srs separations processes: Topics by Science.gov

Sample records for srs separations processes

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
Recent Advances in SRS on Hydrogen Isotope Separation Using Thermal Cycling Absorption Process

DOE PAGES

Xiao, Xin; Sessions, Henry T.; Heung, L. Kit

2015-02-01

The recent Thermal Cycling Absorption Process (TCAP) advances at Savannah River Site (SRS) include compressor-free concept for heating/cooling, push and pull separation using an active inverse column, and compact column design. The new developments allow significantly higher throughput and better reliability from 1/10th of the current production system’s footprint while consuming 60% less energy. Various versions are derived in the meantime for external customers to be used in fusion energy projects and medical isotope production.
Measurement of actinides and strontium-90 in high activity waste

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

Maxwell, S.L. III; Nelson, M.R.

1994-08-01

The reliable measurement of trace radionuclides in high activity waste is important to support waste processing activities at SRS (F and H Area Waste Tanks, Extended Sludge Processing (ESP) and In-Tank precipitation (ITP) processing). Separation techniques are needed to remove high levels of gamma activity and alpha/beta interferences prior to analytical measurement. Using new extraction chromatographic resins from EiChrom Industries, Inc., the SRS Central Laboratory has developed new high speed separation methods that enable measurement of neptunium, thorium, uranium, plutonium, americium and strontium-90 in high activity waste solutions. Small particle size resin and applied vacuum are used to reduce analysismore » times and enhance column performance. Extraction chromatographic resins are easy to use and eliminate the generation of contaminated liquid organic waste.« 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
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
Assessment of plutonium in the Savannah River Site environment. Revision 1

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

Carlton, W.H.; Evans, A.G.; Geary, L.A.

1992-12-31

Plutonium in the Savannah River Site Environment is published as a part of the Radiological Assessment Program (RAP). It is the fifth in a series of eight documents on individual radioisotopes released to the environment as a result of Savannah River Site (SRS) operations. These are living documents, each to be revised and updated on a two-year schedule. This document describes the sources of plutonium in the environment, its release from SRS, environmental transport and ecological concentration of plutonium, and the radiological impact of SRS releases to the environment. Plutonium exists in the environment as a result of above-ground nuclearmore » weapons tests, the Chernobyl accident, the destruction of satellite SNAP 9-A, plane crashes involving nuclear weapons, and small releases from reactors and reprocessing plants. Plutonium has been produced at SRS during the operation of five production reactors and released in small quantities during the processing of fuel and targets in chemical separations facilities. Approximately 0.6 Ci of plutonium was released into streams and about 12 Ci was released to seepage basins, where it was tightly bound by clay in the soil. A smaller quantity, about 3.8 Ci, was released to the atmosphere. Virtually all releases have occurred in F- and H-Area separation facilities. Plutonium concentration and transport mechanisms for the atmosphere, surface water, and ground water releases have been extensively studied by Savannah River Technology Center (SRTC) and ecological mechanisms have been studied by Savannah River Ecology Laboratory (SREL). The overall radiological impact of SRS releases to the offsite maximum individual can be characterized by a total dose of 15 mrem (atmospheric) and 0.18 mrem (liquid), compared with the dose of 12,960 mrem from non-SRS sources during the same period of time (1954--1989). Plutonium releases from SRS facilities have resulted in a negligible impact to the environment and the population it supports.« less
Savannah River Site Spent Nuclear Fuel Management Final Environmental Impact Statement

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

N /A

The proposed DOE action considered in this environmental impact statement (EIS) is to implement appropriate processes for the safe and efficient management of spent nuclear fuel and targets at the Savannah River Site (SRS) in Aiken County, South Carolina, including placing these materials in forms suitable for ultimate disposition. Options to treat, package, and store this material are discussed. The material included in this EIS consists of approximately 68 metric tons heavy metal (MTHM) of spent nuclear fuel 20 MTHM of aluminum-based spent nuclear fuel at SRS, as much as 28 MTHM of aluminum-clad spent nuclear fuel from foreign andmore » domestic research reactors to be shipped to SRS through 2035, and 20 MTHM of stainless-steel or zirconium-clad spent nuclear fuel and some Americium/Curium Targets stored at SRS. Alternatives considered in this EIS encompass a range of new packaging, new processing, and conventional processing technologies, as well as the No Action Alternative. A preferred alternative is identified in which DOE would prepare about 97% by volume (about 60% by mass) of the aluminum-based fuel for disposition using a melt and dilute treatment process. The remaining 3% by volume (about 40% by mass) would be managed using chemical separation. Impacts are assessed primarily in the areas of water resources, air resources, public and worker health, waste management, socioeconomic, and cumulative impacts.« less
Enterprise SRS: Leveraging Ongoing Operations to Advance National Programs - 13108

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

Marra, J.E.; Murray, A.M.; McGuire, P.W.

2013-07-01

The 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 their technologies in amore » 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 the Center for Applied Nuclear Materials Processing and Engineering Research (CANMPER). 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 leveraging SRS assets (e.g. facilities, staff, and property) for those critical engineering-scale demonstrations necessary to assure the successful deployment of new technologies. CANMPER 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 CANMPER will be on the effective use of SRS assets for these demonstrations, CANMPER 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). The demonstration 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 CANMPER 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 CANMPER 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 demonstrations is the use of H-Canyon to demonstrate new nuclear materials separations technologies critical for advancing the mission needs of three major program offices: DOE-EM, DOE-Nuclear Energy (DOE-NE), and the NNSA. Given the modular design of H-Canyon, the 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
Annual Radioactive Waste Tank Inspection Program 1994

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

McNatt, F.G. Sr.

1995-04-01

Aqueous radioactive wastes from Savannah River Site (SRS) separations processes are contained in large underground carbon steel tanks. Inspections made during 1994 to evaluate these vessels and evaluations based on data accrued by inspections made since the tanks were constructed are the subject of this report.
ANNUAL RADIOACTIVE WASTE TANK INSPECTION PROGRAM 2008

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

West, B.; Waltz, R.

2009-06-11

Aqueous radioactive wastes from Savannah River Site (SRS) separations and vitrification processes are contained in large underground carbon steel tanks. Inspections made during 2008 to evaluate these vessels and other waste handling facilities along with evaluations based on data from previous inspections are the subject of this report.
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
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
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
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.
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.
300 GPM Solids Removal System A True Replacement for Back Flushable Powdered Filter Systems - 13607

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

Ping, Mark R.; Lewis, Mark

2013-07-01

The EnergySolutions Solids Removal System (SRS) utilizes stainless steel cross-flow ultra-filtration (XUF) technology which allows it to reliably remove suspended solids greater than one (1) micron from liquid radwaste streams. The SRS is designed as a pre-treatment step for solids separation prior to processing through other technologies such as Ion Exchange Resin (IER) and/or Reverse Osmosis (RO), etc. Utilizing this pre-treatment approach ensures successful production of reactor grade water while 1) decreasing the amount of radioactive water being discharged to the environment; and 2) decreasing the amount of radioactive waste that must ultimately be disposed of due to the eliminationmore » of spent powdered filter media. (authors)« less
Stimulated Raman diagnostics in diesel droplets

NASA Astrophysics Data System (ADS)

Golombok, Michael

1991-09-01

Stimulated Raman spectroscopy (SRS) can simultaneously measure droplet sizes and the associated component concentrations in a fuel injection. As spray evaporation is crucial in determining the performance parameters of a diesel engine, such as cold start and particulate emission formation, the new application of the method for spatially and temporally resolved measurements is a useful new diagnostic, extending our understanding of spray processes. Droplet sizes can be obtained from single shot SRS spectra by measuring the separation between morphology-dependent resonances (MDR) that correspond to standing wave modes confined near the droplet circumference. Power spectrum analysis allows the measurement of more than one droplet from a spectrum using a pumped laser sheet in the fuel spray. The MDRs are responsible for the simultaneous stimulation of multiple Raman spectral lines over and above those seen in bulk liquids. The SRS method for concentration measurement is effectively self-calibrating in that the relative intensity of two adjacent lines is used to measure concentration. Any particular fuel has a unique ratio of SRS antisymmetric to symmetric C-H stretch intensity. If individual components in a fuel blend are characterized beforehand, one can monitor the evolution of the spray during injection by measuring signal intensity ratios which yield the volume fraction of the component of interest. The SRS technique is being used to examine a number of spray dynamics phenomena such as fuel atomization, droplet evolution and front-end volatility effects, which are of current interest in diesel development studies.
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
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.

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
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.
Continuous-wave stimulated Raman scattering

NASA Astrophysics Data System (ADS)

Bryant, C. H.; Golombok, M.

1991-04-01

The first observation of continuous-wave stimulated Raman scattering (SRS) is reported. Both forward and enhanced backward SRS were observed in liquids, and the large spectral frequency shift between pump and probe makes signal detection easy. No separate collection optics are necessary for the backscattered SRS, whose signal-to-noise ratio is much improved compared with that measured by forward or side scatter. This is attributed to the existence of a phase-conjugate beam. Higher orders of Stokes scattering are also observed in return. Contrary to theoretical expectation, both forward-scattered and backscattered signals have identical gains owing to saturation effects in a number of the high-gain liquids studied.
PROCESSING ALTERNATIVES FOR DESTRUCTION OF TETRAPHENYLBORATE

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

Lambert, D; Thomas Peters, T; Samuel Fink, S

Two processes were chosen in the 1980's at the Savannah River Site (SRS) to decontaminate the soluble High Level Waste (HLW). The In Tank Precipitation (ITP) process (1,2) was developed at SRS for the removal of radioactive cesium and actinides from the soluble HLW. Sodium tetraphenylborate was added to the waste to precipitate cesium and monosodium titanate (MST) was added to adsorb actinides, primarily uranium and plutonium. Two products of this process were a low activity waste stream and a concentrated organic stream containing cesium tetraphenylborate and actinides adsorbed on monosodium titanate (MST). A copper catalyzed acid hydrolysis process wasmore » built to process (3, 4) the Tank 48H cesium tetraphenylborate waste in the SRS's Defense Waste Processing Facility (DWPF). Operation of the DWPF would have resulted in the production of benzene for incineration in SRS's Consolidated Incineration Facility. This process was abandoned together with the ITP process in 1998 due to high benzene in ITP caused by decomposition of excess sodium tetraphenylborate. Processing in ITP resulted in the production of approximately 1.0 million liters of HLW. SRS has chosen a solvent extraction process combined with adsorption of the actinides to decontaminate the soluble HLW stream (5). However, the waste in Tank 48H is incompatible with existing waste processing facilities. As a result, a processing facility is needed to disposition the HLW in Tank 48H. This paper will describe the process for searching for processing options by SRS task teams for the disposition of the waste in Tank 48H. In addition, attempts to develop a caustic hydrolysis process for in tank destruction of tetraphenylborate will be presented. Lastly, the development of both a caustic and acidic copper catalyzed peroxide oxidation process will be discussed.« less
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
25 Years Of Environmental Remediation In The General Separations Area Of The Savannah River Site: Lessons Learned About What Worked And What Did Not Work In Soil And Groundwater Cleanup

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

Blount, Gerald; Thibault, Jeffrey; Millings, Margaret

The Savannah River Site (SRS) is owned and administered by the US Department of Energy (DOE). SRS covers an area of approximately 900 square kilometers. The General Separation Area (GSA) is located roughly in the center of the SRS and includes: radioactive material chemical separations facilities, radioactive waste tank farms, a variety of radioactive seepage basins, and the radioactive waste burial grounds. Radioactive wastes were disposed in the GSA from the mid-1950s through the mid-1990s. Radioactive operations at the F Canyon began in 1954; radioactive operations at H Canyon began in 1955. Waste water disposition to the F and Hmore » Seepage Basins began soon after operations started in the canyons. The Old Radioactive Waste Burial Ground (ORWBG) began operations in 1952 to manage solid waste that could be radioactive from all the site operations, and ceased receiving waste in 1972. The Mixed Waste Management Facility (MWMF) and Low Level Radioactive Waste Disposal Facility (LLRWDF) received radioactive solid waste from 1969 until 1995. Environmental legislation enacted in the 1970s, 1980s, and 1990s led to changes in waste management and environmental cleanup practices at SRS. The US Congress passed the Clean Air Act in 1970, and the Clean Water Act in 1972; the Resource Conservation and Recovery Act (RCRA) was enacted in 1976; the Comprehensive Environmental Response Compensation, and Liability Act (CERCLA) was enacted by Congress in 1980; the Federal Facilities Compliance Act (FFCA) was signed into law in 1992. Environmental remediation at the SRS essentially began with a 1987 Settlement Agreement between the SRS and the State of South Carolina (under the South Carolina Department of Health and Environmental Control - SCDHEC), which recognized linkage between many SRS waste management facilities and RCRA. The SRS manages several of the larger groundwater remedial activities under RCRA for facilities recognized early on as environmental problems. All subsequent environmental remediation projects tend to be managed under tri-party agreement (DOE, Environmental Protection Agency, and SCDHEC) through the Federal Facilities Agreement. During 25 years of environmental remediation SRS has stabilized and capped seepage basins, and consolidated and capped waste units and burial grounds in the GSA. Groundwater activities include: pump and treat systems in the groundwater, installation of deep subsurface barrier systems to manage groundwater flow, in situ chemical treatments in the groundwater, and captured contaminated groundwater discharges at the surface for management in a forest irrigation system. Over the last 25 years concentrations of contaminants in the aquifers beneath the GSA and in surface water streams in the GSA have dropped significantly. Closure of 65 waste sites and 4 RCRA facilities has been successfully accomplished. Wastes have been successfully isolated in place beneath a variety of caps and cover systems. Environmental clean-up has progressed to the stage where most of the work involves monitoring, optimization, and maintenance of existing remedial systems. Many lessons have been learned in the process. Geotextile covers outperform low permeability clay caps, especially with respect to the amount of repairs required to upkeep the drainage layers as the caps age. Passive, enhanced natural processes to address groundwater contamination are much more cost effective than pump and treat systems. SRS operated two very large pump and treat systems at the F and H Seepage Basins to attempt to limit the release of tritium to Fourmile Branch, a tributary of the Savannah River. The systems were designed to extract contaminated acidic groundwater, remove all contamination except tritium (not possible to remove the tritium from the water), and inject the tritiated groundwater up-gradient of the source area and the plume. The concept was to increase the travel time of the injected water for radioactive decay of the tritium. The two systems were found to be non-effective and potentially mobilizing more contamination. SRS invested approximately $50 million in construction and approximately $100 million in 6 years of operation. The H Seepage Basin pump and treat system was replaced by a series of subsurface barriers that alters the groundwater velocity; the F Seepage Basin pump and treat system was replaced by subsurface barriers forming a funnel and gate augmented by chemical treatment within the gates. These replacement systems are mostly passive and cost approximately $13 million to construct, and have reduced the tritium flux to Fourmile Branch, in these plumes, by over 70%. SRS manages non-acidic tritiated groundwater releases to Fourmile Branch from the southwest plume of the MWMF with a forest irrigation system. Tritiated water is captured with a sheetpile dam below the springs that caused releases to Fourmile Branch. Water from the irrigation pond is pumped to a filter plant prior to irrigation of approximately 26 hectares of mixed forest and developing pine plantation. SRS has almost achieved a 70% reduction in tritium flux to the Branch from this plume. The system cost approximately $5 million to construct with operation cost of approximately $500K per year. In conclusion, many lessons have been learned in 25 years of relatively aggressive remedial activities in the GSA. Geotextile covers outperform low permeability clay caps, especially with respect to the amount of repairs required to upkeep the drainage layers as the caps age. Passive, enhanced natural processes to address groundwater contamination are much more cost effective than pump and treat systems. In water management situations with non-accumulative contaminants (tritium, VOCs, etc.) irrigation in a forest setting can be very effective.« less
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
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.
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.
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.
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
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."
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
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.
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.
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.
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
Substance Identification Information from EPA's Substance Registry

EPA Pesticide Factsheets

The Substance Registry Services (SRS) is the authoritative resource for basic information about substances of interest to the U.S. EPA and its state and tribal partners. Substances, particularly chemicals, can have many valid synonyms. For example, toluene, methyl benzene, and phenyl methane, are commonly used names for the same chemical. EPA programs collect environmental data for this chemical using each of these names, plus others. This diversity leads to problems when a user is looking for programmatic data for toluene but is unaware that the data is stored under the synonym methyl benzene. For each substance, the SRS identifies the statutes, EPA programs, as well as organization external to EPA, that track or regulate that substance and the synonym used by that statute, EPA program or external organization. Besides standardized information for each chemical, such as the Chemical Abstracts Services name and the Chemical Abstracts Number and the EPA Registry Name (the EPA standard name), the SRS also includes additional information, such as molecular weight and molecular formula. Additionally, an SRS Internal Tracking Number uniquely identifies each substance, enabling cross-walking between synonyms. EPA is providing a large .ZIP file providing the SRS data in CSV format, and a separate small metadata file in XML containing the field names and definitions.

Final Report - "Foaming and Antifoaming and Gas Entrainment in Radioactive Waste Pretreatment and Immobilization Processes"

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

Wasan, Darsh T.

2007-10-09

The Savannah River Site (SRS) and Hanford site are in the process of stabilizing millions of gallons of radioactive waste slurries remaining from production of nuclear materials for the Department of Energy (DOE). The Defense Waste Processing Facility (DWPF) at SRS is currently vitrifying the waste in borosilicate glass, while the facilities at the Hanford site are in the construction phase. Both processes utilize slurry-fed joule-heated melters to vitrify the waste slurries. The DWPF has experienced difficulty during operations. The cause of the operational problems has been attributed to foaming, gas entrainment and the rheological properties of the process slurries.more » The rheological properties of the waste slurries limit the total solids content that can be processed by the remote equipment during the pretreatment and meter feed processes. Highly viscous material can lead to air entrainment during agitation and difficulties with pump operations. Excessive foaming in waste evaporators can cause carryover of radionuclides and non-radioactive waste to the condensate system. Experimental and theoretical investigations of the surface phenomena, suspension rheology and bubble generation of interactions that lead to foaming and air entrainment problems in the DOE High Level and Low Activity Radioactive Waste separation and immobilization processes were pursued under this project. The first major task accomplished in the grant proposal involved development of a theoretical model of the phenomenon of foaming in a three-phase gas-liquid-solid slurry system. This work was presented in a recently completed Ph.D. thesis (9). The second major task involved the investigation of the inter-particle interaction and microstructure formation in a model slurry by the batch sedimentation method. Both experiments and modeling studies were carried out. The results were presented in a recently completed Ph.D. thesis. The third task involved the use of laser confocal microscopy to study the effectiveness of three slurry rheology modifiers. An effective modifier was identified which resulted in lowering the yield stress of the waste simulant. Therefore, the results of this research have led to the basic understanding of the foaming/antifoaming mechanism in waste slurries as well as identification of a rheology modifier, which enhances the processing throughput, and accelerates the DOE mission. The objectives of this research effort were to develop a fundamental understanding of the physico-chemical mechanisms that produced foaming and air entrainment in the DOE High Level (HLW) and Low Activity (LAW) radioactive waste separation and immobilization processes, and to develop and test advanced antifoam/defoaming/rheology modifier agents. Antifoams/rheology modifiers developed from this research ere tested using non-radioactive simulants of the radioactive wastes obtained from Hanford and the Savannah River Site (SRS).« 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.
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
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.
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
Quantitative measurements of in-cylinder gas composition in a controlled auto-ignition combustion engine

NASA Astrophysics Data System (ADS)

Zhao, H.; Zhang, S.

2008-01-01

One of the most effective means to achieve controlled auto-ignition (CAI) combustion in a gasoline engine is by the residual gas trapping method. The amount of residual gas and mixture composition have significant effects on the subsequent combustion process and engine emissions. In order to obtain quantitative measurements of in-cylinder residual gas concentration and air/fuel ratio, a spontaneous Raman scattering (SRS) system has been developed recently. The optimized optical SRS setups are presented and discussed. The temperature effect on the SRS measurement is considered and a method has been developed to correct for the overestimated values due to the temperature effect. Simultaneous measurements of O2, H2O, CO2 and fuel were obtained throughout the intake, compression, combustion and expansion strokes. It shows that the SRS can provide valuable data on this process in a CAI combustion engine.
Efficacy of Stereotactic Radiosurgery in Patients with Multiple Metastases: Importance of Volume Rather Than Number of Lesions.

PubMed

Dahshan, Basem A; Mattes, Malcolm D; Bhatia, Sanjay; Palek, Mary Susan; Cifarelli, Christopher P; Hack, Joshua D; Vargo, John A

2017-12-19

The role of stereotactic radiosurgery (SRS) in the treatment of multiple brain metastases is controversial. While whole brain radiation therapy (WBRT) has historically been the mainstay of treatment, its value is increasingly being questioned as emerging data supports that SRS alone can provide comparable therapeutic outcomes for limited (one to three) intracranial metastases with fewer adverse effects, including neurocognitive decline. Multiple recent studies have also demonstrated that patients with multiple (> 3) intracranial metastases with a low overall tumor volume have a favorable therapeutic response to SRS, with no significant difference compared to patients with limited metastases. Herein, we present a patient with previously controlled breast cancer who presented with multiple recurrences of intracranial metastases but low total intracranial tumor volume each time. This patient underwent SRS alone for a total of 40 metastatic lesions over three separate procedures with good local control and without any significant cognitive toxicity. The patient eventually opted for enrollment in the NRG-CC001 clinical trial after multiple cranial recurrences. She received conventional WBRT with six months of memantine and developed significant neurocognitive side effects. This case highlights the growing body of literature supporting the role of SRS alone in the management of multiple brain metastases and the importance of maximizing neurocognition as advances in systemic therapies prolong survival in Stage IV cancer.
Efficacy of Stereotactic Radiosurgery in Patients with Multiple Metastases: Importance of Volume Rather Than Number of Lesions

PubMed Central

Mattes, Malcolm D; Bhatia, Sanjay; Palek, Mary Susan; Cifarelli, Christopher P; Hack, Joshua D; Vargo, John A

2017-01-01

The role of stereotactic radiosurgery (SRS) in the treatment of multiple brain metastases is controversial. While whole brain radiation therapy (WBRT) has historically been the mainstay of treatment, its value is increasingly being questioned as emerging data supports that SRS alone can provide comparable therapeutic outcomes for limited (one to three) intracranial metastases with fewer adverse effects, including neurocognitive decline. Multiple recent studies have also demonstrated that patients with multiple (> 3) intracranial metastases with a low overall tumor volume have a favorable therapeutic response to SRS, with no significant difference compared to patients with limited metastases. Herein, we present a patient with previously controlled breast cancer who presented with multiple recurrences of intracranial metastases but low total intracranial tumor volume each time. This patient underwent SRS alone for a total of 40 metastatic lesions over three separate procedures with good local control and without any significant cognitive toxicity. The patient eventually opted for enrollment in the NRG-CC001 clinical trial after multiple cranial recurrences. She received conventional WBRT with six months of memantine and developed significant neurocognitive side effects. This case highlights the growing body of literature supporting the role of SRS alone in the management of multiple brain metastases and the importance of maximizing neurocognition as advances in systemic therapies prolong survival in Stage IV cancer. PMID:29492355
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
Decommissioning the physics laboratory, building 777-10A, at the Savannah River Site (SRS)

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

Musall, John C.; Cope, Jeff L.

2008-01-15

SRS recently completed a four year mission to decommission {approx}250 excess facilities. As part of that effort, SRS decommissioned a 48,000 ft{sup 2} laboratory that housed four low-power test reactors, formerly used by SRS to determine reactor physics. This paper describes and reviews the decommissioning, with a focus on component segmentation and handling (i.e. hazardous material removal, demolition, and waste handling). The paper is intended to be a resource for engineers, planners, and project managers, who face similar decommissioning challenges. Building 777-10A, located at the south end of SRS's A/M-Area, was built in 1953 and had a gross area of {approx}48,000 ft{sup 2}. Building 777-10A had two main areas: a west wing, which housed four experimental reactors and associated equipment; and an east wing, which housed laboratories, and shops, offices. The reactors were located in two separate areas: one area housed the Process Development Pile (PDP) reactor and the Lattice Test Reactor (LTR), while the second area housed the Standard Pile (SP) and the Sub-critical Experiment (SE) reactors. The west wing had five levels: three below and three above grade (floor elevations of -37', -28', -15', 0', +13'/+16' and +27' (roof elevation of +62')), while the east wing had two levels: one below and one above grade (floor elevations of -15' and 0' (roof elevation of +16')). Below-grade exterior walls were constructed of reinforced concrete, {approx}1' thick. In general, above-grade exterior walls were steel frames covered by insulation and corrugated, asbestos-cement board. The two interior walls around the PDP/LTR were reinforced concrete {approx}5' thick and {approx}30' high, while the SP/SE reactors resided in a reinforced, concrete cell with 3.5'-6' thick walls/roof. All other interior walls were constructed of metal studs covered with either asbestos-cement or gypsum board. In general, the floors were constructed of reinforced concrete on cast-in-place concrete beams below-grade and concrete on metal beams above-grade. The roofs were flat concrete slabs on metal beams. Building 777-10A was an important SRS research and development location. The reactors helped determine safe operational limits and loading patterns for fuel used in the SRS production reactors, and supported various low power reactor physics studies. All four reactors were shut down and de-inventoried in the 1970's. The building was DD and R 2007, Chattanooga, Tennessee, September 16-19, 2007 169 subsequently used by various SRS organizations for office space, audio/visual studio, and computer network hub. SRS successfully decommissioned Building 777-10A over a thirty month period at a cost of {approx}more » $$14 M ({approx}$$290/ft{sup 2}). The decommissioning was a complex and difficult effort due to the building's radiological contamination, height, extensive basement, and thick concrete walls. Extensive planning and extensive hazard analysis (e.g. of structural loads/modifications leading to unplanned collapse) ensured the decommissioning was completed safely and without incident. The decommissioning met contract standards for residual contamination and physical/chemical hazards, and was the last in a series of decommissioning projects that prepared the lower A/M-Area for SRS's environmental restoration program.« less
General Separations Area (GSA) Groundwater Flow Model Update: Hydrostratigraphic Data

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

Bagwell, L.; Bennett, P.; Flach, G.

2017-02-21

This document describes the assembly, selection, and interpretation of hydrostratigraphic data for input to an updated groundwater flow model for the General Separations Area (GSA; Figure 1) at the Department of Energy’s (DOE) Savannah River Site (SRS). This report is one of several discrete but interrelated tasks that support development of an updated groundwater model (Bagwell and Flach, 2016).
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
Composite analysis E-area vaults and saltstone disposal facilities

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

Cook, J.R.

1997-09-01

This report documents the Composite Analysis (CA) performed on the two active Savannah River Site (SRS) low-level radioactive waste (LLW) disposal facilities. The facilities are the Z-Area Saltstone Disposal Facility and the E-Area Vaults (EAV) Disposal Facility. The analysis calculated potential releases to the environment from all sources of residual radioactive material expected to remain in the General Separations Area (GSA). The GSA is the central part of SRS and contains all of the waste disposal facilities, chemical separations facilities and associated high-level waste storage facilities as well as numerous other sources of radioactive material. The analysis considered 114 potentialmore » sources of radioactive material containing 115 radionuclides. The results of the CA clearly indicate that continued disposal of low-level waste in the saltstone and EAV facilities, consistent with their respective radiological performance assessments, will have no adverse impact on future members of the public.« less
SRS SWPF Construction Completion

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

Craig, Jack; Sheppard, Frank; Marks, Pam

Now that construction is complete, DOE and construction contractor Parsons, are focusing on testing the Savannah River Site’s Salt Waste Processing Facility (SWPF) systems and training the workforce to operate the plant in preparation for the start of operations. Once in operation, the SWPF will significantly increase processing rates at SRS tank farms in an effort to empty the site’s high-level radioactive waste tanks.
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.
Label-free observation of tissues by high-speed stimulated Raman spectral microscopy and independent component analysis

NASA Astrophysics Data System (ADS)

Ozeki, Yasuyuki; Otsuka, Yoichi; Sato, Shuya; Hashimoto, Hiroyuki; Umemura, Wataru; Sumimura, Kazuhiko; Nishizawa, Norihiko; Fukui, Kiichi; Itoh, Kazuyoshi

2013-02-01

We have developed a video-rate stimulated Raman scattering (SRS) microscope with frame-by-frame wavenumber tunability. The system uses a 76-MHz picosecond Ti:sapphire laser and a subharmonically synchronized, 38-MHz Yb fiber laser. The Yb fiber laser pulses are spectrally sliced by a fast wavelength-tunable filter, which consists of a galvanometer scanner, a 4-f optical system and a reflective grating. The spectral resolution of the filter is ~ 3 cm-1. The wavenumber was scanned from 2800 to 3100 cm-1 with an arbitrary waveform synchronized to the frame trigger. For imaging, we introduced a 8-kHz resonant scanner and a galvanometer scanner. We were able to acquire SRS images of 500 x 480 pixels at a frame rate of 30.8 frames/s. Then these images were processed by principal component analysis followed by a modified algorithm of independent component analysis. This algorithm allows blind separation of constituents with overlapping Raman bands from SRS spectral images. The independent component (IC) spectra give spectroscopic information, and IC images can be used to produce pseudo-color images. We demonstrate various label-free imaging modalities such as 2D spectral imaging of the rat liver, two-color 3D imaging of a vessel in the rat liver, and spectral imaging of several sections of intestinal villi in the mouse. Various structures in the tissues such as lipid droplets, cytoplasm, fibrous texture, nucleus, and water-rich region were successfully visualized.
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.

SU-F-T-304: Complex Multi-PTV Treatment Evaluation Using a Remotely Processed 3D Gel Dosimeter

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

Hoisak, J; Dragojevic, I; Sutlief, S

Purpose: A new 3D gel dosimeter (ClearView™, Modus Medical Systems) was investigated for use as a QA tool for stereotactic radiosurgery (SRS) plans exhibiting high dose gradients and spatially separated treatment targets. The unique feature of this gel dosimeter is the remote processing service provided by Modus Medical Systems. Methods: The gel dosimeters were filled in either 10 cm diameter or 15 cm diameter clear plastic jars. The jars were then shipped in ice-cooled containers to our department for irradiation. Clinical SRS plans for treatment of multiple metastases and plans with simulated concave structures were applied to a CT scanmore » of the gel dosimeter. The gel was irradiated in treatment position using modulated arcs and then returned in the cooled container for processing. The 3D gel dose was compared to the DICOM-RT dose from the treatment plan to assess dosimetric and geometric agreement. Results: There was no discernible difference between the planned and measured dose for dose gradients as high as 10%/mm, which was the highest gradient we evaluated. Geometric agreement for distant metastases separated by 6 cm was within 1.5 mm. Among three identically irradiated gels using a plan intended for nine metastases, the 3%/3mm gamma passing rate was 84.5% with a range of 14.7%, measured over the entire volume of the dosimeter. Regions of larger gamma values correlated with geometric offsets between the planned and measured data. Conclusion: The gel dosimeter exhibits the dosimetric and geometric characteristics necessary for 3D evaluation of treatment plan deliverability. The range of observed gamma passing rates suggests a high sensitivity to geometric registration. With proper management of geometric registration between planned and measured data, this service should enable a radiation oncology department to use 3D dosimetry in end-to-end testing or patient plan delivery QA without the expense of an in-house processing system.« 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.
Assessment of mercury in the Savannah River Site environment

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

Kvartek, E.J.; Carlton, W.H.; Denham, M.

Mercury has been valued by humans for several millennia. Its principal ore, cinnabar, was mined for its distinctive reddish-gold color and high density. Mercury and its salts were used as medicines and aphrodisiacs. At SRS, mercury originated from one of the following: as a processing aid in aluminum dissolution and chloride precipitation; as part of the tritium facilities` gas handling system; from experimental, laboratory, or process support facilities; and as a waste from site operations. Mercury is also found in Par Pond and some SRS streams as the result of discharges from a mercury-cell-type chlor-alkali plant near the city ofmore » Augusta, GA. Reactor cooling water, drawn from the Savannah River, transported mercury onto the SRS. Approximately 80,000 kg of mercury is contained in the high level waste tanks and 10,000 kg is located in the SWDF. Additional quantities are located in the various seepage basins. In 1992, 617 wells were monitored for mercury contamination, with 47 indicating contamination in excess of the 0.002-ppm EPA Primary Drinking Water Standard. More than 20 Savannah River Ecology Laboratory (SREL) reports and publications pertinent to mercury (Hg) have been generated during the last two decades. They are divided into three groupings: SRS-specific studies, basic studies of bioaccumulation, and basic studies of effect. Many studies have taken place at Par Pond and Upper Three Runs Creek. Mercury has been detected in wells monitoring the groundwater beneath SRS, but not in water supply wells in excess of the Primary Drinking Water Limit of 0.002 ppm. There has been no significant release of mercury from SRS to the Savannah River. While releases to air are likely, based on process knowledge, modeling of the releases indicates concentrations that are well below the SCDHEC ambient standard.« less
Snore related signals processing in a private cloud computing system.

PubMed

Qian, Kun; Guo, Jian; Xu, Huijie; Zhu, Zhaomeng; Zhang, Gongxuan

2014-09-01

Snore related signals (SRS) have been demonstrated to carry important information about the obstruction site and degree in the upper airway of Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) patients in recent years. To make this acoustic signal analysis method more accurate and robust, big SRS data processing is inevitable. As an emerging concept and technology, cloud computing has motivated numerous researchers and engineers to exploit applications both in academic and industry field, which could have an ability to implement a huge blue print in biomedical engineering. Considering the security and transferring requirement of biomedical data, we designed a system based on private cloud computing to process SRS. Then we set the comparable experiments of processing a 5-hour audio recording of an OSAHS patient by a personal computer, a server and a private cloud computing system to demonstrate the efficiency of the infrastructure we proposed.
Basal Body and Striated Rootlet Changes in Primate Macular Retinal Pigmented Epithelium After Low Level Diffuse Argon Laser Radiation.

DTIC Science & Technology

1982-09-01

first two animals. In these exposed maculas , the outer seg- ments were separated from the RPE and the space was filled with proteinaceous fluid. No...separation was observed in the maculas of the occluded eyes or eyes of the third animal which showed a smaller increase in the number of BBs and SRs. The... maculas , the outer sepments were separate(. from the RPE and the space was fil led with proteinaceous fluid. No separation was observed in tht- macu],s
Batch Tests with IONSIV IE-911 and a Simulant of the Savannah River Site ''Average'' Supernatant: Distribution Ratios vs Time

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

Anderson, K.K.; Collins, J.L.; Hunt, R.D.

1999-02-01

The Department of Energy (DOE) is required by law to treat and safely dispose of the radioactive wastes from its nuclear weapon production activities. The primary radionuclide in the DOE liquid wastes or supernatants is {sup 137}Cs. At the Savannah River Site (SRS), the In-Tank Precipitation (ITP) process was selected as the baseline technology to remove {sup 137}Cs from the supernatants, which are stored in underground storage tanks. In the ITP process, tetraphenylborate reacts with the water-soluble cesium to form a precipitant. The treated supernatant can then be immobilized in grout or saltstone and stored in vaults at the SRS.more » However, problems were encountered during the full-scale ITP processing. These difficulties have led to the evaluation of alternative technologies and/or concepts to the currently configured ITP process. The High-Level Waste Salt Disposition Team at the SRS is currently performing this assessment. After an initial screening of all potential alternatives, the Salt Disposition Team selected four primary options to evaluate further before the final down-selection. Crystalline silicotitanate (CST), an inorganic ion exchanger, was chosen as one of the leading alternatives. Since nearly all of the CST tests have been performed on supernatants from Hanford and Oak Ridge, the Salt Disposition Team has requested that personnel at the SRS and Oak Ridge National Laboratory (ORNL) determine the performance of the engineered form of CST, IONSIV{reg_sign} IE-911, with actual and simulated SRS supernatants.« less
SRS SWPF Construction Completion

ScienceCinema

Craig, Jack; Sheppard, Frank; Marks, Pam

2018-01-16

Now that construction is complete, DOE and construction contractor Parsons, are focusing on testing the Savannah River Siteâs Salt Waste Processing Facility (SWPF) systems and training the workforce to operate the plant in preparation for the start of operations. Once in operation, the SWPF will significantly increase processing rates at SRS tank farms in an effort to empty the siteâs high-level radioactive waste tanks.
Phenotypic and genetic characterization of Piscirickettsia salmonis from Chilean and Canadian salmonids.

PubMed

Otterlei, Alexander; Brevik, Øyvind J; Jensen, Daniel; Duesund, Henrik; Sommerset, Ingunn; Frost, Petter; Mendoza, Julio; McKenzie, Peter; Nylund, Are; Apablaza, Patricia

2016-03-15

The study presents the phenotypic and genetic characterization of selected P. salmonis isolates from Atlantic salmon and rainbow trout suffering from SRS (salmonid rickettsial septicemia) in Chile and in Canada. The phenotypic characterization of the P. salmonis isolates were based on growth on different agar media (including a newly developed medium), different growth temperatures, antibiotics susceptibility and biochemical tests. This is the first study differentiating Chilean P. salmonis isolates into two separate genetic groups. Genotyping, based on 16S rRNA-ITS and concatenated housekeeping genes grouped the selected isolates into two clades, constituted by the Chilean strains, while the Canadian isolates form a branch in the phylogenetic tree. The latter consisted of two isolates that were different in both genetic and phenotypic characteristics. The phylogenies and the MLST do not reflect the origin of the isolates with respect to host species. The isolates included were heterogeneous in phenotypic tests. The genotyping methods developed in this study provided a tool for separation of P. salmonis isolates into distinct clades. The SRS outbreaks in Chile are caused by minimum two different genetic groups of P. salmonis. This heterogeneity should be considered in future development of vaccines against this bacterium in Chile. Two different strains of P. salmonis, in regards to genetic and phenotypic characteristics, can occur in the same contemporary outbreak of SRS.
Spectroscopic Evidence of Uranium Immobilization in Acidic ...

EPA Pesticide Factsheets

Biogeochemistry of uranium in wetlands plays important roles in U immobilization in storage ponds of U mining and processing facilities but has not been well understood. The objective of this work was to study molecular mechanisms responsible for high U retention by Savannah River Site (SRS) wetland sediments under varying redox and acidic (pH = 2.6-5.8) conditions using U L3-edge X-ray absorption spectroscopy. Uranium in the SRS wetland sediments existed primarily as U(VI) bonded as a bidentate to carboxylic sites (U-C bond distance at ~2.88 Å), rather than phenolic or other sites of natural organic matter (NOM). In microcosms simulating the SRS wetland process, U immobilization on roots was 2 orders of magnitude higher than on the adjacent brown or more distant white sands in which U was U(VI). Uranium on the roots were both U(IV) and U(VI), which were bonded as a bidentate to carbon, but the U(VI) may also form a U phosphate mineral. After 140 days of air exposure, all U(IV) was reoxidized to U(VI) but remained as a bidentate bonding to carbon. This study demonstrated NOM and plant roots can highly immobilize U(VI) in the SRS acidic sediments, which has significant implication on the long-term stewardship of U-contaminated wetlands. There were several former U processing facilities at the Savannah River Site (SRS), Aiken, SC. As a result of their operations, uranium has entered the surrounding environments. For example, approximately 45,000 kg o
Effect of the magnetic field on coexisting stimulated Raman and Brillouin backscattering of an extraordinary mode

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

Vyas, Ashish, E-mail: ashishvyas.optics@gmail.com; Singh, Ram Kishor, E-mail: ram007kishor@gmail.com; Sharma, R. P., E-mail: rpsharma@ces.iitd.ernet.in

2016-01-15

This paper presents a model to study the interplay between the stimulated Raman scattering (SRS) and stimulated Brillouin scattering (SBS) in the presence of background magnetic field. This formalism is applicable to laser produced plasma as well as to heating mechanism in toroidal system by an extraordinary electromagnetic wave. In the former case, the magnetic field is self-generated, while in the latter case (toroidal plasmas) magnetic field is applied externally. The behavior of one scattering process is explicitly dependent on the coexisting scattering process as well as on the magnetic field. Explicit expressions for the back-reflectivity of scattered beams (SRSmore » and SBS) are presented. It has been demonstrated that due to the magnetic field and coexistence of the scattering processes (SRS and SBS) the back-reflectivity gets modified significantly. Results are also compared with the three wave interaction case (isolated SRS or SBS case)« less
Thirty-year solid waste generation forecast for facilities at SRS

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

Not Available

1994-07-01

The information supplied by this 30-year solid waste forecast has been compiled as a source document to the Waste Management Environmental Impact Statement (WMEIS). The WMEIS will help to select a sitewide strategic approach to managing present and future Savannah River Site (SRS) waste generated from ongoing operations, environmental restoration (ER) activities, transition from nuclear production to other missions, and decontamination and decommissioning (D&D) programs. The EIS will support project-level decisions on the operation of specific treatment, storage, and disposal facilities within the near term (10 years or less). In addition, the EIS will provide a baseline for analysis ofmore » future waste management activities and a basis for the evaluation of the specific waste management alternatives. This 30-year solid waste forecast will be used as the initial basis for the EIS decision-making process. The Site generates and manages many types and categories of waste. With a few exceptions, waste types are divided into two broad groups-high-level waste and solid waste. High-level waste consists primarily of liquid radioactive waste, which is addressed in a separate forecast and is not discussed further in this document. The waste types discussed in this solid waste forecast are sanitary waste, hazardous waste, low-level mixed waste, low-level radioactive waste, and transuranic waste. As activities at SRS change from primarily production to primarily decontamination and decommissioning and environmental restoration, the volume of each waste s being managed will change significantly. This report acknowledges the changes in Site Missions when developing the 30-year solid waste forecast.« less
SU-E-T-128: Applying Failure Modes and Effects Analysis to a Risk-Based Quality Management for Stereotactic Radiosurgery in Brazil

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

Teixeira, F; Universidade do Estado do Rio de Janeiro, Rio De Janeiro, RJ; Almeida, C de

2015-06-15

Purpose: The goal of the present work was to evaluate the process maps for stereotactic radiosurgery (SRS) treatment at three radiotherapy centers in Brazil and apply the FMEA technique to evaluate similarities and differences, if any, of the hazards and risks associated with these processes. Methods: A team, consisting of professionals from different disciplines and involved in the SRS treatment, was formed at each center. Each team was responsible for the development of the process map, and performance of FMEA and FTA. A facilitator knowledgeable in these techniques led the work at each center. The TG100 recommended scales were usedmore » for the evaluation of hazard and severity for each step for the major process “treatment planning”. Results: Hazard index given by the Risk Priority Number (RPN) is found to range from 4–270 for various processes and the severity (S) index is found to range from 1–10. The RPN values > 100 and severity value ≥ 7 were chosen to flag safety improvement interventions. Number of steps with RPN ≥100 were found to be 6, 59 and 45 for the three centers. The corresponding values for S ≥ 7 are 24, 21 and 25 respectively. The range of RPN and S values for each center belong to different process steps and failure modes. Conclusion: These results show that interventions to improve safety is different for each center and it is associated with the skill level of the professional team as well as the technology used to provide radiosurgery treatment. The present study will very likely be a model for implementation of risk-based prospective quality management program for SRS treatment in Brazil where currently there are 28 radiotherapy centers performing SRS. A complete FMEA for SRS for these three radiotherapy centers is currently under development.« less
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
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.
[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.
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
MPST Software: MoonKommand

NASA Technical Reports Server (NTRS)

Kwok, John H.; Call, Jared A.; Khanampornpan, Teerapat

2012-01-01

This software automatically processes Sally Ride Science (SRS) delivered MoonKAM camera control files (ccf) into uplink products for the GRAIL-A and GRAIL-B spacecraft as part of an education and public outreach (EPO) extension to the Grail Mission. Once properly validated and deemed safe for execution onboard the spacecraft, MoonKommand generates the command products via the Automated Sequence Processor (ASP) and generates uplink (.scmf) files for radiation to the Grail-A and/or Grail-B spacecraft. Any errors detected along the way are reported back to SRS via email. With Moon Kommand, SRS can control their EPO instrument as part of a fully automated process. Inputs are received from SRS as either image capture files (.ccficd) for new image requests, or downlink/delete files (.ccfdl) for requesting image downlink from the instrument and on-board memory management. The Moon - Kommand outputs are command and file-load (.scmf) files that will be uplinked by the Deep Space Network (DSN). Without MoonKommand software, uplink product generation for the MoonKAM instrument would be a manual process. The software is specific to the Moon - KAM instrument on the GRAIL mission. At the time of this writing, the GRAIL mission was making final preparations to begin the science phase, which was scheduled to continue until June 2012.
Stimulated Raman scattering holography for time-resolved imaging of methane gas.

PubMed

Amer, Eynas; Gren, Per; Edenharder, Stefan; Sjödahl, Mikael

2016-05-01

In this paper, pulsed digital holographic detection is coupled to the stimulated Raman scattering (SRS) process for imaging gases. A Q-switched Nd-YAG laser (532 nm) has been used to pump methane gas (CH₄) at pressures up to 12 bars. The frequency-tripled (355 nm) beam from the same laser was used to pump an optical parametric oscillator (OPO). The Stokes beam (from the OPO) has been tuned to 629.93 nm so that the frequency difference between the pump (532 nm) and the Stokes beams fits a Raman active vibrational mode of the methane molecule (2922 cm^-1). The pump beam has been spatially modulated with fringes produced in a Michelson interferometer. The pump and the Stokes beams were overlapped in time, space, and polarization on the gas molecules, resulting in a stimulated Raman gain of the Stokes beam and a corresponding loss of the pump beam through the SRS process. The resulting gain of the Stokes beam has been detected using pulsed digital holography by blending it with a reference beam on the detector. Two holograms of the Stokes beam, without and with the pump beam fringes present, were recorded. Intensity maps calculated from the recorded digital holograms showed amplification of the Stokes beam at the position of overlap with the pump beam fringes and the gas molecules. The gain of the Stokes beam has been separated from the background in the Fourier domain. A gain of about 4.5% at a pump beam average intensity of 4 MW/cm² and a Stokes beam intensity of 0.16 MW/cm² have been recorded at a gas pressure of 12 bars. The gain decreased linearly with decreasing gas pressure. The results show that SRS holography is a promising technique to pinpoint a specific species and record its spatial and temporal distribution.
Clinical response to Vim's thalamic stereotactic radiosurgery for essential tremor is associated with distinctive functional connectivity patterns.

PubMed

Tuleasca, Constantin; Najdenovska, Elena; Régis, Jean; Witjas, Tatiana; Girard, Nadine; Champoudry, Jérôme; Faouzi, Mohamed; Thiran, Jean-Philippe; Cuadra, Meritxell Bach; Levivier, Marc; Van De Ville, Dimitri

2018-03-01

Essential tremor (ET) is the most common movement disorder. Drug-resistant ET can benefit from standard surgical stereotactic procedures (deep brain stimulation, thalamotomy) or minimally invasive high-intensity focused ultrasound (HIFU) or stereotactic radiosurgical thalamotomy (SRS-T). Resting-state fMRI (rs-fMRI) is a non-invasive imaging method acquired in absence of a task. We examined whether rs-fMRI correlates with tremor score on the treated hand (TSTH) improvement 1 year after SRS-T. We included 17 consecutive patients treated with left unilateral SRS-T in Marseille, France. Tremor score evaluation and rs-fMRI were acquired at baseline and 1 year after SRS-T. Resting-state data (34 scans) were analyzed without a priori hypothesis, in Lausanne, Switzerland. Based on degree of improvement in TSTH, to consider SRS-T at least as effective as medication, we separated two groups: 1, ≤ 50% (n = 6, 35.3%); 2, > 50% (n = 11, 64.7%). They did not differ statistically by age (p = 0.86), duration of symptoms (p = 0.41), or lesion volume at 1 year (p = 0.06). We report TSTH improvement correlated with interconnectivity strength between salience network with the left claustrum and putamen, as well as between bilateral motor cortices, frontal eye fields and left cerebellum lobule VI with right visual association area (the former also with lesion volume). Longitudinal changes showed additional associations in interconnectivity strength between right dorsal attention network with ventro-lateral prefrontal cortex and a reminiscent salience network with fusiform gyrus. Brain connectivity measured by resting-state fMRI relates to clinical response after SRS-T. Relevant networks are visual, motor, and attention. Interconnectivity between visual and motor areas is a novel finding, revealing implication in movement sensory guidance.
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.

Metastatic brain cancer: prediction of response to whole-brain helical tomotherapy with simultaneous intralesional boost for metastatic disease using quantitative MR imaging features

NASA Astrophysics Data System (ADS)

Sharma, Harish; Bauman, Glenn; Rodrigues, George; Bartha, Robert; Ward, Aaron

2014-03-01

The sequential application of whole brain radiotherapy (WBRT) and more targeted stereotactic radiosurgery (SRS) is frequently used to treat metastatic brain tumors. However, SRS has side effects related to necrosis and edema, and requires separate and relatively invasive localization procedures. Helical tomotherapy (HT) allows for a SRS-type simultaneous infield boost (SIB) of multiple brain metastases, synchronously with WBRT and without separate stereotactic procedures. However, some patients' tumors may not respond to HT+SIB, and would be more appropriately treated with radiosurgery or conventional surgery despite the additional risks and side effects. As a first step toward a broader objective of developing a means for response prediction to HT+SIB, the goal of this study was to investigate whether quantitative measurements of tumor size and appearance (including first- and second-order texture features) on a magnetic resonance imaging (MRI) scan acquired prior to treatment could be used to differentiate responder and nonresponder patient groups after HT+SIB treatment of metastatic disease of the brain. Our results demonstrated that smaller lesions may respond better to this form of therapy; measures of appearance provided limited added value over measures of size for response prediction. With further validation on a larger data set, this approach may lead to a means for prediction of individual patient response based on pre-treatment MRI, supporting appropriate therapy selection for patients with metastatic brain cancer.
Why SRS Matters - K Area

ScienceCinema

Hunt, Paul; Lawson, Janice

2018-06-22

A video series presenting an overview of the Savannah River Site (SRS) mission and operations. Each episode features a specific area/operation and how it contributes to help make the world safer. This episode features K Area's mission and operations. K area is the former production reactor that's been re-purposed to serve as a plutonium processing and storage facility.
Onset and saturation of backward stimulated Raman scattering of laser in trapping regime in three spatial dimensions

NASA Astrophysics Data System (ADS)

Yin, L.; Albright, B. J.; Rose, H. A.; Bowers, K. J.; Bergen, B.; Montgomery, D. S.; Kline, J. L.; Fernández, J. C.

2009-11-01

A suite of three-dimensional (3D) VPIC [K. J. Bowers et al., Phys. Plasmas 15, 055703 (2008)] particle-in-cell simulations of backward stimulated Raman scattering (SRS) in inertial confinement fusion hohlraum plasma has been performed on the heterogeneous multicore supercomputer, Roadrunner, presently the world's most powerful supercomputer. These calculations reveal the complex nonlinear behavior of SRS and point to a new era of "at scale" 3D modeling of SRS in solitary and multiple laser speckles. The physics governing nonlinear saturation of SRS in a laser speckle in 3D is consistent with that of prior two-dimensional (2D) studies [L. Yin et al., Phys. Rev. Lett. 99, 265004 (2007)], but with important differences arising from enhanced diffraction and side loss in 3D compared with 2D. In addition to wave front bowing of electron plasma waves (EPWs) due to trapped electron nonlinear frequency shift and amplitude-dependent damping, we find for the first time that EPW self-focusing, which evolved from trapped particle modulational instability [H. A. Rose and L. Yin, Phys. Plasmas 15, 042311 (2008)], also exhibits loss of angular coherence by formation of a filament necklace, a process not available in 2D. These processes in 2D and 3D increase the side-loss rate of trapped electrons, increase wave damping, decrease source coherence for backscattered light, and fundamentally limit how much backscatter can occur from a laser speckle. For both SRS onset and saturation, the nonlinear trapping induced physics is not captured in linear gain modeling of SRS. A simple metric is described for using single-speckle reflectivities obtained from VPIC simulations to infer the total reflectivity from the population of laser speckles of amplitude sufficient for significant trapping-induced nonlinearity to arise.
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
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.
The effect of time-of-flight and point spread function modeling on 82Rb myocardial perfusion imaging of obese patients.

PubMed

Dasari, Paul K R; Jones, Judson P; Casey, Michael E; Liang, Yuanyuan; Dilsizian, Vasken; Smith, Mark F

2018-06-15

The effect of time-of-flight (TOF) and point spread function (PSF) modeling in image reconstruction has not been well studied for cardiac PET. This study assesses their separate and combined influence on 82 Rb myocardial perfusion imaging in obese patients. Thirty-six obese patients underwent rest-stress 82 Rb cardiac PET. Images were reconstructed with and without TOF and PSF modeling. Perfusion was quantitatively compared using the AHA 17-segment model for patients grouped by BMI, cross-sectional body area in the scanner field of view, gender, and left ventricular myocardial volume. Summed rest scores (SRS), summed stress scores (SSS), and summed difference scores (SDS) were compared. TOF improved polar map visual uniformity and increased septal wall perfusion by up to 10%. This increase was greater for larger patients, more evident for patients grouped by cross-sectional area than by BMI, and more prominent for females. PSF modeling increased perfusion by about 1.5% in all cardiac segments. TOF modeling generally decreased SRS and SSS with significant decreases between 2.4 and 3.0 (P < .05), which could affect risk stratification; SDS remained about the same. With PSF modeling, SRS, SSS, and SDS were largely unchanged. TOF and PSF modeling affect regional and global perfusion, SRS, and SSS. Clinicians should consider these effects and gender-dependent differences when interpreting 82 Rb perfusion studies.
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.
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.
Vector solitons in coupled nonlinear Schrödinger equations with spatial stimulated scattering and inhomogeneous dispersion

NASA Astrophysics Data System (ADS)

Gromov, E. M.; Malomed, B. A.; Tyutin, V. V.

2018-01-01

The dynamics of two-component solitons is studied, analytically and numerically, in the framework of a system of coupled extended nonlinear Schrödinger equations, which incorporate the cross-phase modulation, pseudo-stimulated-Raman-scattering (pseudo-SRS), cross-pseudo-SRS, and spatially inhomogeneous second-order dispersion (SOD). The system models co-propagation of electromagnetic waves with orthogonal polarizations in plasmas. It is shown that the soliton's wavenumber downshift, caused by pseudo-SRS, may be compensated by an upshift, induced by the inhomogeneous SOD, to produce stable stationary two-component solitons. The corresponding approximate analytical solutions for stable solitons are found. Analytical results are well confirmed by their numerical counterparts. Further, the evolution of inputs composed of spatially even and odd components is investigated by means of systematic simulations, which reveal three different outcomes: formation of a breather which keeps opposite parities of the components; splitting into a pair of separating vector solitons; and spreading of the weak odd component into a small-amplitude pedestal with an embedded dark soliton.
Effects of variables upon pyrotechnically induced shock response spectra, part 2

NASA Technical Reports Server (NTRS)

Smith, James Lee

1988-01-01

Throughout the aerospace industry, large variations of 50 percent (6 dB) or more in shock response spectra (SRS) derived from pyrotechnic separation events continue to be reported from actual spaceflight data and from laboratory tests. As a result of these variations, NASA funded a research program for 1984 through 1986. The purpose of the 1984 through 1986 project was to analyze variations in pyrotechnically induced SRS and to determine if and to what degree manufacturing and assembly variables and tolerances, distance from the shock source, data acquisition instrumentation, and shock energy propagation affect the SRS. Sixty-four free-free boundary plate tests were performed. NASA funded an additional study for 1987 through 1988. This paper is a summary of the additional study. The purpose was to evaluate shock dissipation through various spacecraft structural joint types, to evaluate shock variation for various manufacturing and assembly variables on clamped boundary test plates, and to verify data correction techniques. Five clamped boundary plate tests investigated manufacturing and assembly variables and mass loading effects. Six free-free boundary plate tests investigated shock dissipation across spacecraft joint structures.
Reliability and concurrent validity of the adapted Chinese version of Scoliosis Research Society-22 (SRS-22) questionnaire.

PubMed

Cheung, Kenneth M C; Senkoylu, Alpaslan; Alanay, Ahmet; Genc, Yasemin; Lau, Sarah; Luk, Keith D

2007-05-01

Validation study to define validity and reliability of an adapted and translated questionnaire. Assessment of the concurrent validity and reliability of a Chinese version of SRS-22 outcome instrument. No valid health-related quality of life (HRQL) outcome instrument exists for patients with spinal deformity in Chinese. The modified SRS-22 questionnaire was proven to be an appropriate outcome instrument in English, and has already been translated and validated in several other languages. The English version of the SRS-22 questionnaire was adapted to Chinese according to the International Quality of Life Assessment Project guidelines. To assess reliability, 48 subjects with adolescent idiopathic scoliosis (mean age, 16.5 years) filled the questionnaire on 2 separate occasions (Group 1). To assess concurrent validity, 50 subjects (mean age, 21 years) filled in the same questionnaire and a previously validated Chinese version of the Short Form-36 (SF36) questionnaire (Group 2). Internal consistency, reproducibility and concurrent validity were determined with Cronbach's alpha coefficient, interclass correlation coefficient and Pearson correlation coefficient, respectively. Cronbach's alpha coefficient for the 4 major domains (function/activity, pain, self-image/appearance and mental health) were high. Intraclass correlation was also excellent for all domains. For concurrent validity, excellent correlation was found in 1 domain, good in 12 domains, moderate in 3 domains, and poor in 1 domain of the 17 relevant domains. Both cultural adaptation and linguistic translation are essential in any attempt to use a HRQL questionnaire across cultures. The Chinese version of the SRS-22 outcome instrument has satisfactory internal consistency and excellent reproducibility. It is ready for use in clinical studies on idiopathic scoliosis in Chinese-speaking societies.
Building upon Historical Competencies: Next-generation Clean-up Technologies for World-Wide Application - 13368

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

Guevara, K.C.; Fellinger, A.P.; Aylward, R.S.

The Department of Energy's Savannah River Site has a 60-year history of successfully operating nuclear facilities and cleaning up the nuclear legacy of the Cold War era through the processing of radioactive and otherwise hazardous wastes, remediation of contaminated soil and groundwater, management of nuclear materials, and deactivation and decommissioning of excess facilities. SRS recently unveiled its Enterprise.SRS (E.SRS) strategic vision to identify and facilitate application of the historical competencies of the site to current and future national and global challenges. E.SRS initiatives such as the initiative to Develop and Demonstrate Next generation Clean-up Technologies seek timely and mutually beneficialmore » engagements with entities around the country and the world. One such ongoing engagement is with government and industry in Japan in the recovery from the devastation of the Fukushima Daiichi Nuclear Power Station. (authors)« less
Environmental assessment for the construction, operation, and decommissioning of the Waste Segregation Facility at the Savannah River Site

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

NONE

1998-01-01

This Environmental Assessment (EA) has been prepared by the Department of Energy (DOE) to assess the potential environmental impacts associated with the construction, operation and decontamination and decommissioning (D&D) of the Waste Segregation Facility (WSF) for the sorting, shredding, and compaction of low-level radioactive waste (LLW) at the Savannah River Site (SRS) located near Aiken, South Carolina. The LLW to be processed consists of two waste streams: legacy waste which is currently stored in E-Area Vaults of SRS and new waste generated from continuing operations. The proposed action is to construct, operate, and D&D a facility to process low-activity job-controlmore » and equipment waste for volume reduction. The LLW would be processed to make more efficient use of low-level waste disposal capacity (E-Area Vaults) or to meet the waste acceptance criteria for treatment at the Consolidated Incineration Facility (CIF) at SRS.« less
Application of failure mode and effects analysis to intracranial stereotactic radiation surgery by linear accelerator.

PubMed

Masini, Laura; Donis, Laura; Loi, Gianfranco; Mones, Eleonora; Molina, Elisa; Bolchini, Cesare; Krengli, Marco

2014-01-01

The aim of this study was to analyze the application of the failure modes and effects analysis (FMEA) to intracranial stereotactic radiation surgery (SRS) by linear accelerator in order to identify the potential failure modes in the process tree and adopt appropriate safety measures to prevent adverse events (AEs) and near-misses, thus improving the process quality. A working group was set up to perform FMEA for intracranial SRS in the framework of a quality assurance program. FMEA was performed in 4 consecutive tasks: (1) creation of a visual map of the process; (2) identification of possible failure modes; (3) assignment of a risk probability number (RPN) to each failure mode based on tabulated scores of severity, frequency of occurrence and detectability; and (4) identification of preventive measures to minimize the risk of occurrence. The whole SRS procedure was subdivided into 73 single steps; 116 total possible failure modes were identified and a score of severity, occurrence, and detectability was assigned to each. Based on these scores, RPN was calculated for each failure mode thus obtaining values from 1 to 180. In our analysis, 112/116 (96.6%) RPN values were <60, 2 (1.7%) between 60 and 125 (63, 70), and 2 (1.7%) >125 (135, 180). The 2 highest RPN scores were assigned to the risk of using the wrong collimator's size and incorrect coordinates on the laser target localizer frame. Failure modes and effects analysis is a simple and practical proactive tool for systematic analysis of risks in radiation therapy. In our experience of SRS, FMEA led to the adoption of major changes in various steps of the SRS procedure.
People and Decisions: Meeting the Information Needs of Managers

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

Blake, J.I.; LeMaster, E.

2000-10-01

The information needs of managers with respect to avian species at the SRS are identified. The process by which information is integrated into decision making are discussed. Numerous studies of upland bird species at SRS were conducted as part of the DOE Biodiversity Program. This information is being incorporated into biological assessments and plan through modeling and geographic information systems.
Why SRS Matters - H Canyon

ScienceCinema

Hunt, Paul; Lewczyk, Mike; Swain, Mike

2018-06-22

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 features H Canyon's mission and operations. H Canyon and its adjoining H B Line facility represent the last full-scale radio chemical processing capabilities left in the United States.
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
Cross-cultural comparison of the Scoliosis Research Society Outcomes Instrument between American and Japanese idiopathic scoliosis patients: are there differences?

PubMed

Watanabe, Kei; Lenke, Lawrence G; Bridwell, Keith H; Hasegawa, Kazuhiro; Hirano, Toru; Endo, Naoto; Cheh, Gene; Kim, Yongjung J; Hensley, Marsha; Stobbs, Georgia; Koester, Linda

2007-11-15

A comparative study. To report a preliminary evaluation of the Scoliosis Research Society Outcomes Instrument (SRS-24) and determine whether differences in baseline scores exist between American and Japanese patients with idiopathic scoliosis. Because the SRS outcomes instrument was primarily introduced for the American population, baseline scores in the Japanese population might differ from the American population. A comparative study using the SRS instrument between American and Japanese patients with idiopathic scoliosis has not been reported. Two comparable groups of 100 idiopathic scoliosis patients before spinal fusion were separated into American (A) and Japanese (J). There were no statistically significant differences between the groups for gender (A: 9 men/91 women vs. J: 13 men/87 women), age (A: 15.0 +/- 2.4 vs. J: 14.9 +/- 3.8), main curve location (A: 77 thoracic/23 lumbar, J: 76 thoracic/24 lumbar), main curve Cobb angle (A: 50.5 +/- 5.2 vs. J: 51.1 +/- 8.7), and thoracic kyphosis (A: 20.9 +/- 14.3 vs. J: 19.9 +/- 12.1) (P > 0.05, for all comparisons). Patients were evaluated using the first section of the SRS-24 which was divided into 4 domains: total pain, general self-image, general function, and activity. SRS-24 scores were statistical compared in individual domains and questions using the Mann-Whitney U test. American patients had significantly lower scores in pain (P < 0.0001, A: 3.7 +/- 0.8 vs. J: 4.3 +/- 0.4), function (P < 0.01, A: 3.9 +/- 0.6 vs. J: 4.2 +/- 0.5), and activity (P < 0.0001, A: 4.5 +/- 0.8 vs. J: 4.9 +/- 0.3) domains compared with Japanese patients. Japanese patients had significantly lower scores in the self-image (P < 0.0001, A: 4.0 +/- 0.7 vs. J: 3.5 +/- 0.5) domain. With regard to individual questions, there were significant differences in the scores between the 2 groups for all questions except 5 and 13 (P < 0.05, for all comparisons). SRS-24 scores in the Japanese idiopathic scoliosis population differed from that of the American population. Japanese patients had less back pain, a negative self-image regarding back deformity, higher general physical function, and daily activity. It is highly probable that patient's perceptions differ due to cultural differences, which affect SRS-24 scores so a cross-cultural comparison of the SRS instrument content is necessary in the future.
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.
DOE Office of Scientific and Technical Information (OSTI.GOV)

Herman, D.

The Savannah River Site (SRS) Actinide Removal Process has been processing salt waste since 2008. This process includes a filtration step in the 512-S facility. Initial operations included the addition, or strike, of monosodium titanate (MST) to remove soluble actinides and strontium. The added MST and any entrained sludge solids were then separated from the supernate by cross flow filtration. During this time, the filter operations have, on many occasions, been the bottleneck process limiting the rate of salt processing. Recently, 512-S- has started operations utilizing “No-MST” where the MST actinide removal strike was not performed and the supernate wasmore » simply pre-filtered prior to Cs removal processing. Direct filtration of decanted tank supernate, as demonstrated in 512-S, is the proposed method of operation for the Hanford Low Activity Waste Pretreatment System (LAWPS) facility. Processing decanted supernate without MST solids has been demonstrated for cross flow filtration to provide a significant improvement in production with the SRS Salt Batches 8 and 9 feed chemistries. The average filtration rate for the first 512-S batch processing cycle using No-MST has increased filtrate production by over 35% of the historical average. The increase was sustained for more than double the amount of filtrate batches processed before cleaning of the filter was necessary. While there are differences in the design of the 512-S and Hanford filter systems, the 512-S system should provide a reasonable indication of LAWPS filter performance with similar feed properties. Based on the data from the 512-S facility and with favorable feed properties, the LAWPS filter, as currently sized at over twice the size of the 512-S filter (532 square feet filtration area versus 235 square feet), has the potential to provide sustained filtrate production at the upper range of the planned LAWPS production rate of 17 gpm.« less

Exact and Heuristic Algorithms for Runway Scheduling

NASA Technical Reports Server (NTRS)

Malik, Waqar A.; Jung, Yoon C.

2016-01-01

This paper explores the Single Runway Scheduling (SRS) problem with arrivals, departures, and crossing aircraft on the airport surface. Constraints for wake vortex separations, departure area navigation separations and departure time window restrictions are explicitly considered. The main objective of this research is to develop exact and heuristic based algorithms that can be used in real-time decision support tools for Air Traffic Control Tower (ATCT) controllers. The paper provides a multi-objective dynamic programming (DP) based algorithm that finds the exact solution to the SRS problem, but may prove unusable for application in real-time environment due to large computation times for moderate sized problems. We next propose a second algorithm that uses heuristics to restrict the search space for the DP based algorithm. A third algorithm based on a combination of insertion and local search (ILS) heuristics is then presented. Simulation conducted for the east side of Dallas/Fort Worth International Airport allows comparison of the three proposed algorithms and indicates that the ILS algorithm performs favorably in its ability to find efficient solutions and its computation times.
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
Feasibility of an Orthogonal Redundant Sensor incorporating Optical plus Redundant Electrochemical Glucose Sensing.

PubMed

McAuley, Sybil A; Dang, Tri T; Horsburgh, Jodie C; Bansal, Anubhuti; Ward, Glenn M; Aroyan, Sarkis; Jenkins, Alicia J; MacIsaac, Richard J; Shah, Rajiv V; O'Neal, David N

2016-05-01

Orthogonal redundancy for glucose sensing (multiple sensing elements utilizing distinct methodologies) may enhance performance compared to nonredundant sensors, and to sensors with multiple elements utilizing the same technology (simple redundancy). We compared the performance of a prototype orthogonal redundant sensor (ORS) combining optical fluorescence and redundant electrochemical sensing via a single insertion platform to an electrochemical simple redundant sensor (SRS). Twenty-one adults with type 1 diabetes wore an ORS and an SRS concurrently for 7 days. Following sensor insertion, and on Day 4 with a standardized meal, frequent venous samples were collected for reference glucose measurement (laboratory [YSI] and meter) over 3 and 4 hours, respectively. Between study visits reference capillary blood glucose testing was undertaken. Sensor data were processed prospectively. ORS mean absolute relative difference (MARD) was (mean ± SD) 10.5 ± 13.2% versus SRS 11.0 ± 10.4% (P = .34). ORS values in Clarke error grid zones A and A+B were 88.1% and 97.6%, respectively, versus SRS 86.4% and 97.8%, respectively (P = .23 and P = .84). ORS Day 1 MARD (10.7 ± 10.7%) was superior to SRS (16.5 ± 13.4%; P < .0001), and comparable to ORS MARD for the week. ORS sensor survival (time-averaged mean) was 92.1% versus SRS 74.4% (P = .10). ORS display time (96.0 ± 5.8%) was equivalent to SRS (95.6 ± 8.9%; P = .87). Combining simple and orthogonal sensor redundancy via a single insertion is feasible, with accuracy comparing favorably to current generation nonredundant sensors. Addition of an optical component potentially improves sensor reliability compared to electrochemical sensing alone. Further improvement in optical sensing performance is required prior to clinical application. © 2016 Diabetes Technology Society.
RTEL1 maintains genomic stability by suppressing homologous recombination.

PubMed

Barber, Louise J; Youds, Jillian L; Ward, Jordan D; McIlwraith, Michael J; O'Neil, Nigel J; Petalcorin, Mark I R; Martin, Julie S; Collis, Spencer J; Cantor, Sharon B; Auclair, Melissa; Tissenbaum, Heidi; West, Stephen C; Rose, Ann M; Boulton, Simon J

2008-10-17

Homologous recombination (HR) is an important conserved process for DNA repair and ensures maintenance of genome integrity. Inappropriate HR causes gross chromosomal rearrangements and tumorigenesis in mammals. In yeast, the Srs2 helicase eliminates inappropriate recombination events, but the functional equivalent of Srs2 in higher eukaryotes has been elusive. Here, we identify C. elegans RTEL-1 as a functional analog of Srs2 and describe its vertebrate counterpart, RTEL1, which is required for genome stability and tumor avoidance. We find that rtel-1 mutant worms and RTEL1-depleted human cells share characteristic phenotypes with yeast srs2 mutants: lethality upon deletion of the sgs1/BLM homolog, hyperrecombination, and DNA damage sensitivity. In vitro, purified human RTEL1 antagonizes HR by promoting the disassembly of D loop recombination intermediates in a reaction dependent upon ATP hydrolysis. We propose that loss of HR control after deregulation of RTEL1 may be a critical event that drives genome instability and cancer.
An automatic method for detection and classification of Ionospheric Alfvén Resonances using signal and image processing techniques

NASA Astrophysics Data System (ADS)

Beggan, Ciaran

2014-05-01

Induction coils permit us to measure the very rapid changes of the magnetic field. In June 2012, the British Geological Survey Geomagnetism team installed two high frequency (100 Hz) induction coil magnetometers at the Eskdalemuir Observatory (55.3° N, 3.2° W, L~3), in the Scottish Borders of the United Kingdom. The Eskdalemuir Observatory is one of the longest running geophysical sites in the UK (beginning operation in 1908) and is located in a rural valley with a quiet magnetic environment. The coils record magnetic field changes over an effective frequency range of about 0.1-40Hz, and encompass phenomena such as the Schumann resonances, magnetospheric pulsations and Ionospheric Alfvén Resonances (IAR). In this study we focus on the IAR, which are related to the vibration of magnetic field lines passing through the ionosphere, believed to be mainly excited by lower atmospheric electrical discharges. The IAR typically manifest as a series of spectral resonances structures (SRS) within the 1-6Hz frequency range, usually appearing a fine bands or fringes in spectrogram plots. The SRS tend to occur daily between 18.00-06.00UT at the Eskdalemuir site, disappearing during the daylight hours. They usually start as a single low frequency before bifurcating into 5-10 separate fringes, increasing in frequency until around midnight. The fringes also widen in frequency before fading around 06.00UT. Occasionally, the fringes decrease in frequency slightly around 03.00UT before fading. In order to quantify the daily, seasonal and annual changes of the SRS, we developed a new method to identify the fringes and to quantify their occurrence in frequency (f) and the change in frequency (Δf). The method uses short time-series of 100 seconds to produce an FFT spectral plot from which the non-stationary peaks are identified using the residuals from a best-fit six order spline. This is repeated for an entire day of data. The peaks from each time-slice are placed into a matrix which is then treated as an image. In combination with the spectrogram image of that day, the SRS are identified using image processing techniques. The peaks can now be mapped as continuous lines throughout the spectrogram. Finally, we can investigate the f and Δf statistics over the entire length of the dataset. We intend to run the coils as a long term experiment. The data and code are available on request.
Impact of Glycolate Anion on Aqueous Corrosion in DWPF and Downstream Facilities

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

Mickalonis, J.

Glycolic acid is being evaluated as an alternate reductant in the preparation of high level waste for the Defense Waste Processing Facility (DWPF) at the Savannah River Site (SRS). During processing, the glycolic acid may not be completely consumed with small quantities of the glycolate anion being carried forward to other high level waste (HLW) facilities. The SRS liquid waste contractor requested an assessment of the impact of the glycolate anion on the corrosion of the materials of construction (MoC) throughout the waste processing system since this impact had not been previously evaluated. A literature review revealed that corrosion datamore » were not available for the MoCs in glycolic-bearing solutions applicable to SRS systems. Data on the material compatibility with only glycolic acid or its derivative products were identified; however, data were limited for solutions containing glycolic acid or the glycolate anion. For the proprietary coating systems applied to the DWPF concrete, glycolic acid was deemed compatible since the coatings were resistant to more aggressive chemistries than glycolic acid. Additionally, similar coating resins showed acceptable resistance to glycolic acid.« less
Impact of Glycolate Anion on Aqueous Corrosion in DWPF and Downstream Facilities

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

Mickalonis, J.

Glycolic acid is being evaluated as an alternate reductant in the preparation of high level waste for the Defense Waste Processing Facility (DWPF) at the Savannah River Site (SRS). During processing, the glycolic acid may not be completely consumed with small quantities of the glycolate anion being carried forward to other high level waste (HLW) facilities. The SRS liquid waste contractor requested an assessment of the impact of the glycolate anion on the corrosion of the materials of construction (MoC) throughout the waste processing system since this impact had not been previously evaluated. A literature review revealed that corrosion datamore » were not available for the MoCs in glycolic-bearing solutions applicable to SRS systems. Data on the material compatibility with only glycolic acid or its derivative products were identified; however, data were limited for solutions containing glycolic acid or the glycolate anion. For the proprietary coating systems applied to the DWPF concrete, glycolic acid was deemed compatible since the coatings were resistant to more aggressive chemistries than glycolic acid. Additionally similar coating resins showed acceptable resistance to glycolic acid.« less
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.
Defense Waste Processing Facility Process Enhancements

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

Bricker, Jonathan

2010-11-01

Jonathan Bricker provides an overview of process enhancements currently being done at the Defense Waste Processing Facility (DWPF) at SRS. Some of these enhancements include: melter bubblers; reduction in water use, and alternate reductant.
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
Search strategies in systematic reviews in periodontology and implant dentistry.

PubMed

Faggion, Clovis M; Atieh, Momen A; Park, Stephanie

2013-09-01

To perform an overview of literature search strategies in systematic reviews (SRs) published in periodontology and implant dentistry. Two electronic databases (PubMed and Cochrane Database of SRs) were searched, independently and in duplicate, for SRs with meta-analyses on interventions, with the last search performed on 11 November 2012. Manual searches of the reference lists of included SRs and 10 specialty dental journals were conducted. Methodological issues of the search strategies of included SRs were assessed with Cochrane collaboration guidelines and AMSTAR recommendations. The search strategies employed in Cochrane and paper-based SRs were compared. A total of 146 SRs with meta-analyses were included, including 19 Cochrane and 127 paper-based SRs. Some issues, such as "the use of keywords," were reported in most of the SRs (86%). Other issues, such as "search of grey literature" and "language restriction," were not fully reported (34% and 50% respectively). The quality of search strategy reporting in Cochrane SRs was better than that of paper-based SRs for seven of the eight criteria assessed. There is room for improving the quality of reporting of search strategies in SRs in periodontology and implant dentistry, particularly in SRs published in paper-based journals. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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.
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.
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.
In vivo chemical and structural analysis of plant cuticular waxes using stimulated Raman scattering microscopy.

PubMed

Littlejohn, George R; Mansfield, Jessica C; Parker, David; Lind, Rob; Perfect, Sarah; Seymour, Mark; Smirnoff, Nicholas; Love, John; Moger, Julian

2015-05-01

The cuticle is a ubiquitous, predominantly waxy layer on the aerial parts of higher plants that fulfils a number of essential physiological roles, including regulating evapotranspiration, light reflection, and heat tolerance, control of development, and providing an essential barrier between the organism and environmental agents such as chemicals or some pathogens. The structure and composition of the cuticle are closely associated but are typically investigated separately using a combination of structural imaging and biochemical analysis of extracted waxes. Recently, techniques that combine stain-free imaging and biochemical analysis, including Fourier transform infrared spectroscopy microscopy and coherent anti-Stokes Raman spectroscopy microscopy, have been used to investigate the cuticle, but the detection sensitivity is severely limited by the background signals from plant pigments. We present a new method for label-free, in vivo structural and biochemical analysis of plant cuticles based on stimulated Raman scattering (SRS) microscopy. As a proof of principle, we used SRS microscopy to analyze the cuticles from a variety of plants at different times in development. We demonstrate that the SRS virtually eliminates the background interference compared with coherent anti-Stokes Raman spectroscopy imaging and results in label-free, chemically specific confocal images of cuticle architecture with simultaneous characterization of cuticle composition. This innovative use of the SRS spectroscopy may find applications in agrochemical research and development or in studies of wax deposition during leaf development and, as such, represents an important step in the study of higher plant cuticles. © 2015 American Society of Plant Biologists. All Rights Reserved.

The Natural Enrichment of Stable Cesium in Weathered Micaceous Materials and Its Implications for 137Cs Sorption.

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

Elliott, W. Crawford; Kahn, Bernd; Rosson, Robert

2011-11-14

In this exploratory project, we are testing two interrelated hypotheses about the sorption of Cs within weathered micaceous materials in subsurface regolith materials from the Savannah River Site (SRS) located on the Atlantic Coastal Plain: 1) that stable cesium has become significantly enriched relative to potassium in subsurface micaceous particles as a result of chemical weathering processes; and 2) that the Cs so present is sufficient to be a major factor determining the ability of the subsurface materials to take up and hold 137Cs. To test these hypotheses, we collected by hand augur soil samples corresponding to soils representative atmore » the SRS: upland regolith (Fuquay series); soils formed on Tobacco Road Sandstone; and, soils formed on Quaternary Alluvium. From our data, the quantification of the amounts of stable cesium concentrated in various sites within 2:1 phyllosilicates by natural processes is highly relevant toward understanding the future sorption of 137Cs by the mica, illite, vermiculite, and hydroxyl interstratified vermiculite (HIV) phases present in the subsurface at and in proximity to SRS. Studying sorption and fixation of Cs in these micaceous phases interlayers potentially leads to increased knowledge to the extent that stable Cs resists exchange with ion exchange cations (Mg, NH4, or even alkyl ammonium compounds) and to the extent that Cs can become fixed over the long term. Such knowledge will help in the development of 137Cs remediation strategies for the long-term, which is a critical aspect of the SBR goals. We characterized the mineralogy, K-Ar ages of the soil and soil clay fractions (before and after acid treatment), and alkali element chemistry (K, Rb, Cs) of the clay fractions of soils collected from these three different types of soils. The clay fractions of the Fuquay soils are composed of kaolinite, and hydroxy interstratified vermiculite (HIV). Kaolinite, HIV, quartz, gibbsite and illite are found in the quaternary soils. Leach experiments using 10% nitric acid and 50% nitric acid were performed on 62 mesh fractions to show the amounts of Cs and Rb relative to K (Cs/K, Rb/K) that are exchangeable in these soils compared to Coastal Plain micas and upper continental crust. The Cs/K and Rb/K of the leachates are considerably higher relative to both upper continental crust and relative to weathered micas found in Georgia Coast Plain sediments. The K-Ar ages of the clay fractions of five different SRS soil series were ca. 320 Ma. After leaching with nitric acid, the ages of the soil clay fractions were approximately the same as the unleached soil clays. Based on the similarity of these ages to the ages of Coastal Plain micas, the K and Ar remaining after treatment is believed to be enclosed in a relect mica in the HIV phases in the soils. The HIV is likely a mica-HIV intergrade. Based on these data, stable cesium has become significantly enriched relative to potassium in subsurface micaceous particles as a result of chemical weathering processes in the SRS Fuquay soils studied thus far. Our data permit the interpretation describing the sorption of Cs and Rb in an apex site or in a hard to reach hard-to-exchange sorption site during pedogenesis. In terms of testing the second hypothesis, our work is ongoing and we report some preliminary data on Cs-137 and Rb-85 exchange experiments on select SRS Fuquay soils (-2 mm). Our isotopic equilibration experiments using Cs and Rb isotopes in separate exchange experiments show only small amounts of Cs and Rb in the original sample is exchangeable isotopically for a period of a few weeks in acidified conditions. The isotope exchange experiments provide support for our interpretation that pedogenically accumulated Cs (and Rb) occupy sites that are unavailable to exchange or exchange slowly in acid conditions corresponding to present conditions in SRS soils. In more basic solutions, greater exchange isotopic exchange is noted and suggests an expansion of interlayer sites thereby permitting more isotopic exchange of Cs and Rb.« less
Spectroscopic evidence of uranium immobilization in acidic wetlands by natural organic matter and plant roots.

PubMed

Li, Dien; Kaplan, Daniel I; Chang, Hyun-Shik; Seaman, John C; Jaffé, Peter R; Koster van Groos, Paul; Scheckel, Kirk G; Segre, Carlo U; Chen, Ning; Jiang, De-Tong; Newville, Matthew; Lanzirotti, Antonio

2015-03-03

Biogeochemistry of uranium in wetlands plays important roles in U immobilization in storage ponds of U mining and processing facilities but has not been well understood. The objective of this work was to study molecular mechanisms responsible for high U retention by Savannah River Site (SRS) wetland sediments under varying redox and acidic (pH = 2.6-5.8) conditions using U L3-edge X-ray absorption spectroscopy. Uranium in the SRS wetland sediments existed primarily as U(VI) bonded as a bidentate to carboxylic sites (U-C bond distance at ∼2.88 Å), rather than phenolic or other sites of natural organic matter (NOM). In microcosms simulating the SRS wetland processes, U immobilization on roots was 2 orders of magnitude higher than on the adjacent brown or more distant white sands in which U was U(VI). Uranium on the roots were both U(IV) and U(VI), which were bonded as a bidentate to carbon, but the U(VI) may also form a U phosphate mineral. After 140 days of air exposure, all U(IV) was reoxidized to U(VI) but remained as a bidentate bonding to carbon. This study demonstrated NOM and plant roots can highly immobilize U(VI) in the SRS acidic sediments, which has significant implication for the long-term stewardship of U-contaminated wetlands.
Spectroscopic evidence of uranium immobilization in acidic wetlands by natural organic matter and plant roots

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

Li, Dien; Kaplan, Daniel I.; Chang, Hyun-Shik

Biogeochemistry of uranium in wetlands plays important roles in U immobilization in storage ponds of U mining and processing facilities but has not been well understood. The objective of this work was to study molecular mechanisms responsible for high U retention by Savannah River Site (SRS) wetland sediments under varying redox and acidic (pH = 2.6–5.8) conditions using U L₃-edge X-ray absorption spectroscopy. Uranium in the SRS wetland sediments existed primarily as U(VI) bonded as a bidentate to carboxylic sites (U–C bond distance at ~2.88 Å), rather than phenolic or other sites of natural organic matter (NOM). In microcosms simulatingmore » the SRS wetland processes, U immobilization on roots was two orders of magnitude higher than on the adjacent brown or more distant white sands in which U was U(VI). Uranium on the roots were both U(IV) and U(VI), which were bonded as a bidentate to carbon, but the U(VI) may also form a U phosphate mineral. After 140 days of air exposure, all U(IV) was re-oxidized to U(VI) but remained as a bidentate bonding to carbon. This study demonstrated NOM and plant roots can highly immobilize U(VI) in the SRS acidic sediments, which has significant implication for the long-term stewardship of U-contaminated wetlands.« less
Spectroscopic evidence of uranium immobilization in acidic wetlands by natural organic matter and plant roots

DOE PAGES

Li, Dien; Kaplan, Daniel I.; Chang, Hyun-Shik; ...

2015-03-03

Biogeochemistry of uranium in wetlands plays important roles in U immobilization in storage ponds of U mining and processing facilities but has not been well understood. The objective of this work was to study molecular mechanisms responsible for high U retention by Savannah River Site (SRS) wetland sediments under varying redox and acidic (pH = 2.6–5.8) conditions using U L₃-edge X-ray absorption spectroscopy. Uranium in the SRS wetland sediments existed primarily as U(VI) bonded as a bidentate to carboxylic sites (U–C bond distance at ~2.88 Å), rather than phenolic or other sites of natural organic matter (NOM). In microcosms simulatingmore » the SRS wetland processes, U immobilization on roots was two orders of magnitude higher than on the adjacent brown or more distant white sands in which U was U(VI). Uranium on the roots were both U(IV) and U(VI), which were bonded as a bidentate to carbon, but the U(VI) may also form a U phosphate mineral. After 140 days of air exposure, all U(IV) was re-oxidized to U(VI) but remained as a bidentate bonding to carbon. This study demonstrated NOM and plant roots can highly immobilize U(VI) in the SRS acidic sediments, which has significant implication for the long-term stewardship of U-contaminated wetlands.« less
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.
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.
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.
Epidemiology and Reporting Characteristics of Systematic Reviews of Biomedical Research: A Cross-Sectional Study.

PubMed

Page, Matthew J; Shamseer, Larissa; Altman, Douglas G; Tetzlaff, Jennifer; Sampson, Margaret; Tricco, Andrea C; Catalá-López, Ferrán; Li, Lun; Reid, Emma K; Sarkis-Onofre, Rafael; Moher, David

2016-05-01

Systematic reviews (SRs) can help decision makers interpret the deluge of published biomedical literature. However, a SR may be of limited use if the methods used to conduct the SR are flawed, and reporting of the SR is incomplete. To our knowledge, since 2004 there has been no cross-sectional study of the prevalence, focus, and completeness of reporting of SRs across different specialties. Therefore, the aim of our study was to investigate the epidemiological and reporting characteristics of a more recent cross-section of SRs. We searched MEDLINE to identify potentially eligible SRs indexed during the month of February 2014. Citations were screened using prespecified eligibility criteria. Epidemiological and reporting characteristics of a random sample of 300 SRs were extracted by one reviewer, with a 10% sample extracted in duplicate. We compared characteristics of Cochrane versus non-Cochrane reviews, and the 2014 sample of SRs versus a 2004 sample of SRs. We identified 682 SRs, suggesting that more than 8,000 SRs are being indexed in MEDLINE annually, corresponding to a 3-fold increase over the last decade. The majority of SRs addressed a therapeutic question and were conducted by authors based in China, the UK, or the US; they included a median of 15 studies involving 2,072 participants. Meta-analysis was performed in 63% of SRs, mostly using standard pairwise methods. Study risk of bias/quality assessment was performed in 70% of SRs but was rarely incorporated into the analysis (16%). Few SRs (7%) searched sources of unpublished data, and the risk of publication bias was considered in less than half of SRs. Reporting quality was highly variable; at least a third of SRs did not report use of a SR protocol, eligibility criteria relating to publication status, years of coverage of the search, a full Boolean search logic for at least one database, methods for data extraction, methods for study risk of bias assessment, a primary outcome, an abstract conclusion that incorporated study limitations, or the funding source of the SR. Cochrane SRs, which accounted for 15% of the sample, had more complete reporting than all other types of SRs. Reporting has generally improved since 2004, but remains suboptimal for many characteristics. An increasing number of SRs are being published, and many are poorly conducted and reported. Strategies are needed to help reduce this avoidable waste in research.
ANNUAL RADIOACTIVE WASTE TANK INSPECTION PROGRAM - 2011

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

West, B.; Waltz, R.

2012-06-21

Aqueous radioactive wastes from Savannah River Site (SRS) separations and vitrification processes are contained in large underground carbon steel tanks. Inspections made during 2011 to evaluate these vessels and other waste handling facilities along with evaluations based on data from previous inspections are the subject of this report. The 2011 inspection program revealed that the structural integrity and waste confinement capability of the Savannah River Site waste tanks were maintained. All inspections scheduled per SRR-LWE-2011-00026, HLW Tank Farm Inspection Plan for 2011, were completed. Ultrasonic measurements (UT) performed in 2011 met the requirements of C-ESR-G-00006, In-Service Inspection Program for Highmore » Level Waste Tanks, Rev. 3, and WSRC-TR-2002-00061, Rev.6. UT inspections were performed on Tanks 25, 26 and 34 and the findings are documented in SRNL-STI-2011-00495, Tank Inspection NDE Results for Fiscal Year 2011, Waste Tanks 25, 26, 34 and 41. A total of 5813 photographs were made and 835 visual and video inspections were performed during 2011. A potential leaksite was discovered at Tank 4 during routine annual inspections performed in 2011. The new crack, which is above the allowable fill level, resulted in no release to the environment or tank annulus. The location of the crack is documented in C-ESR-G-00003, SRS High Level Waste Tank Leaksite Information, Rev.6.« 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.
Librarian co-authors correlated with higher quality reported search strategies in general internal medicine systematic reviews.

PubMed

Rethlefsen, Melissa L; Farrell, Ann M; Osterhaus Trzasko, Leah C; Brigham, Tara J

2015-06-01

To determine whether librarian and information specialist authorship was associated with better reported systematic review (SR) search quality. SRs from high-impact general internal medicine journals were reviewed for search quality characteristics and reporting quality by independent reviewers using three instruments, including a checklist of Institute of Medicine Recommended Standards for the Search Process and a scored modification of the Peer Review of Electronic Search Strategies instrument. The level of librarian and information specialist participation was significantly associated with search reproducibility from reported search strategies (Χ(2) = 23.5; P < 0.0001). Librarian co-authored SRs had significantly higher odds of meeting 8 of 13 analyzed search standards than those with no librarian participation and six more than those with mentioned librarian participation. One-way ANOVA showed that differences in total search quality scores between all three groups were statistically significant (F2,267 = 10.1233; P < 0.0001). Problems remain with SR search quality and reporting. SRs with librarian or information specialist co-authors are correlated with significantly higher quality reported search strategies. To minimize bias in SRs, authors and editors could encourage librarian engagement in SRs including authorship as a potential way to help improve documentation of the search strategy. Copyright © 2015 Elsevier Inc. All rights reserved.
Split-root systems applied to the study of the legume-rhizobial symbiosis: what have we learned?

PubMed

Larrainzar, Estíbaliz; Gil-Quintana, Erena; Arrese-Igor, Cesar; González, Esther M; Marino, Daniel

2014-12-01

Split-root system (SRS) approaches allow the differential treatment of separate and independent root systems, while sharing a common aerial part. As such, SRS is a useful tool for the discrimination of systemic (shoot origin) versus local (root/nodule origin) regulation mechanisms. This type of approach is particularly useful when studying the complex regulatory mechanisms governing the symbiosis established between legumes and Rhizobium bacteria. The current work provides an overview of the main insights gained from the application of SRS approaches to understand how nodule number (nodulation autoregulation) and nitrogen fixation are controlled both under non-stressful conditions and in response to a variety of stresses. Nodule number appears to be mainly controlled at the systemic level through a signal which is produced by nodule/root tissue, translocated to the shoot, and transmitted back to the root system, involving shoot Leu-rich repeat receptor-like kinases. In contrast, both local and systemic mechanisms have been shown to operate for the regulation of nitrogenase activity in nodules. Under drought and heavy metal stress, the regulation is mostly local, whereas the application of exogenous nitrogen seems to exert a regulation of nitrogen fixation both at the local and systemic levels. © 2014 Institute of Botany, Chinese Academy of Sciences.
Novel Fission-Product Separation based on Room-Temperature Ionic Liquids

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

Rogers, Robin D.

2004-12-31

U.S. DOE's underground storage tanks at Hanford, SRS, and INEEL contain liquid wastes with high concentrations of radioactive cesium-137 and strontium-90. Because the primary chemical components of alkaline supernatants are sodium nitrate and sodium hydroxide, the majority of this could be disposed of as low level waste if radioactive cesium-137 and strontium- 90 could be selectively removed. The underlying goal of this project was to investigate the application of ionic liquids as novel solvents for new solvent extraction processes for separation of cesium-137 and strontium-90 from tank wastes. Ionic liquids are a distinct sub-set of liquids, comprising only of cationsmore » and anions they are proving to be increasingly interesting fluids for application in systems from electrochemistry to energetic materials, and are also rapidly establishing their promise as viable media for synthesis and separations operations. Properties including low melting points, electrochemical conductivity, wide liquid ranges, lack of vapor-pressure, and chemical tunability have encouraged researchers to explore the uses of ILs in place of volatile organic solvents. The most promising current developments arise from control of the unique combinations of chemical and physical properties characteristic of ionic liquids.« less
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
Special raster scanning for reduction of charging effects in scanning electron microscopy.

PubMed

Suzuki, Kazuhiko; Oho, Eisaku

2014-01-01

A special raster scanning (SRS) method for reduction of charging effects is developed for the field of SEM. Both a conventional fast scan (horizontal direction) and an unusual scan (vertical direction) are adopted for acquiring raw data consisting of many sub-images. These data are converted to a proper SEM image using digital image processing techniques. About sharpness of the image and reduction of charging effects, the SRS is compared with the conventional fast scan (with frame-averaging) and the conventional slow scan. Experimental results show the effectiveness of SRS images. By a successful combination of the proposed scanning method and low accelerating voltage (LV)-SEMs, it is expected that higher-quality SEM images can be more easily acquired by the considerable reduction of charging effects, while maintaining the resolution. © 2013 Wiley Periodicals, Inc.
Epidemiology and Reporting Characteristics of Systematic Reviews of Biomedical Research: A Cross-Sectional Study

PubMed Central

Page, Matthew J.; Shamseer, Larissa; Altman, Douglas G.; Tetzlaff, Jennifer; Tricco, Andrea C.; Catalá-López, Ferrán; Li, Lun; Reid, Emma K.; Sarkis-Onofre, Rafael; Moher, David

2016-01-01

Background Systematic reviews (SRs) can help decision makers interpret the deluge of published biomedical literature. However, a SR may be of limited use if the methods used to conduct the SR are flawed, and reporting of the SR is incomplete. To our knowledge, since 2004 there has been no cross-sectional study of the prevalence, focus, and completeness of reporting of SRs across different specialties. Therefore, the aim of our study was to investigate the epidemiological and reporting characteristics of a more recent cross-section of SRs. Methods and Findings We searched MEDLINE to identify potentially eligible SRs indexed during the month of February 2014. Citations were screened using prespecified eligibility criteria. Epidemiological and reporting characteristics of a random sample of 300 SRs were extracted by one reviewer, with a 10% sample extracted in duplicate. We compared characteristics of Cochrane versus non-Cochrane reviews, and the 2014 sample of SRs versus a 2004 sample of SRs. We identified 682 SRs, suggesting that more than 8,000 SRs are being indexed in MEDLINE annually, corresponding to a 3-fold increase over the last decade. The majority of SRs addressed a therapeutic question and were conducted by authors based in China, the UK, or the US; they included a median of 15 studies involving 2,072 participants. Meta-analysis was performed in 63% of SRs, mostly using standard pairwise methods. Study risk of bias/quality assessment was performed in 70% of SRs but was rarely incorporated into the analysis (16%). Few SRs (7%) searched sources of unpublished data, and the risk of publication bias was considered in less than half of SRs. Reporting quality was highly variable; at least a third of SRs did not report use of a SR protocol, eligibility criteria relating to publication status, years of coverage of the search, a full Boolean search logic for at least one database, methods for data extraction, methods for study risk of bias assessment, a primary outcome, an abstract conclusion that incorporated study limitations, or the funding source of the SR. Cochrane SRs, which accounted for 15% of the sample, had more complete reporting than all other types of SRs. Reporting has generally improved since 2004, but remains suboptimal for many characteristics. Conclusions An increasing number of SRs are being published, and many are poorly conducted and reported. Strategies are needed to help reduce this avoidable waste in research. PMID:27218655
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.

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
Single-Isocenter Multiple-Target Stereotactic Radiosurgery: Risk of Compromised Coverage

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

Roper, Justin, E-mail: justin.roper@emory.edu; Department of Biostatistics and Bioinformatics, Winship Cancer Institute of Emory University, Atlanta, Georgia; Chanyavanich, Vorakarn

2015-11-01

Purpose: To determine the dosimetric effects of rotational errors on target coverage using volumetric modulated arc therapy (VMAT) for multitarget stereotactic radiosurgery (SRS). Methods and Materials: This retrospective study included 50 SRS cases, each with 2 intracranial planning target volumes (PTVs). Both PTVs were planned for simultaneous treatment to 21 Gy using a single-isocenter, noncoplanar VMAT SRS technique. Rotational errors of 0.5°, 1.0°, and 2.0° were simulated about all axes. The dose to 95% of the PTV (D95) and the volume covered by 95% of the prescribed dose (V95) were evaluated using multivariate analysis to determine how PTV coverage was relatedmore » to PTV volume, PTV separation, and rotational error. Results: At 0.5° rotational error, D95 values and V95 coverage rates were ≥95% in all cases. For rotational errors of 1.0°, 7% of targets had D95 and V95 values <95%. Coverage worsened substantially when the rotational error increased to 2.0°: D95 and V95 values were >95% for only 63% of the targets. Multivariate analysis showed that PTV volume and distance to isocenter were strong predictors of target coverage. Conclusions: The effects of rotational errors on target coverage were studied across a broad range of SRS cases. In general, the risk of compromised coverage increased with decreasing target volume, increasing rotational error and increasing distance between targets. Multivariate regression models from this study may be used to quantify the dosimetric effects of rotational errors on target coverage given patient-specific input parameters of PTV volume and distance to isocenter.« less
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.
Selective suppression of CARS signal with three-beam competing stimulated Raman scattering processes.

PubMed

Choi, Dae Sik; Rao, B Jayachander; Kim, Doyeon; Shim, Sang-Hee; Rhee, Hanju; Cho, Minhaeng

2018-06-14

Coherent Raman scattering spectroscopy and microscopy are useful methods for studying the chemical and biological structures of molecules with Raman-active modes. In particular, coherent anti-Stokes Raman scattering (CARS) microscopy, which is a label-free method capable of imaging structures by displaying the vibrational contrast of the molecules, has been widely used. However, the lack of a technique for switching-off the CARS signal has prevented the development of the super-resolution Raman imaging method. Here, we demonstrate that a selective suppression of the CARS signal is possible by using a three-beam double stimulated Raman scattering (SRS) scheme; the three beams are the pump, Stokes, and depletion lights in order of frequency. Both pump-Stokes and pump-depletion beam pairs can generate SRS processes by tuning their beat frequencies to match two different vibrational modes, then two CARS signals induced by pump-Stokes-pump and pump-depletion-pump interactions can be generated, where the two CARS signals are coupled with each other because they both involve interactions with the common pump beam. Herein, we show that as the intensity of the depletion beam is increased, one can selectively suppress the pump-Stokes-pump CARS signal because the pump-depletion SRS depletes the pump photons. A detailed theoretical description of the coupled differential equations for the three incident fields and the generated CARS signal fields is presented. Taking benzene as a molecular system, we obtained a maximum CARS suppression efficiency of about 97% with our experimental scheme, where the ring breathing mode of the benzene is associated with pump-Stokes-pump CARS, while the C-H stretching mode is associated with the competing pump-depletion SRS process. We anticipate that this selective switching-off scheme will be of use in developing super-resolution label-free CARS microscopy.
Commercial integration and partnering at Savannah River Site

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

Steele, J.R.; Babione, R.A.; Shikashio, L.A.

1994-06-01

Savannah River Site (SRS), particularly the Savannah River Technology Center (SRTC) with the experience from the first successful Integrated Technology Demonstration, can provide an excellent foundation for meeting DOE-EM`s objectives with the new DOE-EM five focus area approach. With this in mind, SRTC established an activity to pursue full commercialization of environmental technologies. This report is an assessment of the status of commercialization at SRS and provides recommendations for enhancement as well as some tools critical to implementation. A review was made of the current situation at SRS with regards to taking technology development to commercial fruition. This was donemore » from the perspective of comparing it to known commercialization models and processes. It was found that SRTC already works through many of the steps in these processes. With integration and action-oriented efforts of the inclusion of business and market factors, SRTC could become an aggressive, successful developer of commercialized technologies. Commercial success criteria tools were developed with regards to integrating them with SRTC selection criteria to ensure that all critical factors are covered in technology commercialization project evaluations. Private investors are very clear that their interest lies in funding commercial enterprises, not merely technologies. Mobilizing private capital is critical to real job growth and long-term economic development. Also, potential industry partners were identified that are willing to be involved with SRS` technology applications and regional development efforts. As another important component to success, regional support organizations were reviewed and evaluated.« less
The SRS-Viewer: A Software Tool for Displaying and Evaluation of Pyroshock Data

NASA Astrophysics Data System (ADS)

Eberl, Stefan

2014-06-01

For the evaluation of the success of a pyroshock, the time domain and the corresponding Shock-Response- Spectra (SRS) have to be considered. The SRS-Viewer is an IABG developed software tool [1] to read data in Universal File format (*.unv) and either display or plot for each accelerometer the time domain, corresponding SRS and the specified Reference-SRS with tolerances in the background.The software calculates the "Average (AVG)", "Maximum (MAX)" and "Minimum (MIN)" SRS of any selection of accelerometers. A statistical analysis calculates the percentages of measured SRS above the specified Reference-SRS level and the percentage within the tolerance bands for comparison with the specified success criteria.Overlay plots of single accelerometers of different test runs enable to monitor the repeatability of the shock input and the integrity of the specimen. Furthermore the difference between the shock on a mass-dummy and the real test unit can be examined.
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
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.
Validity and reliability of an adapted Thai version of Scoliosis Research Society-22 questionnaire for adolescent idiopathic scoliosis.

PubMed

Sathira-Angkura, Vera; Pithankuakul, Kongkit; Sakulpipatana, Susana; Piyaskulkaew, Chaiwat; Kunakornsawat, Sombat

2012-04-20

Cross-sectional observational study to investigate psychometric properties of an adapted Thai version of the refined Scoliosis Research Society-22 (SRS-22) questionnaire. To evaluate the reliability and validity of the adapted Thai version of the refined SRS-22 questionnaire. The SRS-22 questionnaire is a valid instrument for assessing the health-related quality of life for patients with adolescent idiopathic scoliosis. Recently, the questionnaire has been translated and validated in many languages for non-English-speaking countries. Translation/retranslation of the English version of the SRS-22 was conducted, and the cross-cultural adaptation process was performed. The Thai version SRS-22 and previously validated Thai version Short-Form survey version 2.0 (SF-36V2) questionnaires were administered to 77 patients with adolescent idiopathic scoliosis who had surgical treatment. Fifty-eight patients (52 adolescent girls) had filled out the first set of questionnaires. Thirty patients of the first-time responders completed the second set of questionnaires. The mean age at the time of operation was 14.6 years and the mean age at the time of the final follow-up was 18.7 years. The mean preoperative scoliosis curve magnitude was 55.4° (range, 30°-95°) and postoperative curve magnitude was 20.1° (range, 0°-60°). Internal consistency was determined with Cronbach α coefficient. Intraclass correlation coefficient was used for test-retest reliability. Concurrent validity was evaluated by comparing SRS-22 domains with relevant domains in the SF-36V2 questionnaire, using the Pearson correlation coefficient. The mean overall Cronbach α coefficient of the adapted Thai version SRS-22 was 0.76. The 2 of corresponding domains (mental health = 0.80 and self-image = 0.83) had satisfactory internal consistency and the remaining domains (pain = 0.78; function/activity = 0.74; and satisfaction = 0.76) were good. The intraclass correlation coefficient for 5 domains was ranged from 0.79 to 0.90, which demonstrated the satisfactory test/retest reproducibility. The concurrent validity, determined by the Pearson correlation coefficient between SRS-22 and SF-36V2 domains, had a good correlation for 15 relevant comparisons (r = 0.50-0.75). The adapted Thai version of the SRS-22 questionnaire had validity and reliability, which can be used to assess the outcome of treatment among Thai-speaking patients with adolescent idiopathic scoliosis.
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.
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
Preserving Plutonium-244 as a National Asset

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

Patton, Bradley D; Alexander, Charles W; Benker, Dennis

Plutonium-244 (244 Pu) is an extremely rare and long-lived isotope of plutonium with a half-life of 80 million years. Measureable amounts of 244 Pu are found in neither reactor-grade nor weapons-grade plutonium. Production of this isotope requires a very high thermal flux to permit the two successive neutron captures that convert 242 Pu to 243 Pu to 244 Pu, particularly given the short (about 5 hour) half-life of 243 Pu. Such conditions simply do not exist in plutonium production processes. Therefore, 244 Pu is ideal for precise radiochemical analyses measuring plutonium material properties and isotopic concentrations in items containing plutonium.more » Isotope dilution mass spectrometry is about ten times more sensitive when using 244 Pu rather than 242 Pu for determining plutonium isotopic content. The isotope can also be irradiated in small quantities to produce superheavy elements. The majority of the existing global inventory of 244 Pu is contained in the outer housing of Mark-18A targets at the Savannah River Site (SRS). The total inventory is about 20 grams of 244 Pu in about 400 grams of plutonium distributed among the 65 targets. Currently, there are no specific plans to preserve these targets. Although the cost of separating and preserving this material would be considerable, it is trivial in comparison to new production costs. For all practical purposes, the material is irreplaceable, because new production would cost billions of dollars and require a series of irradiation and chemical separation cycles spanning up to 50 years. This paper will discuss a set of options for overcoming the significant challenges to preserve the 244 Pu as a National Asset: (1) the need to relocate the material from SRS in a timely manner, (2) the need to reduce the volume of material to the extent possible for storage, and (3) the need to establish an operational capability to enrich the 244 Pu in significant quantities. This paper suggests that if all the Mark-18A plutonium is separated, it would occupy a small volume and would be inexpensive to store while an enrichment capability is developed. Very small quantities could be enriched in existing mass separators to support critical needs.« less
Phytoremediation of Trichloroethylene and Perchloroethylene at the Savannah River Site

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

Brigmon, R.L.

Bioremediation of chlorinated solvents, both natural and accelerated, is exemplified by phytoremediation and biodegradation by rhizosphere microorganisms. Phytoremediation is the use of vegetation for the treatment of contaminated soils, sediments, and water. The potential for phytoremediation of chlorinated solvents has been demonstrated at the Savannah River Site (SRS) Miscellaneous Chemical Basin, Southern Sector of A/M Area and TNX/D-Area. Recent characterization work at the SRS has delineated widespread plumes (1-2 miles) of low concentration (40 ppb -10-ppm range) trichloroethylene (TCE) and perchloroethylene (PCE) contaminated groundwater. Phytoremediation deployments are underway for TCE and PCE phytoremediation in select SRS areas. Phytoremediation appears tomore » be an excellent technology to intercept and control plume migration. The ongoing Southern Sector treatability study is part of a multi-year field study of SRS seepline-soil systems maintained under saturated conditions. The primary focus is on determining how trees, seepline groundcover, soil microbial communities, and geochemical and surface-volatilization processes affect TCE and PCE in contaminated groundwater that flows through surface seepline areas. Therefore, FY00 represented an initial acclimation phase for soil and plant systems and will facilitate examination of seepline phyto- and bioactivity in subsequent growth season in FY01.« 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
Effect of Sodium Hydroxide Pretreatment of UOP IONSIV IE-911 Crystalline Silicotitanate Sorbent

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

Wilmarth, W.R.

2000-08-29

Use of crystalline silicotitanate (CST) to remove cesium represents one of the alternatives identified for High Level Waste pretreatment at the Savannah River Site (SRS). Previous deployment of CST in the Department of Energy complex subjected the material to mildly caustic environments. Processing of SRS waste will expose CST to very alkaline solutions for extended period of time (typically 12 months in the proposed design). Results of elevated temperature stability tests showed that silicon and one of the proprietary materials leached from the CST. UOP personnel indicated to SRS personnel that these materials exist in the sorbent in excess ofmore » required stoichiometry. The authors examined the pretreatment of CST with sodium hydroxide to remove these components prior to placing the CST in radioactive service. Additionally, researchers analyzed solids discovered in the feed line during a test by non-destructive techniques.« less
Observations of stimulated Raman scattering and laser-induced breakdown in millimeter-sized droplets

NASA Technical Reports Server (NTRS)

Biswas, A.; Pinnick, R. G.; Xie, J.-G.; Ruekgauer, T. E.; Armstrong, R. L.

1992-01-01

We report the first observations, to our knowledge, of nonlinear optical effects in large (millimeter-sized) droplets. Stimulated Raman scattering (SRS) and laser-induced breakdown (LIB) are simultaneously observed in acoustically levitated millimeter-sized glycerol droplets irradiated by either a frequency-doubled (532-nm) or a frequency-tripled (355-nm) Nd:YAG laser. The two processes, which occur above a nearby coincident irradiation threshold, are conjectured to arise from a common initiation mechanism: self-focusing. LIB generates vapor bubbles within the droplet, resulting in the quenching of SRS emission.
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.
The EBI SRS server-new features.

PubMed

Zdobnov, Evgeny M; Lopez, Rodrigo; Apweiler, Rolf; Etzold, Thure

2002-08-01

Here we report on recent developments at the EBI SRS server (http://srs.ebi.ac.uk). SRS has become an integration system for both data retrieval and sequence analysis applications. The EBI SRS server is a primary gateway to major databases in the field of molecular biology produced and supported at EBI as well as European public access point to the MEDLINE database provided by US National Library of Medicine (NLM). It is a reference server for latest developments in data and application integration. The new additions include: concept of virtual databases, integration of XML databases like the Integrated Resource of Protein Domains and Functional Sites (InterPro), Gene Ontology (GO), MEDLINE, Metabolic pathways, etc., user friendly data representation in 'Nice views', SRSQuickSearch bookmarklets. SRS6 is a licensed product of LION Bioscience AG freely available for academics. The EBI SRS server (http://srs.ebi.ac.uk) is a free central resource for molecular biology data as well as a reference server for the latest developments in data integration.
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.
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
ANNUAL RADIOACTIVE WASTE TANK INSPECTION PROGRAM- 2007

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

West, B; Ruel Waltz, R

2008-06-05

Aqueous radioactive wastes from Savannah River Site (SRS) separations and vitrification processes are contained in large underground carbon steel tanks. The 2007 inspection program revealed that the structural integrity and waste confinement capability of the Savannah River Site waste tanks were maintained. A very small amount of material had seeped from Tank 12 from a previously identified leaksite. The material observed had dried on the tank wall and did not reach the annulus floor. A total of 5945 photographs were made and 1221 visual and video inspections were performed during 2007. Additionally, ultrasonic testing was performed on four Waste Tanksmore » (15, 36, 37 and 38) in accordance with approved inspection plans that met the requirements of WSRC-TR-2002- 00061, Revision 2 'In-Service Inspection Program for High Level Waste Tanks'. The Ultrasonic Testing (UT) In-Service Inspections (ISI) are documented in a separate report that is prepared by the ISI programmatic Level III UT Analyst. Tanks 15, 36, 37 and 38 are documented in 'Tank Inspection NDE Results for Fiscal Year 2007'; WSRC-TR-2007-00064.« less
The Social Responsiveness Scale in relation to DSM IV and DSM5 ASD in Korean Children

PubMed Central

Cheon, Keun-Ah; Park, Jee-In; Koh, Yun-Joo; Song, Jungeun; Hong, Hyun-Joo; Kim, Young-Kee; Lim, Eun-Chung; Kwon, Hojang; Ha, Mina; Lim, Myung-Ho; Paik, Ki-Chung; Constantino, John N.; Leventhal, Bennett; Kim, Young Shin

2017-01-01

LAY ABSTRACT The Social Responsiveness Scale(SRS) is an autism rating scales in widespread use, with over 20 official foreign language translations. It has proven highly feasible for quantitative ascertainment of autistic social impairment in public health settings, however, little is known about the validity of the reinforcement in Asia populations or in references to DSM5. The current study aims to evaluate psychometric properties and cross-cultural aspects of the SRS-Korean version (K-SRS). Our results indicate that the K-SRS exhibits adequate reliability and validity for measuring Autism Spectrum Disorder (ASD) symptoms in Korean children with DSM IV PDD and DSM5 ASD. Our findings further suggest that it is difficult to distinguish Social Communication Disorder (SCD) from other child psychiatric conditions using the K-SRS. This is the first study to examine the relationship between the SRS subscales and DSM5 based clinical diagnosis. This study provides cross-cultural confirmation of the factor structure of ASD symptoms and traits measured by the SRS. SCIENTIFIC ABSTRACT The Social Responsiveness Scale(SRS) is an autism rating scales in widespread use, with over 20 official foreign language translations. It has proven highly feasible for quantitative ascertainment of autistic social impairment in public health settings, however, little is known about the validity of the reinforcement in Asia populations or in references to DSM5. The current study aims to evaluate psychometric properties and cross-cultural aspects of the SRS-Korean version(K-SRS). The study subjects were ascertained from three samples: a general sample from 3 regular education elementary schools(n=790), a clinical sample(n=154) of 6–12-year-olds from four psychiatric clinics, and an epidemiological sample of children with ASD, diagnosed using both DSM IV PDD, DSM5 ASD and SCD criteria(n=151). Their parents completed the K-SRS and the Autism Spectrum Screening Questionnaire(ASSQ). Descriptive statistics, correlation analyses and principal components analysis (PCA) were performed on the total population. Mean total scores on the K-SRS differed significantly between the three samples. ASSQ scores were significantly correlated with the K-SRS T-scores. PCA suggested a one-factor solution for the total population. Our results indicate that the K-SRS exhibits adequate reliability and validity for measuring ASD symptoms in Korean children with DSM IV PDD and DSM5 ASD. Our findings further suggest that it is difficult to distinguish SCD from other child psychiatric conditions using the K-SRS. This is the first study to examine the relationship between the SRS subscales and DSM5-based clinical diagnoses. This study provides cross-cultural confirmation of the factor structure for ASD symptoms and traits measured by the SRS. PMID:27604989
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.
Spontaneous Raman Scattering Diagnostics: Applications in Practical Combustion Systems. Chapter 5

NASA Technical Reports Server (NTRS)

Kojima, Jun; Viet-Nguyen, Quang; Lackner, Maximilian (Editor); Winter, Franz (Editor); Agarwal, Avinash (Editor)

2010-01-01

In this chapter, the recent advancements and practical aspects of laser SRS diagnostics have been reviewed wi til regards to applications in practical combustion systems. Clearly, SRS represents a theoretically and experimentally mature diagnostic technology that has become an essential tool for multiscalar measurements in turbulent combustion at elevated pressures. Today, time-, space-, spectrally, and even polarization-resolved S RS diagnostics is at hand, with aid from recent innovations in theoretical and technological developments on electro-optical or electromechanical devices. Whilst a linear increase in SRS signals can be expected in high-pressure systems (this is perhaps one of the most important advantages for using SRS in high-pressure systems), there are practical (often severe) restrictions associated with pressurized vessels, due mainly to the limited degree of optical access. This narrows ti,e available choice of diagnostics that can be employed at any given time. Point-wise SRS diagnostics provides the highest accuracy on the chemical species and temperature measurements, and will continue to remain a vital approach for the study in such harsh environments. The practical design considerations and hands-on set-up guide for SRS diagnostics provided in this chapter are rarely presented elsewhere. Although the second-harmonic Nd:YAG pulsed laser (532 nm), combined with pulse-stretching optics or the recently introduced White Cell-based laser, seems to be the most favored excitation source of choice by the research community, UV excitation will undoubtedly continue to be used on many occasions, and especially in sooting flames. Detection methods may be divided into ICCD-based nanosecond-gate detection or a rotary-chopper electromechanical shutter-based CCD array detection, and the levels of background flame emission in individual cases would determine this critical design choice. Here, a process of Raman signal calibration based on ti,e crosstalk matrix formalism was explained step-by-step. As tI,is process may be very time-consuming and expensive, a well-planned experimental approach (01' building a transferable calibration database or library (at least with in a user's own facility over a series of different testing and runs) is vitally important. Hands on advice on the design and construction of flow control systems for high pressure burner facilities were also presented.
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
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.
Impact of glycolate anion on aqueous corrosion in DWPF and downstream facilities

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

Mickalonis, J. I.

2015-12-15

Glycolic acid is being evaluated as an alternate reductant in the preparation of high level waste for the Defense Waste Processing Facility (DWPF) at the Savannah River Site (SRS). During processing, the glycolic acid may not be completely consumed with small quantities of the glycolate anion being carried forward to other high level waste (HLW) facilities. The impact of the glycolate anion on the corrosion of the materials of construction (MoC) throughout the waste processing system has not been previously evaluated. A literature review had revealed that corrosion data were not available for the MoCs in glycolic-bearing solutions applicable tomore » SRS systems. Data on the material compatibility with only glycolic acid or its derivative products were identified; however, data were limited for solutions containing glycolic acid or the glycolate anion.« less
Eye-movement strategies in developmental prosopagnosia and "super" face recognition.

PubMed

Bobak, Anna K; Parris, Benjamin A; Gregory, Nicola J; Bennetts, Rachel J; Bate, Sarah

2017-02-01

Developmental prosopagnosia (DP) is a cognitive condition characterized by a severe deficit in face recognition. Few investigations have examined whether impairments at the early stages of processing may underpin the condition, and it is also unknown whether DP is simply the "bottom end" of the typical face-processing spectrum. To address these issues, we monitored the eye-movements of DPs, typical perceivers, and "super recognizers" (SRs) while they viewed a set of static images displaying people engaged in naturalistic social scenarios. Three key findings emerged: (a) Individuals with more severe prosopagnosia spent less time examining the internal facial region, (b) as observed in acquired prosopagnosia, some DPs spent less time examining the eyes and more time examining the mouth than controls, and (c) SRs spent more time examining the nose-a measure that also correlated with face recognition ability in controls. These findings support previous suggestions that DP is a heterogeneous condition, but suggest that at least the most severe cases represent a group of individuals that qualitatively differ from the typical population. While SRs seem to merely be those at the "top end" of normal, this work identifies the nose as a critical region for successful face recognition.
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.
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
Human iPSC-Derived GABA Ergic Precursor Cell Therapy for Chronic Epilepsy

DTIC Science & Technology

2015-10-01

1) Induction of status epilepticus (SE) in young rats through kainic acid injections to generate rats exhibiting chronic TLE typified by SRS. (2...of status epilepticus (SE) via graded kainic acid injections, termination of acute seizures 2 hours after SE onset via diazepam injections and...injections to these rats to induce acute seizures or status epilepticus (SE) in 11 separate experimental sessions (n=8-12/session). These experiments
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.
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.
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
Long-term follow-up of individuals undergoing sex reassignment surgery: Psychiatric morbidity and mortality.

PubMed

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

2016-01-01

There is a lack of long-term register-based follow-up studies of sex-reassigned individuals concerning mortality and psychiatric morbidity. Accordingly, the present study investigated both mortality and psychiatric morbidity using a sample of individuals with transsexualism which comprised 98% (n = 104) of all individuals in Denmark. (1) To investigate psychiatric morbidity before and after sex reassignment surgery (SRS) among Danish individuals who underwent SRS during the period of 1978-2010. (2) To investigate mortality among Danish individuals who underwent SRS during the period of 1978-2010. Psychiatric morbidity and mortality were identified by data from the Danish Psychiatric Central Research Register and the Cause of Death Register through a retrospective register study of 104 sex-reassigned individuals. Overall, 27.9% of the sample were registered with psychiatric morbidity before SRS and 22.1% after SRS (p = not significant). A total of 6.7% of the sample were registered with psychiatric morbidity both before and after SRS. Significantly more psychiatric diagnoses were found before SRS for those assigned as female at birth. Ten individuals were registered as deceased post-SRS with an average age of death of 53.5 years. No significant difference in psychiatric morbidity or mortality was found between male to female and female to male (FtM) save for the total number of psychiatric diagnoses where FtM held a significantly higher number of psychiatric diagnoses overall. Despite the over-representation of psychiatric diagnoses both pre- and post-SRS the study found that only a relatively limited number of individuals had received diagnoses both prior to and after SRS. This suggests that generally SRS may reduce psychological morbidity for some individuals while increasing it for others.
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
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.
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.
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.
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.
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.
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.
Effective Half-Life of Caesium-137 in Various Environmental Media at the Savannah River Site

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

Paller, M. H.; Jannik, G. T.; Baker, R. A.

2014-05-01

During the operational history of the Savannah River Site (SRS), many different radionuclides have been released from site facilities into the SRS environment. However, only a relatively small number of pathways, most importantly 137Cs in fish and deer, have contributed significantly to doses and risks to the public. The “effective” half-lives (T e) of 137Cs (which include both physical decay and environmental dispersion) in Savannah River floodplain soil and vegetation and in fish and white-tailed deer from the SRS were estimated using long-term monitoring data. For 1974–2011, the T es of 137Cs in Savannah River floodplain soil and vegetation weremore » 17.0 years (95% CI = 14.2–19.9) and 13.4 years (95% CI = 10.8–16.0), respectively. These T es were greater than in a previous study that used data collected only through 2005 as a likely result of changes in the flood regime of the Savannah River. Field analyses of 137Cs concentrations in deer collected during yearly controlled hunts at the SRS indicated an overall T e of 15.9 years (95% CI = 12.3–19.6) for 1965–2011; however, the T e for 1990–2011 was significantly shorter (11.8 years, 95% CI = 4.8–18.8) due to an increase in the rate of 137Cs removal. The shortest T es were for fish in SRS streams and the Savannah River (3.5–9.0 years), where dilution and dispersal resulted in rapid 137Cs removal. Long-term data show that T es are significantly shorter than the physical half-life of 137Cs in the SRS environment but that they can change over time. Therefore, it is desirable have a long period of record for calculating Tes and risky to extrapolate T es beyond this period unless the processes governing 137Cs removal are clearly understood.« less
ENHANCED CHEMICAL CLEANING: A NEW PROCESS FOR CHEMICALLY CLEANING SAVANNAH RIVER WASTE TANKS

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

Ketusky, E; Neil Davis, N; Renee Spires, R

2008-01-17

The Savannah River Site (SRS) has 49 high level waste (HLW) tanks that must be emptied, cleaned, and closed as required by the Federal Facilities Agreement. The current method of chemical cleaning uses several hundred thousand gallons per tank of 8 weight percent (wt%) oxalic acid to partially dissolve and suspend residual waste and corrosion products such that the waste can be pumped out of the tank. This adds a significant quantity of sodium oxalate to the tanks and, if multiple tanks are cleaned, renders the waste incompatible with the downstream processing. Tank space is also insufficient to store thismore » stream given the large number of tanks to be cleaned. Therefore, a search for a new cleaning process was initiated utilizing the TRIZ literature search approach, and Chemical Oxidation Reduction Decontamination--Ultraviolet (CORD-UV), a mature technology currently used for decontamination and cleaning of commercial nuclear reactor primary cooling water loops, was identified. CORD-UV utilizes oxalic acid for sludge dissolution, but then decomposes the oxalic acid to carbon dioxide and water by UV treatment outside the system being treated. This allows reprecipitation and subsequent deposition of the sludge into a selected container without adding significant volume to that container, and without adding any new chemicals that would impact downstream treatment processes. Bench top and demonstration loop measurements on SRS tank sludge stimulant demonstrated the feasibility of applying CORD-UV for enhanced chemical cleaning of SRS HLW tanks.« 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…
Two Devices for Removing Sludge From Bioreactor Wastewater

NASA Technical Reports Server (NTRS)

Archer, Shivaun; Hitchens, G. DUncan; Jabs, Harry; Cross, Jennifer; Pilkinton, Michelle; Taylor, Michael

2007-01-01

Two devices a magnetic separator and a special filter denoted a self-regenerating separator (SRS) have been developed for separating sludge from the stream of wastewater from a bioreactor. These devices were originally intended for use in microgravity, but have also been demonstrated to function in normal Earth gravity. The magnetic separator (see Figure 1) includes a thin-walled nonmagnetic, stainless-steel cylindrical drum that rotates within a cylindrical housing. The wastewater enters the separator through a recirculation inlet, and about 80 percent of the wastewater flow leaves through a recirculation outlet. Inside the drum, a magnet holder positions strong permanent magnets stationary and, except near a recirculation outlet, close to the inner drum surface. To enable magnetic separation, magnetite (a ferromagnetic and magnetically soft iron oxide) powder is mixed into the bioreactor wastewater. The magnetite becomes incorporated into the sludge by condensation, onto the powder particles, of microbe flocks that constitute the sludge. As a result, the magnets inside the drum magnetically attract the sludge onto the outer surface of the drum.
Quality Assurance Results for a Commercial Radiosurgery System: A Communication.

PubMed

Ruschin, Mark; Lightstone, Alexander; Beachey, David; Wronski, Matt; Babic, Steven; Yeboah, Collins; Lee, Young; Soliman, Hany; Sahgal, Arjun

2015-10-01

The purpose of this communication is to inform the radiosurgery community of quality assurance (QA) results requiring attention in a commercial FDA-approved linac-based cone stereo-tactic radiosurgery (SRS) system. Standard published QA guidelines as per the American Association of Physics in Medicine (AAPM) were followed during the SRS system's commissioning process including end-to-end testing, cone concentricity testing, image transfer verification, and documentation. Several software and hardware deficiencies that were deemed risky were uncovered during the process and QA processes were put in place to mitigate these risks during clinical practice. In particular, the present work focuses on daily cone concentricity testing and commissioning-related findings associated with the software. Cone concentricity/alignment is measured daily using both optical light field inspection, as well as quantitative radiation field tests with the electronic portal imager. In 10 out of 36 clini-cal treatments, adjustments to the cone position had to be made to align the cone with the collimator axis to less than 0.5 mm and on two occasions the pre-adjustment measured offset was 1.0 mm. Software-related errors discovered during commissioning included incorrect transfer of the isocentre in DICOM coordinates, improper handling of non-axial image sets, and complex handling of beam data, especially for multi-target treatments. QA processes were established to mitigate the occurrence of the software errors. With proper QA processes, the reported SRS system complies with tolerances set out in established guidelines. Discussions with the vendor are ongoing to address some of the hardware issues related to cone alignment. © The Author(s) 2014.
RAPID METHOD FOR DETERMINATION OF RADIOSTRONTIUM IN EMERGENCY MILK SAMPLES

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

Maxwell, S.; Culligan, B.

2008-07-17

A new rapid separation method for radiostrontium in emergency milk samples was developed at the Savannah River Site (SRS) Environmental Bioassay Laboratory (Aiken, SC, USA) that will allow rapid separation and measurement of Sr-90 within 8 hours. The new method uses calcium phosphate precipitation, nitric acid dissolution of the precipitate to coagulate residual fat/proteins and a rapid strontium separation using Sr Resin (Eichrom Technologies, Darien, IL, USA) with vacuum-assisted flow rates. The method is much faster than previous method that use calcination or cation exchange pretreatment, has excellent chemical recovery, and effectively removes beta interferences. When a 100 ml samplemore » aliquot is used, the method has a detection limit of 0.5 Bq/L, well below generic emergency action levels.« less
Systematic reviews on neurodevelopmental and neurodegenerative disorders linked to pesticide exposure: Methodological features and impact on risk assessment.

PubMed

Hernández, Antonio F; González-Alzaga, Beatriz; López-Flores, Inmaculada; Lacasaña, Marina

2016-01-01

Epidemiological data are not currently used in the risk assessment of chemical substances in a systematic and consistent manner. However, systematic reviews (SRs) could be useful for risk assessment as they appraise and synthesize the best epidemiological knowledge available. To conduct a comprehensive literature search of SRs pertaining to pesticide exposure and various neurological outcomes, namely neurodevelopmental abnormalities, Parkinson's disease (PD) and Alzheimer's disease (AD), and to assess the potential contribution of SRs to the risk assessment process. Search was conducted in PubMed and Web of Science databases and articles were selected if the following inclusion criteria were met: being a SR, published until April 2015 and without language restrictions. For each neurological outcome, two review authors independently screened the search results for included studies. Data were extracted and summarized in two tables according to 16 criteria. Disagreements were resolved by discussion. The total number of studies identified in the first search was 65, 304 and 108 for neurodevelopment, PD and AD, respectively. From them, 8, 10 and 2 met the defined inclusion criteria for those outcomes, respectively. Overall, results suggest that prenatal exposure to organophosphates is associated with neurodevelopmental disturbances in preschool and school children. In contrast, postnatal exposures failed to show a clear effect across cohort studies. Regarding PD, 6 SRs reported statistically significant combined effect size estimates, with OR/RR ranging between 1.28 and 1.94. As for AD, 2 out of the 8 original articles included in the SRs found significant associations, with OR of 2.39 and 4.35, although the quality of the data was rather low. The critical appraisal of the SRs identified allowed for discussing the implications of SRs for risk assessment, along with the identification of gaps and limitations of current epidemiological studies that hinder their use for risk assessment. Recommendations are proposed to improve studies for this purpose. In particular, harmonized quantitative data (expressed in standardized units) would allow a better interpretation of results and would facilitate direct comparison of data across studies. Outcomes should be also harmonized for an accurate and reproducible measurement of adverse effects. Appropriate SRs and quantitative synthesis of the evidence should be performed regularly for a continuous update of the risk factors on health outcomes and to determine, if possible, dose-response curves for risk assessment. Copyright © 2016 Elsevier Ltd. All rights reserved.
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.
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
Examining the Distribution, Modularity, and Community Structure in Article Networks for Systematic Reviews.

PubMed

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

2015-01-01

Systematic reviews (SRs) provide high quality evidence for clinical practice, but the article screening process is time and labor intensive. As SRs aim to identify relevant articles with a specific scope, we propose that a pre-defined article relationship, using similarity metrics, could accelerate this process. In this study, we established the article relationship using MEDLINE element similarities and visualized the article network with the Force Atlas layout. We also analyzed the article networks with graph diameter, closeness centrality, and module classes. The results revealed the distribution of articles and found that included articles tended to aggregate together in some module classes, providing further evidence of the existence of strong relationships among included articles. This approach can be utilized to facilitate the articles selection process through early identification of these dominant module classes. We are optimistic that the use of article network visualization can help better SR work prioritization.
Examining the Distribution, Modularity, and Community Structure in Article Networks for Systematic Reviews

PubMed Central

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

2015-01-01

Systematic reviews (SRs) provide high quality evidence for clinical practice, but the article screening process is time and labor intensive. As SRs aim to identify relevant articles with a specific scope, we propose that a pre-defined article relationship, using similarity metrics, could accelerate this process. In this study, we established the article relationship using MEDLINE element similarities and visualized the article network with the Force Atlas layout. We also analyzed the article networks with graph diameter, closeness centrality, and module classes. The results revealed the distribution of articles and found that included articles tended to aggregate together in some module classes, providing further evidence of the existence of strong relationships among included articles. This approach can be utilized to facilitate the articles selection process through early identification of these dominant module classes. We are optimistic that the use of article network visualization can help better SR work prioritization. PMID:26958292
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.
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.
SU-F-P-05: Initial Experience with an Independent Certification Program for Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

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

Solberg, T; Robar, J; Gevaert, T

Purpose: The ASTRO document “Safety is no accident: A FRAMEWORK FOR QUALITY RADIATION ONCOLOGY AND CARE” recommends external reviews of specialized modalities. The purpose of this presentation is to describe the implementation of such a program for Stereotactic Radiosurgery (SRS) and Stereotactic Body radiation Therapy (SBRT). Methods: The margin of error for SRS and SBRT delivery is significantly smaller than that of conventional radiotherapy and therefore requires special attention and diligence. The Novalis Certified program was created to fill an unmet need for specialized SRS / SBRT credentialing. A standards document was drafted by a panel of experts from severalmore » disciplines, including medical physics, radiation oncology and neurosurgery. The document, based on national and international standards, covers requirements in program structure, personnel, training, clinical application, technology, quality management, and patient and equipment QA. The credentialing process was modeled after existing certification programs and includes an institution-generated self-study, extensive document review and an onsite audit. Reviewers generate a descriptive report, which is reviewed by a multidisciplinary expert panel. Outcomes of the review may include mandatory requirements and optional recommendations. Results: 15 institutions have received Novalis Certification, including 3 in the US, 7 in Europe, 4 in Australia and 1 in Asia. 87 other centers are at various stages of the process. Nine reviews have resulted in mandatory requirements, however all of these were addressed within three months of the audit report. All reviews have produced specific recommendations ranging from programmatic to technical in nature. Institutions felt that the credentialing process addressed a critical need and was highly valuable to the institution. Conclusion: Novalis Certification is a unique peer review program assessing safety and quality in SRS and SBRT, while recognizing international practice standards. The approach is capable of highlighting outstanding requirements and providing recommendations to enhance both new and established programs. Timothy Solberg is co-owner of Global Radiosurgery services, LLC.« less
Efficient frequency conversion by stimulated Raman scattering in a sodium nitrate aqueous solution

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

Ganot, Yuval, E-mail: yuvalga@sapir.ac.il, E-mail: ibar@bgu.ac.il; Bar, Ilana, E-mail: yuvalga@sapir.ac.il, E-mail: ibar@bgu.ac.il

2015-09-28

Frequency conversion of laser beams, based on stimulated Raman scattering (SRS) is an appealing technique for generating radiation at new wavelengths. Here, we investigated experimentally the SRS due to a single pass of a collimated frequency-doubled Nd:YAG laser beam (532 nm) through a saturated aqueous solution of sodium nitrate (NaNO{sub 3}), filling a 50 cm long cell. These experiments resulted in simultaneous generation of 1st (564 nm) and 2nd (599 nm) Stokes beams, corresponding to the symmetric stretching mode of the nitrate ion, ν{sub 1}(NO{sub 3}{sup −}), with 40 and 12 mJ/pulse maximal converted energies, equivalent to 12% and 4% efficiencies, respectively, for a 340more » mJ/pulse pump energy. The results indicate that the pump and SRS beams were thermally defocused and that four-wave mixing was responsible for the second order Stokes process onset.« less
Savannah River Site generic data base development

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

Blanton, C.H.; Eide, S.A.

This report describes the results of a project to improve the generic component failure data base for the Savannah River Site (SRS). A representative list of components and failure modes for SRS risk models was generated by reviewing existing safety analyses and component failure data bases and from suggestions from SRS safety analysts. Then sources of data or failure rate estimates were identified and reviewed for applicability. A major source of information was the Nuclear Computerized Library for Assessing Reactor Reliability, or NUCLARR. This source includes an extensive collection of failure data and failure rate estimates for commercial nuclear powermore » plants. A recent Idaho National Engineering Laboratory report on failure data from the Idaho Chemical Processing Plant was also reviewed. From these and other recent sources, failure data and failure rate estimates were collected for the components and failure modes of interest. This information was aggregated to obtain a recommended generic failure rate distribution (mean and error factor) for each component failure mode.« less
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.
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.
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.
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
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
SU-F-T-637: Single-Isocenter Versus Multiple-Isocenter VMAT SRS for Unusual Multiple Metastasis Case with Two Widely Separated Lesions

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

Thomas, EM; Popple, RA; Fiveash, JB

Purpose: Single-isocenter (SI) volumetric modulated arc therapy has been shown to be an effective and efficient approach to multiple metastasis radiosurgery. However, certain extreme cases raise the question of whether multiple-isocenter (MI) approaches can still generate superior plans. In this study, we ask this question with respect to a clinical case with two very widely separated lesions. Methods: A patient with two widely separated (d = 12cm) tumors was treated with SI-VMAT SRS using 10MV flattening filter free (FFF) beam with high-definition multi-leaf collimator (HD-MLC, 2.5/5mm) in two non-coplanar arcs using concentric rings to enforce steep gradient. Because of lesionmore » positioning with respect to collimator angle selection, lesions were treated by 5mm leaves. We re-planned the case with a congruent arc arrangement but separate isocenter for each lesion. In this manner, lesions were treated by 2.5mm leaves. Conformity index (CI), V50%, and mean brain dose were compared. Results: Neither conformity (CI-SI = 1.12, CI-MI = 1.08) nor V50% (V50%-SI =8.82cc, V50%-MI =8.81cc) were improved by utilizing a separate isocenter for each lesion. Mean brain dose was slightly reduced (dmean-SI = 118.4 cGy, dmean-MI = 88.7 cGy) by using multiple isocenters. Conclusion: For this case with a lesion at the apex of the brain and another distantly located at the base of skull, employing a separate isocenter for each target did not meaningfully improve plan quality. Single-isocenter VMAT has been shown feasible and equivalent to multiple-isocenter VMAT for multiple metastasis cases in general. In this extreme case, single- and multiple- isocenter VMAT were also equivalent. If rotational setup errors are appropriately corrected, the increased delivery efficiency of the single-isocenter approach renders it preferable to the multiple isocenter approach. Dr’s Thomas, Popple, and Fiveash have all received honoraria from Varian Medical Systems for discussing their experiences with stereotactic radiosurgery.« less
Savannah River Region: Transition between the Gulf and Atlantic Coastal Plains. Proceedings

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

Zullo, V.A.; Harris, W.B.; Price, V.

1990-12-31

The focus of the this conference of Coastal Plains geologists was on the Savannah River region of Georgia and South Carolina, and particularly on the geology of the US Department of Energy`s 300 square mile Savannah River Site (SRS) in western South Carolina. Current geological studies indicate that the Mesozoic-Cenozoic section in the Savannah River region is transitional between that of the Gulf Coastal Plain to the southwest and that of the Atlantic Coastal Plain to the northeast. With the transitional aspect of the region as its theme, the first session was devoted to overviews of Cretaceous and Paleogene geologymore » in the Gulf and Atlantic Coastal Plains. Succeeding presentations and resulting discussions dealt with more specific problems in structural, lithostratigraphic, hydrological, biostratigraphic, and cyclostratigraphic analysis, and of correlation to standard stratigraphic frameworks. For these conference proceedings, individual papers have been processed separately for the Energy Data Base.« less
At convenience and systematic random sampling: effects on the prognostic value of nuclear area assessments in breast cancer patients.

PubMed

Jannink, I; Bennen, J N; Blaauw, J; van Diest, P J; Baak, J P

1995-01-01

This study compares the influence of two different nuclear sampling methods on the prognostic value of assessments of mean and standard deviation of nuclear area (MNA, SDNA) in 191 consecutive invasive breast cancer patients with long term follow up. The first sampling method used was 'at convenience' sampling (ACS); the second, systematic random sampling (SRS). Both sampling methods were tested with a sample size of 50 nuclei (ACS-50 and SRS-50). To determine whether, besides the sampling methods, sample size had impact on prognostic value as well, the SRS method was also tested using a sample size of 100 nuclei (SRS-100). SDNA values were systematically lower for ACS, obviously due to (unconsciously) not including small and large nuclei. Testing prognostic value of a series of cut off points, MNA and SDNA values assessed by the SRS method were prognostically significantly stronger than the values obtained by the ACS method. This was confirmed in Cox regression analysis. For the MNA, the Mantel-Cox p-values from SRS-50 and SRS-100 measurements were not significantly different. However, for the SDNA, SRS-100 yielded significantly lower p-values than SRS-50. In conclusion, compared with the 'at convenience' nuclear sampling method, systematic random sampling of nuclei is not only superior with respect to reproducibility of results, but also provides a better prognostic value in patients with invasive breast cancer.
Scatter of orthopaedic research: can orthopods stay up-to-date with research?

PubMed

Wijenayake, Lahann; Conroy, Sophie; Turner, Douglas; Thorning, Sarah; Glasziou, Paul

2015-06-01

The volume of orthopaedic literature is increasing exponentially, becoming more widely scattered among journals. The rate of increase in orthopaedics is greater than other specialties. We aimed to identify the number of different journals an orthopaedic surgeon would need to read to stay up-to-date with current evidence. We searched PubMed for all orthopaedic-related systematic reviews (SR) and randomized controlled trials (RCT) published in 2011 using MESH (Medical Subject Headings) terms. The search was based on the Australian Orthopaedic Association syllabus of March 2011. The results of the search were exported to EndNote, then Microsoft Excel. We then calculated the least number of journals needed to read 25%, 50% and 100% of the articles. This was done separately for SRs and RCTs. We found 1400 orthopaedic RCTs spread over 392 journals. Ten journals contained 25% of the articles, 36 journals contained 50% and 114 journals contained 75%. Three hundred journals contained three or fewer RCTs. We found 354 orthopaedic-relevant SRs spread over 152 journals. Six journals contained 25% of the articles, 23 journals contained 50% and 63 journals contained 75%. Ninety-three journals contained only one SR. Our results demonstrate the vast scatter of orthopaedic research. Four orthopaedic RCTs are published every day. To read even 25% of the new RCTs and SRs published in orthopaedics, a surgeon would require a subscription to 13 different journals monthly, a costly and time-consuming endeavour. © 2014 Royal Australasian College of Surgeons.
IRD dropout study

NASA Technical Reports Server (NTRS)

Yalowitz, Jeffrey S.; Schroer, Michael A.; Dickson, John E., Jr.

1992-01-01

This final report describes work performed by SRS Technologies for the NASA Marshall Space Flight Center under Contract NAS8-39077, entitled 'Integrated Receiver-Decoder Dropout Study'. The purpose of the study was to determine causes of signal fading effects on ultra-high-frequency (UHF) range safety transmissions to the Space Shuttle during flyout. Of particular interest were deep fades observed at the External Tank (ET) Integrated Receiver-Decoder (IRD) during the flyout interval between solid rocket booster separation and ET separation. Analytical and simulation methods were employed in this study to assess observations captured in flight telemetry data records. Conclusions based on the study are presented in this report, and recommendations are given for future experimental validation of the results.
In-service Inspection of Radioactive Waste Tanks at the Savannah River Site – 15410

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

Wiersma, Bruce; Maryak, Matthew; Baxter, Lindsay

2015-01-12

Liquid radioactive wastes from the Savannah River Site (SRS) separation process are stored in large underground carbon steel tanks. The high level wastes are processed in several of the tanks and then transferred by piping to other site facilities for further processing before they are stabilized in a vitrified or grout waste form. Based on waste removal and processing schedules, many of the tanks will be required to be in service for times exceeding the initial intended life. Until the waste is removed from storage, transferred, and processed, the materials and structures of the tanks must maintain a confinement functionmore » by providing a barrier to the environment and by maintaining acceptable structural stability during design basis events, which include loadings from both normal service and abnormal (e.g., earthquake) conditions. A structural integrity program is in place to maintain the structural and leak integrity functions of these waste tanks throughout their intended service life. In-service inspection (ISI) is an essential element of a comprehensive structural integrity program for the waste tanks at the Savannah River Site (SRS). The ISI program was developed to determine the degree of degradation the waste tanks have experienced due to service conditions. As a result of the inspections, an assessment can be made of the effectiveness of corrosion controls for the waste chemistry, which precludes accelerated localized and general corrosion of the waste tanks. Ultrasonic inspections (UT) are performed to detect and quantify the degree of general wall thinning, pitting and cracking as a measure of tank degradation. The results from these inspections through 2013, for the 27 Type III/IIIA tanks, indicate no reportable in-service corrosion degradation in the primary tank (i.e., general, pitting, or cracking). The average wall thickness for all tanks remains above the manufactured nominal thickness minus 0.25 millimeter and the largest pit identified is approximately 1.70 millimeter deep (i.e., less than 10% through-wall). Improvements to the inspection program were recently instituted to provide additional confidence in the degradation rates. Thickness measurements from a single vertical strip along the accessible height of the primary tank have been used as a baseline to compare historical measurements. Changes in wall thickness and pit depths along this vertical strip are utilized to estimate the rate of corrosion degradation. An independent review of the ISI program methodology, results, and path forward was held in August 2009. The review recommended statistical sampling of the tanks to improve the confidence of the single strip inspection program. The statistical sampling plan required that SRS increase the amount of area scanned per tank. Therefore, in addition to the baseline vertical strip that is obtained for historical comparisons, four additional randomly selected vertical strips are inspected. To date, a total of 104 independent vertical strips along the height of the primary tank have been completed. A statistical analysis of the data indicates that at this coverage level there is a 99.5% confidence level that one of the worst 5% of all the vertical strips was inspected. That is, there is a relatively high likelihood that the SRS inspection program has covered one of the most corroded areas of any of the Type III/IIIA waste tanks. These data further support the conclusion that there are no significant indications of wall thinning or pitting. Random sampling will continue to increase the confidence that one of the worst 5% has been inspected. In order to obtain the additional vertical strips, and minimize budget and schedule impacts, data collection speed for the UT system was optimized. Prior to 2009, the system collected data at a rate of 32 square centimeters per minute. The scan rate was increased to 129 - 160 square centimeters per minute by increasing the scanner step and pixel sizes in the data acquisition set-up. Laboratory testing was utilized to optimize the scan index/pixel size such that the requirements for wall thinning and pit detection were still maintained. SRS continues to evaluate improvements to ultrasonic equipment.« 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.
Two-photon interband absorption coefficients in tungstate and molybdate crystals

NASA Astrophysics Data System (ADS)

Lukanin, V. I.; Karasik, A. Ya.

2015-02-01

Two-photon absorption (TPA) coefficients were measured in tungstate and molybdate crystals - BaWO4, KGW, CaMoO4, BaMoO4, CaWO4, PbWO4 and ZnWO4 upon different orientations of excitation polarization with respect to the crystallographic axes. Trains of 25 ps pulses with variable radiation intensities of third (349 nm) harmonics of passively mode-locked 1047 nm Nd:YLF laser were used for interband two-photon excitation of the crystals. It was suggested that in the case, when 349 nm radiation pumping energy exceeds the bandgap width (hν>Eg), the nonlinear excitation process can be considered as two-step absorption. The interband two-photon absorption in all the studied crystals induces the following one-photon absorption from the exited states, which affects the nonlinear process dynamics and leads to a hysteresis in the dependence of the transmission on the excitation intensity. This fact was taken into account under analysis of the experimental dependences of the reciprocal transmission on the excitation intensity. Laser excitation in the transparency region of the crystals caused stimulated Raman scattering (SRS) not for all the crystals studied. The measured nonlinear coefficients allowed us to explain the suppression of SRS in crystals as a result of competition between the SRS and TPA.
Third order nonlinear phenomena in silica solid and hollow whispering gallery mode resonators

NASA Astrophysics Data System (ADS)

Farnesi, D.; Barucci, A.; Berneschi, S.; Cosi, F.; Righini, G. C.; Nunzi Conti, G.; Soria, Silvia

2016-03-01

We report efficient generation of nonlinear phenomena related to third order optical non-linear susceptibility χ(3) interactions in resonant silica microspheres and microbubbles in the regime of normal dispersion. The interactions here reported are: Stimulated Raman Scattering (SRS), and four wave mixing processes comprising Stimulated Anti-stokes Raman Scattering (SARS) and comb generation. Unusually strong anti-Stokes components and extraordinarily symmetric spectra have been observed. Resonant SARS and SRS corresponding to different Raman bands were also observed. The lack of correlation between stimulated anti-stokes and stokes scattering spectra indicates that the signal has to be resonant with the cavity.

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.
Characterization of a signal recording system for accurate velocity estimation using a VISAR

NASA Astrophysics Data System (ADS)

Rav, Amit; Joshi, K. D.; Singh, Kulbhushan; Kaushik, T. C.

2018-02-01

The linearity of a signal recording system (SRS) in time as well as in amplitude are important for the accurate estimation of the free surface velocity history of a moving target during shock loading and unloading when measured using optical interferometers such as a velocity interferometer system for any reflector (VISAR). Signal recording being the first step in a long sequence of signal processes, the incorporation of errors due to nonlinearity, and low signal-to-noise ratio (SNR) affects the overall accuracy and precision of the estimation of velocity history. In shock experiments the small duration (a few µs) of loading/unloading, the reflectivity of moving target surface, and the properties of optical components, control the amount of input of light to the SRS of a VISAR and this in turn affects the linearity and SNR of the overall measurement. These factors make it essential to develop in situ procedures for (i) minimizing the effect of signal induced noise and (ii) determine the linear region of operation for the SRS. Here we report on a procedure for the optimization of SRS parameters such as photodetector gain, optical power, aperture etc, so as to achieve a linear region of operation with a high SNR. The linear region of operation so determined has been utilized successfully to estimate the temporal history of the free surface velocity of the moving target in shock experiments.
Development of the Next-Generation Caustic-Side Solvent Extraction (NG-CSSX) Process for Cesium Removal from High-Level Tank Waste

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

Moyer, Bruce A; Bonnesen, Peter V; Delmau, Laetitia Helene

2011-01-01

This paper describes the chemical performance of the Next-Generation Caustic-Side Solvent Extraction (NG-CSSX) process in its current state of development for removal of cesium from the alkaline high-level tank wastes at the Savannah River Site (SRS) in the US Department of Energy (USDOE) complex. Overall, motivation for seeking a major enhancement in performance for the currently deployed CSSX process stems from needs for accelerating the cleanup schedule and reducing the cost of salt-waste disposition. The primary target of the NG-CSSX development campaign in the past year has been to formulate a solvent system and to design a corresponding flowsheet thatmore » boosts the performance of the SRS Modular CSSX Unit (MCU) from a current minimum decontamination factor of 12 to 40,000. The chemical approach entails use of a more soluble calixarene-crown ether, called MaxCalix, allowing the attainment of much higher cesium distribution ratios (DCs) on extraction. Concurrently decreasing the Cs-7SB modifier concentration is anticipated to promote better hydraulics. A new stripping chemistry has been devised using a vitrification-friendly aqueous boric acid strip solution and a guanidine suppressor in the solvent, resulting in sharply decreased DCs on stripping. Results are reported herein on solvent phase behavior and batch Cs distribution for waste simulants and real waste together with a preliminary flowsheet applicable for implementation in the MCU. The new solvent will enable MCU to process a much wider range of salt feeds and thereby extend its service lifetime beyond its design life of three years. Other potential benefits of NG-CSSX include increased throughput of the SRS Salt Waste Processing Facility (SWPF), currently under construction, and an alternative modular near-tank application at Hanford.« less
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.
Dispersion-based stimulated Raman scattering spectroscopy, holography, and optical coherence tomography

PubMed Central

Robles, Francisco E.; Fischer, Martin C.; Warren, Warren S.

2016-01-01

Stimulated Raman scattering (SRS) enables fast, high resolution imaging of chemical constituents important to biological structures and functional processes, both in a label-free manner and using exogenous biomarkers. While this technology has shown remarkable potential, it is currently limited to point scanning and can only probe a few Raman bands at a time (most often, only one). In this work we take a fundamentally different approach to detecting the small nonlinear signals based on dispersion effects that accompany the loss/gain processes in SRS. In this proof of concept, we demonstrate that the dispersive measurements are more robust to noise compared to amplitude-based measurements, which then permit spectral or spatial multiplexing (potentially both, simultaneously). Finally, we illustrate how this method may enable different strategies for biochemical imaging using phase microscopy and optical coherence tomography. PMID:26832279
3 kW single stage all-fiber Yb-doped single-mode fiber laser for highly reflective and highly thermal conductive materials processing

NASA Astrophysics Data System (ADS)

Ikoma, S.; Nguyen, H. K.; Kashiwagi, M.; Uchiyama, K.; Shima, K.; Tanaka, D.

2017-02-01

A 3 kW single stage all-fiber Yb-doped single-mode fiber laser with bi-directional pumping configuration has been demonstrated. Our newly developed high-power LD modules are employed for a high available pump power of 4.9 kW. The length of the delivery fiber is 20 m which is long enough to be used in most of laser processing machines. An output power of 3 kW was achieved at a pump power of 4.23 kW. The slope efficiency was 70%. SRS was able to be suppressed at the same output power by increasing ratio of backward pump power. The SRS level was improved by 5dB when 57% backward pump ratio was adopted compared with the case of 50%. SRS was 35dB below the laser power at the output power of 3 kW even with a 20-m delivery fiber. The M-squared factor was 1.3. Single-mode beam quality was obtained. To evaluate practical utility of the 3 kW single-mode fiber laser, a Bead-on-Plate (BoP) test onto a pure copper plate was executed. The BoP test onto a copper plate was made without stopping or damaging the laser system. That indicates our high power single-mode fiber lasers can be used practically in processing of materials with high reflectivity and high thermal conductivity.
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.
ANNUAL RADIOACTIVE WASTE TANK INSPECTION PROGRAM 2010

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

West, B.; Waltz, R.

Aqueous radioactive wastes from Savannah River Site (SRS) separations and vitrification processes are contained in large underground carbon steel tanks. Inspections made during 2010 to evaluate these vessels and other waste handling facilities along with evaluations based on data from previous inspections are the subject of this report. The 2010 inspection program revealed that the structural integrity and waste confinement capability of the Savannah River Site waste tanks were maintained. All inspections scheduled per SRR-LWE-2009-00138, HLW Tank Farm Inspection Plan for 2010, were completed. Ultrasonic measurements (UT) performed in 2010 met the requirements of C-ESG-00006, In-Service Inspection Program for Highmore » Level Waste Tanks, Rev. 3, and WSRC-TR-2002-00061, Rev.6. UT inspections were performed on Tanks 30, 31 and 32 and the findings are documented in SRNL-STI-2010-00533, Tank Inspection NDE Results for Fiscal Year 2010, Waste Tanks 30, 31 and 32. A total of 5824 photographs were made and 1087 visual and video inspections were performed during 2010. Ten new leaksites at Tank 5 were identified in 2010. The locations of these leaksites are documented in C-ESR-G-00003, SRS High Level Waste Tank Leaksite Information, Rev.5. Ten leaksites at Tank 5 were documented during tank wall/annulus cleaning activities. None of these new leaksites resulted in a release to the environment. The leaksites were documented during wall cleaning activities and the waste nodules associated with the leaksites were washed away. Previously documented leaksites were reactivated at Tank 12 during waste removal activities.« less
Speciation of mercury in sludge solids: washed sludge

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

Bannochie, C. J.; Lourie, A. P.

2017-10-24

The objective of this applied research task was to study the type and concentration of mercury compounds found within the contaminated Savannah River Site Liquid Waste System (SRS LWS). A method of selective sequential extraction (SSE), developed by Eurofins Frontier Global Sciences1,2 and adapted by SRNL, utilizes an extraction procedure divided into seven separate tests for different species of mercury. In the SRNL’s modified procedure four of these tests were applied to a washed sample of high level radioactive waste sludge.
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.
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.
Corrosion impact of reductant on DWPF and downstream facilities

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

Mickalonis, J. I.; Imrich, K. J.; Jantzen, C. M.

2014-12-01

Glycolic acid is being evaluated as an alternate reductant in the preparation of high level waste for the Defense Waste Processing Facility (DWPF) at the Savannah River Site (SRS). During processing, the glycolic acid is not completely consumed and small quantities of the glycolate anion are carried forward to other high level waste (HLW) facilities. The impact of the glycolate anion on the corrosion of the materials of construction throughout the waste processing system has not been previously evaluated. A literature review had revealed that corrosion data in glycolate-bearing solution applicable to SRS systems were not available. Therefore, testing wasmore » recommended to evaluate the materials of construction of vessels, piping and components within DWPF and downstream facilities. The testing, conducted in non-radioactive simulants, consisted of both accelerated tests (electrochemical and hot-wall) with coupons in laboratory vessels and prototypical tests with coupons immersed in scale-up and mock-up test systems. Eight waste or process streams were identified in which the glycolate anion might impact the performance of the materials of construction. These streams were 70% glycolic acid (DWPF feed vessels and piping), SRAT/SME supernate (Chemical Processing Cell (CPC) vessels and piping), DWPF acidic recycle (DWPF condenser and recycle tanks and piping), basic concentrated recycle (HLW tanks, evaporators, and transfer lines), salt processing (ARP, MCU, and Saltstone tanks and piping), boric acid (MCU separators), and dilute waste (HLW evaporator condensate tanks and transfer line and ETF components). For each stream, high temperature limits and worst-case glycolate concentrations were identified for performing the recommended tests. Test solution chemistries were generally based on analytical results of actual waste samples taken from the various process facilities or of prototypical simulants produced in the laboratory. The materials of construction for most vessels, components and piping were not impacted with the presence of glycolic acid or the impact is not expected to affect the service life. However, the presence of the glycolate anion was found to affect corrosion susceptibility of some materials of construction in the DWPF and downstream facilities, especially at elevated temperatures. The following table summarizes the results of the electrochemical and hot wall testing and indicates expected performance in service with the glycolate anion present.« less
Somatostatin receptor scintigraphy in patients with rheumatoid arthritis and secondary Sjögren's syndrome treated with Infliximab: a pilot study.

PubMed

Anzola-Fuentes, L K; Chianelli, M; Galli, F; Glaudemans, A W J M; Martin Martin, L; Todino, V; Migliore, A; Signore, A

2016-12-01

Human T lymphocytes infiltrating tissues in autoimmune diseases are known to express somatostatin receptors amongst other activation markers. In this study, we evaluated whether somatostatin receptor scintigraphy (SRS) using a radiolabelled somatostatin analogue ((99m)Tc-EDDA/tricine-HYNIC-tyr(3)-octreotide ((99m)Tc-EDDA/HYNIC-TOC)) is able to detect the presence of immune-mediated processes in patients with rheumatoid arthritis and secondary Sjögren's syndrome. We also aimed to evaluate whether positivity to SRS was predictive of therapeutic response and if SRS could be used for monitoring the efficacy of immunomodulatory treatment. Eighteen patients with rheumatoid arthritis and secondary Sjögren's syndrome not responding to conventional treatment were recruited for treatment with infliximab, a monoclonal antibody against TNF-α. All patients had complete blood cell count, renal and liver function tests, measurements of ESR, CRP, ANA, ENA, and anti-dsDNA antibodies, functional salivary gland scintigraphy, labial biopsy, and ophthalmologic assessment with Schirmer's test and tear film break-up time (BUT). Diagnosis was made according to the revised criteria of the American-European Consensus Group. All patients underwent SRS at baseline and after 3-6 months of therapy with infliximab. Eleven out of 18 had repeat SRS images. Images of the salivary glands and major joints were acquired 3 h after injection of 370 MBq of (99m)Tc-EDDA/HYNIC-TOC. Image analysis was performed semi-quantitatively. All patients showed uptake of (99m)Tc-EDDA/HYNIC-TOC in the joints. Salivary glands also showed variable radiopharmaceutical uptake in 12 out of 18 patients, but all patients showed presence of lymphocytic infiltration at labial salivary gland biopsy. All patients, who repeated the study after treatment, showed significant reduction of somatostatin uptake in the joints but not in the salivary glands. SRS using (99m)Tc-EDDA/HYNIC-TOC may be a useful imaging tool to assess disease activity and extent in patients with rheumatoid arthritis and may help to detect secondary Sjögren's syndrome. It may also aid therapy decision-making with anti-TNFα antibodies in the joints but not in salivary glands.
Quantifying the variability of financial disclosure information reported by authors presenting at annual spine conferences.

PubMed

Ju, Brian L; Miller, Christopher P; Whang, Peter G; Grauer, Jonathan N

2011-01-01

In recent years, greater attention has been directed toward determining how potential financial conflicts of interest may affect the integrity of biomedical research. To address this issue, various disclosure policies have been adopted in an attempt to increase the transparency of this process. However, the consistency of such reporting among spine surgeons remains unknown. This study quantifies the variability in the self-reported disclosures of individual authors presenting at multiple spine conferences during the same year. The author disclosure information published for the 2008 North American Spine Society (NASS), Cervical Spine Research Society (CSRS), and Scoliosis Research Society (SRS), conferences were compiled into a database. We evaluated the disclosure policy for each society and compared the disclosure listings of authors who presented at more than one of these meetings. Disclosure records were available for 1,231 authors at NASS, 550 at CSRS, and 642 at SRS. Of these individuals, 278 (NASS), 129 (CSRS), and 181 (SRS) presented at one of the other conferences and 40 presented at all three conferences. North American Spine Society and CSRS required disclosure of all financial relationships, whereas SRS only requested disclosures pertinent to authors' presentations. Of the 153 authors who presented at the NASS and CSRS meetings, 51% exhibited discrepancies in their disclosure information. In contrast, only 9% of the 205 individuals whose data was listed at both the NASS and SRS conferences demonstrated irregularities. Similarly, 18% of the 56 authors who had provided information to both CSRS and SRS were inconsistent in their reporting. These findings emphasize the significant variability that currently exists in the reporting of financial conflicts of interest by authors who presented at three major spine conferences within the past year. We believe these discrepancies are likely because of confusion regarding what relationships should be acknowledged in certain situations and the clear lack of uniformity among the disclosure policies established by these various associations. This study evaluates financial conflicts of interests in clinical research. Copyright © 2011 Elsevier Inc. All rights reserved.
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.

The social responsiveness scale in relation to DSM IV and DSM5 ASD in Korean children.

PubMed

Cheon, Keun-Ah; Park, Jee-In; Koh, Yun-Joo; Song, Jungeun; Hong, Hyun-Joo; Kim, Young-Kee; Lim, Eun-Chung; Kwon, Hojang; Ha, Mina; Lim, Myung-Ho; Paik, Ki-Chung; Constantino, John N; Leventhal, Bennett; Kim, Young Shin

2016-09-01

The Social Responsiveness Scale (SRS) is an autism rating scales in widespread use, with over 20 official foreign language translations. It has proven highly feasible for quantitative ascertainment of autistic social impairment in public health settings, however, little is known about the validity of the reinforcement in Asia populations or in references to DSM5. The current study aims to evaluate psychometric properties and cross-cultural aspects of the SRS-Korean version (K-SRS).The study subjects were ascertained from three samples: a general sample from 3 regular education elementary schools (n=790), a clinical sample (n=154) of 6-12-year-olds from four psychiatric clinics, and an epidemiological sample of children with ASD, diagnosed using both DSM IV PDD, DSM5 ASD and SCD criteria (n=151). Their parents completed the K-SRS and the Autism Spectrum Screening Questionnaire(ASSQ). Descriptive statistics, correlation analyses and principal components analysis (PCA) were performed on the total population. Mean total scores on the K-SRS differed significantly between the three samples. ASSQ scores were significantly correlated with the K-SRS T-scores. PCA suggested a one-factor solution for the total population.Our results indicate that the K-SRS exhibits adequate reliability and validity for measuring ASD symptoms in Korean children with DSM IV PDD and DSM5 ASD. Our findings further suggest that it is difficult to distinguish SCD from other child psychiatric conditions using the K-SRS.This is the first study to examine the relationship between the SRS subscales and DSM5-based clinical diagnoses. This study provides cross-cultural confirmation of the factor structure for ASD symptoms and traits measured by the SRS. Autism Res 2016, 9: 970-980. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
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.
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.
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.
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.
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.
Comparison of Separation Shock for Explosive and Nonexplosive Release Actuators on a Small Spacecraft Panel

NASA Technical Reports Server (NTRS)

Lucy, M. H.; Buehrle, R. D.; Woolley, J. P.

1996-01-01

Functional shock, safety, overall system costs, and emergence of new technologies, have raised concerns regarding continued use of pyrotechnics on spacecraft. NASA Headquarters-Office of Chief Engineer requested Langley Research Center (LaRC) study pyrotechnic alternatives using non-explosive actuators (NEA's), and LARC participated with Lockheed Martin Missile and Space Co. (LMMSC)-Sunnyvale, CA in objectively evaluating applicability of some NEA mechanisms to reduce small spacecraft and booster separation event shock. Comparative tests were conducted on a structural simulator using five different separation nut mechanisms, consisting of three pyrotechnics from OEA-Aerospace and Hi-Shear Technology and two NEA's from G&H Technology and Lockheed Martin Astronautics (LMA)-Denver, CO. Multiple actuations were performed with preloads up to 7000 pounds, 7000 being the comparison standard. All devices except LMA's NEA rotary flywheel-nut concept were available units with no added provisions to attenuate shock. Accelerometer measurements were recorded, reviewed, processed into Shock Response Spectra (SRS), and comparisons performed. For the standard preload, pyrotechnics produced the most severe and the G&H NEA the least severe functional shock levels. Comparing all results, the LMA concept produced the lowest levels, with preload limited to approximately 4200 pounds. Testing this concept over a range of 3000 to 4200 pounds indicated no effect of preload on shock response levels. This report presents data from these tests and the comparative results.
Comparison of local adipose tissue content and SRS-derived NIRS muscle oxygenation measurements in 90 individuals.

PubMed

Cooper, Chris E; Penfold, Stacey-Marie; Elwell, Clare E; Angus, Caroline

2010-01-01

Adipose content in the region over the vastus lateralis muscle was measured in a young (21.1 +/- 3.1 years old, mean +/- SD) population of males (n = 62) and females (n = 28). Three techniques were used: skinfold thickness, ultrasound and near infrared spectroscopy. All techniques closely correlated with each other and all showed a significantly larger adipose content in females and a limited overlap with the range of values in males. Spatially resolved near infrared spectroscopy (SRS-NIRS) was then used to measure the tissue oxygenation index (TOI) at the same site. A source-detector separation of 4 cm was used to allow for significant light penetration into muscle tissue. TOI at rest was significantly higher in the female (65.3 +/- 7.0, mean +/- SD) than the male (61.9 +/- 5.1, mean +/- SD) group. There was a strong positive correlation between adipose content and TOI in male subjects. However, no correlation was seen in the female group. The possible optical and physiological explanations for these results are discussed.
Chromatin reprogramming in breast cancer.

PubMed

Swinstead, Erin E; Paakinaho, Ville; Hager, Gordon

2018-04-24

Reprogramming of the chromatin landscape is a critical component to the transcriptional response in breast cancer. Effects of sex hormones such as estrogens and progesterone have been well described to have a critical impact on breast cancer proliferation. However, the complex network of the chromatin landscape, enhancer regions, and mode of function of steroid receptors (SRs) and other transcription factors (TFs), is an intricate web of signaling and functional processes that is still largely misunderstood at the mechanistic level. In this review, we describe what is currently known about the dynamic interplay between TFs with chromatin and the reprogramming of enhancer elements. Emphasis has been placed on characterizing the different modes of action of TFs in regulating enhancer activity, specifically, how different SRs target enhancer regions and reprogram chromatin in breast cancer cells. In addition, we discuss current techniques employed to study enhancer function at a genome-wide level. Further, we have noted recent advances in live cell imaging technology. These single cell approaches enable the coupling of population based assays with real-time studies to address many unsolved questions about SRs and chromatin dynamics in breast cancer.
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
Environmental Implementation Plan

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

Not Available

1994-02-01

The Environmental Implementation Plan (EIP) is a dynamic long-range environmental-protection plan for SRS. The EIP communicates the current and future (five year) environmental plans from individual organizations and divisions as well as site environmental initiatives which are designed to protect the environment and meet or exceed compliance with changing environmental/ regulatory requirements. Communication with all site organizations is essential for making the site environmental planning process work. Demonstrating environmental excellence is a high priority embodied in DOE and WSRC policy. Because of your support and participation in the three EIP initiatives; Reflections, Sectional Revision, and Integrated Planning, improvements are beingmore » made to the EIP and SRS environmental protection programs. I appreciate the ``Partnership in Environmental Excellence`` formed by the environmental coordinators and professionals who work daily toward our goal of compliance and environmental excellence. I look forward to seeing continued success and improvement in our environmental protection programs through combined efforts of all site organizations to protect our employees, the public health, and the environment. Together, we will achieve our site vision for SRS to be the recognized model for Environmental Excellence in the DOE Nuclear Weapons Complex.« less
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
Bubblers Speed Nuclear Waste Processing at SRS

ScienceCinema

None

2018-05-23

At the Department of Energy's Savannah River Site, American Recovery and Reinvestment Act funding has supported installation of bubbler technology and related enhancements in the Defense Waste Processing Facility (DWPF). The improvements will accelerate the processing of radioactive waste into a safe, stable form for storage and permit expedited closure of underground waste tanks holding 37 million gallons of liquid nuclear waste.
LITERATURE REVIEWS TO SUPPORT ION EXCHANGE TECHNOLOGY SELECTION FOR MODULAR SALT PROCESSING

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

King, W

2007-11-30

This report summarizes the results of literature reviews conducted to support the selection of a cesium removal technology for application in a small column ion exchange (SCIX) unit supported within a high level waste tank. SCIX is being considered as a technology for the treatment of radioactive salt solutions in order to accelerate closure of waste tanks at the Savannah River Site (SRS) as part of the Modular Salt Processing (MSP) technology development program. Two ion exchange materials, spherical Resorcinol-Formaldehyde (RF) and engineered Crystalline Silicotitanate (CST), are being considered for use within the SCIX unit. Both ion exchange materials havemore » been studied extensively and are known to have high affinities for cesium ions in caustic tank waste supernates. RF is an elutable organic resin and CST is a non-elutable inorganic material. Waste treatment processes developed for the two technologies will differ with regard to solutions processed, secondary waste streams generated, optimum column size, and waste throughput. Pertinent references, anticipated processing sequences for utilization in waste treatment, gaps in the available data, and technical comparisons will be provided for the two ion exchange materials to assist in technology selection for SCIX. The engineered, granular form of CST (UOP IE-911) was the baseline ion exchange material used for the initial development and design of the SRS SCIX process (McCabe, 2005). To date, in-tank SCIX has not been implemented for treatment of radioactive waste solutions at SRS. Since initial development and consideration of SCIX for SRS waste treatment an alternative technology has been developed as part of the River Protection Project Waste Treatment Plant (RPP-WTP) Research and Technology program (Thorson, 2006). Spherical RF resin is the baseline media for cesium removal in the RPP-WTP, which was designed for the treatment of radioactive waste supernates and is currently under construction in Hanford, WA. Application of RF for cesium removal in the Hanford WTP does not involve in-riser columns but does utilize the resin in large scale column configurations in a waste treatment facility. The basic conceptual design for SCIX involves the dissolution of saltcake in SRS Tanks 1-3 to give approximately 6 M sodium solutions and the treatment of these solutions for cesium removal using one or two columns supported within a high level waste tank. Prior to ion exchange treatment, the solutions will be filtered for removal of entrained solids. In addition to Tanks 1-3, solutions in two other tanks (37 and 41) will require treatment for cesium removal in the SCIX unit. The previous SCIX design (McCabe, 2005) utilized CST for cesium removal with downflow supernate processing and included a CST grinder following cesium loading. Grinding of CST was necessary to make the cesium-loaded material suitable for vitrification in the SRS Defense Waste Processing Facility (DWPF). Because RF resin is elutable (and reusable) and processing requires conversion between sodium and hydrogen forms using caustic and acidic solutions more liquid processing steps are involved. The WTP baseline process involves a series of caustic and acidic solutions (downflow processing) with water washes between pH transitions across neutral. In addition, due to resin swelling during conversion from hydrogen to sodium form an upflow caustic regeneration step is required. Presumably, one of these basic processes (or some variation) will be utilized for MSP for the appropriate ion exchange technology selected. CST processing involves two primary waste products: loaded CST and decontaminated salt solution (DSS). RF processing involves three primary waste products: spent RF resin, DSS, and acidic cesium eluate, although the resin is reusable and typically does not require replacement until completion of multiple treatment cycles. CST processing requires grinding of the ion exchange media, handling of solids with high cesium loading, and handling of liquid wash and conditioning solutions. RF processing requires handling and evaporation of cesium eluates, disposal of spent organic resin, and handling of the various liquid wash and regenerate solutions used. In both cases, the DSS will be immobilized in a low activity waste form. It appears that both technologies are mature, well studied, and generally suitable for this application. Technology selection will likely be based on downstream impacts or preferences between the various processing options for the two materials rather than on some unacceptable performance property identified for one material. As a result, the following detailed technical review and summary of the two technologies should be useful to assist in technology selection for SCIX.« less
Monitoring Environmental Impacts on Mangrove Ecosystem in the Indus Delta of Pakistan

NASA Astrophysics Data System (ADS)

Siddiqui, Mehrun-Nisa

Monitoring Environmental Impacts on Mangrove Ecosystem in the Indus Delta of Pakistan The mangrove forests growing in intertidal region along the tropical coastlines form a unique ecosystem with rich floral species and marine resources. In Pakistan, large mangrove forests are found all along the muddy coast of Sindh province at Indus Deltaic region. These mangroves are threatened by a variety of environmental pollution, like: dumping of untreated industrial and urban waste, sewage water; hazardous chemical released during ship breaking, oil spills, mangroves cutting, over fishing, scarcity of fresh water, seawater intrusion and unplanned urban development, etc. Dams and barrages, constructed on the mighty Indus River have reduced the supply of freshwater into the delta and consequently, seawater intruding into the riverine tract. The Tidal Link, constructed in 1995 to drain the agriculture effluents of cultivated areas of Sindh to sea, has also greatly damaged the ecology of the area. This study is based on integrated use of RS & GIS techniques for monitoring environmental impacts on the mangroves ecosystem of Indus Delta, for management and planning of this coastal ecosystem. Temporal satellite remote sensing (SRS) data acquired between 1976 to 2005 have been analysed using image processing and GIS techniques and coastal landuse maps representing coverage of the deltaic region have been prepared, which enabled to monitor dynamic and geomorphological changes occurred in the area. The tidal boundaries derived from temporal SRS data have been integrated to understand the coastal processes and their impact on mangroves ecosystem, and on tidal / intertidal zones. From the analysis, it was observed that the surface salt accumulation and dryness in the deltaic region and waterlogging & salinity in inland areas have been increased over the last 30 years, indicate the intrusion of seawater in groundwater aquifers and reduction in over all biomass in the area. This study demonstrated that the temporal SRS data used in this study are found suitable for monitoring environmental impacts on mangrove ecosystem and in identification of dynamic changes taking place in the Indus Delta of Pakistan. Key Words: Indus Delta, mangroves, ecosystem, temporal SRS data, environmental pollution, environmental impacts, seawater intrusion, coastal process, waterlogging & salinity
Field Deployment for In-situ Metal and Radionuclide Stabilization by Microbial Metabolites

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

Turick, C. E.; Knox, A. S.; Dixon, K. L.

2005-09-26

A novel biotechnology is reported here that was demonstrated at SRS that facilitates metal and actinide immobilization by incorporating the physiology and ecology of indigenous bacteria. This technology is based on our previous work with pyomelanin-producing bacteria isolated from SRS soils. Through tyrosine supplementation, overproduction of pyomelanin was achieved, which lead ultimately to metal and actinide immobilization, both in-vitro and in-situ. Pyomelanin is a recalcitrant microbial pigment and a humic type compound in the class of melanin pigments. Pyomelanin has electron shuttling and metal chelation capabilities and thus accelerates the bacterial reduction and/or immobilization of metals. Pyomelanin is produced outsidemore » the cell and either diffuses away or attaches to the cell surface. In either case, the reduced pyomelanin is capable of transferring electrons to metals as well as chelating metals. Because of its recalcitrance and redox cycling properties, pyomelanin molecules can be used over and over again for metal transformation. When produced in excess, pyomelanin produced by one bacterial species can be used by other species for metal reduction, thereby extending the utility of pyomelanin and further accelerating metal immobilization rates. Soils contaminated with Ni and U were the focus of this study in order to develop in-situ, metal bioimmobilization technologies. We have demonstrated pyomelanin production in soil from the Tims Branch area of SRS as a result of tyrosine amendments. These results were documented in laboratory soil column studies and field deployment studies. The amended soils demonstrated increased redox behavior and sequestration capacity of U and transition metals following pyomelanin production. Treatments incorporating tyrosine and lactate demonstrated the highest levels of pyomelanin production. In order to determine the potential use of this technology at other areas of SRS, pyomelanin producing bacteria were also quantified from metal contaminated soils at TNX and D areas of SRS. A bacterial culture collection from subsurface studies near P Area of SRS were also evaluated for pyomelanin production. Bacterial densities of pyomelanin producers were determined to be >10{sup 6} cells/g soil at TNX and D areas. In addition, approximately 25% of isolates from P area demonstrated pyomelanin production in the presence of tyrosine. Biogeochemical activity is an ongoing and dynamic process due, in part, to bacterial activity in the subsurface. Bacteria contribute significantly to biotransformation of metals and radionuclides. An understanding and application of the mechanisms of metal and radionuclide reduction offers tremendous potential for development into bioremedial processes and technologies. This report demonstrates the application of recent advances in bacterial physiology and soil ecology for future bioremediation activities involving metal and actinide immobilization.« 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.
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.
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
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
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.
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
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.
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
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.
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.
Gaze Tracking System for User Wearing Glasses

PubMed Central

Gwon, Su Yeong; Cho, Chul Woo; Lee, Hyeon Chang; Lee, Won Oh; Park, Kang Ryoung

2014-01-01

Conventional gaze tracking systems are limited in cases where the user is wearing glasses because the glasses usually produce noise due to reflections caused by the gaze tracker's lights. This makes it difficult to locate the pupil and the specular reflections (SRs) from the cornea of the user's eye. These difficulties increase the likelihood of gaze detection errors because the gaze position is estimated based on the location of the pupil center and the positions of the corneal SRs. In order to overcome these problems, we propose a new gaze tracking method that can be used by subjects who are wearing glasses. Our research is novel in the following four ways: first, we construct a new control device for the illuminator, which includes four illuminators that are positioned at the four corners of a monitor. Second, our system automatically determines whether a user is wearing glasses or not in the initial stage by counting the number of white pixels in an image that is captured using the low exposure setting on the camera. Third, if it is determined that the user is wearing glasses, the four illuminators are turned on and off sequentially in order to obtain an image that has a minimal amount of noise due to reflections from the glasses. As a result, it is possible to avoid the reflections and accurately locate the pupil center and the positions of the four corneal SRs. Fourth, by turning off one of the four illuminators, only three corneal SRs exist in the captured image. Since the proposed gaze detection method requires four corneal SRs for calculating the gaze position, the unseen SR position is estimated based on the parallelogram shape that is defined by the three SR positions and the gaze position is calculated. Experimental results showed that the average gaze detection error with 20 persons was about 0.70° and the processing time is 63.72 ms per each frame. PMID:24473283
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
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.
Universal Solid-phase Reversible Sample-Prep for Concurrent Proteome and N-glycome Characterization

PubMed Central

Zhou, Hui; Morley, Samantha; Kostel, Stephen; Freeman, Michael R.; Joshi, Vivek; Brewster, David; Lee, Richard S.

2017-01-01

SUMMARY We describe a novel Solid-phase Reversible Sample-Prep (SRS) platform, which enables rapid sample preparation for concurrent proteome and N-glycome characterization by mass spectrometry. SRS utilizes a uniquely functionalized, silica-based bead that has strong affinity toward proteins with minimal-to-no affinity for peptides and other small molecules. By leveraging the inherent size difference between, SRS permits high-capacity binding of proteins, rapid removal of small molecules (detergents, metabolites, salts, etc.), extensive manipulation including enzymatic and chemical treatments on beads-bound proteins, and easy recovery of N-glycans and peptides. The efficacy of SRS was evaluated in a wide range of biological samples including single glycoprotein, whole cell lysate, murine tissues, and human urine. To further demonstrate the SRS platform, we coupled a quantitative strategy to SRS to investigate the differences between DU145 prostate cancer cells and its DIAPH3-silenced counterpart. Our previous studies suggested that DIAPH3 silencing in DU145 prostate cancer cells induced transition to an amoeboid phenotype that correlated with tumor progression and metastasis. In this analysis we identified distinct proteomic and N-glycomic alterations between the two cells. Intriguingly, a metastasis-associated tyrosine kinase receptor ephrin-type-A receptor (EPHA2) was highly upregulated in DIAPH3-silenced cells, indicating underling connection between EPHA2 and DIAPH3. Moreover, distinct alterations in the N-glycome were identified, suggesting a cross-link between DIAPH3 and glycosyltransferase networks. Overall, SRS is an enabling universal sample preparation strategy that is not size limited and has the capability to efficiently prepare and clean peptides and N-glycans concurrently from nearly all sample types. Conceptually, SRS can be utilized for the analysis of other posttranslational modifications, and the unique surface chemistry can be further transformed for high-throughput automation. The technical simplicity, robustness, and modularity of SRS make it a highly promising technology with great potential in proteomic-based research. PMID:26791391
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.
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.
Stereotactic Radiosurgery With or Without Whole-Brain Radiation Therapy for Limited Brain Metastases: A Secondary Analysis of the North Central Cancer Treatment Group N0574 (Alliance) Randomized Controlled Trial.

PubMed

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

2017-12-01

To determine whether whole-brain radiation therapy (WBRT) is associated with improved overall survival among non-small cell lung cancer (NSCLC) patients with favorable prognoses at diagnosis. In the N0574 trial, patients with 1 to 3 brain metastases were randomized to receive stereotactic radiosurgery (SRS) or SRS plus WBRT (SRS + WBRT), with a primary endpoint of cognitive deterioration. We calculated diagnosis-specific graded prognostic assessment (DS-GPA) scores for NSCLC patients and evaluated overall survival according to receipt of WBRT and DS-GPA score using 2 separate cut-points (≥2.0 vs <2.0 and ≥2.5 vs <2.5). A total of 126 NSCLC patients were included for analysis, with median follow-up of 14.2 months. Data for DS-GPA calculation were available for 86.3% of all enrolled NSCLC patients. Overall, 50.0% of patients had DS-GPA score ≥2.0, and 23.0% of patients had DS-GPA scores ≥2.5. The SRS and SRS + WBRT groups were well balanced with regard to prognostic factors. The median survival according to receipt of WBRT was 11.3 months (+WBRT) and 17.9 months (-WBRT) for patients with DS-GPA ≥2.0 (favorable prognoses, P=.63; hazard ratio 0.86; 95% confidence interval 0.47-1.59). Median survival was 3.7 months (+WBRT) and 6.6 months (-WBRT) for patients with DS-GPA <2.0 patients (unfavorable prognoses, P=.85; hazard ratio 0.95; 95% confidence interval 0.56-1.62). Outcomes according to the receipt of WBRT and DS-GPA remained similar utilizing DS-GPA ≥2.5 as a cutoff for favorable prognoses. There was no interaction between the continuum of the DS-GPA groups and WBRT on overall survival (P=.53). We observed no significant differences in survival according to receipt of WBRT in favorable-prognosis NSCLC patients. This study further supports the approach of SRS alone in the majority of patients with limited brain metastases. Copyright © 2017 Elsevier Inc. All rights reserved.
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.
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.
DWPF Safely Dispositioning Liquid Waste

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

None

2016-01-05

The only operating radioactive waste glassification plant in the nation, the Defense Waste Processing Facility (DWPF) converts the liquid radioactive waste currently stored at the Savannah River Site (SRS) into a solid glass form suitable for long-term storage and disposal. Scientists have long considered this glassification process, called “vitrification,” as the preferred option for treating liquid radioactive waste.
An ERP Study of the Processing of Subject and Object Relative Clauses in Japanese

ERIC Educational Resources Information Center

Ueno, Mieko; Garnsey, Susan M.

2008-01-01

Using reading times and event-related brain potentials (ERPs), we investigated the processing of Japanese subject and object relative clauses (SRs/ORs). Previous research on English relative clauses shows that ORs take longer to read (King & Just, 1991) and elicit anterior negativity between fillers and gaps (King & Kutas, 1995), which is…
D-Area Drip Irrigation/Phytoremediation Project: SRTC Report on Phase 1

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

Wilde, E.W.

2001-09-11

The overall objective of this project is to evaluate a novel drip irrigation-phytoremediation process for remediating volatile organic contaminants (VOCs), primarily trichloroethylene (TCE), from groundwater in D-Area at the Savannah River Site (SRS). The process is expected to be less expensive and more beneficial to the environment than alternative TCE remediation technologies.
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
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.
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.
Variable methodological quality and use found in systematic reviews referenced in STEMI clinical practice guidelines.

PubMed

Scott, Jared; Howard, Benjamin; Sinnett, Philip; Schiesel, Michael; Baker, Jana; Henderson, Patrick; Vassar, Matt

2017-12-01

The objective of this study was to assess the methodological quality and clarity of reporting of the systematic reviews (SRs) supporting clinical practice guideline (CPG) recommendations in the management of ST-elevation myocardial infarction (STEMI) across international CPGs. We searched 13 guideline clearinghouses including the National Guideline Clearinghouse and Guidelines International Network (GIN). To meet inclusion criteria CPGs must be pertinent to the management of STEMI, endorsed by a governing body or national organization, and written in English. We retrieved SRs from the reference sections using a combination of keywords and hand searching. Two investigators scored eligible SRs using AMSTAR and PRISMA. We included four CPGs. We extracted 71 unique SRs. These SRs received AMSTAR scores ranging from 1 (low) to 9 (high) on an 11-point scale. All CPGs consistently underperformed in areas including disclosure of funding sources, risk of bias, and publication bias according to AMSTAR. PRISMA checklist completeness ranged from 44% to 96%. The PRISMA scores indicated that SRs did not provide a full search strategy, study protocol and registration, assessment of publication bias or report funding sources. Only one SR was referenced in all four CPGs. All CPGs omitted a large subset of available SRs cited by other guidelines. Our study demonstrates the variable quality of SRs used to establish recommendations within guidelines included in our sample. Although guideline developers have acknowledged this variability, it remains a significant finding that needs to be addressed further. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Copyright © 2017 Elsevier Inc. All rights reserved.
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
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.
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.
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
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
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.
Effects of living environment on the postoperative Scoliosis Research Society-24 results in females with adolescent idiopathic scoliosis.

PubMed

Misterska, Ewa; Głowacki, Maciej; Panek, Sławomir; Ignyś-O'Byrne, Anna; Głowacki, Jakub; Ignyś, Iwona; Krauss, Hanna; Piątek, Jacek

2012-08-01

There are many factors influencing postoperative health-related quality of life of adolescent idiopathic scoliosis patients, including the degree of the deformity, culture, differences in geography, rural versus urban living environments, and social factors. The objective of this study was to analyze the significance of geographic factors and their differences influencing the postoperative quality of life in females with adolescent idiopathic scoliosis residing in urban and rural environments, by use of the Polish version of the SRS-24 questionnaire. Forty urban and 20 rural postoperative patients with adolescent scoliosis with a minimum 2-year follow-up period after surgery were included in the study. The process of cross-cultural adaptation was performed according to the IQOLA Project. General results of the Polish SRS-24 equalled 4.1 (SD 0.5) and 4.0 (SD.0.5) in the rural and urban groups of patients, respectively. The 2 groups do not differ in incidence of floor and ceiling effects. The Cronbach's alpha values are excellent for the general result of SRS-24 in urban and rural groups (0.85 and 0.85, respectively). The sub-groups differed significantly in the self-image after surgery domain (p=0.048). Patients from the rural group scored higher in the self-image after surgery domain but reported higher pain levels when compared to urban patients. The associations between SRS-24 results and radiographic parameters in the rural group of patients were strong, compared with moderate relations reported in the urban group.
It takes longer than you think: librarian time spent on systematic review tasks*

PubMed Central

Bullers, Krystal; Howard, Allison M.; Hanson, Ardis; Kearns, William D.; Orriola, John J.; Polo, Randall L.; Sakmar, Kristen A.

2018-01-01

Introduction The authors examined the time that medical librarians spent on specific tasks for systematic reviews (SRs): interview process, search strategy development, search strategy translation, documentation, deliverables, search methodology writing, and instruction. We also investigated relationships among the time spent on SR tasks, years of experience, and number of completed SRs to gain a better understanding of the time spent on SR tasks from time, staffing, and project management perspectives. Methods A confidential survey and study description were sent to medical library directors who were members of the Association of Academic Health Sciences Libraries as well as librarians serving members of the Association of American Medical Colleges or American Osteopathic Association. Results Of the 185 participants, 143 (77%) had worked on an SR within the last 5 years. The number of SRs conducted by participants during their careers ranged from 1 to 500, with a median of 5. The major component of time spent was on search strategy development and translation. Average aggregated time for standard tasks was 26.9 hours, with a median of 18.5 hours. Task time was unrelated to the number of SRs but was positively correlated with years of SR experience. Conclusion The time required to conduct the librarian’s discrete tasks in an SR varies substantially, and there are no standard time frames. Librarians with more SR experience spent more time on instruction and interviews; time spent on all other tasks varied widely. Librarians also can expect to spend a significant amount of their time on search strategy development, translation, and writing. PMID:29632442
Evidence Synthesis and Translation for Nutrition Interventions to Combat Micronutrient Deficiencies with Particular Focus on Food Fortification.

PubMed

Lawrence, Mark; Wingrove, Kate; Naude, Celeste; Durao, Solange

2016-09-08

Over two billion people suffer from micronutrient deficiencies. Food fortification is a prominent nutrition intervention to combat such deficiencies; however, its effectiveness, risks, and ethical implications vary depending on the contexts associated with the deficiency it is addressing and the circumstances with its implementation. The aim of this research was to analyse the profile of nutrition interventions for combating micronutrient deficiency with particular focus on food fortification reported in existing systematic reviews (SRs), guidelines and policy statements, and implementation actions for nutrition. A review of secondary data available from online databases of SRs, guidelines and policy statements, and implementation actions, categorised as either "nutrition-specific interventions" (NSpI) or "nutrition-sensitive interventions" (NSeI), was conducted. Currently, there is evidence available for a diversity of food fortification topics, and there has been much translation into action. Indeed, food fortification and micronutrient supplementation interventions and NSpI more broadly dominate the profile of interventions for which there were SRs, guidelines, and policy statements available. The findings demonstrate that, although there is a rational linear relationship between evidence synthesis and translation in formulating policy and actions to combat micronutrient deficiencies, the various nutrition interventions available to help combat micronutrient deficiencies are not equally represented in the evidence synthesis and translation processes. Effective and safe policies and actions to combat micronutrient deficiencies require decisions to be informed from a body of evidence that consists of evidence from a variety of interventions. Into the future, investment in making available a higher number of SRs, guidelines and policy statements, and actions of NSeI is indicated.
Improving the efficiency of cognitive-behavioural therapy by using formal client feedback.

PubMed

Janse, Pauline D; De Jong, Kim; Van Dijk, Maarten K; Hutschemaekers, Giel J M; Verbraak, Marc J P M

2017-09-01

Feedback from clients on their view of progress and the therapeutic relationship can improve effectiveness and efficiency of psychological treatments in general. However, what the added value is of client feedback specifically within cognitive-behavioural therapy (CBT), is not known. Therefore, the extent to which the outcome of CBT can be improved is investigated by providing feedback from clients to therapists using the Outcome Rating Scale (ORS) and Session Rating Scale (SRS). Outpatients (n = 1006) of a Dutch mental health organization either participated in the "treatment as usual" (TAU) condition, or in Feedback condition of the study. Clients were invited to fill in the ORS and SRS and in the Feedback condition therapists were asked to frequently discuss client feedback. Outcome on the SCL-90 was only improved specifically with mood disorders in the Feedback condition. Also, in the Feedback condition, in terms of process, the total number of required treatment sessions was on average two sessions fewer. Frequently asking feedback from clients using the ORS/SRS does not necessarily result in a better treatment outcome in CBT. However, for an equal treatment outcome significantly fewer sessions are needed within the Feedback condition, thus improving efficiency of CBT.
Radionuclide field lysimeter experiment (RadFLEx): geochemical and hydrological data for SRS performance assessments

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

Kaplan, D.; Powell, B.; Barber, K.

The SRNL Radiological Field Lysimeter Experiment (RadFLEx) is a one-of-a-kind test bed facility designed to study radionuclide geochemical processes in the Savannah River Site (SRS) vadose zone at a larger spatial scale (from grams to tens of kilograms of sediment) and temporal scale (from months to decade) than is readily afforded through laboratory studies. RadFLEx is a decade-long project that was initiated on July 5, 2012 and is funded by six different sources. The objective of this status report is as follows: 1) to report findings to date that have an impact on SRS performance assessment (PA) calculations, and 2)more » to provide performance metrics of the RadFLEx program. The PA results are focused on measurements of transport parameters, such as distribution coefficients (Kd values), solubility, and unsaturated flow values. As this is an interim report, additional information from subsequent research may influence our interpretation of current results. Research related to basic understanding of radionuclide geochemistry in these vadose zone soils and other source terms are not described here but are referenced for the interested reader.« less
HIGHLY ENRICHED URANIUM BLEND DOWN PROGRAM AT THE SAVANNAH RIVER SITE PRESENT AND FUTURE

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

Magoulas, V; Charles Goergen, C; Ronald Oprea, R

2008-06-05

The Department of Energy (DOE) and Tennessee Valley Authority (TVA) entered into an Interagency Agreement to transfer approximately 40 metric tons of highly enriched uranium (HEU) to TVA for conversion to fuel for the Browns Ferry Nuclear Power Plant. Savannah River Site (SRS) inventories included a significant amount of this material, which resulted from processing spent fuel and surplus materials. The HEU is blended with natural uranium (NU) to low enriched uranium (LEU) with a 4.95% 235U isotopic content and shipped as solution to the TVA vendor. The HEU Blend Down Project provided the upgrades needed to achieve the productmore » throughput and purity required and provided loading facilities. The first blending to low enriched uranium (LEU) took place in March 2003 with the initial shipment to the TVA vendor in July 2003. The SRS Shipments have continued on a regular schedule without any major issues for the past 5 years and are due to complete in September 2008. The HEU Blend program is now looking to continue its success by dispositioning an additional approximately 21 MTU of HEU material as part of the SRS Enriched Uranium Disposition Project.« less
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.
Growth of ring ripple in a collisionless plasma in relativistic-ponderomotive regime and its effect on stimulated Raman backscattering process

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

Rawat, Priyanka; Purohit, Gunjan, E-mail: gunjan75@gmail.com; Gauniyal, Rakhi

A theoretical and numerical study has been made of the propagation of a ring rippled laser beam in collisionless plasma with dominant relativistic ponderomotive nonlinearity and its effect on the excitation of electron plasma wave and stimulated Raman backscattering process. The growth of ring ripple, riding on an intense Gaussian laser beam in plasma has also been studied. A paraxial-ray and WKB approximation has been invoked to understand the nature of propagation of the ring rippled Gaussian laser beam in plasma, electron plasma wave and back reflectivity under the influence of both nonlinearities. The growth rate and focusing of amore » ring rippled beam is found to be considerably affected by the power of the main beam and the phase angle between the electric vectors of the main beam and the ring ripple. It has also been observed that the focusing is released by the coupling of relativistic and ponderomotive nonlinearities, which significantly affected the dynamics of the excitation of electron plasma wave and back reflectivity of stimulated Raman scattering (SRS). Due to the strong coupling between ring rippled laser beam and the excited electron plasma wave, back reflectivity of SRS is enhanced. It has been observed from the computational results that the effect of the increased intensity leads to suppression of SRS back reflectivity. The results have been presented for established laser and plasma parameters.« less
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.
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 Â© 2016. Published by Elsevier Ltd.
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
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
POROUS WALL, HOLLOW GLASS MICROSPHERES

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

Sexton, W.

Hollow Glass Microspheres (HGM) is not a new technology. All one has to do is go to the internet and Google{trademark} HGM. Anyone can buy HGM and they have a wide variety of uses. HGM are usually between 1 to 100 microns in diameter, although their size can range from 100 nanometers to 5 millimeters in diameter. HGM are used as lightweight filler in composite materials such as syntactic foam and lightweight concrete. In 1968 a patent was issued to W. Beck of the 3M{trademark} Company for 'Glass Bubbles Prepared by Reheating Solid Glass Particles'. In 1983 P. Howell wasmore » issued a patent for 'Glass Bubbles of Increased Collapse Strength' and in 1988 H. Marshall was issued a patent for 'Glass Microbubbles'. Now Google{trademark}, Porous Wall, Hollow Glass Microspheres (PW-HGMs), the key words here are Porous Wall. Almost every article has its beginning with the research done at the Savannah River National Laboratory (SRNL). The Savannah River Site (SRS) where SRNL is located has a long and successful history of working with hydrogen and its isotopes for national security, energy, waste management and environmental remediation applications. This includes more than 30 years of experience developing, processing, and implementing special ceramics, including glasses for a variety of Department of Energy (DOE) missions. In the case of glasses, SRS and SRNL have been involved in both the science and engineering of vitreous or glass based systems. As a part of this glass experience and expertise, SRNL has developed a number of niches in the glass arena, one of which is the development of porous glass systems for a variety of applications. These porous glass systems include sol gel glasses, which include both xerogels and aerogels, as well as phase separated glass compositions, that can be subsequently treated to produce another unique type of porosity within the glass forms. The porous glasses can increase the surface area compared to 'normal glasses of a 1 to 2 order of magnitude, which can result in unique properties in areas such as hydrogen storage, gas transport, gas separations and purifications, sensors, global warming applications, new drug delivery systems and so on. One of the most interesting porous glass products that SRNL has developed and patented is Porous Wall, Hollow Glass Microspheres (PW-HGMs) that are being studied for many different applications. The European Patent Office (EPO) just recently notified SRS that the continuation-in-part patent application for the PW-HGMs has been accepted. The original patent, which was granted by the EPO on June 2, 2010, was validated in France, Germany and the United Kingdom. The microspheres produced are generally in the range of 2 to 100 microns, with a 1 to 2 micron wall. What makes the SRNL microspheres unique from all others is that the team in Figure 1 has found a way to induce and control porosity through the thin walls on a scale of 100 to 3000 {angstrom}. This is what makes the SRNL HW-HGMs one-of-a-kind, and is responsible for many of their unique properties and potential for various applications, including those in tritium storage, gas separations, H-storage for vehicles, and even a variety of new medical applications in the areas of drug delivery and MRI contrast agents. SRNL Hollow Glass Microspheres, and subsequent, Porous Wall, Hollow Glass Microspheres are fabricated using a flame former apparatus. Figure 2 is a schematic of the apparatus.« less
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
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.
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
DWPF Safely Dispositioning Liquid Waste

ScienceCinema

None

2018-06-21

The only operating radioactive waste glassification plant in the nation, the Defense Waste Processing Facility (DWPF) converts the liquid radioactive waste currently stored at the Savannah River Site (SRS) into a solid glass form suitable for long-term storage and disposal. Scientists have long considered this glassification process, called âvitrification,â as the preferred option for treating liquid radioactive waste.
77 FR 1920 - Second Amended Notice of Intent To Modify the Scope of the Surplus Plutonium Disposition...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-12

... suitable for MOX fuel fabrication is disposal at the Waste Isolation Pilot Plant (WIPP) in New Mexico... Waste Processing Facility at SRS or disposal at the Waste Isolation Pilot Plant (WIPP) in New Mexico. On... are safety (criticality) limits on how much plutonium can be sent to the Defense Waste Processing...
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
Radionuclide inventories for the F- and H-area seepage basin groundwater plumes

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

Hiergesell, Robert A; Kubilius, Walter P.

2016-05-01

Within the General Separations Areas (GSA) at the Savannah River Site (SRS), significant inventories of radionuclides exist within two major groundwater contamination plumes that are emanating from the F- and H-Area seepage basins. These radionuclides are moving slowly with groundwater migration, albeit more slowly due to interaction with the soil and aquifer matrix material. The purpose of this investigation is to quantify the activity of radionuclides associated with the pore water component of the groundwater plumes. The scope of this effort included evaluation of all groundwater sample analyses obtained from the wells that have been established by the Environmental Compliancemore » & Area Completion Projects (EC&ACP) Department at SRS to monitor groundwater contamination emanating from the F- and H-Area Seepage Basins. Using this data, generalized groundwater plume maps for the radionuclides that occur in elevated concentrations (Am-241, Cm-243/244, Cs-137, I-129, Ni-63, Ra-226/228, Sr-90, Tc-99, U-233/234, U-235 and U-238) were generated and utilized to calculate both the volume of contaminated groundwater and the representative concentration of each radionuclide associated with different plume concentration zones.« less
Super-recognition in development: A case study of an adolescent with extraordinary face recognition skills.

PubMed

Bennetts, Rachel J; Mole, Joseph; Bate, Sarah

2017-09-01

Face recognition abilities vary widely. While face recognition deficits have been reported in children, it is unclear whether superior face recognition skills can be encountered during development. This paper presents O.B., a 14-year-old female with extraordinary face recognition skills: a "super-recognizer" (SR). O.B. demonstrated exceptional face-processing skills across multiple tasks, with a level of performance that is comparable to adult SRs. Her superior abilities appear to be specific to face identity: She showed an exaggerated face inversion effect and her superior abilities did not extend to object processing or non-identity aspects of face recognition. Finally, an eye-movement task demonstrated that O.B. spent more time than controls examining the nose - a pattern previously reported in adult SRs. O.B. is therefore particularly skilled at extracting and using identity-specific facial cues, indicating that face and object recognition are dissociable during development, and that super recognition can be detected in adolescence.
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.
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.
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.
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
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
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.

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.
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.
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.
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.
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
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
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.
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.
Delphi`s DETOXSM process: Preparing to treat high organic content hazardous and mixed wastes

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

Robertson, D.T.; Rogers, T.W.; Goldblatt, S.D.

1998-12-31

The US Department of Energy (DOE) Federal Energy Technology Center is sponsoring a full-scale technology demonstration of Delphi Research, Inc.`s patented DETOX{sup SM} catalytic wet chemical oxidation waste treatment process at the Savannah River Site (SRS) in South Carolina. The process is being developed primarily to treat hazardous and mixed wastes within the DOE complex as an alternative to incineration, but it has significant potential to treat wastes in the commercial sector. The results of the demonstration will be intensively studied and used to validate the technology. A critical objective in preparing for the demonstration was the successful completion ofmore » a programmatic Operational Readiness Review. Readiness Reviews are required by DOE for all new process startups. The Readiness Review provided the vehicle to ensure that Delphi was ready to start up and operate the DETOX{sup SM} process in the safest manner possible by implementing industry accepted management practices for safe operation. This paper provides an overview of the DETOX{sup SM} demonstration at SRS, and describes the crucial areas of the Readiness Review that marked the first steps in Delphi`s transition from a technology developer to an operating waste treatment services provider.« less
NEW COLUMN SEPARATION METHOD FOR EMERGENCY URINE SAMPLES

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

Maxwell, S; Brian Culligan, B

2007-08-28

The Savannah River Site Environmental Bioassay Lab participated in the 2007 NRIP Emergency Response program administered by the National Institute for Standards and Technology (NIST) in May, 2007. A new rapid column separation method was applied directly to the NRIP 2007 emergency urine samples, with only minimal sample preparation to reduce preparation time. Calcium phosphate precipitation, previously used to pre-concentrate actinides and Sr-90 in NRIP 2006 urine and water samples, was not used for the NRIP 2007 urine samples. Instead, the raw urine was acidified and passed directly through the stacked resin columns (TEVA+TRU+SR Resins) to separate the actinides andmore » strontium from the NRIP urine samples more quickly. This improvement reduced sample preparation time for the NRIP 2007 emergency urine analyses significantly. This approach works well for small volume urine samples expected during an emergency response event. Based on initial feedback from NIST, the SRS Environmental Bioassay Lab had the most rapid analysis times for actinides and strontium-90 analyses for NRIP 2007 urine samples.« 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.
Environmental Biosciences Program Quarterly Report

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

Lawrence C. Mohr, M.D.

2009-01-30

Current research projects have focused Environmental Biosciences Program (EBP) talent and resources on providing the scientific basis for risk-based standards, risk-based decision making and the accelerated clean-up of widespread environmental hazards. These hazards include trichloroethylene, low-dose ionizing radiation (gamma and neutron) and alpha radiation from plutonium. Trichloroethylene research has been conducted as a joint collaborative effort with the University of Georgia. Work on the trichloroethylene research projects has been slowed as a result of funding uncertainties. The impact of these funding uncertainties has been discussed with the United States Department of Energy (DOE). Laboratory work has been completed on severalmore » trichloroethylene risk assessment projects, and these projects have been brought to a close. Plans for restructuring the performance schedule of the remaining trichloroethylene projects have been submitted to the department. A comprehensive manuscript on the scientific basis of trichloroethylene risk assessment is in preparation. Work on the low-dose radiation risk assessment projects is also progressing at a slowed rate as a result of funding uncertainties. It has been necessary to restructure the proponency and performance schedule of these projects, with the project on Low-Dose Radiation: Epidemiology Risk Models transferred to DOE Office of Science proponency under a separate funding instrument. Research on this project will continue under the provisions of the DOE Office of Science funding instrument, with progress reported in accordance with the requirements of that funding instrument. Progress on that project will no longer be reported in quarterly reports for DE-FC09-02CH11109. Following a meeting at the Savannah River Site on May 8, 2008, a plan was submitted for development of an epidemiological cohort study and prospective medical surveillance system for the assessment of disease rates among workers at the Savannah River Site (SRS). This project will be incorporated into the ongoing project on Population Health Risks in the Vicinity of the Savannah River Site. During a meeting at the SRS on October 21, 2008, a presentation was made on EBP participation in the development and operation of an Epidemiology Consortium at the SRS. A follow-up meeting with SRS officials is planned for 29 and 30 January 2009 at Medical University of South Carolina (MUSC).An epidemiology project on population health risk assessment is being conducted to assess health risks among populations in the vicinity of the SRS. This project is using the capabilities of the EBP GIS for the geographical assessment of cancer and non-cancer disease rates, as well as the potential association of population health risks with environmental exposures. Although funding uncertainties have slowed progress on some aspects of this project, it has not been necessary to restructure the performance schedule to date.« less
Natural Remediation at Savannah River Site

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

Lewis, C. M.; Van Pelt, R.

2002-02-25

Natural remediation is a general term that includes any technology or strategy that takes advantage of natural processes to remediate a contaminated media to a condition that is protective of human health and the environment. Natural remediation techniques are often passive and minimally disruptive to the environment. They are generally implemented in conjunction with traditional remedial solutions for source control (i.e., capping, stabilization, removal, soil vapor extraction, etc.). Natural remediation techniques being employed at Savannah River Site (SRS) include enhanced bio-remediation, monitored natural attenuation, and phytoremediation. Enhanced bio-remediation involves making nutrients available and conditions favorable for microbial growth. With propermore » precautions and feeding, the naturally existing microbes flourish and consume the contaminants. Case studies of enhanced bio-remediation include surface soils contaminated with PCBs and pesticides, and Volatile Organic Compound (VOC) contamination in both the vadose zone and groundwater. Monitored natural attenuation (MNA) has been selected as the preferred alternative for groundwater clean up at several SRS waste units. Successful implementation of MNA has been based on demonstration that sources have been controlled, groundwater modeling that indicates that plumes will not expand or reach surface water discharge points at levels that exceed regulatory limits, and continued monitoring. Phytoremediation is being successfully utilized at several SRS waste units. Phytoremediation involves using plants and vegetation to uptake, break down, or manage contaminants in groundwater or soils. Case studies at SRS include managing groundwater plumes of tritium and VOCs with pine trees that are native to the area. Significant decreases in tritium discharge to a site stream have been realized in one phytoremediation project. Studies of other vegetation types, methods of application, and other target contaminants are underway.« less
Characterization of a calcium/calmodulin-regulated SR/CAMTA gene family during tomato fruit development and ripening

PubMed Central

2012-01-01

Background Fruit ripening is a complicated development process affected by a variety of external and internal cues. It is well established that calcium treatment delays fruit ripening and senescence. However, the underlying molecular mechanisms remain unclear. Results Previous studies have shown that calcium/calmodulin-regulated SR/CAMTAs are important for modulation of disease resistance, cold sensitivity and wounding response in vegetative tissues. To study the possible roles of this gene family in fruit development and ripening, we cloned seven SR/CAMTAs, designated as SlSRs, from tomato, a model fruit-bearing crop. All seven genes encode polypeptides with a conserved DNA-binding domain and a calmodulin-binding site. Calmodulin specifically binds to the putative targeting site in a calcium-dependent manner. All SlSRs were highly yet differentially expressed during fruit development and ripening. Most notably, the expression of SlSR2 was scarcely detected at the mature green and breaker stages, two critical stages of fruit development and ripening; and SlSR3L and SlSR4 were expressed exclusively in fruit tissues. During the developmental span from 10 to 50 days post anthesis, the expression profiles of all seven SlSRs were dramatically altered in ripening mutant rin compared with wildtype fruit. By contrast, only minor alterations were noted for ripening mutant nor and Nr fruit. In addition, ethylene treatment of mature green wildtype fruit transiently stimulated expression of all SlSRs within one to two hours. Conclusions This study indicates that SlSR expression is influenced by both the Rin-mediated developmental network and ethylene signaling. The results suggest that calcium signaling is involved in the regulation of fruit development and ripening through calcium/calmodulin/SlSR interactions. PMID:22330838

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.
Studying the potential impact of automated document classification on scheduling a systematic review update.

PubMed

Cohen, Aaron M; Ambert, Kyle; McDonagh, Marian

2012-04-19

Systematic Reviews (SRs) are an essential part of evidence-based medicine, providing support for clinical practice and policy on a wide range of medical topics. However, producing SRs is resource-intensive, and progress in the research they review leads to SRs becoming outdated, requiring updates. Although the question of how and when to update SRs has been studied, the best method for determining when to update is still unclear, necessitating further research. In this work we study the potential impact of a machine learning-based automated system for providing alerts when new publications become available within an SR topic. Some of these new publications are especially important, as they report findings that are more likely to initiate a review update. To this end, we have designed a classification algorithm to identify articles that are likely to be included in an SR update, along with an annotation scheme designed to identify the most important publications in a topic area. Using an SR database containing over 70,000 articles, we annotated articles from 9 topics that had received an update during the study period. The algorithm was then evaluated in terms of the overall correct and incorrect alert rate for publications meeting the topic inclusion criteria, as well as in terms of its ability to identify important, update-motivating publications in a topic area. Our initial approach, based on our previous work in topic-specific SR publication classification, identifies over 70% of the most important new publications, while maintaining a low overall alert rate. We performed an initial analysis of the opportunities and challenges in aiding the SR update planning process with an informatics-based machine learning approach. Alerts could be a useful tool in the planning, scheduling, and allocation of resources for SR updates, providing an improvement in timeliness and coverage for the large number of medical topics needing SRs. While the performance of this initial method is not perfect, it could be a useful supplement to current approaches to scheduling an SR update. Approaches specifically targeting the types of important publications identified by this work are likely to improve results.
Studying the potential impact of automated document classification on scheduling a systematic review update

PubMed Central

2012-01-01

Background Systematic Reviews (SRs) are an essential part of evidence-based medicine, providing support for clinical practice and policy on a wide range of medical topics. However, producing SRs is resource-intensive, and progress in the research they review leads to SRs becoming outdated, requiring updates. Although the question of how and when to update SRs has been studied, the best method for determining when to update is still unclear, necessitating further research. Methods In this work we study the potential impact of a machine learning-based automated system for providing alerts when new publications become available within an SR topic. Some of these new publications are especially important, as they report findings that are more likely to initiate a review update. To this end, we have designed a classification algorithm to identify articles that are likely to be included in an SR update, along with an annotation scheme designed to identify the most important publications in a topic area. Using an SR database containing over 70,000 articles, we annotated articles from 9 topics that had received an update during the study period. The algorithm was then evaluated in terms of the overall correct and incorrect alert rate for publications meeting the topic inclusion criteria, as well as in terms of its ability to identify important, update-motivating publications in a topic area. Results Our initial approach, based on our previous work in topic-specific SR publication classification, identifies over 70% of the most important new publications, while maintaining a low overall alert rate. Conclusions We performed an initial analysis of the opportunities and challenges in aiding the SR update planning process with an informatics-based machine learning approach. Alerts could be a useful tool in the planning, scheduling, and allocation of resources for SR updates, providing an improvement in timeliness and coverage for the large number of medical topics needing SRs. While the performance of this initial method is not perfect, it could be a useful supplement to current approaches to scheduling an SR update. Approaches specifically targeting the types of important publications identified by this work are likely to improve results. PMID:22515596
Savannah River Site Eastern Transportation Hub: A Concept For a DOE Eastern Packaging, Staging and Maintenance Center - 13143

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

England, Jeffery L.; Adams, Karen; Maxted, Maxcine

2013-07-01

The Department of Energy (DOE) is working to de-inventory sites and consolidate hazardous materials for processing and disposal. The DOE administers a wide range of certified shipping packages for the transport of hazardous materials to include Special Nuclear Material (SNM), radioactive materials, sealed sources and radioactive wastes. A critical element to successful and safe transportation of these materials is the availability of certified shipping packages. There are over seven thousand certified packagings (i.e., Type B/Type AF) utilized within the DOE for current missions. The synergistic effects of consolidated maintenance, refurbishment, testing, certification, and costing of these services would allow formore » efficient management of the packagings inventory and to support anticipated future in-commerce shipping needs. The Savannah River Site (SRS) receives and ships radioactive materials (including SNM) and waste on a regular basis for critical missions such as consolidated storage, stabilization, purification, or disposition using H-Canyon and HB-Line. The Savannah River National Laboratory (SRNL) has the technical capability and equipment for all aspects of packaging management. SRS has the only active material processing facility in the DOE complex and is one of the sites of choice for nuclear material consolidation. SRS is a logical location to perform maintenance and periodic testing of the DOE fleet of certified packagings. This initiative envisions a DOE Eastern Packaging Staging and Maintenance Center (PSMC) at the SRS and a western hub at the Nevada National Security Site (NNSS), an active DOE Regional Disposal Site. The PSMC's would be the first place DOE would go to meet their radioactive packaging needs and the primary locations projects would go to disposition excess packaging for beneficial reuse. These two hubs would provide the centralized management of a packaging fleet rather than the current approach to design, procure, maintain and dispose of packagings on a project-by-project basis. This initiative provides significant savings in packaging costs and acceleration of project schedules. In addition to certified packaging, the PSMC would be well suited for select designs of 7A Type A packaging and Industrial Packaging. (authors)« less
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.
In vivo study of lipid synthesis and lipolysis dynamics by stimulated Raman scattering microscopy

NASA Astrophysics Data System (ADS)

Li, Xuesong; Li, Yan; He, Sicong; Chen, Congping; Qin, Zhongya; Mak, Ho Yi; Qu, Jianan Y.

2018-02-01

To understand the mechanisms of important lipid-related biological processes and diseases, it is highly demanded to study the dynamics of lipids in living biological system with high spatiotemporal resolution. However, in vivo quantitative analysis of lipid synthesis and lipolysis has been technically difficult to achieve by conventional lipid extraction and fluorescent staining methods. Recently, SRS microscopy has emerged as a powerful tool to probe small molecules with alkyne (C≡C) or deuterium (C-D) labeling in cell-silent region. The Raman tags have been used for the quantitative study of lipids in cells. In this study, we investigated metabolic dynamics of lipid droplets (LDs) by tracing the alkyne-tagged fatty acid 17-ODYA and deuterium-labeled saturated and unsaturated fatty acids PA-D31 & OA-D34 in living C. elegans. Specifically, we developed a hyperspectral SRS microscope system for LDs characterization. The system can sequentially excite and probe the stimulated Raman scattering-induced CH2 stretching of endogenous lipids information (2863 cm-1), C≡C stretching from 17-ODYA (2125 cm-1) and C-D stretching from deuterium-labeled fatty acids (2117 cm-1). We first examined the concentration levels of fatty acids in E. coli OP50. Two major lipid metabolic processes, namely uptake and turnover, were further studied in adult C. elegans. We imaged alkyne-tagged and deuterated fatty acids using SRS and traced their uptake, transportation, incorporation and turnover over time. Additionally, several other treatments including starvation were also conducted to study their effects on metabolic dynamics of pulse labeled 17-ODYA, PA-D31 and OA-D34.
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.
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
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
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.
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.
Phenotype classification of single cells using SRS microscopy, RNA sequencing, and microfluidics (Conference Presentation)

NASA Astrophysics Data System (ADS)

Streets, Aaron M.; Cao, Chen; Zhang, Xiannian; Huang, Yanyi

2016-03-01

Phenotype classification of single cells reveals biological variation that is masked in ensemble measurement. This heterogeneity is found in gene and protein expression as well as in cell morphology. Many techniques are available to probe phenotypic heterogeneity at the single cell level, for example quantitative imaging and single-cell RNA sequencing, but it is difficult to perform multiple assays on the same single cell. In order to directly track correlation between morphology and gene expression at the single cell level, we developed a microfluidic platform for quantitative coherent Raman imaging and immediate RNA sequencing (RNA-Seq) of single cells. With this device we actively sort and trap cells for analysis with stimulated Raman scattering microscopy (SRS). The cells are then processed in parallel pipelines for lysis, and preparation of cDNA for high-throughput transcriptome sequencing. SRS microscopy offers three-dimensional imaging with chemical specificity for quantitative analysis of protein and lipid distribution in single cells. Meanwhile, the microfluidic platform facilitates single-cell manipulation, minimizes contamination, and furthermore, provides improved RNA-Seq detection sensitivity and measurement precision, which is necessary for differentiating biological variability from technical noise. By combining coherent Raman microscopy with RNA sequencing, we can better understand the relationship between cellular morphology and gene expression at the single-cell level.
Survey of systematic review authors in dentistry: challenges in methodology and reporting.

PubMed

Major, Michael P; Warren, Sharon; Flores-Mir, Carlos

2009-04-01

The study reported in this article had three objectives: 1) identify the challenges faced by authors of dental systematic reviews (SR) during the process of literature search and selection; 2) determine whether dental SR authors' responses to survey questions about their study methodology were consistent with the reported published methodology; and 3) assess whether dental SR authors' evidence-based publication experience was associated with reported methodology. Seventy-eight authors (53 percent) of dental SRs out of 147 potential authors published from 2000 to 2006 responded to an online survey. According to the respondents, the most challenging aspects of literature search and selection were the initial design and performing extended literature searches. Agreement between the protocol identified by SR authors on the survey and the actual protocol described in their publications was fair to moderate. There were virtually no correlations between authors' publication experience, systematic review literature search, and selection thoroughness except for the number of past SRs published, and no differences in thoroughness between SRs written by clinicians (dental practitioners in the community) and dental school faculty members. Dental SR authors do not appear to fully appreciate the importance of extensive literature searches as central to the validity of their systematic review methods and potential findings.
SRS 2010 Vegetation Inventory GeoStatistical Mapping Results for Custom Reaction Intensity and Total Dead Fuels.

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

Edwards, Lloyd A.; Paresol, Bernard

This report of the geostatistical analysis results of the fire fuels response variables, custom reaction intensity and total dead fuels is but a part of an SRS 2010 vegetation inventory project. For detailed description of project, theory and background including sample design, methods, and results please refer to USDA Forest Service Savannah River Site internal report “SRS 2010 Vegetation Inventory GeoStatistical Mapping Report”, (Edwards & Parresol 2013).
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
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.
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.
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.
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.
Maxdose-SR and popdose-SR routine release atmospheric dose models used at SRS

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

Jannik, G. T.; Trimor, P. P.

MAXDOSE-SR and POPDOSE-SR are used to calculate dose to the offsite Reference Person and to the surrounding Savannah River Site (SRS) population respectively following routine releases of atmospheric radioactivity. These models are currently accessed through the Dose Model Version 2014 graphical user interface (GUI). MAXDOSE-SR and POPDOSE-SR are personal computer (PC) versions of MAXIGASP and POPGASP, which both resided on the SRS IBM Mainframe. These two codes follow U.S. Nuclear Regulatory Commission (USNRC) Regulatory Guides 1.109 and 1.111 (1977a, 1977b). The basis for MAXDOSE-SR and POPDOSE-SR are USNRC developed codes XOQDOQ (Sagendorf et. al 1982) and GASPAR (Eckerman et. almore » 1980). Both of these codes have previously been verified for use at SRS (Simpkins 1999 and 2000). The revisions incorporated into MAXDOSE-SR and POPDOSE-SR Version 2014 (hereafter referred to as MAXDOSE-SR and POPDOSE-SR unless otherwise noted) were made per Computer Program Modification Tracker (CPMT) number Q-CMT-A-00016 (Appendix D). Version 2014 was verified for use at SRS in Dixon (2014).« less
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.
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.
Requirements Analysis for Large Ada Programs: Lessons Learned on CCPDS- R

DTIC Science & Technology

1989-12-01

when the design had matured and This approach was not optimal from the formal the SRS role was to be the tester’s contract, implemen- testing and...on the software development CPU processing load. These constraints primar- process is the necessity to include sufficient testing ily affect algorithm...allocations and timing requirements are by-products of the software design process when multiple CSCls are a P R StrR eSOFTWARE ENGINEERING executed within
High-Level Waste System Process Interface Description

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

d'Entremont, P.D.

1999-01-14

The High-Level Waste System is a set of six different processes interconnected by pipelines. These processes function as one large treatment plant that receives, stores, and treats high-level wastes from various generators at SRS and converts them into forms suitable for final disposal. The three major forms are borosilicate glass, which will be eventually disposed of in a Federal Repository, Saltstone to be buried on site, and treated water effluent that is released to the environment.
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
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.
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.

Why SRS Matters - Tritium

ScienceCinema

Howell, Steve; Schifer, Lee

2018-01-16

A video series presenting an overview of the Savannah River Siteâs (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.
Systematic reviews on child welfare services: identifying and disseminating the evidence.

PubMed

Kornør, Hege; Bergman, Hanna; Maayan, Nicola; Soares-Weiser, Karla; Bjørndal, Arild

2015-10-01

Evidence-based practice is at an early stage of uptake within child welfare services. To facilitate well-informed decisions, we disseminated evidence from systematic reviews (SR) to local child welfare stakeholders in Norway through plain language summaries on a website (http://www.r-bup.no). We developed and implemented our dissemination strategy through seven steps: (1) systematic literature search; (2) selection of relevant SRs; (3) assembly of an advisory board; (4) selection of child welfare SRs relevant to Norway; (5) prioritization of the included SRs; (6) development of a plain language summary (PLS) after feedback from the advisory board; and (7) implementation of website. A total of 9266 potentially relevant records were screened and 120 SRs were included. The advisory board was assembled from local policymakers, practitioners, researchers, carers and consumers. The advisory board members independently ranked the 120 SRs according to relevance and prioritized 20 SRs that were written up into the PLS. The format of the PLS was tested and agreed with the board members. A website was developed and the PLSs were published starting September 2014. We think that the PLSs will be valuable resources to practitioners and it will be easily accessible to caregivers and consumers. This knowledge will inform research priorities and practice in Norway, leading the way to the use of evidence-based decisions in local child welfare services. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.
Systematic overview of economic evaluations of health-related rehabilitation.

PubMed

Howard-Wilsher, Stephanie; Irvine, Lisa; Fan, Hong; Shakespeare, Tom; Suhrcke, Marc; Horton, Simon; Poland, Fiona; Hooper, Lee; Song, Fujian

2016-01-01

Health related rehabilitation is instrumental in improving functioning and promoting participation by people with disabilities. To make clinical and policy decisions about health-related rehabilitation, resource allocation and cost issues need to be considered. To provide an overview of systematic reviews (SRs) on economic evaluations of health-related rehabilitation. We searched multiple databases to identify relevant SRs of economic evaluations of health-related rehabilitation. Review quality was assessed by AMSTAR checklist. We included 64 SRs, most of which included economic evaluations alongside randomized controlled trials (RCTs). The review quality was low to moderate (AMSTAR score 5-8) in 35, and high (score 9-11) in 29 of the included SRs. The included SRs addressed various health conditions, including spinal or other pain conditions (n = 14), age-related problems (11), stroke (7), musculoskeletal disorders (6), heart diseases (4), pulmonary (3), mental health problems (3), and injury (3). Physiotherapy was the most commonly evaluated rehabilitation intervention in the included SRs (n = 24). Other commonly evaluated interventions included multidisciplinary programmes (14); behavioral, educational or psychological interventions (11); home-based interventions (11); complementary therapy (6); self-management (6); and occupational therapy (4). Although the available evidence is often described as limited, inconsistent or inconclusive, some rehabilitation interventions were cost-effective or showed cost-saving in a variety of disability conditions. Available evidence comes predominantly from high income countries, therefore economic evaluations of health-related rehabilitation are urgently required in less resourced settings. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Interval From Imaging to Treatment Delivery in the Radiation Surgery Age: How Long Is Too Long?

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

Seymour, Zachary A., E-mail: seymourz@radonc.ucsf.edu; Fogh, Shannon E.; Westcott, Sarah K.

Purpose: The purpose of this study was to evaluate workflow and patient outcomes related to frameless stereotactic radiation surgery (SRS) for brain metastases. Methods and Materials: We reviewed all treatment demographics, clinical outcomes, and workflow timing, including time from magnetic resonance imaging (MRI), computed tomography (CT) simulation, insurance authorization, and consultation to the start of SRS for brain metastases. Results: A total of 82 patients with 151 brain metastases treated with SRS were evaluated. The median times from consultation, insurance authorization, CT simulation, and MRI for treatment planning were 15, 7, 6, and 11 days to SRS. Local freedom from progressionmore » (LFFP) was lower in metastases with MRI ≥14 days before treatment (P=.0003, log rank). The 6- and 12-month LFFP rate were 95% and 75% for metastasis with interval of <14 days from MRI to treatment compared to 56% and 34% for metastases with MRI ≥14 days before treatment. On multivariate analysis, LFFP remained significantly lower for lesions with MRI ≥14 days at SRS (P=.002, Cox proportional hazards; hazard ratio: 3.4, 95% confidence interval: 1.6-7.3). Conclusions: Delay from MRI to SRS treatment delivery for brain metastases appears to reduce local control. Future studies should monitor the timing from imaging acquisition to treatment delivery. Our experience suggests that the time from MRI to treatment should be <14 days.« less
Hydrodynamics simulations of 2{omega} laser propagation in underdense gasbag plasmas

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

Meezan, N.B.; Divol, L.; Marinak, M.M.

2004-12-01

Recent 2{omega} laser propagation and stimulated Raman backscatter (SRS) experiments performed on the Helen laser have been analyzed using the radiation-hydrodynamics code HYDRA [M. M. Marinak, G. D. Kerbel, N. A. Gentile, O. Jones, D. Munro, S. Pollaine, T. R. Dittrich, and S. W. Haan, Phys. Plasmas 8, 2275 (2001)]. These experiments utilized two diagnostics sensitive to the hydrodynamics of gasbag targets: a fast x-ray framing camera (FXI) and a SRS streak spectrometer. With a newly implemented nonlocal thermal transport model, HYDRA is able to reproduce many features seen in the FXI images and the SRS streak spectra. Experimental andmore » simulated side-on FXI images suggest that propagation can be explained by classical laser absorption and the resulting hydrodynamics. Synthetic SRS spectra generated from the HYDRA results reproduce the details of the experimental SRS streak spectra. Most features in the synthetic spectra can be explained solely by axial density and temperature gradients. The total SRS backscatter increases with initial gasbag fill density up to {approx_equal}0.08 times the critical density, then decreases. Data from a near-backscatter imaging camera show that severe beam spray is not responsible for the trend in total backscatter. Filamentation does not appear to be a significant factor in gasbag hydrodynamics. The simulation and analysis techniques established here can be used in ongoing experimental campaigns on the Omega laser facility and the National Ignition Facility.« less
Subscriber Response System; El Segundo Interim Test Report.

ERIC Educational Resources Information Center

Callais, Richard T.

A new cable television system, called the Subscriber Response System (SRS), is being tested prior to a trial installation in El Segundo, California. The components include two bidirectional cables, a computer for processing subscribers' requests, and subscriber terminals to be located in homes or offices. The home terminal includes a three-digit…
Comparison of stimulated and spontaneous laser-radar methods for the remote sensing of ocean physical properties

NASA Astrophysics Data System (ADS)

Leonard, Donald A.; Sweeney, Harold E.

1990-09-01

The physical properties of ocean water, in the top few ten meters, are of great interest in the scientific, engineering, and general oceanographic communities. Subsurface profiles of temperature, salinity, and sound speed measured by laser radar in real time on a synoptic basis over a wide area from an airborne platform would provide valuable information complementary to the data that is now readily available. The laser-radar technique specifically applicable to ocean sensing uses spectroscopic analysis of the inelastic backscattered optical signal. Two methods have received considerable attention for remote sensing and both have been demonstrated in field experiments. These are spontaneous Raman1 and spontaneous Brillouin2 scattering. A discussion of these two processes and a comparison of their properties that are useful for remote sensing was presented3 at SPIE Ocean Optics IX. This paper compares ocean remote sensing using stimulated Brillouin scattering (SBS) and stimulated Raman scattering (SRS) processes with better known spontaneous methods. The results of laboratory measurements of temperature using SBS and some preliminary results of SRS are presented with extensions to performance estimates of potential field systems.
Materials characterization studies on LANA75/85 materials for replacement beds

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

Shanahan, Kirk L.

2016-12-30

During FY15 and FY16, a purchase order (PO) was placed with Japan Metals and Chemicals, USA after an open bidding procurement process for 282 kg of LaNi 4.25Al 0.75 and 226 kg. of LaNi 4.15Al 0.85. These materials were to be used in Tritium Facility replacement beds for existing beds that have reached the end of their useful life. As part of the PO, a 100 g. sample of each material was delivered to the SRNL Hydrogen Processing Group for characterization studies as is typically done for all newly acquired hydride materials. The PO actually employed a “trust but verify”more » approach where JMCUSA was allowed to ship materials it felt met specifications without SRS confirmation, as long as the data used to do so was delivered to SRS as part of the PO documentation package. Subsequent SRNL analysis revealed that the material met all specifications and was of very high quality. This report documents those findings.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)

Nave, S.E.

Recent advances in fiber optics, diode lasers, CCD detectors, dielectric and holographic optical filters, grating spectrometers, and chemometric data analysis have greatly simplified Raman spectroscopy. In order to make a rugged fiber optic Raman probe for solids/slurries like these at Savannah River, we have designed a probe that eliminates as many optical elements and surfaces as possible. The diffuse reflectance probe tip is modified for Raman scattering by installing thin dielectric in-line filters. Effects of each filter are shown for the NaNO{sub 3} Raman spectrum. By using a diode laser excitation at 780 nm, fluorescence is greatly reduced, and excellentmore » spectra may be obtained from organic solids. At SRS, fiber optic Raman probes are being developed for in situ chemical mapping of radioactive waste storage tanks. Radiation darkening of silica fiber optics is negligible beyond 700 nm. Corrosion resistance is being evaluated. Analysis of process gas (off-gas from SRS processes) is investigated in some detail: hydrogen in nitrogen with NO{sub 2} interference. Other applications and the advantages of the method are pointed out briefly.« less
Discriminative and predictive validity of the scoliosis research society-22 questionnaire in management and curve-severity subgroups of adolescents with idiopathic scoliosis.

PubMed

Parent, Eric C; Hill, Doug; Mahood, Jim; Moreau, Marc; Raso, Jim; Lou, Edmond

2009-10-15

Prospective cross-sectional measurement study. To determine the ability of the Scoliosis Research Society (SRS)-22 questionnaire to discriminate among management and scoliosis severity subgroups and to correlate with internal and external measures of curve severity. In earlier studies of the SRS-22 discriminative ability, age was not a controlled factor. The ability of the SRS-22 to predict curve severity has not been thoroughly examined. The SRS-22 was completed by 227 females with adolescent idiopathic scoliosis. Using Analysis of covariance analyses controlling for age, the SRS-22 scores were compared among management subgroups (observation, brace, presurgery, and postsurgery) and curve-severity subgroups (in nonoperated subjects: Cobb angles of <30 degrees, 30 degrees -50 degrees, and >50 degrees). A stepwise discriminant analysis was used to identify the SRS-22 domains most discriminative for curve-severity categories. Correlation between SRS-22 scores and radiographic or surface topography measurements was used to determine the predictive ability of the questionnaire. Pain was better for subjects treated with braces than for those planning surgery. Self-image was better for subjects under observation or postsurgery than for those planning surgery. Satisfaction was better for the brace and postsurgery subgroups than for the observation or presurgery subgroups. Statistically significant mean differences between subgroups were all larger than 0.5, which is within the range of minimal clinically important differences recommended for each of the 5-point SRS-22 domain scoring scales. Pain and mental health were worse for those with Cobb angles of >50 degrees than with Cobb angles of 30 degrees to 50 degrees. Self-image and total scores were worse for those with Cobb angles of >50 degrees than both other subgroups. Using discriminant analysis, self-image was the only SRS-22 domain score selected to classify subjects within curve severity subgroups. The percentage of patients accurately classified was 54% when trying to classify within 3 curve severity subgroups. The percentage of patients accurately classified was 73% when classifying simply as those with curves larger or smaller than 50 degrees . Pain, self-image, and satisfaction scores could discriminate among management subgroups, but function, mental health and total scores could not. The total score and all domain scores except satisfaction discriminated among curve-severity subgroups. Using discriminant analysis, self-image was the only domain retained in a model predicting curve-severity categories.
Rod fracture in adult spinal deformity surgery fused to the sacrum: prevalence, risk factors, and impact on health-related quality of life in 526 patients.

PubMed

Lertudomphonwanit, Thamrong; Kelly, Michael P; Bridwell, Keith H; Lenke, Lawrence G; McAnany, Steven J; Punyarat, Prachya; Bryan, Timothy P; Buchowski, Jacob M; Zebala, Lukas P; Sides, Brenda A; Steger-May, Karen; Gupta, Munish C

2018-02-28

Risk factors associated with rod fracture (RF) following adult spinal deformity (ASD) surgery fused to the sacrum remain debatable, and the impact of RF on patient-reported outcomes (PROs) after ASD surgery has not been investigated. We aimed to evaluate the prevalence of and risk factors for RF and determine PROs changes associated with RF after ASD surgery fused to the sacrum. A retrospective single-center cohort study was performed. Patients undergoing long-construct posterior spinal fusions to the sacrum performed at a single institution by two senior spine surgeons from 2004 to 2014 were included. Patient demographics, radiographic parameters, and surgical factors were assessed for risk factors associated with RF. Oswestry Disability Index (ODI) and Scoliosis Research Society-30 (SRS-30) scores were assessed at baseline, 1 year postoperatively, and latest follow-up. Inclusion criteria were ASD patients age >18 who had ≥5 vertebrae instrumented and fused posteriorly to the sacrum and either development of RF or no development of RF with minimum 2-year follow-up. Patient characteristics, operative data, radiographic parameters, and PROs were analyzed at baseline and follow-up. Separate Cox proportional hazard models based on rod material and diameter were used to determine factors associated with RF. Five hundred twenty-six patients (80%) were available for analysis. RF occurred in 97 (18.4%) patients (unilateral RF n=61 [63%]; bilateral RF n=36 [37%]). Risk factors for fracture of 5.5 mm cobalt chromium (CC) instrumentation (CC 5.5 model) included preoperative sagittal vertical axis (hazard ratio [HR] 1.07, 95% confidence interval [95% CI] 1.02-1.14 per 1-cm increase), preoperative thoracolumbar kyphosis (HR 1.02, 95% CI 1.01-1.04 per 1-degree increase), and number of levels fused for patients who received rhBMP-2 <12 mg per level fused (HR 1.48, 95% CI 1.20-1.82 per 1-level increase). Implants that were 5.5-mm CC constructs were at a higher risk for fracture than 6.35-mm stainless steel (SS) constructs (HR 8.49, 95% CI 4.26-16.89). The RF group had less overall improvement in SRS Satisfaction (0.93 vs. 1.32; p=.007) and SRS Self-image domain scores (0.72 vs. 1.02; p=.01). The bilateral RF group had less overall improvement in ODI (8.1 vs. 15.8; p=.02), SRS Subscore (0.51 vs. 0.85; p=.03), and SRS Pain domain scores (0.48 vs. 0.95; p=.02) compared with the non-RF group at final follow-up. The prevalence of all RF after index procedures was 18.4%, 37% for bilateral RF. Greater preoperative sagittal vertical axis, greater preoperative thoracolumbar kyphosis, increased number of vertebrae fused for patients who received rhBMP-2 <12 mg per level fused, and CC 5.5-mm rod were associated with RF. Less improvement in patient satisfaction and self-image was noted in the RF group. Furthermore, bilateral RF significantly affected PROs as measured by ODI and SRS Subscore at final follow-up. Copyright © 2018 Elsevier Inc. All rights reserved.
Single speckle SRS threshold as determined by electron trapping, collisions and speckle duration

NASA Astrophysics Data System (ADS)

Rose, Harvey; Daughton, William; Yin, Lin; Langdon, Bruce

2008-11-01

Speckle SRS intensity threshold has been shown to increase with spatial dimension, D, because both diffraction and trapped electron escape rate increase with D, though the net effect is to substantially decrease the threshold compared to 1D linear gain calculations. On the other hand, the apparent threshold appears to decrease with integration time in PIC simulations. We present an optimum nonlinearly resonant calculation of the SRS threshold, taking into account large fluctuations of the SRS seed reflectivity, R0. Such fluctuations, absent in 1D, are caused by a gap in the linear reflectivity gain spectrum which leads to an exponential probability distribution for R0. While the SRS threshold intensity is of course finite, these fluctuations lead to a decrease of apparent threshold with increasing speckle lifetime. L. Yin et al., Physics of Plasmas 15, 013109 (2008). D. S. Montgomery et al., 9, 2311(2002). Bruce Langdon et al., 38^th Anomalous Absorption Conference (2008). Harvey A. Rose, Physics of Plasmas 10, 1468 (2003). Harvey A. Rose and L. Yin, Physics of Plasmas 15, 042311 (2008)., Harvey A. Rose and David A. Russell, Phys. Plasma 8, 4784 (2001).

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