency (Cronbach alpha) were 0.81 and 0.82, and for test-retest reproducibility the intraclass correlations (ICC) were 0.73 and 0.61. Concurrent validity was r > or = 0.68 or more for relevant function, pain, and mental health domains. The SRS Self-Image and particularly the Satisfaction/Dissatisfaction with Management domains did not correlate well with any CHQ-CF87 domains (r = 0.50 and 0.30, respectively). In a spinal deformity population 8 to 18 years of age, the score distribution and reliability, internal consistency, and reproducibility of the SRS-22r were at least as good as the CHQ-CF87. The SRS-22r function, pain, and mental health domains were concurrently valid in comparison to relevant CHQ-CF87 domains, but the SRS-22r self-image and satisfaction/dissatisfaction domains were not, thereby providing health-related quality-of-life information not provided for by the CHQ-CF87.

Stochastic shock response spectrum decomposition method based on probabilistic definitions of temporal peak acceleration, spectral energy, and phase lag distributions of mechanical impact pyrotechnic shock test data

NASA Astrophysics Data System (ADS)

Hwang, James Ho-Jin; Duran, Adam

2016-08-01

Most of the times pyrotechnic shock design and test requirements for space systems are provided in Shock Response Spectrum (SRS) without the input time history. Since the SRS does not describe the input or the environment, a decomposition method is used to obtain the source time history. The main objective of this paper is to develop a decomposition method producing input time histories that can satisfy the SRS requirement based on the pyrotechnic shock test data measured from a mechanical impact test apparatus. At the heart of this decomposition method is the statistical representation of the pyrotechnic shock test data measured from the MIT Lincoln Laboratory (LL) designed Universal Pyrotechnic Shock Simulator (UPSS). Each pyrotechnic shock test data measured at the interface of a test unit has been analyzed to produce the temporal peak acceleration, Root Mean Square (RMS) acceleration, and the phase lag at each band center frequency. Maximum SRS of each filtered time history has been calculated to produce a relationship between the input and the response. Two new definitions are proposed as a result. The Peak Ratio (PR) is defined as the ratio between the maximum SRS and the temporal peak acceleration at each band center frequency. The ratio between the maximum SRS and the RMS acceleration is defined as the Energy Ratio (ER) at each band center frequency. Phase lag is estimated based on the time delay between the temporal peak acceleration at each band center frequency and the peak acceleration at the lowest band center frequency. This stochastic process has been applied to more than one hundred pyrotechnic shock test data to produce probabilistic definitions of the PR, ER, and the phase lag. The SRS is decomposed at each band center frequency using damped sinusoids with the PR and the decays obtained by matching the ER of the damped sinusoids to the ER of the test data. The final step in this stochastic SRS decomposition process is the Monte Carlo (MC) simulation. The MC simulation identifies combinations of the PR and decays that can meet the SRS requirement at each band center frequency. Decomposed input time histories are produced by summing the converged damped sinusoids with the MC simulation of the phase lag distribution.

A semisynthetic diterpenoid lactone inhibits NF-κB signalling to ameliorate inflammation and airway hyperresponsiveness in a mouse asthma model

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

Lim, J.C.-W.

Andrographolide (AGP) and 14-deoxy-11,12-didehydroandrographolide (DDAG), two main diterpenoid constituents of Andrographis paniculata were previously shown to ameliorate asthmatic symptoms in a mouse model. However, due to inadequacies of both compounds in terms of drug-likeness, DDAG analogues were semisynthesised for assessment of their anti-asthma activity. A selected analogue, 3,19-diacetyl-14-deoxy-11,12-didehydroandrographolide (SRS27), was tested for inhibitory activity of NF-κB activation in TNF-α-induced A549 cells and was subsequently evaluated in a mouse model of ovalbumin (OVA)-induced asthma. Female BALB/c mice, 6–8 weeks old were sensitized on days 0 and 14, and challenged on days 22, 23 and 24 with OVA. Compound or vehicle (3%more » dimethyl sulfoxide) was administered intraperitoneally 1 h before and 11 h after each OVA aerosol challenge. On day 25, pulmonary eosinophilia, airway hyperresponsiveness, mucus hypersecretion, inflammatory cytokines such as IL-4, -5 and -13 in BAL fluid, gene expression of inflammatory mediators such as 5-LOX, E-selectin, VCAM-1, CCL5, TNF-α, AMCase, Ym2, YKL-40, Muc5ac, CCL2 and iNOS in animal lung tissues, and serum IgE were determined. SRS27 at 30 μM was found to suppress NF-κB nuclear translocation in A549 cells. In the ovalbumin-induced mouse asthma model, SRS27 at 3 mg/kg displayed a substantial decrease in pulmonary eosinophilia, BAL fluid inflammatory cytokines level, serum IgE production, mucus hypersecretion and gene expression of inflammatory mediators in lung tissues. SRS27 is the first known DDAG analogue effective in ameliorating inflammation and airway hyperresponsiveness in the ovalbumin-induced mouse asthma model. - Highlights: • SRS27 was synthesised to overcome inadequacies of its parent compound in terms of drug-likeness. • SRS27 was tested in TNF-α-induced A549 lung cells and ovalbumin (OVA)-induced mouse asthma model. • SRS27 suppressed NF-κB nuclear translocation in A549 cells. • SRS27 alleviated lung inflammation and airway hyperresponsiveness in mouse asthma model. • SRS27 is the first known DDAG analogue tested positive in ameliorating asthma.« less

Technology-assisted title and abstract screening for systematic reviews: a retrospective evaluation of the Abstrackr machine learning tool.

PubMed

Gates, Allison; Johnson, Cydney; Hartling, Lisa

2018-03-12

Machine learning tools can expedite systematic review (SR) processes by semi-automating citation screening. Abstrackr semi-automates citation screening by predicting relevant records. We evaluated its performance for four screening projects. We used a convenience sample of screening projects completed at the Alberta Research Centre for Health Evidence, Edmonton, Canada: three SRs and one descriptive analysis for which we had used SR screening methods. The projects were heterogeneous with respect to search yield (median 9328; range 5243 to 47,385 records; interquartile range (IQR) 15,688 records), topic (Antipsychotics, Bronchiolitis, Diabetes, Child Health SRs), and screening complexity. We uploaded the records to Abstrackr and screened until it made predictions about the relevance of the remaining records. Across three trials for each project, we compared the predictions to human reviewer decisions and calculated the sensitivity, specificity, precision, false negative rate, proportion missed, and workload savings. Abstrackr's sensitivity was > 0.75 for all projects and the mean specificity ranged from 0.69 to 0.90 with the exception of Child Health SRs, for which it was 0.19. The precision (proportion of records correctly predicted as relevant) varied by screening task (median 26.6%; range 14.8 to 64.7%; IQR 29.7%). The median false negative rate (proportion of records incorrectly predicted as irrelevant) was 12.6% (range 3.5 to 21.2%; IQR 12.3%). The workload savings were often large (median 67.2%, range 9.5 to 88.4%; IQR 23.9%). The proportion missed (proportion of records predicted as irrelevant that were included in the final report, out of the total number predicted as irrelevant) was 0.1% for all SRs and 6.4% for the descriptive analysis. This equated to 4.2% (range 0 to 12.2%; IQR 7.8%) of the records in the final reports. Abstrackr's reliability and the workload savings varied by screening task. Workload savings came at the expense of potentially missing relevant records. How this might affect the results and conclusions of SRs needs to be evaluated. Studies evaluating Abstrackr as the second reviewer in a pair would be of interest to determine if concerns for reliability would diminish. Further evaluations of Abstrackr's performance and usability will inform its refinement and practical utility.

Stereotactic radiosurgery for the treatment of symptomatic brainstem cavernous malformations.

PubMed

Monaco, Edward A; Khan, Aftab A; Niranjan, Ajay; Kano, Hideyuki; Grandhi, Ramesh; Kondziolka, Douglas; Flickinger, John C; Lunsford, L Dade

2010-09-01

The authors performed a retrospective review of prospectively collected data to evaluate the safety and efficacy of stereotactic radiosurgery (SRS) for the treatment of patients harboring symptomatic solitary cavernous malformations (CMs) of the brainstem that bleed repeatedly and are high risk for resection. Between 1988 and 2005, 68 patients (34 males and 34 females) with solitary, symptomatic CMs of the brainstem underwent Gamma Knife surgery. The mean patient age was 41.2 years, and all patients had suffered at least 2 symptomatic hemorrhages (range 2-12 events) before radiosurgery. Prior to SRS, 15 patients (22.1%) had undergone attempted resection. The mean volume of the malformation treated was 1.19 ml, and the mean prescribed marginal radiation dose was 16 Gy. The mean follow-up period was 5.2 years (range 0.6-12.4 years). The pre-SRS annual hemorrhage rate was 32.38%, or 125 hemorrhages, excluding the first hemorrhage, over a total of 386 patient-years. Following SRS, 11 hemorrhages were observed within the first 2 years of follow-up (8.22% annual hemorrhage rate) and 3 hemorrhages were observed in the period after the first 2 years of follow-up (1.37% annual hemorrhage rate). A significant reduction (p < 0.0001) in the risk of brainstem CM hemorrhages was observed following radiosurgical treatment, as well as in latency period of 2 years after SRS (p < 0.0447). Eight patients (11.8%) experienced new neurological deficits as a result of adverse radiation effects following SRS. The results of this study support a role for the use of SRS for symptomatic CMs of the brainstem, as it is relatively safe and appears to reduce rebleeding rates in this high-surgical-risk location.

The Role of Palliative Radiosurgery When Cancer Invades the Cavernous Sinus

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

Kano, Hideyuki; Niranjan, Ajay; Kondziolka, Douglas

2009-03-01

Purpose: Involvement of the cavernous sinus by direct invasion from skull base cancer or from metastatic spread of cancers is a challenging problem. We evaluated the role of stereotactic radiosurgery (SRS) in the treatment of patients who developed cavernous sinus metastases or direct invasion. Methods and Materials: We retrospectively reviewed the data from 37 patients who had cavernous sinus metastases or had cavernous sinus invasion from adjacent skull base cancers and who underwent SRS between 1992 and 2006 at University of Pittsburgh Medical Center. The median patient age was 57.8 years. Previous adjuvant management included fractionated radiotherapy in 8, chemotherapymore » in 16, and both radiotherapy and chemotherapy in 5. The primary sites of metastases or invasion were nasopharyngeal carcinoma (n = 7), parotid gland carcinoma (n = 7), and metastases from systemic cancer (n = 23). The median target volume was 6.3 cm{sup 3} (range, 0.3-33.6), and the median margin dose was 14 Gy (range, 12-20). Results: At a mean of 12.9 months (range, 0.8-63.9), 32 patients had died and 5 were living. The overall survival rate after SRS was 36.6% and 19.4% at 1 and 2 years, respectively. Progression-free survival was related to a greater marginal dose. After SRS, 12 (35.3%) of 34 patients with neurologic symptoms exhibited improvement. SRS early after diagnosis was significantly associated with improvement of cranial nerve dysfunction. Conclusion: SRS is a minimally invasive palliative option for patients whose cancer has invaded the cavernous sinus. The benefits for cranial nerve deficits are best when SRS is performed early.« less

Methodological Quality Assessment of Meta-Analyses and Systematic Reviews of Probiotics in Inflammatory Bowel Disease and Pouchitis.

PubMed

Dong, Jinpei; Teng, Guigen; Wei, Tiantong; Gao, Wen; Wang, Huahong

2016-01-01

Probiotics are widely used for the induction and maintenance of remission in inflammatory bowel disease (IBD) and pouchitis. There are a large number of meta-analyses (MAs)/ systematic reviews (SRs) on this subject, the methodological quality of which has not been evaluated. This study aimed to evaluate the methodological quality of and summarize the evidence obtained from MAs/SRs of probiotic treatments for IBD and pouchitis patients. The PubMed, EMBASE, Cochrane Library and China National Knowledge Infrastructure (CNKI) databases were searched to identify Chinese and English language MAs/SRs of the use of probiotics for IBD and pouchitis. The Assessment of Multiple Systematic Reviews (AMSTAR) scale was used to assess the methodological quality of the studies. A total of 36 MAs/SRs were evaluated. The AMSTAR scores of the included studies ranged from 1 to 10, and the average score was 5.81. According to the Canadian Agency for Drugs and Technologies in Health, 4 articles were classified as high quality, 24 articles were classified as moderate quality, and 8 articles were classified as low quality. Most of the MAs/SRs suggested that probiotics had potential benefits for patients with ulcerative colitis (UC), but failed to show effectiveness in the induction and maintenance of remission in Crohn's disease (CD). The probiotic preparation VSL#3 may play a beneficial role in pouchitis. The overall methodological quality of the current MAs/SRs in the field of probiotics for IBD and pouchitis was found to be low to moderate. More MAs/SRs of high quality are required to support using probiotics to treat IBD and pouchitis.

Intracranial control and radiographic changes with adjuvant radiation therapy for resected brain metastases: whole brain radiotherapy versus stereotactic radiosurgery alone.

PubMed

Patel, Kirtesh R; Prabhu, Roshan S; Kandula, Shravan; Oliver, Daniel E; Kim, Sungjin; Hadjipanayis, Constantinos; Olson, Jeffery J; Oyesiku, Nelson; Curran, Walter J; Khan, Mohammad K; Shu, Hui-Kuo; Crocker, Ian

2014-12-01

The aim of this study was to compare outcomes of postoperative whole brain radiation therapy (WBRT) to stereotactic radiosurgery (SRS) alone in patients with resected brain metastases (BM). We reviewed records of patients who underwent surgical resection of BM followed by WBRT or SRS alone between 2003 and 2013. Local control (LC) of the treated resected cavity, distant brain control (DBC), leptomeningeal disease (LMD), overall survival (OS), and radiographic leukoencephalopathy rates were estimated by the Kaplan-Meier method. One-hundred thirty-two patients underwent surgical resection for 141 intracranial metastases: 36 (27 %) patients received adjuvant WBRT and 96 (73 %) received SRS alone to the resection cavity. One-year OS (56 vs. 55 %, p = 0.64) and LC (83 vs. 74 %, p = 0.31) were similar between patients receiving WBRT and SRS. After controlling for number of BM, WBRT was associated with higher 1-year DBC compared with SRS (70 vs. 48 %, p = 0.03); single metastasis and WBRT were the only significant predictors for reduced distant brain recurrence in multi-variate analysis. Freedom from LMD was higher with WBRT at 18 months (87 vs. 69 %, p = 0.045), while incidence of radiographic leukoencephalopathy was higher with WBRT at 12 months (47 vs. 7 %, p = 0.001). One-year freedom from WBRT in the SRS alone group was 86 %. Compared with WBRT for patients with resected BM, SRS alone demonstrated similar LC, higher rates of LMD and inferior DBC, after controlling for the number of BM. However, OS was similar between groups. The results of ongoing clinical trials are needed to confirm these findings.

The role of stereotactic radiosurgery and whole brain radiation therapy as primary treatment in the treatment of patients with brain oligometastases — A systematic review

PubMed Central

Sheehan, Jason P.

2016-01-01

The management of patients presenting with a limited number of brain metastases (BM) (oligo-metastases, defined as less than 3 BM) has evolved from Whole-Brain Radiotherapy (WBRT) alone to more aggressive strategies adding surgical resection and Stereotactic Radiosurgery (SRS) to the armamentarium. In choosing treatment modalities, the relative importance of the patient’s age and clinical parameters, the number or volume of BM and the potential treatment related adverse-effects has been a matter of much debate. For patients with oligometastatic BM, local therapy using SRS in addition to WBRT was shown to improve time to neurologic deterioration, relapse rate and Overall Survival (OS). In patients who receive local therapy (SRS or surgery), adjuvant WBRT was shown to improve regional (brain) relapse rate. In the contemporary era, the beneficial effect of WBRT on lengthening the time of neurologic independence or OS when compared to no further treatment is unclear. One Meta-analysis pooling of information from several reports concluded that for younger patients (<50 years), SRS alone favored survival and that the initial omission of WBRT did not impact distant brain relapse rates. Other recent reports demonstrated on the contrary an OS benefit, more pronounced in good prognosis patients (diagnosis-specific Graded Prognostic Assessment 2.4–4.0) treated with SRS+WBRT compared to those who received SRS alone. As of today, there remains a role for both SRS and WBRT in the management of patients with oligo-metastatic BM but consensus about when to employ one or both is lacking. The exact patient selection criteria to benefit from either or both are still a matter of active research and heated debate. PMID:29296432

Impact of Onyx Embolization on Radiosurgical Management of Cerebral Arteriovenous Malformations: Treatment and Outcome.

PubMed

Strauss, Ido; Haim, Oz; Umansky, Daniel; Corn, Benjamin W; Frolov, Vladimir; Shtraus, Natan; Maimon, Shimon; Kanner, Andrew A

2017-12-01

Stereotactic radiosurgery (SRS) is a well-established treatment modality for cerebral arteriovenous malformations (AVMs). The main limiting factor in the radiosurgical treatment of AVMs is the volume of the nidus, with high-grade lesions often requiring combined treatment to reduce the SRS target volume. To overcome this limitation, we have been using a combined treatment approach consisting of endovascular embolization with Onyx followed by SRS. To evaluate our clinical experience for safety and feasibility of this multimodality treatment approach. This is a retrospective review of all adult patients with cerebral AVMs who received SRS treatment to their AVM after endovascular embolization with Onyx between June 2007 and June 2014. Thirty-five consecutive patients were identified. The mean follow-up period was 52.4 ± 22.6 months (range 18-97 months). We confirmed 18 (51.4%) complete nidus closures at a median time of 49.5 months (range 6.5-81 months) from SRS. High-resolution Magnetic resonance imaging/magnetic resonance angiography was performed routinely in all patients until closure of the nidus. Digital subtraction angiography was performed to confirm complete obliteration in 5 of the patients (28%); 13 patients are either planned for digital subtraction angiography or have refused it. In 6 patients (17%) a significant flow reduction was noted after a mean of 32 ± 16 months. No significant improvement was observed in 9 patients (26%) during the follow-up period. Two patients were lost to follow-up. The multimodality treatment of cerebral AVMs using embolization with Onyx followed by SRS is feasible and safe. The use of Onyx significantly reduced the SRS treatment target volume. Copyright © 2017 Elsevier Inc. All rights reserved.

Stereotactic Radiosurgery for Cushing Disease: Results of an International, Multicenter Study.

PubMed

Mehta, Gautam U; Ding, Dale; Patibandla, Mohana Rao; Kano, Hideyuki; Sisterson, Nathaniel; Su, Yan-Hua; Krsek, Michal; Nabeel, Ahmed M; El-Shehaby, Amr; Kareem, Khaled A; Martinez-Moreno, Nuria; Mathieu, David; McShane, Brendan; Blas, Kevin; Kondziolka, Douglas; Grills, Inga; Lee, John Y; Martinez-Alvarez, Roberto; Reda, Wael A; Liscak, Roman; Lee, Cheng-Chia; Lunsford, L Dade; Vance, Mary Lee; Sheehan, Jason P

2017-11-01

Cushing disease (CD) due to adrenocorticotropic hormone-secreting pituitary tumors can be a management challenge. To better understand the outcomes of stereotactic radiosurgery (SRS) for CD and define its role in management. International, multicenter, retrospective cohort analysis. Ten medical centers participating in the International Gamma Knife Research Foundation. Patients with CD with >6 months endocrine follow-up. SRS using Gamma Knife radiosurgery. The primary outcome was control of hypercortisolism (defined as normalization of free urinary cortisol). Radiologic response and adverse radiation effects (AREs) were recorded. In total, 278 patients met inclusion criteria, with a mean follow-up of 5.6 years (0.5 to 20.5 years). Twenty-two patients received SRS as a primary treatment of CD. Mean margin dose was 23.7 Gy. Cumulative initial control of hypercortisolism was 80% at 10 years. Mean time to cortisol normalization was 14.5 months. Recurrences occurred in 18% with initial cortisol normalization. Overall, the rate of durable control of hypercortisolism was 64% at 10 years and 68% among patients who received SRS as a primary treatment. AREs included hypopituitarism (25%) and cranial neuropathy (3%). Visual deficits were related to treatment of tumor within the suprasellar cistern (P = 0.01), whereas both visual (P < 0.0001) and nonvisual cranial neuropathy (P = 0.02) were related to prior pituitary irradiation. SRS for CD is well tolerated and frequently results in control of hypercortisolism. However, recurrences can occur. SRS should be considered for patients with persistent hypercortisolism after pituitary surgery and as a primary treatment in those unfit for surgery. Long-term endocrine follow-up is essential after SRS. Copyright © 2017 Endocrine Society

Long-term follow-up of patients with surgical intractable acromegaly after linear accelerator radiosurgery.

PubMed

Yan, Jiun-Lin; Chang, Chen-Nen; Chuang, Chi-Cheng; Hsu, Peng-Wei; Lin, Jen-Der; Wei, Kuo-Chen; Lee, Shi-Tseng; Tseng, Jen-Kan; Pai, Ping-Ching; Chen, Yao-Liang

2013-07-01

Radiotherapy is a crucial treatment for acromegalic patients with growth hormone (GH)-secreting pituitary tumors. However, its effect takes time. We retrospectively reviewed the long-term outcome of linear accelerator stereotactic radiosurgery (LINAC SRS) for patients with acromegaly from the perspective of biochemical remission and associated factors. Twenty-two patients presenting with residual or recurrent (GH)-secreting functional pituitary tumor between 1994 and 2004 who received LINAC SRS were enrolled and followed up for at least 3 years. Residual or recurrent tumor was defined as persistent elevated GH or insulin-like growth factor-1 (IGF-1) level and image-confirmed tumor after previous surgical treatment. Biochemical remission was defined as fasting GH less than 2.5 ng/mL with normal sex-and-age adjusted IGF-1. The mean follow-up period was 94.7 months (range 36-161 months). Overall mean biochemical remission time was 53 months (median 30 months). Biochemical control was achieved in 15 patients (68.2%) over the follow up period. One patient experienced recurrence after SRS and underwent another operation. Initial GH at diagnosis and pre-SRS GH correlated with biochemical control (p = 0.005 and p < 0.0001, respectively). Further evaluation demonstrated that biochemical control stabilized after 7.5 years. Overall post-SRS hormone deficit persisted in five patients (22.7%). In comparison to other radiosurgery modalities, LINAC radiosurgery also provides a satisfactory outcome. SRS has maximum effect over the first 2 years and stabilizes after 7.5 years. Moreover, SRS elicits long-term biochemical effects and requires longer follow-up for better biochemical remission. Copyright © 2012. Published by Elsevier B.V.

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

PubMed

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

2018-05-22

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

Concurrent Stereotactic Radiosurgery and Bevacizumab in Recurrent Malignant Gliomas: A Prospective Trial

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

Cabrera, Alvin R.; Cuneo, Kyle C.; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan

2013-08-01

Purpose: Virtually all patients with malignant glioma (MG) eventually recur. This study evaluates the safety of concurrent stereotactic radiosurgery (SRS) and bevacizumab (BVZ), an antiangiogenic agent, in treatment of recurrent MG. Methods and Materials: Fifteen patients with recurrent MG, treated at initial diagnosis with surgery and adjuvant radiation therapy/temozolomide and then at least 1 salvage chemotherapy regimen, were enrolled in this prospective trial. Lesions <3 cm in diameter were treated in a single fraction, whereas those 3 to 5 cm in diameter received 5 5-Gy fractions. BVZ was administered immediately before SRS and 2 weeks later. Neurocognitive testing (Mini-Mental Statusmore » Exam, Trail Making Test A/B), Functional Assessment of Cancer Therapy-Brain (FACT-Br) quality-of-life assessment, physical exam, and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) were performed immediately before SRS and 1 week and 2 months following completion of SRS. The primary endpoint was central nervous system (CNS) toxicity. Secondary endpoints included survival, quality of life, microvascular properties as measured by DCE-MRI, steroid usage, and performance status. Results: One grade 3 (severe headache) and 2 grade 2 CNS toxicities were observed. No patients experienced grade 4 to 5 toxicity or intracranial hemorrhage. Neurocognition, quality of life, and Karnofsky performance status did not change significantly with treatment. DCE-MRI results suggest a significant decline in tumor perfusion and permeability 1 week after SRS and further decline by 2 months. Conclusions: Treatment of recurrent MG with concurrent SRS and BVZ was not associated with excessive toxicity in this prospective trial. A randomized trial of concurrent SRS/BVZ versus conventional salvage therapy is needed to establish the efficacy of this approach.« less

Comparative effectiveness of stereotactic radiosurgery versus whole-brain radiation therapy for patients with brain metastases from breast or non-small cell lung cancer.

PubMed

Halasz, Lia M; Uno, Hajime; Hughes, Melissa; D'Amico, Thomas; Dexter, Elisabeth U; Edge, Stephen B; Hayman, James A; Niland, Joyce C; Otterson, Gregory A; Pisters, Katherine M W; Theriault, Richard; Weeks, Jane C; Punglia, Rinaa S

2016-07-01

The optimal treatment for patients with brain metastases remains controversial as the use of stereotactic radiosurgery (SRS) alone, replacing whole-brain radiation therapy (WBRT), has increased. This study determined the patterns of care at multiple institutions before 2010 and examined whether or not survival was different between patients treated with SRS and patients treated with WBRT. This study examined the overall survival of patients treated with radiation therapy for brain metastases from non-small cell lung cancer (NSCLC; initially diagnosed in 2007-2009) or breast cancer (initially diagnosed in 1997-2009) at 5 centers. Propensity score analyses were performed to adjust for confounding factors such as the number of metastases, the extent of extracranial metastases, and the treatment center. Overall, 27.8% of 400 NSCLC patients and 13.4% of 387 breast cancer patients underwent SRS alone for the treatment of brain metastases. Few patients with more than 3 brain metastases or lesions ≥ 4 cm in size underwent SRS. Patients with fewer than 4 brain metastases less than 4 cm in size (n = 189 for NSCLC and n = 117 for breast cancer) who were treated with SRS had longer survival (adjusted hazard ratio [HR] for NSCLC, 0.58; 95% confidence Interval [CI], 0.38-0.87; P = .01; adjusted HR for breast cancer, 0.54; 95% CI, 0.33-0.91; P = .02) than those treated with WBRT. Patients treated for fewer than 4 brain metastases from NSCLC or breast cancer with SRS alone had longer survival than those treated with WBRT in this multi-institutional, retrospective study, even after adjustments for the propensity to undergo SRS. Cancer 2016;122:2091-100. © 2016 American Cancer Society. © 2016 American Cancer Society.

WHOQOL-100 Before and After Sex Reassignment Surgery in Brazilian Male-to-Female Transsexual Individuals.

PubMed

Cardoso da Silva, Dhiordan; Schwarz, Karine; Fontanari, Anna Martha Vaitses; Costa, Angelo Brandelli; Massuda, Raffael; Henriques, Alexandre Annes; Salvador, Jaqueline; Silveira, Esalba; Elias Rosito, Tiago; Lobato, Maria Inês Rodrigues

2016-06-01

The 100-item World Health Organization Quality of Life Assessment (WHOQOL-100) evaluates quality of life as a subjective and multidimensional construct. Currently, particularly in Brazil, there are controversies concerning quality of life after sex reassignment surgery (SRS). To assess the impact of surgical interventions on quality of life of 47 Brazilian male-to-female transsexual individuals using the WHOQOL-100. This was a prospective cohort study using the WHOQOL-100 and sociodemographic questions for individuals diagnosed with gender identity disorder according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The protocol was used when a transsexual person entered the ambulatory clinic and at least 12 months after SRS. Initially, improvement or worsening of quality of life was assessed using 6 domains and 24 facets. Subsequently, quality of life was assessed for individuals who underwent new surgical interventions and those who did not undergo these procedures 1 year after SRS. The participants showed significant improvement after SRS in domains II (psychological) and IV (social relationships) of the WHOQOL-100. In contrast, domains I (physical health) and III (level of independence) were significantly worse after SRS. Individuals who underwent additional surgery had a decrease in quality of life reflected in domains II and IV. During statistical analysis, all results were controlled for variations in demographic characteristics, without significant results. The WHOQOL-100 is an important instrument to evaluate the quality of life of male-to-female transsexuals during different stages of treatment. SRS promotes the improvement of psychological aspects and social relationships. However, even 1 year after SRS, male-to-female transsexuals continue to report problems in physical health and difficulty in recovering their independence. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Hot deformation characteristics of AZ80 magnesium alloy: Work hardening effect and processing parameter sensitivities

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

Cai, Y.; Wan, L.; Guo, Z. H.

Isothermal compression experiment of AZ80 magnesium alloy was conducted by Gleeble thermo-mechanical simulator in order to quantitatively investigate the work hardening (WH), strain rate sensitivity (SRS) and temperature sensitivity (TS) during hot processing of magnesium alloys. The WH, SRS and TS were described by Zener-Hollomon parameter (Z) coupling of deformation parameters. The relationships between WH rate and true strain as well as true stress were derived from Kocks-Mecking dislocation model and validated by our measurement data. The slope defined through the linear relationship of WH rate and true stress was only related to the annihilation coefficient Ω. Obvious WH behaviormore » could be exhibited at a higher Z condition. Furthermore, we have identified the correlation between the microstructural evolution including β-Mg17Al12 precipitation and the SRS and TS variations. Intensive dynamic recrystallization and homogeneous distribution of β-Mg17Al12 precipitates resulted in greater SRS coefficient at higher temperature. The deformation heat effect and β-Mg17Al12 precipitate content can be regarded as the major factors determining the TS behavior. At low Z condition, the SRS becomes stronger, in contrast to the variation of TS. The optimum hot processing window was validated based on the established SRS and TS values distribution maps for AZ80 magnesium alloy.« less

Evaluation of Patient Outcome and Satisfaction after Surgical Treatment of Adolescent Idiopathic Scoliosis Using Scoliosis Research Society-30.

PubMed

Ghandehari, Hasan; Mahabadi, Maryam Ameri; Mahdavi, Seyed Mani; Shahsavaripour, Ali; Seyed Tari, Hossein Vahid; Safdari, Farshad

2015-04-01

Adolescent idiopathic scoliosis (AIS) may lead to physical and mental problems. It also can adversely affect patient satisfaction and the quality of life. In this study, we assessed the outcomes and satisfaction rate after surgical treatment of AIS using scoliosis research society-30 questionnaire (SRS-30). We enrolled 135 patients with AIS undergoing corrective surgery. Patients were followed for at least 2 years. We compared pre- and post-operative x-rays in terms of Cobb's angles and coronal balance. At the last visit, patients completed the SRS-30 questionnaire. We then assessed the correlation between radiographic measures, SRS-30 total score, and patient satisfaction. Cobb's angle and coronal balance improved significantly after surgery (P<0.001). The scores of functional activity, pain, self-image/cosmesis, mental health, and satisfaction were 27±4.3, 26±2.5, 33±5.2, 23±3.5, and 13±1.8, respectively. The total SRS-30 score was 127±13. Radiographic measures showed significant positive correlation with satisfaction and SRS-30 total scores. There was also a positive correlation between satisfaction and self-image/cosmesis domain scores. The greater the radiographic angles were corrected the higher the SRS-30 total score and patient satisfaction were. It is intuitive that the appearance and cosmesis is of most important factor associated with patient satisfaction.

Diagnosis and management of Silver-Russell syndrome: first international consensus statement.

PubMed

Wakeling, Emma L; Brioude, Frédéric; Lokulo-Sodipe, Oluwakemi; O'Connell, Susan M; Salem, Jennifer; Bliek, Jet; Canton, Ana P M; Chrzanowska, Krystyna H; Davies, Justin H; Dias, Renuka P; Dubern, Béatrice; Elbracht, Miriam; Giabicani, Eloise; Grimberg, Adda; Grønskov, Karen; Hokken-Koelega, Anita C S; Jorge, Alexander A; Kagami, Masayo; Linglart, Agnes; Maghnie, Mohamad; Mohnike, Klaus; Monk, David; Moore, Gudrun E; Murray, Philip G; Ogata, Tsutomu; Petit, Isabelle Oliver; Russo, Silvia; Said, Edith; Toumba, Meropi; Tümer, Zeynep; Binder, Gerhard; Eggermann, Thomas; Harbison, Madeleine D; Temple, I Karen; Mackay, Deborah J G; Netchine, Irène

2017-02-01

This Consensus Statement summarizes recommendations for clinical diagnosis, investigation and management of patients with Silver-Russell syndrome (SRS), an imprinting disorder that causes prenatal and postnatal growth retardation. Considerable overlap exists between the care of individuals born small for gestational age and those with SRS. However, many specific management issues exist and evidence from controlled trials remains limited. SRS is primarily a clinical diagnosis; however, molecular testing enables confirmation of the clinical diagnosis and defines the subtype. A 'normal' result from a molecular test does not exclude the diagnosis of SRS. The management of children with SRS requires an experienced, multidisciplinary approach. Specific issues include growth failure, severe feeding difficulties, gastrointestinal problems, hypoglycaemia, body asymmetry, scoliosis, motor and speech delay and psychosocial challenges. An early emphasis on adequate nutritional status is important, with awareness that rapid postnatal weight gain might lead to subsequent increased risk of metabolic disorders. The benefits of treating patients with SRS with growth hormone include improved body composition, motor development and appetite, reduced risk of hypoglycaemia and increased height. Clinicians should be aware of possible premature adrenarche, fairly early and rapid central puberty and insulin resistance. Treatment with gonadotropin-releasing hormone analogues can delay progression of central puberty and preserve adult height potential. Long-term follow up is essential to determine the natural history and optimal management in adulthood.

Inoculation of Ni-resistant plant growth promoting bacterium Psychrobacter sp. strain SRS8 for the improvement of nickel phytoextraction by energy crops.

PubMed

Ma, Y; Rajkumar, M; Vicente, J A F; Freitas, H

2011-02-01

This study was conducted to elucidate effects of inoculating plant growth-promoting bacterium Psychrobacter sp. SRS8 on the growth and phytoextraction potential of energy crops Ricinus communis and Helianthus annuus in artificially Ni contaminated soils. The toxicity symptom in plants under Ni stress expressed as chlorophyll, protein content, growth inhibition, and Fe, P concentrations were studied, and the possible relationship among them were also discussed. The PGPB SRS8 was found capable of stimulating plant growth and Ni accumulation in both plant species. Further, the stimulation effect on plant biomass, chlorophyll, and protein content was concomitant with increased Fe and P assimilation from soil to plants. Further, the induction of catalase and peroxidase activities was also involved in the ability of SRS8 to increase the tolerance in both plant species under Ni stress. The findings suggest that strain SRS8 play an important role in promoting the growth and phytoextraction efficiency of R. communis and H. annuus, which may be used for remediation of metal contaminated sites.

Antioxidant activities of aqueous extract from Stevia rebaudiana stem waste to inhibit fish oil oxidation and identification of its phenolic compounds.

PubMed

Yu, Hui; Yang, Gangqiang; Sato, Minoru; Yamaguchi, Toshiyasu; Nakano, Toshiki; Xi, Yinci

2017-10-01

We investigated the potential for exploiting Stevia rebaudiana stem (SRS) waste as a source of edible plant-based antioxidants finding for the first time that the hot water extract of SRS had significantly higher antioxidant activity against fish oil oxidation than that of the leaf, despite SRS extract having lower total phenolic content, DPPH radical scavenging activity and ORAC values. To locate the major antioxidant ingredients, SRS extract was fractionated using liquid chromatography. Five phenolic compounds (primary antioxidant components in activity-containing fractions) were identified by NMR and HR-ESI-MS: vanillic acid 4-O-β-d-glucopyranoside (1), protocatechuic acid (2), caffeic acid (3), chlorogenic acid (4) and cryptochlorogenic acid (5). Further analysis showed that, among compounds 2-5, protocatechuic acid had the highest capacity to inhibit peroxides formation, but exhibited the lowest antioxidant activities in DPPH and ORAC assays. These results indicate that SRS waste can be used as strong natural antioxidant materials in the food industry. Copyright © 2017 Elsevier Ltd. All rights reserved.

Influence of reabsorption and reemission on stimulated Raman scattering of polymethine dyes in multiple scattering media

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

Yashchuk, V P; Komyshan, A O; Smaliuk, A P

2013-12-31

It is shown that reabsorption of the luminescence radiation in the range of its overlapping with the absorption spectrum and the following reemission to a long-wavelength range may noticeably affect the process of stimulated Raman scattering (SRS) in polymethine dyes in multiple scattering media (MSM). This is related to the fact that SRS in such media occurs jointly with the random lasing (RL), which favors SRS and makes up with it a united nonlinear process. Reemission into the long-wavelength spectrum range amplified in MSM causes the RL spectrum to shift to longer wavelengths and initiates the long-wavelength band of RL,more » in which a main part of the lasing energy is concentrated. This weakens or completely stops the SRS if the band is beyond the range of possible spectral localisation of Stokes lines. This process depends on the efficiency of light scattering, dye concentration, temperature and pump intensity; hence, there exist optimal values of these parameters for obtaining SRS in MSM. (nonlinear optical phenomena)« less

Do technological advances in linear accelerators improve dosimetric outcomes in stereotaxy? A head-on comparison of seven linear accelerators using volumetric modulated arc therapy-based stereotactic planning.

PubMed

Sarkar, B; Pradhan, A; Munshi, A

2016-01-01

Linear accelerator (Linac) based stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) using volumetric modulated arc therapy (VMAT) has been used for treating small intracranial lesions. Recent development in the Linacs such as inbuilt micro multileaf collimator (MLC) and flattening filter free (FFF) beam are intended to provide a better dose conformity and faster delivery when using VMAT technique. This study was aimed to compare the dosimetric outcomes and monitor units (MUs) of the stereotactic treatment plans for different commercially available MLC models and beam profiles. Ten patients having 12 planning target volume (PTV)/gross target volume's (GTVs) who received the SRS/SRT treatment in our clinic using Axesse Linac (considered reference arm gold standard) were considered for this study. The test arms comprised of plans using Elekta Agility with FFF, Elekta Agility with the plane beam, Elekta APEX, Varian Millennium 120, Varian Millennium 120HD, and Elekta Synergy in Monaco treatment planning system. Planning constraints and calculation grid spacing were not altered in the test plans. To objectively evaluate the efficacy of MLC-beam model, the resultant dosimetric outcomes were subtracted from the reference arm parameters. V95%, V100%, V105%, D1%, maximum dose, and mean dose of PTV/GTV showed a maximum inter MLC - beam model variation of 1.5% and 2% for PTV and GTV, respectively. Average PTV conformity index and heterogeneity index shows a variation in the range 0.56-0.63 and 1.08-1.11, respectively. Mean dose difference (excluding Axesse) for all organs varied between 1.1 cGy and 74.8 cGy (mean dose = 6.1 cGy standard deviation [SD] = 26.9 cGy) and 1.7 cGy-194.5 cGy (mean dose 16.1 cGy SD = 57.2 cGy) for single and multiple fraction, respectively. The dosimetry of VMAT-based SRS/SRT treatment plan had minimal dependence on MLC and beam model variations. All tested MLC and beam model could fulfil the desired PTV coverage and organs at risk dose constraints. The only notable difference was the halving of the MU for FFF beam as compared to the plane beam. This has the potential to reduce the total patient on couch time by 15% (approximately 2 min).

Additional molecular findings in 11p15-associated imprinting disorders: an urgent need for multi-locus testing.

PubMed

Eggermann, Thomas; Heilsberg, Ann-Kathrin; Bens, Susanne; Siebert, Reiner; Beygo, Jasmin; Buiting, Karin; Begemann, Matthias; Soellner, Lukas

2014-07-01

The chromosomal region 11p15 contains two imprinting control regions (ICRs) and is a key player in molecular processes regulated by genomic imprinting. Genomic as well as epigenetic changes affecting 11p15 are associated either with Silver-Russell syndrome (SRS) or Beckwith-Wiedemann syndrome (BWS). In the last years, a growing number of patients affected by imprinting disorders (IDs) have reported carrying the disease-specific 11p15 hypomethylation patterns as well as methylation changes at imprinted loci at other chromosomal sites (multi-locus methylation defects, MLMD). Furthermore, in several patients, molecular alterations (e.g., uniparental disomies, UPDs) additional to the primary epimutations have been reported. To determine the frequency and distribution of mutations and epimutations in patients referred as SRS or BWS for genetic testing, we retrospectively ascertained our routine patient cohort consisting of 711 patients (SRS, n = 571; BWS, n = 140). As this cohort represents the typical cohort in a routine diagnostic lab without clinical preselection, the detection rates were much lower than those reported from clinically characterized cohorts in the literature (SRS, 19.9%; BWS, 28.6%). Among the molecular subgroups known to be predisposed to MLMD, the frequencies corresponded to that in the literature (SRS, 7.1% in ICR1 hypomethylation carriers; BWS, 20.8% in ICR2 hypomethylation patients). In several patients, more than one epigenetic or genetic disturbance could be identified. Our study illustrates that the complex molecular alterations as well as the overlapping and sometimes unusual clinical findings in patients with imprinting disorders (IDs) often make the decision for a specific imprinting disorder test difficult. We therefore suggest to implement molecular assays in routine ID diagnostics which allow the detection of a broad range of (epi)mutation types (epimutations, UPDs, chromosomal imbalances) and cover the clinically most relevant known ID loci because of the following: (a) Multi-locus tests increase the detection rates as they cover numerous loci. (b) Patients with unexpected molecular alterations are detected. (c) The testing of rare imprinting disorders becomes more efficient and quality of molecular diagnosis increases. (d) The tests identify MLMDs. In the future, the detailed characterization of clinical and molecular findings in ID patients will help us to decipher the complex regulation of imprinting and thereby providing the basis for more directed genetic counseling and therapeutic managements in IDs. Molecular disturbances in patients with imprinting disorders are often not restricted to the disease-specific locus but also affect other chromosomal regions. These additional disturbances include methylation defects, uniparental disomies as well as chromosomal imbalances. The identification of these additional alterations is mandatory for a well-directed genetic counseling. Furthermore, these findings help to decipher the complex regulation of imprinting.

Thermal Release of 3He from Tritium Aged LaNi 4.25Al 0.75 Hydride

DOE PAGES

Staack, Gregory C.; Crowder, Mark L.; Klein, James E.

2015-02-01

Recently, the demand for He-3 has increased dramatically due to widespread use in nuclear nonproliferation, cryogenic, and medical applications. Essentially all of the world’s supply of He-3 is created by the radiolytic decay of tritium. The Savannah River Site Tritium Facilities (SRS-TF) utilizes LANA.75 in the tritium process to store hydrogen isotopes. The vast majority of He-3 “born” from tritium stored in LANA.75 is trapped in the hydride metal matrix. The SRS-TF has multiple LANA.75 tritium storage beds that have been retired from service with significant quantities of He-3 trapped in the metal. To support He-3 recovery, the Savannah Rivermore » National Laboratory (SRNL) conducted thermogravimetric analysis coupled with mass spectrometry (TGA-MS) on a tritium aged LANA.75 sample. TGA-MS testing was performed in an argon environment. Prior to testing, the sample was isotopically exchanged with deuterium to reduce residual tritium and passivated with air to alleviate pyrophoric concerns associated with handling the material outside of an inert glovebox. Analyses indicated that gas release from this sample was bimodal, with peaks near 220 and 490°C. The first peak consisted of both He-3 and residual hydrogen isotopes, the second was primarily He-3. The bulk of the gas was released by 600 °C« less

Comparison of Precision of Biomass Estimates in Regional Field Sample Surveys and Airborne LiDAR-Assisted Surveys in Hedmark County, Norway

NASA Technical Reports Server (NTRS)

Naesset, Erik; Gobakken, Terje; Bollandsas, Ole Martin; Gregoire, Timothy G.; Nelson, Ross; Stahl, Goeran

2013-01-01

Airborne scanning LiDAR (Light Detection and Ranging) has emerged as a promising tool to provide auxiliary data for sample surveys aiming at estimation of above-ground tree biomass (AGB), with potential applications in REDD forest monitoring. For larger geographical regions such as counties, states or nations, it is not feasible to collect airborne LiDAR data continuously ("wall-to-wall") over the entire area of interest. Two-stage cluster survey designs have therefore been demonstrated by which LiDAR data are collected along selected individual flight-lines treated as clusters and with ground plots sampled along these LiDAR swaths. Recently, analytical AGB estimators and associated variance estimators that quantify the sampling variability have been proposed. Empirical studies employing these estimators have shown a seemingly equal or even larger uncertainty of the AGB estimates obtained with extensive use of LiDAR data to support the estimation as compared to pure field-based estimates employing estimators appropriate under simple random sampling (SRS). However, comparison of uncertainty estimates under SRS and sophisticated two-stage designs is complicated by large differences in the designs and assumptions. In this study, probability-based principles to estimation and inference were followed. We assumed designs of a field sample and a LiDAR-assisted survey of Hedmark County (HC) (27,390 km2), Norway, considered to be more comparable than those assumed in previous studies. The field sample consisted of 659 systematically distributed National Forest Inventory (NFI) plots and the airborne scanning LiDAR data were collected along 53 parallel flight-lines flown over the NFI plots. We compared AGB estimates based on the field survey only assuming SRS against corresponding estimates assuming two-phase (double) sampling with LiDAR and employing model-assisted estimators. We also compared AGB estimates based on the field survey only assuming two-stage sampling (the NFI plots being grouped in clusters) against corresponding estimates assuming two-stage sampling with the LiDAR and employing model-assisted estimators. For each of the two comparisons, the standard errors of the AGB estimates were consistently lower for the LiDAR-assisted designs. The overall reduction of the standard errors in the LiDAR-assisted estimation was around 40-60% compared to the pure field survey. We conclude that the previously proposed two-stage model-assisted estimators are inappropriate for surveys with unequal lengths of the LiDAR flight-lines and new estimators are needed. Some options for design of LiDAR-assisted sample surveys under REDD are also discussed, which capitalize on the flexibility offered when the field survey is designed as an integrated part of the overall survey design as opposed to previous LiDAR-assisted sample surveys in the boreal and temperate zones which have been restricted by the current design of an existing NFI.

Impact of Sexual Orientation Identity on Medical Morbidities in Male-to-Female Transgender Patients.

PubMed

Gaither, Thomas W; Awad, Mohannad A; Osterberg, E Charles; Romero, Angelita; Bowers, Marci L; Breyer, Benjamin N

2017-02-01

We aim to describe the relationship between sexual orientation identity and medical morbidities in a large sample of male-to-female (MTF) transgender patients. We reviewed medical records of patients presenting for MTF sex reassignment surgery (SRS) by a single, high-volume surgeon from 2011 to 2015. Sexual attraction to men (heterosexual), women (lesbian), or both (bisexual) was asked of each patient. We examined 16 medical morbidities for this analysis. During the study period, 330 MTF transgender patients presented for SRS. The average age at the time of surgery was 38.9 (range 18-76). One hundred and one patients (32%) reported being heterosexual, 110 patients (34%) reported being lesbian, and 108 patients (34%) reported being bisexual. Lesbian patients presented for SRS at older ages (mean = 43 years old) compared with heterosexual patients (mean = 36 years old) and bisexual patients (mean = 37), P < 0.01. No differences were found in the majority of coexisting medical morbidities by sexual orientation identity. Lesbian patients had greater odds of having a history of depression, age-adjusted odds ratio (aOR) = 2.36, 95% confidence interval (CI) 1.26-4.40, compared with heterosexual patients. Lesbian patients had higher odds of being married or partnered, aOR = 2.31, 95% CI (1.27-4.19), compared with heterosexual patients. Heterosexual patients had higher odds of having human immunodeficiency virus (HIV), aOR = 9.07, 95% CI (1.08-76.5) compared with lesbian patients. Sexual orientation identity in MTF transgender patients is variable. The majority of medical morbidities are not associated with sexual orientation identity. Although HIV and depression are common morbidities among MTF patients seeking SRS, the prevalence of these morbidities differs by sexual orientation identity, but these findings need replication. Counseling and future research initiatives in transgender care should incorporate sexual orientation identity and associated risk behavior.

Publication trends of study protocols in rehabilitation.

PubMed

Jesus, Tiago S; Colquhoun, Heather L

2017-09-04

Growing evidence points for the need to publish study protocols in the health field. To observe whether the growing interest in publishing study protocols in the broader health field has been translated into increased publications of rehabilitation study protocols. Observational study using publication data and its indexation in PubMed. Not applicable. Not applicable. PubMed was searched with appropriate combinations of Medical Subject Headings up to December 2014. The effective presence of study protocols was manually screened. Regression models analyzed the yearly growth of publications. Two-sample Z-tests analyzed whether the proportion of Systematic Reviews (SRs) and Randomized Controlled Trials (RCTs) among study protocols differed from that of the same designs for the broader rehabilitation research. Up to December 2014, 746 publications of rehabilitation study protocols were identified, with an exponential growth since 2005 (r2=0.981; p<0.001). RCT protocols were the most common among rehabilitation study protocols (83%), while RCTs were significantly more prevalent among study protocols than among the broader rehabilitation research (83% vs. 35.8%; p<0.001). For SRs, the picture was reversed: significantly less common among study protocols (2.8% vs. 9.3%; p<0.001). Funding was more often reported by rehabilitation study protocols than the broader rehabilitation research (90% vs. 53.1%; p<0.001). Rehabilitation journals published a significantly lower share of rehabilitation study protocols than they did for the broader rehabilitation research (1.8% vs.16.7%; p<0.001). Identifying the reasons for these discrepancies and reverting unwarranted disparities (e.g. low rate of publication for rehabilitation SR protocols) are likely new avenues for rehabilitation research and its publication. SRs, particularly those aggregating RCT results, are considered the best standard of evidence to guide rehabilitation clinical practice; however, that standard can be improved in rigor and/or transparency if the publications of rehabilitation SRs protocols become more common.

Effect of higher implant density on curve correction in dystrophic thoracic scoliosis secondary to neurofibromatosis Type 1.

PubMed

Li, Yang; Yuan, Xinxin; Sha, Shifu; Liu, Zhen; Zhu, Weiguo; Qiu, Yong; Wang, Bin; Yu, Yang; Zhu, Zezhang

2017-10-01

OBJECTIVE The aim of this study was to investigate how implant density affects radiographic results and clinical outcomes in patients with dystrophic scoliosis secondary to neurofibromatosis Type 1 (NF1). METHODS A total of 41 patients with dystrophic scoliosis secondary to NF1 who underwent 1-stage posterior correction between June 2011 and December 2013 were included. General information about patients was recorded, as were preoperative and postoperative scores from Scoliosis Research Society (SRS)-22 questionnaires. Pearson correlation analysis was used to analyze the associations among implant density, coronal Cobb angle correction rate and correction loss at last follow-up, change of sagittal curve, and apical vertebral translation. Patients were then divided into 2 groups: those with low-density and those with high-density implants. Independent-sample t-tests were used to compare demographic data, radiographic findings, and clinical outcomes before surgery and at last follow-up between the groups. RESULTS Significant correlations were found between the implant density and the coronal correction rate of the main curve (r = 0.505, p < 0.01) and the coronal correction loss at final follow-up (r = -0.379, p = 0.015). There was no significant correlation between implant density and change of sagittal profile (p = 0.662) or apical vertebral translation (p = 0.062). The SRS-22 scores improved in the appearance, activity, and mental health domains within both groups, but there was no difference between the groups in any of the SRS-22 domains at final follow-up (p > 0.05 for all). CONCLUSIONS Although no significant differences between the high- and low-density groups were found in any of the SRS-22 domains at final follow-up, higher implant density was correlated with superior coronal correction and less postoperative correction loss in patients with dystrophic NF1-associated scoliosis.

Autistic Traits in Mothers and Children Associated With Child’s Gender Nonconformity

PubMed Central

Shumer, Daniel E; Roberts, Andrea L; Reisner, Sari L; Lyall, Kristen; Austin, S Bryn

2015-01-01

We examined relationships between autistic traits in children, mothers, and fathers and gender nonconformity (GNC) in children using data from the Nurses' Health Study II (NHSII) and the Growing Up Today Study 1 (GUTS1). Autistic traits of mothers, fathers and children were measured using the Social Responsiveness Scale (SRS). GNC in children was measured using questions from the Recalled Childhood Gender Identity/Gender Role Questionnaire. In multivariable analyses increase in child’s SRS score was associated with increased odds (OR 1.35; p=0.03) of being in a higher GNC category. Increase in maternal SRS score was also associated with increased odds (OR 1.46; p=0.005) of the child being in a higher GNC category. Paternal SRS scores were not related to child's GNC category. PMID:25358249

A SINS/SRS/GNS Autonomous Integrated Navigation System Based on Spectral Redshift Velocity Measurements.

PubMed

Wei, Wenhui; Gao, Zhaohui; Gao, Shesheng; Jia, Ke

2018-04-09

In order to meet the requirements of autonomy and reliability for the navigation system, combined with the method of measuring speed by using the spectral redshift information of the natural celestial bodies, a new scheme, consisting of Strapdown Inertial Navigation System (SINS)/Spectral Redshift (SRS)/Geomagnetic Navigation System (GNS), is designed for autonomous integrated navigation systems. The principle of this SINS/SRS/GNS autonomous integrated navigation system is explored, and the corresponding mathematical model is established. Furthermore, a robust adaptive central difference particle filtering algorithm is proposed for this autonomous integrated navigation system. The simulation experiments are conducted and the results show that the designed SINS/SRS/GNS autonomous integrated navigation system possesses good autonomy, strong robustness and high reliability, thus providing a new solution for autonomous navigation technology.

Simultaneous stimulated Raman scattering and higher harmonic generation imaging for liver disease diagnosis without labeling

NASA Astrophysics Data System (ADS)

Lin, Jian; Wang, Zi; Zheng, Wei; Huang, Zhiwei

2014-02-01

Nonlinear optical microscopy (e.g., higher harmonic (second-/third- harmonic) generation (HHG), simulated Raman scattering (SRS)) has high diagnostic sensitivity and chemical specificity, making it a promising tool for label-free tissue and cell imaging. In this work, we report a development of a simultaneous SRS and HHG imaging technique for characterization of liver disease in a bile-duct-ligation rat-modal. HHG visualizes collagens formation and reveals the cell morphologic changes associated with liver fibrosis; whereas SRS identifies the distributions of hepatic fat cells formed in steatosis liver tissue. This work shows that the co-registration of SRS and HHG images can be an effective means for label-free diagnosis and characterization of liver steatosis/fibrosis at the cellular and molecular levels.

Influence of strong and weak hydrogen bonds in ices on stimulated Raman scattering.

PubMed

Li, Tianyu; Li, Fangfang; Li, Zhanlong; Sun, Chenglin; Tong, Junhong; Fang, Wenhui; Men, Zhiwei

2016-03-15

Stimulated Raman scattering (SRS) in liquid water and ice Ih using Nd:YAG laser is investigated. The spectrum of backward SRS (BSRS) in water is acquired. The spectrum shows an unexpected SRS peak at around 3453  cm(-1) besides the normal peak, which is similar to the spontaneous Raman spectrum of ice VII. The ice VII phase will be formed by laser-induced shock compression in liquid water. Simultaneously, unlike the spontaneous Raman spectrum, the pre-resonance SRS of ice Ih at around 3110 and 3210  cm(-1) is observed. The Raman peaks appeared in liquid water and ice Ih are attributed to the effect of strong and weak hydrogen bonds (H bonds), which should be ubiquitous in other ice phases.

pF3D Simulations of SBS and SRS in NIF Hohlraum Experiments

NASA Astrophysics Data System (ADS)

Langer, Steven; Strozzi, David; Amendt, Peter; Chapman, Thomas; Hopkins, Laura; Kritcher, Andrea; Sepke, Scott

2016-10-01

We present simulations of stimulated Brillouin scattering (SBS) and stimulated Raman scattering (SRS) for NIF experiments using high foot pulses in cylindrical hohlraums and for low foot pulses in rugby-shaped hohlraums. We use pF3D, a massively-parallel, paraxial-envelope laser plasma interaction code, with plasma profiles obtained from the radiation-hydrodynamics codes Lasnex and HYDRA. We compare the simulations to experimental data for SBS and SRS power and spectrum. We also show simulated SRS and SBS intensities at the target chamber wall and report the fraction of the backscattered light that passes through and misses the lenses. Work performed under the auspices of the U.S. Department of Energy by LLNL under Contract DE-AC52-07NA27344. Release number LLNL-ABS-697482.

Stereotactic radiosurgery for intracranial metastases: linac-based and gamma-dedicated unit approach.

PubMed

Alongi, Filippo; Fiorentino, Alba; Mancosu, Pietro; Navarria, Pierina; Giaj Levra, Niccolò; Mazzola, Rosario; Scorsetti, Marta

2016-07-01

For intracranial metastases, the role of stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy is well recognized. Historically, the first technology, for stereotactic device able to irradiate a brain tumor volume, was Gamma Knife® (GK). Due to the technological advancement of linear accelerator (Linac), there was a continuous increasing interest in SRS Linac-based applications. In those decades, it was assumed a superiority of GK compared to SRS Linac-based for brain tumor in terms of dose conformity and rapid fall-off dose close to the target. Expert commentary: Recently, due to the Linac technologic advancement, the choice of SRS GK-based is not necessarily so exclusive. The current review discussed in details the technical and clinical aspects comparing the two approaches for brain metastases.

Fiducial Marker Placement

MedlinePlus

... such as stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) , or proton therapy . Fiducial markers are small ... Proton Therapy Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiotherapy (SBRT) Images related to Fiducial Marker Placement Sponsored ...

Nuclear criticality safety evaluation of SRS 9971 shipping package. [SRS (Savannah River Site)

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

Vescovi, P.J.

1993-02-01

This evaluation is requested to revise the criticality evaluation used to generate Chapter 6 (Criticality Evaluation) of the Safety Analysis Report for Packaging (SARP) for shipment Of UO[sub 3] product from the Uranium Solidification Facility (USF) in the SRS 9971 shipping package. The pertinent document requesting this evaluation is included as Attachment I. The results of the evaluation are given in Attachment II which is written as Chapter 6 of a NRC format SARP.

Presence and absence of bats across habitat scales in the Upper Coastal Plain of South Carolina

Treesearch

W. Mark Ford; Jennifer M. Menzel; Michael A. Menzel; John W. Edwards; John C. Kilgo

2006-01-01

During 2001, we used active acoustical sampling (Anabat II) to survey foraging habitat relationships of bats on the Savannah River Site (SRS) in the upper Coastal Plain of South Carolina. Using an a priori information-theoretic approach, we conducted logistic regression analysis to examine presence of individual bat species relative to a suite of microhabitat, stand,...

Research and absence of bats across habitat scales in the upper coastal plain of South Carolina

Treesearch

W. Mark Ford; Jennifer M. Menzel; Michael A. Menzel; John W. Edwards; John C. Kilgo

2006-01-01

During 2001, we used active acoustical sampling (Anabat 11) to survey foraging habitat relationships of bats on the Savannah River Site (SRS) in the upper Coastal Plain of South Carolina. Using an a priori information-theoretic approach, we conducted logistic regression analysis to examine presence of individual bat species relative to a suite of microhabitat, stand,...

Identifying approaches for assessing methodological and reporting quality of systematic reviews: a descriptive study.

PubMed

Pussegoda, Kusala; Turner, Lucy; Garritty, Chantelle; Mayhew, Alain; Skidmore, Becky; Stevens, Adrienne; Boutron, Isabelle; Sarkis-Onofre, Rafael; Bjerre, Lise M; Hróbjartsson, Asbjørn; Altman, Douglas G; Moher, David

2017-06-19

The methodological quality and completeness of reporting of the systematic reviews (SRs) is fundamental to optimal implementation of evidence-based health care and the reduction of research waste. Methods exist to appraise SRs yet little is known about how they are used in SRs or where there are potential gaps in research best-practice guidance materials. The aims of this study are to identify reports assessing the methodological quality (MQ) and/or reporting quality (RQ) of a cohort of SRs and to assess their number, general characteristics, and approaches to 'quality' assessment over time. The Cochrane Library, MEDLINE®, and EMBASE® were searched from January 1990 to October 16, 2014, for reports assessing MQ and/or RQ of SRs. Title, abstract, and full-text screening of all reports were conducted independently by two reviewers. Reports assessing the MQ and/or RQ of a cohort of ten or more SRs of interventions were included. All results are reported as frequencies and percentages of reports. Of 20,765 unique records retrieved, 1189 of them were reviewed for full-text review, of which 76 reports were included. Eight previously published approaches to assessing MQ or reporting guidelines used as proxy to assess RQ were used in 80% (61/76) of identified reports. These included two reporting guidelines (PRISMA and QUOROM) and five quality assessment tools (AMSTAR, R-AMSTAR, OQAQ, Mulrow, Sacks) and GRADE criteria. The remaining 24% (18/76) of reports developed their own criteria. PRISMA, OQAQ, and AMSTAR were the most commonly used published tools to assess MQ or RQ. In conjunction with other approaches, published tools were used in 29% (22/76) of reports, with 36% (8/22) assessing adherence to both PRISMA and AMSTAR criteria and 26% (6/22) using QUOROM and OQAQ. The methods used to assess quality of SRs are diverse, and none has become universally accepted. The most commonly used quality assessment tools are AMSTAR, OQAQ, and PRISMA. As new tools and guidelines are developed to improve both the MQ and RQ of SRs, authors of methodological studies are encouraged to put thoughtful consideration into the use of appropriate tools to assess quality and reporting.

A Descriptive Analysis of Overviews of Reviews Published between 2000 and 2011

PubMed Central

Hartling, Lisa; Chisholm, Annabritt; Thomson, Denise; Dryden, Donna M.

2012-01-01

Background Overviews of systematic reviews compile data from multiple systematic reviews (SRs) and are a new method of evidence synthesis. Objectives To describe the methodological approaches in overviews of interventions. Design Descriptive study. Methods We searched 4 databases from 2000 to July 2011; we handsearched Evidence-based Child Health: A Cochrane Review Journal. We defined an overview as a study that: stated a clear objective; examined an intervention; used explicit methods to identify SRs; collected and synthesized outcome data from the SRs; and intended to include only SRs. We did not restrict inclusion by population characteristics (e.g., adult or children only). Two researchers independently screened studies and applied eligibility criteria. One researcher extracted data with verification by a second. We conducted a descriptive analysis. Results From 2,245 citations, 75 overviews were included. The number of overviews increased from 1 in 2000 to 14 in 2010. The interventions were pharmacological (n = 20, 26.7%), non-pharmacological (n = 26, 34.7%), or both (n = 29, 38.7%). Inclusion criteria were clearly stated in 65 overviews. Thirty-three (44%) overviews searched at least 2 databases. The majority reported the years and databases searched (n = 46, 61%), and provided key words (n = 58, 77%). Thirty-nine (52%) overviews included Cochrane SRs only. Two reviewers independently screened and completed full text review in 29 overviews (39%). Methods of data extraction were reported in 45 (60%). Information on quality of individual studies was extracted from the original SRs in 27 (36%) overviews. Quality assessment of the SRs was performed in 28 (37%) overviews; at least 9 different tools were used. Quality of the body of evidence was assessed in 13 (17%) overviews. Most overviews provided a narrative or descriptive analysis of the included SRs. One overview conducted indirect analyses and the other conducted mixed treatment comparisons. Publication bias was discussed in 18 (24%) overviews. Conclusions This study shows considerable variation in the methods used for overviews. There is a need for methodological rigor and consistency in overviews, as well as empirical evidence to support the methods employed. PMID:23166744

A descriptive analysis of overviews of reviews published between 2000 and 2011.

PubMed

Hartling, Lisa; Chisholm, Annabritt; Thomson, Denise; Dryden, Donna M

2012-01-01

Overviews of systematic reviews compile data from multiple systematic reviews (SRs) and are a new method of evidence synthesis. To describe the methodological approaches in overviews of interventions. Descriptive study. We searched 4 databases from 2000 to July 2011; we handsearched Evidence-based Child Health: A Cochrane Review Journal. We defined an overview as a study that: stated a clear objective; examined an intervention; used explicit methods to identify SRs; collected and synthesized outcome data from the SRs; and intended to include only SRs. We did not restrict inclusion by population characteristics (e.g., adult or children only). Two researchers independently screened studies and applied eligibility criteria. One researcher extracted data with verification by a second. We conducted a descriptive analysis. From 2,245 citations, 75 overviews were included. The number of overviews increased from 1 in 2000 to 14 in 2010. The interventions were pharmacological (n = 20, 26.7%), non-pharmacological (n = 26, 34.7%), or both (n = 29, 38.7%). Inclusion criteria were clearly stated in 65 overviews. Thirty-three (44%) overviews searched at least 2 databases. The majority reported the years and databases searched (n = 46, 61%), and provided key words (n = 58, 77%). Thirty-nine (52%) overviews included Cochrane SRs only. Two reviewers independently screened and completed full text review in 29 overviews (39%). Methods of data extraction were reported in 45 (60%). Information on quality of individual studies was extracted from the original SRs in 27 (36%) overviews. Quality assessment of the SRs was performed in 28 (37%) overviews; at least 9 different tools were used. Quality of the body of evidence was assessed in 13 (17%) overviews. Most overviews provided a narrative or descriptive analysis of the included SRs. One overview conducted indirect analyses and the other conducted mixed treatment comparisons. Publication bias was discussed in 18 (24%) overviews. This study shows considerable variation in the methods used for overviews. There is a need for methodological rigor and consistency in overviews, as well as empirical evidence to support the methods employed.

Treatment of Five or More Brain Metastases With Stereotactic Radiosurgery

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

Hunter, Grant K.; Suh, John H.; Reuther, Alwyn M.

2012-08-01

Purpose: To examine the outcomes of patients with five or more brain metastases treated in a single session with stereotactic radiosurgery (SRS). Methods and Materials: Sixty-four patients with brain metastases treated with SRS to five or more lesions in a single session were reviewed. Primary disease type, number of lesions, Karnofsky performance score (KPS) at SRS, and status of primary and systemic disease at SRS were included. Patients were treated using dosing as defined by Radiation Therapy Oncology Group Protocol 90-05, with adjustments for critical structures. We defined prior whole-brain radiotherapy (WBRT) as WBRT completed >1 month before SRS andmore » concurrent WBRT as WBRT completed within 1 month before or after SRS. Kaplan-Meier estimates and Cox proportional hazard regression were used to determine which patient and treatment factors predicted overall survival (OS). Results: The median OS after SRS was 7.5 months. The median KPS was 80 (range, 60-100). A KPS of {>=}80 significantly influenced OS (median OS, 4.8 months for KPS {<=}70 vs. 8.8 months for KPS {>=}80, p = 0.0097). The number of lesions treated did not significantly influence OS (median OS, 6.6 months for eight or fewer lesions vs. 9.9 months for more than eight, p = nonsignificant). Primary site histology did not significantly influence median OS. On multivariate Cox modeling, KPS and prior WBRT significantly predicted for OS. Whole-brain radiotherapy before SRS compared with concurrent WBRT significantly influenced survival, with a risk ratio of 0.423 (95% confidence interval 0.191-0.936, p = 0.0338). No significant differences were observed when no WBRT was compared with concurrent WBRT or when the no WBRT group was compared with prior WBRT. A KPS of {<=}70 predicted for poorer outcomes, with a risk ratio of 2.164 (95% confidence interval 1.157-4.049, p = 0.0157). Conclusions: Stereotactic radiosurgery to five or more brain lesions is an effective treatment option for patients with metastatic cancer, especially for patients previously treated with WBRT. A KPS of {>=}80 predicts for an improved outcome.« less

The relevance of systematic reviews on pharmaceutical policy to low- and middle-income countries.

PubMed

Gray, Andrew Lofts; Suleman, Fatima

2015-10-01

Low- and middle-income countries (LMICs) rely on available evidence when devising and implementing pharmaceutical policies. Aim of the review To provide a critical overview of systematic reviews of pharmaceutical policies, with particular focus on the relevance of such reviews in low- and middle-income countries. A search for systematic reviews (SRs) of studies of the interventions of interest was conducted until May 2009 in MEDLINE, EconLit, CINAHL, the Cochrane site, ProQuest, EMBASE, JOLIS, ISI Web of Science, International Pharmaceutical Abstracts, International Network for Rational Use of Drugs, National Technical Information Service, Public Affairs Information Service, SourceOECD, the System for Information on Grey Literature in Europe, and the WHO library database. The search was updated to July 2013, based on the yields of the initial search strategy. 20 SRs that met all inclusion criteria were retrieved in full text. Four SRs were subsequently rejected on the basis of quality considerations and the findings of 16 SRs were extracted and their applicability in LMICs considered. Of these, 5 were Cochrane Reviews. All included SRs were published in English. SRs related to registration and classification policies, marketing policies, prescribing policies, reimbursement policies, policies on price and payments, co-payments and caps and multi-component policies were retrieved. No SRs related to patent and profit policies, sales and dispensing policies, policies that regulate the provision of health insurance, or policies on patient information were retrieved. Only one of the systematic reviews retrieved utilised a study conducted in a developing country. The direct applicability of the evidence from these SRs in LMICs is limited. However, as middle-income countries move towards universal health coverage, the multi-component policies that govern reimbursement for medicines, and which impose caps on payments and co-payments by patients, may become more applicable. As such they will have direct implications for the practice of clinical pharmacy in such settings. Considerable effort will be needed to systemically review the available primary evidence from studies conducted in developing country settings, where such data exist.

Surgical Resection of Brain Metastases and the Risk of Leptomeningeal Recurrence in Patients Treated With Stereotactic Radiosurgery

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

Johnson, Matthew D., E-mail: Matthewjohnson@beaumont.edu; Avkshtol, Vladimir; Baschnagel, Andrew M.

Purpose: Recent prospective data have shown that patients with solitary or oligometastatic disease to the brain may be treated with upfront stereotactic radiosurgery (SRS) with deferral of whole-brain radiation therapy (WBRT). This has been extrapolated to the treatment of patients with resected lesions. The aim of this study was to assess the risk of leptomeningeal disease (LMD) in patients treated with SRS to the postsurgical resection cavity for brain metastases compared with patients treated with SRS to intact metastases. Methods and Materials: Four hundred sixty-five patients treated with SRS without upfront WBRT at a single institution were identified; 330 ofmore » these with at least 3 months' follow-up were included in this analysis. One hundred twelve patients had undergone surgical resection of at least 1 lesion before SRS compared with 218 treated for intact metastases. Time to LMD and overall survival (OS) time were estimated from date of radiosurgery, and LMD was analyzed by the use of cumulative incidence method with death as a competing risk. Univariate and multivariate analyses were performed with competing risk regression to determine whether various clinical factors predicted for LMD. Results: With a median follow-up time of 9.0 months, 39 patients (12%) experienced LMD at a median of 6.0 months after SRS. At 1 year, the cumulative incidence of LMD, with death as a competing risk, was 5.2% for the patients without surgical resection versus 16.9% for those treated with surgery (Gray test, P<.01). On multivariate analysis, prior surgical resection (P<.01) and breast cancer primary (P=.03) were significant predictors of LMD development. The median OS times for patients undergoing surgery compared with SRS alone were 12.9 and 10.6 months, respectively (log-rank P=.06). Conclusions: In patients undergoing SRS with deferral of upfront WBRT for intracranial metastatic disease, prior surgical resection and breast cancer primary are associated with an increased risk for the development of LMD.« less

A New Treatment Paradigm: Neoadjuvant Radiosurgery Before Surgical Resection of Brain Metastases With Analysis of Local Tumor Recurrence

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

Asher, Anthony L., E-mail: asher@cnsa.com; Carolina Neurosurgery and Spine Associates, Charlotte, North Carolina; Burri, Stuart H.

Purpose: Resected brain metastases (BM) require radiation therapy to reduce local recurrence. Whole brain radiation therapy (WBRT) reduces recurrence, but with potential toxicity. Postoperative stereotactic radiosurgery (SRS) is a strategy without prospective data and problematic target delineation. SRS delivered in the preoperative setting (neoadjuvant, or NaSRS) allows clear target definition and reduction of intraoperative dissemination of tumor cells. Methods and Materials: Our treatment of resectable BM with NaSRS was begun in 2005. Subsequently, a prospective trial of NaSRS was undertaken. A total of 47 consecutively treated patients (23 database and 24 prospective trial) with a total of 51 lesions weremore » reviewed. No statistical difference was observed between the 2 cohorts, and they were combined for analysis. The median follow-up time was 12 months (range, 1-58 months), and the median age was 57. A median of 1 day elapsed between NaSRS and resection. The median diameter of lesions was 3.04 cm (range, 1.34-5.21 cm), and the median volume was 8.49 cc (range, 0.89-46.7 cc). A dose reduction strategy was used, with a median dose of 14 Gy (range, 11.6-18 Gy) prescribed to 80% isodose. Results: Kaplan-Meier overall survival was 77.8% and 60.0% at 6 and 12 months. Kaplan-Meier local control was 97.8%, 85.6%, and 71.8% at 6, 12, and 24 months, respectively. Five of 8 failures were proved pathologically without radiation necrosis. There were no perioperative adverse events. Ultimately, 14.8% of the patients were treated with WBRT. Local failure was more likely with lesions >10 cc (P=.01), >3.4 cm (P=.014), with a trend in surface lesions (P=.066) and eloquent areas (P=.052). Six of the 8 failures had an obvious dural attachment or proximity to draining veins. Conclusions: NaSRS can be performed safely and effectively with excellent results without documented radiation necrosis. Local control was excellent even in the setting of large (>3 cm) lesions. The strong majority of patients were able to avoid WBRT. NaSRS merits consideration in a multi-institution trial.« less

Analysis of the Factors Contributing to Vertebral Compression Fractures After Spine Stereotactic Radiosurgery

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

Boyce-Fappiano, David; Elibe, Erinma; Schultz, Lonni

Purpose: To determine our institutional vertebral compression fracture (VCF) rate after spine stereotactic radiosurgery (SRS) and determine contributory factors. Methods and Materials: Retrospective analysis from 2001 to 2013 at a single institution was performed. With institutional review board approval, electronic medical records of 1905 vertebral bodies from 791 patients who were treated with SRS for the management of primary or metastatic spinal lesions were reviewed. A total of 448 patients (1070 vertebral bodies) with adequate follow-up imaging studies available were analyzed. Doses ranging from 10 Gy in 1 fraction to 60 Gy in 5 fractions were delivered. Computed tomography and magnetic resonancemore » imaging were used to evaluate the primary endpoints of this study: development of a new VCF, progression of an existing VCF, and requirement of stabilization surgery after SRS. Results: A total of 127 VCFs (11.9%; 95% confidence interval [CI] 9.5%-14.2%) in 97 patients were potentially SRS induced: 46 (36%) were de novo, 44 (35%) VCFs progressed, and 37 (29%) required stabilization surgery after SRS. Our rate for radiologic VCF development/progression (excluding patients who underwent surgery) was 8.4%. Upon further exclusion of patients with hematologic malignancies the VCF rate was 7.6%. In the univariate analyses, females (hazard ratio [HR] 1.54, 95% CI 1.01-2.33, P=.04), prior VCF (HR 1.99, 95% CI 1.30-3.06, P=.001), primary hematologic malignancies (HR 2.68, 95% CI 1.68-4.28, P<.001), thoracic spine lesions (HR 1.46, 95% CI 1.02-2.10, P=.02), and lytic lesions had a significantly increased risk for VCF after SRS. On multivariate analyses, prior VCF and lesion type remained contributory. Conclusions: Single-fraction SRS doses of 16 to 18 Gy to the spine seem to be associated with a low rate of VCFs. To the best of our knowledge, this is the largest reported experience analyzing SRS-induced VCFs, with one of the lowest event rates reported.« less

Machine-Specific Magnetic Resonance Imaging Quality Control Procedures for Stereotactic Radiosurgery Treatment Planning

PubMed Central

Taghizadeh, Somayeh; Yang, Claus Chunli; R. Kanakamedala, Madhava; Morris, Bart; Vijayakumar, Srinivasan

2017-01-01

Purpose Magnetic resonance (MR) images are necessary for accurate contouring of intracranial targets, determination of gross target volume and evaluation of organs at risk during stereotactic radiosurgery (SRS) treatment planning procedures. Many centers use magnetic resonance imaging (MRI) simulators or regular diagnostic MRI machines for SRS treatment planning; while both types of machine require two stages of quality control (QC), both machine- and patient-specific, before use for SRS, no accepted guidelines for such QC currently exist. This article describes appropriate machine-specific QC procedures for SRS applications. Methods and materials We describe the adaptation of American College of Radiology (ACR)-recommended QC tests using an ACR MRI phantom for SRS treatment planning. In addition, commercial Quasar MRID3D and Quasar GRID3D phantoms were used to evaluate the effects of static magnetic field (B0) inhomogeneity, gradient nonlinearity, and a Leksell G frame (SRS frame) and its accessories on geometrical distortion in MR images. Results QC procedures found in-plane distortions (Maximum = 3.5 mm, Mean = 0.91 mm, Standard deviation = 0.67 mm, >2.5 mm (%) = 2) in X-direction (Maximum = 2.51 mm, Mean = 0.52 mm, Standard deviation = 0.39 mm, > 2.5 mm (%) = 0) and in Y-direction (Maximum = 13. 1 mm , Mean = 2.38 mm, Standard deviation = 2.45 mm, > 2.5 mm (%) = 34) in Z-direction and < 1 mm distortion at a head-sized region of interest. MR images acquired using a Leksell G frame and localization devices showed a mean absolute deviation of 2.3 mm from isocenter. The results of modified ACR tests were all within recommended limits, and baseline measurements have been defined for regular weekly QC tests. Conclusions With appropriate QC procedures in place, it is possible to routinely obtain clinically useful MR images suitable for SRS treatment planning purposes. MRI examination for SRS planning can benefit from the improved localization and planning possible with the superior image quality and soft tissue contrast achieved under optimal conditions. PMID:29487771

Machine-Specific Magnetic Resonance Imaging Quality Control Procedures for Stereotactic Radiosurgery Treatment Planning.

PubMed

Fatemi, Ali; Taghizadeh, Somayeh; Yang, Claus Chunli; R Kanakamedala, Madhava; Morris, Bart; Vijayakumar, Srinivasan

2017-12-18

Purpose Magnetic resonance (MR) images are necessary for accurate contouring of intracranial targets, determination of gross target volume and evaluation of organs at risk during stereotactic radiosurgery (SRS) treatment planning procedures. Many centers use magnetic resonance imaging (MRI) simulators or regular diagnostic MRI machines for SRS treatment planning; while both types of machine require two stages of quality control (QC), both machine- and patient-specific, before use for SRS, no accepted guidelines for such QC currently exist. This article describes appropriate machine-specific QC procedures for SRS applications. Methods and materials We describe the adaptation of American College of Radiology (ACR)-recommended QC tests using an ACR MRI phantom for SRS treatment planning. In addition, commercial Quasar MRID 3D and Quasar GRID 3D phantoms were used to evaluate the effects of static magnetic field (B 0 ) inhomogeneity, gradient nonlinearity, and a Leksell G frame (SRS frame) and its accessories on geometrical distortion in MR images. Results QC procedures found in-plane distortions (Maximum = 3.5 mm, Mean = 0.91 mm, Standard deviation = 0.67 mm, >2.5 mm (%) = 2) in X-direction (Maximum = 2.51 mm, Mean = 0.52 mm, Standard deviation = 0.39 mm, > 2.5 mm (%) = 0) and in Y-direction (Maximum = 13. 1 mm , Mean = 2.38 mm, Standard deviation = 2.45 mm, > 2.5 mm (%) = 34) in Z-direction and < 1 mm distortion at a head-sized region of interest. MR images acquired using a Leksell G frame and localization devices showed a mean absolute deviation of 2.3 mm from isocenter. The results of modified ACR tests were all within recommended limits, and baseline measurements have been defined for regular weekly QC tests. Conclusions With appropriate QC procedures in place, it is possible to routinely obtain clinically useful MR images suitable for SRS treatment planning purposes. MRI examination for SRS planning can benefit from the improved localization and planning possible with the superior image quality and soft tissue contrast achieved under optimal conditions.

A new treatment paradigm: neoadjuvant radiosurgery before surgical resection of brain metastases with analysis of local tumor recurrence.

PubMed

Asher, Anthony L; Burri, Stuart H; Wiggins, Walter F; Kelly, Renee P; Boltes, Margaret O; Mehrlich, Melissa; Norton, H James; Fraser, Robert W

2014-03-15

Resected brain metastases (BM) require radiation therapy to reduce local recurrence. Whole brain radiation therapy (WBRT) reduces recurrence, but with potential toxicity. Postoperative stereotactic radiosurgery (SRS) is a strategy without prospective data and problematic target delineation. SRS delivered in the preoperative setting (neoadjuvant, or NaSRS) allows clear target definition and reduction of intraoperative dissemination of tumor cells. Our treatment of resectable BM with NaSRS was begun in 2005. Subsequently, a prospective trial of NaSRS was undertaken. A total of 47 consecutively treated patients (23 database and 24 prospective trial) with a total of 51 lesions were reviewed. No statistical difference was observed between the 2 cohorts, and they were combined for analysis. The median follow-up time was 12 months (range, 1-58 months), and the median age was 57. A median of 1 day elapsed between NaSRS and resection. The median diameter of lesions was 3.04 cm (range, 1.34-5.21 cm), and the median volume was 8.49 cc (range, 0.89-46.7 cc). A dose reduction strategy was used, with a median dose of 14 Gy (range, 11.6-18 Gy) prescribed to 80% isodose. Kaplan-Meier overall survival was 77.8% and 60.0% at 6 and 12 months. Kaplan-Meier local control was 97.8%, 85.6%, and 71.8% at 6, 12, and 24 months, respectively. Five of 8 failures were proved pathologically without radiation necrosis. There were no perioperative adverse events. Ultimately, 14.8% of the patients were treated with WBRT. Local failure was more likely with lesions >10 cc (P=.01), >3.4 cm (P=.014), with a trend in surface lesions (P=.066) and eloquent areas (P=.052). Six of the 8 failures had an obvious dural attachment or proximity to draining veins. NaSRS can be performed safely and effectively with excellent results without documented radiation necrosis. Local control was excellent even in the setting of large (>3 cm) lesions. The strong majority of patients were able to avoid WBRT. NaSRS merits consideration in a multi-institution trial. Copyright © 2014 Elsevier Inc. All rights reserved.

99mTc-EDDA/HYNIC-octreotate scintigraphy, an efficient method for the detection and staging of carcinoid tumours: results of 3 years' experience.

PubMed

Hubalewska-Dydejczyk, A; Fröss-Baron, K; Mikołajczak, R; Maecke, H R; Huszno, B; Pach, D; Sowa-Staszczak, A; Janota, B; Szybiński, P; Kulig, J

2006-10-01

At all stages of the disease, serious difficulties are encountered in the imaging diagnosis of carcinoids. Somatostatin receptor scintigraphy (SRS) holds great promise for detecting primary tumours and metastases. 99mTc-EDDA/HYNIC-octreotate should significantly improve the diagnosis of carcinoids in comparison with 111In-Octreoscan owing to the better affinity for SSR2 and the higher count rate. The aim of this study was to assess the diagnostic efficiency of 99mTc-EDDA/HYNIC-octreotate scintigraphy in the detection and staging of carcinoid tumours. The study population comprised 75 patients (age 48.5+/-15.5 years): 46 with histological confirmation of carcinoid and 29 with suspected disease. 99mTc-EDDA/HYNIC-octreotate (740 MBq) SRS and CT were performed in all patients. Fifteen patients were examined with 111In-Octreoscan. High-quality 99mTc-EDDA/HYNIC-octreotate images were obtained in all cases, with maximum tumour tracer accumulation 4 h p.i. The mean target/non-target ratios for whole body (WB) and SPECT scans were, respectively, as follows: primary lesions: 4.5 and 10.2; metastases: liver, 3.1 and 12.3; abdominal focal lesions, 2.7 and 5.8; lung, 2.7 and 8.3; mediastinum, 3.4 and 7.6; bones, 6.8 and 19.0. 99mTc-EDDA/HYNIC-octreotate WB scans revealed more metastases than 111In-Octreoscan, with better individual separation. 99mTc-EDDA/HYNIC-octreotate SRS revealed new metastatic lesions in seven patients with confirmed carcinoid, and in four with dissemination the primary focus was found. Five patients qualified for radioguided surgery and 11 were referred to 90Y-DOTA-TATE therapy. The sensitivity of SRS in comparison with CT was higher for primary lesions and liver and abdominal lymph node metastases. In the subgroup of patients with suspected neuroendocrine tumours, two duodenal carcinoids, one thymic carcinoid and one ileal carcinoid were found. 99mTc-EDDA/HYNIC-octreotate, with high imaging quality, is an excellent alternative to 111In-Octreoscan for staging of carcinoids, and it seems to be the method of choice for detection of the primary focus in patients with metastases from an unknown primary tumour.

Why SRS Matters - Tritium

ScienceCinema

Howell, Steve; Schifer, Lee

2018-01-16

A video series presenting an overview of the Savannah River Site’s (SRS) mission and operations. Each episode features a specific area/operation and how it contributes to help make the world safer.

Can autism spectrum disorders and social anxiety disorders be differentiated by the social responsiveness scale in children and adolescents?

PubMed

Cholemkery, Hannah; Mojica, Laura; Rohrmann, Sonja; Gensthaler, Angelika; Freitag, Christine M

2014-05-01

Autism spectrum disorder (ASD) as well as social phobia (SP), and selective mutism (SM) are characterised by impaired social interaction. We assessed the validity of the Social Responsiveness Scale (SRS) to differentiate between ASD, and SP/SM. Raw scores were compared in 6-18 year old individuals with ASD (N = 60), SP (N = 38), SM (N = 43), and typically developed (N = 42). Sensitivity and specificity were examined. The three disorders showed overlapping SRS scores. Especially in boys with SM (ROC-AUC = .81), presence of ASD was overestimated by the SRS. A combination of three disorder specific questionnaires resulted in marginally improved diagnostic accuracy. For the clinically very relevant differential diagnosis of SP/SM, SRS results must be interpreted with caution.

A SINS/SRS/GNS Autonomous Integrated Navigation System Based on Spectral Redshift Velocity Measurements

PubMed Central

Wei, Wenhui; Gao, Zhaohui; Gao, Shesheng; Jia, Ke

2018-01-01

In order to meet the requirements of autonomy and reliability for the navigation system, combined with the method of measuring speed by using the spectral redshift information of the natural celestial bodies, a new scheme, consisting of Strapdown Inertial Navigation System (SINS)/Spectral Redshift (SRS)/Geomagnetic Navigation System (GNS), is designed for autonomous integrated navigation systems. The principle of this SINS/SRS/GNS autonomous integrated navigation system is explored, and the corresponding mathematical model is established. Furthermore, a robust adaptive central difference particle filtering algorithm is proposed for this autonomous integrated navigation system. The simulation experiments are conducted and the results show that the designed SINS/SRS/GNS autonomous integrated navigation system possesses good autonomy, strong robustness and high reliability, thus providing a new solution for autonomous navigation technology. PMID:29642549

Lessons From a 17-Year Radiosurgery Experience at the Royal Adelaide Hospital

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

Roos, Daniel E., E-mail: daniel.roos@health.sa.gov.au; Brophy, Brian P.; Taylor, James

2012-01-01

Purpose: To illustrate some of the potential pitfalls of cranial stereotactic radiosurgery (SRS) and its planning based on prospectively gathered data from a 17-year experience at the Royal Adelaide Hospital. Methods and Materials: More than 250 treatments have been planned since 1993 using previously described standard SRS techniques for intracranial benign and malignant lesions. Results: Five case studies are presented (1 meningioma, 1 acoustic neuroma, 2 solitary brain metastasis, 1 arteriovenous malformation), each of which demonstrates at least one salutary lesson. Conclusions: Because SRS delivers a highly conformal dose distribution, it is unforgiving of any geographic miss due to inaccuratemore » outlining and thus dependent on neuroradiological expertise and collaboration. There are also potentially significant implications of misdiagnosis in SRS cases without histological proof-in particular, presumed brain metastases.« less

Update to agency for toxic substances and disease registry 2012 report on assessment of biota exposure to mercury originating from Savannah River Site.

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

Kuhne, W.

The purpose of this report is to 1) update previous Savannah River National Laboratory (SRNL) assessment reports (Kvartek et al. 1994 and Halverson et al. 2008) on the fate of mercury in the Savannah River Site (SRS) environment and 2) address comments and recommendations from the review of SRS by the Agency for Toxic Substances and Disease Registry (ATSDR) concerning the evaluation of exposures to contaminants in biota originating from the SRS. The ATSDR reviewed and evaluated data from SRS, South Carolina Department of Health & Environmental Control (SCDHEC) and the Georgia Department of Natural Resources (GDNR) concerning the non-radioactivemore » contaminant mercury. This report will provide a response and update to conclusions and recommendations made by the ATSDR.« less

Energy dissipation rate as a determiner of Langmuir Wave turbulence in Stimulated Raman Scattering

NASA Astrophysics Data System (ADS)

Rose, Harvey A.

1998-11-01

In the steady state, the Manley Rowe relation relates the spatial growth of backscattered SRS to the local rate of Langmuir wave (LW) energy dissipation, ɛ. Past some threshold, the beating of the laser and the backscatter generates LW turbulence (LWT). Numerical simulations of SRS support the thesis that the LWT properties, such as various energy densities and enhanced LW decay rate, ν _eff, are determined primarily by ɛ, in the "inertial regime", where ν _eff>>ν_0, the linear rate, thus providing the basis for an SRS-LWT model. Energy conservation and turbulent stabilization of the SRS daughter LW against the decay instability imply that (ν_eff)^2>ω _pɛ /(16ν_ianT_e). Simulations reveal that, qualitatively, the inequality may be replaced by equality if the factor of 16 is replaced by 8.

Stereotactic Radiosurgery for Intracranial Ependymomas: An International Multicenter Study.

PubMed

Kano, Hideyuki; Su, Yan-Hua; Wu, Hsiu-Mei; Simonova, Gabriela; Liscak, Roman; Cohen-Inbar, Or; Sheehan, Jason P; Meola, Antonio; Sharma, Mayur; Barnett, Gene H; Mathieu, David; Vasas, Lucas T; Kaufmann, Anthony M; Jacobs, Rachel C; Lunsford, L Dade

2018-03-28

Stereotactic radiosurgery (SRS) is a potentially important option for intracranial ependymoma patients. To analyze the outcomes of intracranial ependymoma patients who underwent SRS as a part of multimodality management. Seven centers participating in the International Gamma Knife Research Foundation identified 89 intracranial ependymoma patients who underwent SRS (113 tumors). The median patient age was 16.3 yr (2.9-80). All patients underwent previous surgical resection and radiation therapy (RT) of their ependymomas and 40 underwent previous chemotherapy. Grade 2 ependymomas were present in 42 patients (52 tumors) and grade 3 ependymomas in 48 patients (61 tumors). The median tumor volume was 2.2 cc (0.03-36.8) and the median margin dose was 15 Gy (9-24). Forty-seven (53%) patients were alive and 42 (47%) patients died at the last follow-up. The overall survival after SRS was 86% at 1 yr, 50% at 3 yr, and 44% at 5 yr. Smaller total tumor volume was associated with longer overall survival (P = .006). Twenty-two patients (grade 2: n = 9, grade 3: n = 13) developed additional recurrent ependymomas in the craniospinal axis. The progression-free survival after SRS was 71% at 1 yr, 56% at 3 yr, and 48% at 5 yr. Adult age, female sex, and smaller tumor volume indicated significantly better progression-free survival. Symptomatic adverse radiation effects were seen in 7 patients (8%). SRS provides another management option for residual or recurrent progressive intracranial ependymoma patients who have failed initial surgery and RT.

Searching for randomized controlled trials and systematic reviews on exercise. A descriptive study.

PubMed

Grande, Antonio José; Hoffmann, Tammy; Glasziou, Paul

2015-01-01

The current paradigm of science is to accumulate as much research data as possible, with less thought given to navigation or synthesis of the resulting mass, which hampers locating and using the research. The aim here was to describe the number of randomized controlled trials (RCTs) and systematic reviews (SRs) focusing on exercise, and their journal sources, that have been indexed in PubMed over time. Descriptive study conducted at Bond University, Australia. To find RCTs, a search was conducted in PubMed Clinical Queries, using the category "Therapy" and the Medical Subject Headings (MeSH) term "Exercise". To find SRs, a search was conducted in PubMed Clinical Queries, using the category "Therapy", the MeSH term "Exercise" and various methodological filters. Up until 2011, 9,354 RCTs about exercise were published in 1,250 journals and 1,262 SRs in 513 journals. Journals in the area of Sports Science published the greatest number of RCTs and journals categorized as belonging to "Other health professions" area (for example nursing or psychology) published the greatest number of SRs. The Cochrane Database of Systematic Reviews was the principal source for SRs, with 9.8% of the total, while the Journal of Strength and Conditioning Research and Medicine & Science in Sports & Exercise published 4.4% and 5.0% of the RCTs, respectively. The rapid growth and resulting scatter of RCTs and SRs on exercise presents challenges for locating and using this research. Solutions for this issue need to be considered.

Stereotactic Radiosurgery for Benign (World Health Organization Grade I) Cavernous Sinus Meningiomas-International Stereotactic Radiosurgery Society (ISRS) Practice Guideline: A Systematic Review.

PubMed

Lee, Cheng-Chia; Trifiletti, Daniel M; Sahgal, Arjun; DeSalles, Antonio; Fariselli, Laura; Hayashi, Motohiro; Levivier, Marc; Ma, Lijun; Álvarez, Roberto Martínez; Paddick, Ian; Regis, Jean; Ryu, Samuel; Slotman, Ben; Sheehan, Jason

2018-03-15

Stereotactic radiosurgery (SRS) has become popular as a standard treatment for cavernous sinus (CS) meningiomas. To summarize the published literature specific to the treatment of CS meningioma with SRS found through a systematic review, and to create recommendations on behalf of the International Stereotactic Radiosurgery Society. Articles published from January 1963 to December 2014 were systemically reviewed. Three electronic databases, PubMed, EMBASE, and The Cochrane Central Register of Controlled Trials, were searched. Publications in English with at least 10 patients (each arm) were included. Of 569 screened abstracts, a total of 49 full-text articles were included in the analysis. All studies were retrospective. Most of the reports had favorable outcomes with 5-yr progression-free survival (PFS) rates ranging from 86% to 99%, and 10-yr PFS rates ranging from 69% to 97%. The post-SRS neurological preservation rate ranged from 80% to 100%. Resection can be considered for the treatment of larger (>3 cm in diameter) and symptomatic CS meningioma in patients both receptive to and medically eligible for open surgery. Adjuvant or salvage SRS for residual or recurrent tumor can be utilized depending on factors such as tumor volume and proximity to adjacent critical organs at risk. The literature is limited to level III evidence with respect to outcomes of SRS in patients with CS meningioma. Based on the observed results, SRS offers a favorable benefit to risk profile for patients with CS meningioma.