SU-E-T-424: Dosimetric Verification of Modulated Electron Radiation Therapy Delivered Using An Electron Specific Multileaf Collimator for Treatment of Scalp Cases

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

Eldib, A; Al-Azhar University Cairo; Jin, L

2014-06-01

Purpose: Modulated electron radiotherapy (MERT) has the potential to achieve better treatment outcome for shallow tumors such as those of breast and scalp. In a separate study with scalp lesions, MERT was compared to volumetric modulated arc therapy. Our results showed a reduction in the dose reaching the brain with MERT. However dose calculation accuracy and delivery efficiency challenges remain. Thus in the current study we proceed to add more cases to demonstrate MERT beneficial outcome and its delivery accuracy using an electron specific multileaf collimator (eMLC). Methods: We have used the MCBEAM code for treatment head simulation and formore » generating phase space files to be used as radiation source input for our Monte Carlo based treatment planning system (MC TPS). MCPLAN code is used for calculation of patient specific dose deposition coefficient and for final MERT plan dose calculation. An in-house developed optimization code is used for the optimization process. MERT plans were generated for real patients and head and neck phantom. Film was used for dosimetric verification. The film was cut following the contour of the curved phantom surface and then sealed with black masking tape. In the measurement, the sealed film packet was sandwiched between two adjacent slabs of the head and neck phantom. The measured 2D dose distribution was then compared with calculations. Results: The eMLC allows effective treatment of scalps with multi-lesions spreading around the patient head, which was usually difficult to plan or very time consuming with conventional applicators. MERT continues to show better reduction in the brain dose. The dosimetric measurements showed slight discrepancy, which was attributed to the film setup. Conclusion: MERT can improve treatment plan quality for patients with scalp cancers. Our in-house MC TPS is capable of performing treatment planning and accurate dose calculation for MERT using the eMLC.« less

Definitions and codes for seral status and structure of vegetation.

Treesearch

Frederick C. Hall; Larry Bryant; Rod Clausnitzer; Kathy Geier-Hayes; Robert Keane; Jane Kertis; Ayn Shlisky; Robert Steel

1995-01-01

Definitions and codes for identifying vegetation seral status and structure are desired for land management planning, appraising wildlife habitat, and prescribing vegetation treatment. Codes are only presented; they are not a system for determining seral status or stand structure. Terms defined are climax, potential natural community (PNC), succession, seral status,...

76 FR 33026 - Agency Information Collection Activity; Proposed Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-07

... deferred under or paid from a nonqualified deferred compensation plan are taken into account as wages for...)(2), relating to treatment of certain nonqualified deferred compensation, was added to the Code by... maintain nonqualified deferred compensation plans and to participants in those plans. Current Actions...

Case Presentations Demonstrating Periodontal Treatment Variation: PEARL Network.

PubMed

Curro, Frederick A; Grill, Ashley C; Matthews, Abigail G; Martin, John; Kalenderian, Elisabeth; Craig, Ronald G; Naftolin, Frederick; Thompson, Van P

2015-06-01

Variation in periodontal terminology can affect the diagnosis and treatment plan as assessed by practicing general dentists in the Practitioners Engaged in Applied Research and Learning (PEARL) Network. General dentists participating in the PEARL Network are highly screened, credentialed, and qualified and may not be representative of the general population of dentists. Ten randomized case presentations ranging from periodontal health to gingivitis, to mild, moderate, and severe periodontitis were randomly presented to respondents. Descriptive comparisons were made between these diagnosis groups in terms of the treatment recommendations following diagnosis. PEARL practitioners assessing periodontal clinical scenarios were found to either over- or under-diagnose the case presentations, which affected treatment planning, while the remaining responses concurred with respect to the diagnosis. The predominant diagnosis was compared with that assigned by two practicing periodontists. There was variation in treatment based on the diagnosis for gingivitis and the lesser forms of periodontitis. Data suggests that a lack of clarity of periodontal terminology affects both diagnosis and treatment planning, and terminology may be improved by having diagnosis codes, which could be used to assess treatment outcomes. This article provides data to support best practice for the use of diagnosis coding and integration of dentistry with medicine using ICD-10 terminology.

Development of a multi-modal Monte-Carlo radiation treatment planning system combined with PHITS

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

Kumada, Hiroaki; Nakamura, Takemi; Komeda, Masao

A new multi-modal Monte-Carlo radiation treatment planning system is under development at Japan Atomic Energy Agency. This system (developing code: JCDS-FX) builds on fundamental technologies of JCDS. JCDS was developed by JAEA to perform treatment planning of boron neutron capture therapy (BNCT) which is being conducted at JRR-4 in JAEA. JCDS has many advantages based on practical accomplishments for actual clinical trials of BNCT at JRR-4, the advantages have been taken over to JCDS-FX. One of the features of JCDS-FX is that PHITS has been applied to particle transport calculation. PHITS is a multipurpose particle Monte-Carlo transport code, thus applicationmore » of PHITS enables to evaluate doses for not only BNCT but also several radiotherapies like proton therapy. To verify calculation accuracy of JCDS-FX with PHITS for BNCT, treatment planning of an actual BNCT conducted at JRR-4 was performed retrospectively. The verification results demonstrated the new system was applicable to BNCT clinical trials in practical use. In framework of R and D for laser-driven proton therapy, we begin study for application of JCDS-FX combined with PHITS to proton therapy in addition to BNCT. Several features and performances of the new multimodal Monte-Carlo radiotherapy planning system are presented.« less

Development of independent MU/treatment time verification algorithm for non-IMRT treatment planning: A clinical experience

NASA Astrophysics Data System (ADS)

Tatli, Hamza; Yucel, Derya; Yilmaz, Sercan; Fayda, Merdan

2018-02-01

The aim of this study is to develop an algorithm for independent MU/treatment time (TT) verification for non-IMRT treatment plans, as a part of QA program to ensure treatment delivery accuracy. Two radiotherapy delivery units and their treatment planning systems (TPS) were commissioned in Liv Hospital Radiation Medicine Center, Tbilisi, Georgia. Beam data were collected according to vendors' collection guidelines, and AAPM reports recommendations, and processed by Microsoft Excel during in-house algorithm development. The algorithm is designed and optimized for calculating SSD and SAD treatment plans, based on AAPM TG114 dose calculation recommendations, coded and embedded in MS Excel spreadsheet, as a preliminary verification algorithm (VA). Treatment verification plans were created by TPSs based on IAEA TRS 430 recommendations, also calculated by VA, and point measurements were collected by solid water phantom, and compared. Study showed that, in-house VA can be used for non-IMRT plans MU/TT verifications.

DEVELOPMENT OF A MULTIMODAL MONTE CARLO BASED TREATMENT PLANNING SYSTEM.

PubMed

Kumada, Hiroaki; Takada, Kenta; Sakurai, Yoshinori; Suzuki, Minoru; Takata, Takushi; Sakurai, Hideyuki; Matsumura, Akira; Sakae, Takeji

2017-10-26

To establish boron neutron capture therapy (BNCT), the University of Tsukuba is developing a treatment device and peripheral devices required in BNCT, such as a treatment planning system. We are developing a new multimodal Monte Carlo based treatment planning system (developing code: Tsukuba Plan). Tsukuba Plan allows for dose estimation in proton therapy, X-ray therapy and heavy ion therapy in addition to BNCT because the system employs PHITS as the Monte Carlo dose calculation engine. Regarding BNCT, several verifications of the system are being carried out for its practical usage. The verification results demonstrate that Tsukuba Plan allows for accurate estimation of thermal neutron flux and gamma-ray dose as fundamental radiations of dosimetry in BNCT. In addition to the practical use of Tsukuba Plan in BNCT, we are investigating its application to other radiation therapies. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

LPT. Shield test facility (TAN646). Floor plan for water treatment ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

LPT. Shield test facility (TAN-646). Floor plan for water treatment room on west facade, tank and filter locations in basement along service tunnel and in coupling station. Ralph M. Parsons 1229-17 ANP/GE-6-646-P-2. April 1957. INEEL Index code no. 037-0645/0646-51-693-107387 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

Ion beams in radiotherapy - from tracks to treatment planning

NASA Astrophysics Data System (ADS)

Krämer, M.; Scifoni, E.; Wälzlein, C.; Durante, M.

2012-07-01

Several dozen clinical sites around the world apply beams of fast light ions for radiotherapeutical purposes. Thus there is a vested interest in the various physical and radiobiological processes governing the interaction of ion beams with matter, specifically living systems. We discuss the various modelling steps which lead from basic interactions to the application in actual patient treatment planning. The nano- and microscopic scale is covered by sample calculations with our TRAX code. On the macroscopic scale we feature the TRiP98 treatment planning system, which was clinically used in GSI's radiotherapy pilot project.

Benchmarking and validation of a Geant4-SHADOW Monte Carlo simulation for dose calculations in microbeam radiation therapy.

PubMed

Cornelius, Iwan; Guatelli, Susanna; Fournier, Pauline; Crosbie, Jeffrey C; Sanchez Del Rio, Manuel; Bräuer-Krisch, Elke; Rosenfeld, Anatoly; Lerch, Michael

2014-05-01

Microbeam radiation therapy (MRT) is a synchrotron-based radiotherapy modality that uses high-intensity beams of spatially fractionated radiation to treat tumours. The rapid evolution of MRT towards clinical trials demands accurate treatment planning systems (TPS), as well as independent tools for the verification of TPS calculated dose distributions in order to ensure patient safety and treatment efficacy. Monte Carlo computer simulation represents the most accurate method of dose calculation in patient geometries and is best suited for the purpose of TPS verification. A Monte Carlo model of the ID17 biomedical beamline at the European Synchrotron Radiation Facility has been developed, including recent modifications, using the Geant4 Monte Carlo toolkit interfaced with the SHADOW X-ray optics and ray-tracing libraries. The code was benchmarked by simulating dose profiles in water-equivalent phantoms subject to irradiation by broad-beam (without spatial fractionation) and microbeam (with spatial fractionation) fields, and comparing against those calculated with a previous model of the beamline developed using the PENELOPE code. Validation against additional experimental dose profiles in water-equivalent phantoms subject to broad-beam irradiation was also performed. Good agreement between codes was observed, with the exception of out-of-field doses and toward the field edge for larger field sizes. Microbeam results showed good agreement between both codes and experimental results within uncertainties. Results of the experimental validation showed agreement for different beamline configurations. The asymmetry in the out-of-field dose profiles due to polarization effects was also investigated, yielding important information for the treatment planning process in MRT. This work represents an important step in the development of a Monte Carlo-based independent verification tool for treatment planning in MRT.

Temperament and impulsivity predictors of smoking cessation outcomes.

PubMed

López-Torrecillas, Francisca; Perales, José C; Nieto-Ruiz, Ana; Verdejo-García, Antonio

2014-01-01

Temperament and impulsivity are powerful predictors of addiction treatment outcomes. However, a comprehensive assessment of these features has not been examined in relation to smoking cessation outcomes. Naturalistic prospective study. Treatment-seeking smokers (n = 140) were recruited as they engaged in an occupational health clinic providing smoking cessation treatment between 2009 and 2013. Participants were assessed at baseline with measures of temperament (Temperament and Character Inventory), trait impulsivity (Barratt Impulsivity Scale), and cognitive impulsivity (Go/No Go, Delay Discounting and Iowa Gambling Task). The outcome measure was treatment status, coded as "dropout" versus "relapse" versus "abstinence" at 3, 6, and 12 months endpoints. Participants were telephonically contacted and reminded of follow-up face to face assessments at each endpoint. The participants that failed to answer the phone calls or self-reported discontinuation of treatment and failed to attend the upcoming follow-up session were coded as dropouts. The participants that self-reported continuing treatment, and successfully attended the upcoming follow-up session were coded as either "relapse" or "abstinence", based on the results of smoking behavior self-reports cross-validated with co-oximetry hemoglobin levels. Multinomial regression models were conducted to test whether temperament and impulsivity measures predicted dropout and relapse relative to abstinence outcomes. Higher scores on temperament dimensions of novelty seeking and reward dependence predicted poorer retention across endpoints, whereas only higher scores on persistence predicted greater relapse. Higher scores on the trait dimension of non-planning impulsivity but not performance on cognitive impulsivity predicted poorer retention. Higher non-planning impulsivity and poorer performance in the Iowa Gambling Task predicted greater relapse at 3 and 6 months and 6 months respectively. Temperament measures, and specifically novelty seeking and reward dependence, predict smoking cessation treatment retention, whereas persistence, non-planning impulsivity and poor decision-making predict smoking relapse.

Interim Status Closure Plan Open Burning Treatment Unit Technical Area 16-399 Burn Tray

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

Vigil-Holterman, Luciana R.

2012-05-07

This closure plan describes the activities necessary to close one of the interim status hazardous waste open burning treatment units at Technical Area (TA) 16 at the Los Alamos National Laboratory (LANL or the Facility), hereinafter referred to as the 'TA-16-399 Burn Tray' or 'the unit'. The information provided in this closure plan addresses the closure requirements specified in the Code of Federal Regulations (CFR), Title 40, Part 265, Subparts G and P for the thermal treatment units operated at the Facility under the Resource Conservation and Recovery Act (RCRA) and the New Mexico Hazardous Waste Act. Closure of themore » open burning treatment unit will be completed in accordance with Section 4.1 of this closure plan.« less

Accuracy Evaluation of Oncentra™ TPS in HDR Brachytherapy of Nasopharynx Cancer Using EGSnrc Monte Carlo Code.

PubMed

Hadad, K; Zohrevand, M; Faghihi, R; Sedighi Pashaki, A

2015-03-01

HDR brachytherapy is one of the commonest methods of nasopharyngeal cancer treatment. In this method, depending on how advanced one tumor is, 2 to 6 Gy dose as intracavitary brachytherapy is prescribed. Due to high dose rate and tumor location, accuracy evaluation of treatment planning system (TPS) is particularly important. Common methods used in TPS dosimetry are based on computations in a homogeneous phantom. Heterogeneous phantoms, especially patient-specific voxel phantoms can increase dosimetric accuracy. In this study, using CT images taken from a patient and ctcreate-which is a part of the DOSXYZnrc computational code, patient-specific phantom was made. Dose distribution was plotted by DOSXYZnrc and compared with TPS one. Also, by extracting the voxels absorbed dose in treatment volume, dose-volume histograms (DVH) was plotted and compared with Oncentra™ TPS DVHs. The results from calculations were compared with data from Oncentra™ treatment planning system and it was observed that TPS calculation predicts lower dose in areas near the source, and higher dose in areas far from the source relative to MC code. Absorbed dose values in the voxels also showed that TPS reports D90 value is 40% higher than the Monte Carlo method. Today, most treatment planning systems use TG-43 protocol. This protocol may results in errors such as neglecting tissue heterogeneity, scattered radiation as well as applicator attenuation. Due to these errors, AAPM emphasized departing from TG-43 protocol and approaching new brachytherapy protocol TG-186 in which patient-specific phantom is used and heterogeneities are affected in dosimetry.

Accuracy Evaluation of Oncentra™ TPS in HDR Brachytherapy of Nasopharynx Cancer Using EGSnrc Monte Carlo Code

PubMed Central

Hadad, K.; Zohrevand, M.; Faghihi, R.; Sedighi Pashaki, A.

2015-01-01

Background HDR brachytherapy is one of the commonest methods of nasopharyngeal cancer treatment. In this method, depending on how advanced one tumor is, 2 to 6 Gy dose as intracavitary brachytherapy is prescribed. Due to high dose rate and tumor location, accuracy evaluation of treatment planning system (TPS) is particularly important. Common methods used in TPS dosimetry are based on computations in a homogeneous phantom. Heterogeneous phantoms, especially patient-specific voxel phantoms can increase dosimetric accuracy. Materials and Methods In this study, using CT images taken from a patient and ctcreate-which is a part of the DOSXYZnrc computational code, patient-specific phantom was made. Dose distribution was plotted by DOSXYZnrc and compared with TPS one. Also, by extracting the voxels absorbed dose in treatment volume, dose-volume histograms (DVH) was plotted and compared with Oncentra™ TPS DVHs. Results The results from calculations were compared with data from Oncentra™ treatment planning system and it was observed that TPS calculation predicts lower dose in areas near the source, and higher dose in areas far from the source relative to MC code. Absorbed dose values in the voxels also showed that TPS reports D90 value is 40% higher than the Monte Carlo method. Conclusion Today, most treatment planning systems use TG-43 protocol. This protocol may results in errors such as neglecting tissue heterogeneity, scattered radiation as well as applicator attenuation. Due to these errors, AAPM emphasized departing from TG-43 protocol and approaching new brachytherapy protocol TG-186 in which patient-specific phantom is used and heterogeneities are affected in dosimetry. PMID:25973408

Family Planning in Substance Use Disorder Treatment Centers: Opportunities and Challenges.

PubMed

Robinowitz, Natanya; Muqueeth, Sadiya; Scheibler, Jill; Salisbury-Afshar, Elizabeth; Terplan, Mishka

2016-09-18

Alcohol, tobacco, and drug use during pregnancy can cause a range of adverse birth outcomes. Promoting family planning among women with substance use disorders (SUD) can help reduce substance exposed pregnancies. We conducted qualitative research to determine the acceptability and feasibility of offering family planning education and services SUD treatment centers. Focus groups and in-depth interviews were conducted with clients, staff and medical providers at three treatment centers. Interviews were transcribed and data was analyzed using a flexible coding scheme. Clients reported being interested in family planning services while they were in treatment. Most preferred to receive these services onsite. Providers also felt that services should be received onsite, though cited several barriers to implementation, including time constraints and staff levels of comfort with the subject. Women in SUD treatment are open to the integration of family planning services into treatment. Treatment centers have the opportunity to serve as models of client-centered health homes that offer a variety of educational, preventive, and medical services for women in both treatment and recovery.

40 CFR 52.2590 - Operating permits.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2590 Operating permits. For... NR 407 of the Wisconsin Administrative Code concern the treatment of sources of greenhouse gas...

40 CFR 52.2590 - Operating permits.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2590 Operating permits. For... NR 407 of the Wisconsin Administrative Code concern the treatment of sources of greenhouse gas...

40 CFR 52.2590 - Operating permits.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2590 Operating permits. For... NR 407 of the Wisconsin Administrative Code concern the treatment of sources of greenhouse gas...

40 CFR 52.2590 - Operating permits.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2590 Operating permits. For... NR 407 of the Wisconsin Administrative Code concern the treatment of sources of greenhouse gas...

Development of an autonomous treatment planning strategy for radiation therapy with effective use of population-based prior data.

PubMed

Wang, Huan; Dong, Peng; Liu, Hongcheng; Xing, Lei

2017-02-01

Current treatment planning remains a costly and labor intensive procedure and requires multiple trial-and-error adjustments of system parameters such as the weighting factors and prescriptions. The purpose of this work is to develop an autonomous treatment planning strategy with effective use of prior knowledge and in a clinically realistic treatment planning platform to facilitate radiation therapy workflow. Our technique consists of three major components: (i) a clinical treatment planning system (TPS); (ii) a formulation of decision-function constructed using an assemble of prior treatment plans; (iii) a plan evaluator or decision-function and an outer-loop optimization independent of the clinical TPS to assess the TPS-generated plan and to drive the search toward a solution optimizing the decision-function. Microsoft (MS) Visual Studio Coded UI is applied to record some common planner-TPS interactions as subroutines for querying and interacting with the TPS. These subroutines are called back in the outer-loop optimization program to navigate the plan selection process through the solution space iteratively. The utility of the approach is demonstrated by using clinical prostate and head-and-neck cases. An autonomous treatment planning technique with effective use of an assemble of prior treatment plans is developed to automatically maneuver the clinical treatment planning process in the platform of a commercial TPS. The process mimics the decision-making process of a human planner and provides a clinically sensible treatment plan automatically, thus reducing/eliminating the tedious manual trial-and-errors of treatment planning. It is found that the prostate and head-and-neck treatment plans generated using the approach compare favorably with that used for the patients' actual treatments. Clinical inverse treatment planning process can be automated effectively with the guidance of an assemble of prior treatment plans. The approach has the potential to significantly improve the radiation therapy workflow. © 2016 American Association of Physicists in Medicine.

Inter-comparison of Dose Distributions Calculated by FLUKA, GEANT4, MCNP, and PHITS for Proton Therapy

NASA Astrophysics Data System (ADS)

Yang, Zi-Yi; Tsai, Pi-En; Lee, Shao-Chun; Liu, Yen-Chiang; Chen, Chin-Cheng; Sato, Tatsuhiko; Sheu, Rong-Jiun

2017-09-01

The dose distributions from proton pencil beam scanning were calculated by FLUKA, GEANT4, MCNP, and PHITS, in order to investigate their applicability in proton radiotherapy. The first studied case was the integrated depth dose curves (IDDCs), respectively from a 100 and a 226-MeV proton pencil beam impinging a water phantom. The calculated IDDCs agree with each other as long as each code employs 75 eV for the ionization potential of water. The second case considered a similar condition of the first case but with proton energies in a Gaussian distribution. The comparison to the measurement indicates the inter-code differences might not only due to different stopping power but also the nuclear physics models. How the physics parameter setting affect the computation time was also discussed. In the third case, the applicability of each code for pencil beam scanning was confirmed by delivering a uniform volumetric dose distribution based on the treatment plan, and the results showed general agreement between each codes, the treatment plan, and the measurement, except that some deviations were found in the penumbra region. This study has demonstrated that the selected codes are all capable of performing dose calculations for therapeutic scanning proton beams with proper physics settings.

Suitability of point kernel dose calculation techniques in brachytherapy treatment planning

PubMed Central

Lakshminarayanan, Thilagam; Subbaiah, K. V.; Thayalan, K.; Kannan, S. E.

2010-01-01

Brachytherapy treatment planning system (TPS) is necessary to estimate the dose to target volume and organ at risk (OAR). TPS is always recommended to account for the effect of tissue, applicator and shielding material heterogeneities exist in applicators. However, most brachytherapy TPS software packages estimate the absorbed dose at a point, taking care of only the contributions of individual sources and the source distribution, neglecting the dose perturbations arising from the applicator design and construction. There are some degrees of uncertainties in dose rate estimations under realistic clinical conditions. In this regard, an attempt is made to explore the suitability of point kernels for brachytherapy dose rate calculations and develop new interactive brachytherapy package, named as BrachyTPS, to suit the clinical conditions. BrachyTPS is an interactive point kernel code package developed to perform independent dose rate calculations by taking into account the effect of these heterogeneities, using two regions build up factors, proposed by Kalos. The primary aim of this study is to validate the developed point kernel code package integrated with treatment planning computational systems against the Monte Carlo (MC) results. In the present work, three brachytherapy applicators commonly used in the treatment of uterine cervical carcinoma, namely (i) Board of Radiation Isotope and Technology (BRIT) low dose rate (LDR) applicator and (ii) Fletcher Green type LDR applicator (iii) Fletcher Williamson high dose rate (HDR) applicator, are studied to test the accuracy of the software. Dose rates computed using the developed code are compared with the relevant results of the MC simulations. Further, attempts are also made to study the dose rate distribution around the commercially available shielded vaginal applicator set (Nucletron). The percentage deviations of BrachyTPS computed dose rate values from the MC results are observed to be within plus/minus 5.5% for BRIT LDR applicator, found to vary from 2.6 to 5.1% for Fletcher green type LDR applicator and are up to −4.7% for Fletcher-Williamson HDR applicator. The isodose distribution plots also show good agreements with the results of previous literatures. The isodose distributions around the shielded vaginal cylinder computed using BrachyTPS code show better agreement (less than two per cent deviation) with MC results in the unshielded region compared to shielded region, where the deviations are observed up to five per cent. The present study implies that the accurate and fast validation of complicated treatment planning calculations is possible with the point kernel code package. PMID:20589118

An Approach in Radiation Therapy Treatment Planning: A Fast, GPU-Based Monte Carlo Method.

PubMed

Karbalaee, Mojtaba; Shahbazi-Gahrouei, Daryoush; Tavakoli, Mohammad B

2017-01-01

An accurate and fast radiation dose calculation is essential for successful radiation radiotherapy. The aim of this study was to implement a new graphic processing unit (GPU) based radiation therapy treatment planning for accurate and fast dose calculation in radiotherapy centers. A program was written for parallel running based on GPU. The code validation was performed by EGSnrc/DOSXYZnrc. Moreover, a semi-automatic, rotary, asymmetric phantom was designed and produced using a bone, the lung, and the soft tissue equivalent materials. All measurements were performed using a Mapcheck dosimeter. The accuracy of the code was validated using the experimental data, which was obtained from the anthropomorphic phantom as the gold standard. The findings showed that, compared with those of DOSXYZnrc in the virtual phantom and for most of the voxels (>95%), <3% dose-difference or 3 mm distance-to-agreement (DTA) was found. Moreover, considering the anthropomorphic phantom, compared to the Mapcheck dose measurements, <5% dose-difference or 5 mm DTA was observed. Fast calculation speed and high accuracy of GPU-based Monte Carlo method in dose calculation may be useful in routine radiation therapy centers as the core and main component of a treatment planning verification system.

COgnitive behavioural therapy versus standardised medical care for adults with Dissociative non-Epileptic Seizures (CODES): statistical and economic analysis plan for a randomised controlled trial.

PubMed

Robinson, Emily J; Goldstein, Laura H; McCrone, Paul; Perdue, Iain; Chalder, Trudie; Mellers, John D C; Richardson, Mark P; Murray, Joanna; Reuber, Markus; Medford, Nick; Stone, Jon; Carson, Alan; Landau, Sabine

2017-06-06

Dissociative seizures (DSs), also called psychogenic non-epileptic seizures, are a distressing and disabling problem for many patients in neurological settings with high and often unnecessary economic costs. The COgnitive behavioural therapy versus standardised medical care for adults with Dissociative non-Epileptic Seizures (CODES) trial is an evaluation of a specifically tailored psychological intervention with the aims of reducing seizure frequency and severity and improving psychological well-being in adults with DS. The aim of this paper is to report in detail the quantitative and economic analysis plan for the CODES trial, as agreed by the trial steering committee. The CODES trial is a multicentre, pragmatic, parallel group, randomised controlled trial performed to evaluate the clinical effectiveness and cost-effectiveness of 13 sessions of cognitive behavioural therapy (CBT) plus standardised medical care (SMC) compared with SMC alone for adult outpatients with DS. The objectives and design of the trial are summarised, and the aims and procedures of the planned analyses are illustrated. The proposed analysis plan addresses statistical considerations such as maintaining blinding, monitoring adherence with the protocol, describing aspects of treatment and dealing with missing data. The formal analysis approach for the primary and secondary outcomes is described, as are the descriptive statistics that will be reported. This paper provides transparency to the planned inferential analyses for the CODES trial prior to the extraction of outcome data. It also provides an update to the previously published trial protocol and guidance to those conducting similar trials. ISRCTN registry ISRCTN05681227 (registered on 5 March 2014); ClinicalTrials.gov NCT02325544 (registered on 15 December 2014).

Dental Faculty Accuracy When Using Diagnostic Codes: A Pilot Study.

PubMed

Sutton, Jeanne C; Fay, Rose-Marie; Huynh, Carolyn P; Johnson, Cleverick D; Zhu, Liang; Quock, Ryan L

2017-05-01

The aim of this study was to examine the accuracy of dental faculty members' utilization of diagnostic codes and resulting treatment planning based on radiographic interproximal tooth radiolucencies. In 2015, 50 full-time and part-time general dentistry faculty members at one U.S. dental school were shown a sequence of 15 bitewing radiographs; one interproximal radiolucency was highlighted on each bitewing. For each radiographic lesion, participants were asked to choose the most appropriate diagnostic code (from a concise list of five codes, corresponding to lesion progression to outer/inner halves of enamel and outer/middle/pulpal thirds of dentin), acute treatment (attempt to arrest/remineralize non-invasively, operative intervention, or no treatment), and level of confidence in choices. Diagnostic and treatment choices of participants were compared to "gold standard" correct responses, as determined by expert radiology and operative faculty members, respectively. The majority of the participants selected the correct diagnostic code for lesions in the outer one-third of dentin (p<0.0001) and the pulpal one-third of dentin (p<0.0001). For lesions in the outer and inner halves of enamel and the middle one-third of dentin, the correct rates were moderate. However, the majority of the participants chose correct treatments on all types of lesions (correct rate 63.6-100%). Faculty members' confidence in their responses was generally high for all lesions, all above 90%. Diagnostic codes were appropriately assigned by participants for the very deepest lesions, but they were not assigned accurately for more incipient lesions (limited to enamel). Paradoxically, treatment choices were generally correct, regardless of diagnostic choices. Further calibration is needed to improve faculty use and teaching of diagnostic codes.

Evaluating a Dental Diagnostic Terminology in an Electronic Health Record

PubMed Central

White, Joel M.; Kalenderian, Elsbeth; Stark, Paul C.; Ramoni, Rachel L.; Vaderhobli, Ram; Walji, Muhammad F.

2011-01-01

Standardized treatment procedure codes and terms are routinely used in dentistry. Utilization of a diagnostic terminology is common in medicine, but there is not a satisfactory or commonly standardized dental diagnostic terminology available at this time. Recent advances in dental informatics have provided an opportunity for inclusion of diagnostic codes and terms as part of treatment planning and documentation in the patient treatment history. This article reports the results of the use of a diagnostic coding system in a large dental school’s predoctoral clinical practice. A list of diagnostic codes and terms, called Z codes, was developed by dental faculty members. The diagnostic codes and terms were implemented into an electronic health record (EHR) for use in a predoctoral dental clinic. The utilization of diagnostic terms was quantified. The validity of Z code entry was evaluated by comparing the diagnostic term entered to the procedure performed, where valid diagnosis-procedure associations were determined by consensus among three calibrated academically based dentists. A total of 115,004 dental procedures were entered into the EHR during the year sampled. Of those, 43,053 were excluded from this analysis because they represent diagnosis or other procedures unrelated to treatments. Among the 71,951 treatment procedures, 27,973 had diagnoses assigned to them with an overall utilization of 38.9 percent. Of the 147 available Z codes, ninety-three were used (63.3 percent). There were 335 unique procedures provided and 2,127 procedure/diagnosis pairs captured in the EHR. Overall, 76.7 percent of the diagnoses entered were valid. We conclude that dental diagnostic terminology can be incorporated within an electronic health record and utilized in an academic clinical environment. Challenges remain in the development of terms and implementation and ease of use that, if resolved, would improve the utilization. PMID:21546594

TU-H-BRC-03: Evaluation of Very High-Energy Electron (VHEE) Beams in Comparison to VMAT and PBS Treatment Plans

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

Schueler, E; Loo, B; Maxim, P

2016-06-15

Purpose: The aim of this study was to evaluate the performance of very high-energy electron (VHEE) beams in comparison to clinically delivered treatment plans generated with volumetric modulated arc therapy (VMAT) and proton pencil beam scanning (PBS) technology. Methods: Three clinical cases were selected (prostate, lung, and pediatric CNS). The VHEE plans were calculated in the Monte Carlo EGSnrc code and pencil beam doses were calculated using the DOSxyznrc MC code for 100 and 200 MeV beams. Treatment plans with VHEE, VMAT, and PBS were optimized in a research version of RayStation using an in house build script in ordermore » to minimize operator bias between the different techniques. Results: For the prostate cancer case, the PBS plan showed lower mean organ at risk (OAR) doses compared to the other modalities. An exception was the femoral heads, due to the lateral beam arrangements. The VMAT plan showed lower mean doses to the rectum and the bladder compared to the 100 MeV VHEE plan. The lung cancer case showed minor differences between the three modalities. However, the PBS plan showed a lower contralateral lung dose. The pediatric CNS case showed a better conformity and lower spinal cord dose for the 100 MeV VHEE plan. For all cases, the 200 MeV VHEE plans were found to be similar to or better than the 100 MeV VHEE plans. Conclusion: The present study showed that VHEE plans are similar or superior to VMAT plans with reduced mean OAR dose and increased target conformity for a variety of clinical cases. With increased VHEE energy, better conformity and even higher reductions in mean OAR doses can be achieved. Funding: DoD, Award#:W81XWH-13-1-0165, Weston Havens Foundation, Bio-X (Stanford University), the Office of the Dean of the Medical School, the Office of the Provost (Stanford University), and the Swedish Childhood Cancer Foundation. BL and PM are founders of TibaRay,Inc. BL and PM have received research grants from Varian and RaySearch Laboratory.« less

SU-E-T-502: Initial Results of a Comparison of Treatment Plans Produced From Automated Prioritized Planning Method and a Commercial Treatment Planning System

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

Tiwari, P; Chen, Y; Hong, L

2015-06-15

Purpose We developed an automated treatment planning system based on a hierarchical goal programming approach. To demonstrate the feasibility of our method, we report the comparison of prostate treatment plans produced from the automated treatment planning system with those produced by a commercial treatment planning system. Methods In our approach, we prioritized the goals of the optimization, and solved one goal at a time. The purpose of prioritization is to ensure that higher priority dose-volume planning goals are not sacrificed to improve lower priority goals. The algorithm has four steps. The first step optimizes dose to the target structures, whilemore » sparing key sensitive organs from radiation. In the second step, the algorithm finds the best beamlet weight to reduce toxicity risks to normal tissue while holding the objective function achieved in the first step as a constraint, with a small amount of allowed slip. Likewise, the third and fourth steps introduce lower priority normal tissue goals and beam smoothing. We compared with prostate treatment plans from Memorial Sloan Kettering Cancer Center developed using Eclipse, with a prescription dose of 72 Gy. A combination of liear, quadratic, and gEUD objective functions were used with a modified open source solver code (IPOPT). Results Initial plan results on 3 different cases show that the automated planning system is capable of competing or improving on expert-driven eclipse plans. Compared to the Eclipse planning system, the automated system produced up to 26% less mean dose to rectum and 24% less mean dose to bladder while having the same D95 (after matching) to the target. Conclusion We have demonstrated that Pareto optimal treatment plans can be generated automatically without a trial-and-error process. The solver finds an optimal plan for the given patient, as opposed to database-driven approaches that set parameters based on geometry and population modeling.« less

Ultrafast treatment plan optimization for volumetric modulated arc therapy (VMAT)

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

Men Chunhua; Romeijn, H. Edwin; Jia Xun

2010-11-15

Purpose: To develop a novel aperture-based algorithm for volumetric modulated arc therapy (VMAT) treatment plan optimization with high quality and high efficiency. Methods: The VMAT optimization problem is formulated as a large-scale convex programming problem solved by a column generation approach. The authors consider a cost function consisting two terms, the first enforcing a desired dose distribution and the second guaranteeing a smooth dose rate variation between successive gantry angles. A gantry rotation is discretized into 180 beam angles and for each beam angle, only one MLC aperture is allowed. The apertures are generated one by one in a sequentialmore » way. At each iteration of the column generation method, a deliverable MLC aperture is generated for one of the unoccupied beam angles by solving a subproblem with the consideration of MLC mechanic constraints. A subsequent master problem is then solved to determine the dose rate at all currently generated apertures by minimizing the cost function. When all 180 beam angles are occupied, the optimization completes, yielding a set of deliverable apertures and associated dose rates that produce a high quality plan. Results: The algorithm was preliminarily tested on five prostate and five head-and-neck clinical cases, each with one full gantry rotation without any couch/collimator rotations. High quality VMAT plans have been generated for all ten cases with extremely high efficiency. It takes only 5-8 min on CPU (MATLAB code on an Intel Xeon 2.27 GHz CPU) and 18-31 s on GPU (CUDA code on an NVIDIA Tesla C1060 GPU card) to generate such plans. Conclusions: The authors have developed an aperture-based VMAT optimization algorithm which can generate clinically deliverable high quality treatment plans at very high efficiency.« less

Ultrafast treatment plan optimization for volumetric modulated arc therapy (VMAT).

PubMed

Men, Chunhua; Romeijn, H Edwin; Jia, Xun; Jiang, Steve B

2010-11-01

To develop a novel aperture-based algorithm for volumetric modulated are therapy (VMAT) treatment plan optimization with high quality and high efficiency. The VMAT optimization problem is formulated as a large-scale convex programming problem solved by a column generation approach. The authors consider a cost function consisting two terms, the first enforcing a desired dose distribution and the second guaranteeing a smooth dose rate variation between successive gantry angles. A gantry rotation is discretized into 180 beam angles and for each beam angle, only one MLC aperture is allowed. The apertures are generated one by one in a sequential way. At each iteration of the column generation method, a deliverable MLC aperture is generated for one of the unoccupied beam angles by solving a subproblem with the consideration of MLC mechanic constraints. A subsequent master problem is then solved to determine the dose rate at all currently generated apertures by minimizing the cost function. When all 180 beam angles are occupied, the optimization completes, yielding a set of deliverable apertures and associated dose rates that produce a high quality plan. The algorithm was preliminarily tested on five prostate and five head-and-neck clinical cases, each with one full gantry rotation without any couch/collimator rotations. High quality VMAT plans have been generated for all ten cases with extremely high efficiency. It takes only 5-8 min on CPU (MATLAB code on an Intel Xeon 2.27 GHz CPU) and 18-31 s on GPU (CUDA code on an NVIDIA Tesla C1060 GPU card) to generate such plans. The authors have developed an aperture-based VMAT optimization algorithm which can generate clinically deliverable high quality treatment plans at very high efficiency.

EDITORIAL: Special section: Selected papers from the Third European Workshop on Monte Carlo Treatment Planning (MCTP2012) Special section: Selected papers from the Third European Workshop on Monte Carlo Treatment Planning (MCTP2012)

NASA Astrophysics Data System (ADS)

Spezi, Emiliano; Leal, Antonio

2013-04-01

The Third European Workshop on Monte Carlo Treatment Planning (MCTP2012) was held from 15-18 May, 2012 in Seville, Spain. The event was organized by the Universidad de Sevilla with the support of the European Workgroup on Monte Carlo Treatment Planning (EWG-MCTP). MCTP2012 followed two successful meetings, one held in Ghent (Belgium) in 2006 (Reynaert 2007) and one in Cardiff (UK) in 2009 (Spezi 2010). The recurrence of these workshops together with successful events held in parallel by McGill University in Montreal (Seuntjens et al 2012), show consolidated interest from the scientific community in Monte Carlo (MC) treatment planning. The workshop was attended by a total of 90 participants, mainly coming from a medical physics background. A total of 48 oral presentations and 15 posters were delivered in specific scientific sessions including dosimetry, code development, imaging, modelling of photon and electron radiation transport, external beam radiation therapy, nuclear medicine, brachitherapy and hadrontherapy. A copy of the programme is available on the workshop's website (www.mctp2012.com). In this special section of Physics in Medicine and Biology we report six papers that were selected following the journal's rigorous peer review procedure. These papers actually provide a good cross section of the areas of application of MC in treatment planning that were discussed at MCTP2012. Czarnecki and Zink (2013) and Wagner et al (2013) present the results of their work in small field dosimetry. Czarnecki and Zink (2013) studied field size and detector dependent correction factors for diodes and ion chambers within a clinical 6MV photon beam generated by a Siemens linear accelerator. Their modelling work based on the BEAMnrc/EGSnrc codes and experimental measurements revealed that unshielded diodes were the best choice for small field dosimetry because of their independence from the electron beam spot size and correction factor close to unity. Wagner et al (2013) investigated the recombination effect on liquid ionization chambers for stereotactic radiotherapy, a field of increasing importance in external beam radiotherapy. They modelled both radiation source (Cyberknife unit) and detector with the BEAMnrc/EGSnrc codes and quantified the dependence of the response of this type of detectors on factors such as the volume effect and the electrode. They also recommended that these dependences be accounted for in measurements involving small fields. In the field of external beam radiotherapy, Chakarova et al (2013) showed how total body irradiation (TBI) could be improved by simulating patient treatments with MC. In particular, BEAMnrc/EGSnrc based simulations highlighted the importance of optimizing individual compensators for TBI treatments. In the same area of application, Mairani et al (2013) reported on a new tool for treatment planning in proton therapy based on the FLUKA MC code. The software, used to model both proton therapy beam and patient anatomy, supports single-field and multiple-field optimization and can be used to optimize physical and relative biological effectiveness (RBE)-weighted dose distribution, using both constant and variable RBE models. In the field of nuclear medicine Marcatili et al (2013) presented RAYDOSE, a Geant4-based code specifically developed for applications in molecular radiotherapy (MRT). RAYDOSE has been designed to work in MRT trials using sequential positron emission tomography (PET) or single-photon emission tomography (SPECT) imaging to model patient specific time-dependent metabolic uptake and to calculate the total 3D dose distribution. The code was validated through experimental measurements in homogeneous and heterogeneous phantoms. Finally, in the field of code development Miras et al (2013) reported on CloudMC, a Windows Azure-based application for the parallelization of MC calculations in a dynamic cluster environment. Although the performance of CloudMC has been tested with the PENELOPE MC code, the authors report that software has been designed in a way that it should be independent of the type of MC code, provided that simulation meets a number of operational criteria. We wish to thank Elekta/CMS Inc., the University of Seville, the Junta of Andalusia and the European Regional Development Fund for their financial support. We would like also to acknowledge the members of EWG-MCTP for their help in peer-reviewing all the abstracts, and all the invited speakers who kindly agreed to deliver keynote presentations in their area of expertise. A final word of thanks to our colleagues who worked on the reviewing process of the papers selected for this special section and to the IOP Publishing staff who made it possible. MCTP2012 was accredited by the European Federation of Organisations for Medical Physics as a CPD event for medical physicists. Emiliano Spezi and Antonio Leal Guest Editors References Chakarova R, Müntzing K, Krantz M, E Hedin E and Hertzman S 2013 Monte Carlo optimization of total body irradiation in a phantom and patient geometry Phys. Med. Biol. 58 2461-69 Czarnecki D and Zink K 2013 Monte Carlo calculated correction factors for diodes and ion chambers in small photon fields Phys. Med. Biol. 58 2431-44 Mairani A, Böhlen T T, Schiavi A, Tessonnier T, Molinelli S, Brons S, Battistoni G, Parodi K and Patera V 2013 A Monte Carlo-based treatment planning tool for proton therapy Phys. Med. Biol. 58 2471-90 Marcatili S, Pettinato C, Daniels S, Lewis G, Edwards P, Fanti S and Spezi E 2013 Development and validation of RAYDOSE: a Geant4 based application for molecular radiotherapy Phys. Med. Biol. 58 2491-508 Miras H, Jiménez R, Miras C and Gomà C 2013 CloudMC: A cloud computing application for Monte Carlo simulation Phys. Med. Biol. 58 N125-33 Reynaert N 2007 First European Workshop on Monte Carlo Treatment Planning J. Phys.: Conf. Ser. 74 011001 Seuntjens J, Beaulieu L, El Naqa I and Després P 2012 Special section: Selected papers from the Fourth International Workshop on Recent Advances in Monte Carlo Techniques for Radiation Therapy Phys. Med. Biol. 57 (11) E01 Spezi E 2010 Special section: Selected papers from the Second European Workshop on Monte Carlo Treatment Planning (MCTP2009) Phys. Med. Biol. 55 (16) E01 Wagner A, Crop F, Lacornerie T, Vandevelde F and Reynaert N 2013 Use of a liquid ionization chamber for stereotactic radiotherapy dosimetry Phys. Med. Biol. 58 2445-59

IET. Coupling station (TAN620), plans and sections. Concrete shielding walls ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

IET. Coupling station (TAN-620), plans and sections. Concrete shielding walls and boron surface treatment. Elevation shows two floor levels, position of periscopes, and stairways. Ralph M. Parsons 902-4-ANP-602-A 325. Date: February 1954. Approved by INEEL Classification Office for public release. INEEL index code no. 035-0620-00-693-106910 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

A&M. TAN633. Utilities plan and profiles. Layout of TAN633 in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

A&M. TAN-633. Utilities plan and profiles. Layout of TAN-633 in relation to neighboring buildings: actuator building, pool building, water filter building, liquid waste treatment plant, and buried storage tanks. Ralph M. Parsons 1229-13-ANP/GE-3-301-U-1. Date: December 1956. INEEL index code no. 034-0301-00-693-107311 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

Monte Carlo simulations of patient dose perturbations in rotational-type radiotherapy due to a transverse magnetic field: A tomotherapy investigation

PubMed Central

Yang, Y. M.; Geurts, M.; Smilowitz, J. B.; Sterpin, E.; Bednarz, B. P.

2015-01-01

Purpose: Several groups are exploring the integration of magnetic resonance (MR) image guidance with radiotherapy to reduce tumor position uncertainty during photon radiotherapy. The therapeutic gain from reducing tumor position uncertainty using intrafraction MR imaging during radiotherapy could be partially offset if the negative effects of magnetic field-induced dose perturbations are not appreciated or accounted for. The authors hypothesize that a more rotationally symmetric modality such as helical tomotherapy will permit a systematic mediation of these dose perturbations. This investigation offers a unique look at the dose perturbations due to homogeneous transverse magnetic field during the delivery of Tomotherapy® Treatment System plans under varying degrees of rotational beamlet symmetry. Methods: The authors accurately reproduced treatment plan beamlet and patient configurations using the Monte Carlo code geant4. This code has a thoroughly benchmarked electromagnetic particle transport physics package well-suited for the radiotherapy energy regime. The three approved clinical treatment plans for this study were for a prostate, head and neck, and lung treatment. The dose heterogeneity index metric was used to quantify the effect of the dose perturbations to the target volumes. Results: The authors demonstrate the ability to reproduce the clinical dose–volume histograms (DVH) to within 4% dose agreement at each DVH point for the target volumes and most planning structures, and therefore, are able to confidently examine the effects of transverse magnetic fields on the plans. The authors investigated field strengths of 0.35, 0.7, 1, 1.5, and 3 T. Changes to the dose heterogeneity index of 0.1% were seen in the prostate and head and neck case, reflecting negligible dose perturbations to the target volumes, a change from 5.5% to 20.1% was observed with the lung case. Conclusions: This study demonstrated that the effect of external magnetic fields can be mitigated by exploiting a more rotationally symmetric treatment modality. PMID:25652485

SU-E-T-626: Accuracy of Dose Calculation Algorithms in MultiPlan Treatment Planning System in Presence of Heterogeneities

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

Moignier, C; Huet, C; Barraux, V

Purpose: Advanced stereotactic radiotherapy (SRT) treatments require accurate dose calculation for treatment planning especially for treatment sites involving heterogeneous patient anatomy. The purpose of this study was to evaluate the accuracy of dose calculation algorithms, Raytracing and Monte Carlo (MC), implemented in the MultiPlan treatment planning system (TPS) in presence of heterogeneities. Methods: First, the LINAC of a CyberKnife radiotherapy facility was modeled with the PENELOPE MC code. A protocol for the measurement of dose distributions with EBT3 films was established and validated thanks to comparison between experimental dose distributions and calculated dose distributions obtained with MultiPlan Raytracing and MCmore » algorithms as well as with the PENELOPE MC model for treatments planned with the homogenous Easycube phantom. Finally, bones and lungs inserts were used to set up a heterogeneous Easycube phantom. Treatment plans with the 10, 7.5 or the 5 mm field sizes were generated in Multiplan TPS with different tumor localizations (in the lung and at the lung/bone/soft tissue interface). Experimental dose distributions were compared to the PENELOPE MC and Multiplan calculations using the gamma index method. Results: Regarding the experiment in the homogenous phantom, 100% of the points passed for the 3%/3mm tolerance criteria. These criteria include the global error of the method (CT-scan resolution, EBT3 dosimetry, LINAC positionning …), and were used afterwards to estimate the accuracy of the MultiPlan algorithms in heterogeneous media. Comparison of the dose distributions obtained in the heterogeneous phantom is in progress. Conclusion: This work has led to the development of numerical and experimental dosimetric tools for small beam dosimetry. Raytracing and MC algorithms implemented in MultiPlan TPS were evaluated in heterogeneous media.« less

Oversight Hearing on Section 529 College Savings Plans: High Fees, Inadequate Disclosure, Disparate State Tax Treatment, and Questionable Broker Sales Practices. Hearing before the Financial Management, the Budget, and International Security Subcommittee of the Committee on Governmental Affairs, United States Senate, One Hundred Eighth Congress, Second Session (September 30, 2004) S. Hrg. 108-716

ERIC Educational Resources Information Center

US Senate, 2004

2004-01-01

The Subcommittee conducted an oversight hearing on Section 529 College Savings Plans, State-sponsored investments that are designed to encourage families to save money for their children's college education. Section 529 refers to the Internal Revenue Code section that authorizes and confers special tax treatment on these entities. Section 529…

Development of a new multi-modal Monte-Carlo radiotherapy planning system.

PubMed

Kumada, H; Nakamura, T; Komeda, M; Matsumura, A

2009-07-01

A new multi-modal Monte-Carlo radiotherapy planning system (developing code: JCDS-FX) is under development at Japan Atomic Energy Agency. This system builds on fundamental technologies of JCDS applied to actual boron neutron capture therapy (BNCT) trials in JRR-4. One of features of the JCDS-FX is that PHITS has been applied to particle transport calculation. PHITS is a multi-purpose particle Monte-Carlo transport code. Hence application of PHITS enables to evaluate total doses given to a patient by a combined modality therapy. Moreover, JCDS-FX with PHITS can be used for the study of accelerator based BNCT. To verify calculation accuracy of the JCDS-FX, dose evaluations for neutron irradiation of a cylindrical water phantom and for an actual clinical trial were performed, then the results were compared with calculations by JCDS with MCNP. The verification results demonstrated that JCDS-FX is applicable to BNCT treatment planning in practical use.

Treatment provider's knowledge of the Health and Disability Commissioner's Code of Consumer Rights.

PubMed

Townshend, Philip L; Sellman, J Douglas

2002-06-01

The Health and Disability Commissioner's (HDC) Code of Health and and Disability Consumers' Rights (the Code) defines in law the rights of consumers of health and disability services in New Zealand. In the first few years after the publication health educators, service providers and the HDC extensively promoted the Code. Providers of health and disability services would be expected to be knowledgeable about the areas covered by the Code if it is routinely used in the development and monitoring of treatment plans. In this study knowledge of the Code was tested in a random sample of 217 clinical staff that included medical staff, psychologists and counsellors working in Alcohol and Drug Treatment (A&D) centres in New Zealand. Any response showing awareness of a right, regardless of wording, was taken as a positive response as it was the areas covered by rights rather than their actual wording that was considered to be the important knowledge for providers. The main finding of this research was that 23% of staff surveyed were aware of none of the ten rights in the Code and only 6% were aware of more than five of the ten rights. Relating these data to results from a wider sample of treatment providers raises the possibility that A&D treatment providers are slightly more aware of the content of the Code than a general sample of health and disability service providers however overall awareness of the content of the Code by health providers is very low. These results imply that consumer rights issues are not prominent in the minds of providers perhaps indicating an ethical blind spot on their part. Ignorance of the content of the Code may indicate that the treatment community do not find it a useful working document or alternatively that clinicians are content to rely on their own good intentions to preserve the rights of their patients. Further research will be required to explain this lack of knowledge, however the current situation is that consumers cannot rely on clinicians being aware of the consumer's rights in health and disability services.

Palliative Care Processes Embedded in the ICU Workflow May Reserve Palliative Care Teams for Refractory Cases.

PubMed

Mun, Eluned; Umbarger, Lillian; Ceria-Ulep, Clementina; Nakatsuka, Craig

2018-01-01

Palliative Care Teams have been shown to be instrumental in the early identification of multiple aspects of advanced care planning. Despite an increased number of services to meet the rising consultation demand, it is conceivable that the numbers of palliative care consultations generated from an ICU alone could become overwhelming for an existing palliative care team. Improve end-of-life care in the ICU by incorporating basic palliative care processes into the daily routine ICU workflow, thereby reserving the palliative care team for refractory situations. A structured, palliative care, quality-improvement program was implemented and evaluated in the ICU at Kaiser Permanente Medical Center in Hawaii. This included selecting trigger criteria, a care model, forming guidelines, and developing evaluation criteria. These included the early identification of the multiple features of advanced care planning, numbers of proactive ICU and palliative care family meetings, and changes in code status and treatment upon completion of either meeting. Early identification of Goals-of-Care, advance directives, and code status by the ICU staff led to a proactive ICU family meeting with resultant increases in changes in code status and treatment. The numbers of palliative care consultations also rose, but not significantly. Palliative care processes could be incorporated into a daily ICU workflow allowing for integration of aspects of advanced care planning to be identified in a systematic and proactive manner. This reserved the palliative care team for situations when palliative care efforts performed by the ICU staff were ineffective.

Commissioning and initial acceptance tests for a commercial convolution dose calculation algorithm for radiotherapy treatment planning in comparison with Monte Carlo simulation and measurement

PubMed Central

Moradi, Farhad; Mahdavi, Seyed Rabi; Mostaar, Ahmad; Motamedi, Mohsen

2012-01-01

In this study the commissioning of a dose calculation algorithm in a currently used treatment planning system was performed and the calculation accuracy of two available methods in the treatment planning system i.e., collapsed cone convolution (CCC) and equivalent tissue air ratio (ETAR) was verified in tissue heterogeneities. For this purpose an inhomogeneous phantom (IMRT thorax phantom) was used and dose curves obtained by the TPS (treatment planning system) were compared with experimental measurements and Monte Carlo (MCNP code) simulation. Dose measurements were performed by using EDR2 radiographic films within the phantom. Dose difference (DD) between experimental results and two calculation methods was obtained. Results indicate maximum difference of 12% in the lung and 3% in the bone tissue of the phantom between two methods and the CCC algorithm shows more accurate depth dose curves in tissue heterogeneities. Simulation results show the accurate dose estimation by MCNP4C in soft tissue region of the phantom and also better results than ETAR method in bone and lung tissues. PMID:22973081

Dosimetric quality, accuracy, and deliverability of modulated radiotherapy treatments for spinal metastases

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

Kairn, Tanya, E-mail: t.kairn@gmail.com; School of Chemistry, Physics, and Mechanical Engineering, Queensland University of Technology, Brisbane; Papworth, Daniel

2016-10-01

Cancer often metastasizes to the vertebra, and such metastases can be treated successfully using simple, static posterior or opposed-pair radiation fields. However, in some cases, including when re-irradiation is required, spinal cord avoidance becomes necessary and more complex treatment plans must be used. This study evaluated 16 sample intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) treatment plans designed to treat 6 typical vertebral and paraspinal volumes using a standard prescription, with the aim of investigating the advantages and limitations of these treatment techniques and providing recommendations for their optimal use in vertebral treatments. Treatment plan quality and beammore » complexity metrics were evaluated using the Treatment And Dose Assessor (TADA) code. A portal-imaging–based quality assurance (QA) system was used to evaluate treatment delivery accuracy, and radiochromic film measurements were used to provide high-resolution verification of treatment plan dose accuracy, especially in the steep dose gradient regions between each vertebral target and spinal cord. All treatment modalities delivered approximately the same doses and the same levels of dose heterogeneity to each planning target volume (PTV), although the minimum PTV doses in the vertebral plans were substantially lower than the prescription, because of the requirement that the plans meet a strict constraint on the dose to the spinal cord and cord planning risk volume (PRV). All plans met required dose constraints on all organs at risk, and all measured PTV-cord dose gradients were steeper than planned. Beam complexity analysis suggested that the IMRT treatment plans were more deliverable (less complex, leading to greater QA success) than the VMAT treatment plans, although the IMRT plans also took more time to deliver. The accuracy and deliverability of VMAT treatment plans were found to be substantially increased by limiting the number of monitor units (MU) per beam at the optimization stage, and thereby limiting beam modulation complexity. The VMAT arcs that were optimized with MU limitation had higher QA pass rates as well as higher modulation complexity scores (less complexity), lower modulation indices (less modulation), lower MU per beam, larger beam segments, and fewer small apertures than the VMAT arcs that were optimized without MU limitation. It is recommended that VMAT treatments for vertebral volumes, where the PTV abuts or surrounds the spinal cord, should be optimized with MU limitation. IMRT treatments may be preferable to the VMAT treatments, for dosimetry and deliverability reasons, but may be inappropriate for some patients because of their increased treatment delivery time.« less

Application programming in C# environment with recorded user software interactions and its application in autopilot of VMAT/IMRT treatment planning.

PubMed

Wang, Henry; Xing, Lei

2016-11-08

An autopilot scheme of volumetric-modulated arc therapy (VMAT)/intensity-modulated radiation therapy (IMRT) planning with the guidance of prior knowl-edge is established with recorded interactions between a planner and a commercial treatment planning system (TPS). Microsoft (MS) Visual Studio Coded UI is applied to record some common planner-TPS interactions as subroutines. The TPS used in this study is a Windows-based Eclipse system. The interactions of our application program with Eclipse TPS are realized through a series of subrou-tines obtained by prerecording the mouse clicks or keyboard strokes of a planner in operating the TPS. A strategy to autopilot Eclipse VMAT/IMRT plan selection process is developed as a specific example of the proposed "scripting" method. The autopiloted planning is navigated by a decision function constructed with a reference plan that has the same prescription and similar anatomy with the case at hand. The calculation proceeds by alternating between the Eclipse optimization and the outer-loop optimization independent of the Eclipse. In the C# program, the dosimetric characteristics of a reference treatment plan are used to assess and modify the Eclipse planning parameters and to guide the search for a clinically sensible treatment plan. The approach is applied to plan a head and neck (HN) VMAT case and a prostate IMRT case. Our study demonstrated the feasibility of application programming method in C# environment with recorded interactions of planner-TPS. The process mimics a planner's planning process and automatically provides clinically sensible treatment plans that would otherwise require a large amount of manual trial and error of a planner. The proposed technique enables us to harness a commercial TPS by application programming via the use of recorded human computer interactions and provides an effective tool to greatly facilitate the treatment planning process. © 2016 The Authors.

Application programming in C# environment with recorded user software interactions and its application in autopilot of VMAT/IMRT treatment planning

PubMed Central

Wang, Henry

2016-01-01

An autopilot scheme of volumetric‐modulated arc therapy (VMAT)/intensity‐modulated radiation therapy (IMRT) planning with the guidance of prior knowledge is established with recorded interactions between a planner and a commercial treatment planning system (TPS). Microsoft (MS) Visual Studio Coded UI is applied to record some common planner‐TPS interactions as subroutines. The TPS used in this study is a Windows‐based Eclipse system. The interactions of our application program with Eclipse TPS are realized through a series of subroutines obtained by prerecording the mouse clicks or keyboard strokes of a planner in operating the TPS. A strategy to autopilot Eclipse VMAT/IMRT plan selection process is developed as a specific example of the proposed “scripting” method. The autopiloted planning is navigated by a decision function constructed with a reference plan that has the same prescription and similar anatomy with the case at hand. The calculation proceeds by alternating between the Eclipse optimization and the outer‐loop optimization independent of the Eclipse. In the C# program, the dosimetric characteristics of a reference treatment plan are used to assess and modify the Eclipse planning parameters and to guide the search for a clinically sensible treatment plan. The approach is applied to plan a head and neck (HN) VMAT case and a prostate IMRT case. Our study demonstrated the feasibility of application programming method in C# environment with recorded interactions of planner‐TPS. The process mimics a planner's planning process and automatically provides clinically sensible treatment plans that would otherwise require a large amount of manual trial and error of a planner. The proposed technique enables us to harness a commercial TPS by application programming via the use of recorded human computer interactions and provides an effective tool to greatly facilitate the treatment planning process. PACS number(s): 87.55.D‐, 87.55.kd, 87.55.de PMID:27929493

Development and validation of MCNPX-based Monte Carlo treatment plan verification system

PubMed Central

Jabbari, Iraj; Monadi, Shahram

2015-01-01

A Monte Carlo treatment plan verification (MCTPV) system was developed for clinical treatment plan verification (TPV), especially for the conformal and intensity-modulated radiotherapy (IMRT) plans. In the MCTPV, the MCNPX code was used for particle transport through the accelerator head and the patient body. MCTPV has an interface with TiGRT planning system and reads the information which is needed for Monte Carlo calculation transferred in digital image communications in medicine-radiation therapy (DICOM-RT) format. In MCTPV several methods were applied in order to reduce the simulation time. The relative dose distribution of a clinical prostate conformal plan calculated by the MCTPV was compared with that of TiGRT planning system. The results showed well implementation of the beams configuration and patient information in this system. For quantitative evaluation of MCTPV a two-dimensional (2D) diode array (MapCHECK2) and gamma index analysis were used. The gamma passing rate (3%/3 mm) of an IMRT plan was found to be 98.5% for total beams. Also, comparison of the measured and Monte Carlo calculated doses at several points inside an inhomogeneous phantom for 6- and 18-MV photon beams showed a good agreement (within 1.5%). The accuracy and timing results of MCTPV showed that MCTPV could be used very efficiently for additional assessment of complicated plans such as IMRT plan. PMID:26170554

Linear energy transfer in water phantom within SHIELD-HIT transport code

NASA Astrophysics Data System (ADS)

Ergun, A.; Sobolevsky, N.; Botvina, A. S.; Buyukcizmeci, N.; Latysheva, L.; Ogul, R.

2017-02-01

The effect of irradiation in tissue is important in hadron therapy for the dose measurement and treatment planning. This biological effect is defined by an equivalent dose H which depends on the Linear Energy Transfer (LET). Usually, H can be expressed in terms of the absorbed dose D and the quality factor K of the radiation under consideration. In literature, various types of transport codes have been used for modeling and simulation of the interaction of the beams of protons and heavier ions with tissue-equivalent materials. In this presentation we used SHIELD-HIT code to simulate decomposition of the absorbed dose by LET in water for 16O beams. A more detailed description of capabilities of the SHIELD-HIT code can be found in the literature.

TRANSP: status and planning

NASA Astrophysics Data System (ADS)

Andre, R.; Carlsson, J.; Gorelenkova, M.; Jardin, S.; Kaye, S.; Poli, F.; Yuan, X.

2016-10-01

TRANSP is an integrated interpretive and predictive transport analysis tool that incorporates state of the art heating/current drive sources and transport models. The treatments and transport solvers are becoming increasingly sophisticated and comprehensive. For instance, the ISOLVER component provides a free boundary equilibrium solution, while the PT- SOLVER transport solver is especially suited for stiff transport models such as TGLF. TRANSP incorporates high fidelity heating and current drive source models, such as NUBEAM for neutral beam injection, the beam tracing code TORBEAM for EC, TORIC for ICRF, the ray tracing TORAY and GENRAY for EC. The implementation of selected components makes efficient use of MPI for speed up of code calculations. Recently the GENRAY-CQL3D solver for modeling of LH heating and current drive has been implemented and currently being extended to multiple antennas, to allow modeling of EAST discharges. Also, GENRAY+CQL3D is being extended to the use of EC/EBW and of HHFW for NSTX-U. This poster will describe present uses of the code worldwide, as well as plans for upgrading the physics modules and code framework. Work supported by the US Department of Energy under DE-AC02-CH0911466.

A research coding method to evaluate medical clinicians conduct of behavioral health care in patients with unexplained symptoms.

PubMed

Grayson-Sneed, Katelyn A; Smith, Robert C

2018-04-01

Develop a reliable coding method of a Behavioral Health Treatment Model for patients with Medically Unexplained Symptoms (BHTM-MUS). Two undergraduates trained for 30h coded videotaped interviews from 161 resident-simulated patient (SP) interactions. Trained on 45 videotapes, coders coded 33 (20%) of 161 study set tapes for the BHTM-MUS. Guetzkow's U, Cohen's Kappa, and percent of agreement were used to measure coders' reliability in unitizing and coding residents' skills for eliciting: education and informing (4 yes/no items), motivating (2), treatment statements (5), commitment and goals (2), negotiates plan (8), non-emotion patient-centered skills (4), and patient-centered emotional skills (8). 60 items were dichotomized a priori from analysis of the BHTM-MUS and were reduced to 33 during training. Guetzkow's U ranged from .00 to .082. Kappa ranged from 0.76 to 0.97 for the 7 variables and 33 individual items. The overall kappa was 0.87, and percent of agreement was 95.7%. Percent of agreement by item ranged from 85 to 100%. A highly reliable coding method is recommended to evaluate medical clinicians' behavioral care skills in patients with unexplained symptoms. A way to rate behavioral care in patients with unexplained symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

Calculations of dose distributions using a neural network model

NASA Astrophysics Data System (ADS)

Mathieu, R.; Martin, E.; Gschwind, R.; Makovicka, L.; Contassot-Vivier, S.; Bahi, J.

2005-03-01

The main goal of external beam radiotherapy is the treatment of tumours, while sparing, as much as possible, surrounding healthy tissues. In order to master and optimize the dose distribution within the patient, dosimetric planning has to be carried out. Thus, for determining the most accurate dose distribution during treatment planning, a compromise must be found between the precision and the speed of calculation. Current techniques, using analytic methods, models and databases, are rapid but lack precision. Enhanced precision can be achieved by using calculation codes based, for example, on Monte Carlo methods. However, in spite of all efforts to optimize speed (methods and computer improvements), Monte Carlo based methods remain painfully slow. A newer way to handle all of these problems is to use a new approach in dosimetric calculation by employing neural networks. Neural networks (Wu and Zhu 2000 Phys. Med. Biol. 45 913-22) provide the advantages of those various approaches while avoiding their main inconveniences, i.e., time-consumption calculations. This permits us to obtain quick and accurate results during clinical treatment planning. Currently, results obtained for a single depth-dose calculation using a Monte Carlo based code (such as BEAM (Rogers et al 2003 NRCC Report PIRS-0509(A) rev G)) require hours of computing. By contrast, the practical use of neural networks (Mathieu et al 2003 Proceedings Journées Scientifiques Francophones, SFRP) provides almost instant results and quite low errors (less than 2%) for a two-dimensional dosimetric map.

Calculations of dose distributions using a neural network model.

PubMed

Mathieu, R; Martin, E; Gschwind, R; Makovicka, L; Contassot-Vivier, S; Bahi, J

2005-03-07

The main goal of external beam radiotherapy is the treatment of tumours, while sparing, as much as possible, surrounding healthy tissues. In order to master and optimize the dose distribution within the patient, dosimetric planning has to be carried out. Thus, for determining the most accurate dose distribution during treatment planning, a compromise must be found between the precision and the speed of calculation. Current techniques, using analytic methods, models and databases, are rapid but lack precision. Enhanced precision can be achieved by using calculation codes based, for example, on Monte Carlo methods. However, in spite of all efforts to optimize speed (methods and computer improvements), Monte Carlo based methods remain painfully slow. A newer way to handle all of these problems is to use a new approach in dosimetric calculation by employing neural networks. Neural networks (Wu and Zhu 2000 Phys. Med. Biol. 45 913-22) provide the advantages of those various approaches while avoiding their main inconveniences, i.e., time-consumption calculations. This permits us to obtain quick and accurate results during clinical treatment planning. Currently, results obtained for a single depth-dose calculation using a Monte Carlo based code (such as BEAM (Rogers et al 2003 NRCC Report PIRS-0509(A) rev G)) require hours of computing. By contrast, the practical use of neural networks (Mathieu et al 2003 Proceedings Journees Scientifiques Francophones, SFRP) provides almost instant results and quite low errors (less than 2%) for a two-dimensional dosimetric map.

A methodological pilot: parenting among women in substance abuse treatment.

PubMed

Lewin, Linda; Farkas, Kathleen; Niazi, Maryam

2014-01-01

Mothers who abuse substances are likely to have insecure emotional attachment with their children, placing their children at risk for social-emotional and psychiatric conditions. Sobriety does not inevitably improve parenting. We tested recruitment methods, audiovisual (AV) recording procedures, the protocol for identifying child abuse risk, the coding of mother-child interactions, and retention of the sample for repeated measures as the first phase in examining mother-child relational quality of women in substance abuse treatment. This innovative study involved AV recordings to capture the in-vivo mother-child interactional behaviors that were later coded and analyzed for mean scores on the 64-item Parent-Child Relational Quality Assessment. Repeated measurement was planned during treatment and two months after discharge from treatment. The pilot involved a small sample (n = 11) of mother-child (<6 years) dyads. Highest and lowest ratings of interaction behaviors were identified. Mothers showed less enthusiasm and creativity but matched their child's emotional state. The children showed appropriate motor skill items and attachment behaviors. The dyad coding showed less mutual enjoyment between the mother and child. Eight of the participants could not be located for the second measurement despite multiple contact methods. AV recordings capture rich, descriptive information that can be coded for interactional quality analysis. Repeated measurement with this cohort was not feasible, thus needing to assess for additional/more frequent contacts to maintain the sample.

Developing a post-treatment survivorship care plan to help breast cancer survivors understand their fertility.

PubMed

Gorman, Jessica R; Julian, Anne K; Roberts, Samantha A; Romero, Sally A D; Ehren, Jennifer L; Krychman, Michael L; Boles, Sarah G; Mao, Jun; Irene Su, H

2018-02-01

Reproductive-aged breast cancer survivors (BCS) who have completed initial cancer treatment frequently want to know about their future fertility potential. The purpose of this qualitative study was to assess if the fertility-related content presented in the survivorship care plan prototype met the informational needs of post-treatment BCS and to provide an opportunity for the target audience to review and react to the proposed content and design. We conducted and analyzed transcripts from seven focus groups with BCS to evaluate their reactions to the survivorship care plan prototype. We independently coded transcripts for consistent themes and sub-themes and used a consensus-building approach to agree on interpretation of results. We identified five themes that describe the post-treatment BCS' responses to the prototype survivorship care plan in the context of their informational needs and experiences: (1) the prototype's fertility-related information is relevant; (2) desire for clinical parameters to help survivors understand their infertility risk; (3) fertility-related information is important throughout survivorship; (4) evidence-based content from a neutral source is trustworthy; and (5) the recommendation to see a fertility specialist is helpful, but cost is a barrier. BCS have concerns and needs related to their fertility potential after initial breast cancer treatment. The evidence-based information offered in our prototype survivorship care plan was acceptable to BCS and has significant potential to address these needs. Additional primary data that identify post-cancer treatment indicators of fertility would advance this effort.

Uplink Coding

NASA Technical Reports Server (NTRS)

Pollara, Fabrizio; Hamkins, Jon; Dolinar, Sam; Andrews, Ken; Divsalar, Dariush

2006-01-01

This viewgraph presentation reviews uplink coding. The purpose and goals of the briefing are (1) Show a plan for using uplink coding and describe benefits (2) Define possible solutions and their applicability to different types of uplink, including emergency uplink (3) Concur with our conclusions so we can embark on a plan to use proposed uplink system (4) Identify the need for the development of appropriate technology and infusion in the DSN (5) Gain advocacy to implement uplink coding in flight projects Action Item EMB04-1-14 -- Show a plan for using uplink coding, including showing where it is useful or not (include discussion of emergency uplink coding).

Helium ions at the heidelberg ion beam therapy center: comparisons between FLUKA Monte Carlo code predictions and dosimetric measurements

NASA Astrophysics Data System (ADS)

Tessonnier, T.; Mairani, A.; Brons, S.; Sala, P.; Cerutti, F.; Ferrari, A.; Haberer, T.; Debus, J.; Parodi, K.

2017-08-01

In the field of particle therapy helium ion beams could offer an alternative for radiotherapy treatments, owing to their interesting physical and biological properties intermediate between protons and carbon ions. We present in this work the comparisons and validations of the Monte Carlo FLUKA code against in-depth dosimetric measurements acquired at the Heidelberg Ion Beam Therapy Center (HIT). Depth dose distributions in water with and without ripple filter, lateral profiles at different depths in water and a spread-out Bragg peak were investigated. After experimentally-driven tuning of the less known initial beam characteristics in vacuum (beam lateral size and momentum spread) and simulation parameters (water ionization potential), comparisons of depth dose distributions were performed between simulations and measurements, which showed overall good agreement with range differences below 0.1 mm and dose-weighted average dose-differences below 2.3% throughout the entire energy range. Comparisons of lateral dose profiles showed differences in full-width-half-maximum lower than 0.7 mm. Measurements of the spread-out Bragg peak indicated differences with simulations below 1% in the high dose regions and 3% in all other regions, with a range difference less than 0.5 mm. Despite the promising results, some discrepancies between simulations and measurements were observed, particularly at high energies. These differences were attributed to an underestimation of dose contributions from secondary particles at large angles, as seen in a triple Gaussian parametrization of the lateral profiles along the depth. However, the results allowed us to validate FLUKA simulations against measurements, confirming its suitability for 4He ion beam modeling in preparation of clinical establishment at HIT. Future activities building on this work will include treatment plan comparisons using validated biological models between proton and helium ions, either within a Monte Carlo treatment planning engine based on the same FLUKA code, or an independent analytical planning system fed with a validated database of inputs calculated with FLUKA.

Helium ions at the heidelberg ion beam therapy center: comparisons between FLUKA Monte Carlo code predictions and dosimetric measurements.

PubMed

Tessonnier, T; Mairani, A; Brons, S; Sala, P; Cerutti, F; Ferrari, A; Haberer, T; Debus, J; Parodi, K

2017-08-01

In the field of particle therapy helium ion beams could offer an alternative for radiotherapy treatments, owing to their interesting physical and biological properties intermediate between protons and carbon ions. We present in this work the comparisons and validations of the Monte Carlo FLUKA code against in-depth dosimetric measurements acquired at the Heidelberg Ion Beam Therapy Center (HIT). Depth dose distributions in water with and without ripple filter, lateral profiles at different depths in water and a spread-out Bragg peak were investigated. After experimentally-driven tuning of the less known initial beam characteristics in vacuum (beam lateral size and momentum spread) and simulation parameters (water ionization potential), comparisons of depth dose distributions were performed between simulations and measurements, which showed overall good agreement with range differences below 0.1 mm and dose-weighted average dose-differences below 2.3% throughout the entire energy range. Comparisons of lateral dose profiles showed differences in full-width-half-maximum lower than 0.7 mm. Measurements of the spread-out Bragg peak indicated differences with simulations below 1% in the high dose regions and 3% in all other regions, with a range difference less than 0.5 mm. Despite the promising results, some discrepancies between simulations and measurements were observed, particularly at high energies. These differences were attributed to an underestimation of dose contributions from secondary particles at large angles, as seen in a triple Gaussian parametrization of the lateral profiles along the depth. However, the results allowed us to validate FLUKA simulations against measurements, confirming its suitability for 4 He ion beam modeling in preparation of clinical establishment at HIT. Future activities building on this work will include treatment plan comparisons using validated biological models between proton and helium ions, either within a Monte Carlo treatment planning engine based on the same FLUKA code, or an independent analytical planning system fed with a validated database of inputs calculated with FLUKA.

Use of Color-Coded Food Photographs for Meal Planning by Adults with Mental Retardation.

ERIC Educational Resources Information Center

Gines, Deon J.; And Others

1990-01-01

Ten adults with mild mental retardation used color-coded food photographs and meal code cards to plan nutritionally balanced meals. Subjects spent an average of nine minutes to plan three meals. Errors, which were primarily omissions, occurred mostly in food groups requiring four servings daily. (JDD)

Generation of a novel phase-space-based cylindrical dose kernel for IMRT optimization.

PubMed

Zhong, Hualiang; Chetty, Indrin J

2012-05-01

Improving dose calculation accuracy is crucial in intensity-modulated radiation therapy (IMRT). We have developed a method for generating a phase-space-based dose kernel for IMRT planning of lung cancer patients. Particle transport in the linear accelerator treatment head of a 21EX, 6 MV photon beam (Varian Medical Systems, Palo Alto, CA) was simulated using the EGSnrc/BEAMnrc code system. The phase space information was recorded under the secondary jaws. Each particle in the phase space file was associated with a beamlet whose index was calculated and saved in the particle's LATCH variable. The DOSXYZnrc code was modified to accumulate the energy deposited by each particle based on its beamlet index. Furthermore, the central axis of each beamlet was calculated from the orientation of all the particles in this beamlet. A cylinder was then defined around the central axis so that only the energy deposited within the cylinder was counted. A look-up table was established for each cylinder during the tallying process. The efficiency and accuracy of the cylindrical beamlet energy deposition approach was evaluated using a treatment plan developed on a simulated lung phantom. Profile and percentage depth doses computed in a water phantom for an open, square field size were within 1.5% of measurements. Dose optimized with the cylindrical dose kernel was found to be within 0.6% of that computed with the nontruncated 3D kernel. The cylindrical truncation reduced optimization time by approximately 80%. A method for generating a phase-space-based dose kernel, using a truncated cylinder for scoring dose, in beamlet-based optimization of lung treatment planning was developed and found to be in good agreement with the standard, nontruncated scoring approach. Compared to previous techniques, our method significantly reduces computational time and memory requirements, which may be useful for Monte-Carlo-based 4D IMRT or IMAT treatment planning.

Designing a framework of intelligent information processing for dentistry administration data.

PubMed

Amiri, N; Matthews, D C; Gao, Q

2005-07-01

This study was designed to test a cumulative view of current data in the clinical database at the Faculty of Dentistry, Dalhousie University. We planned to examine associations among demographic factors and treatments. Three tables were selected from the database of the faculty: patient, treatment and procedures. All fields and record numbers in each table were documented. Data was explored using SQL server and Visual Basic and then cleaned by removing incongruent fields. After transformation, a data warehouse was created. This was imported to SQL analysis services manager to create an OLAP (Online Analytic Process) cube. The multidimensional model used for access to data was created using a star schema. Treatment count was the measurement variable. Five dimensions--date, postal code, gender, age group and treatment categories--were used to detect associations. Another data warehouse of 8 tables (international tooth code # 1-8) was created and imported to SAS enterprise miner to complete data mining. Association nodes were used for each table to find sequential associations and minimum criteria were set to 2% of cases. Findings of this study confirmed most assumptions of treatment planning procedures. There were some small unexpected patterns of clinical interest. Further developments are recommended to create predictive models. Recent improvements in information technology offer numerous advantages for conversion of raw data from faculty databases to information and subsequently to knowledge. This knowledge can be used by decision makers, managers, and researchers to answer clinical questions, affect policy change and determine future research needs.

DPM, a fast, accurate Monte Carlo code optimized for photon and electron radiotherapy treatment planning dose calculations

NASA Astrophysics Data System (ADS)

Sempau, Josep; Wilderman, Scott J.; Bielajew, Alex F.

2000-08-01

A new Monte Carlo (MC) algorithm, the `dose planning method' (DPM), and its associated computer program for simulating the transport of electrons and photons in radiotherapy class problems employing primary electron beams, is presented. DPM is intended to be a high-accuracy MC alternative to the current generation of treatment planning codes which rely on analytical algorithms based on an approximate solution of the photon/electron Boltzmann transport equation. For primary electron beams, DPM is capable of computing 3D dose distributions (in 1 mm3 voxels) which agree to within 1% in dose maximum with widely used and exhaustively benchmarked general-purpose public-domain MC codes in only a fraction of the CPU time. A representative problem, the simulation of 1 million 10 MeV electrons impinging upon a water phantom of 1283 voxels of 1 mm on a side, can be performed by DPM in roughly 3 min on a modern desktop workstation. DPM achieves this performance by employing transport mechanics and electron multiple scattering distribution functions which have been derived to permit long transport steps (of the order of 5 mm) which can cross heterogeneity boundaries. The underlying algorithm is a `mixed' class simulation scheme, with differential cross sections for hard inelastic collisions and bremsstrahlung events described in an approximate manner to simplify their sampling. The continuous energy loss approximation is employed for energy losses below some predefined thresholds, and photon transport (including Compton, photoelectric absorption and pair production) is simulated in an analogue manner. The δ-scattering method (Woodcock tracking) is adopted to minimize the computational costs of transporting photons across voxels.

Incorporating diagnosis and treatment of hyperhidrosis into clinical practice.

PubMed

Pariser, David M

2014-10-01

Proper billing and coding are essential to document the diagnosis of hyperhidrosis and to assure proper reimbursement for treatment. Providers should become familiar with the payment policies of local health plans to streamline the preauthorization process that is often needed for many treatments commonly used for hyperhidrosis. Having a preprinted letter of medical necessity and patient intake forms that record the necessary historical information about the disease, previous treatments, and other pertinent information will help increase the speed of the office flow. This article presents algorithms for treatment of the various forms of primary focal hyperhidrosis. Copyright © 2014 Elsevier Inc. All rights reserved.

MO-H-19A-02: Investigation of Modulated Electron Arc (MeArc) Therapy for the Treatment of Scalp Tumors

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

Eldib, A; Al-Azhar University, Cairo; Jin, L

2014-06-15

Purpose: Electron arc therapy has long been proposed as the most suitable technique for the treatment of superficial tumors that follow circularly curved surfaces. However it was challenged by unsuitability of the conventional applicators and the lack of adequate 3-D dose calculation tools for arc electron beams in the treatment planning systems (TPS). Now with the availability of an electron specific multi-leaf collimator (eMLC) and an in-house Monte Carlo (MC) based TPS, we were motivated to investigate more advanced modulated electron arc (MeARC) therapy and its beneficial outcome. Methods: We initiated the study by a film measurement conducted in amore » head and neck phantom, where we delivered electron arcs in a step and shoot manner using the light field as a guide to avoid fields abutments. This step was done to insure enough clearance for the arcs with eMLC. MCBEAM and MCPLAN MC codes were used for the treatment head simulation and phantom dose calculation, respectively. Treatment plans were generated for targets drawn in real patient CTs and head and neck phantom. We utilized beams eye view available from a commercial planning system to create beamlets having same isocenter and adjoined at the scalp surface. Then dose-deposition coefficients from those beamlets were calculated for all electron energies using MCPLAN. An in-house optimization code was then used to find the optimum weights needed from individual beamlets. Results: MeARC showed a nicely tailored dose distribution around the circular curved target on the scalp. Some hot spots were noticed and could be attributed to fields abutment problem owing to the bulging nature of electron profiles. Brain dose was shown to be at lower levels compared to photon treatment. Conclusion: MeARC was shown to be a promising modality for treating scalp cases and could be beneficial to all superficial tumors with a circular curvature.« less

31 CFR 29.302 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... Code (1997) (under the Police and Firefighters Plan) or section 31-1231(a) of the D.C. Code (1997... accrue, that is, age 55 under the Police and Firefighters Plan and age 62 under the Teachers Plan... and Firefighters Plan or Teachers Plan. Department service or departmental service may include certain...

31 CFR 29.302 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... Code (1997) (under the Police and Firefighters Plan) or section 31-1231(a) of the D.C. Code (1997... accrue, that is, age 55 under the Police and Firefighters Plan and age 62 under the Teachers Plan... and Firefighters Plan or Teachers Plan. Department service or departmental service may include certain...

31 CFR 29.302 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... Code (1997) (under the Police and Firefighters Plan) or section 31-1231(a) of the D.C. Code (1997... accrue, that is, age 55 under the Police and Firefighters Plan and age 62 under the Teachers Plan... and Firefighters Plan or Teachers Plan. Department service or departmental service may include certain...

31 CFR 29.302 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... Code (1997) (under the Police and Firefighters Plan) or section 31-1231(a) of the D.C. Code (1997... accrue, that is, age 55 under the Police and Firefighters Plan and age 62 under the Teachers Plan... and Firefighters Plan or Teachers Plan. Department service or departmental service may include certain...

77 FR 6504 - Roth Feature to the Thrift Savings Plan and Miscellaneous Uniformed Services Account Amendments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-08

... one of the following methods: Mail: Office of General Counsel, Attn: Thomas Emswiler, Federal... from, a Roth TSP balance. The tax treatment of a contribution to, or distribution from, a Roth TSP balance is governed by section 402A of the Internal Revenue Code. Types of TSP Accounts and Balances The...

Medical Applications of the PHITS Code (3): User Assistance Program for Medical Physics Computation.

PubMed

Furuta, Takuya; Hashimoto, Shintaro; Sato, Tatsuhiko

2016-01-01

DICOM2PHITS and PSFC4PHITS are user assistance programs for medical physics PHITS applications. DICOM2PHITS is a program to construct the voxel PHITS simulation geometry from patient CT DICOM image data by using a conversion table from CT number to material composition. PSFC4PHITS is a program to convert the IAEA phase-space file data to PHITS format to be used as a simulation source of PHITS. Both of the programs are useful for users who want to apply PHITS simulation to verification of the treatment planning of radiation therapy. We are now developing a program to convert dose distribution obtained by PHITS to DICOM RT-dose format. We also want to develop a program which is able to implement treatment information included in other DICOM files (RT-plan and RT-structure) as a future plan.

A feasibility study to calculate unshielded fetal doses to pregnant patients in 6-MV photon treatments using Monte Carlo methods and anatomically realistic phantoms

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

Bednarz, Bryan; Xu, X. George

2008-07-15

A Monte Carlo-based procedure to assess fetal doses from 6-MV external photon beam radiation treatments has been developed to improve upon existing techniques that are based on AAPM Task Group Report 36 published in 1995 [M. Stovall et al., Med. Phys. 22, 63-82 (1995)]. Anatomically realistic models of the pregnant patient representing 3-, 6-, and 9-month gestational stages were implemented into the MCNPX code together with a detailed accelerator model that is capable of simulating scattered and leakage radiation from the accelerator head. Absorbed doses to the fetus were calculated for six different treatment plans for sites above the fetusmore » and one treatment plan for fibrosarcoma in the knee. For treatment plans above the fetus, the fetal doses tended to increase with increasing stage of gestation. This was due to the decrease in distance between the fetal body and field edge with increasing stage of gestation. For the treatment field below the fetus, the absorbed doses tended to decrease with increasing gestational stage of the pregnant patient, due to the increasing size of the fetus and relative constant distance between the field edge and fetal body for each stage. The absorbed doses to the fetus for all treatment plans ranged from a maximum of 30.9 cGy to the 9-month fetus to 1.53 cGy to the 3-month fetus. The study demonstrates the feasibility to accurately determine the absorbed organ doses in the mother and fetus as part of the treatment planning and eventually in risk management.« less

SU-E-T-296: Single Field Per Day Vs. Multiple Fields Per Day and the Impact On BED in Proton Therapy Treatment

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

Grantham, K; Wooten, H; Zhao, T

2014-06-01

Purpose: A common practice, in proton therapy, is to deliver a rotating subset of fields from the treatment plan for the daily fractions. This study compares the impact this practice has on the biological effective dose (BED) versus delivering all planned fields daily. Methods: For two scenarios (a phantom with a geometry approximating the anatomy of a prostate treatment with opposing lateral beams, and a clinical 3-field brain treatment), treatment plans were produced in Eclipse (Varian) to simulate delivery of one, two, and three fields per fraction. The RT-Dose file, structure set, and α/β ratios were processed using in-house MATLABmore » code to return a new RT-Dose file containing the BED (including a proton RBE of 1.1) which was imported back into Eclipse for analysis. Results: For targets and regions of field overlap in the treatment plan, BED is not affected by delivery regimen. In the phantom, BED in the femoral heads showed increased by 20% when a single field was used rather than two fields. In the brain treatment, the minimum BED to the left optic nerve and the pituitary gland increased by 13% and 10% respectively, for a one-field regime compared to three-fields per fraction. Comparing the two-field and threefield regimes, the optic nerve BED was not significantly affected and the minimum pituitary BED was 4% higher for two fields per day. Conclusion: Hypo-fractionation effects, in regions of non-overlap of fields, significantly increase the BED to the involved tissues by as much as 20%. Care should be taken to avoid inadvertently sacrificing plan effectiveness in the interest of reduced treatment time.« less

Poster - 40: Treatment Verification of a 3D-printed Eye Phantom for Proton Therapy

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

Dunning, Chelsea; Lindsay, Clay; Unick, Nick

Purpose: Ocular melanoma is a form of eye cancer which is often treated using proton therapy. The benefit of the steep proton dose gradient can only be leveraged for accurate patient eye alignment. A treatment-planning program was written to plan on a 3D-printed anatomical eye-phantom, which was then irradiated to demonstrate the feasibility of verifying in vivo dosimetry for proton therapy using PET imaging. Methods: A 3D CAD eye model with critical organs was designed and voxelized into the Monte-Carlo transport code FLUKA. Proton dose and PET isotope production were simulated for a treatment plan of a test tumour, generatedmore » by a 2D treatment-planning program developed using NumPy and proton range tables. Next, a plastic eye-phantom was 3D-printed from the CAD model, irradiated at the TRIUMF Proton Therapy facility, and imaged using a PET scanner. Results: The treatment-planning program prediction of the range setting and modulator wheel was verified in FLUKA to treat the tumour with at least 90% dose coverage for both tissue and plastic. An axial isotope distribution of the PET isotopes was simulated in FLUKA and converted to PET scan counts. Meanwhile, the 3D-printed eye-phantom successfully yielded a PET signal. Conclusions: The 2D treatment-planning program can predict required parameters to sufficiently treat an eye tumour, which was experimentally verified using commercial 3D-printing hardware to manufacture eye-phantoms. Comparison between the simulated and measured PET isotope distribution could provide a more realistic test of eye alignment, and a variation of the method using radiographic film is being developed.« less

Report of the AAPM Task Group No. 105: Issues associated with clinical implementation of Monte Carlo-based photon and electron external beam treatment planning.

PubMed

Chetty, Indrin J; Curran, Bruce; Cygler, Joanna E; DeMarco, John J; Ezzell, Gary; Faddegon, Bruce A; Kawrakow, Iwan; Keall, Paul J; Liu, Helen; Ma, C M Charlie; Rogers, D W O; Seuntjens, Jan; Sheikh-Bagheri, Daryoush; Siebers, Jeffrey V

2007-12-01

The Monte Carlo (MC) method has been shown through many research studies to calculate accurate dose distributions for clinical radiotherapy, particularly in heterogeneous patient tissues where the effects of electron transport cannot be accurately handled with conventional, deterministic dose algorithms. Despite its proven accuracy and the potential for improved dose distributions to influence treatment outcomes, the long calculation times previously associated with MC simulation rendered this method impractical for routine clinical treatment planning. However, the development of faster codes optimized for radiotherapy calculations and improvements in computer processor technology have substantially reduced calculation times to, in some instances, within minutes on a single processor. These advances have motivated several major treatment planning system vendors to embark upon the path of MC techniques. Several commercial vendors have already released or are currently in the process of releasing MC algorithms for photon and/or electron beam treatment planning. Consequently, the accessibility and use of MC treatment planning algorithms may well become widespread in the radiotherapy community. With MC simulation, dose is computed stochastically using first principles; this method is therefore quite different from conventional dose algorithms. Issues such as statistical uncertainties, the use of variance reduction techniques, the ability to account for geometric details in the accelerator treatment head simulation, and other features, are all unique components of a MC treatment planning algorithm. Successful implementation by the clinical physicist of such a system will require an understanding of the basic principles of MC techniques. The purpose of this report, while providing education and review on the use of MC simulation in radiotherapy planning, is to set out, for both users and developers, the salient issues associated with clinical implementation and experimental verification of MC dose algorithms. As the MC method is an emerging technology, this report is not meant to be prescriptive. Rather, it is intended as a preliminary report to review the tenets of the MC method and to provide the framework upon which to build a comprehensive program for commissioning and routine quality assurance of MC-based treatment planning systems.

Status and Plans for the TRANSP Interpretive and Predictive Simulation Code

NASA Astrophysics Data System (ADS)

Kaye, Stanley; Andre, Robert; Marina, Gorelenkova; Yuan, Xingqui; Hawryluk, Richard; Jardin, Steven; Poli, Francesca

2015-11-01

TRANSP is an integrated interpretive and predictive transport analysis tool that incorporates state of the art heating/current drive sources and transport models. The treatments and transport solvers are becoming increasingly sophisticated and comprehensive. For instance, the ISOLVER component provides a free boundary equilibrium solution, while the PT_SOLVER transport solver is especially suited for stiff transport models such as TGLF. TRANSP also incorporates such source models as NUBEAM for neutral beam injection, GENRAY, TORAY, TORBEAM, TORIC and CQL3D for ICRH, LHCD, ECH and HHFW. The implementation of selected components makes efficient use of MPI for speed up of code calculations. TRANSP has a wide international user-base, and it is run on the FusionGrid to allow for timely support and quick turnaround by the PPPL Computational Plasma Physics Group. It is being used as a basis for both analysis and development of control algorithms and discharge operational scenarios, including simulation of ITER plasmas. This poster will describe present uses of the code worldwide, as well as plans for upgrading the physics modules and code framework. Progress on implementing TRANSP as a component in the ITER IMAS will also be described. This research was supported by the U.S. Department of Energy under contracts DE-AC02-09CH11466.

Dosimetric accuracy of a treatment planning system for actively scanned proton beams and small target volumes: Monte Carlo and experimental validation

NASA Astrophysics Data System (ADS)

Magro, G.; Molinelli, S.; Mairani, A.; Mirandola, A.; Panizza, D.; Russo, S.; Ferrari, A.; Valvo, F.; Fossati, P.; Ciocca, M.

2015-09-01

This study was performed to evaluate the accuracy of a commercial treatment planning system (TPS), in optimising proton pencil beam dose distributions for small targets of different sizes (5-30 mm side) located at increasing depths in water. The TPS analytical algorithm was benchmarked against experimental data and the FLUKA Monte Carlo (MC) code, previously validated for the selected beam-line. We tested the Siemens syngo® TPS plan optimisation module for water cubes fixing the configurable parameters at clinical standards, with homogeneous target coverage to a 2 Gy (RBE) dose prescription as unique goal. Plans were delivered and the dose at each volume centre was measured in water with a calibrated PTW Advanced Markus® chamber. An EBT3® film was also positioned at the phantom entrance window for the acquisition of 2D dose maps. Discrepancies between TPS calculated and MC simulated values were mainly due to the different lateral spread modeling and resulted in being related to the field-to-spot size ratio. The accuracy of the TPS was proved to be clinically acceptable in all cases but very small and shallow volumes. In this contest, the use of MC to validate TPS results proved to be a reliable procedure for pre-treatment plan verification.

Dosimetric accuracy of a treatment planning system for actively scanned proton beams and small target volumes: Monte Carlo and experimental validation.

PubMed

Magro, G; Molinelli, S; Mairani, A; Mirandola, A; Panizza, D; Russo, S; Ferrari, A; Valvo, F; Fossati, P; Ciocca, M

2015-09-07

This study was performed to evaluate the accuracy of a commercial treatment planning system (TPS), in optimising proton pencil beam dose distributions for small targets of different sizes (5-30 mm side) located at increasing depths in water. The TPS analytical algorithm was benchmarked against experimental data and the FLUKA Monte Carlo (MC) code, previously validated for the selected beam-line. We tested the Siemens syngo(®) TPS plan optimisation module for water cubes fixing the configurable parameters at clinical standards, with homogeneous target coverage to a 2 Gy (RBE) dose prescription as unique goal. Plans were delivered and the dose at each volume centre was measured in water with a calibrated PTW Advanced Markus(®) chamber. An EBT3(®) film was also positioned at the phantom entrance window for the acquisition of 2D dose maps. Discrepancies between TPS calculated and MC simulated values were mainly due to the different lateral spread modeling and resulted in being related to the field-to-spot size ratio. The accuracy of the TPS was proved to be clinically acceptable in all cases but very small and shallow volumes. In this contest, the use of MC to validate TPS results proved to be a reliable procedure for pre-treatment plan verification.

Exploring Type and Amount of Parent Talk during Individualized Family Service Plan Meetings

ERIC Educational Resources Information Center

Ridgley, Robyn; Snyder, Patricia; McWilliam, R. A.

2014-01-01

We discuss the utility of a coding system designed to evaluate the amount and type of parent talk during individualized family service plan (IFSP) meetings. The iterative processes used to develop the "Parent Communication Coding System" (PCCS) and its associated codes are described. In addition, we explored whether PCCS codes could be…

Monte Carlo MCNP-4B-based absorbed dose distribution estimates for patient-specific dosimetry.

PubMed

Yoriyaz, H; Stabin, M G; dos Santos, A

2001-04-01

This study was intended to verify the capability of the Monte Carlo MCNP-4B code to evaluate spatial dose distribution based on information gathered from CT or SPECT. A new three-dimensional (3D) dose calculation approach for internal emitter use in radioimmunotherapy (RIT) was developed using the Monte Carlo MCNP-4B code as the photon and electron transport engine. It was shown that the MCNP-4B computer code can be used with voxel-based anatomic and physiologic data to provide 3D dose distributions. This study showed that the MCNP-4B code can be used to develop a treatment planning system that will provide such information in a time manner, if dose reporting is suitably optimized. If each organ is divided into small regions where the average energy deposition is calculated with a typical volume of 0.4 cm(3), regional dose distributions can be provided with reasonable central processing unit times (on the order of 12-24 h on a 200-MHz personal computer or modest workstation). Further efforts to provide semiautomated region identification (segmentation) and improvement of marrow dose calculations are needed to supply a complete system for RIT. It is envisioned that all such efforts will continue to develop and that internal dose calculations may soon be brought to a similar level of accuracy, detail, and robustness as is commonly expected in external dose treatment planning. For this study we developed a code with a user-friendly interface that works on several nuclear medicine imaging platforms and provides timely patient-specific dose information to the physician and medical physicist. Future therapy with internal emitters should use a 3D dose calculation approach, which represents a significant advance over dose information provided by the standard geometric phantoms used for more than 20 y (which permit reporting of only average organ doses for certain standardized individuals)

SU-G-TeP1-06: Fast GPU Framework for Four-Dimensional Monte Carlo in Adaptive Intensity Modulated Proton Therapy (IMPT) for Mobile Tumors

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

Botas, P; Heidelberg University, Heidelberg; Grassberger, C

Purpose: To demonstrate the feasibility of fast Monte Carlo (MC) treatment planning and verification using four-dimensional CT (4DCT) for adaptive IMPT for lung cancer patients. Methods: A validated GPU MC code, gPMC, has been linked to the patient database at our institution and employed to compute the dose-influence matrices (Dij) on the planning CT (pCT). The pCT is an average of the respiratory motion of the patient. The Dijs and patient structures were fed to the optimizer to calculate a treatment plan. To validate the plan against motion, a 4D dose distribution averaged over the possible starting phases is calculatedmore » using the 4DCT and a model of the time structure of the delivered spot map. The dose is accumulated using vector maps created by a GPU-accelerated deformable image registration program (DIR) from each phase of the 4DCT to the reference phase using the B-spline method. Calculation of the Dij matrices and the DIR are performed on a cluster, with each field and vector map calculated in parallel. Results: The Dij production takes ∼3.5s per beamlet for 10e6 protons, depending on the energy and the CT size. Generating a plan with 4D simulation of 1000 spots in 4 fields takes approximately 1h. To test the framework, IMPT plans for 10 lung cancer patients were generated for validation. Differences between the planned and the delivered dose of 19% in dose to some organs at risk and 1.4/21.1% in target mean dose/homogeneity with respect to the plan were observed, suggesting potential for improvement if adaptation is considered. Conclusion: A fast MC treatment planning framework has been developed that allows reliable plan design and verification for mobile targets and adaptation of treatment plans. This will significantly impact treatments for lung tumors, as 4D-MC dose calculations can now become part of planning strategies.« less

Dosimetric evaluation of the clinical implementation of the first commercial IMRT Monte Carlo treatment planning system at 6 MV

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

Heath, Emily; Seuntjens, Jan; Sheikh-Bagheri, Daryoush

2004-10-01

In this work we dosimetrically evaluated the clinical implementation of a commercial Monte Carlo treatment planning software (PEREGRINE, North American Scientific, Cranberry Township, PA) intended for quality assurance (QA) of intensity modulated radiation therapy treatment plans. Dose profiles calculated in homogeneous and heterogeneous phantoms using this system were compared to both measurements and simulations using the EGSnrc Monte Carlo code for the 6 MV beam of a Varian CL21EX linear accelerator. For simple jaw-defined fields, calculations agree within 2% of the dose at d{sub max} with measurements in homogeneous phantoms with the exception of the buildup region where the calculationsmore » overestimate the dose by up to 8%. In heterogeneous lung and bone phantoms the agreement is within 3%, on average, up to 5% for a 1x1 cm{sup 2} field. We tested two consecutive implementations of the MLC model. After matching the calculated and measured MLC leakage, simulations of static and dynamic MLC-defined fields using the most recent MLC model agreed to within 2% with measurements.« less

Planned Comparisons as Better Alternatives to ANOVA Omnibus Tests.

ERIC Educational Resources Information Center

Benton, Roberta L.

Analyses of data are presented to illustrate the advantages of using a priori or planned comparisons rather than omnibus analysis of variance (ANOVA) tests followed by post hoc or posteriori testing. The two types of planned comparisons considered are planned orthogonal non-trend coding contrasts and orthogonal polynomial or trend contrast coding.…

SU-D-207-07: Implementation of Full/half Bowtie Filter Model in a Commercial Treatment Planning System for Kilovoltage X-Ray Imaging Dose Estimation

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

Kim, S; Alaei, P

2015-06-15

Purpose: To implement full/half bowtie filter models in a commercial treatment planning system (TPS) to calculate kilovoltage (kV) x-ray imaging dose of Varian On-Board Imager (OBI) cone beam CT (CBCT) system. Methods: Full/half bowtie filters of Varian OBI were created as compensator models in Pinnacle TPS (version 9.6) using Matlab software (version 2011a). The profiles of both bowtie filters were acquired from the manufacturer, imported into the Matlab system and hard coded in binary file format. A Pinnacle script was written to import each bowtie filter data into a Pinnacle treatment plan as a compensator. A kV x-ray beam modelmore » without including the compensator model was commissioned per each bowtie filter setting based on percent depth dose and lateral profile data acquired from Monte Carlo simulations. To validate the bowtie filter models, a rectangular water phantom was generated in the planning system and an anterior/posterior beam with each bowtie filter was created. Using the Pinnacle script, each bowtie filter compensator was added to the treatment plan. Lateral profile at the depth of 3cm and percent depth dose were measured using an ion chamber and compared with the data extracted from the treatment plans. Results: The kV x-ray beams for both full and half bowtie filter have been modeled in a commercial TPS. The difference of lateral and depth dose profiles between dose calculations and ion chamber measurements were within 6%. Conclusion: Both full/half bowtie filter models provide reasonable results in kV x-ray dose calculations in the water phantom. This study demonstrates the possibility of using a model-based treatment planning system to calculate the kV imaging dose for both full and half bowtie filter modes. Further study is to be performed to evaluate the models in clinical situations.« less

A flexible Monte Carlo tool for patient or phantom specific calculations: comparison with preliminary validation measurements

NASA Astrophysics Data System (ADS)

Davidson, S.; Cui, J.; Followill, D.; Ibbott, G.; Deasy, J.

2008-02-01

The Dose Planning Method (DPM) is one of several 'fast' Monte Carlo (MC) computer codes designed to produce an accurate dose calculation for advanced clinical applications. We have developed a flexible machine modeling process and validation tests for open-field and IMRT calculations. To complement the DPM code, a practical and versatile source model has been developed, whose parameters are derived from a standard set of planning system commissioning measurements. The primary photon spectrum and the spectrum resulting from the flattening filter are modeled by a Fatigue function, cut-off by a multiplying Fermi function, which effectively regularizes the difficult energy spectrum determination process. Commonly-used functions are applied to represent the off-axis softening, increasing primary fluence with increasing angle ('the horn effect'), and electron contamination. The patient dependent aspect of the MC dose calculation utilizes the multi-leaf collimator (MLC) leaf sequence file exported from the treatment planning system DICOM output, coupled with the source model, to derive the particle transport. This model has been commissioned for Varian 2100C 6 MV and 18 MV photon beams using percent depth dose, dose profiles, and output factors. A 3-D conformal plan and an IMRT plan delivered to an anthropomorphic thorax phantom were used to benchmark the model. The calculated results were compared to Pinnacle v7.6c results and measurements made using radiochromic film and thermoluminescent detectors (TLD).

Clinical implementation and failure mode and effects analysis of HDR skin brachytherapy using Valencia and Leipzig surface applicators.

PubMed

Sayler, Elaine; Eldredge-Hindy, Harriet; Dinome, Jessie; Lockamy, Virginia; Harrison, Amy S

2015-01-01

The planning procedure for Valencia and Leipzig surface applicators (VLSAs) (Nucletron, Veenendaal, The Netherlands) differs substantially from CT-based planning; the unfamiliarity could lead to significant errors. This study applies failure modes and effects analysis (FMEA) to high-dose-rate (HDR) skin brachytherapy using VLSAs to ensure safety and quality. A multidisciplinary team created a protocol for HDR VLSA skin treatments and applied FMEA. Failure modes were identified and scored by severity, occurrence, and detectability. The clinical procedure was then revised to address high-scoring process nodes. Several key components were added to the protocol to minimize risk probability numbers. (1) Diagnosis, prescription, applicator selection, and setup are reviewed at weekly quality assurance rounds. Peer review reduces the likelihood of an inappropriate treatment regime. (2) A template for HDR skin treatments was established in the clinic's electronic medical record system to standardize treatment instructions. This reduces the chances of miscommunication between the physician and planner as well as increases the detectability of an error. (3) A screen check was implemented during the second check to increase detectability of an error. (4) To reduce error probability, the treatment plan worksheet was designed to display plan parameters in a format visually similar to the treatment console display, facilitating data entry and verification. (5) VLSAs are color coded and labeled to match the electronic medical record prescriptions, simplifying in-room selection and verification. Multidisciplinary planning and FMEA increased detectability and reduced error probability during VLSA HDR brachytherapy. This clinical model may be useful to institutions implementing similar procedures. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Current issues in billing and coding in interventional pain medicine.

PubMed

Manchikanti, L

2000-10-01

Interventional pain management is a dynamic field with changes occurring on a daily basis, not only with technology but also with regulations that have a substantial financial impact on practices. Regulations are imposed not only by the federal government and other regulatory agencies, and also by a multitude of other payors, state governments and medical boards. Documentation of medical necessity with coding that correlates with multiple components of the patient's medical record, operative report, and billing statement is extremely important. Numerous changes which have occurred in the practice of interventional pain management in the new millennium continue to impact the financial viability of interventional pain practices along with patient access to these services. Thus, while complying with regulations of billing, coding and proper, effective, and ethical practice of pain management, it is also essential for physicians to understand financial aspects and the impact of various practice patterns. This article provides guidelines which are meant to provide practical considerations for billing and coding of interventional techniques in the management of chronic pain based on the current state of the art and science of interventional pain management. Hence, these guidelines do not constitute inflexible treatment, coding, billing or documentation recommendations. It is expected that a provider will establish a plan of care on a case-by-case basis taking into account an individual patient's medical condition, personal needs, and preferences, along with physician's experience and in a similar manner, billing and coding practices will be developed. Based on an individual patient's needs, treatment, billing and coding, different from what is outlined here is not only warranted but essential.

Dosimetric quality control of Eclipse treatment planning system using pelvic digital test object

NASA Astrophysics Data System (ADS)

Benhdech, Yassine; Beaumont, Stéphane; Guédon, Jeanpierre; Crespin, Sylvain

2011-03-01

Last year, we demonstrated the feasibility of a new method to perform dosimetric quality control of Treatment Planning Systems in radiotherapy, this method is based on Monte-Carlo simulations and uses anatomical Digital Test Objects (DTOs). The pelvic DTO was used in order to assess this new method on an ECLIPSE VARIAN Treatment Planning System. Large dose variations were observed particularly in air and bone equivalent material. In this current work, we discuss the results of the previous paper and provide an explanation for observed dose differences, the VARIAN Eclipse (Anisotropic Analytical) algorithm was investigated. Monte Carlo simulations (MC) were performed with a PENELOPE code version 2003. To increase efficiency of MC simulations, we have used our parallelized version based on the standard MPI (Message Passing Interface). The parallel code has been run on a 32- processor SGI cluster. The study was carried out using pelvic DTOs and was performed for low- and high-energy photon beams (6 and 18MV) on 2100CD VARIAN linear accelerator. A square field (10x10 cm2) was used. Assuming the MC data as reference, χ index analyze was carried out. For this study, a distance to agreement (DTA) was set to 7mm while the dose difference was set to 5% as recommended in the TRS-430 and TG-53 (on the beam axis in 3-D inhomogeneities). When using Monte Carlo PENELOPE, the absorbed dose is computed to the medium, however the TPS computes dose to water. We have used the method described by Siebers et al. based on Bragg-Gray cavity theory to convert MC simulated dose to medium to dose to water. Results show a strong consistency between ECLIPSE and MC calculations on the beam axis.

TU-AB-BRC-12: Optimized Parallel MonteCarlo Dose Calculations for Secondary MU Checks

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

French, S; Nazareth, D; Bellor, M

Purpose: Secondary MU checks are an important tool used during a physics review of a treatment plan. Commercial software packages offer varying degrees of theoretical dose calculation accuracy, depending on the modality involved. Dose calculations of VMAT plans are especially prone to error due to the large approximations involved. Monte Carlo (MC) methods are not commonly used due to their long run times. We investigated two methods to increase the computational efficiency of MC dose simulations with the BEAMnrc code. Distributed computing resources, along with optimized code compilation, will allow for accurate and efficient VMAT dose calculations. Methods: The BEAMnrcmore » package was installed on a high performance computing cluster accessible to our clinic. MATLAB and PYTHON scripts were developed to convert a clinical VMAT DICOM plan into BEAMnrc input files. The BEAMnrc installation was optimized by running the VMAT simulations through profiling tools which indicated the behavior of the constituent routines in the code, e.g. the bremsstrahlung splitting routine, and the specified random number generator. This information aided in determining the most efficient compiling parallel configuration for the specific CPU’s available on our cluster, resulting in the fastest VMAT simulation times. Our method was evaluated with calculations involving 10{sup 8} – 10{sup 9} particle histories which are sufficient to verify patient dose using VMAT. Results: Parallelization allowed the calculation of patient dose on the order of 10 – 15 hours with 100 parallel jobs. Due to the compiler optimization process, further speed increases of 23% were achieved when compared with the open-source compiler BEAMnrc packages. Conclusion: Analysis of the BEAMnrc code allowed us to optimize the compiler configuration for VMAT dose calculations. In future work, the optimized MC code, in conjunction with the parallel processing capabilities of BEAMnrc, will be applied to provide accurate and efficient secondary MU checks.« less

Methodology, status and plans for development and assessment of Cathare code

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

Bestion, D.; Barre, F.; Faydide, B.

1997-07-01

This paper presents the methodology, status and plans for the development, assessment and uncertainty evaluation of the Cathare code. Cathare is a thermalhydraulic code developed by CEA (DRN), IPSN, EDF and FRAMATOME for PWR safety analysis. First, the status of the code development and assessment is presented. The general strategy used for the development and the assessment of the code is presented. Analytical experiments with separate effect tests, and component tests are used for the development and the validation of closure laws. Successive Revisions of constitutive laws are implemented in successive Versions of the code and assessed. System tests ormore » integral tests are used to validate the general consistency of the Revision. Each delivery of a code Version + Revision is fully assessed and documented. A methodology is being developed to determine the uncertainty on all constitutive laws of the code using calculations of many analytical tests and applying the Discrete Adjoint Sensitivity Method (DASM). At last, the plans for the future developments of the code are presented. They concern the optimization of the code performance through parallel computing - the code will be used for real time full scope plant simulators - the coupling with many other codes (neutronic codes, severe accident codes), the application of the code for containment thermalhydraulics. Also, physical improvements are required in the field of low pressure transients and in the modeling for the 3-D model.« less

Very high-energy electron (VHEE) beams in radiation therapy; Treatment plan comparison between VHEE, VMAT, and PPBS.

PubMed

Schüler, Emil; Eriksson, Kjell; Hynning, Elin; Hancock, Steven L; Hiniker, Susan M; Bazalova-Carter, Magdalena; Wong, Tony; Le, Quynh-Thu; Loo, Billy W; Maxim, Peter G

2017-06-01

The aim of this study was to evaluate the performance of very high-energy electron beams (VHEE) in comparison to clinically derived treatment plans generated with volumetric modulated arc therapy (VMAT) and proton pencil beam scanning (PPBS) technology. We developed a custom optimization script that could be applied automatically across modalities to eliminate operator bias during IMRT optimization. Four clinical cases were selected (prostate cancer, lung cancer, pediatric brain tumor, and head and neck cancer (HNC)). The VHEE beams were calculated in the EGSnrc/DOSXYZnrc Monte Carlo code for 100 and 200 MeV beams. Treatment plans with VHEE, VMAT, and PPBS were optimized in a research version of RayStation using an in-house developed script to minimize operator bias between the different techniques. The in-house developed script generated similar or superior plans to the clinically used plans. In the comparisons between the modalities, the integral dose was lowest for the PPBS-generated plans in all cases. For the prostate case, the 200 MeV VHEE plan showed reduced integral dose and reduced organ at risk (OAR) dose compared to the VMAT plan. For all other cases, both the 100 and the 200 MeV VHEE plans were superior to the VMAT plans, and the VHEE plans showed better conformity and lower spinal cord dose in the pediatric brain case and lower brain stem dose in the HNC case when compared to the PPBS plan. The automated optimization developed in this study generated similar or superior plans as compared to the clinically used plan and represents an unbiased approach to compare treatment plans generated for different modalities. In the present study, we also show that VHEE plans are similar or superior to VMAT plans with reduced mean OAR dose and increased target conformity for a variety of clinical cases, and VHEE plans can even achieve reductions in OAR doses compared to PPBS plans for shallow targets. With increased VHEE energy, better conformity and even higher reductions in mean OAR doses are achieved. On the whole, VHEE was intermediate between photon VMAT and PPBS for OAR sparing. © 2017 American Association of Physicists in Medicine.

31 CFR 29.302 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Code (1997) (under the Police and Firefighters Plan) or section 31-1231(a) of the D.C. Code (1997... accrue, that is, age 55 under the Police and Firefighters Plan and age 62 under the Teachers Plan. Department service or departmental service means any period of employment in a position covered by the Police...

The CORSAIR Turbomachinery Code: Status and Plans

NASA Technical Reports Server (NTRS)

Dorney, Daniel J.; Sondak, Douglas L.; Turner, James (Technical Monitor)

2002-01-01

This viewgraph presentation gives an overview of the CORSAIR turbomachinery code's status and plans. Details are provided on the CORSAIR algorithms, full- and partial-admission turbine simulations, the Simplex turbine, instantaneous Mach number, unsteady pressure admission graphs, variable fluid property RLV-133 simulations, instantaneous entropy function, pumps and inducers, and future plans.

Dosimetric comparisons of carbon ion treatment plans for 1D and 2D ripple filters with variable thicknesses

NASA Astrophysics Data System (ADS)

Printz Ringbæk, Toke; Weber, Uli; Santiago, Alina; Simeonov, Yuri; Fritz, Peter; Krämer, Michael; Wittig, Andrea; Bassler, Niels; Engenhart-Cabillic, Rita; Zink, Klemens

2016-06-01

A ripple filter (RiFi)—also called mini-ridge filter—is a passive energy modulator used in particle beam treatments that broadens the Bragg peak (BP) as a function of its maximum thickness. The number of different energies requested from the accelerator can thus be reduced, which significantly reduces the treatment time. A new second generation RiFi with 2D groove shapes was developed using rapid prototyping, which optimizes the beam-modulating material and enables RiFi thicknesses of up to 6 mm. Carbon ion treatment plans were calculated using the standard 1D 3 mm thick RiFi and the new 4 and 6 mm 2D RiFis for spherical planning target volumes (PTVs) in water, eight stage I non-small cell lung cancer cases, four skull base chordoma cases and three prostate cancer cases. TRiP98 was used for treatment planning with facility-specific base data calculated with the Monte Carlo code SHIELD-HIT12A. Dose-volume-histograms, spatial dose distributions and dosimetric indexes were used for plan evaluation. Plan homogeneity and conformity of thinner RiFis were slightly superior to thicker RiFis but satisfactory results were obtained for all RiFis investigated. For the 6 mm RiFi, fine structures in the dose distribution caused by the larger energy steps were observed at the PTV edges, in particular for superficial and/or very small PTVs but performances for all RiFis increased with penetration depth due to straggling and scattering effects. Plans with the new RiFi design yielded for the studied cases comparable dosimetric results to the standard RiFi while the 4 and 6 mm RiFis lowered the irradiation time by 25-30% and 45-49%, respectively.

SU-C-BRD-02: A Team Focused Clinical Implementation and Failure Mode and Effects Analysis of HDR Skin Brachytherapy Using Valencia and Leipzig Surface Applicators

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

Sayler, E; Harrison, A; Eldredge-Hindy, H

Purpose: and Leipzig applicators (VLAs) are single-channel brachytherapy surface applicators used to treat skin lesions up to 2cm diameter. Source dwell times can be calculated and entered manually after clinical set-up or ultrasound. This procedure differs dramatically from CT-based planning; the novelty and unfamiliarity could lead to severe errors. To build layers of safety and ensure quality, a multidisciplinary team created a protocol and applied Failure Modes and Effects Analysis (FMEA) to the clinical procedure for HDR VLA skin treatments. Methods: team including physicists, physicians, nurses, therapists, residents, and administration developed a clinical procedure for VLA treatment. The procedure wasmore » evaluated using FMEA. Failure modes were identified and scored by severity, occurrence, and detection. The clinical procedure was revised to address high-scoring process nodes. Results: Several key components were added to the clinical procedure to minimize risk probability numbers (RPN): -Treatments are reviewed at weekly QA rounds, where physicians discuss diagnosis, prescription, applicator selection, and set-up. Peer review reduces the likelihood of an inappropriate treatment regime. -A template for HDR skin treatments was established in the clinical EMR system to standardize treatment instructions. This reduces the chances of miscommunication between the physician and planning physicist, and increases the detectability of an error during the physics second check. -A screen check was implemented during the second check to increase detectability of an error. -To reduce error probability, the treatment plan worksheet was designed to display plan parameters in a format visually similar to the treatment console display. This facilitates data entry and verification. -VLAs are color-coded and labeled to match the EMR prescriptions, which simplifies in-room selection and verification. Conclusion: Multidisciplinary planning and FMEA increased delectability and reduced error probability during VLA HDR Brachytherapy. This clinical model may be useful to institutions implementing similar procedures.« less

SU-E-T-222: Computational Optimization of Monte Carlo Simulation On 4D Treatment Planning Using the Cloud Computing Technology

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

Chow, J

Purpose: This study evaluated the efficiency of 4D lung radiation treatment planning using Monte Carlo simulation on the cloud. The EGSnrc Monte Carlo code was used in dose calculation on the 4D-CT image set. Methods: 4D lung radiation treatment plan was created by the DOSCTP linked to the cloud, based on the Amazon elastic compute cloud platform. Dose calculation was carried out by Monte Carlo simulation on the 4D-CT image set on the cloud, and results were sent to the FFD4D image deformation program for dose reconstruction. The dependence of computing time for treatment plan on the number of computemore » node was optimized with variations of the number of CT image set in the breathing cycle and dose reconstruction time of the FFD4D. Results: It is found that the dependence of computing time on the number of compute node was affected by the diminishing return of the number of node used in Monte Carlo simulation. Moreover, the performance of the 4D treatment planning could be optimized by using smaller than 10 compute nodes on the cloud. The effects of the number of image set and dose reconstruction time on the dependence of computing time on the number of node were not significant, as more than 15 compute nodes were used in Monte Carlo simulations. Conclusion: The issue of long computing time in 4D treatment plan, requiring Monte Carlo dose calculations in all CT image sets in the breathing cycle, can be solved using the cloud computing technology. It is concluded that the optimized number of compute node selected in simulation should be between 5 and 15, as the dependence of computing time on the number of node is significant.« less

SU-E-T-157: CARMEN: A MatLab-Based Research Platform for Monte Carlo Treatment Planning (MCTP) and Customized System for Planning Evaluation

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

Baeza, J.A.; Ureba, A.; Jimenez-Ortega, E.

Purpose: Although there exist several radiotherapy research platforms, such as: CERR, the most widely used and referenced; SlicerRT, which allows treatment plan comparison from various sources; and MMCTP, a full MCTP system; it is still needed a full MCTP toolset that provides users complete control of calculation grids, interpolation methods and filters in order to “fairly” compare results from different TPSs, supporting verification with experimental measurements. Methods: This work presents CARMEN, a MatLab-based platform including multicore and GPGPU accelerated functions for loading RT data; designing treatment plans; and evaluating dose matrices and experimental data.CARMEN supports anatomic and functional imaging inmore » DICOM format, as well as RTSTRUCT, RTPLAN and RTDOSE. Besides, it contains numerous tools to accomplish the MCTP process, managing egs4phant and phase space files.CARMEN planning mode assist in designing IMRT, VMAT and MERT treatments via both inverse and direct optimization. The evaluation mode contains a comprehensive toolset (e.g. 2D/3D gamma evaluation, difference matrices, profiles, DVH, etc.) to compare datasets from commercial TPS, MC simulations (i.e. 3ddose) and radiochromic film in a user-controlled manner. Results: CARMEN has been validated against commercial RTPs and well-established evaluation tools, showing coherent behavior of its multiple algorithms. Furthermore, CARMEN platform has been used to generate competitive complex treatment that has been published in comparative studies. Conclusion: A new research oriented MCTP platform with a customized validation toolset has been presented. Despite of being coded with a high-level programming language, CARMEN is agile due to the use of parallel algorithms. The wide-spread use of MatLab provides straightforward access to CARMEN’s algorithms to most researchers. Similarly, our platform can benefit from the MatLab community scientific developments as filters, registration algorithms etc. Finally, CARMEN arises the importance of grid and filtering control in treatment plan comparison.« less

Hazardous Waste Certification Plan: Hazardous Waste Handling Facility, Lawrence Berkeley Laboratory

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

Not Available

1992-02-01

The purpose of this plan is to describe the organization and methodology for the certification of hazardous waste (HW) handled in the Lawrence Berkeley Laboratory (LBL) Hazardous Waste Handling Facility (HWHF). The plan also incorporates the applicable elements of waste reduction, which include both up-front minimization and end- product treatment to reduce the volume and toxicity of the waste; segregation of the waste as it applies to certification; and executive summary of the Quality Assurance Program Plan (QAPP) for the HWHF and a list of the current and planned implementing procedures used in waste certification. The plan provides guidance frommore » the HWHF to waste generators, waste handlers, and the Systems Group Manager to enable them to conduct their activities and carry out their responsibilities in a manner that complies with several requirements of the Federal Resource Conservation and Resource Recovery Act (RCRA), the Federal Department of Transportation (DOT), and the State of California, Code of Regulations (CCR), Title 22.« less

SU-F-T-156: Monte Carlo Simulation Using TOPAS for Synchrotron Based Proton Discrete Spot Scanning System

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

Moskvin, V; Pirlepesov, F; Tsiamas, P

Purpose: This study provides an overview of the design and commissioning of the Monte Carlo (MC) model of the spot-scanning proton therapy nozzle and its implementation for the patient plan simulation. Methods: The Hitachi PROBEAT V scanning nozzle was simulated based on vendor specifications using the TOPAS extension of Geant4 code. FLUKA MC simulation was also utilized to provide supporting data for the main simulation. Validation of the MC model was performed using vendor provided data and measurements collected during acceptance/commissioning of the proton therapy machine. Actual patient plans using CT based treatment geometry were simulated and compared to themore » dose distributions produced by the treatment planning system (Varian Eclipse 13.6), and patient quality assurance measurements. In-house MATLAB scripts are used for converting DICOM data into TOPAS input files. Results: Comparison analysis of integrated depth doses (IDDs), therapeutic ranges (R90), and spot shape/sizes at different distances from the isocenter, indicate good agreement between MC and measurements. R90 agreement is within 0.15 mm across all energy tunes. IDDs and spot shapes/sizes differences are within statistical error of simulation (less than 1.5%). The MC simulated data, validated with physical measurements, were used for the commissioning of the treatment planning system. Patient geometry simulations were conducted based on the Eclipse produced DICOM plans. Conclusion: The treatment nozzle and standard option beam model were implemented in the TOPAS framework to simulate a highly conformal discrete spot-scanning proton beam system.« less

14 CFR 93.339 - Requirements for operating in the DC SFRA, including the DC FRZ.

Code of Federal Regulations, 2010 CFR

2010-01-01

... aircraft in the DC SFRA, including the DC FRZ, the pilot obtains and transmits a discrete transponder code... flight plan by obtaining a discrete transponder code. The flight plan is closed upon landing at an... transmitting an Air Traffic Control-assigned discrete transponder code. (c) When operating an aircraft in the...

Attention in Relation to Coding and Planning in Reading

ERIC Educational Resources Information Center

Mahapatra, Shamita

2015-01-01

A group of 50 skilled readers and a group of 50 less-skilled readers of Grade 5 matched for age and intelligence and selected on the basis of their proficiency in reading comprehension were tested for their competence in word reading and the processes of attention, simultaneous coding, successive coding and planning at three levels, i.e.,…

76 FR 16285 - Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update Water...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-23

... Plan to update the Commission's human health and aquatic life stream quality objectives (also called... DELAWARE RIVER BASIN COMMISSION 18 CFR Part 410 Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update Water Quality Criteria for Toxic Pollutants in the Delaware...

Tradeoffs of Using Administrative Claims and Medical Records to Identify the Use of Personalized Medicine for Patients with Breast Cancer

PubMed Central

Liang, Su-Ying; Phillips, Kathryn A.; Wang, Grace; Keohane, Carol; Armstrong, Joanne; Morris, William M.; Haas, Jennifer S.

2012-01-01

Background Administrative claims and medical records are important data sources to examine healthcare utilization and outcomes. Little is known about identifying personalized medicine technologies in these sources. Objectives To describe agreement, sensitivity, and specificity of administrative claims compared to medical records for two pairs of targeted tests and treatments for breast cancer. Research Design Retrospective analysis of medical records linked to administrative claims from a large health plan. We examined whether agreement varied by factors that facilitate tracking in claims (coding and cost) and that enhance medical record completeness (records from multiple providers). Subjects Women (35 – 65 years) with incident breast cancer diagnosed in 2006–2007 (n=775). Measures Use of human epidermal growth factor receptor 2 (HER2) and gene expression profiling (GEP) testing, trastuzumab and adjuvant chemotherapy in claims and medical records. Results Agreement between claims and records was substantial for GEP, trastuzumab, and chemotherapy, and lowest for HER2 tests. GEP, an expensive test with unique billing codes, had higher agreement (91.6% vs. 75.2%), sensitivity (94.9% vs. 76.7%), and specificity (90.1% vs. 29.2%) than HER2, a test without unique billing codes. Trastuzumab, a treatment with unique billing codes, had slightly higher agreement (95.1% vs. 90%) and sensitivity (98.1% vs. 87.9%) than adjuvant chemotherapy. Conclusions Higher agreement and specificity were associated with services that had unique billing codes and high cost. Administrative claims may be sufficient for examining services with unique billing codes. Medical records provide better data for identifying tests lacking specific codes and for research requiring detailed clinical information. PMID:21422962

“The chief of the services is very enthusiastic about it”: A qualitative study of the adoption of buprenorphine for opioid addiction treatment

PubMed Central

Green, Carla A.; McCarty, Dennis; Mertens, Jennifer; Lynch, Frances L.; Hilde, Anadam; Firemark, Alison; Weisner, Constance M.; Pating, David; Anderson, Bradley M.

2013-01-01

Qualified physicians may prescribe buprenorphine to treat opioid dependence, but medication use remains controversial. We examined adoption of buprenorphine in two not-for-profit integrated health plans, over time, completing 101 semi-structured interviews with clinicians and clinician-administrators from primary and specialty care. Transcripts were reviewed, coded, and analyzed. A strong leader championing the new treatment was critical for adoption in both health plans. Once clinicians began using buprenorphine, patients’ and other clinicians’ experiences affected decisions more than did the champion. With experience, protocols developed to manage unsuccessful patients and changed to support maintenance rather than detoxification. Diffusion outside addiction and mental health settings was nonexistent; primary care clinicians cited scope-of-practice issues and referred patients to specialty care. With greater diffusion came questions about long-term use and safety. Recognizing how implementation processes develop may suggest where, when, and how to best expend resources to increase adoption of such treatments. PMID:24268947

MO-F-CAMPUS-T-02: An Electronic Whiteboard Platform to Manage Treatment Planning Process

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

DiCostanzo, D; Woollard, J; Gupta, N

2015-06-15

Purpose: In an effort to improve patient safety and streamline the radiotherapy treatment planning (TP) process, a software based whiteboard had been developed and put in use in our facility Methods: The electronic whiteboard developed using SQL database (DB) and PHP/JavaScript based web interface, is published via department intranet and login credentials. The DB stores data for each TP process such as patient information, plan type, simulation/start dates, physician, dosimetrist, QA and the current status in planning process. Users interact with the DB per plan and perform status updates in real time as the planning process progresses. All user interactionsmore » with the DB are recorded with timestamps so as to calculate statistical information for TP process management such as contouring times, planning and review times, dosimetry, physics and therapist QA times. External beam and brachytherapy plans are categorized according to complexity (ex: IMRT, 3D, HDR, LDR etc) and treatment types and applicators. Each plan category is assigned specific timelines for each planning process. When a plan approaches or passes the predetermined timeline, users are alerted via color coded graphical cues. When certain process items are not completed in time, pre-determined actions are triggered such as a delay in treatment start date. Results: Our institution has been using the electronic whiteboard for two years. Implementation of pre-determined actions based on the statistical information collected by the whiteboard improved our TP process. For example, the average time for normal tissue contouring decreased from 0.73±1.37 to 0.24±0.33 days. The average time for target volume contouring decreased from 3.2±2.84 to 2.37±2.54 days. This increase in efficiency allows more time for quality assurance processes, improving patient safety. Conclusion: The electronic whiteboard has been an invaluable tool for streamlining our TP processes. It facilitates timely and accurate communication between all parties involved in the TP process increasing patient safety.« less

77 FR 32686 - Proposed Exemptions From Certain Prohibited Transaction Restrictions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

...This document contains notices of pendency before the Department of Labor (the Department) of proposed exemptions from certain of the prohibited transaction restrictions of the Employee Retirement Income Security Act of 1974 (ERISA or the Act) and/or the Internal Revenue Code of 1986 (the Code). This notice includes the following proposed exemptions: D-11649, Meridian Medical Associates, S.C, Employees' Retirement Plan and Trust (the Plan); D-11710, El Paso Corporation Retirement Savings Plan (the Plan); and D-11714, Ed Laur Defined Benefit Plan (the Plan).

3718-F Alkali Metal Treatment and Storage Facility Closure Plan. Revision 1

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

None

The Hanford Site, located northwest of the city of Richland, Washington, houses reactors, chemical-separation systems, and related facilities used for the production of special nuclear materials, as well as for activities associated with nuclear energy development. The 300 Area of the Hanford Site contains reactor fuel manufacturing facilities and several research and development laboratories. The 3718-F Alkali Metal Treatment and Storage Facility (3718-F Facility), located in the 300 Area, was used to store and treat alkali metal wastes. Therefore, it is subject to the regulatory requirements for the storage and treatment of dangerous wastes. Closure will be conducted pursuant tomore » the requirements of the Washington Administrative Code (WAC) 173-303-610 (Ecology 1989) and 40 CFR 270.1. Closure also will satisfy the thermal treatment facility closure requirements of 40 CFR 265.381. This closure plan presents a description of the 3718-F Facility, the history of wastes managed, and the approach that will be followed to close the facility. Only hazardous constituents derived from 3718-F Facility operations will be addressed.« less

A CyberCIEGE Scenario Illustrating Secrecy Issues in an Internal Corporate Network Connected to the Internet

DTIC Science & Technology

2004-09-01

to provide access to and protect are the NG Game Code, Employee Files, E -MAIL, Marketing Plans and Legacy Code. The NG Game Code is the MOST...major hit. E -MAIL is classified NON- SENSITIVE. The Marketing Plans are for the NG Game Code. They contain information concerning what the new...simulation games currently on the market except that, rather than allowing players to choose rides, refreshments and facilities, CyberCIEGE will

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

Unkelbach, Jan, E-mail: junkelbach@mgh.harvard.edu; Botas, Pablo; Faculty of Physics, Ruprecht-Karls-Universität Heidelberg, Heidelberg

Purpose: We describe a treatment plan optimization method for intensity modulated proton therapy (IMPT) that avoids high values of linear energy transfer (LET) in critical structures located within or near the target volume while limiting degradation of the best possible physical dose distribution. Methods and Materials: To allow fast optimization based on dose and LET, a GPU-based Monte Carlo code was extended to provide dose-averaged LET in addition to dose for all pencil beams. After optimizing an initial IMPT plan based on physical dose, a prioritized optimization scheme is used to modify the LET distribution while constraining the physical dosemore » objectives to values close to the initial plan. The LET optimization step is performed based on objective functions evaluated for the product of LET and physical dose (LET×D). To first approximation, LET×D represents a measure of the additional biological dose that is caused by high LET. Results: The method is effective for treatments where serial critical structures with maximum dose constraints are located within or near the target. We report on 5 patients with intracranial tumors (high-grade meningiomas, base-of-skull chordomas, ependymomas) in whom the target volume overlaps with the brainstem and optic structures. In all cases, high LET×D in critical structures could be avoided while minimally compromising physical dose planning objectives. Conclusion: LET-based reoptimization of IMPT plans represents a pragmatic approach to bridge the gap between purely physical dose-based and relative biological effectiveness (RBE)-based planning. The method makes IMPT treatments safer by mitigating a potentially increased risk of side effects resulting from elevated RBE of proton beams near the end of range.« less

The structure of affective action representations: temporal binding of affective response codes.

PubMed

Eder, Andreas B; Müsseler, Jochen; Hommel, Bernhard

2012-01-01

Two experiments examined the hypothesis that preparing an action with a specific affective connotation involves the binding of this action to an affective code reflecting this connotation. This integration into an action plan should lead to a temporary occupation of the affective code, which should impair the concurrent representation of affectively congruent events, such as the planning of another action with the same valence. This hypothesis was tested with a dual-task setup that required a speeded choice between approach- and avoidance-type lever movements after having planned and before having executed an evaluative button press. In line with the code-occupation hypothesis, slower lever movements were observed when the lever movement was affectively compatible with the prepared evaluative button press than when the two actions were affectively incompatible. Lever movements related to approach and avoidance and evaluative button presses thus seem to share a code that represents affective meaning. A model of affective action control that is based on the theory of event coding is discussed.

10 CFR 420.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Planning Organization means that organization required by the Department of Transportation, and designated... planning provisions in a Standard Metropolitan Statistical Area. Model Energy Code, 1993, including Errata, means the model building code published by the Council of American Building Officials, which is...

Idaho National Laboratory (INL) Site Greenhouse Gas (GHG) Monitoring Plan - 40 CFR 98

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

Deborah L. Layton; Kimberly Frerichs

2011-12-01

The purpose of this Greenhouse Gas (GHG) Monitoring Plan is to meet the monitoring plan requirements of Title 40 of the Code of Federal Regulations Part 98.3(g)(5). This GHG Monitoring Plan identifies procedures and methodologies used at the Idaho National Laboratory Site (INL Site) to collect data used for GHG emissions calculations and reporting requirements from stationary combustion and other regulated sources in accordance with 40 CFR 98, Subparts A and other applicable subparts. INL Site Contractors determined subpart applicability through the use of a checklist (Appendix A). Each facility/contractor reviews operations to determine which subparts are applicable and themore » results are compiled to determine which subparts are applicable to the INL Site. This plan is applicable to the 40 CFR 98-regulated activities managed by the INL Site contractors: Idaho National Laboratory (INL), Idaho Cleanup Project (ICP), Advanced Mixed Waste Treatment Project (AMWTP), and Naval Reactors Facilities (NRF).« less

Idaho National Laboratory (INL) Site Greenhouse Gas (GHG) Monitoring Plan - 40 CFR 98

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

Deborah L. Layton; Kimberly Frerichs

2010-07-01

The purpose of this Greenhouse Gas (GHG) Monitoring Plan is to meet the monitoring plan requirements of Title 40 of the Code of Federal Regulations Part 98.3(g)(5). This GHG Monitoring Plan identifies procedures and methodologies used at the Idaho National Laboratory Site (INL Site) to collect data used for GHG emissions calculations and reporting requirements from stationary combustion and other regulated sources in accordance with 40 CFR 98, Subparts A and other applicable subparts. INL Site Contractors determined subpart applicability through the use of a checklist (Appendix A). Each facility/contractor reviews operations to determine which subparts are applicable and themore » results are compiled to determine which subparts are applicable to the INL Site. This plan is applicable to the 40 CFR 98-regulated activities managed by the INL Site contractors: Idaho National Laboratory (INL), Idaho Cleanup Project (ICP), Advanced Mixed Waste Treatment Project (AMWTP), and Naval Reactors Facilities (NRF).« less

78 FR 51139 - Notice of Proposed Changes to the National Handbook of Conservation Practices for the Natural...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-20

... (Code 324), Field Border (Code 386), Filter Strip (Code 393), Land Smoothing (Code 466), Livestock... the implementation requirement document to the specifications and plans. Filter Strip (Code 393)--The...

76 FR 69172 - Determination of Governmental Plan Status

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

...The Treasury Department and IRS anticipate issuing regulations under section 414(d) of the Internal Revenue Code (Code) to define the term ``governmental plan.'' This document describes the rules that the Treasury Department and IRS are considering proposing relating to the determination of whether a plan is a governmental plan within the meaning of section 414(d) and contains an appendix that includes a draft notice of proposed rulemaking on which the Treasury Department and IRS invite comments from the public. This document applies to sponsors of, and participants and beneficiaries in, employee benefit plans that are determined to be governmental plans.

Radiation therapy for people with cancer: what do written information materials tell them?

PubMed

Smith, S K; Yan, B; Milross, C; Dhillon, H M

2016-07-01

This study aimed to compare and contrast the contents of different types of written patient information about radiotherapy, namely (1) hospital radiotherapy departments vs. cancer control organisations and (2) generic vs. tumour-specific materials. A coding framework, informed by existing patients' information needs literature, was developed and applied to 54 radiotherapy information resources. The framework comprised 12 broad themes; cancer diagnosis, general information about radiotherapy, treatment planning, daily treatment, side effects, self-care management, external radiotherapy, internal radiotherapy, impact on daily activities, post-treatment, psychosocial health and other content, such as a glossary. Materials produced by cancer organisations contained significantly more information than hospital resources on diagnosis, general radiotherapy information, internal radiotherapy and psychosocial health. However, hospital materials provided more information about treatment planning, daily treatment and the impact on daily activities. Compared to generic materials, tumour-specific resources were superior in providing information about diagnosis, daily treatment, side effects, post-treatment and psychosocial health. Information about internal radiotherapy, prognosis and chronic side effects were poorly covered by most resources. Collectively, hospital and cancer organisation resources complement each other in meeting patients' information needs. Identifying ways to consolidate different information sources could help comprehensively address patients' medical and psychosocial information needs about radiotherapy. © 2015 John Wiley & Sons Ltd.

The Monte Carlo code MCPTV--Monte Carlo dose calculation in radiation therapy with carbon ions.

PubMed

Karg, Juergen; Speer, Stefan; Schmidt, Manfred; Mueller, Reinhold

2010-07-07

The Monte Carlo code MCPTV is presented. MCPTV is designed for dose calculation in treatment planning in radiation therapy with particles and especially carbon ions. MCPTV has a voxel-based concept and can perform a fast calculation of the dose distribution on patient CT data. Material and density information from CT are taken into account. Electromagnetic and nuclear interactions are implemented. Furthermore the algorithm gives information about the particle spectra and the energy deposition in each voxel. This can be used to calculate the relative biological effectiveness (RBE) for each voxel. Depth dose distributions are compared to experimental data giving good agreement. A clinical example is shown to demonstrate the capabilities of the MCPTV dose calculation.

SU-E-T-348: Verification MU Calculation for Conformal Radiotherapy with Multileaf Collimator Using Report AAPM TG 114

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

Adrada, A; Tello, Z; Medina, L

Purpose: The purpose of this work was to develop and validate an open source independent MU dose calculation software for 3D conformal radiotherapy with multileaf high and low resolution according to the report of AAPM TG 11 Methods: Treatment plans were done using Iplan v4.5 BrainLAB TPS. A 6MV photon beam produced by Primus and Novalis linear accelerators equipped with an Optifocus MLC and HDMLC, respectively. TPS dose calculation algorithms were pencil beam and Monte Carlo. 1082 treatments plans were selected for the study. The algorithm was written in free and open source CodeBlocks C++ platform. Treatment plans were importedmore » by the software using RTP format. Equivalent size field is obtained from the positions of the leaves; the effective depth of calculation can be introduced by TPS's dosimetry report or automatically calculated starting from SSD. The inverse square law is calculated by the 3D coordinates of the isocenter and normalization point of the treatment plan. The dosimetric parameters TPR, Sc, Sp and WF are linearly interpolated. Results: 1082 plans of both machines were analyzed. The average uncertainty between the TPS and the independent calculation was −0.43% ± 2.42% [−7.90%, 7.50%]. Specifically for the Primus the variation obtained was −0.85% ± 2.53% and for the Novalis 0.00% ± 2.23%. Data show that 94.8% of the cases the uncertainty was less than or equal to 5%, while 98.9% is less than or equal to 6%. Conclusion: The developed software is appropriate for use in calculation of UM. This software can be obtained upon request.« less

Cloud-based design of high average power traveling wave linacs

NASA Astrophysics Data System (ADS)

Kutsaev, S. V.; Eidelman, Y.; Bruhwiler, D. L.; Moeller, P.; Nagler, R.; Barbe Welzel, J.

2017-12-01

The design of industrial high average power traveling wave linacs must accurately consider some specific effects. For example, acceleration of high current beam reduces power flow in the accelerating waveguide. Space charge may influence the stability of longitudinal or transverse beam dynamics. Accurate treatment of beam loading is central to the design of high-power TW accelerators, and it is especially difficult to model in the meter-scale region where the electrons are nonrelativistic. Currently, there are two types of available codes: tracking codes (e.g. PARMELA or ASTRA) that cannot solve self-consistent problems, and particle-in-cell codes (e.g. Magic 3D or CST Particle Studio) that can model the physics correctly but are very time-consuming and resource-demanding. Hellweg is a special tool for quick and accurate electron dynamics simulation in traveling wave accelerating structures. The underlying theory of this software is based on the differential equations of motion. The effects considered in this code include beam loading, space charge forces, and external magnetic fields. We present the current capabilities of the code, provide benchmarking results, and discuss future plans. We also describe the browser-based GUI for executing Hellweg in the cloud.

47 CFR 52.19 - Area code relief.

Code of Federal Regulations, 2010 CFR

2010-10-01

... new area codes within their states. Such matters may include, but are not limited to: Directing... realignment; establishing new area code boundaries; establishing necessary dates for the implementation of... code relief planning encompasses all functions related to the implementation of new area codes that...

47 CFR 52.19 - Area code relief.

Code of Federal Regulations, 2011 CFR

2011-10-01

... new area codes within their states. Such matters may include, but are not limited to: Directing... realignment; establishing new area code boundaries; establishing necessary dates for the implementation of... code relief planning encompasses all functions related to the implementation of new area codes that...

A Comparative Study on Diagnostic Accuracy of Colour Coded Digital Images, Direct Digital Images and Conventional Radiographs for Periapical Lesions – An In Vitro Study

PubMed Central

Mubeen; K.R., Vijayalakshmi; Bhuyan, Sanat Kumar; Panigrahi, Rajat G; Priyadarshini, Smita R; Misra, Satyaranjan; Singh, Chandravir

2014-01-01

Objectives: The identification and radiographic interpretation of periapical bone lesions is important for accurate diagnosis and treatment. The present study was undertaken to study the feasibility and diagnostic accuracy of colour coded digital radiographs in terms of presence and size of lesion and to compare the diagnostic accuracy of colour coded digital images with direct digital images and conventional radiographs for assessing periapical lesions. Materials and Methods: Sixty human dry cadaver hemimandibles were obtained and periapical lesions were created in first and second premolar teeth at the junction of cancellous and cortical bone using a micromotor handpiece and carbide burs of sizes 2, 4 and 6. After each successive use of round burs, a conventional, RVG and colour coded image was taken for each specimen. All the images were evaluated by three observers. The diagnostic accuracy for each bur and image mode was calculated statistically. Results: Our results showed good interobserver (kappa > 0.61) agreement for the different radiographic techniques and for the different bur sizes. Conventional Radiography outperformed Digital Radiography in diagnosing periapical lesions made with Size two bur. Both were equally diagnostic for lesions made with larger bur sizes. Colour coding method was least accurate among all the techniques. Conclusion: Conventional radiography traditionally forms the backbone in the diagnosis, treatment planning and follow-up of periapical lesions. Direct digital imaging is an efficient technique, in diagnostic sense. Colour coding of digital radiography was feasible but less accurate however, this imaging technique, like any other, needs to be studied continuously with the emphasis on safety of patients and diagnostic quality of images. PMID:25584318

TRIAD VIII: Nationwide Multicenter Evaluation to Determine Whether Patient Video Testimonials Can Safely Help Ensure Appropriate Critical Versus End-of-Life Care.

PubMed

Mirarchi, Ferdinando L; Cooney, Timothy E; Venkat, Arvind; Wang, David; Pope, Thaddeus M; Fant, Abra L; Terman, Stanley A; Klauer, Kevin M; Williams-Murphy, Monica; Gisondi, Michael A; Clemency, Brian; Doshi, Ankur A; Siegel, Mari; Kraemer, Mary S; Aberger, Kate; Harman, Stephanie; Ahuja, Neera; Carlson, Jestin N; Milliron, Melody L; Hart, Kristopher K; Gilbertson, Chelsey D; Wilson, Jason W; Mueller, Larissa; Brown, Lori; Gordon, Bradley D

2017-06-01

End-of-life interventions should be predicated on consensus understanding of patient wishes. Written documents are not always understood; adding a video testimonial/message (VM) might improve clarity. Goals of this study were to (1) determine baseline rates of consensus in assigning code status and resuscitation decisions in critically ill scenarios and (2) determine whether adding a VM increases consensus. We randomly assigned 2 web-based survey links to 1366 faculty and resident physicians at institutions with graduate medical education programs in emergency medicine, family practice, and internal medicine. Each survey asked for code status interpretation of stand-alone Physician Orders for Life-Sustaining Treatment (POLST) and living will (LW) documents in 9 scenarios. Respondents assigned code status and resuscitation decisions to each scenario. For 1 of 2 surveys, a VM was included to help clarify patient wishes. Response rate was 54%, and most were male emergency physicians who lacked formal advanced planning document interpretation training. Consensus was not achievable for stand-alone POLST or LW documents (68%-78% noted "DNR"). Two of 9 scenarios attained consensus for code status (97%-98% responses) and treatment decisions (96%-99%). Adding a VM significantly changed code status responses by 9% to 62% (P ≤ 0.026) in 7 of 9 scenarios with 4 achieving consensus. Resuscitation responses changed by 7% to 57% (P ≤ 0.005) with 4 of 9 achieving consensus with VMs. For most scenarios, consensus was not attained for code status and resuscitation decisions with stand-alone LW and POLST documents. Adding VMs produced significant impacts toward achieving interpretive consensus.

77 FR 19345 - Proposed Exemptions From Certain Prohibited Transaction Restrictions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-30

...This document contains notices of pendency before the Department of Labor (the Department) of proposed exemptions from certain of the prohibited transaction restrictions of the Employee Retirement Income Security Act of 1974 (ERISA or the Act) and/or the Internal Revenue Code of 1986 (the Code). This notice includes the following proposed exemptions: D-11582, South Plains Financial, Inc. Employee Stock Ownership Plan (the Plan or the Applicant); and D-11668, TIB Financial Corp. Employee Stock Ownership Plan with 401(k) Provisions (the Plan).

MCNP-based computational model for the Leksell gamma knife.

PubMed

Trnka, Jiri; Novotny, Josef; Kluson, Jaroslav

2007-01-01

We have focused on the usage of MCNP code for calculation of Gamma Knife radiation field parameters with a homogenous polystyrene phantom. We have investigated several parameters of the Leksell Gamma Knife radiation field and compared the results with other studies based on EGS4 and PENELOPE code as well as the Leksell Gamma Knife treatment planning system Leksell GammaPlan (LGP). The current model describes all 201 radiation beams together and simulates all the sources in the same time. Within each beam, it considers the technical construction of the source, the source holder, collimator system, the spherical phantom, and surrounding material. We have calculated output factors for various sizes of scoring volumes, relative dose distributions along basic planes including linear dose profiles, integral doses in various volumes, and differential dose volume histograms. All the parameters have been calculated for each collimator size and for the isocentric configuration of the phantom. We have found the calculated output factors to be in agreement with other authors' works except the case of 4 mm collimator size, where averaging over the scoring volume and statistical uncertainties strongly influences the calculated results. In general, all the results are dependent on the choice of the scoring volume. The calculated linear dose profiles and relative dose distributions also match independent studies and the Leksell GammaPlan, but care must be taken about the fluctuations within the plateau, which can influence the normalization, and accuracy in determining the isocenter position, which is important for comparing different dose profiles. The calculated differential dose volume histograms and integral doses have been compared with data provided by the Leksell GammaPlan. The dose volume histograms are in good agreement as well as integral doses calculated in small calculation matrix volumes. However, deviations in integral doses up to 50% can be observed for large volumes such as for the total skull volume. The differences observed in treatment of scattered radiation between the MC method and the LGP may be important in this case. We have also studied the influence of differential direction sampling of primary photons and have found that, due to the anisotropic sampling, doses around the isocenter deviate from each other by up to 6%. With caution about the details of the calculation settings, it is possible to employ the MCNP Monte Carlo code for independent verification of the Leksell Gamma Knife radiation field properties.

75 FR 61931 - Proposed Exemptions From Certain Prohibited Transaction Restrictions

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-06

...This document contains notices of pendency before the Department of Labor (the Department) of proposed exemptions from certain of the prohibited transaction restrictions of the Employee Retirement Income Security Act of 1974 (ERISA or the Act) and/or the Internal Revenue Code of 1986 (the Code). This notice includes the following proposed exemptions: D-11576, Bank of America, NA et al.; D-11591, Citigroup Inc. and its affiliates (Citigroup), the Citigroup 401(k) Plan, the Citibuilder 401(k) Plan for Puerto Rico the (Citibuilder Plan) and collectively with the Citigroup 401(k) Plan, the Participant Directed Plans, the Citigroup Pension Plan (and collectively with the Participant Directed Plans, the Plans) (the Applicants); and D-11611, The West Coast Bancorp 401(k) Plan (the Plan); et al.

SU-E-P-26: Oncospace: A Shared Radiation Oncology Database System Designed for Personalized Medicine, Decision Support, and Research

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

Bowers, M; Robertson, S; Moore, J

Purpose: Advancement in Radiation Oncology (RO) practice develops through evidence based medicine and clinical trial. Knowledge usable for treatment planning, decision support and research is contained in our clinical data, stored in an Oncospace database. This data store and the tools for populating and analyzing it are compatible with standard RO practice and are shared with collaborating institutions. The question is - what protocol for system development and data sharing within an Oncospace Consortium? We focus our example on the technology and data meaning necessary to share across the Consortium. Methods: Oncospace consists of a database schema, planning and outcomemore » data import and web based analysis tools.1) Database: The Consortium implements a federated data store; each member collects and maintains its own data within an Oncospace schema. For privacy, PHI is contained within a single table, accessible to the database owner.2) Import: Spatial dose data from treatment plans (Pinnacle or DICOM) is imported via Oncolink. Treatment outcomes are imported from an OIS (MOSAIQ).3) Analysis: JHU has built a number of webpages to answer analysis questions. Oncospace data can also be analyzed via MATLAB or SAS queries.These materials are available to Consortium members, who contribute enhancements and improvements. Results: 1) The Oncospace Consortium now consists of RO centers at JHU, UVA, UW and the University of Toronto. These members have successfully installed and populated Oncospace databases with over 1000 patients collectively.2) Members contributing code and getting updates via SVN repository. Errors are reported and tracked via Redmine. Teleconferences include strategizing design and code reviews.3) Successfully remotely queried federated databases to combine multiple institutions’ DVH data for dose-toxicity analysis (see below – data combined from JHU and UW Oncospace). Conclusion: RO data sharing can and has been effected according to the Oncospace Consortium model: http://oncospace.radonc.jhmi.edu/ . John Wong - SRA from Elekta; Todd McNutt - SRA from Elekta; Michael Bowers - funded by Elekta.« less

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

Ureba, A.; Salguero, F. J.; Barbeiro, A. R.

Purpose: The authors present a hybrid direct multileaf collimator (MLC) aperture optimization model exclusively based on sequencing of patient imaging data to be implemented on a Monte Carlo treatment planning system (MC-TPS) to allow the explicit radiation transport simulation of advanced radiotherapy treatments with optimal results in efficient times for clinical practice. Methods: The planning system (called CARMEN) is a full MC-TPS, controlled through aMATLAB interface, which is based on the sequencing of a novel map, called “biophysical” map, which is generated from enhanced image data of patients to achieve a set of segments actually deliverable. In order to reducemore » the required computation time, the conventional fluence map has been replaced by the biophysical map which is sequenced to provide direct apertures that will later be weighted by means of an optimization algorithm based on linear programming. A ray-casting algorithm throughout the patient CT assembles information about the found structures, the mass thickness crossed, as well as PET values. Data are recorded to generate a biophysical map for each gantry angle. These maps are the input files for a home-made sequencer developed to take into account the interactions of photons and electrons with the MLC. For each linac (Axesse of Elekta and Primus of Siemens) and energy beam studied (6, 9, 12, 15 MeV and 6 MV), phase space files were simulated with the EGSnrc/BEAMnrc code. The dose calculation in patient was carried out with the BEAMDOSE code. This code is a modified version of EGSnrc/DOSXYZnrc able to calculate the beamlet dose in order to combine them with different weights during the optimization process. Results: Three complex radiotherapy treatments were selected to check the reliability of CARMEN in situations where the MC calculation can offer an added value: A head-and-neck case (Case I) with three targets delineated on PET/CT images and a demanding dose-escalation; a partial breast irradiation case (Case II) solved with photon and electron modulated beams (IMRT + MERT); and a prostatic bed case (Case III) with a pronounced concave-shaped PTV by using volumetric modulated arc therapy. In the three cases, the required target prescription doses and constraints on organs at risk were fulfilled in a short enough time to allow routine clinical implementation. The quality assurance protocol followed to check CARMEN system showed a high agreement with the experimental measurements. Conclusions: A Monte Carlo treatment planning model exclusively based on maps performed from patient imaging data has been presented. The sequencing of these maps allows obtaining deliverable apertures which are weighted for modulation under a linear programming formulation. The model is able to solve complex radiotherapy treatments with high accuracy in an efficient computation time.« less

MCTP system model based on linear programming optimization of apertures obtained from sequencing patient image data maps.

PubMed

Ureba, A; Salguero, F J; Barbeiro, A R; Jimenez-Ortega, E; Baeza, J A; Miras, H; Linares, R; Perucha, M; Leal, A

2014-08-01

The authors present a hybrid direct multileaf collimator (MLC) aperture optimization model exclusively based on sequencing of patient imaging data to be implemented on a Monte Carlo treatment planning system (MC-TPS) to allow the explicit radiation transport simulation of advanced radiotherapy treatments with optimal results in efficient times for clinical practice. The planning system (called CARMEN) is a full MC-TPS, controlled through aMATLAB interface, which is based on the sequencing of a novel map, called "biophysical" map, which is generated from enhanced image data of patients to achieve a set of segments actually deliverable. In order to reduce the required computation time, the conventional fluence map has been replaced by the biophysical map which is sequenced to provide direct apertures that will later be weighted by means of an optimization algorithm based on linear programming. A ray-casting algorithm throughout the patient CT assembles information about the found structures, the mass thickness crossed, as well as PET values. Data are recorded to generate a biophysical map for each gantry angle. These maps are the input files for a home-made sequencer developed to take into account the interactions of photons and electrons with the MLC. For each linac (Axesse of Elekta and Primus of Siemens) and energy beam studied (6, 9, 12, 15 MeV and 6 MV), phase space files were simulated with the EGSnrc/BEAMnrc code. The dose calculation in patient was carried out with the BEAMDOSE code. This code is a modified version of EGSnrc/DOSXYZnrc able to calculate the beamlet dose in order to combine them with different weights during the optimization process. Three complex radiotherapy treatments were selected to check the reliability of CARMEN in situations where the MC calculation can offer an added value: A head-and-neck case (Case I) with three targets delineated on PET/CT images and a demanding dose-escalation; a partial breast irradiation case (Case II) solved with photon and electron modulated beams (IMRT + MERT); and a prostatic bed case (Case III) with a pronounced concave-shaped PTV by using volumetric modulated arc therapy. In the three cases, the required target prescription doses and constraints on organs at risk were fulfilled in a short enough time to allow routine clinical implementation. The quality assurance protocol followed to check CARMEN system showed a high agreement with the experimental measurements. A Monte Carlo treatment planning model exclusively based on maps performed from patient imaging data has been presented. The sequencing of these maps allows obtaining deliverable apertures which are weighted for modulation under a linear programming formulation. The model is able to solve complex radiotherapy treatments with high accuracy in an efficient computation time.

NOTE: MCDE: a new Monte Carlo dose engine for IMRT

NASA Astrophysics Data System (ADS)

Reynaert, N.; DeSmedt, B.; Coghe, M.; Paelinck, L.; Van Duyse, B.; DeGersem, W.; DeWagter, C.; DeNeve, W.; Thierens, H.

2004-07-01

A new accurate Monte Carlo code for IMRT dose computations, MCDE (Monte Carlo dose engine), is introduced. MCDE is based on BEAMnrc/DOSXYZnrc and consequently the accurate EGSnrc electron transport. DOSXYZnrc is reprogrammed as a component module for BEAMnrc. In this way both codes are interconnected elegantly, while maintaining the BEAM structure and only minimal changes to BEAMnrc.mortran are necessary. The treatment head of the Elekta SLiplus linear accelerator is modelled in detail. CT grids consisting of up to 200 slices of 512 × 512 voxels can be introduced and up to 100 beams can be handled simultaneously. The beams and CT data are imported from the treatment planning system GRATIS via a DICOM interface. To enable the handling of up to 50 × 106 voxels the system was programmed in Fortran95 to enable dynamic memory management. All region-dependent arrays (dose, statistics, transport arrays) were redefined. A scoring grid was introduced and superimposed on the geometry grid, to be able to limit the number of scoring voxels. The whole system uses approximately 200 MB of RAM and runs on a PC cluster consisting of 38 1.0 GHz processors. A set of in-house made scripts handle the parallellization and the centralization of the Monte Carlo calculations on a server. As an illustration of MCDE, a clinical example is discussed and compared with collapsed cone convolution calculations. At present, the system is still rather slow and is intended to be a tool for reliable verification of IMRT treatment planning in the case of the presence of tissue inhomogeneities such as air cavities.

Sensitivity of an Elekta iView GT a-Si EPID model to delivery errors for pre-treatment verification of IMRT fields.

PubMed

Herwiningsih, Sri; Hanlon, Peta; Fielding, Andrew

2014-12-01

A Monte Carlo model of an Elekta iViewGT amorphous silicon electronic portal imaging device (a-Si EPID) has been validated for pre-treatment verification of clinical IMRT treatment plans. The simulations involved the use of the BEAMnrc and DOSXYZnrc Monte Carlo codes to predict the response of the iViewGT a-Si EPID model. The predicted EPID images were compared to the measured images obtained from the experiment. The measured EPID images were obtained by delivering a photon beam from an Elekta Synergy linac to the Elekta iViewGT a-Si EPID. The a-Si EPID was used with no additional build-up material. Frame averaged EPID images were acquired and processed using in-house software. The agreement between the predicted and measured images was analyzed using the gamma analysis technique with acceptance criteria of 3 %/3 mm. The results show that the predicted EPID images for four clinical IMRT treatment plans have a good agreement with the measured EPID signal. Three prostate IMRT plans were found to have an average gamma pass rate of more than 95.0 % and a spinal IMRT plan has the average gamma pass rate of 94.3 %. During the period of performing this work a routine MLC calibration was performed and one of the IMRT treatments re-measured with the EPID. A change in the gamma pass rate for one field was observed. This was the motivation for a series of experiments to investigate the sensitivity of the method by introducing delivery errors, MLC position and dosimetric overshoot, into the simulated EPID images. The method was found to be sensitive to 1 mm leaf position errors and 10 % overshoot errors.

A preliminary study of in-house Monte Carlo simulations: an integrated Monte Carlo verification system.

PubMed

Mukumoto, Nobutaka; Tsujii, Katsutomo; Saito, Susumu; Yasunaga, Masayoshi; Takegawa, Hideki; Yamamoto, Tokihiro; Numasaki, Hodaka; Teshima, Teruki

2009-10-01

To develop an infrastructure for the integrated Monte Carlo verification system (MCVS) to verify the accuracy of conventional dose calculations, which often fail to accurately predict dose distributions, mainly due to inhomogeneities in the patient's anatomy, for example, in lung and bone. The MCVS consists of the graphical user interface (GUI) based on a computational environment for radiotherapy research (CERR) with MATLAB language. The MCVS GUI acts as an interface between the MCVS and a commercial treatment planning system to import the treatment plan, create MC input files, and analyze MC output dose files. The MCVS consists of the EGSnrc MC codes, which include EGSnrc/BEAMnrc to simulate the treatment head and EGSnrc/DOSXYZnrc to calculate the dose distributions in the patient/phantom. In order to improve computation time without approximations, an in-house cluster system was constructed. The phase-space data of a 6-MV photon beam from a Varian Clinac unit was developed and used to establish several benchmarks under homogeneous conditions. The MC results agreed with the ionization chamber measurements to within 1%. The MCVS GUI could import and display the radiotherapy treatment plan created by the MC method and various treatment planning systems, such as RTOG and DICOM-RT formats. Dose distributions could be analyzed by using dose profiles and dose volume histograms and compared on the same platform. With the cluster system, calculation time was improved in line with the increase in the number of central processing units (CPUs) at a computation efficiency of more than 98%. Development of the MCVS was successful for performing MC simulations and analyzing dose distributions.

78 FR 41101 - Proposed Exemptions From Certain Prohibited Transaction Restrictions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-09

...This document contains notices of pendency before the Department of Labor (the Department) of proposed exemptions from certain of the prohibited transaction restrictions of the Employee Retirement Income Security Act of 1974 (ERISA or the Act) and/or the Internal Revenue Code of 1986 (the Code). This notice includes the following proposed exemptions: D-11640, Wells Fargo Bank, N.A. (the Applicant or the Bank); D-11772, UBS AG (UBS or the Applicant); and D- 11739, D-11740, & D-11741, Sears Holdings Savings Plan (the Savings Plan), Sears Holdings Puerto Rico Savings Plan (the PR Plan) and The Lands' End, Inc. Retirement Plan (the Lands' End Plan).

RELAP-7 Code Assessment Plan and Requirement Traceability Matrix

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

Yoo, Junsoo; Choi, Yong-joon; Smith, Curtis L.

2016-10-01

The RELAP-7, a safety analysis code for nuclear reactor system, is under development at Idaho National Laboratory (INL). Overall, the code development is directed towards leveraging the advancements in computer science technology, numerical solution methods and physical models over the last decades. Recently, INL has also been putting an effort to establish the code assessment plan, which aims to ensure an improved final product quality through the RELAP-7 development process. The ultimate goal of this plan is to propose a suitable way to systematically assess the wide range of software requirements for RELAP-7, including the software design, user interface, andmore » technical requirements, etc. To this end, we first survey the literature (i.e., international/domestic reports, research articles) addressing the desirable features generally required for advanced nuclear system safety analysis codes. In addition, the V&V (verification and validation) efforts as well as the legacy issues of several recently-developed codes (e.g., RELAP5-3D, TRACE V5.0) are investigated. Lastly, this paper outlines the Requirement Traceability Matrix (RTM) for RELAP-7 which can be used to systematically evaluate and identify the code development process and its present capability.« less

Multistep Lattice-Voxel method utilizing lattice function for Monte-Carlo treatment planning with pixel based voxel model.

PubMed

Kumada, H; Saito, K; Nakamura, T; Sakae, T; Sakurai, H; Matsumura, A; Ono, K

2011-12-01

Treatment planning for boron neutron capture therapy generally utilizes Monte-Carlo methods for calculation of the dose distribution. The new treatment planning system JCDS-FX employs the multi-purpose Monte-Carlo code PHITS to calculate the dose distribution. JCDS-FX allows to build a precise voxel model consisting of pixel based voxel cells in the scale of 0.4×0.4×2.0 mm(3) voxel in order to perform high-accuracy dose estimation, e.g. for the purpose of calculating the dose distribution in a human body. However, the miniaturization of the voxel size increases calculation time considerably. The aim of this study is to investigate sophisticated modeling methods which can perform Monte-Carlo calculations for human geometry efficiently. Thus, we devised a new voxel modeling method "Multistep Lattice-Voxel method," which can configure a voxel model that combines different voxel sizes by utilizing the lattice function over and over. To verify the performance of the calculation with the modeling method, several calculations for human geometry were carried out. The results demonstrated that the Multistep Lattice-Voxel method enabled the precise voxel model to reduce calculation time substantially while keeping the high-accuracy of dose estimation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Review of medical radiography and tomography with proton beams

NASA Astrophysics Data System (ADS)

Johnson, Robert P.

2018-01-01

The use of hadron beams, especially proton beams, in cancer radiotherapy has expanded rapidly in the past two decades. To fully realize the advantages of hadron therapy over traditional x-ray and gamma-ray therapy requires accurate positioning of the Bragg peak throughout the tumor being treated. A half century ago, suggestions had already been made to use protons themselves to develop images of tumors and surrounding tissue, to be used for treatment planning. The recent global expansion of hadron therapy, coupled with modern advances in computation and particle detection, has led several collaborations around the world to develop prototype detector systems and associated reconstruction codes for proton computed tomography (pCT), as well as more simple proton radiography, with the ultimate intent to use such systems in clinical treatment planning and verification. Recent imaging results of phantoms in hospital proton beams are encouraging, but many technical and programmatic challenges remain to be overcome before pCT scanners will be introduced into clinics. This review introduces hadron therapy and the perceived advantages of pCT and proton radiography for treatment planning, reviews its historical development, and discusses the physics related to proton imaging, the associated experimental and computation issues, the technologies used to attack the problem, contemporary efforts in detector and computational development, and the current status and outlook.

77 FR 68834 - Proposed Exemptions From Certain Prohibited Transaction Restrictions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-16

...This document contains notices of pendency before the Department of Labor (the Department) of proposed exemptions from certain of the prohibited transaction restrictions of the Employee Retirement Income Security Act of 1974 (ERISA or the Act) and/or the Internal Revenue Code of 1986 (the Code). This notice includes the following proposed exemptions: D-11610, UBS Financial Services, Inc. D- 11666, Central Pacific Bank 401(k) Retirement and Savings Plan (the Plan); D-11672, Studley, Inc. Section 401(k) Plan Profit Sharing Plan (the Plan); and D-11724, EquiLend Holdings LLC (EquiLend).

Building an effective corporate compliance plan.

PubMed

Ryan, E

1997-09-01

Corporate compliance plans are essential for healthcare organizations to cope with, and perhaps even stave off, investigations arising from allegations of illegal business practices. Initial development and implementation of a corporate compliance plan can be facilitated through four steps: determining the content of the code of conduct, determining how the code will be distributed, assigning responsibility for implementing the plan, and appointing a compliance task force to guide the implementation process. Special attention should be paid to education requirements of the United States Sentencing Guidelines to see that all employees understand and can apply provisions of the plan.

TOPAS Tool for Particle Simulation

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

Perl, Joseph

2013-05-30

TOPAS lets users simulate the passage of subatomic particles moving through any kind of radiation therapy treatment system, can import a patient geometry, can record dose and other quantities, has advanced graphics, and is fully four-dimensional (3D plus time) to handle the most challenging time-dependent aspects of modern cancer treatments.TOPAS unlocks the power of the most accurate particle transport simulation technique, the Monte Carlo (MC) method, while removing the painstaking coding work such methods used to require. Research physicists can use TOPAS to improve delivery systems towards safer and more effective radiation therapy treatments, easily setting up and running complexmore » simulations that previously used to take months of preparation. Clinical physicists can use TOPAS to increase accuracy while reducing side effects, simulating patient-specific treatment plans at the touch of a button. TOPAS is designed as a “user code” layered on top of the Geant4 Simulation Toolkit. TOPAS includes the standard Geant4 toolkit, plus additional code to make Geant4 easier to control and to extend Geant4 functionality. TOPAS aims to make proton simulation both “reliable” and “repeatable.” “Reliable” means both accurate physics and a high likelihood to simulate precisely what the user intended to simulate, reducing issues of wrong units, wrong materials, wrong scoring locations, etc. “Repeatable” means not just getting the same result from one simulation to another, but being able to easily restore a previously used setup and reducing sources of error when a setup is passed from one user to another. TOPAS control system incorporates key lessons from safety management, proactively removing possible sources of user error such as line-ordering mistakes In control files. TOPAS has been used to model proton therapy treatment examples including the UCSF eye treatment head, the MGH stereotactic alignment in radiosurgery treatment head and the MGH gantry treatment heads in passive scattering and scanning modes, and has demonstrated dose calculation based on patient-specific CT data.« less

The FLUKA Monte Carlo code coupled with the NIRS approach for clinical dose calculations in carbon ion therapy

NASA Astrophysics Data System (ADS)

Magro, G.; Dahle, T. J.; Molinelli, S.; Ciocca, M.; Fossati, P.; Ferrari, A.; Inaniwa, T.; Matsufuji, N.; Ytre-Hauge, K. S.; Mairani, A.

2017-05-01

Particle therapy facilities often require Monte Carlo (MC) simulations to overcome intrinsic limitations of analytical treatment planning systems (TPS) related to the description of the mixed radiation field and beam interaction with tissue inhomogeneities. Some of these uncertainties may affect the computation of effective dose distributions; therefore, particle therapy dedicated MC codes should provide both absorbed and biological doses. Two biophysical models are currently applied clinically in particle therapy: the local effect model (LEM) and the microdosimetric kinetic model (MKM). In this paper, we describe the coupling of the NIRS (National Institute for Radiological Sciences, Japan) clinical dose to the FLUKA MC code. We moved from the implementation of the model itself to its application in clinical cases, according to the NIRS approach, where a scaling factor is introduced to rescale the (carbon-equivalent) biological dose to a clinical dose level. A high level of agreement was found with published data by exploring a range of values for the MKM input parameters, while some differences were registered in forward recalculations of NIRS patient plans, mainly attributable to differences with the analytical TPS dose engine (taken as reference) in describing the mixed radiation field (lateral spread and fragmentation). We presented a tool which is being used at the Italian National Center for Oncological Hadrontherapy to support the comparison study between the NIRS clinical dose level and the LEM dose specification.

Developing a Treatment Planning Software Based on TG-43U1 Formalism for Cs-137 LDR Brachytherapy.

PubMed

Sina, Sedigheh; Faghihi, Reza; Soleimani Meigooni, Ali; Siavashpour, Zahra; Mosleh-Shirazi, Mohammad Amin

2013-08-01

The old Treatment Planning Systems (TPSs) used for intracavitary brachytherapy with Cs-137 Selectron source utilize traditional dose calculation methods, considering each source as a point source. Using such methods introduces significant errors in dose estimation. As of 1995, TG-43 is used as the main dose calculation formalism in treatment TPSs. The purpose of this study is to design and establish a treatment planning software for Cs-137 Solectron brachytherapy source, based on TG-43U1 formalism by applying the effects of the applicator and dummy spacers. Two softwares used for treatment planning of Cs-137 sources in Iran (STPS and PLATO), are based on old formalisms. The purpose of this work is to establish and develop a TPS for Selectron source based on TG-43 formalism. In this planning system, the dosimetry parameters of each pellet in different places inside applicators were obtained by MCNP4c code. Then the dose distribution around every combination of active and inactive pellets was obtained by summing the doses. The accuracy of this algorithm was checked by comparing its results for special combination of active and inactive pellets with MC simulations. Finally, the uncertainty of old dose calculation formalism was investigated by comparing the results of STPS and PLATO softwares with those obtained by the new algorithm. For a typical arrangement of 10 active pellets in the applicator, the percentage difference between doses obtained by the new algorithm at 1cm distance from the tip of the applicator and those obtained by old formalisms is about 30%, while the difference between the results of MCNP and the new algorithm is less than 5%. According to the results, the old dosimetry formalisms, overestimate the dose especially towards the applicator's tip. While the TG-43U1 based software perform the calculations more accurately.

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

Gorissen, BL; Giantsoudi, D; Unkelbach, J

Purpose: Cell survival experiments suggest that the relative biological effectiveness (RBE) of proton beams depends on linear energy transfer (LET), leading to higher RBE near the end of range. With intensity-modulated proton therapy (IMPT), multiple treatment plans that differ in the dose contribution per field may yield a similar physical dose distribution, but the RBE-weighted dose distribution may be disparate. RBE models currently do not have the required predictive power to be included in an optimization model due to the variations in experimental data. We propose an LET-based planning method that guides IMPT optimization models towards plans with reduced RBE-weightedmore » dose in surrounding organs at risk (OARs) compared to inverse planning based on physical dose alone. Methods: Optimization models for physical dose are extended with a term for dose times LET (doseLET). Monte Carlo code is used to generate the physical dose and doseLET distribution of each individual pencil beam. The method is demonstrated for an atypical meningioma patient where the target volume abuts the brainstem and partially overlaps with the optic nerve. Results: A reference plan optimized based on physical dose alone yields high doseLET values in parts of the brainstem and optic nerve. Minimizing doseLET in these critical structures as an additional planning goal reduces the risk of high RBE-weighted dose. The resulting treatment plan avoids the distal fall-off of the Bragg peaks for shaping the dose distribution in front of critical stuctures. The maximum dose in the OARs evaluated with RBE models from literature is reduced by 8–14\\% with our method compared to conventional planning. Conclusion: LET-based inverse planning for IMPT offers the ability to reduce the RBE-weighted dose in OARs without sacrificing target dose. This project was in part supported by NCI - U19 CA 21239.« less

Radioactive waste isolation in salt: special advisory report on the status of the Office of Nuclear Waste Isolation's plans for repository performance assessment

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

Ditmars, J.D.; Walbridge, E.W.; Rote, D.M.

1983-10-01

Repository performance assessment is analysis that identifies events and processes that might affect a repository system for isolation of radioactive waste, examines their effects on barriers to waste migration, and estimates the probabilities of their occurrence and their consequences. In 1983 Battelle Memorial Institute's Office of Nuclear Waste Isolation (ONWI) prepared two plans - one for performance assessment for a waste repository in salt and one for verification and validation of performance assessment technology. At the request of the US Department of Energy's Salt Repository Project Office (SRPO), Argonne National Laboratory reviewed those plans and prepared this report to advisemore » SRPO of specific areas where ONWI's plans for performance assessment might be improved. This report presents a framework for repository performance assessment that clearly identifies the relationships among the disposal problems, the processes underlying the problems, the tools for assessment (computer codes), and the data. In particular, the relationships among important processes and 26 model codes available to ONWI are indicated. A common suggestion for computer code verification and validation is the need for specific and unambiguous documentation of the results of performance assessment activities. A major portion of this report consists of status summaries of 27 model codes indicated as potentially useful by ONWI. The code summaries focus on three main areas: (1) the code's purpose, capabilities, and limitations; (2) status of the elements of documentation and review essential for code verification and validation; and (3) proposed application of the code for performance assessment of salt repository systems. 15 references, 6 figures, 4 tables.« less

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

Bazalova, Magdalena, E-mail: bazalova@stanford.edu; Nelson, Geoff; Noll, John M.

Purpose: Small animal radiation therapy has advanced significantly in recent years. Whereas in the past dose was delivered using a single beam and a lead shield for sparing of healthy tissue, conformal doses can be now delivered using more complex dedicated small animal radiotherapy systems with image guidance. The goal of this paper is to investigate dose distributions for three small animal radiation treatment modalities. Methods: This paper presents a comparison of dose distributions generated by the three approaches—a single-field irradiator with a 200 kV beam and no image guidance, a small animal image-guided conformal system based on a modified microCTmore » scanner with a 120 kV beam developed at Stanford University, and a dedicated conformal system, SARRP, using a 220 kV beam developed at Johns Hopkins University. The authors present a comparison of treatment plans for the three modalities using two cases: a mouse with a subcutaneous tumor and a mouse with a spontaneous lung tumor. A 5 Gy target dose was calculated using the EGSnrc Monte Carlo codes. Results: All treatment modalities generated similar dose distributions for the subcutaneous tumor case, with the highest mean dose to the ipsilateral lung and bones in the single-field plan (0.4 and 0.4 Gy) compared to the microCT (0.1 and 0.2 Gy) and SARRP (0.1 and 0.3 Gy) plans. The lung case demonstrated that due to the nine-beam arrangements in the conformal plans, the mean doses to the ipsilateral lung, spinal cord, and bones were significantly lower in the microCT plan (2.0, 0.4, and 1.9 Gy) and the SARRP plan (1.5, 0.5, and 1.8 Gy) than in single-field irradiator plan (4.5, 3.8, and 3.3 Gy). Similarly, the mean doses to the contralateral lung and the heart were lowest in the microCT plan (1.5 and 2.0 Gy), followed by the SARRP plan (1.7 and 2.2 Gy), and they were highest in the single-field plan (2.5 and 2.4 Gy). For both cases, dose uniformity was greatest in the single-field irradiator plan followed by the SARRP plan due to the sensitivity of the lower energy microCT beam to target heterogeneities and image noise. Conclusions: The two treatment planning examples demonstrate that modern small animal radiotherapy techniques employing image guidance, variable collimation, and multiple beam angles deliver superior dose distributions to small animal tumors as compared to conventional treatments using a single-field irradiator. For deep-seated mouse tumors, however, higher-energy conformal radiotherapy could result in higher doses to critical organs compared to lower-energy conformal radiotherapy. Treatment planning optimization for small animal radiotherapy should therefore be developed to take full advantage of the novel conformal systems.« less

Modality comparison for small animal radiotherapy: A simulation study

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

Bazalova, Magdalena, E-mail: bazalova@stanford.edu; Nelson, Geoff; Noll, John M.

Purpose: Small animal radiation therapy has advanced significantly in recent years. Whereas in the past dose was delivered using a single beam and a lead shield for sparing of healthy tissue, conformal doses can be now delivered using more complex dedicated small animal radiotherapy systems with image guidance. The goal of this paper is to investigate dose distributions for three small animal radiation treatment modalities. Methods: This paper presents a comparison of dose distributions generated by the three approaches—a single-field irradiator with a 200 kV beam and no image guidance, a small animal image-guided conformal system based on a modified microCTmore » scanner with a 120 kV beam developed at Stanford University, and a dedicated conformal system, SARRP, using a 220 kV beam developed at Johns Hopkins University. The authors present a comparison of treatment plans for the three modalities using two cases: a mouse with a subcutaneous tumor and a mouse with a spontaneous lung tumor. A 5 Gy target dose was calculated using the EGSnrc Monte Carlo codes. Results: All treatment modalities generated similar dose distributions for the subcutaneous tumor case, with the highest mean dose to the ipsilateral lung and bones in the single-field plan (0.4 and 0.4 Gy) compared to the microCT (0.1 and 0.2 Gy) and SARRP (0.1 and 0.3 Gy) plans. The lung case demonstrated that due to the nine-beam arrangements in the conformal plans, the mean doses to the ipsilateral lung, spinal cord, and bones were significantly lower in the microCT plan (2.0, 0.4, and 1.9 Gy) and the SARRP plan (1.5, 0.5, and 1.8 Gy) than in single-field irradiator plan (4.5, 3.8, and 3.3 Gy). Similarly, the mean doses to the contralateral lung and the heart were lowest in the microCT plan (1.5 and 2.0 Gy), followed by the SARRP plan (1.7 and 2.2 Gy), and they were highest in the single-field plan (2.5 and 2.4 Gy). For both cases, dose uniformity was greatest in the single-field irradiator plan followed by the SARRP plan due to the sensitivity of the lower energy microCT beam to target heterogeneities and image noise. Conclusions: The two treatment planning examples demonstrate that modern small animal radiotherapy techniques employing image guidance, variable collimation, and multiple beam angles deliver superior dose distributions to small animal tumors as compared to conventional treatments using a single-field irradiator. For deep-seated mouse tumors, however, higher-energy conformal radiotherapy could result in higher doses to critical organs compared to lower-energy conformal radiotherapy. Treatment planning optimization for small animal radiotherapy should therefore be developed to take full advantage of the novel conformal systems.« less

Practices in Code Discoverability: Astrophysics Source Code Library

NASA Astrophysics Data System (ADS)

Allen, A.; Teuben, P.; Nemiroff, R. J.; Shamir, L.

2012-09-01

Here we describe the Astrophysics Source Code Library (ASCL), which takes an active approach to sharing astrophysics source code. ASCL's editor seeks out both new and old peer-reviewed papers that describe methods or experiments that involve the development or use of source code, and adds entries for the found codes to the library. This approach ensures that source codes are added without requiring authors to actively submit them, resulting in a comprehensive listing that covers a significant number of the astrophysics source codes used in peer-reviewed studies. The ASCL now has over 340 codes in it and continues to grow. In 2011, the ASCL has on average added 19 codes per month. An advisory committee has been established to provide input and guide the development and expansion of the new site, and a marketing plan has been developed and is being executed. All ASCL source codes have been used to generate results published in or submitted to a refereed journal and are freely available either via a download site or from an identified source. This paper provides the history and description of the ASCL. It lists the requirements for including codes, examines the advantages of the ASCL, and outlines some of its future plans.

78 FR 58985 - Proposed Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-25

... DELAWARE RIVER BASIN COMMISSION 18 CFR Part 410 Proposed Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update Water Quality Criteria for pH AGENCY: Delaware River... public hearing to receive comments on proposed amendments to the Commission's Water Quality Regulations...

Building a Better Campus: An Update on Building Codes.

ERIC Educational Resources Information Center

Madden, Michael J.

2002-01-01

Discusses the implications for higher education institutions in terms of facility planning, design, construction, and renovation of the move from regionally-developed model-building codes to two international sets of codes. Also addresses the new performance-based design option within the codes. (EV)

Treatment outcomes and patient-reported quality of life after orthognathic surgery with computer-assisted 2- or 3-dimensional planning: A randomized double-blind active-controlled clinical trial.

PubMed

Bengtsson, Martin; Wall, Gert; Larsson, Pernilla; Becktor, Jonas P; Rasmusson, Lars

2018-06-01

Thorough treatment planning is essential for a good clinical outcome in orthognathic treatment. The planning is often digital. Both 2-dimensional (2D) and 3-dimensional (3D) software options are available. The aim of this randomized 2-arm parallel double-blinded active-controlled clinical trial was to compare the outcomes of computer-based 2D and 3D planning techniques according to patient-reported health related quality of life. The hypothesis was that a 3D technique would give a better treatment outcome compared with a 2D technique. Orthognathic treatment for 62 subjects, aged 18 to 28 years, with severe Class III malocclusion was planned with both 2D and 3D techniques. After treatment planning but before surgery, the patients were randomly allocated via blind collection of 1 enveloped card for each subject in a 1:1 ratio to the test (3D) or the control (2D) group. Thus, the intervention was according to which planning technique was used. The primary outcome was patient-reported outcome measures. The secondary outcome was relationship between patient-reported outcome measures and cephalometric accuracy. Questionnaires on the patient's health-related quality of life (HRQoL) were distributed preoperatively and 12 months after surgical treatment. The questionnaires were coded, meaning blinding throughout the analysis. Differences between groups were tested with the Fisher permutation test. The HRQoL was also compared with measurements of cephalometric accuracy for the 2 groups. Three subjects were lost to clinical follow-up, leaving 57 included. Of these, 55 subjects completed the questionnaires, 28 in the 2D and 27 in the 3D groups. No statistically significant difference regarding HRQoL was found between the studied planning techniques: the Oral Health Impact Profile total showed -3.69 (95% confidence interval, -19.68 to 12.30). Consistent results on HRQoL and cephalometric accuracy showed a difference between pretreatment and posttreatment that increased in both groups but to a higher level in the 3D group. A difference between pretreatment and posttreatment HRQoL was shown for both groups, indicating increased quality of life after treatment. This supports recent findings comparing 3D and 2D planning techniques. No serious harm was observed during the study. Improvements of HRQoL were shown after treatment independent of which planning technique, 2D or 3D, was used. No statistically significant difference was found between the planning techniques. This trial was not registered. The protocol was not published before trial commencement. This project was supported by personal grants to Martin Bengtsson from the Scandinavian Association of Oral and Maxillofacial Surgeons (25000 SEK), the Southern Region of the Swedish Dental Association (50000 SEK), and the Swedish Association of Oral and Maxillofacial Surgeons (25000 SEK). The sponsors had no influence on the study design, analysis of the data, or the writing of the article. Copyright © 2018 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Applications of the microdosimetric function implemented in the macroscopic particle transport simulation code PHITS.

PubMed

Sato, Tatsuhiko; Watanabe, Ritsuko; Sihver, Lembit; Niita, Koji

2012-01-01

Microdosimetric quantities such as lineal energy are generally considered to be better indices than linear energy transfer (LET) for expressing the relative biological effectiveness (RBE) of high charge and energy particles. To calculate their probability densities (PD) in macroscopic matter, it is necessary to integrate microdosimetric tools such as track-structure simulation codes with macroscopic particle transport simulation codes. As an integration approach, the mathematical model for calculating the PD of microdosimetric quantities developed based on track-structure simulations was incorporated into the macroscopic particle transport simulation code PHITS (Particle and Heavy Ion Transport code System). The improved PHITS enables the PD in macroscopic matter to be calculated within a reasonable computation time, while taking their stochastic nature into account. The microdosimetric function of PHITS was applied to biological dose estimation for charged-particle therapy and risk estimation for astronauts. The former application was performed in combination with the microdosimetric kinetic model, while the latter employed the radiation quality factor expressed as a function of lineal energy. Owing to the unique features of the microdosimetric function, the improved PHITS has the potential to establish more sophisticated systems for radiological protection in space as well as for the treatment planning of charged-particle therapy.

River Protection Project (RPP) Dangerous Waste Training Plan

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

POHTO, R.E.

2000-03-09

This supporting document contains the training plan for dangerous waste management at River Protection Project TSD Units. This document outlines the dangerous waste training program developed and implemented for all Treatment, Storage, and Disposal (TSD) Units operated by River Protection Project (RPP) in the Hanford 200 East, 200 West and 600 Areas and the <90 Day Accumulation Area at 209E. Operating TSD Units managed by RPP are: the Double-Shell Tank (DST) System, 204-AR Waste Unloading Facility, Grout, and the Single-Shell Tank (SST) System. The program is designed in compliance with the requirements of Washington Administrative Code (WAC) 173-303-330 and Titlemore » 40 Code of Federal Regulations (CFR) 265.16 for the development of a written dangerous waste training program and the Hanford Facility Permit. Training requirements were determined by an assessment of employee duties and responsibilities. The RPP training program is designed to prepare employees to operate and maintain the Tank Farms in a safe, effective, efficient, and environmentally sound manner. In addition to preparing employees to operate and maintain the Tank Farms under normal conditions, the training program ensures that employees are prepared to respond in a prompt and effective manner should abnormal or emergency conditions occur. Emergency response training is consistent with emergency responses outlined in the following Building Emergency Plans: HNF-IP-0263-TF and HNF-=IP-0263-209E.« less

Combined experimental and Monte Carlo verification of brachytherapy plans for vaginal applicators

NASA Astrophysics Data System (ADS)

Sloboda, Ron S.; Wang, Ruqing

1998-12-01

Dose rates in a phantom around a shielded and an unshielded vaginal applicator containing Selectron low-dose-rate sources were determined by experiment and Monte Carlo simulation. Measurements were performed with thermoluminescent dosimeters in a white polystyrene phantom using an experimental protocol geared for precision. Calculations for the same set-up were done using a version of the EGS4 Monte Carlo code system modified for brachytherapy applications into which a new combinatorial geometry package developed by Bielajew was recently incorporated. Measured dose rates agree with Monte Carlo estimates to within 5% (1 SD) for the unshielded applicator, while highlighting some experimental uncertainties for the shielded applicator. Monte Carlo calculations were also done to determine a value for the effective transmission of the shield required for clinical treatment planning, and to estimate the dose rate in water at points in axial and sagittal planes transecting the shielded applicator. Comparison with dose rates generated by the planning system indicates that agreement is better than 5% (1 SD) at most positions. The precision thermoluminescent dosimetry protocol and modified Monte Carlo code are effective complementary tools for brachytherapy applicator dosimetry.

A GPU-accelerated Monte Carlo dose calculation platform and its application toward validating an MRI-guided radiation therapy beam model

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

Wang, Yuhe; Mazur, Thomas R.; Green, Olga

Purpose: The clinical commissioning of IMRT subject to a magnetic field is challenging. The purpose of this work is to develop a GPU-accelerated Monte Carlo dose calculation platform based on PENELOPE and then use the platform to validate a vendor-provided MRIdian head model toward quality assurance of clinical IMRT treatment plans subject to a 0.35 T magnetic field. Methods: PENELOPE was first translated from FORTRAN to C++ and the result was confirmed to produce equivalent results to the original code. The C++ code was then adapted to CUDA in a workflow optimized for GPU architecture. The original code was expandedmore » to include voxelized transport with Woodcock tracking, faster electron/positron propagation in a magnetic field, and several features that make gPENELOPE highly user-friendly. Moreover, the vendor-provided MRIdian head model was incorporated into the code in an effort to apply gPENELOPE as both an accurate and rapid dose validation system. A set of experimental measurements were performed on the MRIdian system to examine the accuracy of both the head model and gPENELOPE. Ultimately, gPENELOPE was applied toward independent validation of patient doses calculated by MRIdian’s KMC. Results: An acceleration factor of 152 was achieved in comparison to the original single-thread FORTRAN implementation with the original accuracy being preserved. For 16 treatment plans including stomach (4), lung (2), liver (3), adrenal gland (2), pancreas (2), spleen(1), mediastinum (1), and breast (1), the MRIdian dose calculation engine agrees with gPENELOPE with a mean gamma passing rate of 99.1% ± 0.6% (2%/2 mm). Conclusions: A Monte Carlo simulation platform was developed based on a GPU- accelerated version of PENELOPE. This platform was used to validate that both the vendor-provided head model and fast Monte Carlo engine used by the MRIdian system are accurate in modeling radiation transport in a patient using 2%/2 mm gamma criteria. Future applications of this platform will include dose validation and accumulation, IMRT optimization, and dosimetry system modeling for next generation MR-IGRT systems.« less

A GPU-accelerated Monte Carlo dose calculation platform and its application toward validating an MRI-guided radiation therapy beam model

PubMed Central

Wang, Yuhe; Mazur, Thomas R.; Green, Olga; Hu, Yanle; Li, Hua; Rodriguez, Vivian; Wooten, H. Omar; Yang, Deshan; Zhao, Tianyu; Mutic, Sasa; Li, H. Harold

2016-01-01

Purpose: The clinical commissioning of IMRT subject to a magnetic field is challenging. The purpose of this work is to develop a GPU-accelerated Monte Carlo dose calculation platform based on penelope and then use the platform to validate a vendor-provided MRIdian head model toward quality assurance of clinical IMRT treatment plans subject to a 0.35 T magnetic field. Methods: penelope was first translated from fortran to c++ and the result was confirmed to produce equivalent results to the original code. The c++ code was then adapted to cuda in a workflow optimized for GPU architecture. The original code was expanded to include voxelized transport with Woodcock tracking, faster electron/positron propagation in a magnetic field, and several features that make gpenelope highly user-friendly. Moreover, the vendor-provided MRIdian head model was incorporated into the code in an effort to apply gpenelope as both an accurate and rapid dose validation system. A set of experimental measurements were performed on the MRIdian system to examine the accuracy of both the head model and gpenelope. Ultimately, gpenelope was applied toward independent validation of patient doses calculated by MRIdian’s kmc. Results: An acceleration factor of 152 was achieved in comparison to the original single-thread fortran implementation with the original accuracy being preserved. For 16 treatment plans including stomach (4), lung (2), liver (3), adrenal gland (2), pancreas (2), spleen(1), mediastinum (1), and breast (1), the MRIdian dose calculation engine agrees with gpenelope with a mean gamma passing rate of 99.1% ± 0.6% (2%/2 mm). Conclusions: A Monte Carlo simulation platform was developed based on a GPU- accelerated version of penelope. This platform was used to validate that both the vendor-provided head model and fast Monte Carlo engine used by the MRIdian system are accurate in modeling radiation transport in a patient using 2%/2 mm gamma criteria. Future applications of this platform will include dose validation and accumulation, IMRT optimization, and dosimetry system modeling for next generation MR-IGRT systems. PMID:27370123

A GPU-accelerated Monte Carlo dose calculation platform and its application toward validating an MRI-guided radiation therapy beam model.

PubMed

Wang, Yuhe; Mazur, Thomas R; Green, Olga; Hu, Yanle; Li, Hua; Rodriguez, Vivian; Wooten, H Omar; Yang, Deshan; Zhao, Tianyu; Mutic, Sasa; Li, H Harold

2016-07-01

The clinical commissioning of IMRT subject to a magnetic field is challenging. The purpose of this work is to develop a GPU-accelerated Monte Carlo dose calculation platform based on penelope and then use the platform to validate a vendor-provided MRIdian head model toward quality assurance of clinical IMRT treatment plans subject to a 0.35 T magnetic field. penelope was first translated from fortran to c++ and the result was confirmed to produce equivalent results to the original code. The c++ code was then adapted to cuda in a workflow optimized for GPU architecture. The original code was expanded to include voxelized transport with Woodcock tracking, faster electron/positron propagation in a magnetic field, and several features that make gpenelope highly user-friendly. Moreover, the vendor-provided MRIdian head model was incorporated into the code in an effort to apply gpenelope as both an accurate and rapid dose validation system. A set of experimental measurements were performed on the MRIdian system to examine the accuracy of both the head model and gpenelope. Ultimately, gpenelope was applied toward independent validation of patient doses calculated by MRIdian's kmc. An acceleration factor of 152 was achieved in comparison to the original single-thread fortran implementation with the original accuracy being preserved. For 16 treatment plans including stomach (4), lung (2), liver (3), adrenal gland (2), pancreas (2), spleen(1), mediastinum (1), and breast (1), the MRIdian dose calculation engine agrees with gpenelope with a mean gamma passing rate of 99.1% ± 0.6% (2%/2 mm). A Monte Carlo simulation platform was developed based on a GPU- accelerated version of penelope. This platform was used to validate that both the vendor-provided head model and fast Monte Carlo engine used by the MRIdian system are accurate in modeling radiation transport in a patient using 2%/2 mm gamma criteria. Future applications of this platform will include dose validation and accumulation, IMRT optimization, and dosimetry system modeling for next generation MR-IGRT systems.

SU-F-P-35: A Multi-Institutional Plan Quality Checking Tool Built On Oncospace: A Shared Radiation Oncology Database System

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

Bowers, M; Robertson, S; Moore, J

Purpose: Late toxicity from radiation to critical structures limits the possible dose in Radiation Therapy. Perfectly conformal treatment of a target is not realizable, so the clinician must accept a certain level of collateral radiation to nearby OARs. But how much? General guidelines exist for healthy tissue sparing which guide RT treatment planning, but are these guidelines good enough to create the optimal plan given the individualized patient anatomy? We propose a means to evaluate the planned dose level to an OAR using a multi-institutional data-store of previously treated patients, so a clinician might reconsider planning objectives. Methods: The toolmore » is built on Oncospace, a federated data-store system, which consists of planning data import, web based analysis tools, and a database containing:1) DVHs: dose by percent volume delivered to each ROI for each patient previously treated and included in the database.2) Overlap Volume Histograms (OVHs): Anatomical measure defined as the percent volume of an ROI within a given distance to target structures.Clinicians know what OARs are important to spare. For any ROI, Oncospace knows for which patients’ anatomy that ROI was harder to plan in the past (the OVH is less). The planned dose should be close to the least dose of previous patients. The tool displays the dose those OARs were subjected to, and the clinician can make a determination about the planning objectives used.Multiple institutions contribute to the Oncospace Consortium, and their DVH and OVH data are combined and color coded in the output. Results: The Oncospace website provides a plan quality display tool which identifies harder to treat patients, and graphically displays the dose delivered to them for comparison with the proposed plan. Conclusion: The Oncospace Consortium manages a data-store of previously treated patients which can be used for quality checking new plans. Grant funding by Elekta.« less

It's a Matter of Trust: Older African Americans Speak About Their Health Care Encounters.

PubMed

Hansen, Bryan R; Hodgson, Nancy A; Gitlin, Laura N

2016-10-01

To examine perceptions of older African Americans' encounters with health care providers and ways to enhance trust. Transcribed semi-structured interviews with African American senior center members were analyzed, using Pattern Coding method. Four themes emerged: "Added Insult of Ageism," "Alternative Remedies," "Good Providers in a 'Broken' System," and "The Foundation of Trust Is Person Recognition." Provider behaviors leading to mistrust included erroneously assuming stereotypical preferences and competence, spending inadequate time listening to patients, disregarding patient preferences, and insufficiently explaining treatments. Of importance to improving trust among older African American patients is valuing individual histories and preferences by reallocating scarce time to person-centered listening, individualizing treatments, more completely explaining interventions, and assuring that patients understand and agree with treatment plans. © The Author(s) 2015.

Translating MAPGEN to ASPEN for MER

NASA Technical Reports Server (NTRS)

Rabideau, Gregg R.; Knight, Russell L.; Lenda, Matthew; Maldague, Pierre F.

2013-01-01

This software translates MAPGEN (Europa and APGEN) domains to ASPEN, and the resulting domain can be used to perform planning for the Mars Exploration Rover (MER). In other words, this is a conversion of two distinct planning languages (both declarative and procedural) to a third (declarative) planning language in order to solve the problem of faithful translation from mixed-domain representations into the ASPEN Modeling Language. The MAPGEN planning system is an example of a hybrid procedural/declarative system where the advantages of each are leveraged to produce an effective planner/scheduler for MER tactical planning. The adaptation of the planning system (ASPEN) was investigated, and, with some translation, much of the procedural knowledge encoding is amenable to declarative knowledge encoding. The approach was to compose translators from the core languages used for adapting MAGPEN, which consists of Europa and APGEN. Europa is a constraint- based planner/scheduler where domains are encoded using a declarative model. APGEN is also constraint-based, in that it tracks constraints on resources and states and other variables. Domains are encoded in both constraints and code snippets that execute according to a forward sweep through the plan. Europa and APGEN communicate to each other using proxy activities in APGEN that represent constraints and/or tokens in Europa. The composition of a translator from Europa to ASPEN was fairly straightforward, as ASPEN is also a declarative planning system, and the specific uses of Europa for the MER domain matched ASPEN s native encoding fairly closely. On the other hand, translating from APGEN to ASPEN was considerably more involved. On the surface, the types of activities and resources one encodes in APGEN appear to match oneto- one to the activities, state variables, and resources in ASPEN. But, when looking into the definitions of how resources are profiled and activities are expanded, one sees code snippets that access various information available during planning for the moment in time being planned to decide at the time what the appropriate profile or expansion is. APGEN is actually a forward (in time) sweeping discrete event simulator, where the model is composed of code snippets that are artfully interleaved by the engine to produce a plan/schedule. To solve this problem, representative code is simulated as a declarative series of task expansions. Predominantly, three types of procedural models were translated: loops, if statements, and code blocks. Loops and if statements were handled using controlled task expansion, and code blocks were handled using constraint networks that maintained the generation of results based on what the order of execution would be for a procedural representation. One advantage with respect to performance for MAPGEN is the use of APGEN s GUI. This GUI is written in C++ and Motif, and performs very well for large plans.

Level-2 Milestone 5588: Deliver Strategic Plan and Initial Scalability Assessment by Advanced Architecture and Portability Specialists Team

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

Draeger, Erik W.

This report documents the fact that the work in creating a strategic plan and beginning customer engagements has been completed. The description of milestone is: The newly formed advanced architecture and portability specialists (AAPS) team will develop a strategic plan to meet the goals of 1) sharing knowledge and experience with code teams to ensure that ASC codes run well on new architectures, and 2) supplying skilled computational scientists to put the strategy into practice. The plan will be delivered to ASC management in the first quarter. By the fourth quarter, the team will identify their first customers within PEMmore » and IC, perform an initial assessment and scalability and performance bottleneck for next-generation architectures, and embed AAPS team members with customer code teams to assist with initial portability development within standalone kernels or proxy applications.« less

77 FR 54663 - Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-05

...This final rule adopts the standard for a national unique health plan identifier (HPID) and establishes requirements for the implementation of the HPID. In addition, it adopts a data element that will serve as an other entity identifier (OEID), or an identifier for entities that are not health plans, health care providers, or individuals, but that need to be identified in standard transactions. This final rule also specifies the circumstances under which an organization covered health care provider must require certain noncovered individual health care providers who are prescribers to obtain and disclose a National Provider Identifier (NPI). Lastly, this final rule changes the compliance date for the International Classification of Diseases, 10th Revision, Clinical Modification (ICD- 10-CM) for diagnosis coding, including the Official ICD-10-CM Guidelines for Coding and Reporting, and the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) for inpatient hospital procedure coding, including the Official ICD-10-PCS Guidelines for Coding and Reporting, from October 1, 2013 to October 1, 2014.

Modification and validation of an analytical source model for external beam radiotherapy Monte Carlo dose calculations.

PubMed

Davidson, Scott E; Cui, Jing; Kry, Stephen; Deasy, Joseph O; Ibbott, Geoffrey S; Vicic, Milos; White, R Allen; Followill, David S

2016-08-01

A dose calculation tool, which combines the accuracy of the dose planning method (DPM) Monte Carlo code and the versatility of a practical analytical multisource model, which was previously reported has been improved and validated for the Varian 6 and 10 MV linear accelerators (linacs). The calculation tool can be used to calculate doses in advanced clinical application studies. One shortcoming of current clinical trials that report dose from patient plans is the lack of a standardized dose calculation methodology. Because commercial treatment planning systems (TPSs) have their own dose calculation algorithms and the clinical trial participant who uses these systems is responsible for commissioning the beam model, variation exists in the reported calculated dose distributions. Today's modern linac is manufactured to tight specifications so that variability within a linac model is quite low. The expectation is that a single dose calculation tool for a specific linac model can be used to accurately recalculate dose from patient plans that have been submitted to the clinical trial community from any institution. The calculation tool would provide for a more meaningful outcome analysis. The analytical source model was described by a primary point source, a secondary extra-focal source, and a contaminant electron source. Off-axis energy softening and fluence effects were also included. The additions of hyperbolic functions have been incorporated into the model to correct for the changes in output and in electron contamination with field size. A multileaf collimator (MLC) model is included to facilitate phantom and patient dose calculations. An offset to the MLC leaf positions was used to correct for the rudimentary assumed primary point source. Dose calculations of the depth dose and profiles for field sizes 4 × 4 to 40 × 40 cm agree with measurement within 2% of the maximum dose or 2 mm distance to agreement (DTA) for 95% of the data points tested. The model was capable of predicting the depth of the maximum dose within 1 mm. Anthropomorphic phantom benchmark testing of modulated and patterned MLCs treatment plans showed agreement to measurement within 3% in target regions using thermoluminescent dosimeters (TLD). Using radiochromic film normalized to TLD, a gamma criteria of 3% of maximum dose and 2 mm DTA was applied with a pass rate of least 85% in the high dose, high gradient, and low dose regions. Finally, recalculations of patient plans using DPM showed good agreement relative to a commercial TPS when comparing dose volume histograms and 2D dose distributions. A unique analytical source model coupled to the dose planning method Monte Carlo dose calculation code has been modified and validated using basic beam data and anthropomorphic phantom measurement. While this tool can be applied in general use for a particular linac model, specifically it was developed to provide a singular methodology to independently assess treatment plan dose distributions from those clinical institutions participating in National Cancer Institute trials.

76 FR 59434 - Proposed Exemptions From Certain Prohibited Transaction Restrictions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-26

...This document contains notices of pendency before the Department of Labor (the Department) of proposed exemptions from certain of the prohibited transaction restrictions of the Employee Retirement Income Security Act of 1974 (ERISA or the Act) and/or the Internal Revenue Code of 1986 (the Code). This notice includes the following proposed exemptions: D- 11676 The Kemper Corporation Pension Plan (the Plan); L-11618 Oregon- Washington Carpenters Employers Apprenticeship and Training Trust Fund (the Plan); and L-11647 R+L Carriers Shared Services, LLC

47 CFR 52.7 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Administration § 52.7 Definitions. As used in this subpart: (a) Area code or numbering plan area (NPA). The term “area code or numbering plan area” refers to the first three digits (NXX) of a ten-digit telephone... “central office code” refers to the second three digits (NXX) of a ten-digit telephone number in the form...

47 CFR 52.7 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Administration § 52.7 Definitions. As used in this subpart: (a) Area code or numbering plan area (NPA). The term “area code or numbering plan area” refers to the first three digits (NXX) of a ten-digit telephone... “central office code” refers to the second three digits (NXX) of a ten-digit telephone number in the form...

47 CFR 52.7 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Administration § 52.7 Definitions. As used in this subpart: (a) Area code or numbering plan area (NPA). The term “area code or numbering plan area” refers to the first three digits (NXX) of a ten-digit telephone... “central office code” refers to the second three digits (NXX) of a ten-digit telephone number in the form...

47 CFR 52.7 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Administration § 52.7 Definitions. As used in this subpart: (a) Area code or numbering plan area (NPA). The term “area code or numbering plan area” refers to the first three digits (NXX) of a ten-digit telephone... “central office code” refers to the second three digits (NXX) of a ten-digit telephone number in the form...

KEEL for Mission Planning

DTIC Science & Technology

2016-10-06

Copyright 2016, Compsim, All Rights Reserved 1 KEEL® Technology in support of Mission Planning and Execution delivering Adaptive...Executing, and Auditing ) This paper focuses on the decision-making component (#2) with the use of Knowledge Enhanced Electronic logic (KEEL) Technology ...Copyright 2016, Compsim, All Rights Reserved 2 • Eliminate “coding errors” (auto-generated code) • 100% explainable and auditable

Responding to the Effects of Extreme Heat: Baltimore City's Code Red Program.

PubMed

Martin, Jennifer L

2016-01-01

Heat response plans are becoming increasingly more common as US cities prepare for heat waves and other effects of climate change. Standard elements of heat response plans exist, but plans vary depending on geographic location and distribution of vulnerable populations. Because heat events vary over time and affect populations differently based on vulnerability, it is difficult to compare heat response plans and evaluate responses to heat events. This article provides an overview of the Baltimore City heat response plan, the Code Red program, and discusses the city's response to the 2012 Ohio Valley/Mid Atlantic Derecho, a complex heat event. Challenges with and strategies for evaluating the program are reviewed and shared.

Performance of two commercial electron beam algorithms over regions close to the lung-mediastinum interface, against Monte Carlo simulation and point dosimetry in virtual and anthropomorphic phantoms.

PubMed

Ojala, J; Hyödynmaa, S; Barańczyk, R; Góra, E; Waligórski, M P R

2014-03-01

Electron radiotherapy is applied to treat the chest wall close to the mediastinum. The performance of the GGPB and eMC algorithms implemented in the Varian Eclipse treatment planning system (TPS) was studied in this region for 9 and 16 MeV beams, against Monte Carlo (MC) simulations, point dosimetry in a water phantom and dose distributions calculated in virtual phantoms. For the 16 MeV beam, the accuracy of these algorithms was also compared over the lung-mediastinum interface region of an anthropomorphic phantom, against MC calculations and thermoluminescence dosimetry (TLD). In the phantom with a lung-equivalent slab the results were generally congruent, the eMC results for the 9 MeV beam slightly overestimating the lung dose, and the GGPB results for the 16 MeV beam underestimating the lung dose. Over the lung-mediastinum interface, for 9 and 16 MeV beams, the GGPB code underestimated the lung dose and overestimated the dose in water close to the lung, compared to the congruent eMC and MC results. In the anthropomorphic phantom, results of TLD measurements and MC and eMC calculations agreed, while the GGPB code underestimated the lung dose. Good agreement between TLD measurements and MC calculations attests to the accuracy of "full" MC simulations as a reference for benchmarking TPS codes. Application of the GGPB code in chest wall radiotherapy may result in significant underestimation of the lung dose and overestimation of dose to the mediastinum, affecting plan optimization over volumes close to the lung-mediastinum interface, such as the lung or heart. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

An efficient method to predict and include Bragg curve degradation due to lung-equivalent materials in Monte Carlo codes by applying a density modulation

NASA Astrophysics Data System (ADS)

Baumann, Kilian-Simon; Witt, Matthias; Weber, Uli; Engenhart-Cabillic, Rita; Zink, Klemens

2017-05-01

Sub-millimetre-sized heterogeneities such as lung parenchyma cause Bragg peak degradation which can lead to an underdose of the tumor and an overdose of healthy tissue when not accounted for in treatment planning. Since commonly used treatment-planning CTs do not resolve the fine structure of lungs, this degradation can hardly be considered. We present a mathematical model capable of predicting and describing Bragg peak degradation due to a lung-equivalent geometry consisting of sub-millimetre voxels filled with either lung tissue or air. The material characteristic ‘modulation power’ is introduced to quantify the Bragg peak degradation. A strategy was developed to transfer the modulating effects of such fine structures to rougher structures such as 2 mm thick CT voxels, which is the resolution of typically used CTs. This is done by using the modulation power to derive a density distribution applicable to these voxels. By replacing the previously used sub-millimetre voxels by 2 mm thick voxels filled with lung tissue and modulating the lung tissue’s density in each voxel individually, we were able to reproduce the Bragg peak degradation. Hence a solution is found to include Bragg curve degradation due to lung-equivalent materials in Monte Carlo-based treatment-planning systems.

Hanford Facility Dangerous Waste Closure Plan - Plutonium Finishing Plant Treatment Unit Glovebox HA-20MB

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

PRIGNANO, A.L.

2003-06-25

This closure plan describes the planned activities and performance standards for closing the Plutonium Finishing Plant (PFP) glovebox HA-20MB that housed an interim status ''Resource Conservation and Recovery Act'' (RCRA) of 1976 treatment unit. This closure plan is certified and submitted to Ecology for incorporation into the Hanford Facility RCRA Permit (HF RCRA Permit) in accordance with Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement; TPA) Milestone M-83-30 requiring submittal of a certified closure plan for ''glovebox HA-20MB'' by July 31, 2003. Glovebox HA-20MB is located within the 231-5Z Building in the 200 West Area of the Hanford Facility.more » Currently glovebox HA-20MB is being used for non-RCRA analytical purposes. The schedule of closure activities under this plan supports completion of TPA Milestone M-83-44 to deactivate and prepare for dismantlement the above grade portions of the 234-5Z and ZA, 243-Z, and 291-Z and 291-Z-1 stack buildings by September 30, 2015. Under this closure plan, glovebox HA-20MB will undergo clean closure to the performance standards of Washington Administrative Code (WAC) 173-303-610 with respect to all dangerous waste contamination from glovebox HA-20MB RCRA operations. Because the intention is to clean close the PFP treatment unit, postclosure activities are not applicable to this closure plan. To clean close the unit, it will be demonstrated that dangerous waste has not been left at levels above the closure performance standard for removal and decontamination. If it is determined that clean closure is not possible or is environmentally impractical, the closure plan will be modified to address required postclosure activities. Because dangerous waste does not include source, special nuclear, and by-product material components of mixed waste, radionuclides are not within the scope of this documentation. Any information on radionuclides is provided only for general knowledge. Clearance form only sent to RHA.« less

Items Supporting the Hanford Internal Dosimetry Program Implementation of the IMBA Computer Code

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

Carbaugh, Eugene H.; Bihl, Donald E.

2008-01-07

The Hanford Internal Dosimetry Program has adopted the computer code IMBA (Integrated Modules for Bioassay Analysis) as its primary code for bioassay data evaluation and dose assessment using methodologies of ICRP Publications 60, 66, 67, 68, and 78. The adoption of this code was part of the implementation plan for the June 8, 2007 amendments to 10 CFR 835. This information release includes action items unique to IMBA that were required by PNNL quality assurance standards for implementation of safety software. Copie of the IMBA software verification test plan and the outline of the briefing given to new users aremore » also included.« less

Female Sex Offenders' Relationship Experiences

PubMed Central

Lawson, Louanne

2010-01-01

Interventions for child sexual abusers should take into account their perspectives on the context of their offenses, but no descriptions of everyday life from the offender's point of view have been published. This study therefore explored female offenders' views of their strengths and challenges. Documented risk assessments of 20 female offenders were analyzed using inductive content analysis (Cavanagh, 1997; Priest, Roberts & Woods, 2002; Woods, Priest & Roberts, 2002). The Good Lives Model provided the initial coding framework and Atlas/ti software (Muhr, 1997) was used for simultaneous data collection and analysis. The content analysis yielded 999 coding decisions organized in three themes. The global theme was relationship experiences. Offenders described the quality of their relationship experiences, including their personal perspectives, intimate relationships and social lives. These descriptions have implications for treatment planning and future research with women who have molested children. PMID:18624098

Current and anticipated uses of thermal hydraulic codes in Korea

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

Kim, Kyung-Doo; Chang, Won-Pyo

1997-07-01

In Korea, the current uses of thermal hydraulic codes are categorized into 3 areas. The first application is in designing both nuclear fuel and NSSS. The codes have usually been introduced based on the technology transfer programs agreed between KAERI and the foreign vendors. Another area is in the supporting of the plant operations and licensing by the utility. The third category is research purposes. In this area assessments and some applications to the safety issue resolutions are major activities using the best estimate thermal hydraulic codes such as RELAP5/MOD3 and CATHARE2. Recently KEPCO plans to couple thermal hydraulic codesmore » with a neutronics code for the design of the evolutionary type reactor by 2004. KAERI also plans to develop its own best estimate thermal hydraulic code, however, application range is different from KEPCO developing code. Considering these activities, it is anticipated that use of the best estimate hydraulic analysis code developed in Korea may be possible in the area of safety evaluation within 10 years.« less

TH-AB-BRA-07: PENELOPE-Based GPU-Accelerated Dose Calculation System Applied to MRI-Guided Radiation Therapy

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

Wang, Y; Mazur, T; Green, O

Purpose: The clinical commissioning of IMRT subject to a magnetic field is challenging. The purpose of this work is to develop a GPU-accelerated Monte Carlo dose calculation platform based on PENELOPE and then use the platform to validate a vendor-provided MRIdian head model toward quality assurance of clinical IMRT treatment plans subject to a 0.35 T magnetic field. Methods: We first translated PENELOPE from FORTRAN to C++ and validated that the translation produced equivalent results. Then we adapted the C++ code to CUDA in a workflow optimized for GPU architecture. We expanded upon the original code to include voxelized transportmore » boosted by Woodcock tracking, faster electron/positron propagation in a magnetic field, and several features that make gPENELOPE highly user-friendly. Moreover, we incorporated the vendor-provided MRIdian head model into the code. We performed a set of experimental measurements on MRIdian to examine the accuracy of both the head model and gPENELOPE, and then applied gPENELOPE toward independent validation of patient doses calculated by MRIdian’s KMC. Results: We achieve an average acceleration factor of 152 compared to the original single-thread FORTRAN implementation with the original accuracy preserved. For 16 treatment plans including stomach (4), lung (2), liver (3), adrenal gland (2), pancreas (2), spleen (1), mediastinum (1) and breast (1), the MRIdian dose calculation engine agrees with gPENELOPE with a mean gamma passing rate of 99.1% ± 0.6% (2%/2 mm). Conclusions: We developed a Monte Carlo simulation platform based on a GPU-accelerated version of PENELOPE. We validated that both the vendor provided head model and fast Monte Carlo engine used by the MRIdian system are accurate in modeling radiation transport in a patient using 2%/2 mm gamma criteria. Future applications of this platform will include dose validation and accumulation, IMRT optimization, and dosimetry system modeling for next generation MR-IGRT systems.« less

76 FR 77593 - Proposed Exemptions From Certain Prohibited Transaction Restrictions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-13

...This document contains notices of pendency before the Department of Labor (the Department) of proposed exemptions from certain of the prohibited transaction restrictions of the Employee Retirement Income Security Act of 1974 (ERISA or the Act) and/or the Internal Revenue Code of 1986 (the Code). This notice includes the following proposed exemptions: D-11517, JPMorgan Chase & Co. and its Current and Future Affiliates and Subsidiaries (JPMorgan Chase); D- 11579, Delaware Charter Guarantee & Trust Co. d\\b\\a\\ Principle Trust Company (Principle Trust); D-11628, Aztec Well Servicing Company and Related Companies Medical Plan Trust Fund (the Plan); D-11669, Genzyme Corporation 401(k) Plan (the Plan or the Applicant); and Retirement Program for Employees of EnPro Industries (the Plan), D-11662 et al.

Understanding Annuity and Deferred Compensation Plans.

ERIC Educational Resources Information Center

Cifelli, Thomas A.

1987-01-01

Summarizes the rules governing Internal Revenue Code (IRC) section 403 (b) annuity plans and IRC section 427 deferred compensation plans. On balance, the burdensome annual form 550 filing requirement of 403 (b) plans seems more than offset by the disadvantages and increased responsibility associated with 427 plans. (MLH)

Characterizing a proton beam scanning system for Monte Carlo dose calculation in patients

NASA Astrophysics Data System (ADS)

Grassberger, C.; Lomax, Anthony; Paganetti, H.

2015-01-01

The presented work has two goals. First, to demonstrate the feasibility of accurately characterizing a proton radiation field at treatment head exit for Monte Carlo dose calculation of active scanning patient treatments. Second, to show that this characterization can be done based on measured depth dose curves and spot size alone, without consideration of the exact treatment head delivery system. This is demonstrated through calibration of a Monte Carlo code to the specific beam lines of two institutions, Massachusetts General Hospital (MGH) and Paul Scherrer Institute (PSI). Comparison of simulations modeling the full treatment head at MGH to ones employing a parameterized phase space of protons at treatment head exit reveals the adequacy of the method for patient simulations. The secondary particle production in the treatment head is typically below 0.2% of primary fluence, except for low-energy electrons (<0.6 MeV for 230 MeV protons), whose contribution to skin dose is negligible. However, there is significant difference between the two methods in the low-dose penumbra, making full treatment head simulations necessary to study out-of-field effects such as secondary cancer induction. To calibrate the Monte Carlo code to measurements in a water phantom, we use an analytical Bragg peak model to extract the range-dependent energy spread at the two institutions, as this quantity is usually not available through measurements. Comparison of the measured with the simulated depth dose curves demonstrates agreement within 0.5 mm over the entire energy range. Subsequently, we simulate three patient treatments with varying anatomical complexity (liver, head and neck and lung) to give an example how this approach can be employed to investigate site-specific discrepancies between treatment planning system and Monte Carlo simulations.

Characterizing a Proton Beam Scanning System for Monte Carlo Dose Calculation in Patients

PubMed Central

Grassberger, C; Lomax, Tony; Paganetti, H

2015-01-01

The presented work has two goals. First, to demonstrate the feasibility of accurately characterizing a proton radiation field at treatment head exit for Monte Carlo dose calculation of active scanning patient treatments. Second, to show that this characterization can be done based on measured depth dose curves and spot size alone, without consideration of the exact treatment head delivery system. This is demonstrated through calibration of a Monte Carlo code to the specific beam lines of two institutions, Massachusetts General Hospital (MGH) and Paul Scherrer Institute (PSI). Comparison of simulations modeling the full treatment head at MGH to ones employing a parameterized phase space of protons at treatment head exit reveals the adequacy of the method for patient simulations. The secondary particle production in the treatment head is typically below 0.2% of primary fluence, except for low–energy electrons (<0.6MeV for 230MeV protons), whose contribution to skin dose is negligible. However, there is significant difference between the two methods in the low-dose penumbra, making full treatment head simulations necessary to study out-of field effects such as secondary cancer induction. To calibrate the Monte Carlo code to measurements in a water phantom, we use an analytical Bragg peak model to extract the range-dependent energy spread at the two institutions, as this quantity is usually not available through measurements. Comparison of the measured with the simulated depth dose curves demonstrates agreement within 0.5mm over the entire energy range. Subsequently, we simulate three patient treatments with varying anatomical complexity (liver, head and neck and lung) to give an example how this approach can be employed to investigate site-specific discrepancies between treatment planning system and Monte Carlo simulations. PMID:25549079

It’s a Matter of Trust: Older African Americans Speak About Their Health Care Encounters

PubMed Central

Hansen, Bryan R.; Hodgson, Nancy A.; Gitlin, Laura N.

2015-01-01

Purpose To examine perceptions of older African Americans’ encounters with health care providers and ways to enhance trust. Method Transcribed semi-structured interviews with African American senior center members were analyzed, using Pattern Coding method. Results Four themes emerged: “Added Insult of Ageism,” “Alternative Remedies,” “Good Providers in a ‘Broken’ System,” and “The Foundation of Trust Is Person Recognition.” Provider behaviors leading to mistrust included erroneously assuming stereotypical preferences and competence, spending inadequate time listening to patients, disregarding patient preferences, and insufficiently explaining treatments. Discussion Of importance to improving trust among older African American patients is valuing individual histories and preferences by reallocating scarce time to person-centered listening, individualizing treatments, more completely explaining interventions, and assuring that patients understand and agree with treatment plans. PMID:25669876

The MIMIC Code Repository: enabling reproducibility in critical care research.

PubMed

Johnson, Alistair Ew; Stone, David J; Celi, Leo A; Pollard, Tom J

2018-01-01

Lack of reproducibility in medical studies is a barrier to the generation of a robust knowledge base to support clinical decision-making. In this paper we outline the Medical Information Mart for Intensive Care (MIMIC) Code Repository, a centralized code base for generating reproducible studies on an openly available critical care dataset. Code is provided to load the data into a relational structure, create extractions of the data, and reproduce entire analysis plans including research studies. Concepts extracted include severity of illness scores, comorbid status, administrative definitions of sepsis, physiologic criteria for sepsis, organ failure scores, treatment administration, and more. Executable documents are used for tutorials and reproduce published studies end-to-end, providing a template for future researchers to replicate. The repository's issue tracker enables community discussion about the data and concepts, allowing users to collaboratively improve the resource. The centralized repository provides a platform for users of the data to interact directly with the data generators, facilitating greater understanding of the data. It also provides a location for the community to collaborate on necessary concepts for research progress and share them with a larger audience. Consistent application of the same code for underlying concepts is a key step in ensuring that research studies on the MIMIC database are comparable and reproducible. By providing open source code alongside the freely accessible MIMIC-III database, we enable end-to-end reproducible analysis of electronic health records. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Application of the MCNP5 code to the Modeling of vaginal and intra-uterine applicators used in intracavitary brachytherapy: a first approach

NASA Astrophysics Data System (ADS)

Gerardy, I.; Rodenas, J.; Van Dycke, M.; Gallardo, S.; Tondeur, F.

2008-02-01

Brachytherapy is a radiotherapy treatment where encapsulated radioactive sources are introduced within a patient. Depending on the technique used, such sources can produce high, medium or low local dose rates. The Monte Carlo method is a powerful tool to simulate sources and devices in order to help physicists in treatment planning. In multiple types of gynaecological cancer, intracavitary brachytherapy (HDR Ir-192 source) is used combined with other therapy treatment to give an additional local dose to the tumour. Different types of applicators are used in order to increase the dose imparted to the tumour and to limit the effect on healthy surrounding tissues. The aim of this work is to model both applicator and HDR source in order to evaluate the dose at a reference point as well as the effect of the materials constituting the applicators on the near field dose. The MCNP5 code based on the Monte Carlo method has been used for the simulation. Dose calculations have been performed with *F8 energy deposition tally, taking into account photons and electrons. Results from simulation have been compared with experimental in-phantom dose measurements. Differences between calculations and measurements are lower than 5%.The importance of the source position has been underlined.

Projection of Patient Condition Code Distributions Based on Mechanism of Injury

DTIC Science & Technology

2003-01-01

The Medical Readiness and Strategic Plan (MRSP)1998-20041 requires that the military services develop a method for linking real world patient load...data with modern Patient Condition (PC) codes to enable planners to forecast medical workload and resource requirements. Determination of the likely...various levels of medical care. Medical planners and logisticians plan for medical contingencies based on anticipated patient streams, distributions of

31 CFR 29.106 - Representative payees.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the same circumstances as each plan permits for non-Federal Benefit Payments under the plan. (See e.g., section 4-629(b) of the D.C. Code (1997) (applicable to the Police and Firefighters Plan).) ...

31 CFR 29.106 - Representative payees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the same circumstances as each plan permits for non-Federal Benefit Payments under the plan. (See e.g., section 4-629(b) of the D.C. Code (1997) (applicable to the Police and Firefighters Plan).) ...

31 CFR 29.106 - Representative payees.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the same circumstances as each plan permits for non-Federal Benefit Payments under the plan. (See e.g., section 4-629(b) of the D.C. Code (1997) (applicable to the Police and Firefighters Plan).) ...

31 CFR 29.106 - Representative payees.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the same circumstances as each plan permits for non-Federal Benefit Payments under the plan. (See e.g., section 4-629(b) of the D.C. Code (1997) (applicable to the Police and Firefighters Plan).) ...

31 CFR 29.106 - Representative payees.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the same circumstances as each plan permits for non-Federal Benefit Payments under the plan. (See e.g., section 4-629(b) of the D.C. Code (1997) (applicable to the Police and Firefighters Plan).) ...

78 FR 28775 - Approval and Promulgation of Implementation Plans; North Carolina; State Implementation Plan...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... Promulgation of Implementation Plans; North Carolina; State Implementation Plan Miscellaneous Revisions AGENCY... a revision to the North Carolina State Implementation Plan submitted on February 3, 2010, through... particulate matter found in the Code of Federal Regulations. In the Final Rules Section of this Federal...

Positive futures? The impact of HIV infection on achieving health, wealth and future planning.

PubMed

Harding, Richard; Molloy, Tim

2008-05-01

Although HIV is now cast as a chronic condition with favourable clinical outcomes under new treatments, it is unclear how living with HIV affects expectations and planning for the future. This mixed-methods study aimed to investigate UK gay men's expectations of their own future when living with HIV, and to identify the heath and social interventions required to enhance roles, participation and personal fulfilment. A preliminary focus group identified relevant domains of enquiry for a subsequent online cross-sectional survey. A total of 347 gay men living in the UK with HIV participated in the survey, and 56.6% were currently on treatment. However, high 7-day prevalence of psychological and physical symptoms was identified (42.6% in pain, 80.2% worrying); 57.8% perceived reduced career options due to their infection and 71.8% reduced life expectancy. Being on treatment was not significantly associated with perceived life expectancy. Coded open-ended survey data identified eight principle themes related to goal planning and attainment. The integrated open and closed data items offer an understanding of barriers and challenges that focus on poor mental health due to clinical inattention, discrimination and stigma, poor career and job opportunities due to benefit and workplace inflexibility and lack of understanding, a lack of personal goals and associated skills deficit related to confidence and self esteem. Gay men living with HIV require an integrated holistic approach to wellbeing that incorporates clinical, social and individual intervention in order to lead productive lives with maximum benefit from treatment gains.

The Astrophysics Source Code Library: An Update

NASA Astrophysics Data System (ADS)

Allen, Alice; Nemiroff, R. J.; Shamir, L.; Teuben, P. J.

2012-01-01

The Astrophysics Source Code Library (ASCL), founded in 1999, takes an active approach to sharing astrophysical source code. ASCL's editor seeks out both new and old peer-reviewed papers that describe methods or experiments that involve the development or use of source code, and adds entries for the found codes to the library. This approach ensures that source codes are added without requiring authors to actively submit them, resulting in a comprehensive listing that covers a significant number of the astrophysics source codes used in peer-reviewed studies. The ASCL moved to a new location in 2010, and has over 300 codes in it and continues to grow. In 2011, the ASCL (http://asterisk.apod.com/viewforum.php?f=35) has on average added 19 new codes per month; we encourage scientists to submit their codes for inclusion. An advisory committee has been established to provide input and guide the development and expansion of its new site, and a marketing plan has been developed and is being executed. All ASCL source codes have been used to generate results published in or submitted to a refereed journal and are freely available either via a download site or from an identified source. This presentation covers the history of the ASCL and examines the current state and benefits of the ASCL, the means of and requirements for including codes, and outlines its future plans.

The NCS code of practice for the quality assurance and control for volumetric modulated arc therapy

NASA Astrophysics Data System (ADS)

Mans, Anton; Schuring, Danny; Arends, Mark P.; Vugts, Cornelia A. J. M.; Wolthaus, Jochem W. H.; Lotz, Heidi T.; Admiraal, Marjan; Louwe, Rob J. W.; Öllers, Michel C.; van de Kamer, Jeroen B.

2016-10-01

In 2010, the NCS (Netherlands Commission on Radiation Dosimetry) installed a subcommittee to develop guidelines for quality assurance and control for volumetric modulated arc therapy (VMAT) treatments. The report (published in 2015) has been written by Dutch medical physicists and has therefore, inevitably, a Dutch focus. This paper is a condensed version of these guidelines, the full report in English is freely available from the NCS website www.radiationdosimetry.org. After describing the transition from IMRT to VMAT, the paper addresses machine quality assurance (QA) and treatment planning system (TPS) commissioning for VMAT. The final section discusses patient specific QA issues such as the use of class solutions, measurement devices and dose evaluation methods.

RELAP-7 Software Verification and Validation Plan - Requirements Traceability Matrix (RTM) Part 2: Code Assessment Strategy, Procedure, and RTM Update

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

Yoo, Jun Soo; Choi, Yong Joon; Smith, Curtis Lee

2016-09-01

This document addresses two subjects involved with the RELAP-7 Software Verification and Validation Plan (SVVP): (i) the principles and plan to assure the independence of RELAP-7 assessment through the code development process, and (ii) the work performed to establish the RELAP-7 assessment plan, i.e., the assessment strategy, literature review, and identification of RELAP-7 requirements. Then, the Requirements Traceability Matrices (RTMs) proposed in previous document (INL-EXT-15-36684) are updated. These RTMs provide an efficient way to evaluate the RELAP-7 development status as well as the maturity of RELAP-7 assessment through the development process.

Technical Note: Defining cyclotron-based clinical scanning proton machines in a FLUKA Monte Carlo system.

PubMed

Fiorini, Francesca; Schreuder, Niek; Van den Heuvel, Frank

2018-02-01

Cyclotron-based pencil beam scanning (PBS) proton machines represent nowadays the majority and most affordable choice for proton therapy facilities, however, their representation in Monte Carlo (MC) codes is more complex than passively scattered proton system- or synchrotron-based PBS machines. This is because degraders are used to decrease the energy from the cyclotron maximum energy to the desired energy, resulting in a unique spot size, divergence, and energy spread depending on the amount of degradation. This manuscript outlines a generalized methodology to characterize a cyclotron-based PBS machine in a general-purpose MC code. The code can then be used to generate clinically relevant plans starting from commercial TPS plans. The described beam is produced at the Provision Proton Therapy Center (Knoxville, TN, USA) using a cyclotron-based IBA Proteus Plus equipment. We characterized the Provision beam in the MC FLUKA using the experimental commissioning data. The code was then validated using experimental data in water phantoms for single pencil beams and larger irregular fields. Comparisons with RayStation TPS plans are also presented. Comparisons of experimental, simulated, and planned dose depositions in water plans show that same doses are calculated by both programs inside the target areas, while penumbrae differences are found at the field edges. These differences are lower for the MC, with a γ(3%-3 mm) index never below 95%. Extensive explanations on how MC codes can be adapted to simulate cyclotron-based scanning proton machines are given with the aim of using the MC as a TPS verification tool to check and improve clinical plans. For all the tested cases, we showed that dose differences with experimental data are lower for the MC than TPS, implying that the created FLUKA beam model is better able to describe the experimental beam. © 2017 The Authors. Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

2005 Federal Radionavigation Plan

DOT National Transportation Integrated Search

2005-12-01

The Federal Radionavigation Plan (FRP) is published in accordance with Section 2281(c) of Title 10, United States Code and delineates : policies and plans for radionavigation services provided by the U.S. Government to ensure efficient use of resourc...

Implications of ICD-10 for Sarcopenia Clinical Practice and Clinical Trials: Report by the International Conference on Frailty and Sarcopenia Research Task Force.

PubMed

Vellas, B; Fielding, R A; Bens, C; Bernabei, R; Cawthon, P M; Cederholm, T; Cruz-Jentoft, A J; Del Signore, S; Donahue, S; Morley, J; Pahor, M; Reginster, J-Y; Rodriguez Mañas, L; Rolland, Y; Roubenoff, R; Sinclair, A; Cesari, M

2018-01-01

Establishment of an ICD-10-CM code for sarcopenia in 2016 was an important step towards reaching international consensus on the need for a nosological framework of age-related skeletal muscle decline. The International Conference on Frailty and Sarcopenia Research Task Force met in April 2017 to discuss the meaning, significance, and barriers to the implementation of the new code as well as strategies to accelerate development of new therapies. Analyses by the Sarcopenia Definitions and Outcomes Consortium are underway to develop quantitative definitions of sarcopenia. A consensus conference is planned to evaluate this analysis. The Task Force also discussed lessons learned from sarcopenia trials that could be applied to future trials, as well as lessons from the osteoporosis field, a clinical condition with many constructs similar to sarcopenia and for which ad hoc treatments have been developed and approved by regulatory agencies.

Coding of Stimuli by Animals: Retrospection, Prospection, Episodic Memory and Future Planning

ERIC Educational Resources Information Center

Zentall, Thomas R.

2010-01-01

When animals code stimuli for later retrieval they can either code them in terms of the stimulus presented (as a retrospective memory) or in terms of the response or outcome anticipated (as a prospective memory). Although retrospective memory is typically assumed (as in the form of a memory trace), evidence of prospective coding has been found…

Supporting the Use of CERT (registered trademark) Secure Coding Standards in DoD Acquisitions

DTIC Science & Technology

2012-07-01

Capability Maturity Model IntegrationSM (CMMI®) [Davis 2009]. SM Team Software Process, TSP, and Capability Maturity Model Integration are service...STP Software Test Plan TEP Test and Evaluation Plan TSP Team Software Process V & V verification and validation CMU/SEI-2012-TN-016 | 47...Supporting the Use of CERT® Secure Coding Standards in DoD Acquisitions Tim Morrow ( Software Engineering Institute) Robert Seacord ( Software

76 FR 6727 - Proposed Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-08

...The Delaware River Basin Commission published in the Federal Register of January 4, 2011 a proposed rule containing tentative dates and locations for public hearings on proposed amendments to its Water Quality Regulations, Water Code and Comprehensive Plan relating to natural gas development projects. The public hearing dates have been changed and locations and times established, as set forth below.

Independent dose verification system with Monte Carlo simulations using TOPAS for passive scattering proton therapy at the National Cancer Center in Korea

NASA Astrophysics Data System (ADS)

Shin, Wook-Geun; Testa, Mauro; Kim, Hak Soo; Jeong, Jong Hwi; Byeong Lee, Se; Kim, Yeon-Joo; Min, Chul Hee

2017-10-01

For the independent validation of treatment plans, we developed a fully automated Monte Carlo (MC)-based patient dose calculation system with the tool for particle simulation (TOPAS) and proton therapy machine installed at the National Cancer Center in Korea to enable routine and automatic dose recalculation for each patient. The proton beam nozzle was modeled with TOPAS to simulate the therapeutic beam, and MC commissioning was performed by comparing percent depth dose with the measurement. The beam set-up based on the prescribed beam range and modulation width was automated by modifying the vendor-specific method. The CT phantom was modeled based on the DICOM CT files with TOPAS-built-in function, and an in-house-developed C++ code directly imports the CT files for positioning the CT phantom, RT-plan file for simulating the treatment plan, and RT-structure file for applying the Hounsfield unit (HU) assignment, respectively. The developed system was validated by comparing the dose distributions with those calculated by the treatment planning system (TPS) for a lung phantom and two patient cases of abdomen and internal mammary node. The results of the beam commissioning were in good agreement of up to 0.8 mm2 g-1 for B8 option in both of the beam range and the modulation width of the spread-out Bragg peaks. The beam set-up technique can predict the range and modulation width with an accuracy of 0.06% and 0.51%, respectively, with respect to the prescribed range and modulation in arbitrary points of B5 option (128.3, 132.0, and 141.2 mm2 g-1 of range). The dose distributions showed higher than 99% passing rate for the 3D gamma index (3 mm distance to agreement and 3% dose difference) between the MC simulations and the clinical TPS in the target volume. However, in the normal tissues, less favorable agreements were obtained for the radiation treatment planning with the lung phantom and internal mammary node cases. The discrepancies might come from the limitations of the clinical TPS, which is the inaccurate dose calculation algorithm for the scattering effect, in the range compensator and inhomogeneous material. Moreover, the steep slope of the compensator, conversion of the HU values to the human phantom, and the dose calculation algorithm for the HU assignment also could be reasons of the discrepancies. The current study could be used for the independent dose validation of treatment plans including high inhomogeneities, the steep compensator, and riskiness such as lung, head & neck cases. According to the treatment policy, the dose discrepancies predicted with MC could be used for the acceptance decision of the original treatment plan.

29 CFR 4041.22 - Administration of plan during pendency of termination process.

Code of Federal Regulations, 2010 CFR

2010-07-01

... out the normal operations of the plan. During that time period, except as provided in paragraph (b) of... Code to receive the distribution; (2) The distribution is consistent with prior plan practice; and (3) The distribution is not reasonably expected to jeopardize the plan's sufficiency for plan benefits. ...

Modification and validation of an analytical source model for external beam radiotherapy Monte Carlo dose calculations

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

Davidson, Scott E., E-mail: sedavids@utmb.edu

Purpose: A dose calculation tool, which combines the accuracy of the dose planning method (DPM) Monte Carlo code and the versatility of a practical analytical multisource model, which was previously reported has been improved and validated for the Varian 6 and 10 MV linear accelerators (linacs). The calculation tool can be used to calculate doses in advanced clinical application studies. One shortcoming of current clinical trials that report dose from patient plans is the lack of a standardized dose calculation methodology. Because commercial treatment planning systems (TPSs) have their own dose calculation algorithms and the clinical trial participant who usesmore » these systems is responsible for commissioning the beam model, variation exists in the reported calculated dose distributions. Today’s modern linac is manufactured to tight specifications so that variability within a linac model is quite low. The expectation is that a single dose calculation tool for a specific linac model can be used to accurately recalculate dose from patient plans that have been submitted to the clinical trial community from any institution. The calculation tool would provide for a more meaningful outcome analysis. Methods: The analytical source model was described by a primary point source, a secondary extra-focal source, and a contaminant electron source. Off-axis energy softening and fluence effects were also included. The additions of hyperbolic functions have been incorporated into the model to correct for the changes in output and in electron contamination with field size. A multileaf collimator (MLC) model is included to facilitate phantom and patient dose calculations. An offset to the MLC leaf positions was used to correct for the rudimentary assumed primary point source. Results: Dose calculations of the depth dose and profiles for field sizes 4 × 4 to 40 × 40 cm agree with measurement within 2% of the maximum dose or 2 mm distance to agreement (DTA) for 95% of the data points tested. The model was capable of predicting the depth of the maximum dose within 1 mm. Anthropomorphic phantom benchmark testing of modulated and patterned MLCs treatment plans showed agreement to measurement within 3% in target regions using thermoluminescent dosimeters (TLD). Using radiochromic film normalized to TLD, a gamma criteria of 3% of maximum dose and 2 mm DTA was applied with a pass rate of least 85% in the high dose, high gradient, and low dose regions. Finally, recalculations of patient plans using DPM showed good agreement relative to a commercial TPS when comparing dose volume histograms and 2D dose distributions. Conclusions: A unique analytical source model coupled to the dose planning method Monte Carlo dose calculation code has been modified and validated using basic beam data and anthropomorphic phantom measurement. While this tool can be applied in general use for a particular linac model, specifically it was developed to provide a singular methodology to independently assess treatment plan dose distributions from those clinical institutions participating in National Cancer Institute trials.« less

An examination of some safety issues among commercial motorcyclists in Nigeria: a case study.

PubMed

Arosanyin, Godwin Tunde; Olowosulu, Adekunle Taiwo; Oyeyemi, Gafar Matanmi

2013-01-01

The reduction of road crashes and injuries among motorcyclists in Nigeria requires a system inquiry into some safety issues at pre-crash, crash and post-crash stages to guide action plans. This paper examines safety issues such as age restriction, motorcycle engine capacity, highway code awareness, licence holding, helmet usage, crash involvement, rescue and payment for treatment among commercial motorcyclists. The primary data derived from a structured questionnaire administered to 334 commercial motorcyclists in Samaru, Zaria were analysed using descriptive statistics and logistic regression technique. There was total compliance with age restriction and motorcycle engine capacity. About 41.8% of the operators were not aware of the existence of the highway code. The odds of licence holding increased with highway code awareness, education with above senior secondary as the reference category and earnings. The odds of crash involvement decreased with highway code awareness, earnings and mode of operation. About 84% of the motorcyclists did not use crash helmet, in spite of being aware of the benefit, and 65.4% of motorcycle crashes was found to be with other road users. The promotion of safety among motorcyclists therefore requires strict traffic law enforcement and modification of road design to segregate traffic and protect pedestrians.

TLD efficiency calculations for heavy ions: an analytical approach

DOE PAGES

Boscolo, Daria; Scifoni, Emanuele; Carlino, Antonio; ...

2015-12-18

The use of thermoluminescent dosimeters (TLDs) in heavy charged particles’ dosimetry is limited by their non-linear dose response curve and by their response dependence on the radiation quality. Thus, in order to use TLDs with particle beams, a model that can reproduce the behavior of these detectors under different conditions is needed. Here a new, simple and completely analytical algorithm for the calculation of the relative TL-efficiency depending on the ion charge Z and energy E is presented. In addition, the detector response is evaluated starting from the single ion case, where the computed effectiveness values have been compared withmore » experimental data as well as with predictions from a different method. The main advantage of this approach is that, being fully analytical, it is computationally fast and can be efficiently integrated into treatment planning verification tools. In conclusion, the calculated efficiency values have been then implemented in the treatment planning code TRiP98 and dose calculations on a macroscopic target irradiated with an extended carbon ion field have been performed and verified against experimental data.« less

3 CFR - Unified Command Plan 2011

Code of Federal Regulations, 2012 CFR

2012-01-01

... 3 The President 1 2012-01-01 2012-01-01 false Unified Command Plan 2011 Presidential Documents Other Presidential Documents Memorandum of April 6, 2011 Unified Command Plan 2011 Memorandum for the... implementation of the revised Unified Command Plan. Consistent with title 10, United States Code, section 161(b...

On-line estimations of delivered radiation doses in three-dimensional conformal radiotherapy treatments of carcinoma uterine cervix patients in linear accelerator

PubMed Central

Putha, Suman Kumar; Saxena, P. U.; Banerjee, S.; Srinivas, Challapalli; Vadhiraja, B. M.; Ravichandran, Ramamoorthy; Joan, Mary; Pai, K. Dinesh

2016-01-01

Transmission of radiation fluence through patient's body has a correlation to the planned target dose. A method to estimate the delivered dose to target volumes was standardized using a beam level 0.6 cc ionization chamber (IC) positioned at electronic portal imaging device (EPID) plane from the measured transit signal (St) in patients with cancer of uterine cervix treated with three-dimensional conformal radiotherapy (3DCRT). The IC with buildup cap was mounted on linear accelerator EPID frame with fixed source to chamber distance of 146.3 cm, using a locally fabricated mount. Sts were obtained for different water phantom thicknesses and radiation field sizes which were then used to generate a calibration table against calculated midplane doses at isocenter (Diso,TPS), derived from the treatment planning system. A code was developed using MATLAB software which was used to estimate the in vivo dose at isocenter (Diso,Transit) from the measured Sts. A locally fabricated pelvic phantom validated the estimations of Diso,Transit before implementing this method on actual patients. On-line dose estimations were made (3 times during treatment for each patient) in 24 patients. The Diso,Transit agreement with Diso,TPS in phantom was within 1.7% and the mean percentage deviation with standard deviation is −1.37% ±2.03% (n = 72) observed in patients. Estimated in vivo dose at isocenter with this method provides a good agreement with planned ones which can be implemented as part of quality assurance in pelvic sites treated with simple techniques, for example, 3DCRT where there is a need for documentation of planned dose delivery. PMID:28144114

On-line estimations of delivered radiation doses in three-dimensional conformal radiotherapy treatments of carcinoma uterine cervix patients in linear accelerator.

PubMed

Putha, Suman Kumar; Saxena, P U; Banerjee, S; Srinivas, Challapalli; Vadhiraja, B M; Ravichandran, Ramamoorthy; Joan, Mary; Pai, K Dinesh

2016-01-01

Transmission of radiation fluence through patient's body has a correlation to the planned target dose. A method to estimate the delivered dose to target volumes was standardized using a beam level 0.6 cc ionization chamber (IC) positioned at electronic portal imaging device (EPID) plane from the measured transit signal (S t ) in patients with cancer of uterine cervix treated with three-dimensional conformal radiotherapy (3DCRT). The IC with buildup cap was mounted on linear accelerator EPID frame with fixed source to chamber distance of 146.3 cm, using a locally fabricated mount. S t s were obtained for different water phantom thicknesses and radiation field sizes which were then used to generate a calibration table against calculated midplane doses at isocenter (D iso,TPS ), derived from the treatment planning system. A code was developed using MATLAB software which was used to estimate the in vivo dose at isocenter (D iso,Transit ) from the measured S t s. A locally fabricated pelvic phantom validated the estimations of D iso,Transit before implementing this method on actual patients. On-line dose estimations were made (3 times during treatment for each patient) in 24 patients. The D iso,Transit agreement with D iso,TPS in phantom was within 1.7% and the mean percentage deviation with standard deviation is -1.37% ±2.03% ( n = 72) observed in patients. Estimated in vivo dose at isocenter with this method provides a good agreement with planned ones which can be implemented as part of quality assurance in pelvic sites treated with simple techniques, for example, 3DCRT where there is a need for documentation of planned dose delivery.

Revision of orthovoltage chest wall treatment using Monte Carlo simulations.

PubMed

Zeinali-Rafsanjani, B; Faghihi, R; Mosleh-Shirazi, M A; Mosalaei, A; Hadad, K

2017-01-01

Given the high local control rates observed in breast cancer patients undergoing chest wall irradiation by kilovoltage x-rays, we aimed to revisit this treatment modality by accurate calculation of dose distributions using Monte Carlo simulation. The machine components were simulated using the MCNPX code. This model was used to assess the dose distribution of chest wall kilovoltage treatment in different chest wall thicknesses and larger contour or fat patients in standard and mid sternum treatment plans. Assessments were performed at 50 and 100 cm focus surface distance (FSD) and different irradiation angles. In order to evaluate different plans, indices like homogeneity index, conformity index, the average dose of heart, lung, left anterior descending artery (LAD) and percentage target coverage (PTC) were used. Finally, the results were compared with the indices provided by electron therapy which is a more routine treatment of chest wall. These indices in a medium chest wall thickness in standard treatment plan at 50 cm FSD and 15 degrees tube angle was as follows: homogeneity index 2.57, conformity index 7.31, average target dose 27.43 Gy, average dose of heart, lung and LAD, 1.03, 2.08 and 1.60 Gy respectively and PTC 11.19%. Assessments revealed that dose homogeneity in planning target volume (PTV) and conformity between the high dose region and PTV was poor. To improve the treatment indices, the reference point was transferred from the chest wall skin surface to the center of PTV. The indices changed as follows: conformity index 7.31, average target dose 60.19 Gy, the average dose of heart, lung and LAD, 3.57, 6.38 and 5.05 Gy respectively and PTC 55.24%. Coverage index of electron therapy was 89% while it was 22.74% in the old orthovoltage method and also the average dose of the target was about 50 Gy but in the given method it was almost 30 Gy. The results of the treatment study show that the optimized standard and mid sternum treatment for different chest wall thicknesses is with 50 cm FSD and zero (vertical) tube angle, while in large contour patients, it is with 100 cm FSD and zero tube angle. Finally, chest wall kilovoltage and electron therapies were compared, which revealed that electron therapy produces a better dose distribution than kilovoltage therapy.

27 CFR 555.109 - Identification of explosive materials.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... (5) If licensed manufacturers or licensed importers desire to use a coding system and omit printed... this section, they must file with ATF a letterhead application displaying the coding that they plan to... proposed coding can be used. (d) Exceptions—(1) Blasting caps. Licensed manufacturers or licensed importers...

Patient recall of specific cognitive therapy contents predicts adherence and outcome in adults with major depressive disorder.

PubMed

Dong, Lu; Zhao, Xin; Ong, Stacie L; Harvey, Allison G

2017-10-01

The current study examined whether and which specific contents of patients' memory for cognitive therapy (CT) were associated with treatment adherence and outcome. Data were drawn from a pilot RCT of forty-eight depressed adults, who received either CT plus Memory Support Intervention (CT + Memory Support) or CT-as-usual. Patients' memory for treatment was measured using the Patient Recall Task and responses were coded into cognitive behavioral therapy (CBT) codes, such as CBT Model and Cognitive Restructuring, and non-CBT codes, such as individual coping strategies and no code. Treatment adherence was measured using therapist and patient ratings during treatment. Depression outcomes included treatment response, remission, and recurrence. Total number of CBT codes recalled was not significantly different comparing CT + Memory Support to CT-as-usual. Total CBT codes recalled were positively associated with adherence, while non-CBT codes recalled were negatively associated with adherence. Treatment responders (vs. non-responders) exhibited a significant increase in their recall of Cognitive Restructuring from session 7 to posttreatment. Greater recall of Cognitive Restructuring was marginally significantly associated with remission. Greater total number of CBT codes recalled (particularly CBT Model) was associated with non-recurrence of depression. Results highlight the important relationships between patients' memory for treatment and treatment adherence and outcome. Copyright © 2017 Elsevier Ltd. All rights reserved.

A trichrome beam model for biological dose calculation in scanned carbon-ion radiotherapy treatment planning.

PubMed

Inaniwa, T; Kanematsu, N

2015-01-07

In scanned carbon-ion (C-ion) radiotherapy, some primary C-ions undergo nuclear reactions before reaching the target and the resulting particles deliver doses to regions at a significant distance from the central axis of the beam. The effects of these particles on physical dose distribution are accounted for in treatment planning by representing the transverse profile of the scanned C-ion beam as the superposition of three Gaussian distributions. In the calculation of biological dose distribution, however, the radiation quality of the scanned C-ion beam has been assumed to be uniform over its cross-section, taking the average value over the plane at a given depth (monochrome model). Since these particles, which have relatively low radiation quality, spread widely compared to the primary C-ions, the radiation quality of the beam should vary with radial distance from the central beam axis. To represent its transverse distribution, we propose a trichrome beam model in which primary C-ions, heavy fragments with atomic number Z ≥ 3, and light fragments with Z ≤ 2 are assigned to the first, second, and third Gaussian components, respectively. Assuming a realistic beam-delivery system, we performed computer simulations using Geant4 Monte Carlo code for analytical beam modeling of the monochrome and trichrome models. The analytical beam models were integrated into a treatment planning system for scanned C-ion radiotherapy. A target volume of 20  ×  20  ×  40 mm(3) was defined within a water phantom. A uniform biological dose of 2.65 Gy (RBE) was planned for the target with the two beam models based on the microdosimetric kinetic model (MKM). The plans were recalculated with Geant4, and the recalculated biological dose distributions were compared with the planned distributions. The mean target dose of the recalculated distribution with the monochrome model was 2.72 Gy (RBE), while the dose with the trichrome model was 2.64 Gy (RBE). The monochrome model underestimated the RBE within the target due to the assumption of no radial variations in radiation quality. Conversely, the trichrome model accurately predicted the RBE even in a small target. Our results verify the applicability of the trichrome model for clinical use in C-ion radiotherapy treatment planning.

A trichrome beam model for biological dose calculation in scanned carbon-ion radiotherapy treatment planning

NASA Astrophysics Data System (ADS)

Inaniwa, T.; Kanematsu, N.

2015-01-01

In scanned carbon-ion (C-ion) radiotherapy, some primary C-ions undergo nuclear reactions before reaching the target and the resulting particles deliver doses to regions at a significant distance from the central axis of the beam. The effects of these particles on physical dose distribution are accounted for in treatment planning by representing the transverse profile of the scanned C-ion beam as the superposition of three Gaussian distributions. In the calculation of biological dose distribution, however, the radiation quality of the scanned C-ion beam has been assumed to be uniform over its cross-section, taking the average value over the plane at a given depth (monochrome model). Since these particles, which have relatively low radiation quality, spread widely compared to the primary C-ions, the radiation quality of the beam should vary with radial distance from the central beam axis. To represent its transverse distribution, we propose a trichrome beam model in which primary C-ions, heavy fragments with atomic number Z ≥ 3, and light fragments with Z ≤ 2 are assigned to the first, second, and third Gaussian components, respectively. Assuming a realistic beam-delivery system, we performed computer simulations using Geant4 Monte Carlo code for analytical beam modeling of the monochrome and trichrome models. The analytical beam models were integrated into a treatment planning system for scanned C-ion radiotherapy. A target volume of 20  ×  20  ×  40 mm3 was defined within a water phantom. A uniform biological dose of 2.65 Gy (RBE) was planned for the target with the two beam models based on the microdosimetric kinetic model (MKM). The plans were recalculated with Geant4, and the recalculated biological dose distributions were compared with the planned distributions. The mean target dose of the recalculated distribution with the monochrome model was 2.72 Gy (RBE), while the dose with the trichrome model was 2.64 Gy (RBE). The monochrome model underestimated the RBE within the target due to the assumption of no radial variations in radiation quality. Conversely, the trichrome model accurately predicted the RBE even in a small target. Our results verify the applicability of the trichrome model for clinical use in C-ion radiotherapy treatment planning.

Comparing respondent-driven sampling and targeted sampling methods of recruiting injection drug users in San Francisco.

PubMed

Kral, Alex H; Malekinejad, Mohsen; Vaudrey, Jason; Martinez, Alexis N; Lorvick, Jennifer; McFarland, Willi; Raymond, H Fisher

2010-09-01

The objective of this article is to compare demographic characteristics, risk behaviors, and service utilization among injection drug users (IDUs) recruited from two separate studies in San Francisco in 2005, one which used targeted sampling (TS) and the other which used respondent-driven sampling (RDS). IDUs were recruited using TS (n = 651) and RDS (n = 534) and participated in quantitative interviews that included demographic characteristics, risk behaviors, and service utilization. Prevalence estimates and 95% confidence intervals (CIs) were calculated to assess whether there were differences in these variables by sampling method. There was overlap in 95% CIs for all demographic variables except African American race (TS: 45%, 53%; RDS: 29%, 44%). Maps showed that the proportion of IDUs distributed across zip codes were similar for the TS and RDS sample, with the exception of a single zip code that was more represented in the TS sample. This zip code includes an isolated, predominantly African American neighborhood where only the TS study had a field site. Risk behavior estimates were similar for both TS and RDS samples, although self-reported hepatitis C infection was lower in the RDS sample. In terms of service utilization, more IDUs in the RDS sample reported no recent use of drug treatment and syringe exchange program services. Our study suggests that perhaps a hybrid sampling plan is best suited for recruiting IDUs in San Francisco, whereby the more intensive ethnographic and secondary analysis components of TS would aid in the planning of seed placement and field locations for RDS.

Fast Biological Modeling for Voxel-based Heavy Ion Treatment Planning Using the Mechanistic Repair-Misrepair-Fixation Model and Nuclear Fragment Spectra

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

Kamp, Florian; Department of Radiation Oncology, Technische Universität München, Klinikum Rechts der Isar, München; Physik-Department, Technische Universität München, Garching

2015-11-01

Purpose: The physical and biological differences between heavy ions and photons have not been fully exploited and could improve treatment outcomes. In carbon ion therapy, treatment planning must account for physical properties, such as the absorbed dose and nuclear fragmentation, and for differences in the relative biological effectiveness (RBE) of ions compared with photons. We combined the mechanistic repair-misrepair-fixation (RMF) model with Monte Carlo-generated fragmentation spectra for biological optimization of carbon ion treatment plans. Methods and Materials: Relative changes in double-strand break yields and radiosensitivity parameters with particle type and energy were determined using the independently benchmarked Monte Carlo damagemore » simulation and the RMF model to estimate the RBE values for primary carbon ions and secondary fragments. Depth-dependent energy spectra were generated with the Monte Carlo code FLUKA for clinically relevant initial carbon ion energies. The predicted trends in RBE were compared with the published experimental data. Biological optimization for carbon ions was implemented in a 3-dimensional research treatment planning tool. Results: We compared the RBE and RBE-weighted dose (RWD) distributions of different carbon ion treatment scenarios with and without nuclear fragments. The inclusion of fragments in the simulations led to smaller RBE predictions. A validation of RMF against measured cell survival data reported in published studies showed reasonable agreement. We calculated and optimized the RWD distributions on patient data and compared the RMF predictions with those from other biological models. The RBE values in an astrocytoma tumor ranged from 2.2 to 4.9 (mean 2.8) for a RWD of 3 Gy(RBE) assuming (α/β){sub X} = 2 Gy. Conclusions: These studies provide new information to quantify and assess uncertainties in the clinically relevant RBE values for carbon ion therapy based on biophysical mechanisms. We present results from the first biological optimization of carbon ion radiation therapy beams on patient data using a combined RMF and Monte Carlo damage simulation modeling approach. The presented method is advantageous for fast biological optimization.« less

Fast Biological Modeling for Voxel-based Heavy Ion Treatment Planning Using the Mechanistic Repair-Misrepair-Fixation Model and Nuclear Fragment Spectra.

PubMed

Kamp, Florian; Cabal, Gonzalo; Mairani, Andrea; Parodi, Katia; Wilkens, Jan J; Carlson, David J

2015-11-01

The physical and biological differences between heavy ions and photons have not been fully exploited and could improve treatment outcomes. In carbon ion therapy, treatment planning must account for physical properties, such as the absorbed dose and nuclear fragmentation, and for differences in the relative biological effectiveness (RBE) of ions compared with photons. We combined the mechanistic repair-misrepair-fixation (RMF) model with Monte Carlo-generated fragmentation spectra for biological optimization of carbon ion treatment plans. Relative changes in double-strand break yields and radiosensitivity parameters with particle type and energy were determined using the independently benchmarked Monte Carlo damage simulation and the RMF model to estimate the RBE values for primary carbon ions and secondary fragments. Depth-dependent energy spectra were generated with the Monte Carlo code FLUKA for clinically relevant initial carbon ion energies. The predicted trends in RBE were compared with the published experimental data. Biological optimization for carbon ions was implemented in a 3-dimensional research treatment planning tool. We compared the RBE and RBE-weighted dose (RWD) distributions of different carbon ion treatment scenarios with and without nuclear fragments. The inclusion of fragments in the simulations led to smaller RBE predictions. A validation of RMF against measured cell survival data reported in published studies showed reasonable agreement. We calculated and optimized the RWD distributions on patient data and compared the RMF predictions with those from other biological models. The RBE values in an astrocytoma tumor ranged from 2.2 to 4.9 (mean 2.8) for a RWD of 3 Gy(RBE) assuming (α/β)X = 2 Gy. These studies provide new information to quantify and assess uncertainties in the clinically relevant RBE values for carbon ion therapy based on biophysical mechanisms. We present results from the first biological optimization of carbon ion radiation therapy beams on patient data using a combined RMF and Monte Carlo damage simulation modeling approach. The presented method is advantageous for fast biological optimization. Copyright © 2015 Elsevier Inc. All rights reserved.

WEC-SIM Validation Testing Plan FY14 Q4.

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

Ruehl, Kelley Michelle

2016-02-01

The WEC-Sim project is currently on track, having met both the SNL and NREL FY14 Milestones, as shown in Table 1 and Table 2. This is also reflected in the Gantt chart uploaded to the WEC-Sim SharePoint site in the FY14 Q4 Deliverables folder. The work completed in FY14 includes code verification through code-to-code comparison (FY14 Q1 and Q2), preliminary code validation through comparison to experimental data (FY14 Q2 and Q3), presentation and publication of the WEC-Sim project at OMAE 2014 [1], [2], [3] and GMREC/METS 2014 [4] (FY14 Q3), WEC-Sim code development and public open-source release (FY14 Q3), andmore » development of a preliminary WEC-Sim validation test plan (FY14 Q4). This report presents the preliminary Validation Testing Plan developed in FY14 Q4. The validation test effort started in FY14 Q4 and will go on through FY15. Thus far the team has developed a device selection method, selected a device, and placed a contract with the testing facility, established several collaborations including industry contacts, and have working ideas on the testing details such as scaling, device design, and test conditions.« less

A MODEL BUILDING CODE ARTICLE ON FALLOUT SHELTERS WITH RECOMMENDATIONS FOR INCLUSION OF REQUIREMENTS FOR FALLOUT SHELTER CONSTRUCTION IN FOUR NATIONAL MODEL BUILDING CODES.

ERIC Educational Resources Information Center

American Inst. of Architects, Washington, DC.

A MODEL BUILDING CODE FOR FALLOUT SHELTERS WAS DRAWN UP FOR INCLUSION IN FOUR NATIONAL MODEL BUILDING CODES. DISCUSSION IS GIVEN OF FALLOUT SHELTERS WITH RESPECT TO--(1) NUCLEAR RADIATION, (2) NATIONAL POLICIES, AND (3) COMMUNITY PLANNING. FALLOUT SHELTER REQUIREMENTS FOR SHIELDING, SPACE, VENTILATION, CONSTRUCTION, AND SERVICES SUCH AS ELECTRICAL…

78 FR 30770 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards Revision AGENCY... Illinois state implementation plan (SIP) to reflect current National Ambient Air Quality Standards (NAAQS... Implementation Plan at 35 Illinois Administrative Code part 243, which updates National Ambient Air Quality...

RELAP-7 Software Verification and Validation Plan

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

Smith, Curtis L.; Choi, Yong-Joon; Zou, Ling

This INL plan comprehensively describes the software for RELAP-7 and documents the software, interface, and software design requirements for the application. The plan also describes the testing-based software verification and validation (SV&V) process—a set of specially designed software models used to test RELAP-7. The RELAP-7 (Reactor Excursion and Leak Analysis Program) code is a nuclear reactor system safety analysis code being developed at Idaho National Laboratory (INL). The code is based on the INL’s modern scientific software development framework – MOOSE (Multi-Physics Object-Oriented Simulation Environment). The overall design goal of RELAP-7 is to take advantage of the previous thirty yearsmore » of advancements in computer architecture, software design, numerical integration methods, and physical models. The end result will be a reactor systems analysis capability that retains and improves upon RELAP5’s capability and extends the analysis capability for all reactor system simulation scenarios.« less

Determination of spatial dose distribution in UCC treatments with LDR brachytherapy using Monte Carlo methods.

PubMed

Benites-Rengifo, Jorge Luis; Vega-Carrillo, Hector Rene

2018-05-19

Using Monte Carlos methods, with the MCNP5 code, a gynecological phantom and a vaginal cylinder were modeled. The spatial distribution of absorbed dose rates in Uterine Cervical Cancer treatment through low dose rate brachytherapy was determined. A liquid water gynecology computational phantom, including a vaginal cylinder applicator made of Lucite, was designed. The applicator has a linear array of four radioactive sources of Cesium 137. Around the vaginal cylinder, 13 water spherical cells of 0.5 cm-diameter were modeled to calculate absorbed dose emulating the procedure made by the treatment planning system. The gamma-ray fluence distribution was estimated, as well as the absorbed doses resulting approximately symmetrical for cells located at upper and lower of vaginal cylinder. Obtained results allow the use of the radioactive decay law to determine dose rate for Uterine Cervical Cancer using low dose rate brachytherapy. Copyright © 2018 Elsevier Ltd. All rights reserved.

MO-F-16A-01: Implementation of MPPG TPS Verification Tests On Various Accelerators

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

Smilowitz, J; Bredfeldt, J; Geurts, M

2014-06-15

Purpose: To demonstrate the implementation of the Medical Physics Practice Guideline (MPPG) for dose calculation and beam parameters verification of treatment planning systems (TPS). Methods: We implemented the draft TPS MPPG for three linacs: Varian Trilogy, TomoHDA and Elekta Infinity. Static and modulated test plans were created. The static fields are different than used in commissioning. Data was collected using ion chambers and diodes in a scanning water tank, Delta4 phantom and a custom phantom. MatLab and Microsoft Excel were used to create analysis tools to compare reference DICOM dose with scan data. This custom code allowed for the interpolation,more » registration and gamma analysis of arbitrary dose profiles. It will be provided as open source code. IMRT fields were validated with Delta4 registration and comparison tools. The time for each task was recorded. Results: The tests confirmed the strengths, and revealed some limitations, of our TPS. The agreement between calculated and measured dose was reported for all beams. For static fields, percent depth dose and profiles were analyzed with criteria in the draft MPPG. The results reveal areas of slight mismatch with the model (MLC leaf penumbra, buildup region.) For TomoTherapy, the IMRT plan 2%/2 mm gamma analysis revealed poorest agreement in the low dose regions. For one static test plan for all 10MV Trilogy photon beams, the plan generation, scan queue creation, data collection, data analysis and report took 2 hours, excluding tank setup. Conclusions: We have demonstrated the implementation feasibility of the TPS MPPG. This exercise generated an open source tool for dose comparisons between scan data and DICOM dose data. An easily reproducible and efficient infrastructure with streamlined data collection was created for repeatable robust testing of the TPS. The tests revealed minor discrepancies in our models and areas for improvement that are being investigated.« less

Combined Edition of Family Planning Library Manual and Family Planning Classification.

ERIC Educational Resources Information Center

Planned Parenthood--World Population, New York, NY. Katherine Dexter McCormick Library.

This edition combines two previous publications of the Katharine Dexter McCormick Library into one volume: the Family Planning Library Manual, a guide for starting a family planning and population library or information center, and the Family Planning Classification, a coding system for organizing book and non-book materials so that they can be…

Current and planned numerical development for improving computing performance for long duration and/or low pressure transients

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

Faydide, B.

1997-07-01

This paper presents the current and planned numerical development for improving computing performance in case of Cathare applications needing real time, like simulator applications. Cathare is a thermalhydraulic code developed by CEA (DRN), IPSN, EDF and FRAMATOME for PWR safety analysis. First, the general characteristics of the code are presented, dealing with physical models, numerical topics, and validation strategy. Then, the current and planned applications of Cathare in the field of simulators are discussed. Some of these applications were made in the past, using a simplified and fast-running version of Cathare (Cathare-Simu); the status of the numerical improvements obtained withmore » Cathare-Simu is presented. The planned developments concern mainly the Simulator Cathare Release (SCAR) project which deals with the use of the most recent version of Cathare inside simulators. In this frame, the numerical developments are related with the speed up of the calculation process, using parallel processing and improvement of code reliability on a large set of NPP transients.« less

Next-generation acceleration and code optimization for light transport in turbid media using GPUs

PubMed Central

Alerstam, Erik; Lo, William Chun Yip; Han, Tianyi David; Rose, Jonathan; Andersson-Engels, Stefan; Lilge, Lothar

2010-01-01

A highly optimized Monte Carlo (MC) code package for simulating light transport is developed on the latest graphics processing unit (GPU) built for general-purpose computing from NVIDIA - the Fermi GPU. In biomedical optics, the MC method is the gold standard approach for simulating light transport in biological tissue, both due to its accuracy and its flexibility in modelling realistic, heterogeneous tissue geometry in 3-D. However, the widespread use of MC simulations in inverse problems, such as treatment planning for PDT, is limited by their long computation time. Despite its parallel nature, optimizing MC code on the GPU has been shown to be a challenge, particularly when the sharing of simulation result matrices among many parallel threads demands the frequent use of atomic instructions to access the slow GPU global memory. This paper proposes an optimization scheme that utilizes the fast shared memory to resolve the performance bottleneck caused by atomic access, and discusses numerous other optimization techniques needed to harness the full potential of the GPU. Using these techniques, a widely accepted MC code package in biophotonics, called MCML, was successfully accelerated on a Fermi GPU by approximately 600x compared to a state-of-the-art Intel Core i7 CPU. A skin model consisting of 7 layers was used as the standard simulation geometry. To demonstrate the possibility of GPU cluster computing, the same GPU code was executed on four GPUs, showing a linear improvement in performance with an increasing number of GPUs. The GPU-based MCML code package, named GPU-MCML, is compatible with a wide range of graphics cards and is released as an open-source software in two versions: an optimized version tuned for high performance and a simplified version for beginners (http://code.google.com/p/gpumcml). PMID:21258498

Drug overdose surveillance using hospital discharge data.

PubMed

Slavova, Svetla; Bunn, Terry L; Talbert, Jeffery

2014-01-01

We compared three methods for identifying drug overdose cases in inpatient hospital discharge data on their ability to classify drug overdoses by intent and drug type(s) involved. We compared three International Classification of Diseases, Ninth Revision, Clinical Modification code-based case definitions using Kentucky hospital discharge data for 2000-2011. The first definition (Definition 1) was based on the external-cause-of-injury (E-code) matrix. The other two definitions were based on the Injury Surveillance Workgroup on Poisoning (ISW7) consensus recommendations for national and state poisoning surveillance using the principal diagnosis or first E-code (Definition 2) or any diagnosis/E-code (Definition 3). Definition 3 identified almost 50% more drug overdose cases than did Definition 1. The increase was largely due to cases with a first-listed E-code describing a drug overdose but a principal diagnosis that was different from drug overdose (e.g., mental disorders, or respiratory or circulatory system failure). Regardless of the definition, more than 53% of the hospitalizations were self-inflicted drug overdoses; benzodiazepines were involved in about 30% of the hospitalizations. The 2011 age-adjusted drug overdose hospitalization rate in Kentucky was 146/100,000 population using Definition 3 and 107/100,000 population using Definition 1. The ISW7 drug overdose definition using any drug poisoning diagnosis/E-code (Definition 3) is potentially the highest sensitivity definition for counting drug overdose hospitalizations, including by intent and drug type(s) involved. As the states enact policies and plan for adequate treatment resources, standardized drug overdose definitions are critical for accurate reporting, trend analysis, policy evaluation, and state-to-state comparison.

28 CFR 54.230 - Transition plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN... Interagency Committee on Education Code of the educational institution submitting such plan, the... bind the institution to all actions set forth in the plan. (2) State whether the educational...

7 CFR 15a.18 - Transition plans.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Office of the Secretary of Agriculture EDUCATION PROGRAMS OR ACTIVITIES RECEIVING OR BENEFITTING FROM... of Education, a transition plan shall: (1) State the name, address, and Federal Interagency Committee on Education (FICE) Code of the educational institution submitting such plan, the administratively...

22 CFR 229.230 - Transition plans.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION... Secretary of Education, a transition plan shall: (1) State the name, address, and Federal Interagency Committee on Education Code of the educational institution submitting such plan, the administratively...

AUSTRALIAN COMPETITION AND CONSUMER COMMISSION v ACN 117 372 915: SHOULD CONSUMER LAW REGULATE DOCTOR-PATIENT RELATIONS IN A CORPORATISED HEALTH CARE SYSTEM?

PubMed

Wallace, Jessica; Pyman, Ella; Faunce, Thomas

2015-09-01

In April 2015, North J of the Federal Court of Australia made a finding of unconscionable conduct against Advanced Medical Institute, a promoter and provider of erectile dysfunction treatment, in a case concerning unfair contract terms (Australian Competition and Consumer Commission vACN 117 372 915 Pty Ltd (in liq) (formerly Advanced Medical Institute Pty Ltd) [2015] FCA 368). The contract required a minimum 12-month commitment, with costs exceeding treatments available from general practitioners, and made refunds available only after all possible treatment plans were exhausted which included penile injections. This column analyses that case, particularly in respect to the consumer law standards of practice under which it was litigated. Those standards refer to patients as "consumers" yet North J made extensive reference to the Good Medical Practice: A Code of Conduct for Doctors in Australia, a text which refers to "patients", as evidence of what constitutes appropriate professional conduct or practice for the health profession. This column considers whether legislative and judicial categorisation of patients (a class of people presumptively suffering, sick and vulnerable) as "consumers" undermines the formal and informal protections accorded to patients under normative systems of medical ethics such as those represented by the Code. The case, it is argued, also illuminates the contemporary tensions between the ethical, legal and human rights standards required of doctors in their treatment of patients and the commercial interests of businesses.

75 FR 46903 - Notice of Proposed Changes to the National Handbook of Conservation Practices for the Natural...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-04

... Treatment (Code 521D), Pond Sealing or Lining--Soil Dispersant Treatment (Code 521B), Salinity and Sodic Soil Management (Code 610), Stream Habitat Improvement and Management (Code 395), Vertical Drain (Code... the criteria section; an expansion of the considerations section to include fish and wildlife and soil...

Utilization of recently developed codes for high power Brayton and Rankine cycle power systems

NASA Technical Reports Server (NTRS)

Doherty, Michael P.

1993-01-01

Two recently developed FORTRAN computer codes for high power Brayton and Rankine thermodynamic cycle analysis for space power applications are presented. The codes were written in support of an effort to develop a series of subsystem models for multimegawatt Nuclear Electric Propulsion, but their use is not limited just to nuclear heat sources or to electric propulsion. Code development background, a description of the codes, some sample input/output from one of the codes, and state future plans/implications for the use of these codes by NASA's Lewis Research Center are provided.

Study of the impact of artificial articulations on the dose distribution under medical irradiation

NASA Astrophysics Data System (ADS)

Buffard, E.; Gschwind, R.; Makovicka, L.; Martin, E.; Meunier, C.; David, C.

2005-02-01

Perturbations due to the presence of high density heterogeneities in the body are not correctly taken into account in the Treatment Planning Systems currently available for external radiotherapy. For this reason, the accuracy of the dose distribution calculations has to be improved by using Monte Carlo simulations. In a previous study, we established a theoretical model by using the Monte Carlo code EGSnrc [I. Kawrakow, D.W.O. Rogers, The EGSnrc code system: MC simulation of electron and photon transport. Technical Report PIRS-701, NRCC, Ottawa, Canada, 2000] in order to obtain the dose distributions around simple heterogeneities. These simulations were then validated by experimental results obtained with thermoluminescent dosemeters and an ionisation chamber. The influence of samples composed of hip prostheses materials (titanium alloy and steel) and a substitute of bone were notably studied. A more complex model was then developed with the Monte Carlo code BEAMnrc [D.W.O. Rogers, C.M. MA, G.X. Ding, B. Walters, D. Sheikh-Bagheri, G.G. Zhang, BEAMnrc Users Manual. NRC Report PPIRS 509(a) rev F, 2001] in order to take into account the hip prosthesis geometry. The simulation results were compared to experimental measurements performed in a water phantom, in the case of a standard treatment of a pelvic cancer for one of the beams passing through the implant. These results have shown the great influence of the prostheses on the dose distribution.

40 CFR 52.824 - Original identification of plan section.

Code of Federal Regulations, 2014 CFR

2014-07-01

... rules, “Iowa Administrative Code,” effective February 22, 1995. This revision approves new definitions... definition updates. (E) “Iowa Administrative Code,” section 567-31.1, effective February 22, 1995. This rule... Quality and replaced the Iowa air pollution control statute which appeared as Chapter 136B of the Code of...

40 CFR 52.824 - Original identification of plan section.

Code of Federal Regulations, 2011 CFR

2011-07-01

... rules, “Iowa Administrative Code,” effective February 22, 1995. This revision approves new definitions... definition updates. (E) “Iowa Administrative Code,” section 567-31.1, effective February 22, 1995. This rule... Quality and replaced the Iowa air pollution control statute which appeared as Chapter 136B of the Code of...

40 CFR 52.824 - Original identification of plan section.

Code of Federal Regulations, 2013 CFR

2013-07-01

... rules, “Iowa Administrative Code,” effective February 22, 1995. This revision approves new definitions... definition updates. (E) “Iowa Administrative Code,” section 567-31.1, effective February 22, 1995. This rule... Quality and replaced the Iowa air pollution control statute which appeared as Chapter 136B of the Code of...

40 CFR 52.824 - Original identification of plan section.

Code of Federal Regulations, 2012 CFR

2012-07-01

... rules, “Iowa Administrative Code,” effective February 22, 1995. This revision approves new definitions... definition updates. (E) “Iowa Administrative Code,” section 567-31.1, effective February 22, 1995. This rule... Quality and replaced the Iowa air pollution control statute which appeared as Chapter 136B of the Code of...

40 CFR 52.1570 - Identification of plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

... regulation, section 7:1-3.1 of New Jersey Air Pollution Control Code, submitted on November 20, 1973, by the... regulation, section 7:27-2.1 of the New Jersey Air Pollution Control Code, submitted on November 19, 1975, by... and Prohibition of Air Pollution by Volatile Organic Substances,” New Jersey Administrative Code (N.J...

40 CFR 52.1570 - Identification of plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

... regulation, section 7:1-3.1 of New Jersey Air Pollution Control Code, submitted on November 20, 1973, by the... regulation, section 7:27-2.1 of the New Jersey Air Pollution Control Code, submitted on November 19, 1975, by... and Prohibition of Air Pollution by Volatile Organic Substances,” New Jersey Administrative Code (N.J...

40 CFR 52.1570 - Identification of plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

... regulation, section 7:1-3.1 of New Jersey Air Pollution Control Code, submitted on November 20, 1973, by the... regulation, section 7:27-2.1 of the New Jersey Air Pollution Control Code, submitted on November 19, 1975, by... and Prohibition of Air Pollution by Volatile Organic Substances,” New Jersey Administrative Code (N.J...

Utilizing codes of ethics in health professions education.

PubMed

Dahnke, Michael D

2014-10-01

Codes of ethics abound in health care, the aims and purposes of which are multiple and varied, from operating as a decision making tool to acting as a standard of practice that can be operational in a legal context to providing a sense of elevated seriousness and professionalism within a field of practice. There is some doubt and controversy, however, regarding the value and use of these codes both in professional practice and in the education of healthcare professionals. I intend to review and analyze the various aims and purposes of ethics codes particularly within the study and practice of healthcare in light of various criticisms of codes of ethics. After weighing the strength and import of these criticisms, I plan to explore effective means for utilizing such codes as part of the ethics education of healthcare professionals. While noting significant limitations of this tool, both in practice and in education, I plan to demonstrate its potential usefulness as well, in both generating critical thinking within the study of ethics and as a guide for practice for the professional.

Clean Energy in City Codes: A Baseline Analysis of Municipal Codification across the United States

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

Cook, Jeffrey J.; Aznar, Alexandra; Dane, Alexander

Municipal governments in the United States are well positioned to influence clean energy (energy efficiency and alternative energy) and transportation technology and strategy implementation within their jurisdictions through planning, programs, and codification. Municipal governments are leveraging planning processes and programs to shape their energy futures. There is limited understanding in the literature related to codification, the primary way that municipal governments enact enforceable policies. The authors fill the gap in the literature by documenting the status of municipal codification of clean energy and transportation across the United States. More directly, we leverage online databases of municipal codes to develop nationalmore » and state-specific representative samples of municipal governments by population size. Our analysis finds that municipal governments with the authority to set residential building energy codes within their jurisdictions frequently do so. In some cases, communities set codes higher than their respective state governments. Examination of codes across the nation indicates that municipal governments are employing their code as a policy mechanism to address clean energy and transportation.« less

Improving accuracy of clinical coding in surgery: collaboration is key.

PubMed

Heywood, Nick A; Gill, Michael D; Charlwood, Natasha; Brindle, Rachel; Kirwan, Cliona C

2016-08-01

Clinical coding data provide the basis for Hospital Episode Statistics and Healthcare Resource Group codes. High accuracy of this information is required for payment by results, allocation of health and research resources, and public health data and planning. We sought to identify the level of accuracy of clinical coding in general surgical admissions across hospitals in the Northwest of England. Clinical coding departments identified a total of 208 emergency general surgical patients discharged between 1st March and 15th August 2013 from seven hospital trusts (median = 20, range = 16-60). Blinded re-coding was performed by a senior clinical coder and clinician, with results compared with the original coding outcome. Recorded codes were generated from OPCS-4 & ICD-10. Of all cases, 194 of 208 (93.3%) had at least one coding error and 9 of 208 (4.3%) had errors in both primary diagnosis and primary procedure. Errors were found in 64 of 208 (30.8%) of primary diagnoses and 30 of 137 (21.9%) of primary procedure codes. Median tariff using original codes was £1411.50 (range, £409-9138). Re-calculation using updated clinical codes showed a median tariff of £1387.50, P = 0.997 (range, £406-10,102). The most frequent reasons for incorrect coding were "coder error" and a requirement for "clinical interpretation of notes". Errors in clinical coding are multifactorial and have significant impact on primary diagnosis, potentially affecting the accuracy of Hospital Episode Statistics data and in turn the allocation of health care resources and public health planning. As we move toward surgeon specific outcomes, surgeons should increase collaboration with coding departments to ensure the system is robust. Copyright © 2016 Elsevier Inc. All rights reserved.

STAR-CCM+ Verification and Validation Plan

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

Pointer, William David

2016-09-30

The commercial Computational Fluid Dynamics (CFD) code STAR-CCM+ provides general purpose finite volume method solutions for fluid dynamics and energy transport. This document defines plans for verification and validation (V&V) of the base code and models implemented within the code by the Consortium for Advanced Simulation of Light water reactors (CASL). The software quality assurance activities described herein are port of the overall software life cycle defined in the CASL Software Quality Assurance (SQA) Plan [Sieger, 2015]. STAR-CCM+ serves as the principal foundation for development of an advanced predictive multi-phase boiling simulation capability within CASL. The CASL Thermal Hydraulics Methodsmore » (THM) team develops advanced closure models required to describe the subgrid-resolution behavior of secondary fluids or fluid phases in multiphase boiling flows within the Eulerian-Eulerian framework of the code. These include wall heat partitioning models that describe the formation of vapor on the surface and the forces the define bubble/droplet dynamic motion. The CASL models are implemented as user coding or field functions within the general framework of the code. This report defines procedures and requirements for V&V of the multi-phase CFD capability developed by CASL THM. Results of V&V evaluations will be documented in a separate STAR-CCM+ V&V assessment report. This report is expected to be a living document and will be updated as additional validation cases are identified and adopted as part of the CASL THM V&V suite.« less

Poster - Thur Eve - 06: Comparison of an open source genetic algorithm to the commercially used IPSA for generation of seed distributions in LDR prostate brachytherapy.

PubMed

McGeachy, P; Khan, R

2012-07-01

In early stage prostate cancer, low dose rate (LDR) prostate brachytherapy is a favorable treatment modality, where small radioactive seeds are permanently implanted throughout the prostate. Treatment centres currently rely on a commercial optimization algorithm, IPSA, to generate seed distributions for treatment plans. However, commercial software does not allow the user access to the source code, thus reducing the flexibility for treatment planning and impeding any implementation of new and, perhaps, improved clinical techniques. An open source genetic algorithm (GA) has been encoded in MATLAB to generate seed distributions for a simplified prostate and urethra model. To assess the quality of the seed distributions created by the GA, both the GA and IPSA were used to generate seed distributions for two clinically relevant scenarios and the quality of the GA distributions relative to IPSA distributions and clinically accepted standards for seed distributions was investigated. The first clinically relevant scenario involved generating seed distributions for three different prostate volumes (19.2 cc, 32.4 cc, and 54.7 cc). The second scenario involved generating distributions for three separate seed activities (0.397 mCi, 0.455 mCi, and 0.5 mCi). Both GA and IPSA met the clinically accepted criteria for the two scenarios, where distributions produced by the GA were comparable to IPSA in terms of full coverage of the prostate by the prescribed dose, and minimized dose to the urethra, which passed straight through the prostate. Further, the GA offered improved reduction of high dose regions (i.e hot spots) within the planned target volume. © 2012 American Association of Physicists in Medicine.

A Strategic Plan for Integrating ICD-10 in Your Practice and Workflow.

PubMed

Bowman, Sue; Cleland, Risë Marie; Staggs, Stuart

2015-01-01

The adoption of the International Classification of Disease (ICD) 10th Revision (ICD-10) diagnosis code set in the United States has been legislatively delayed several times with the most recent date for implementation set for October 1, 2015. The transition from ICD-9 to ICD-10 will be a major undertaking that will require a substantial amount of planning. In the following article, we outline the steps to develop and implement a strategic plan for the transition to the new code set, identify training needs throughout the practice, and review the challenges and opportunities associated with the transition to ICD-10.

NEAMS SOFTWARE V&V PLAN FOR THE MARMOT SOFTWARE

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

Michael R Tonks

2014-03-01

In order to ensure the accuracy and quality of the microstructure based materials models being developed in conjunction with MARMOT simulations, MARMOT must undergo exhaustive verification and validation. Only after this process can we confidently rely on the MARMOT code to predict the microstructure evolution within the fuel. Therefore, in this report we lay out a V&V plan for the MARMOT code, highlighting where existing data could be used and where new data is required.

Top 10 Tips for Using Advance Care Planning Codes in Palliative Medicine and Beyond.

PubMed

Jones, Christopher A; Acevedo, Jean; Bull, Janet; Kamal, Arif H

2016-12-01

Although recommended for all persons with serious illness, advance care planning (ACP) has historically been a charitable clinical service. Inadequate or unreliable provisions for reimbursement, among other barriers, have spurred a gap between the evidence demonstrating the importance of timely ACP and recognition by payers for its delivery. 1 For the first time, healthcare is experiencing a dramatic shift in billing codes that support increased care management and care coordination. ACP, chronic care management, and transitional care management codes are examples of this newer recognition of the value of these types of services. ACP discussions are an integral component of comprehensive, high-quality palliative care delivery. The advent of reimbursement mechanisms to recognize these services has an enormous potential to impact palliative care program sustainability and growth. In this article, we highlight 10 tips to effectively using the new ACP codes reimbursable under Medicare. The importance of documentation, proper billing, and nuances regarding coding is addressed.

Top 10 Tips for Using Advance Care Planning Codes in Palliative Medicine and Beyond

PubMed Central

Acevedo, Jean; Bull, Janet; Kamal, Arif H.

2016-01-01

Abstract Although recommended for all persons with serious illness, advance care planning (ACP) has historically been a charitable clinical service. Inadequate or unreliable provisions for reimbursement, among other barriers, have spurred a gap between the evidence demonstrating the importance of timely ACP and recognition by payers for its delivery.1 For the first time, healthcare is experiencing a dramatic shift in billing codes that support increased care management and care coordination. ACP, chronic care management, and transitional care management codes are examples of this newer recognition of the value of these types of services. ACP discussions are an integral component of comprehensive, high-quality palliative care delivery. The advent of reimbursement mechanisms to recognize these services has an enormous potential to impact palliative care program sustainability and growth. In this article, we highlight 10 tips to effectively using the new ACP codes reimbursable under Medicare. The importance of documentation, proper billing, and nuances regarding coding is addressed. PMID:27682147

MO-A-213-00: Economics Update

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

NONE

2015-06-15

The purpose of this session is to introduce attendees to the healthcare reimbursement system and how it applies to the clinical work of a Medical Physicist. This will include general information about the different categories of payers and payees, how work is described by CPT© codes, and how various payers set values for this work in different clinical settings. 2015 is a year of significant changes to the payment system. Many CPT© codes have been deleted and replaced with new CPT© codes. These codes define some of the most common work performed in our clinics including treatment planning and delivery.more » This presentation will describe what work is encompassed in these codes and will give attendees an overview of the changes for 2015 as they apply to radiation oncology. Finally, some insight into what can be expected during 2016 will be presented. This includes what information is typically released by the Centers for Medicaid & Medicare Services (CMS) during the year and how we as an organization respond. This will include ways members can interact with the AAPM professional economics committee and other resources members may find helpful. Learning Objectives: Basics of how Medicare is structured and how reimbursement rates are set. Basic understanding of proposed changes to the 2016 Medicare rules. What resources are available from the AAPM and how to interact with the professional economics committee. Ownership in pxAlpha, LLC, a medical device start up company.« less

MO-A-213-01: 2015 Economics Update Part 1

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

Dirksen, B.

2015-06-15

The purpose of this session is to introduce attendees to the healthcare reimbursement system and how it applies to the clinical work of a Medical Physicist. This will include general information about the different categories of payers and payees, how work is described by CPT© codes, and how various payers set values for this work in different clinical settings. 2015 is a year of significant changes to the payment system. Many CPT© codes have been deleted and replaced with new CPT© codes. These codes define some of the most common work performed in our clinics including treatment planning and delivery.more » This presentation will describe what work is encompassed in these codes and will give attendees an overview of the changes for 2015 as they apply to radiation oncology. Finally, some insight into what can be expected during 2016 will be presented. This includes what information is typically released by the Centers for Medicaid & Medicare Services (CMS) during the year and how we as an organization respond. This will include ways members can interact with the AAPM professional economics committee and other resources members may find helpful. Learning Objectives: Basics of how Medicare is structured and how reimbursement rates are set. Basic understanding of proposed changes to the 2016 Medicare rules. What resources are available from the AAPM and how to interact with the professional economics committee. Ownership in pxAlpha, LLC, a medical device start up company.« less

MO-A-213-02: 2015 Economics Update Part 2

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

Fontenot, J.

2015-06-15

The purpose of this session is to introduce attendees to the healthcare reimbursement system and how it applies to the clinical work of a Medical Physicist. This will include general information about the different categories of payers and payees, how work is described by CPT© codes, and how various payers set values for this work in different clinical settings. 2015 is a year of significant changes to the payment system. Many CPT© codes have been deleted and replaced with new CPT© codes. These codes define some of the most common work performed in our clinics including treatment planning and delivery.more » This presentation will describe what work is encompassed in these codes and will give attendees an overview of the changes for 2015 as they apply to radiation oncology. Finally, some insight into what can be expected during 2016 will be presented. This includes what information is typically released by the Centers for Medicaid & Medicare Services (CMS) during the year and how we as an organization respond. This will include ways members can interact with the AAPM professional economics committee and other resources members may find helpful. Learning Objectives: Basics of how Medicare is structured and how reimbursement rates are set. Basic understanding of proposed changes to the 2016 Medicare rules. What resources are available from the AAPM and how to interact with the professional economics committee. Ownership in pxAlpha, LLC, a medical device start up company.« less

Perception of dental illness among persons receiving public assistance in Montreal.

PubMed

Bedos, Christophe; Brodeur, Jean-Marc; Levine, Alissa; Richard, Lucie; Boucheron, Laurence; Mereus, Witnisse

2005-08-01

We examined rationales for behaviors related to dental care among persons receiving public assistance in Montreal, Quebec. Fifty-seven persons receiving public assistance participated in 8 focus groups conducted in 2002. Sessions were recorded on audiotape and transcribed; analyses included debriefing sessions and coding and interpreting transcribed data. In the absence of dental pain and any visible cavity, persons receiving public assistance believed they were free of dental illness. However, they knew that dental pain signals a pathological process that progressively leads to tooth decay and, therefore, should be treated by a dentist. However, when in pain, despite recognizing that they needed professional treatment, they preferred to wait and suffer because of a fear of painful dental treatments and a reluctance to undertake certain procedures. Persons receiving public assistance have perceptions about dental health and illness that prevent them from receiving early treatment for tooth decay, which may lead to disagreements with dentists when planning dental treatments.

140. ARAIII Grading and drainage plan showing plot plan, including ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

140. ARA-III Grading and drainage plan showing plot plan, including berms around waste storage tank and fuel oil storage tank. Aerojet-general 880-area-GCRE-101-1. Date: February 1958. Ineel index code no. 063-0101-00-013-102507. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

12 CFR 221.119 - Applicability of plan-lender provisions to financing of stock options and stock purchase rights...

Code of Federal Regulations, 2010 CFR

2010-01-01

... experience that in some nonqualified plans, particularly stock purchase plans, the credit arrangement is... financing of stock options and stock purchase rights qualified or restricted under Internal Revenue Code... PURCHASING OR CARRYING MARGIN STOCK (REGULATION U) Interpretations § 221.119 Applicability of plan-lender...

Succession Planning in the Iranian Health System: A Case Study of the Ministry of Health and Medical Education

PubMed Central

Mehrtak, Mohamad; Vatankhah, Soodabeh; Delgoshaei, Bahram; Gholipour, Arian

2014-01-01

Background: Succession planning promotes the culture of private ownership, staff loyalty to the organization and develops organizational commitment, and increases organizational stability. The study was conducted to examine the status of succession planning in the Iranian health system in order to highlight the key concepts, provide new insight, and attract the attention of senior managers of the Ministry of Health and Medical Education to the importance of succession planning in achieving organizational goals. Methods: In a qualitative study with a framework analysis approach, semi-structured interviews were conducted with a sample selected using purposive and snowball sampling procedure. The MAXQDA-10 was used to apply the codes and manage the data. The codes were extracted using inductive and deductive methods. Results: Fourteen themes and six main subthemes were identified, including planning, organizational culture, system approach, competency model, career path, and senior managers. Our findings indicate a lack of succession planning in the Iranian health system. Conclusion: lack of succession planning could lead to inefficiency and ineffectiveness in health services provision. Implementation of succession planning could maximize human resources utilization. PMID:25168998

Succession planning in the Iranian health system: a case study of the Ministry of Health and Medical Education.

PubMed

Mehrtak, Mohamad; Vatankhah, Soodabeh; Delgoshaei, Bahram; Gholipour, Arian

2014-05-30

Succession planning promotes the culture of private ownership, staff loyalty to the organization and develops organizational commitment, and increases organizational stability. The study was conducted to examine the status of succession planning in the Iranian health system in order to highlight the key concepts, provide new insight, and attract the attention of senior managers of the Ministry of Health and Medical Education to the importance of succession planning in achieving organizational goals. In a qualitative study with a framework analysis approach, semi-structured interviews were conducted with a sample selected using purposive and snowball sampling procedure. The MAXQDA-10 was used to apply the codes and manage the data. The codes were extracted using inductive and deductive methods. Fourteen themes and six main subthemes were identified, including planning, organizational culture, system approach, competency model, career path, and senior managers. Our findings indicate a lack of succession planning in the Iranian health system. lack of succession planning could lead to inefficiency and ineffectiveness in health services provision. Implementation of succession planning could maximize human resources utilization.

78 FR 31584 - Notice of Proposed Amendment to Prohibited Transaction Exemption 80-26 (PTE 80-26) For Certain...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

...This document contains a notice of pendency before the Department of Labor (the Department) of a proposed amendment to PTE 80- 26. PTE 80-26 is a class exemption that permits parties in interest with respect to employee benefit plans to make certain interest free loans and extensions of credit to such plans, provided the conditions of the exemption are met. The proposed amendment, if adopted, would give retroactive and temporary exemptive relief for certain guarantees of the payment of debits to plan investment accounts (including IRAs) by parties in interest to such plans as well as certain loans and loan repayments made pursuant to such guarantees. The proposed amendment would affect employee benefit plans described in section 3(3) of the Employee Retirement Income Security Act of 1974, as amended (ERISA or the Act), and plans described in section 4975(e)(1) of the Internal Revenue Code of 1986, as amended (the Code), the participants and beneficiaries of such plans, and parties in interest with respect to those plans engaging in the described transactions.

Relevance of stroke code, stroke unit and stroke networks in organization of acute stroke care--the Madrid acute stroke care program.

PubMed

Alonso de Leciñana-Cases, María; Gil-Núñez, Antonio; Díez-Tejedor, Exuperio

2009-01-01

Stroke is a neurological emergency. The early administration of specific treatment improves the prognosis of the patients. Emergency care systems with early warning for the hospital regarding patients who are candidates for this treatment (stroke code) increases the number of patients treated. Currently, reperfusion via thrombolysis for ischemic stroke and attention in stroke units are the bases of treatment. Healthcare professionals and health provision authorities need to work together to organize systems that ensure continuous quality care for the patients during the whole process of their disease. To implement this, there needs to be an appropriate analysis of the requirements and resources with the objective of their adjustment for efficient use. It is necessary to provide adequate information and continuous training for all professionals who are involved in stroke care, including primary care physicians, extrahospital emergency teams and all physicians involved in the care of stroke patients within the hospital. The neurologist has the function of coordinating the protocols of intrahospital care. These organizational plans should also take into account the process beyond the acute phase, to ensure the appropriate application of measures of secondary prevention, rehabilitation, and chronic care of the patients that remain in a dependent state. We describe here the stroke care program in the Community of Madrid (Spain). (c) 2009 S. Karger AG, Basel.

Evaluation of audit-based performance measures for dental care plans.

PubMed

Bader, J D; Shugars, D A; White, B A; Rindal, D B

1999-01-01

Although a set of clinical performance measures, i.e., a report card for dental plans, has been designed for use with administrative data, most plans do not have administrative data systems containing the data needed to calculate the measures. Therefore, we evaluated the use of a set of proxy clinical performance measures calculated from data obtained through chart audits. Chart audits were conducted in seven dental programs--three public health clinics, two dental health maintenance organizations (DHMO), and two preferred provider organizations (PPO). In all instances audits were completed by clinical staff who had been trained using telephone consultation and a self-instructional audit manual. The performance measures were calculated for the seven programs, audit reliability was assessed in four programs, and for one program the audit-based proxy measures were compared to the measures calculated using administrative data. The audit-based measures were sensitive to known differences in program performance. The chart audit procedures yielded reasonably reliable data. However, missing data in patient charts rendered the calculation of some measures problematic--namely, caries and periodontal disease assessment and experience. Agreement between administrative and audit-based measures was good for most, but not all, measures in one program. The audit-based proxy measures represent a complex but feasible approach to the calculation of performance measures for those programs lacking robust administrative data systems. However, until charts contain more complete diagnostic information (i.e., periodontal charting and diagnostic codes or reason-for-treatment codes), accurate determination of these aspects of clinical performance will be difficult.

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

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

Jensen, C; Palma, B; Qu, B

2014-06-01

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

Designing insurance to promote use of childhood obesity prevention services.

PubMed

Rask, Kimberly J; Gazmararian, Julie A; Kohler, Susan S; Hawley, Jonathan N; Bogard, Jenny; Brown, Victoria A

2013-01-01

Childhood obesity is a recognized public health crisis. This paper reviews the lessons learned from a voluntary initiative to expand insurance coverage for childhood obesity prevention and treatment services in the United States. In-depth telephone interviews were conducted with key informants from 16 participating health plans and employers in 2010-11. Key informants reported difficulty ensuring that both providers and families were aware of the available services. Participating health plans and employers are beginning new tactics including removing enrollment requirements, piloting enhanced outreach to selected physician practices, and educating providers on effective care coordination and use of obesity-specific billing codes through professional organizations. The voluntary initiative successfully increased private health insurance coverage for obesity services, but the interviews described variability in implementation with both best practices and barriers identified. Increasing utilization of obesity-related health services in the long term will require both family- and provider-focused interventions in partnership with improved health insurance coverage.

Measurement of charge- and mass-changing cross sections for 4He+12C collisions in the energy range 80-220 MeV/u for applications in ion beam therapy

NASA Astrophysics Data System (ADS)

Horst, Felix; Schuy, Christoph; Weber, Uli; Brinkmann, Kai-Thomas; Zink, Klemens

2017-08-01

4He ions are considered to be used for hadron radiotherapy due to their favorable physical and radiobiological properties. For an accurate dose calculation the fragmentation of the primary 4He ions occurring as a result of nuclear collisions must be taken into account. Therefore precise nuclear reaction models need to be implemented in the radiation transport codes used for dose calculation. A fragmentation experiment using thin graphite targets was conducted at the Heidelberg Ion Beam Therapy Center (HIT) to obtain new and precise 4He-nucleus cross section data in the clinically relevant energy range. Measured values for the charge-changing cross section, mass-changing cross section, as well as the inclusive 3He production cross section for 4He+12C collisions at energies between 80 and 220 MeV /u are presented. These data are compared to the 4He-nucleus reaction model by DeVries and Peng as well as to the parametrizations by Tripathi et al. and by Cucinotta et al., which are implemented in the treatment planning code trip98 and several other radiation transport codes.

Civil Behavior, Safe-School Planning, and Dress Codes

ERIC Educational Resources Information Center

Studak, Cathryn M.; Workman, Jane E.

2007-01-01

This research examined news reports in order to identify incidents that precipitated dress code revisions. News reports were examined within the framework of rules for civil behavior. Using key words "school dress codes" and "violence," LEXIS/NEXIS was used to access 104 articles from 44 U.S. newspapers from December 3, 2004 to December 2, 2005.…

SU-F-J-99: Dose Accumulation and Evaluation in Lung SBRT Among All Phases of Respiration

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

Azcona, JD; Barbes, B; Aristu, J

Purpose: To calculate the total planning dose on lung tumors (GTV) by accumulating the dose received in all respiration phases. Methods: A patient 4D planning CT (phase-binned, from a Siemens Somatom CT) was used to locate the GTV of a lung tumor in all respiratory phases with Pinnacle (v9.10). GTV contours defined in all phases were projected to the reference phase, where the ITV was defined. Centroids were calculated for all the GTV projections. No deformation or rotation was taken into account. The only GTV contour as defined in the reference phase was voxelized to track each voxel individually. Wemore » accumulated the absorbed dose in different phases on each voxel. A 3DCRT and a VMAT plan were designed on the reference phase fulfilling the ITV dosimetric requirements, using the 10MV FFF photon model from an Elekta Versa linac. ITV-to-PTV margins were set to 5mm. In-house developed MATLAB code was used for tumor voxeling and dose accumulation, assuming that the dose distribution planned in the reference phase behaved as a “dose-cloud” during patient breathing. Results: We tested the method on a patient 4DCT set of images exhibiting limited tumor motion (<5mm). For the 3DCRT plan, D95 was calculated for the GTV with motion and for the ITV, showing an agreement of 0.04%. For the VMAT plan, we calculated the D95 for every phase as if the GTV in that phase had received the whole treatment. Differences in D95 for all phases are within 1%, and estimate the potential interplay effect during delivery. Conclusion: A method for dose accumulation and assessment was developed that can compare GTV motion with ITV dosage, and estimate the potential interplay effect for VMAT plans. Work in progress includes the incorporation of deformable image registration and 4D CBCT dose calculation for dose reconstruction and assessment during treatment.« less

MO-F-CAMPUS-T-05: Correct Or Not to Correct for Rotational Patient Set-Up Errors in Stereotactic Radiosurgery

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

Briscoe, M; Ploquin, N; Voroney, JP

2015-06-15

Purpose: To quantify the effect of patient rotation in stereotactic radiation therapy and establish a threshold where rotational patient set-up errors have a significant impact on target coverage. Methods: To simulate rotational patient set-up errors, a Matlab code was created to rotate the patient dose distribution around the treatment isocentre, located centrally in the lesion, while keeping the structure contours in the original locations on the CT and MRI. Rotations of 1°, 3°, and 5° for each of the pitch, roll, and yaw, as well as simultaneous rotations of 1°, 3°, and 5° around all three axes were applied tomore » two types of brain lesions: brain metastasis and acoustic neuroma. In order to analyze multiple tumour shapes, these plans included small spherical (metastasis), elliptical (acoustic neuroma), and large irregular (metastasis) tumour structures. Dose-volume histograms and planning target volumes were compared between the planned patient positions and those with simulated rotational set-up errors. The RTOG conformity index for patient rotation was also investigated. Results: Examining the tumour volumes that received 80% of the prescription dose in the planned and rotated patient positions showed decreases in prescription dose coverage of up to 2.3%. Conformity indices for treatments with simulated rotational errors showed decreases of up to 3% compared to the original plan. For irregular lesions, degradation of 1% of the target coverage can be seen for rotations as low as 3°. Conclusions: This data shows that for elliptical or spherical targets, rotational patient set-up errors less than 3° around any or all axes do not have a significant impact on the dose delivered to the target volume or the conformity index of the plan. However the same rotational errors would have an impact on plans for irregular tumours.« less

[Evaluation of therapeutical appropriateness in psychiatric treatment of schizophrenia, by integrating computer data records with clinical audit results].

PubMed

Farina, Giuseppina; Menditto, Enrica; Corea, Gabriella; Manna, Sonia; Pagliaro, Claudia; Troncone, Chiara; Linguiti, Claudio; Orlando, Valentina; Putignano, Daria; Tari, Daniele Ugo; Buffardi, Gianfranco

2015-01-01

The aim is to evaluate prescriptive patterns of atypical antipsychotic drugs for the treatment of schizophrenia in the LHU Caserta in 2011-2013, and to indicate potentially inappropriate therapy; to plan or schedule corrective/preventive activities to support the continuous improvement of health services. Retrospective cohort study, based on integration of health records and clinical audit. The study was performed in the following steps: data retrieval and analysis; comparison of data with international literature; editing of the Diagnostic-Therapeutic Path. The analysis was performed by using the administrative database of drug prescriptions and treatment plans in the SANIARP portal, a web platform available to specialist facilities and private and public pharmacies of LHU Caserta. The subject of our analysis was to gain information about the diagnosis and treatment of users of atypical antipsychotics in the LHU of Caserta in the years 2011-2013. We identified 2,768 patients with at least one prescription of atypical antipsychotics and diagnosis coded in the study period. Schizophrenia is the most frequent diagnosis (31.1%) and the most common drug in use is olanzapine (29.1%). About 70% of schizophrenics were on monotherapy with no change in drug, 23.6% were under polytherapy and 7.9% made a switch. Our findings were a starting point for editing Diagnostic and Therapeutic Paths aimed at raising the awareness of the scientific community about the appropriateness of diagnosis and treatment in schizophrenia. Pharmacological treatment of schizophrenia should be focused on improving the overall quality of life aimed at remission and possible recovery, although difficult.

SU-F-T-364: Monte Carlo-Dose Verification of Volumetric Modulated Arc Therapy Plans Using AAPM TG-119 Test Patterns

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

Onizuka, R; Araki, F; Ohno, T

2016-06-15

Purpose: To investigate the Monte Carlo (MC)-based dose verification for VMAT plans by a treatment planning system (TPS). Methods: The AAPM TG-119 test structure set was used for VMAT plans by the Pinnacle3 (convolution/superposition), using a Synergy radiation head of a 6 MV beam with the Agility MLC. The Synergy was simulated with the EGSnrc/BEAMnrc code, and VMAT dose distributions were calculated with the EGSnrc/DOSXYZnrc code by the same irradiation conditions as TPS. VMAT dose distributions of TPS and MC were compared with those of EBT3 film, by 2-D gamma analysis of ±3%/3 mm criteria with a threshold of 30%more » of prescribed doses. VMAT dose distributions between TPS and MC were also compared by DVHs and 3-D gamma analysis of ±3%/3 mm criteria with a threshold of 10%, and 3-D passing rates for PTVs and OARs were analyzed. Results: TPS dose distributions differed from those of film, especially for Head & neck. The dose difference between TPS and film results from calculation accuracy for complex motion of MLCs like tongue and groove effect. In contrast, MC dose distributions were in good agreement with those of film. This is because MC can model fully the MLC configuration and accurately reproduce the MLC motion between control points in VMAT plans. D95 of PTV for Prostate, Head & neck, C-shaped, and Multi Target was 97.2%, 98.1%, 101.6%, and 99.7% for TPS and 95.7%, 96.0%, 100.6%, and 99.1% for MC, respectively. Similarly, 3-D gamma passing rates of each PTV for TPS vs. MC were 100%, 89.5%, 99.7%, and 100%, respectively. 3-D passing rates of TPS reduced for complex VMAT fields like Head & neck because MLCs are not modeled completely for TPS. Conclusion: MC-calculated VMAT dose distributions is useful for the 3-D dose verification of VMAT plans by TPS.« less

Resistance is Futile: STScI's Science Planning and Scheduling Team Switches From VMS to Unix Operations

NASA Astrophysics Data System (ADS)

Adler, D. S.

2000-12-01

The Science Planning and Scheduling Team (SPST) of the Space Telescope Science Institute (STScI) has historically operated exclusively under VMS. Due to diminished support for VMS-based platforms at STScI, SPST is in the process of transitioning to Unix operations. In the summer of 1999, SPST selected Python as the primary scripting language for the operational tools and began translation of the VMS DCL code. As of October 2000, SPST has installed a utility library of 16 modules consisting of 8000 lines of code and 80 Python tools consisting of 13000 lines of code. All tasks related to calendar generation have been switched to Unix operations. Current work focuses on translating the tools used to generate the Science Mission Specifications (SMS). The software required to generate the Mission Schedule and Command Loads (PASS), maintained by another team at STScI, will take longer to translate than the rest of the SPST operational code. SPST is planning on creating tools to access PASS from Unix in the short term. We are on schedule to complete the work needed to fully transition SPST to Unix operations (while remotely accessing PASS on VMS) by the fall of 2001.

29 CFR 4281.18 - Outstanding claims for withdrawal liability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INSOLVENCY, REORGANIZATION, TERMINATION, AND OTHER RULES APPLICABLE TO MULTIEMPLOYER PLANS DUTIES OF PLAN... in insolvency proceedings. The plan sponsor shall value an outstanding claim for withdrawal liability... title 11, United States Code, or any case or proceeding under similar provisions of state insolvency...

Hepatitis C: Treatment

MedlinePlus

... Public Home » Hepatitis C » Hepatitis C Treatment Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For ... Enter ZIP code here Enter ZIP code here Hepatitis C Treatment for Veterans and the Public Treatment ...

Planning perception and action for cognitive mobile manipulators

NASA Astrophysics Data System (ADS)

Gaschler, Andre; Nogina, Svetlana; Petrick, Ronald P. A.; Knoll, Alois

2013-12-01

We present a general approach to perception and manipulation planning for cognitive mobile manipulators. Rather than hard-coding single purpose robot applications, a robot should be able to reason about its basic skills in order to solve complex problems autonomously. Humans intuitively solve tasks in real-world scenarios by breaking down abstract problems into smaller sub-tasks and use heuristics based on their previous experience. We apply a similar idea for planning perception and manipulation to cognitive mobile robots. Our approach is based on contingent planning and run-time sensing, integrated in our knowledge of volumes" planning framework, called KVP. Using the general-purpose PKS planner, we model information-gathering actions at plan time that have multiple possible outcomes at run time. As a result, perception and sensing arise as necessary preconditions for manipulation, rather than being hard-coded as tasks themselves. We demonstrate the e ectiveness of our approach on two scenarios covering visual and force sensing on a real mobile manipulator.

Comparison study on flexible pavement design using FAA (Federal Aviation Administration) and LCN (Load Classification Number) code in Ahmad Yani international airport’s runway

NASA Astrophysics Data System (ADS)

Santoso, S. E.; Sulistiono, D.; Mawardi, A. F.

2017-11-01

FAA code for airport design has been broadly used by Indonesian Ministry of Aviation since decades ago. However, there is not much comprehensive study about its relevance and efficiency towards current situation in Indonesia. Therefore, a further comparison study on flexible pavement design for airport runway using comparable method has become essential. The main focus of this study is to compare which method between FAA and LCN that offer the most efficient and effective way in runway pavement planning. The comparative methods in this study mainly use the variety of variable approach. FAA code for instance, will use the approach on the aircraft’s maximum take-off weight and annual departure. Whilst LCN code use the variable of equivalent single wheel load and tire pressure. Based on the variables mentioned above, a further classification and rated method will be used to determine which code is best implemented. According to the analysis, it is clear that FAA method is the most effective way to plan runway design in Indonesia with consecutively total pavement thickness of 127cm and LCN method total pavement thickness of 70cm. Although, FAA total pavement is thicker that LCN its relevance towards sustainable and pristine condition in the future has become an essential aspect to consider in design and planning.

Comparison of optimized single and multifield irradiation plans of antiproton, proton and carbon ion beams.

PubMed

Bassler, Niels; Kantemiris, Ioannis; Karaiskos, Pantelis; Engelke, Julia; Holzscheiter, Michael H; Petersen, Jørgen B

2010-04-01

Antiprotons have been suggested as a possibly superior modality for radiotherapy, due to the energy released when antiprotons annihilate, which enhances the Bragg peak and introduces a high-LET component to the dose. However, concerns are expressed about the inferior lateral dose distribution caused by the annihilation products. We use the Monte Carlo code FLUKA to generate depth-dose kernels for protons, antiprotons, and carbon ions. Using these we then build virtual treatment plans optimized according to ICRU recommendations for the different beam modalities, which then are recalculated with FLUKA. Dose-volume histograms generated from these plans can be used to compare the different irradiations. The enhancement in physical and possibly biological dose from annihilating antiprotons can significantly lower the dose in the entrance channel; but only at the expense of a diffuse low dose background from long-range secondary particles. Lateral dose distributions are improved using active beam delivery methods, instead of flat fields. Dose-volume histograms for different treatment scenarios show that antiprotons have the potential to reduce the volume of normal tissue receiving medium to high dose, however, in the low dose region antiprotons are inferior to both protons and carbon ions. This limits the potential usage to situations where dose to normal tissue must be reduced as much as possible. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

SHIELD-HIT12A - a Monte Carlo particle transport program for ion therapy research

NASA Astrophysics Data System (ADS)

Bassler, N.; Hansen, D. C.; Lühr, A.; Thomsen, B.; Petersen, J. B.; Sobolevsky, N.

2014-03-01

Purpose: The Monte Carlo (MC) code SHIELD-HIT simulates the transport of ions through matter. Since SHIELD-HIT08 we added numerous features that improves speed, usability and underlying physics and thereby the user experience. The "-A" fork of SHIELD-HIT also aims to attach SHIELD-HIT to a heavy ion dose optimization algorithm to provide MC-optimized treatment plans that include radiobiology. Methods: SHIELD-HIT12A is written in FORTRAN and carefully retains platform independence. A powerful scoring engine is implemented scoring relevant quantities such as dose and track-average LET. It supports native formats compatible with the heavy ion treatment planning system TRiP. Stopping power files follow ICRU standard and are generated using the libdEdx library, which allows the user to choose from a multitude of stopping power tables. Results: SHIELD-HIT12A runs on Linux and Windows platforms. We experienced that new users quickly learn to use SHIELD-HIT12A and setup new geometries. Contrary to previous versions of SHIELD-HIT, the 12A distribution comes along with easy-to-use example files and an English manual. A new implementation of Vavilov straggling resulted in a massive reduction of computation time. Scheduled for later release are CT import and photon-electron transport. Conclusions: SHIELD-HIT12A is an interesting alternative ion transport engine. Apart from being a flexible particle therapy research tool, it can also serve as a back end for a MC ion treatment planning system. More information about SHIELD-HIT12A and a demo version can be found on http://www.shieldhit.org.

37. ELECTRICAL PLAN AND DETAILS. SHOWS PLANNED LOCATION OF PORTABLE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

37. ELECTRICAL PLAN AND DETAILS. SHOWS PLANNED LOCATION OF PORTABLE GENERATOR. FUNCTION OF FOUR-FOOT SQUARE PIT IS SHOWN AS 'D.C. POWER SUPPLY PIT.' F.C. TORKELSON DRAWING NUMBER 842-ARVFS-701-E-1. INEL INDEX CODE NUMBER: 075 0701 10 851 151973. - Idaho National Engineering Laboratory, Advanced Reentry Vehicle Fusing System, Scoville, Butte County, ID

9 CFR 590.146 - Application for continuous inspection in official plants; approval.

Code of Federal Regulations, 2010 CFR

2010-01-01

... copies of each print drawing as specified in this section of the complete floor plan, plot plan... zip code or an accurate description of the location. (3) Plot plan of entire premises shall include..., and vehicular loading areas. The plot plan may be drawn to a scale of one-thirty-second inch per foot...

MO-FG-303-06: Evaluation of the Performance of Very High-Energy Electron (VHEE) Beams in Radiotherapy: Five Clinical Cases

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

Palma, B; Bazalova-Carter, M; Qu, B

Purpose: To evaluate the performance of 100–120 MeV very-high energy electron (VHEE) scanning pencil beams to radiotherapy by means of Monte Carlo (MC) simulations. Methods: We selected five clinical cases with target sizes of 1.2 cm{sup 3} to 990.4 cm{sup 3}. We calculated VHEE treatment plans using the MC EGSnrc code implemented in a MATLAB-based graphical user interface developed by our group. We generated phase space data for beam energies: 100 and 120 MeV and pencil beam spot sizes of 1, 3, and 5 mm at FWHM. The number of equidistant beams considered in this work was 16 or 32.more » Dose was calculated and then imported into a research version of RayStation where treatment plan optimization was performed. We compared the VHEE plans with the clinically delivered volumetric modulated arc therapy (VMAT) plan to evaluate VHEE plans performance. Results: VHEE plans provided the same PTV coverage and dose homogeneity than VMAT plans for all the cases. In average, the mean dose to organs at risk (OARs) was 24% lower for the VHEE plans. The structures that benefited the most from using VHEE were: large bowel for the esophagus case, chest wall for the liver case, brainstem for the acoustic case, carina for the lung case, and genitalia for the anal case, with 23.7–34.6% lower dose. VHEE dose distributions were more conformal than VMAT solution as confirmed by conformity indices CI100 and CI50. Integral dose to the body was in average 19.6% (9.2%–36.5%) lower for the VHEE plans. Conclusion: We have shown that VHEE plans resulted in similar or superior dose distributions compared to clinical VMAT plans for five different cases and a wide range of target volumes, including a case with a small target (1.2 cm{sup 3}), which represents a challenge for VMAT planning and might require the use of more complex non-coplanar VMAT plans. B Palma: None. M Bazalova: None. B Hardemark: Employee, RaySearch Laboratories AB. E Hynning: Employee, RaySearch Laboratories AB. B Qu: None. B Loo Jr.: Research support, RaySearch, Varian. P Maxim: Research support, RaySearch, Varian.« less

School Emergency Planning Guide. [Revised.

ERIC Educational Resources Information Center

Pennsylvania State Emergency Management Agency, Harrisburg.

Guidelines to help school districts in Pennsylvania recognize potential hazards and develop a plan of community action are presented in this guidebook. The 1988 Emergency Management Services Code requires that every publicly funded state school have a disaster response plan that is exercised annually. Further, all publicly funded educational…

42 CFR 422.4 - Types of MA plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... availability, service area, and quality. (ii) Coordinated care plans may include mechanisms to control... requirements of sections 138 and 220 of the Internal Revenue Code. (3) MA private fee-for-service plan. An MA... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...

32 CFR 634.24 - Traffic planning and codes.

Code of Federal Regulations, 2014 CFR

2014-07-01

... use of primary and secondary roads. Circulation planning should be a major part of all long-range... using planned direction, including measures for special events and adverse road or weather conditions... or wardens, including trained school-crossing guards. (4) Use of traffic control signs and devices...

32 CFR 634.24 - Traffic planning and codes.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and most efficient use of primary and secondary roads. Circulation planning should be a major part of... control of traffic using planned direction, including measures for special events and adverse road or... traffic directors or wardens, including trained school-crossing guards. (4) Use of traffic control signs...

32 CFR 634.24 - Traffic planning and codes.

Code of Federal Regulations, 2012 CFR

2012-07-01

... use of primary and secondary roads. Circulation planning should be a major part of all long-range... using planned direction, including measures for special events and adverse road or weather conditions... or wardens, including trained school-crossing guards. (4) Use of traffic control signs and devices...

32 CFR 634.24 - Traffic planning and codes.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and most efficient use of primary and secondary roads. Circulation planning should be a major part of... control of traffic using planned direction, including measures for special events and adverse road or... traffic directors or wardens, including trained school-crossing guards. (4) Use of traffic control signs...

78 FR 55103 - Notice of Proposed Exemption involving AT&T Inc. (Together With AT&T Inc.'s Affiliates, AT&T or...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-09

...This document contains a notice of pendency before the Department of Labor (the Department) of a proposed individual exemption from certain prohibited transaction restrictions of the Employee Retirement Income Security Act of 1974, as amended (ERISA or the Act), and the Internal Revenue Code of 1986, as amended (the Code). The proposed transactions involve AT&T, the AT&T Pension Benefit Plan (the Plan), and the SBC Master Pension Trust (the Trust). The proposed exemption, if granted, would affect the Plan and its participants and beneficiaries. Effective Date: If granted, this proposed exemption will be effective as of September 1, 2013.

76 FR 14083 - Proposed Exemptions From Certain Prohibited Transaction Restrictions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-15

...This document contains notices of pendency before the Department of Labor (the Department) of proposed exemptions from certain of the prohibited transaction restrictions of the Employee Retirement Income Security Act of 1974 (ERISA or the Act) and/or the Internal Revenue Code of 1986 (the Code). This notice includes the following proposed exemptions: D-11468 & D-11469 The Krispy Kreme Doughnut Corporation Retirement Savings Plan, The Krispy Kreme Profit- Sharing Stock Ownership Plan; D-11632 Millenium Trust Co. LLC, Custodian FBO William Etherington IRA; D-11642 H-E-B Brand Savings & Retirement Plan and H.E. Butt Grocery Company; and L-11625 The International Union of Painters and Allied Trades Finishing Institute.

Methodology, status, and plans for development and assessment of the RELAP5 code

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

Johnson, G.W.; Riemke, R.A.

1997-07-01

RELAP/MOD3 is a computer code used for the simulation of transients and accidents in light-water nuclear power plants. The objective of the program to develop and maintain RELAP5 was and is to provide the U.S. Nuclear Regulatory Commission with an independent tool for assessing reactor safety. This paper describes code requirements, models, solution scheme, language and structure, user interface validation, and documentation. The paper also describes the current and near term development program and provides an assessment of the code`s strengths and limitations.

VICTORIA: A mechanistic model for radionuclide behavior in the reactor coolant system

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

Schaperow, J.H.; Bixler, N.E.

1996-12-31

VICTORIA is the U.S. Nuclear Regulatory Commission`s (NRC`s) mechanistic, best-estimate code for analysis of fission product release from the core and subsequent transport in the reactor vessel and reactor coolant system. VICTORIA requires thermal-hydraulic data (i.e., temperatures, pressures, and velocities) as input. In the past, these data have been taken from the results of calculations from thermal-hydraulic codes such as SCDAP/RELAP5, MELCOR, and MAAP. Validation and assessment of VICTORIA 1.0 have been completed. An independent peer review of VICTORIA, directed by Brookhaven National Laboratory and supported by experts in the areas of fuel release, fission product chemistry, and aerosol physics,more » has been undertaken. This peer review, which will independently assess the code`s capabilities, is nearing completion with the peer review committee`s final report expected in Dec 1996. A limited amount of additional development is expected as a result of the peer review. Following this additional development, the NRC plans to release VICTORIA 1.1 and an updated and improved code manual. Future plans mainly involve use of the code for plant calculations to investigate specific safety issues as they arise. Also, the code will continue to be used in support of the Phebus experiments.« less

RMP Guidance for Warehouses - Appendix A/B: 40 CFR part 68/Selected NAICS Codes

EPA Pesticide Factsheets

These appendices contain the full text of 40 Code of Federal Regulations Part 68, Chemical Accident Prevention Provisions; which includes hazard assessment, emergency response, substance thresholds, reporting requirements, and the Risk Management Plan.

A Varian DynaLog file-based procedure for patient dose-volume histogram-based IMRT QA.

PubMed

Calvo-Ortega, Juan F; Teke, Tony; Moragues, Sandra; Pozo, Miquel; Casals-Farran, Joan

2014-03-06

In the present study, we describe a method based on the analysis of the dynamic MLC log files (DynaLog) generated by the controller of a Varian linear accelerator in order to perform patient-specific IMRT QA. The DynaLog files of a Varian Millennium MLC, recorded during an IMRT treatment, can be processed using a MATLAB-based code in order to generate the actual fluence for each beam and so recalculate the actual patient dose distribution using the Eclipse treatment planning system. The accuracy of the DynaLog-based dose reconstruction procedure was assessed by introducing ten intended errors to perturb the fluence of the beams of a reference plan such that ten subsequent erroneous plans were generated. In-phantom measurements with an ionization chamber (ion chamber) and planar dose measurements using an EPID system were performed to investigate the correlation between the measured dose changes and the expected ones detected by the reconstructed plans for the ten intended erroneous cases. Moreover, the method was applied to 20 cases of clinical plans for different locations (prostate, lung, breast, and head and neck). A dose-volume histogram (DVH) metric was used to evaluate the impact of the delivery errors in terms of dose to the patient. The ionometric measurements revealed a significant positive correlation (R² = 0.9993) between the variations of the dose induced in the erroneous plans with respect to the reference plan and the corresponding changes indicated by the DynaLog-based reconstructed plans. The EPID measurements showed that the accuracy of the DynaLog-based method to reconstruct the beam fluence was comparable with the dosimetric resolution of the portal dosimetry used in this work (3%/3 mm). The DynaLog-based reconstruction method described in this study is a suitable tool to perform a patient-specific IMRT QA. This method allows us to perform patient-specific IMRT QA by evaluating the result based on the DVH metric of the planning CT image (patient DVH-based IMRT QA).

Logical qubit fusion

NASA Astrophysics Data System (ADS)

Moussa, Jonathan; Ryan-Anderson, Ciaran

The canonical modern plan for universal quantum computation is a Clifford+T gate set implemented in a topological error-correcting code. This plan has the basic disparity that logical Clifford gates are natural for codes in two spatial dimensions while logical T gates are natural in three. Recent progress has reduced this disparity by proposing logical T gates in two dimensions with doubled, stacked, or gauge color codes, but these proposals lack an error threshold. An alternative universal gate set is Clifford+F, where a fusion (F) gate converts two logical qubits into a logical qudit. We show that logical F gates can be constructed by identifying compatible pairs of qubit and qudit codes that stabilize the same logical subspace, much like the original Bravyi-Kitaev construction of magic state distillation. The simplest example of high-distance compatible codes results in a proposal that is very similar to the stacked color code with the key improvement of retaining an error threshold. Sandia National Labs is a multi-program laboratory managed and operated by Sandia Corp, a wholly owned subsidiary of Lockheed Martin Corp, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000.

Technology Development for Human Exploration Beyond LEO in the New Millennium IAA-13-3 Strategies and Plans for Human Mars Missions

NASA Technical Reports Server (NTRS)

Larson, William E.; Lueck, Dale E.; Parrish, Clyde F.; Sanders, Gerald B.; Trevathan, Joseph R.; Baird, R. Scott; Simon, Tom; Peters, T.; Delgado, H. (Technical Monitor)

2001-01-01

As we look forward into the new millennium, the extension of human presence beyond Low-Earth Orbit (LEO) looms large in the plans of NASA. The Agency's Strategic Plan specifically calls out the need to identify and develop technologies for 100 and 1000-day class missions beyond LEO. To meet the challenge of these extended duration missions, it is important that we learn how to utilize the indigenous resources available to us on extraterrestrial bodies. This concept, known as In-Situ Resource Utilization (ISRU) can greatly reduce the launch mass & cost of human missions while reducing the risk. These technologies may also pave the way for the commercial development of space. While no specific target beyond LEO is identified in NASA's Strategic Plan, mission architecture studies have been on-going for the Moon, Mars, Near-Earth Asteroids and Earth/Moon & Earth/Sun Libration Points. As a result of these studies, the NASA Office of Space Flight (Code M) through the Johnson and Kennedy Space Centers, is leading the effort to develop ISRU technologies and systems to meet the current and future needs of human missions beyond LEO and on to Mars. This effort also receives support from the NASA Office of Biological and Physical Research (Code U), the Office of Space Science (Code S), and the Office of Aerospace Technology (Code R). This paper will present unique developments in the area of fuel and oxidizer production, breathing air production, water production, C02 collection, separation of atmospheric gases, and gas liquefaction and storage. A technology overview will be provided for each topic along with the results achieved to date, future development plans, and the mission architectures that these technologies support.

40 CFR 62.8102 - Identification of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) APPROVAL AND PROMULGATION OF STATE PLANS FOR DESIGNATED FACILITIES AND POLLUTANTS New York Sulfuric Acid... Plants” of Title 6 of the New York Code of Rules and Regulations effective May 10, 1984. (2) Supplemental...

40 CFR 85.1803 - Remedial Plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... POLLUTION FROM MOBILE SOURCES Recall Regulations § 85.1803 Remedial Plan. (a) When any manufacturer is... the total parts requirement of each person who is to perform the repair under the remedial plan to be...: (i) The recall campaign number; and (ii) A code designating the campaign facility at which the repair...

75 FR 20942 - Approval and Promulgation of Air Quality Implementation Plans; New Mexico; Transportation...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-22

... Promulgation of Air Quality Implementation Plans; New Mexico; Transportation Conformity Requirement for... proposing to approve a revision to the New Mexico State Implementation Plan (SIP) at New Mexico Administrative Code 20.11.3, concerning transportation conformity rules for Bernalillo County, New Mexico. The...

The K-ABC, Coding, and Planning: An Investigation of Cognitive Processes.

ERIC Educational Resources Information Center

Das, J. P.; And Others

1990-01-01

Evaluated elementary school students (N=198) using six mental processing subtests of the Kaufman Assessment Battery for Children (K-ABC) and three tests of planning. Results indicated orthogonal simultaneous and sequential factors emerged; the verbal simultaneous test was a good addition; and a "planning" factor identified by three…

40 CFR 62.8102 - Identification of plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Mist Emissions from Existing Sulfuric Acid Plants § 62.8102 Identification of plan. (a) [Reserved] (b... Plants” of Title 6 of the New York Code of Rules and Regulations effective May 10, 1984. (2) Supplemental information submitted on March 29, 1985. (c) Identification of sources. The plan includes the following plants...

40 CFR 62.8102 - Identification of plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Mist Emissions from Existing Sulfuric Acid Plants § 62.8102 Identification of plan. (a) [Reserved] (b... Plants” of Title 6 of the New York Code of Rules and Regulations effective May 10, 1984. (2) Supplemental information submitted on March 29, 1985. (c) Identification of sources. The plan includes the following plants...

40 CFR 62.8102 - Identification of plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Mist Emissions from Existing Sulfuric Acid Plants § 62.8102 Identification of plan. (a) [Reserved] (b... Plants” of Title 6 of the New York Code of Rules and Regulations effective May 10, 1984. (2) Supplemental information submitted on March 29, 1985. (c) Identification of sources. The plan includes the following plants...

40 CFR 62.8102 - Identification of plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Mist Emissions from Existing Sulfuric Acid Plants § 62.8102 Identification of plan. (a) [Reserved] (b... Plants” of Title 6 of the New York Code of Rules and Regulations effective May 10, 1984. (2) Supplemental information submitted on March 29, 1985. (c) Identification of sources. The plan includes the following plants...

Drug Overdose Surveillance Using Hospital Discharge Data

PubMed Central

Bunn, Terry L.; Talbert, Jeffery

2014-01-01

Objectives We compared three methods for identifying drug overdose cases in inpatient hospital discharge data on their ability to classify drug overdoses by intent and drug type(s) involved. Methods We compared three International Classification of Diseases, Ninth Revision, Clinical Modification code-based case definitions using Kentucky hospital discharge data for 2000–2011. The first definition (Definition 1) was based on the external-cause-of-injury (E-code) matrix. The other two definitions were based on the Injury Surveillance Workgroup on Poisoning (ISW7) consensus recommendations for national and state poisoning surveillance using the principal diagnosis or first E-code (Definition 2) or any diagnosis/E-code (Definition 3). Results Definition 3 identified almost 50% more drug overdose cases than did Definition 1. The increase was largely due to cases with a first-listed E-code describing a drug overdose but a principal diagnosis that was different from drug overdose (e.g., mental disorders, or respiratory or circulatory system failure). Regardless of the definition, more than 53% of the hospitalizations were self-inflicted drug overdoses; benzodiazepines were involved in about 30% of the hospitalizations. The 2011 age-adjusted drug overdose hospitalization rate in Kentucky was 146/100,000 population using Definition 3 and 107/100,000 population using Definition 1. Conclusion The ISW7 drug overdose definition using any drug poisoning diagnosis/E-code (Definition 3) is potentially the highest sensitivity definition for counting drug overdose hospitalizations, including by intent and drug type(s) involved. As the states enact policies and plan for adequate treatment resources, standardized drug overdose definitions are critical for accurate reporting, trend analysis, policy evaluation, and state-to-state comparison. PMID:25177055

Monte Carlo characterization of materials for prosthetic implants and dosimetric validation of Pinnacle 3 TPS

NASA Astrophysics Data System (ADS)

Palleri, Francesca; Baruffaldi, Fabio; Angelini, Anna Lisa; Ferri, Andrea; Spezi, Emiliano

2008-12-01

In external beam radiotherapy the calculation of dose distribution for patients with hip prostheses is critical. Metallic implants not only degrade the image quality but also perturb the dose distribution. Conventional treatment planning systems do not accurately account for high-Z prosthetic implants heterogeneities, especially at interfaces. The materials studied in this work have been chosen on the basis of a statistical investigation on the hip prostheses implanted in 70 medical centres. The first aim of this study is a systematic characterization of materials used for hip prostheses, and it has been provided by BEAMnrc Monte Carlo code. The second aim is to evaluate the capabilities of a specific treatment planning system, Pinnacle 3, when dealing with dose calculations in presence of metals, also close to the regions of high-Z gradients. In both cases it has been carried out an accurate comparison versus experimental measurements for two clinical photon beam energies (6 MV and 18 MV) and for two experimental sets-up: metallic cylinders inserted in a water phantom and in a specifically built PMMA slab. Our results show an agreement within 2% between experiments and MC simulations. TPS calculations agree with experiments within 3%.

FY08 LDRD Final Report A New Method for Wave Propagation in Elastic Media LDRD Project Tracking Code: 05-ERD-079

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

Petersson, A

The LDRD project 'A New Method for Wave Propagation in Elastic Media' developed several improvements to the traditional finite difference technique for seismic wave propagation, including a summation-by-parts discretization which is provably stable for arbitrary heterogeneous materials, an accurate treatment of non-planar topography, local mesh refinement, and stable outflow boundary conditions. This project also implemented these techniques in a parallel open source computer code called WPP, and participated in several seismic modeling efforts to simulate ground motion due to earthquakes in Northern California. This research has been documented in six individual publications which are summarized in this report. Of thesemore » publications, four are published refereed journal articles, one is an accepted refereed journal article which has not yet been published, and one is a non-refereed software manual. The report concludes with a discussion of future research directions and exit plan.« less

What component of executive functions contributes to normal and impaired reading comprehension in young adults?

PubMed

Georgiou, George K; Das, J P

2016-01-01

The purpose of this study was two-fold: (a) to examine what component of executive functions (EF) - planning and working memory - predicts reading comprehension in young adults (Study 1), and (b) to examine if less skilled comprehenders experience deficits in the EF components (Study 2). In Study 1, we assessed 178 university students (120 females; mean age=21.82 years) on planning (Planned Connections, Planned Codes, and Planned Patterns), working memory (Listening Span, Digit Span Backward, and Digit Memory), and reading comprehension (Nelson-Denny Reading Test). The results of structural equation modeling indicated that only planning was a significant predictor of reading comprehension. In Study 2, we assessed 30 university students with a specific reading comprehension deficit (19 females; mean age=23.01 years) and 30 controls (18 females; mean age=22.77 years) on planning (Planned Connections and Crack the Code) and working memory (Listening Span and Digit Span Backward). The results showed that less skilled comprehenders performed significantly poorer than controls only in planning. Taken together, the findings of both studies suggest that planning is the preeminent component of EF that is driving its relationship with reading comprehension in young adults. Copyright © 2015 Elsevier Ltd. All rights reserved.

Paying for College: Prepaid Tuition and College Savings Plans. ERIC Digest.

ERIC Educational Resources Information Center

Loane, Shannon

To cover the costs of college, students and their families are using loans, grants, savings, and, increasingly, a specific type of college savings plan known as a "529." These planned are named after a Section of the Internal Revenue Code that confers tax exemption to qualified state tuition programs. There are two types of 529 plans:…

Parental Perspectives of Communication at the End of Life at a Pediatric Oncology Institution.

PubMed

Snaman, Jennifer M; Torres, Carlos; Duffy, Brian; Levine, Deena R; Gibson, Deborah V; Baker, Justin N

2016-03-01

The interaction of health care providers and hospital staff with patients and families at the end of life affects the parental grief experience. Both verbal and nonverbal communication are key components of this interaction. The study objective was to explore the communication between hospital staff members and patients and families at the time of patients' health decline near the end of life. Twelve bereaved parents participated in a focus group. Semantic content analysis was used to analyze the transcript. Parents' responses to the prompt about typical ways the medical team communicated yielded 109 codes, which were grouped into 12 themes. The most common themes were "patient inclusion" and "explanation of medical plan," both used in 17% of responses. Responses to the prompt about positive and negative aspects of communication generated 208 codes, yielding 15 different themes. The most common theme about positive communication was the "strong relationship between family and staff." The theme "variations in care with a negative impact" was used most frequently in describing negative communication. This study helps to identify techniques that should be used by clinicians as they work with children with cancer and their families, particularly including patients in treatment decisions, ongoing relationship building, communicating with caring and empathy, using an interdisciplinary team for additional support, and pairing bad news with a plan of action.

Code Sharing and Collaboration: Experiences from the Scientist's Expert Assistant Project and their Relevance to the Virtual Observatory

NASA Technical Reports Server (NTRS)

Jones, Jeremy; Grosvenor, Sandy; Wolf, Karl; Li, Connie; Koratkar, Anuradha; Powers, Edward I. (Technical Monitor)

2001-01-01

In the Virtual Observatory (VO), software tools will perform the functions that have traditionally been performed by physical observatories and their instruments. These tools will not be adjuncts to VO functionality but will make up the very core of the VO. Consequently, the tradition of observatory and system independent tools serving a small user base is not valid for the VO. For the VO to succeed, we must improve software collaboration and code sharing between projects and groups. A significant goal of the Scientist's Expert Assistant (SEA) project has been promoting effective collaboration and code sharing between groups. During the past three years, the SEA project has been developing prototypes for new observation planning software tools and strategies. Initially funded by the Next Generation Space Telescope, parts of the SEA code have since been adopted by the Space Telescope Science Institute. SEA has also supplied code for SOFIA, the SIRTF planning tools, and the JSky Open Source Java library. The potential benefits of sharing code are clear. The recipient gains functionality for considerably less cost. The provider gains additional developers working with their code. If enough users groups adopt a set of common code and tools, defacto standards can emerge (as demonstrated by the success of the FITS standard). Code sharing also raises a number of challenges related to the management of the code. In this talk, we will review our experiences with SEA - both successes and failures - and offer some lessons learned that may promote further successes in collaboration and re-use.

Code Sharing and Collaboration: Experiences From the Scientist's Expert Assistant Project and Their Relevance to the Virtual Observatory

NASA Technical Reports Server (NTRS)

Korathkar, Anuradha; Grosvenor, Sandy; Jones, Jeremy; Li, Connie; Mackey, Jennifer; Neher, Ken; Obenschain, Arthur F. (Technical Monitor)

2001-01-01

In the Virtual Observatory (VO), software tools will perform the functions that have traditionally been performed by physical observatories and their instruments. These tools will not be adjuncts to VO functionality but will make up the very core of the VO. Consequently, the tradition of observatory and system independent tools serving a small user base is not valid for the VO. For the VO to succeed, we must improve software collaboration and code sharing between projects and groups. A significant goal of the Scientist's Expert Assistant (SEA) project has been promoting effective collaboration and code sharing among groups. During the past three years, the SEA project has been developing prototypes for new observation planning software tools and strategies. Initially funded by the Next Generation Space Telescope, parts of the SEA code have since been adopted by the Space Telescope Science Institute. SEA has also supplied code for the SIRTF (Space Infrared Telescope Facility) planning tools, and the JSky Open Source Java library. The potential benefits of sharing code are clear. The recipient gains functionality for considerably less cost. The provider gains additional developers working with their code. If enough users groups adopt a set of common code and tools, de facto standards can emerge (as demonstrated by the success of the FITS standard). Code sharing also raises a number of challenges related to the management of the code. In this talk, we will review our experiences with SEA--both successes and failures, and offer some lessons learned that might promote further successes in collaboration and re-use.

Estimating Medicare and patient savings from the use of bevacizumab for the treatment of exudative age-related macular degeneration.

PubMed

Rosenfeld, Philip J; Windsor, Matthew A; Feuer, William J; Sun, Sissi J J; Frick, Kevin D; Swanson, Eric A; Huang, David

2018-04-12

The Medicare cost savings from the use of bevacizumab in the United States for the treatment of exudative age-related macular degeneration (AMD) were estimated by replacing the use of bevacizumab with ranibizumab and aflibercept. Retrospective trend study. Main outcome measures were spending by Medicare as tracked by Current Procedural Terminology (CPT) codes for intravitreal injections (67028) and treatment-specific J-codes (J0178, J2778, J9035, J3490 and J3590) for inhibitors of vascular endothelial growth factor. These claims were identified from the Medicare Provider Utilization and Payment Data from the Centers for Medicare and Medicaid Services among fee-for-service (FFS) Medicare beneficiaries from 2012 - 2015. The 2008 claims were acquired from the 100% fee-for-service (FFS) Part B Medicare Claims File. The use of bevacizumab from 2008 to 2015 resulted in an estimated savings of $17.3 billion, which corresponded to a $13.8 billion savings to Medicare and a $3.5 billion savings to patients. This amount underestimated the actual cost-savings to Medicare providers since approximately 30% of Medicare-eligible recipients received care within Medicare Advantage plans and were not included in this analysis. The cost savings from the use of bevacizumab from 2008-2015 for Medicare fee-for-service patients undergoing treatment for exudative AMD was estimated at $17.3 billion. Additional savings over the $17.3 billion would have accrued from the use of bevacizumab if diagnostic categories such as diabetic macular edema and retinal vein occlusion were included in this study. Copyright © 2018. Published by Elsevier Inc.

Development of practice principles for the management of ongoing suicidal ideation in young people diagnosed with major depressive disorder.

PubMed

Rice, Simon M; Simmons, Magenta B; Bailey, Alan P; Parker, Alexandra G; Hetrick, Sarah E; Davey, Christopher G; Phelan, Mark; Blaikie, Simon; Edwards, Jane

2014-01-01

There is a lack of clear guidance regarding the management of ongoing suicidality in young people experiencing major depressive disorder. This study utilised an expert consensus approach in identifying practice principles to complement relevant clinical guidelines for the treatment of major depressive disorder in young people. The study also sought to outline a broad treatment framework for clinical intervention with young people experiencing ongoing suicidal ideation. In-depth focus groups were undertaken with a specialist multidisciplinary clinical team (the Youth Mood Clinic at Orygen Youth Health Clinical Program, Melbourne) working with young people aged 15-25 years experiencing ongoing suicidal ideation. Each focus group was audio recorded and transcribed verbatim using orthographic conventions. Principles of grounded theory and thematic analysis were used to analyse and code the resultant data. The identified codes were subsequently synthesised into eight practice principles reflecting engagement and consistency of care, ongoing risk assessment and documentation, individualised crisis planning, engaging systems of support, engendering hopefulness, development of adaptive coping, management of acute risk, and consultation and supervision. The identified practice principles provide a broad management framework, and may assist to improve treatment consistency and clinical management of young people experiencing ongoing suicidal ideation. The practice principles may be of use to health professionals working within a team-based setting involved in the provision of care, even if peripherally, to young people with ongoing suicidal ideation. Findings address the lack of treatment consistency and shared terminology and may provide containment and guidance to multidisciplinary clinicians working with this at-risk group.

Annual Report of the ECSU Home-Institution Support Program (1993)

DTIC Science & Technology

1993-09-30

summer of 1992. Stephanie plans to attend graduate school at the University of Alabama at Birmingham. r 3 . Deborah Jones has attended the ISSP program for...computer equipment Component #2 A visiting lecturer series Component # 3 : Students pay & faculty release time Component #4 Student/sponsor travel program...DTXC QUA, ty rNpBT 3 S. 0. CODE: 1133 DISBURSING CODE: N001 79 AGO CODE: N66005 CAGE CODE: OJLKO 3 PART I: A succinct narrative which should

Psychometric challenges and proposed solutions when scoring facial emotion expression codes.

PubMed

Olderbak, Sally; Hildebrandt, Andrea; Pinkpank, Thomas; Sommer, Werner; Wilhelm, Oliver

2014-12-01

Coding of facial emotion expressions is increasingly performed by automated emotion expression scoring software; however, there is limited discussion on how best to score the resulting codes. We present a discussion of facial emotion expression theories and a review of contemporary emotion expression coding methodology. We highlight methodological challenges pertinent to scoring software-coded facial emotion expression codes and present important psychometric research questions centered on comparing competing scoring procedures of these codes. Then, on the basis of a time series data set collected to assess individual differences in facial emotion expression ability, we derive, apply, and evaluate several statistical procedures, including four scoring methods and four data treatments, to score software-coded emotion expression data. These scoring procedures are illustrated to inform analysis decisions pertaining to the scoring and data treatment of other emotion expression questions and under different experimental circumstances. Overall, we found applying loess smoothing and controlling for baseline facial emotion expression and facial plasticity are recommended methods of data treatment. When scoring facial emotion expression ability, maximum score is preferred. Finally, we discuss the scoring methods and data treatments in the larger context of emotion expression research.

Simulation of the Mg(Ar) ionization chamber currents by different Monte Carlo codes in benchmark gamma fields

NASA Astrophysics Data System (ADS)

Lin, Yi-Chun; Liu, Yuan-Hao; Nievaart, Sander; Chen, Yen-Fu; Wu, Shu-Wei; Chou, Wen-Tsae; Jiang, Shiang-Huei

2011-10-01

High energy photon (over 10 MeV) and neutron beams adopted in radiobiology and radiotherapy always produce mixed neutron/gamma-ray fields. The Mg(Ar) ionization chambers are commonly applied to determine the gamma-ray dose because of its neutron insensitive characteristic. Nowadays, many perturbation corrections for accurate dose estimation and lots of treatment planning systems are based on Monte Carlo technique. The Monte Carlo codes EGSnrc, FLUKA, GEANT4, MCNP5, and MCNPX were used to evaluate energy dependent response functions of the Exradin M2 Mg(Ar) ionization chamber to a parallel photon beam with mono-energies from 20 keV to 20 MeV. For the sake of validation, measurements were carefully performed in well-defined (a) primary M-100 X-ray calibration field, (b) primary 60Co calibration beam, (c) 6-MV, and (d) 10-MV therapeutic beams in hospital. At energy region below 100 keV, MCNP5 and MCNPX both had lower responses than other codes. For energies above 1 MeV, the MCNP ITS-mode greatly resembled other three codes and the differences were within 5%. Comparing to the measured currents, MCNP5 and MCNPX using ITS-mode had perfect agreement with the 60Co, and 10-MV beams. But at X-ray energy region, the derivations reached 17%. This work shows us a better insight into the performance of different Monte Carlo codes in photon-electron transport calculation. Regarding the application of the mixed field dosimetry like BNCT, MCNP with ITS-mode is recognized as the most suitable tool by this work.

Clinical Decision-Making in Community Children's Mental Health: Using Innovative Methods to Compare Clinicians With and Without Training in Evidence-Based Treatment.

PubMed

Baker-Ericzén, Mary J; Jenkins, Melissa M; Park, Soojin; Garland, Ann F

2015-02-01

Mental health professionals' decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. The present study explored the role of prior training in evidence-based treatments on clinicians' assessment and treatment formulations using case vignettes. Specifically, study aims included using the Naturalistic Decision Making (NDM) cognitive theory to 1) examine potential associations between EBT training and decision-making processes (novice versus expert type), and 2) explore how client and family contextual information affects clinical decision-making. Forty-eight clinicians across two groups (EBT trained=14, Not EBT trained=34) participated. Clinicians were comparable on professional experience, demographics, and discipline. The quasi-experimental design used an analog "think aloud" method where clinicians read case vignettes about a child with disruptive behavior problems and verbalized case conceptualization and treatment planning out-loud. Responses were coded according to NDM theory. MANOVA results were significant for EBT training status such that EBT trained clinicians' displayed cognitive processes more closely aligned with "expert" decision-makers and non-EBT trained clinicians' decision processes were more similar to "novice" decision-makers, following NDM theory. Non-EBT trained clinicians assigned significantly more diagnoses, provided less detailed treatment plans and discussed fewer EBTs. Parent/family contextual information also appeared to influence decision-making. This study offers a preliminary investigation of the possible broader impacts of EBT training and potential associations with development of expert decision-making skills. Targeting clinicians' decision-making may be an important avenue to pursue within dissemination-implementation efforts in mental health practice.

76 FR 70495 - Proposed Exemptions From Certain Prohibited Transaction Restrictions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-14

...This document contains notices of pendency before the Department of Labor (the Department) of proposed exemptions from certain of the prohibited transaction restrictions of the Employee Retirement Income Security Act of 1974 (ERISA or the Act) and/or the Internal Revenue Code of 1986 (the Code). This notice includes the following proposed exemptions: D-11637 HSBC-North America (U.S.) Tax Reduction Investment Plan; D-11679 Sammons Enterprises, Inc. Employee Stock Ownership ESOP; and D-11683 First Federal Bancshares of Arkansas, Inc. Employees' Savings and Profit Sharing Plan.

78 FR 47241 - Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Revise the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

...The Delaware River Basin Commission (``DRBC'' or ``Commission'') will hold a public hearing to receive comments on proposed amendments to the Commission's Water Quality Regulations, Water Code and Comprehensive Plan to revise the water quality criteria for polychlorinated biphenyls (``PCBs'') in the Delaware Estuary and Bay, DRBC Water Quality Management Zones 2 through 6, for the protection of human health from carcinogenic effects. The Commission will simultaneously solicit comment on a draft implementation strategy to support achievement of the criteria.

HIV/AIDS National Strategic Plans of Sub-Saharan African countries: an analysis for gender equality and sex-disaggregated HIV targets

PubMed Central

Sherwood, Jennifer; Sharp, Alana; Cooper, Bergen; Roose-Snyder, Beirne; Blumenthal, Susan

2017-01-01

Abstract National Strategic Plans (NSPs) for HIV/AIDS are country planning documents that set priorities for programmes and services, including a set of targets to quantify progress toward national and international goals. The inclusion of sex-disaggregated targets and targets to combat gender inequality is important given the high disease burden among young women and adolescent girls in Sub-Saharan Africa, yet no comprehensive gender-focused analysis of NSP targets has been performed. This analysis quantitatively evaluates national HIV targets, included in NSPs from eighteen Sub-Saharan African countries, for sex-disaggregation. Additionally, NSP targets aimed at reducing gender-based inequality in health outcomes are compiled and inductively coded to report common themes. On average, in the eighteen countries included in this analysis, 31% of NSP targets include sex-disaggregation (range 0–92%). Three countries disaggregated a majority (>50%) of their targets by sex. Sex-disaggregation in data reporting was more common for targets related to the early phases of the HIV care continuum: 83% of countries included any sex-disaggregated targets for HIV prevention, 56% for testing and linkage to care, 22% for improving antiretroviral treatment coverage, and 11% for retention in treatment. The most common target to reduce gender inequality was to prevent gender-based violence (present in 50% of countries). Other commonly incorporated target areas related to improving women’s access to family planning, human and legal rights, and decision-making power. The inclusion of sex-disaggregated targets in national planning is vital to ensure that programmes make progress for all population groups. Improving the availability and quality of indicators to measure gender inequality, as well as evaluating programme outcomes by sex, is critical to tracking this progress. This analysis reveals an urgent need to set specific and separate targets for men and women in order to achieve an equitable and effective HIV response and align government planning with international priorities for gender equality. PMID:28973358

47 CFR 52.19 - Area code relief.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) NUMBERING... commissions may perform any or all functions related to initiation and development of area code relief plans... paragraph (b)(2) of this section. For the purposes of this paragraph, initiation and development of area...

47 CFR 52.19 - Area code relief.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) NUMBERING... commissions may perform any or all functions related to initiation and development of area code relief plans... paragraph (b)(2) of this section. For the purposes of this paragraph, initiation and development of area...

47 CFR 52.19 - Area code relief.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) NUMBERING... commissions may perform any or all functions related to initiation and development of area code relief plans... paragraph (b)(2) of this section. For the purposes of this paragraph, initiation and development of area...

Tax policy as social policy: cafeteria plans, 1978-1985.

PubMed

Fox, D M; Schaffer, D C

1987-01-01

Since the passage of Section 125 of the Internal Revenue Code in 1978, cafeteria plans have offered employees a choice of tax-free fringe benefits. Although these plans have been popular with employers and employees, Treasury Department officials and many tax lawyers soon came to regard Section 125 as a mistake. The Treasury has tried to reclaim through regulation the revenue and the fundamental principles of tax law it had asked Congress to give away in 1978. This paper is a history of Section 125 that emphasizes its relationship to health policy. On the basis of interviews and printed primary sources, the paper argues that Treasury officials made a less than rigorous assessment of the impact of cafeteria plans because they were preoccupied with a larger agenda of making tax-free benefits more equitable. Moreover, they saw no reason to collaborate with the health policy community to plan this agenda; they saw themselves as implementing a social policy already in the Internal Revenue Code.

SU-F-19A-10: Recalculation and Reporting Clinical HDR 192-Ir Head and Neck Dose Distributions Using Model Based Dose Calculation

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

Carlsson Tedgren, A; Persson, M; Nilsson, J

Purpose: To retrospectively re-calculate dose distributions for selected head and neck cancer patients, earlier treated with HDR 192Ir brachytherapy, using Monte Carlo (MC) simulations and compare results to distributions from the planning system derived using TG43 formalism. To study differences between dose to medium (as obtained with the MC code) and dose to water in medium as obtained through (1) ratios of stopping powers and (2) ratios of mass energy absorption coefficients between water and medium. Methods: The MC code Algebra was used to calculate dose distributions according to earlier actual treatment plans using anonymized plan data and CT imagesmore » in DICOM format. Ratios of stopping power and mass energy absorption coefficients for water with various media obtained from 192-Ir spectra were used in toggling between dose to water and dose to media. Results: Differences between initial planned TG43 dose distributions and the doses to media calculated by MC are insignificant in the target volume. Differences are moderate (within 4–5 % at distances of 3–4 cm) but increase with distance and are most notable in bone and at the patient surface. Differences between dose to water and dose to medium are within 1-2% when using mass energy absorption coefficients to toggle between the two quantities but increase to above 10% for bone using stopping power ratios. Conclusion: MC predicts target doses for head and neck cancer patients in close agreement with TG43. MC yields improved dose estimations outside the target where a larger fraction of dose is from scattered photons. It is important with awareness and a clear reporting of absorbed dose values in using model based algorithms. Differences in bone media can exceed 10% depending on how dose to water in medium is defined.« less

26 CFR 1.614-4 - Treatment under the Internal Revenue Code of 1939 with respect to separate operating mineral...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Treatment under the Internal Revenue Code of 1939..., in the case of oil and gas wells. 1.614-4 Section 1.614-4 Internal Revenue INTERNAL REVENUE SERVICE....614-4 Treatment under the Internal Revenue Code of 1939 with respect to separate operating mineral...

42 CFR 423.128 - Dissemination of Part D plan information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... plan sponsor's toll free customer service line or by accessing the plan sponsor's internet Web site. (8... redetermination processes via an Internet Web site; and (iii) A system that transmits codes to network pharmacies...— (1) A toll-free customer call center that— (i) Is open during usual business hours. (ii) Provides...

78 FR 2694 - Meeting of the ACRS Subcommittee on Planning and Procedures; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-14

... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Planning and Procedures; Notice of Meeting The ACRS Subcommittee on Planning and Procedures..., Advisory Committee on Reactor Safeguards. [FR Doc. 2013-00543 Filed 1-11-13; 8:45 am] BILLING CODE 7590-01...

Athletic Facilities: Planning, Designing, and Operating Today's Physical-Education Centers.

ERIC Educational Resources Information Center

Spoor, Dana L.

1998-01-01

Examines what should be featured in an athletic facility, how to plan for the many different sports and activities that will be housed, and how to get the community involved. Areas addressed include planning for locker rooms and storage, flooring and lighting, building code adherence, spectator seating, building security, and outdoor recreation…

75 FR 73026 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Clean Air Interstate Rule

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-29

... Promulgation of Air Quality Implementation Plans; Indiana; Clean Air Interstate Rule AGENCY: Environmental... State Implementation Plan (SIP) under the Clean Air Act (CAA). The State has submitted amendments to the Indiana Administrative Code (IAC), which supplement Indiana's Clean Air Interstate Rule (CAIR), for which...

75 FR 6827 - Approval of Air Quality Implementation Plans; New Mexico; Albuquerque/Bernalillo County

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-11

... Quality Implementation Plans; New Mexico; Albuquerque/Bernalillo County AGENCY: Environmental Protection... Plan submitted by the Governor of New Mexico on May 24, 2006. The revisions address Title 20 of the New Mexico Administrative Code, Chapter 11, Part 102 (denoted 20.11.102 NMAC), which apply to oxygenated...

Stability and Change in Mother-Child Planning over Middle Childhood

ERIC Educational Resources Information Center

Gauvain, Mary; Perez, Susan M.; Reisz, Z.

2018-01-01

This longitudinal research examines maternal and child behaviors during joint planning over a 3-year period of middle childhood. 118 mother-child dyads were observed once a year beginning when the children were 8 years of age. Coding focused on mother and child planning behaviors, maternal instructional support, and child task engagement.…

MINIMUM CHECK LIST FOR MECHANICAL PLANS AND SPECIFICATIONS.

ERIC Educational Resources Information Center

PIERCE, J.L.

THIS BULLETIN HAS BEEN PREPARED FOR USE AS A MINIMUM CHECK LIST IN THE DEVELOPMENT AND REVIEW OF MECHANICAL AND ELECTRICAL PLANS AND SPECIFICATIONS BY ENGINEERS, ARCHITECTS, AND SUPERINTENDENTS IN PLANNING PUBLIC SCHOOL FACILITIES. THREE LEVELS OF GUIDELINES ARE MENTIONED--(1) MANDATORY BECAUSE OF LAW, CODE, OR REGULATION, (2) RECOMMENDED AS MOST…

29 CFR 825.209 - Maintenance of employee benefits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... maintain the employee's coverage under any group health plan (as defined in the Internal Revenue Code of... of “group health plan” is set forth in § 825.800. For purposes of FMLA, the term “group health plan... not increase in the event the employment relationship terminates. (b) The same group health plan...

Guideline for the Comprehensive Campus Master Plan System.

ERIC Educational Resources Information Center

State Univ. System of Florida, Tallahassee.

This document is a guideline for institutions in the Florida State University System to use as they comply with state mandates requiring them to develop campus master plans and land management plans. It supplements the minimum criteria in the state's Administrative Code. For each element the guide offers description of its purpose, data…

75 FR 65594 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality Standards AGENCY... the Ohio Administrative Code (OAC) relating to the consolidation of Ohio's Ambient Air Quality Standards (AAQS) into Ohio's State Implementation Plan (SIP) under the Clean Air Act. On April 8, 2009, and...

75 FR 10416 - Approval and Promulgation of Implementation Plans; Texas; Revisions to Chapter 116 Which Relate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-08

... Promulgation of Implementation Plans; Texas; Revisions to Chapter 116 Which Relate to the Application Review... direct final action to approve revisions to the applicable State Implementation Plan (SIP) for the State... Texas Health and Safety Code, section 382.0566, concerning specific deadlines for review and issuance of...

Extension, validation and application of the NASCAP code

NASA Technical Reports Server (NTRS)

Katz, I.; Cassidy, J. J., III; Mandell, M. J.; Schnuelle, G. W.; Steen, P. G.; Parks, D. E.; Rotenberg, M.; Alexander, J. H.

1979-01-01

Numerous extensions were made in the NASCAP code. They fall into three categories: a greater range of definable objects, a more sophisticated computational model, and simplified code structure and usage. An important validation of NASCAP was performed using a new two dimensional computer code (TWOD). An interactive code (MATCHG) was written to compare material parameter inputs with charging results. The first major application of NASCAP was performed on the SCATHA satellite. Shadowing and charging calculation were completed. NASCAP was installed at the Air Force Geophysics Laboratory, where researchers plan to use it to interpret SCATHA data.

Searching for Planning and Design Solutions.

ERIC Educational Resources Information Center

Roark, Steven

2001-01-01

Presents the fourth article in a series on the Longview Community College (Kansas City, Missouri) Liberal Arts building project. How architects are revising floor plans, evaluating building systems, deciding on furniture, and dealing with building codes are discussed. (GR)

Reading your own lips: common-coding theory and visual speech perception.

PubMed

Tye-Murray, Nancy; Spehar, Brent P; Myerson, Joel; Hale, Sandra; Sommers, Mitchell S

2013-02-01

Common-coding theory posits that (1) perceiving an action activates the same representations of motor plans that are activated by actually performing that action, and (2) because of individual differences in the ways that actions are performed, observing recordings of one's own previous behavior activates motor plans to an even greater degree than does observing someone else's behavior. We hypothesized that if observing oneself activates motor plans to a greater degree than does observing others, and if these activated plans contribute to perception, then people should be able to lipread silent video clips of their own previous utterances more accurately than they can lipread video clips of other talkers. As predicted, two groups of participants were able to lipread video clips of themselves, recorded more than two weeks earlier, significantly more accurately than video clips of others. These results suggest that visual input activates speech motor activity that links to word representations in the mental lexicon.

The Perceived Impact of 42 CFR Part 2 on Coordination and Integration of Care: A Qualitative Analysis.

PubMed

McCarty, Dennis; Rieckmann, Traci; Baker, Robin L; McConnell, K John

2017-03-01

Title 42 of the Code of Federal Regulations Part 2 (42 CFR Part 2) controls the release of patient information about treatment for substance use disorders. In 2016, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a proposed rule to update the regulations, reduce provider burdens, and facilitate information exchange. Oregon's Medicaid program (Oregon Health Plan) altered the financing and structure of medical, dental, and behavioral care to promote greater integration and coordination. A qualitative analysis examined the perceived impact of 42 CFR Part 2 on care coordination and integration. Interviews with 76 stakeholders (114 interviews) conducted in 2012-2015 probed the processes of integrating behavioral health into primary care settings in Oregon and assessed issues associated with adherence to 42 CFR Part 2. Respondents expressed concerns that the regulations caused legal confusion, inhibited communication and information sharing, and required updating. Addiction treatment directors noted the challenges of obtaining patient consent to share information with primary care providers. The confidentiality regulations were perceived as a barrier to care coordination and integration. The Oregon Health Authority, therefore, requested regulatory changes. SAMHSA's proposed revisions permit a general consent to an entire health care team and allow inclusion of substance use disorder information within health information exchanges, but they mandate data segmentation of diagnostic and procedure codes related to substance use disorders and restrict access only to parties with authorized consent, possibly adding barriers to the coordination and integration of addiction treatment with primary care.

Micromagnetic Code Development of Advanced Magnetic Structures Final Report CRADA No. TC-1561-98

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

Cerjan, Charles J.; Shi, Xizeng

The specific goals of this project were to: Further develop the previously written micromagnetic code DADIMAG (DOE code release number 980017); Validate the code. The resulting code was expected to be more realistic and useful for simulations of magnetic structures of specific interest to Read-Rite programs. We also planned to further the code for use in internal LLNL programs. This project complemented LLNL CRADA TC-840-94 between LLNL and Read-Rite, which allowed for simulations of the advanced magnetic head development completed under the CRADA. TC-1561-98 was effective concurrently with LLNL non-exclusive copyright license (TL-1552-98) to Read-Rite for DADIMAG Version 2 executablemore » code.« less

The evaluation and planning of light dose in photodynamic therapy for port wine stains

NASA Astrophysics Data System (ADS)

Zhang, Feng-juan; Hu, Xiaoming; Zhang, Qi-shen

2014-11-01

Photodynamic therapy (PDT) is one of the best available treatment for dermatology, especially for port wine stains (PWS), in which the efficacy is associated with the light dose, the photosensitizer concentration, the oxygen concentration and so on. Accurate control of the light dose will help doctors develop more effective treatment protocols, and reduce the treatment cost. Considering the characters of PWS, a binocular vision system composed of a camera, a digital projector and a computing unit is designed. An accurate 3D modeling of patients was achieved using a gray coding structured light, and then the lesions were segmented based on HSV space. Subsequently, each 3D point is fit on the surface by a nearest neighbor algorithm and the surface normal can be obtained. Three dimensional localization of lesion provide digital objective basis for automatic control of light device. The irradiance on the surface at a given angle can be assessed, and the optimum angle for the treatment can be solved and optimized by the doctor to improve irradiation areas.

The association between patient-therapist MATRIX congruence and treatment outcome.

PubMed

Mendlovic, Shlomo; Saad, Amit; Roll, Uri; Ben Yehuda, Ariel; Tuval-Mashiah, Rivka; Atzil-Slonim, Dana

2018-03-14

The present study aimed to examine the association between patient-therapist micro-level congruence/incongruence ratio and psychotherapeutic outcome. Nine good- and nine poor-outcome psychodynamic treatments (segregated by comparing pre- and post-treatment BDI-II) were analyzed (N = 18) moment by moment using the MATRIX (total number of MATRIX codes analyzed = 11,125). MATRIX congruence was defined as similar adjacent MATRIX codes. the congruence/incongruence ratio tended to increase as the treatment progressed only in good-outcome treatments. Progression of MATRIX codes' congruence/incongruence ratio is associated with good outcome of psychotherapy.

Use of convolution/superposition-based treatment planning system for dose calculations in the kilovoltage energy range

NASA Astrophysics Data System (ADS)

Alaei, Parham

2000-11-01

A number of procedures in diagnostic radiology and cardiology make use of long exposures to x rays from fluoroscopy units. Adverse effects of these long exposure times on the patients' skin have been documented in recent years. These include epilation, erythema, and, in severe cases, moist desquamation and tissue necrosis. Potential biological effects from these exposures to other organs include radiation-induced cataracts and pneumonitis. Although there have been numerous studies to measure or calculate the dose to skin from these procedures, there have only been a handful of studies to determine the dose to other organs. Therefore, there is a need for accurate methods to measure the dose in tissues and organs other than the skin. This research was concentrated in devising a method to determine accurately the radiation dose to these tissues and organs. The work was performed in several stages: First, a three dimensional (3D) treatment planning system used in radiation oncology was modified and complemented to make it usable with the low energies of x rays used in diagnostic radiology. Using the system for low energies required generation of energy deposition kernels using Monte Carlo methods. These kernels were generated using the EGS4 Monte Carlo system of codes and added to the treatment planning system. Following modification, the treatment planning system was evaluated for its accuracy of calculations in low energies within homogeneous and heterogeneous media. A study of the effects of lungs and bones on the dose distribution was also performed. The next step was the calculation of dose distributions in humanoid phantoms using this modified system. The system was used to calculate organ doses in these phantoms and the results were compared to those obtained from other methods. These dose distributions can subsequently be used to create dose-volume histograms (DVHs) for internal organs irradiated by these beams. Using this data and the concept of normal tissue complication probability (NTCP) developed for radiation oncology, the risk of future complications in a particular organ can be estimated.

SU-E-T-381: Evaluation of Calculated Dose Accuracy for Organs-At-Risk Located at Out-Of-Field in a Commercial Treatment Planning System for High Energy Photon Beams Produced From TrueBeam Accelerators

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

Wang, L; Ding, G

Purpose: Dose calculation accuracy for the out-of-field dose is important for predicting the dose to the organs-at-risk when they are located outside primary beams. The investigations on evaluating the calculation accuracy of treatment planning systems (TPS) on out-of-field dose in existing publications have focused on low energy (6MV) photon. This study evaluates out-of-field dose calculation accuracy of AAA algorithm for 15MV high energy photon beams. Methods: We used the EGSnrc Monte Carlo (MC) codes to evaluate the AAA algorithm in Varian Eclipse TPS (v.11). The incident beams start with validated Varian phase-space sources for a TrueBeam linac equipped with Millenniummore » 120 MLC. Dose comparisons between using AAA and MC for CT based realistic patient treatment plans using VMAT techniques for prostate and lung were performed and uncertainties of organ dose predicted by AAA at out-of-field location were evaluated. Results: The results show that AAA calculations under-estimate doses at the dose level of 1% (or less) of prescribed dose for CT based patient treatment plans using VMAT techniques. In regions where dose is only 1% of prescribed dose, although AAA under-estimates the out-of-field dose by 30% relative to the local dose, it is only about 0.3% of prescribed dose. For example, the uncertainties of calculated organ dose to liver or kidney that is located out-of-field is <0.3% of prescribed dose. Conclusion: For 15MV high energy photon beams, very good agreements (<1%) in calculating dose distributions were obtained between AAA and MC. The uncertainty of out-of-field dose calculations predicted by the AAA algorithm for realistic patient VMAT plans is <0.3% of prescribed dose in regions where the dose relative to the prescribed dose is <1%, although the uncertainties can be much larger relative to local doses. For organs-at-risk located at out-of-field, the error of dose predicted by Eclipse using AAA is negligible. This work was conducted in part using the resources of Varian research grant VUMC40590-R.« less

[Penal treatment and rehabilitation of the convict in the new Penal Code of San Marino. Juridical and criminological aspects].

PubMed

Sclafani, F; Starace, A

1978-01-01

The Republic of San Marino adopted a new Penal Code which came into force on Ist January 1975; it replaced the former one of 15th Sept. 1865. After having stated the typical aspects of the Penal Procedure System therein enforceable, the Authors examine the rules concerning criminal responsibility and the danger of committing new crimes. They point out and criticize the relevant contradictions. In explaining the measures regarding punishment and educational rehabilitation provided for by the San Marino's legal system, the Authors later consider them from a juridical and criminological viewpoint. If some reforms must be approved (for example: biopsychical inquiry on the charged person, probation, week-end imprisonments, fines according to the incomes of the condemned, etc.). the Authors stress that some legal provisions may appear useless and unrealistic when one considers the environmental conditions of the little Republic. The Authors conclude that Penal Procedure Law is not in accordance with Penal Law and, consequently, they hope that a new reform will be grounded on the needs arising from the crimes perpetrated in loco. It shall be, however, necessary to plan a co-ordination among the two Codes within a framework of de-criminalization of many acts which are now punishable as crime.

Teaching Treatment Planning.

ERIC Educational Resources Information Center

Seligman, Linda

1993-01-01

Describes approach to teaching treatment planning that author has used successfully in both seminars and graduate courses. Clarifies nature and importance of systematic treatment planning, then describes context in which treatment planning seems more effectively taught, and concludes with step-by-step plan for teaching treatment planning.…

An exploratory analysis of behavioral health care use within families.

PubMed

Lave, Judith R; Peele, Pamela B; Xu, Ying; Scholle, Sarah H; Pincus, Harold Alan

2002-06-01

The authors studied enrollees in employer-sponsored managed health plans to determine the extent of multiple behavioral health consumers within families, use of behavioral health services by employees who have another family member using such services, congruence of diagnoses between two family members using behavioral health services, and the effect on covered charge per behavioral health consumer when other family members use behavioral health services. Claims data from 911 plans sold or managed by a single managed behavioral health care company were examined. The plans provided coverage for 724,789 employees and covered about 1.7 million lives. Family members of employees were identified by the relationship codes on the claims. Service utilization rates were calculated for employees overall and for employees who had spouses or children who used behavioral health services. Mean and median covered charges were determined and were examined by number and type of consumers in the family. The use of behavioral health services was greater among employees whose children or spouses used behavioral health services. Utilization rates varied by the child's or spouse's diagnoses. More than 50 percent of male employees whose children received treatment for a depressive disorder also received such treatment. Congruence of diagnoses within families was noted. Covered charges per person generally increased with the number of family members who used behavioral health services. Greater knowledge about patterns of use of behavioral health services within families may help in improving access to care and developing more effective family interventions.

Researching English in the Philippines: Bibliographical Resources

ERIC Educational Resources Information Center

Bautista, Ma. Lourdes S.

2004-01-01

The academic literature on issues related to the Philippine English language and literature is substantial. This bibliography surveys relevant work on such related fields as the sociology of language and language planning, Bilingualism, bilingual education, and languages in education, language attitudes, code-switching and code-mixing, Philippine…

Instructional Planning Time: A Review of Existing Research and Educator Practice during the 2012-2013 School Year

ERIC Educational Resources Information Center

Hixson, Nate; Stohr, Amber D.; Hammer, Patricia Cahape

2013-01-01

A study of instructional planning periods was undertaken in late 2013 pursuant to West Virginia State Code §18A-4-14 which states: "The state board shall conduct a study on planning periods. The study shall include, but not be limited to, the appropriate length for planning periods at the various grade levels and for the different types of…

New York State Plan for Education of Students with Disabilities, 1993-1995.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Office for Special Education Services.

This state plan describes how the state of New York intends to comply with legislative mandates concerning education of children with disabilities, specifically the Individuals with Disabilities Education Act (IDEA) and Part 300 of the Code of Federal Regulations. It also describes the planning and program initiatives that will be undertaken at…

142. ARAIII General plan of GCRE area, including electrical distribution ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

142. ARA-III General plan of GCRE area, including electrical distribution plan for power and lighting. Includes detail of floodlight and security lighting poles and fixtures. Aerojet-general 880-area/GCRE-406-1. Date: February 1958. Ineel index code no. 063-0406-00-013-102539. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

76 FR 9281 - Approval and Promulgation of Air Quality Implementation Plans; Massachusetts; Revised Carbon...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-17

... Massachusetts. This SIP submittal contains revisions to the carbon monoxide (CO) maintenance plan for Lowell... plan. The intended effect of this action is to propose approval of this revision to the Lowell CO..., 5 Post Office Square--Suite 100, (Mail code OEP05-2), Boston, MA 02109-3912. 5. Hand Delivery or...

40 CFR Appendix Xi to Part 86 - Sampling Plans for Selective Enforcement Auditing of Light-Duty Vehicles

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Sampling Plans for Selective Enforcement Auditing of Light-Duty Vehicles XI Appendix XI to Part 86 Protection of Environment ENVIRONMENTAL... Enforcement Auditing of Light-Duty Vehicles 40% AQL Table 1—Sampling Plan Code Letter Annual sales of...

The Challenges of Planning Language Objectives in Content-Based ESL Instruction

ERIC Educational Resources Information Center

Baecher, Laura; Farnsworth, Tim; Ediger, Anne

2014-01-01

The purpose of this research was to investigate the major patterns in content-based instruction (CBI) lesson plans among practicum teachers at the final stage of an MA TESOL program. One hundred and seven lesson plans were coded according to a typology developed to evaluate clarity and identify areas of potential difficulty in the design of…

78 FR 5292 - Approval and Promulgation of Air Quality Implementation Plans; Massachusetts and New Hampshire...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-25

... and New Hampshire. The revised programs in Massachusetts and New Hampshire include a test and repair..., EPA New England Regional Office, Office of Ecosystem Protection, Air Quality Planning Unit, 5 Post... Protection, Air Quality Planning Unit, 5 Post Office Square--Suite 100, (Mail code OEP05-2), Boston, MA 02109...

75 FR 10449 - Approval and Promulgation of Implementation Plans; Texas; Revisions to Chapter 116 Which Relate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-08

... Promulgation of Implementation Plans; Texas; Revisions to Chapter 116 Which Relate to the Application Review... approve revisions to the Texas State Implementation Plan (SIP) submitted by the State of Texas to EPA on... implements the requirements of House Bill 3732, 80th Legislature (2007), and the Texas Health and Safety Code...

Which characteristics of planning matter? Individual and dyadic physical activity plans and their effects on plan enactment.

PubMed

Keller, Jan; Fleig, Lena; Hohl, Diana Hilda; Wiedemann, Amelie U; Burkert, Silke; Luszczynska, Aleksandra; Knoll, Nina

2017-09-01

Past research supports individual planning as an effective intervention strategy to increase physical activity in individuals. A similar strategy, dyadic planning, adds a planning partner who supports an individual's planning processes. Whether the two planning formats differ in terms of participants' entered plan content and whether and how different content characteristics are linked to plan enactment remains unknown. By investigating the content of generated plans, this study aimed at distinguishing plan characteristics of the two planning formats and examining their role as predictors of later plan enactment. Secondary analyses of a three-arm RCT with German couples (data collection between 2013 and 2015). Couples were assigned to an individual (IPC, n = 114) or dyadic planning condition (DPC, n = 111) and formulated up to 5 physical activity plans for a target person. Couples assigned to a control condition were not included as they did not generate plans. The following characteristics were distinguished and coded for each plan: number of planned opportunities, presence of a planned routine, planned cue- or activity-related specificity, activity-related intensity, and chronological plan rank. One week before (T0) and two weeks following (T2) the intervention (T1), increase vs. no increase of the planned activity was coded as a dichotomous plan enactment variable. Multilevel logistic regressions were fit. Plan enactment was higher in dyadic than in individual planners. Findings indicated that routines (e.g., after work) were positively related to plan enactment, whereas a high specificity of when-cues (e.g., Friday at 6.30 p.m.) showed a negative relationship. None of the examined plan characteristics could explain differences in enactment between IPC and DPC. Linking health behaviours to other behavioural routines seems beneficial for subsequent plan enactment. Dyadic planning was linked with higher enactment rates than individual planning. However, as mechanisms underlying this effect remain unclear, they should be investigated further. Copyright © 2017 Elsevier Ltd. All rights reserved.

MO-B-BRB-01: Optimize Treatment Planning Process in Clinical Environment

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

Feng, W.

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

MO-B-BRB-00: Optimizing the Treatment Planning Process

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

NONE

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

MO-B-BRB-03: Systems Engineering Tools for Treatment Planning Process Optimization in Radiation Medicine

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

Kapur, A.

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

MO-B-BRB-02: Maintain the Quality of Treatment Planning for Time-Constraint Cases

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

Chang, J.

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

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

Hermeston, Mark W.

Franklin County noxious weed management along BPA rights-of-ways, transmission structures, roads, and switches listed in Attachment 1. Attachment 1 identifies the ROW, ROW width, and ROW length of the proposed action. Includes all BPA 115kV, 230kV, and 500 kV ROWs in Franklin County, Washington. BPA proposes to clear noxious and/or unwanted low-growing vegetation in all BPA ROWs in Franklin County, Washington. In a cooperative effort, BPA, through landowners and the Franklin County Weed Control Board, plan to eradicate noxious plants and other unwanted, low-growing vegetation within the ROW width including all structures and access roads. BPA’s overall goal is tomore » eradicate all noxious and unwanted vegetation through chemical treatment and reseeding. Selective and nonselective chemical treatment using spot, local and broadcast methods. All work will be executed in accordance with the National Electrical Safety Code and BPA standards. Work is to begin in March 2002.« less

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

Hermeston, Mark W.

Benton County noxious weed management along BPA rights-of-ways, transmission structures, roads, and switches listed in Attachment 1. Attachment 1 identifies the ROW, ROW width, and ROW length of the proposed action. Includes all BPA 115kV, 230kV, 345kV and 500 kV ROWs in Benton County, Washington. BPA proposes to clear noxious and/or unwanted low-growing vegetation in all BPA ROWs in Benton County, Washington. In a cooperative effort, BPA, through landowners and the Benton County Weed Control Board, plan to eradicate noxious plants and other unwanted, low-growing vegetation within the ROW width including all structures and access roads. BPA’s overall goal ismore » to eradicate all noxious and unwanted vegetation through chemical treatment and reseeding. Selective and nonselective chemical treatment using spot, local and broadcast methods. All work will be executed in accordance with the National Electrical Safety Code and BPA standards. Work is to begin in March 2002.« less

A-7 Aloft Demonstration Flight Test Plan

DTIC Science & Technology

1975-09-01

6095979 72A2130 Power Supply 12 VDC 6095681 72A29 NOC 72A30 ALOFT ASCU Adapter Set 72A3100 ALOFT ASCU Adapter L20-249-1 72A3110 Page assy L Bay and ASCU ...checks will also be performed for each of the following: 3.1.2.1.1 ASCU Codes. Verification will be made that all legal ASCU codes are recognized and...invalid codes inhibit attack mode. A check will also be made to verify that the ASCU codes for pilot-option weapons A-25 enable the retarded weapons

[Application of digital design of orthodontic-prosthodontic multidisciplinary treatment plan in esthetic rehabilitation of anterior teeth].

PubMed

Liu, Y S; Li, Z; Zhao, Y J; Ye, H Q; Zhou, Y Q; Hu, W J; Liu, Y S; Xun, C L; Zhou, Y S

2018-02-18

To develop a digital workflow of orthodontic-prosthodontic multidisciplinary treatment plan which can be applied in complicated anterior teeth esthetic rehabilitation, in order to enhance the efficiency of communication between dentists and patients, and improve the predictability of treatment outcome. Twenty patients with the potential needs of orthodontic-prosthodontic multidisciplinary treatment to solve their complicated esthetic problems in anterior teeth were recruited in this study. Digital models of patients' both dental arches and soft tissues were captured using intra oral scanner. Direct prosthodontic (DP) treatment plan and orthodontic-prosthodontic (OP) treatment plan were carried out for each patient. For DP treatment plans, digital wax-up models were directly designed on original digital models using prosthodontic design system. For OP treatment plans, virtual-setups were performed using orthodontic analyze system according to orthodontic and esthetic criteria and imported to prosthodontic design system to finalize the digital wax-up models. These two treatment plans were shown to the patients and demonstrated elaborately. Each patient rated two treatment plans using visual analogue scales and the medians of scores of two treatment plans were analyzed using signed Wilcoxon test. Having taken into consideration various related factors, including time, costs of treatment, each patient chose a specific treatment plan. For the patients chose DP treatment plans, digital wax-up models were exported and printed into resin diagnostic models which would be utilized in the prosthodontic treatment process. For the patients chose OP treatment plans, virtual-setups were used to fabricate aligners or indirect bonding templates and digital wax-up models were also exported and printed into resin diagnostic models for prosthodontic treatment after orthodontic treatment completed. The medians of scores of DP treatment plan and OP treatment plan were calculated and analyzed by IBM SPSS 20. The median of scores of DP treatment plan was 8.4, the minimum value was 6.9 and the maximum value was 9.3. The median of scores of OP treatment plan was 9.0, the minimum value was 7.9 and the maximum value was 9.6. The median of scores of OP was significantly higher than that of DP (Z=-3.23, P<0.01). Finally, 12 patients chose OP treatment plans and 8 patients chose DP treatment plans. For cases with complex esthetic problems in anterior teeth, a digital workflow can demonstrate final treatment outcome and help patients make suitable treatment decisions. In our study, the orthodontic-prosthodontic multidisciplinary treatment plan is feasible which can provide predictions of treatment outcome and improve esthetic outcome with patients' satisfaction.

32 CFR 634.24 - Traffic planning and codes.

Code of Federal Regulations, 2010 CFR

2010-07-01

... enforcement officer, engineer, safety officer, and other concerned staff agencies. Highway engineering representatives from adjacent civil communities must be consulted to ensure the installation plan is compatible... and minor routes, location of traffic control devices, and conditions requiring engineering or...

When Crisis Strikes.

ERIC Educational Resources Information Center

Caudle, Melissa

1994-01-01

School crises may be categorized as emergency situations, human-made crises, natural events, medical emergencies, and mechanical crises. Central to any successful crisis-management plan are onsite and district-level crisis response teams. Plans should specify staff responsibilities; provide for communication codes, devices, and procedures;…

77 FR 70189 - Manufacturer of Controlled Substances; Notice of Registration; Cayman Chemical Company

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-23

... propylthiophenethylamine (7348). Marihuana (7360) I Tetrahydrocannabinols (7370) I Mescaline (7381) I 3,4,5... manufacture small quantities of marihuana derivatives for research purposes. In reference to drug code 7360 (Marihuana), the company plans to bulk manufacture cannabidiol. In reference to drug code 7370...

29 CFR 1910.35 - Compliance with alternate exit-route codes.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 1910.35 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH STANDARDS Exit Routes and Emergency Planning § 1910.35...-route provisions of NFPA 101, Life Safety Code, 2009 edition, or the exit-route provisions of the...

75 FR 8246 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Volatile Organic Compound...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-24

...)(2).) List of Subjects in 40 CFR Part 52 Environmental protection, Air pollution control...) Incorporation by reference. (A) Indiana Administrative Code Title 326: Air Pollution Control Board, Article 8..., 2009 (DIN: 20091202-IR-326090220FRA). (B) Indiana Administrative Code Title 326: Air Pollution Control...

Hypersonic CFD applications at NASA Langley using CFL3D and CFL3DE

NASA Technical Reports Server (NTRS)

Richardson, Pamela F.

1989-01-01

The CFL3D/CFL3DE CFD codes and the industrial use status of the codes are outlined. Comparison of grid density, pressure, heat transfer, and aerodynamic coefficience are presented. Future plans related to the National Aerospace Plane Program are briefly outlined.

VoxelMages: a general-purpose graphical interface for designing geometries and processing DICOM images for PENELOPE.

PubMed

Giménez-Alventosa, V; Ballester, F; Vijande, J

2016-12-01

The design and construction of geometries for Monte Carlo calculations is an error-prone, time-consuming, and complex step in simulations describing particle interactions and transport in the field of medical physics. The software VoxelMages has been developed to help the user in this task. It allows to design complex geometries and to process DICOM image files for simulations with the general-purpose Monte Carlo code PENELOPE in an easy and straightforward way. VoxelMages also allows to import DICOM-RT structure contour information as delivered by a treatment planning system. Its main characteristics, usage and performance benchmarking are described in detail. Copyright © 2016 Elsevier Ltd. All rights reserved.

2002 CNA Code of Ethics: some recommendations.

PubMed

Kikuchi, June F

2004-07-01

The Canadian Nurses Association (CNA) recently revised its 1997 Code of Ethics for Registered Nurses to reflect the context within which nurses practise today. Given the unprecedented changes that have taken place within the profession, healthcare and society, it was timely for the CNA to review and revise its Code. But the revisions were relatively minor; important problematic, substantive aspects of the Code were essentially left untouched and persist in the updated 2002 Code. In this paper, three of those aspects are examined and discussed: the 2002 Code's (a) definition of health and well-being, (b) notion of respect and (c) conception of justice. Recommendations are made. It is hoped that these comments will encourage nurse leaders in Canada to initiate discussion of the Code now, in preparation for its next planned revision in 2007.

Scanned carbon beam irradiation of moving films: comparison of measured and calculated response

PubMed Central

2012-01-01

Background Treatment of moving target volumes with scanned particle beams benefits from treatment planning that includes the time domain (4D). Part of 4D treatment planning is calculation of the expected result. These calculation codes should be verified against suitable measurements. We performed simulations and measurements to validate calculation of the film response in the presence of target motion. Methods All calculations were performed with GSI's treatment planning system TRiP. Interplay patterns between scanned particle beams and moving film detectors are very sensitive to slight deviations of the assumed motion parameters and therefore ideally suited to validate 4D calculations. In total, 14 film motion parameter combinations with lateral motion amplitudes of 8, 15, and 20 mm and 4 combinations for lateral motion including range changes were used. Experimental and calculated film responses were compared by relative difference, mean deviation in two regions-of-interest, as well as line profiles. Results Irradiations of stationary films resulted in a mean relative difference of -1.52% ± 2.06% of measured and calculated responses. In comparison to this reference result, measurements with translational film motion resulted in a mean difference of -0.92% ± 1.30%. In case of irradiations incorporating range changes with a stack of 5 films as detector the deviations increased to -6.4 ± 2.6% (-10.3 ± 9.0% if film in distal fall-off is included) in comparison to -3.6% ± 2.5% (-13.5% ± 19.9% including the distal film) for the stationary irradiation. Furthermore, the comparison of line profiles of 4D calculations and experimental data showed only slight deviations at the borders of the irradiated area. The comparisons of pure lateral motion were used to determine the number of motion states that are required for 4D calculations depending on the motion amplitude. 6 motion states per 10 mm motion amplitude are sufficient to calculate the film response in the presence of motion. Conclusions By comparison to experimental data, the 4D extension of GSI's treatment planning system TRiP has been successfully validated for film response calculations in the presence of target motion within the accuracy limitation given by film-based dosimetry. PMID:22462523

Is Access to Outpatient Neurosurgery Affected by Narrow Insurance Networks? Results From Statewide Analysis of Marketplace Plans in Louisiana.

PubMed

Dossani, Rimal H; Kalakoti, Piyush; Nanda, Anil; Guthikonda, Bharat; Tumialán, Luis M

2018-02-06

The main objective of the Affordable Care Act (ACA) was to make health insurance affordable to all Americans while addressing the lack of coverage for 48 million people. In the face of rapidly increasing enrollment and rising demand for inexpensive plans, insurance providers are limiting in-network physicians. Provider networks offering plans with limited in-network physicians have become known as "narrow networks." To assesses the adequacy of ACA marketplace plans for outpatient neurosurgery in Louisiana. The Marketplace Public Use Files were searched for all "silver" plans. A total of 7 silver plans were identified in Louisiana. Using the plans' online directories, a search of in-network neurosurgeons in Louisiana parishes with >100 000 population was performed. The primary outcome was lack of in-network neurosurgeon(s) in silver plans within 50 miles of selected zip code for each parish with >100 000 population. Plans without in-network neurosurgeon(s) are labeled as neurosurgeon-deficient plans. Several plans in Louisiana are neurosurgeon deficient, ie no in-network neurosurgeon within 50 miles of the designated parish zip code. Company A's plan 3 is deficient in all 5 parishes, while company C and company D silver plans are deficient in 4 out of 14 (29%). Combined results from all counties and plans demonstrate that 43% (3 out of 7) of all silver plans in Louisiana are neurosurgeon deficient in at least 4 parishes with population >100 000. In Louisiana, narrow networks have limited access to neurosurgical care for those patients with ACA silver plans. Copyright © 2018 by the Congress of Neurological Surgeons

Quality of Antiepileptic Treatment Among Older Medicare Beneficiaries With Epilepsy: A Retrospective Claims Data Analysis.

PubMed

Pisu, Maria; Richman, Joshua; Piper, Kendra; Martin, Roy; Funkhouser, Ellen; Dai, Chen; Juarez, Lucia; Szaflarski, Jerzy P; Faught, Edward

2017-07-01

Enzyme-inducing antiepileptic drugs (EI-AEDs) are not recommended for older adults with epilepsy. Quality Indicator for Epilepsy Treatment 9 (QUIET-9) states that new patients should not receive EI-AEDs as first line of treatment. In light of reported racial/ethnic disparities in epilepsy care, we investigated EI-AED use and QUIET-9 concordance across major racial/ethnic groups of Medicare beneficiaries. Retrospective analyses of 2008-2010 Medicare claims for a 5% random sample of beneficiaries 67 years old and above in 2009 augmented for minority representation. Logistic regressions examined QUIET-9 concordance differences by race/ethnicity adjusting for individual, socioeconomic, and geography factors. Epilepsy prevalent (≥1 International Classification of Disease-version 9 code 345.x or ≥2 International Classification of Disease-version 9 code 780.3x, ≥1 AED), and new (same as prevalent+no seizure/epilepsy events nor AEDs in 365 d before index event) cases. Use of EI-AEDs and QUIET-9 concordance (no EI-AEDs for the first 2 AEDs). Cases were 21% white, 58% African American, 12% Hispanic, 6% Asian, 2% American Indian/Alaskan Native. About 65% of prevalent, 43.6% of new cases, used EI-AEDs. QUIET-9 concordance was found for 71% Asian, 65% white, 61% Hispanic, 57% African American, 55% American Indian/Alaskan new cases: racial/ethnic differences were not significant in adjusted model. Beneficiaries without neurology care, in deductible drug benefit phase, or in high poverty areas were less likely to have QUIET-9 concordant care. EI-AED use is high, and concordance with recommendations low, among all racial/ethnic groups of older adults with epilepsy. Potential socioeconomic disparities and drug coverage plans may affect treatment quality and opportunities to live well with epilepsy.

Demographics of emergency medical care at the Indianapolis 500 mile race (1983-1990).

PubMed

Bock, H C; Cordell, W H; Hawk, A C; Bowdish, G E

1992-10-01

The Indianapolis 500 Mile Race, the largest single-day, single-venue sporting event in the world, is attended by an estimated 400,000 people. Major illness and injury are treated at the Hanna Emergency Medical Center, the track hospital. Minor illness is treated at ten outlying aid stations. We describe the demographics of emergency medical care at the Hanna Emergency Medical Center. Descriptive. Patient care data for patients treated at the medical center are first recorded on paper charts and then coded and transferred to computer. Data regarding patients treated at the medical center during eight consecutive races (1983-1990) were analyzed. Frequency of treatment and medical cardiac arrest rates were calculated. Aid station data and medical center records from nonrace days were not analyzed. The average number of patients treated per year at the track hospital was 139. The total number treated over the eight-year period was 1,113, yielding a frequency of treatment of 0.35 per 1,000. Analysis showed 16.2% of the proprietary treatment codes involved intoxication; 15.4%, lacerations (other than feet); 11.0%, pre-existing conditions; and 8.5%, heat illness. During the eight years, there were four medical cardiac arrests (incidence of 0.0125 per 10,000 spectators), all resulting in death. A fifth spectator died after being struck by a wheel from a race car. There were no driver deaths on race day. Descriptive data regarding medical care of crowds may be useful to emergency specialists who must staff, order supplies, and plan treatment facilities for similar mass gatherings. It is evident from this and other mass-gathering studies that there is a need for consistency in nomenclature and data collection. This will allow more accurate comparisons of emergency medical care between venues.

Simulation of nonlinear propagation of biomedical ultrasound using PZFlex and the KZK Texas code

NASA Astrophysics Data System (ADS)

Qiao, Shan; Jackson, Edward; Coussios, Constantin-C.; Cleveland, Robin

2015-10-01

In biomedical ultrasound nonlinear acoustics can be important in both diagnostic and therapeutic applications and robust simulations tools are needed in the design process but also for day-to-day use such as treatment planning. For most biomedical application the ultrasound sources generate focused sound beams of finite amplitude. The KZK equation is a common model as it accounts for nonlinearity, absorption and paraxial diffraction and there are a number of solvers available, primarily developed by research groups. We compare the predictions of the KZK Texas code (a finite-difference time-domain algorithm) to an FEM-based commercial software, PZFlex. PZFlex solves the continuity equation and momentum conservation equation with a correction for nonlinearity in the equation of state incorporated using an incrementally linear, 2nd order accurate, explicit algorithm in time domain. Nonlinear ultrasound beams from two transducers driven at 1 MHz and 3.3 MHz respectively were simulated by both the KZK Texas code and PZFlex, and the pressure field was also measured by a fibre-optic hydrophone to validate the models. Further simulations were carried out a wide range of frequencies. The comparisons showed good agreement for the fundamental frequency for PZFlex, the KZK Texas code and the experiments. For the harmonic components, the KZK Texas code was in good agreement with measurements but PZFlex underestimated the amplitude: 32% for the 2nd harmonic and 66% for the 3rd harmonic. The underestimation of harmonics by PZFlex was more significant when the fundamental frequency increased. Furthermore non-physical oscillations in the axial profile of harmonics occurred in the PZFlex results when the amplitudes were relatively low. These results suggest that careful benchmarking of nonlinear simulations is important.

Simulation of nonlinear propagation of biomedical ultrasound using PZFlex and the KZK Texas code

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

Qiao, Shan, E-mail: shan.qiao@eng.ox.ac.uk; Jackson, Edward; Coussios, Constantin-C

In biomedical ultrasound nonlinear acoustics can be important in both diagnostic and therapeutic applications and robust simulations tools are needed in the design process but also for day-to-day use such as treatment planning. For most biomedical application the ultrasound sources generate focused sound beams of finite amplitude. The KZK equation is a common model as it accounts for nonlinearity, absorption and paraxial diffraction and there are a number of solvers available, primarily developed by research groups. We compare the predictions of the KZK Texas code (a finite-difference time-domain algorithm) to an FEM-based commercial software, PZFlex. PZFlex solves the continuity equationmore » and momentum conservation equation with a correction for nonlinearity in the equation of state incorporated using an incrementally linear, 2nd order accurate, explicit algorithm in time domain. Nonlinear ultrasound beams from two transducers driven at 1 MHz and 3.3 MHz respectively were simulated by both the KZK Texas code and PZFlex, and the pressure field was also measured by a fibre-optic hydrophone to validate the models. Further simulations were carried out a wide range of frequencies. The comparisons showed good agreement for the fundamental frequency for PZFlex, the KZK Texas code and the experiments. For the harmonic components, the KZK Texas code was in good agreement with measurements but PZFlex underestimated the amplitude: 32% for the 2nd harmonic and 66% for the 3rd harmonic. The underestimation of harmonics by PZFlex was more significant when the fundamental frequency increased. Furthermore non-physical oscillations in the axial profile of harmonics occurred in the PZFlex results when the amplitudes were relatively low. These results suggest that careful benchmarking of nonlinear simulations is important.« less

Administering the Preschool Facility.

ERIC Educational Resources Information Center

Coonrod, Debbie

Securing the right environment for a preschool program requires planning and research. Administrators or searching parties are advised to study zoning codes to become acquainted with state sanitation and safety regulations and laws, to involve teachers in cooperative planning, to design facilities which discourage vandalism, facilitate…

40 CFR 52.2569 - Identification of plan-conditional approval.

Code of Federal Regulations, 2012 CFR

2012-07-01

... PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2569... the date specified. (1)-(3) [Reserved] (4) On November 15, 1993, and July 28, 1994, the Wisconsin...'s conditional approval. (i) Incorporation by reference. (A) Wisconsin Administrative Code, Chapter...

40 CFR 52.2569 - Identification of plan-conditional approval.

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2569... the date specified. (1)-(3) [Reserved] (4) On November 15, 1993, and July 28, 1994, the Wisconsin...'s conditional approval. (i) Incorporation by reference. (A) Wisconsin Administrative Code, Chapter...

40 CFR 52.2569 - Identification of plan-conditional approval.

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2569... the date specified. (1)-(3) [Reserved] (4) On November 15, 1993, and July 28, 1994, the Wisconsin...'s conditional approval. (i) Incorporation by reference. (A) Wisconsin Administrative Code, Chapter...

40 CFR 52.2569 - Identification of plan-conditional approval.

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2569... the date specified. (1)-(3) [Reserved] (4) On November 15, 1993, and July 28, 1994, the Wisconsin...'s conditional approval. (i) Incorporation by reference. (A) Wisconsin Administrative Code, Chapter...

40 CFR 52.2569 - Identification of plan-conditional approval.

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2569... the date specified. (1)-(3) [Reserved] (4) On November 15, 1993, and July 28, 1994, the Wisconsin...'s conditional approval. (i) Incorporation by reference. (A) Wisconsin Administrative Code, Chapter...

40 CFR 52.2470 - Identification of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

...; Washington Administrative Code Chapter 173-430 (Burning of Field and Forage and Turf Grasses Grown for Seed...; Appendix G, Outline of Puget Sound Tropospheric Ozone Research Plan; and Appendix H, Prospective Vehicle... Households; Appendix H, Portland/Vancouver Carbon Monoxide Nonattainment Area Separation Documentation...

SIMULATION MODEL FOR WATERSHED MANAGEMENT PLANNING. VOLUME 2. MODEL USER MANUAL

EPA Science Inventory

This report provides a user manual for the hydrologic, nonpoint source pollution simulation of the generalized planning model for evaluating forest and farming management alternatives. The manual contains an explanation of application of specific code and indicates changes that s...

ADM. Fuel Pump House (TAN611). Elevations, floor plan. Drawing includes ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

ADM. Fuel Pump House (TAN-611). Elevations, floor plan. Drawing includes elevation and plans for "H.M." structures (Hose Storage?). Ralph M. Parsons 902-2-ANP-611-A 78 Date: December 1952. Approved by INEEL Classification Office for public release. INEEL index code no. 035-0611-00-693-106741 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

126. ARAII Plot plan showing location of SL1 power plant ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

126. ARA-II Plot plan showing location of SL-1 power plant (reactor) building, and planned location of administrative and technical support building. C.A. Sundberg and Associates 866-area/ALPR-606-U-1. Date: May 1958. Ineel index code no. 070-0100-00-822-102834. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

137. ARAII Building ARA602 floor plan as it appeared in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

137. ARA-II Building ARA-602 floor plan as it appeared in 1980 when electrical modifications were being made. Shows partial layout of floor plan. EG&G Idaho, Inc. 1570-ARA-II-602-E-3. Date: April 1980. Ineel index code no. 070--0602-10-220-159761. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

Monte Carlo calculations of positron emitter yields in proton radiotherapy.

PubMed

Seravalli, E; Robert, C; Bauer, J; Stichelbaut, F; Kurz, C; Smeets, J; Van Ngoc Ty, C; Schaart, D R; Buvat, I; Parodi, K; Verhaegen, F

2012-03-21

Positron emission tomography (PET) is a promising tool for monitoring the three-dimensional dose distribution in charged particle radiotherapy. PET imaging during or shortly after proton treatment is based on the detection of annihilation photons following the ß(+)-decay of radionuclides resulting from nuclear reactions in the irradiated tissue. Therapy monitoring is achieved by comparing the measured spatial distribution of irradiation-induced ß(+)-activity with the predicted distribution based on the treatment plan. The accuracy of the calculated distribution depends on the correctness of the computational models, implemented in the employed Monte Carlo (MC) codes that describe the interactions of the charged particle beam with matter and the production of radionuclides and secondary particles. However, no well-established theoretical models exist for predicting the nuclear interactions and so phenomenological models are typically used based on parameters derived from experimental data. Unfortunately, the experimental data presently available are insufficient to validate such phenomenological hadronic interaction models. Hence, a comparison among the models used by the different MC packages is desirable. In this work, starting from a common geometry, we compare the performances of MCNPX, GATE and PHITS MC codes in predicting the amount and spatial distribution of proton-induced activity, at therapeutic energies, to the already experimentally validated PET modelling based on the FLUKA MC code. In particular, we show how the amount of ß(+)-emitters produced in tissue-like media depends on the physics model and cross-sectional data used to describe the proton nuclear interactions, thus calling for future experimental campaigns aiming at supporting improvements of MC modelling for clinical application of PET monitoring. © 2012 Institute of Physics and Engineering in Medicine

Project W-211, initial tank retrieval systems, retrieval control system software configuration management plan

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

RIECK, C.A.

1999-02-23

This Software Configuration Management Plan (SCMP) provides the instructions for change control of the W-211 Project, Retrieval Control System (RCS) software after initial approval/release but prior to the transfer of custody to the waste tank operations contractor. This plan applies to the W-211 system software developed by the project, consisting of the computer human-machine interface (HMI) and programmable logic controller (PLC) software source and executable code, for production use by the waste tank operations contractor. The plan encompasses that portion of the W-211 RCS software represented on project-specific AUTOCAD drawings that are released as part of the C1 definitive designmore » package (these drawings are identified on the drawing list associated with each C-1 package), and the associated software code. Implementation of the plan is required for formal acceptance testing and production release. The software configuration management plan does not apply to reports and data generated by the software except where specifically identified. Control of information produced by the software once it has been transferred for operation is the responsibility of the receiving organization.« less

Livermore Site Spill Prevention, Control, and Countermeasures (SPCC) Plan

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

Bellah, W.; Griffin, D.; Mertesdorf, E.

This Spill Prevention, Control, and Countermeasure (SPCC) Plan describes the measures that are taken at Lawrence Livermore National Laboratory’s (LLNL) Livermore Site in Livermore, California, to prevent, control, and handle potential spills from aboveground containers that can contain 55 gallons or more of oil. This SPCC Plan complies with the Oil Pollution Prevention regulation in Title 40 of the Code of Federal Regulations (40 CFR), Part 112 (40 CFR 112) and with 40 CFR 761.65(b) and (c), which regulates the temporary storage of polychlorinated biphenyls (PCBs). This Plan has also been prepared in accordance with Division 20, Chapter 6.67 ofmore » the California Health and Safety Code (HSC 6.67) requirements for oil pollution prevention (referred to as the Aboveground Petroleum Storage Act [APSA]), and the United States Department of Energy (DOE) Order No. 436.1. This SPCC Plan establishes procedures, methods, equipment, and other requirements to prevent the discharge of oil into or upon the navigable waters of the United States or adjoining shorelines for aboveground oil storage and use at the Livermore Site.« less

Clinical Decision-Making in Community Children’s Mental Health: Using Innovative Methods to Compare Clinicians With and Without Training in Evidence-Based Treatment

PubMed Central

Baker-Ericzén, Mary J.; Jenkins, Melissa M.; Park, Soojin; Garland, Ann F.

2014-01-01

Background Mental health professionals’ decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. Objective The present study explored the role of prior training in evidence-based treatments on clinicians’ assessment and treatment formulations using case vignettes. Specifically, study aims included using the Naturalistic Decision Making (NDM) cognitive theory to 1) examine potential associations between EBT training and decision-making processes (novice versus expert type), and 2) explore how client and family contextual information affects clinical decision-making. Methods Forty-eight clinicians across two groups (EBT trained=14, Not EBT trained=34) participated. Clinicians were comparable on professional experience, demographics, and discipline. The quasi-experimental design used an analog “think aloud” method where clinicians read case vignettes about a child with disruptive behavior problems and verbalized case conceptualization and treatment planning out-loud. Responses were coded according to NDM theory. Results MANOVA results were significant for EBT training status such that EBT trained clinicians’ displayed cognitive processes more closely aligned with “expert” decision-makers and non-EBT trained clinicians’ decision processes were more similar to “novice” decision-makers, following NDM theory. Non-EBT trained clinicians assigned significantly more diagnoses, provided less detailed treatment plans and discussed fewer EBTs. Parent/family contextual information also appeared to influence decision-making. Conclusion This study offers a preliminary investigation of the possible broader impacts of EBT training and potential associations with development of expert decision-making skills. Targeting clinicians’ decision-making may be an important avenue to pursue within dissemination-implementation efforts in mental health practice. PMID:25892901

Tsunami Preparedness, Response, Mitigation, and Recovery Planning in California

NASA Astrophysics Data System (ADS)

Miller, K.; Wilson, R. I.; Johnson, L. A.; Mccrink, T. P.; Schaffer, E.; Bower, D.; Davis, M.

2016-12-01

In California officials of state, federal, and local governments have coordinated to implement a Tsunami Preparedness and Mitigation Program. Building upon past preparedness efforts carried out year-round this group has leveraged government support at all levels. A primary goal is for everyone who lives at or visits the coast to understand basic life-safety measures when responding to official tsunami alerts or natural warnings. Preparedness actions include: observation of National Tsunami Preparedness Week, local "tsunami walk" drills, scenario-based exercises, testing of notification systems for public alert messaging, outreach materials, workshops, presentations, and media events.Program partners have worked together to develop emergency operations, evacuation plans, and tsunami annexes to plans for counties, cities, communities, and harbors in 20 counties along the coast. Working with the state and federal partner agencies, coastal communities have begun to incorporate sophisticated tsunami "Playbook" scenario information into their planning. These innovative tsunami evacuation and response tools provide detailed evacuation maps and associated real-time response information for identifying areas where flooding could occur. This is critical information for evacuating populations on land, near the shoreline.Acting on recommendations from the recent USGS-led, multi-discipline Science Application for Risk Reduction Tsunami Scenario report on impacts to California and American Society of Civil Engineering adoption proposals to the International Building Code, the state has begun to develop a strategy to incorporate probabilistic tsunami findings into state level policy recommendations for addressing building code adoption, as well as approach land use planning and building code implementation in local jurisdictions. Additional efforts, in the context of sustained community resiliency, include developing recovery planning guidance for local communities.

GIS-assisted spatial analysis for urban regulatory detailed planning: designer's dimension in the Chinese code system

NASA Astrophysics Data System (ADS)

Yu, Yang; Zeng, Zheng

2009-10-01

By discussing the causes behind the high amendments ratio in the implementation of urban regulatory detailed plans in China despite its law-ensured status, the study aims to reconcile conflict between the legal authority of regulatory detailed planning and the insufficient scientific support in its decision-making and compilation by introducing into the process spatial analysis based on GIS technology and 3D modeling thus present a more scientific and flexible approach to regulatory detailed planning in China. The study first points out that the current compilation process of urban regulatory detailed plan in China employs mainly an empirical approach which renders it constantly subjected to amendments; the study then discusses the need and current utilization of GIS in the Chinese system and proposes the framework of a GIS-assisted 3D spatial analysis process from the designer's perspective which can be regarded as an alternating processes between the descriptive codes and physical design in the compilation of regulatory detailed planning. With a case study of the processes and results from the application of the framework, the paper concludes that the proposed framework can be an effective instrument which provides more rationality, flexibility and thus more efficiency to the compilation and decision-making process of urban regulatory detailed plan in China.

A Model of Human Cognitive Behavior in Writing Code for Computer Programs. Volume 1

DTIC Science & Technology

1975-05-01

nearly all programming languages, each line of code actually involves a great many decisions - basic statement types, variable and expression choices...labels, etc. - and any heuristic which evaluates code on the basis of a single decision is not likely to have sufficient power. Only the use of plans...recalculated in the following line because It was needed again. The second reason is that there are some decisions about the structure of a program

How to review 4 million lines of ATLAS code

NASA Astrophysics Data System (ADS)

Stewart, Graeme A.; Lampl, Walter; ATLAS Collaboration

2017-10-01

As the ATLAS Experiment prepares to move to a multi-threaded framework (AthenaMT) for Run3, we are faced with the problem of how to migrate 4 million lines of C++ source code. This code has been written over the past 15 years and has often been adapted, re-written or extended to the changing requirements and circumstances of LHC data taking. The code was developed by different authors, many of whom are no longer active, and under the deep assumption that processing ATLAS data would be done in a serial fashion. In order to understand the scale of the problem faced by the ATLAS software community, and to plan appropriately the significant efforts posed by the new AthenaMT framework, ATLAS embarked on a wide ranging review of our offline code, covering all areas of activity: event generation, simulation, trigger, reconstruction. We discuss the difficulties in even logistically organising such reviews in an already busy community, how to examine areas in sufficient depth to learn key areas in need of upgrade, yet also to finish the reviews in a timely fashion. We show how the reviews were organised and how the ouptuts were captured in a way that the sub-system communities could then tackle the problems uncovered on a realistic timeline. Further, we discuss how the review has inuenced the overall planning for the Run 3 ATLAS offline code.

Definition of a prospective payment system to reimburse emergency departments.

PubMed

Levaggi, Rosella; Montefiori, Marcello

2013-10-11

Payers are increasingly turning to Prospective Payment Systems (PPSs) because they incentivize efficiency, but their application to emergency departments (EDs) is difficult because of the high level of uncertainty and variability in the cost of treating each patient.To the best of our knowledge, our work represents the first attempt at defining a PPS for this part of hospital activity. Data were specifically collected for this study and relate to 1011 patients who were triaged at an ED of a major Italian hospital, during 1 week in December 2010.The cost for each patient was analytically estimated by adding up several components: 1) physician and other staff costs that were imputed on the basis of the time each physician claimed to have spent treating the patient; 2) the cost for each test/treatment each patient actually underwent; 3) overhead costs, shared among patients using the time elapsed between first examination and discharge from the ED. The distribution of costs by triage code shows that, although the average cost increases across the four triage groups, the variance within each code is quite high. The maximum cost for a yellow code is €1074.7, compared with €680 for red, the most serious code. Using cluster analysis, the red code cluster is enveloped by yellow, and their costs are therefore indistinguishable, while green codes span all cost groups. This suggests that triage code alone is not a good proxy for the patient cost, and that other cost drivers need to be included. Crude triage codes cannot be used to define PPSs because they are not sufficiently correlated with costs and are characterized by large variances. However, if combined with other information, such as the number of laboratory and non-laboratory tests/examinations, it is possible to define cost groups that are sufficiently homogeneous to be reimbursed prospectively. This should discourage strategic behavior and allow the ED to break even or create profits, which can be reinvested to improve services. The study provides health policy administrators with a new and feasible tool to implement prospective payment for EDs, and improve planning and cost control.

SU-F-T-65: AutomaticTreatment Planning for High-Dose Rate (HDR) Brachytherapy with a VaginalCylinder Applicator

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

Zhou, Y; Tan, J; Jiang, S

Purpose: High dose rate (HDR) brachytherapy treatment planning is conventionally performed in a manual fashion. Yet it is highly desirable to perform computerized automated planning to improve treatment planning efficiency, eliminate human errors, and reduce plan quality variation. The goal of this research is to develop an automatic treatment planning tool for HDR brachytherapy with a cylinder applicator for vaginal cancer. Methods: After inserting the cylinder applicator into the patient, a CT scan was acquired and was loaded to an in-house developed treatment planning software. The cylinder applicator was automatically segmented using image-processing techniques. CTV was generated based on user-specifiedmore » treatment depth and length. Locations of relevant points (apex point, prescription point, and vaginal surface point), central applicator channel coordinates, and dwell positions were determined according to their geometric relations with the applicator. Dwell time was computed through an inverse optimization process. The planning information was written into DICOM-RT plan and structure files to transfer the automatically generated plan to a commercial treatment planning system for plan verification and delivery. Results: We have tested the system retrospectively in nine patients treated with vaginal cylinder applicator. These cases were selected with different treatment prescriptions, lengths, depths, and cylinder diameters to represent a large patient population. Our system was able to generate treatment plans for these cases with clinically acceptable quality. Computation time varied from 3–6 min. Conclusion: We have developed a system to perform automated treatment planning for HDR brachytherapy with a cylinder applicator. Such a novel system has greatly improved treatment planning efficiency and reduced plan quality variation. It also served as a testbed to demonstrate the feasibility of automatic HDR treatment planning for more complicated cases.« less

41 CFR 102-37.150 - What must a State legislature include in the plan?

Code of Federal Regulations, 2010 CFR

2010-07-01

... set forth in Appendix B of this part. It may also include in the plan other provisions not inconsistent with the purposes of title 40 of the United States Code and the requirements of this part. [67 FR...

77 FR 22550 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; Small Container...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-16

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R05-OAR-2012-0073; FRL-9651-6] Approval and Promulgation of Air Quality Implementation Plans; Illinois; Small Container Exemption From VOC Coating Rules... Administrative Code by adding [[Page 22551

WE-DE-201-11: Sensitivity and Specificity of Verification Methods Based On Total Reference Air Kerma (TRAK) Or On User Provided Dose Points for Graphically Planned Skin HDR Brachytherapy

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

Damato, A; Devlin, P; Bhagwat, M

Purpose: To investigate the sensitivity and specificity of a novel verification methodology for image-guided skin HDR brachytherapy plans using a TRAK-based reasonableness test, compared to a typical manual verification methodology. Methods: Two methodologies were used to flag treatment plans necessitating additional review due to a potential discrepancy of 3 mm between planned dose and clinical target in the skin. Manual verification was used to calculate the discrepancy between the average dose to points positioned at time of planning representative of the prescribed depth and the expected prescription dose. Automatic verification was used to calculate the discrepancy between TRAK of themore » clinical plan and its expected value, which was calculated using standard plans with varying curvatures, ranging from flat to cylindrically circumferential. A plan was flagged if a discrepancy >10% was observed. Sensitivity and specificity were calculated using as a criteria for true positive that >10% of plan dwells had a distance to prescription dose >1 mm different than prescription depth (3 mm + size of applicator). All HDR image-based skin brachytherapy plans treated at our institution in 2013 were analyzed. Results: 108 surface applicator plans to treat skin of the face, scalp, limbs, feet, hands or abdomen were analyzed. Median number of catheters was 19 (range, 4 to 71) and median number of dwells was 257 (range, 20 to 1100). Sensitivity/specificity were 57%/78% for manual and 70%/89% for automatic verification. Conclusion: A check based on expected TRAK value is feasible for irregularly shaped, image-guided skin HDR brachytherapy. This test yielded higher sensitivity and specificity than a test based on the identification of representative points, and can be implemented with a dedicated calculation code or with pre-calculated lookup tables of ideally shaped, uniform surface applicators.« less

Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System

PubMed Central

Court, Laurence E.; Kisling, Kelly; McCarroll, Rachel; Zhang, Lifei; Yang, Jinzhong; Simonds, Hannah; du Toit, Monique; Trauernicht, Chris; Burger, Hester; Parkes, Jeannette; Mejia, Mike; Bojador, Maureen; Balter, Peter; Branco, Daniela; Steinmann, Angela; Baltz, Garrett; Gay, Skylar; Anderson, Brian; Cardenas, Carlos; Jhingran, Anuja; Shaitelman, Simona; Bogler, Oliver; Schmeller, Kathleen; Followill, David; Howell, Rebecca; Nelson, Christopher; Peterson, Christine; Beadle, Beth

2018-01-01

The Radiation Planning Assistant (RPA) is a system developed for the fully automated creation of radiotherapy treatment plans, including volume-modulated arc therapy (VMAT) plans for patients with head/neck cancer and 4-field box plans for patients with cervical cancer. It is a combination of specially developed in-house software that uses an application programming interface to communicate with a commercial radiotherapy treatment planning system. It also interfaces with a commercial secondary dose verification software. The necessary inputs to the system are a Treatment Plan Order, approved by the radiation oncologist, and a simulation computed tomography (CT) image, approved by the radiographer. The RPA then generates a complete radiotherapy treatment plan. For the cervical cancer treatment plans, no additional user intervention is necessary until the plan is complete. For head/neck treatment plans, after the normal tissue and some of the target structures are automatically delineated on the CT image, the radiation oncologist must review the contours, making edits if necessary. They also delineate the gross tumor volume. The RPA then completes the treatment planning process, creating a VMAT plan. Finally, the completed plan must be reviewed by qualified clinical staff. PMID:29708544

49 CFR 80.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 4974(c) of the Internal Revenue Code of 1986, 26 U.S.C. 4974(c)) that is a qualified institutional buyer; and (2) A governmental plan (as defined in section 414(d) of the Internal Revenue Code of 1986... issued by an obligor and funded by a lender. Local servicer means: (1) A State infrastructure bank...

Recoding Numerics to Geometrics for Complex Discrimination Tasks; A Feasibility Study of Coding Strategy.

ERIC Educational Resources Information Center

Simpkins, John D.

Processing complex multivariate information effectively when relational properties of information sub-groups are ambiguous is difficult for man and man-machine systems. However, the information processing task is made easier through code study, cybernetic planning, and accurate display mechanisms. An exploratory laboratory study designed for the…

75 FR 9434 - Civil Rights Division, Disability Rights Section; Agency Information Collection Activities Under...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-02

... Rights (or his or her designee) may certify that a State or local building code or similar ordinance that establishes accessibility requirements (Code) meets or exceeds the minimum requirements of the ADA for..., Policy and Planning Staff, Justice Management Division, Patrick Henry Building, Suite 1600, 601 D Street...

78 FR 23495 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; Small Container...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-19

...) which specify that Illinois' surface coating VOC emission limitations shall not apply to touch-up and... Administrative Code (Ill. Adm. Code) by adding a ``small container exemption'' for pleasure craft surface coating... technology (RACT) policy. DATES: This final rule is effective on May 20, 2013. ADDRESSES: EPA has established...

PlasmaPy: initial development of a Python package for plasma physics

NASA Astrophysics Data System (ADS)

Murphy, Nicholas; Leonard, Andrew J.; Stańczak, Dominik; Haggerty, Colby C.; Parashar, Tulasi N.; Huang, Yu-Min; PlasmaPy Community

2017-10-01

We report on initial development of PlasmaPy: an open source community-driven Python package for plasma physics. PlasmaPy seeks to provide core functionality that is needed for the formation of a fully open source Python ecosystem for plasma physics. PlasmaPy prioritizes code readability, consistency, and maintainability while using best practices for scientific computing such as version control, continuous integration testing, embedding documentation in code, and code review. We discuss our current and planned capabilities, including features presently under development. The development roadmap includes features such as fluid and particle simulation capabilities, a Grad-Shafranov solver, a dispersion relation solver, atomic data retrieval methods, and tools to analyze simulations and experiments. We describe several ways to contribute to PlasmaPy. PlasmaPy has a code of conduct and is being developed under a BSD license, with a version 0.1 release planned for 2018. The success of PlasmaPy depends on active community involvement, so anyone interested in contributing to this project should contact the authors. This work was partially supported by the U.S. Department of Energy.

GLOBECOM '87 - Global Telecommunications Conference, Tokyo, Japan, Nov. 15-18, 1987, Conference Record. Volumes 1, 2, & 3

NASA Astrophysics Data System (ADS)

The present conference on global telecommunications discusses topics in the fields of Integrated Services Digital Network (ISDN) technology field trial planning and results to date, motion video coding, ISDN networking, future network communications security, flexible and intelligent voice/data networks, Asian and Pacific lightwave and radio systems, subscriber radio systems, the performance of distributed systems, signal processing theory, satellite communications modulation and coding, and terminals for the handicapped. Also discussed are knowledge-based technologies for communications systems, future satellite transmissions, high quality image services, novel digital signal processors, broadband network access interface, traffic engineering for ISDN design and planning, telecommunications software, coherent optical communications, multimedia terminal systems, advanced speed coding, portable and mobile radio communications, multi-Gbit/second lightwave transmission systems, enhanced capability digital terminals, communications network reliability, advanced antimultipath fading techniques, undersea lightwave transmission, image coding, modulation and synchronization, adaptive signal processing, integrated optical devices, VLSI technologies for ISDN, field performance of packet switching, CSMA protocols, optical transport system architectures for broadband ISDN, mobile satellite communications, indoor wireless communication, echo cancellation in communications, and distributed network algorithms.

Applying graphics user interface ot group technology classification and coding at the Boeing aerospace company

NASA Astrophysics Data System (ADS)

Ness, P. H.; Jacobson, H.

1984-10-01

The thrust of 'group technology' is toward the exploitation of similarities in component design and manufacturing process plans to achieve assembly line flow cost efficiencies for small batch production. The systematic method devised for the identification of similarities in component geometry and processing steps is a coding and classification scheme implemented by interactive CAD/CAM systems. This coding and classification scheme has led to significant increases in computer processing power, allowing rapid searches and retrievals on the basis of a 30-digit code together with user-friendly computer graphics.

Open Rotor Noise Prediction Methods at NASA Langley- A Technology Review

NASA Technical Reports Server (NTRS)

Farassat, F.; Dunn, Mark H.; Tinetti, Ana F.; Nark, Douglas M.

2009-01-01

Open rotors are once again under consideration for propulsion of the future airliners because of their high efficiency. The noise generated by these propulsion systems must meet the stringent noise standards of today to reduce community impact. In this paper we review the open rotor noise prediction methods available at NASA Langley. We discuss three codes called ASSPIN (Advanced Subsonic-Supersonic Propeller Induced Noise), FW - Hpds (Ffowcs Williams-Hawkings with penetrable data surface) and the FSC (Fast Scattering Code). The first two codes are in the time domain and the third code is a frequency domain code. The capabilities of these codes and the input data requirements as well as the output data are presented. Plans for further improvements of these codes are discussed. In particular, a method based on equivalent sources is outlined to get rid of spurious signals in the FW - Hpds code.

[The Patient Rights Act (PatRG)--part 1: legislative procedure, treatment contract, contracting parties and their obligations to cooperate and inform].

PubMed

Parzeller, Markus; Zedler, Barbara

2013-01-01

The article deals with the new regulations in the German Civil Code (BGB) which came into effect in Germany on 26 Feb 2013 as the Patient Rights Act (PatRG). In Part I, the legislative procedure, the treatment contract and the contracting parties (Section 630a Civil Code), the applicable regulations (Section 630b Civil Code) and the obligations to cooperate and inform (Section 630c Civil Code) are discussed and critically analysed.

A qualitative study on physicians' perceptions of specialty characteristics.

PubMed

Park, Kwi Hwa; Jun, Soo-Koung; Park, Ie Byung

2016-09-01

There has been limited research on physicians' perceptions of the specialty characteristics that are needed to sustain a successful career in medical specialties in Korea. Medical Specialty Preference Inventory in the United States or SCI59 (specialty choice inventory) in the United Kingdom are implemented to help medical students plan their careers. The purpose of this study was to explore the characteristics of the major specialties in Korea. Twelve physicians from different specialties participated in an exploratory study consisting of qualitative interviews about the personal ability and emotional characteristics and job attributes of each specialty. The collected data were analysed with content analysis methods. Twelve codes were extracted for ability & skill attributes, 23 codes for emotion & attitude attributes, and 12 codes for job attributes. Each specialty shows a different profile in terms of its characteristic attributes. The findings have implications for the design of career planning programs for medical students.

Construction and Utilization of a Beowulf Computing Cluster: A User's Perspective

NASA Technical Reports Server (NTRS)

Woods, Judy L.; West, Jeff S.; Sulyma, Peter R.

2000-01-01

Lockheed Martin Space Operations - Stennis Programs (LMSO) at the John C Stennis Space Center (NASA/SSC) has designed and built a Beowulf computer cluster which is owned by NASA/SSC and operated by LMSO. The design and construction of the cluster are detailed in this paper. The cluster is currently used for Computational Fluid Dynamics (CFD) simulations. The CFD codes in use and their applications are discussed. Examples of some of the work are also presented. Performance benchmark studies have been conducted for the CFD codes being run on the cluster. The results of two of the studies are presented and discussed. The cluster is not currently being utilized to its full potential; therefore, plans are underway to add more capabilities. These include the addition of structural, thermal, fluid, and acoustic Finite Element Analysis codes as well as real-time data acquisition and processing during test operations at NASA/SSC. These plans are discussed as well.

CASL Verification and Validation Plan

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

Mousseau, Vincent Andrew; Dinh, Nam

2016-06-30

This report documents the Consortium for Advanced Simulation of LWRs (CASL) verification and validation plan. The document builds upon input from CASL subject matter experts, most notably the CASL Challenge Problem Product Integrators, CASL Focus Area leaders, and CASL code development and assessment teams. This document will be a living document that will track progress on CASL to do verification and validation for both the CASL codes (including MPACT, CTF, BISON, MAMBA) and for the CASL challenge problems (CIPS, PCI, DNB). The CASL codes and the CASL challenge problems are at differing levels of maturity with respect to validation andmore » verification. The gap analysis will summarize additional work that needs to be done. Additional VVUQ work will be done as resources permit. This report is prepared for the Department of Energy’s (DOE’s) CASL program in support of milestone CASL.P13.02.« less

SU-F-T-366: Dosimetric Parameters Enhancement of 120-Leaf Millennium MLC Using EGSnrc and IAEA Phase-Space Data

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

Haddad, K; Alopoor, H

Purpose: Recently, the multileaf collimators (MLC) have become an important part of any LINAC collimation systems because they reduce the treatment planning time and improves the conformity. Important factors that affects the MLCs collimation performance are leaves material composition and their thickness. In this study, we investigate the main dosimetric parameters of 120-leaf Millennium MLC including dose in the buildup point, physical penumbra as well as average and end leaf leakages. Effects of the leaves geometry and density on these parameters are evaluated Methods: From EGSnrc Monte Carlo code, BEAMnrc and DOSXYZnrc modules are used to evaluate the dosimetric parametersmore » of a water phantom exposed to a Varian xi for 100cm SSD. Using IAEA phasespace data just above MLC (Z=46cm) and BEAMnrc, for the modified 120-leaf Millennium MLC a new phase space data at Z=52cm is produces. The MLC is modified both in leaf thickness and material composition. EGSgui code generates 521ICRU library for tungsten alloys. DOSXYZnrc with the new phase space evaluates the dose distribution in a water phantom of 60×60×20 cm3 with voxel size of 4×4×2 mm3. Using DOSXYZnrc dose distributions for open beam and closed beam as well as the leakages definition, end leakage, average leakage and physical penumbra are evaluated. Results: A new MLC with improved dosimetric parameters is proposed. The physical penumbra for proposed MLC is 4.7mm compared to 5.16 mm for Millennium. Average leakage in our design is reduced to 1.16% compared to 1.73% for Millennium, the end leaf leakage suggested design is also reduced to 4.86% compared to 7.26% of Millennium. Conclusion: The results show that the proposed MLC with enhanced dosimetric parameters could improve the conformity of treatment planning.« less

Diffusion of anti-VEGF injections in the Portuguese National Health System

PubMed Central

Marques, Ana Patrícia; Macedo, António Filipe; Perelman, Julian; Aguiar, Pedro; Rocha-Sousa, Amândio; Santana, Rui

2015-01-01

Objectives To analyse the temporal and geographical diffusion of antivascular endothelial growth factor (anti-VEGF) interventions, and its determinants in a National Health System (NHS). Setting NHS Portuguese hospitals. Participants All inpatient and day cases related to eye diseases at all Portuguese public hospitals for the period 2002–2012 were selected on the basis of four International Classification of Diseases 9th revision, Clinical Modification (ICD-9-CM) codes for procedures: 1474, 1475, 1479 and 149. Primary and secondary outcome measures We measured anti-VEGF treatment rates by year and county. The determinants of the geographical diffusion were investigated using generalised linear modelling. Results We analysed all hospital discharges from all NHS hospitals in Portugal (98 408 hospital discharges corresponding to 57 984 patients). National rates of hospitals episodes for the codes for procedures used were low before anti-VEGF approval in 2007 (less than 12% of hospital discharges). Between 2007 and 2012, the rates of hospital episodes related to the introduction of anti-VEGF injections increased by 27% per year. Patients from areas without ophthalmology departments received fewer treatments than those from areas with ophthalmology departments. The availability of an ophthalmology department in the county increased the rates of hospital episodes by 243%, and a 100-persons greater density per km2 raised the rates by 11%. Conclusions Our study shows a large but unequal diffusion of anti-VEGF treatments despite the universal coverage and very low copayments. The technological innovation in ophthalmology may thus produce unexpected inequalities related to financial constraints unless the implementation of innovative techniques is planned and regulated. PMID:26597866

Development and clinical introduction of automated radiotherapy treatment planning for prostate cancer

NASA Astrophysics Data System (ADS)

Winkel, D.; Bol, G. H.; van Asselen, B.; Hes, J.; Scholten, V.; Kerkmeijer, L. G. W.; Raaymakers, B. W.

2016-12-01

To develop an automated radiotherapy treatment planning and optimization workflow to efficiently create patient specifically optimized clinical grade treatment plans for prostate cancer and to implement it in clinical practice. A two-phased planning and optimization workflow was developed to automatically generate 77Gy 5-field simultaneously integrated boost intensity modulated radiation therapy (SIB-IMRT) plans for prostate cancer treatment. A retrospective planning study (n  =  100) was performed in which automatically and manually generated treatment plans were compared. A clinical pilot (n  =  21) was performed to investigate the usability of our method. Operator time for the planning process was reduced to  <5 min. The retrospective planning study showed that 98 plans met all clinical constraints. Significant improvements were made in the volume receiving 72Gy (V72Gy) for the bladder and rectum and the mean dose of the bladder and the body. A reduced plan variance was observed. During the clinical pilot 20 automatically generated plans met all constraints and 17 plans were selected for treatment. The automated radiotherapy treatment planning and optimization workflow is capable of efficiently generating patient specifically optimized and improved clinical grade plans. It has now been adopted as the current standard workflow in our clinic to generate treatment plans for prostate cancer.

Evaluative methodology for comprehensive water quality management planning

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

Dyer, H. L.

Computer-based evaluative methodologies have been developed to provide for the analysis of coupled phenomena associated with natural resource comprehensive planning requirements. Provisions for planner/computer interaction have been included. Each of the simulation models developed is described in terms of its coded procedures. An application of the models for water quality management planning is presented; and the data requirements for each of the models are noted.

131. ARAII Administration building (ARA613) floor plans for first and ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

131. ARA-II Administration building (ARA-613) floor plans for first and second floors. Includes roof plan. Shows use of rooms as offices, laboratory, conference room. F.C. Torkelson Company 842-area/SL-1-613-A-1. Date: October 1958. Ineel index code no. 070-0613-00-851-150718. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

Flight software issues in onboard automated planning: lessons learned on EO-1

NASA Technical Reports Server (NTRS)

Tran, Daniel; Chien, Steve; Rabideau, Gregg; Cichy, Benjamin

2004-01-01

This paper focuses on the onboard planner and scheduler CASPER, whose core planning engine is based on the ground system ASPEN. Given the challenges of developing flight software, we discuss several of the issues encountered in preparing the planner for flight, including reducing the code image size, determining what data to place within the engineering telemetry packet, and performing long term planning.

Coding accuracy for Parkinson's disease hospital admissions: implications for healthcare planning in the UK.

PubMed

Muzerengi, S; Rick, C; Begaj, I; Ives, N; Evison, F; Woolley, R L; Clarke, C E

2017-05-01

Hospital Episode Statistics data are used for healthcare planning and hospital reimbursements. Reliability of these data is dependent on the accuracy of individual hospitals reporting Secondary Uses Service (SUS) which includes hospitalisation. The number and coding accuracy for Parkinson's disease hospital admissions at a tertiary centre in Birmingham was assessed. Retrospective, routine-data-based study. A retrospective electronic database search for all Parkinson's disease patients admitted to the tertiary hospital over a 4-year period (2009-2013) was performed on the SUS database using International Classification of Disease codes, and on the local inpatient electronic prescription database, Prescription and Information Communications System, using medication prescriptions. Capture-recapture methods were used to estimate the number of patients and admissions missed by both databases. From the two databases, between July 2009 and June 2013, 1068 patients with Parkinson's disease accounted for 1999 admissions. During these admissions, the Parkinson's disease was coded as a primary or secondary diagnosis. Ninety-one percent of these admissions were recorded on the SUS database. Capture-recapture methods estimated that the number of Parkinson's disease patients admitted during this period was 1127 patients (95% confidence interval: 1107-1146). A supplementary search of both SUS and Prescription and Information Communications System was undertaken using the hospital numbers of these 1068 patients. This identified another 479 admissions. SUS database under-estimated Parkinson's disease admissions by 27% during the study period. The accuracy of disease coding is critical for healthcare policy planning and must be improved. If the under-reporting of Parkinson's disease admissions on the SUS database is repeated nationally, expenditure on Parkinson's disease admissions in England is under-estimated by approximately £61 million per year. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

ART/Ada design project, phase 1. Task 3 report: Test plan

NASA Technical Reports Server (NTRS)

Allen, Bradley P.

1988-01-01

The plan is described for the integrated testing and benchmark of Phase Ada based ESBT Design Research Project. The integration testing is divided into two phases: (1) the modules that do not rely on the Ada code generated by the Ada Generator are tested before the Ada Generator is implemented; and (2) all modules are integrated and tested with the Ada code generated by the Ada Generator. Its performance and size as well as its functionality is verified in this phase. The target platform is a DEC Ada compiler on VAX mini-computers and VAX stations running the VMS operating system.

WE-A-304-01: Strategies and Technologies for Cranial Radiosurgery Planning: MLC-Based Linac

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

Kim, G.

2015-06-15

The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Futuremore » directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB.« less

WE-A-304-02: Strategies and Technologies for Cranial Radiosurgery Planning: Gamma Knife

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

Schlesinger, D.

2015-06-15

The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Futuremore » directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB.« less

Performance of dose calculation algorithms from three generations in lung SBRT: comparison with full Monte Carlo‐based dose distributions

PubMed Central

Kapanen, Mika K.; Hyödynmaa, Simo J.; Wigren, Tuija K.; Pitkänen, Maunu A.

2014-01-01

The accuracy of dose calculation is a key challenge in stereotactic body radiotherapy (SBRT) of the lung. We have benchmarked three photon beam dose calculation algorithms — pencil beam convolution (PBC), anisotropic analytical algorithm (AAA), and Acuros XB (AXB) — implemented in a commercial treatment planning system (TPS), Varian Eclipse. Dose distributions from full Monte Carlo (MC) simulations were regarded as a reference. In the first stage, for four patients with central lung tumors, treatment plans using 3D conformal radiotherapy (CRT) technique applying 6 MV photon beams were made using the AXB algorithm, with planning criteria according to the Nordic SBRT study group. The plans were recalculated (with same number of monitor units (MUs) and identical field settings) using BEAMnrc and DOSXYZnrc MC codes. The MC‐calculated dose distributions were compared to corresponding AXB‐calculated dose distributions to assess the accuracy of the AXB algorithm, to which then other TPS algorithms were compared. In the second stage, treatment plans were made for ten patients with 3D CRT technique using both the PBC algorithm and the AAA. The plans were recalculated (with same number of MUs and identical field settings) with the AXB algorithm, then compared to original plans. Throughout the study, the comparisons were made as a function of the size of the planning target volume (PTV), using various dose‐volume histogram (DVH) and other parameters to quantitatively assess the plan quality. In the first stage also, 3D gamma analyses with threshold criteria 3%/3 mm and 2%/2 mm were applied. The AXB‐calculated dose distributions showed relatively high level of agreement in the light of 3D gamma analysis and DVH comparison against the full MC simulation, especially with large PTVs, but, with smaller PTVs, larger discrepancies were found. Gamma agreement index (GAI) values between 95.5% and 99.6% for all the plans with the threshold criteria 3%/3 mm were achieved, but 2%/2 mm threshold criteria showed larger discrepancies. The TPS algorithm comparison results showed large dose discrepancies in the PTV mean dose (D50%), nearly 60%, for the PBC algorithm, and differences of nearly 20% for the AAA, occurring also in the small PTV size range. This work suggests the application of independent plan verification, when the AAA or the AXB algorithm are utilized in lung SBRT having PTVs smaller than 20‐25 cc. The calculated data from this study can be used in converting the SBRT protocols based on type ‘a’ and/or type ‘b’ algorithms for the most recent generation type ‘c’ algorithms, such as the AXB algorithm. PACS numbers: 87.55.‐x, 87.55.D‐, 87.55.K‐, 87.55.kd, 87.55.Qr PMID:24710454

CACTI: free, open-source software for the sequential coding of behavioral interactions.

PubMed

Glynn, Lisa H; Hallgren, Kevin A; Houck, Jon M; Moyers, Theresa B

2012-01-01

The sequential analysis of client and clinician speech in psychotherapy sessions can help to identify and characterize potential mechanisms of treatment and behavior change. Previous studies required coding systems that were time-consuming, expensive, and error-prone. Existing software can be expensive and inflexible, and furthermore, no single package allows for pre-parsing, sequential coding, and assignment of global ratings. We developed a free, open-source, and adaptable program to meet these needs: The CASAA Application for Coding Treatment Interactions (CACTI). Without transcripts, CACTI facilitates the real-time sequential coding of behavioral interactions using WAV-format audio files. Most elements of the interface are user-modifiable through a simple XML file, and can be further adapted using Java through the terms of the GNU Public License. Coding with this software yields interrater reliabilities comparable to previous methods, but at greatly reduced time and expense. CACTI is a flexible research tool that can simplify psychotherapy process research, and has the potential to contribute to the improvement of treatment content and delivery.

42 CFR 411.101 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Under Group Health Plans: General Provisions § 411.101 Definitions. As used in this subpart and in... individual States, Puerto Rico, the Virgin Islands, Guam, American Samoa, the Northern Mariana Islands, and... taxes on employers and employees under section 21 of the Internal Revenue Code. Group health plan (GHP...

146. ARAIII Control building (ARA607) Roof plan and details. Aerojetgeneral ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

146. ARA-III Control building (ARA-607) Roof plan and details. Aerojet-general 880-area/GCRE-607-A-3. Date: February 1958. Ineel index code no. 063-0607-00-013-102548. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

75 FR 9027 - Proposed Collection; Comment Request for Regulation Project

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-26

... concerning REG-105885-99 (T.D. 9075) Compensation Deferred Under Eligible deferred Compensation Plans (Sec. 1... Deferred Under Eligible Deferred Compensation Plans. OMB Number: 1545-1580. Regulation Project Number: REG... made changes to rules under Internal Revenue Code section 457 regarding eligible deferred compensation...

75 FR 9614 - Manufacturer of Controlled Substances; Notice of Registration

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-03

... manufacturer of the basic classes of controlled substances listed in schedule I: Drug Schedule Marihuana (7360) I Tetrahydrocannabinols (7370) I The company plans to manufacture small quantities of marihuana derivatives for research purposes. In reference to drug code 7360 (Marihuana), the company plans to bulk...

76 FR 21917 - Manufacturer of Controlled Substances; Notice of Registration

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-19

... manufacturer of the following basic classes of controlled substances: Drug Schedule Marihuana (7360) I Tetrahydrocannabinols (7370) I The company plans to manufacture small quantities of marihuana derivatives for research purposes. In reference to drug code 7360 (Marihuana), the company plans to bulk manufacture cannabidiol. In...

75 FR 64744 - Manufacturer of Controlled Substances; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-20

... manufacturer of the basic classes of controlled substances listed in schedule I: Drug Schedule Marihuana (7360) I Tetrahydrocannabinols (7370) I The company plans to manufacture small quantities of marihuana derivatives for research purposes. In reference to drug code 7360 (Marihuana), the company plans to bulk...

The Annuity Option.

ERIC Educational Resources Information Center

Demsey, Brian R.

1991-01-01

For school executives, annuities have become the preferred retirement vehicle, because other private-sector investments (some deferred compensation and profit-sharing plans) are closed to public employees. This article explains Internal Revenue Code sections 403 (b) and 457 and 1986 Tax Reform Act provisions related to tax-sheltered annuity plans.…

LOFT. Containment and service building (TAN650). Roof plan and details. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

LOFT. Containment and service building (TAN-650). Roof plan and details. Kaiser engineers 6413-11-STEP/LOFT-650-A-8. Date: October 1964. INEEL index code no. 036-650-00-486-122220 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

Physician Reimbursement in Medicare Advantage Compared With Traditional Medicare and Commercial Health Insurance.

PubMed

Trish, Erin; Ginsburg, Paul; Gascue, Laura; Joyce, Geoffrey

2017-09-01

Nearly one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, yet little is known about the prices that MA plans pay for physician services. Medicare Advantage insurers typically also sell commercial plans, and the extent to which MA physician reimbursement reflects traditional Medicare (TM) rates vs negotiated commercial prices is unclear. To compare prices paid for physician and other health care services in MA, traditional Medicare, and commercial plans. Retrospective analysis of claims data evaluating MA prices paid to physicians and for laboratory services and durable medical equipment between 2007 and 2012 in 348 US core-based statistical areas. The study population included all MA and commercial enrollees with a large national health insurer operating in both markets, as well as a 20% sample of TM beneficiaries. Enrollment in an MA plan. Mean reimbursement paid to physicians, laboratories, and durable medical equipment suppliers for MA and commercial enrollees relative to TM rates for 11 Healthcare Common Procedure Coding Systems (HCPCS) codes spanning 7 sites of care. The sample consisted of 144 million claims. Physician reimbursement in MA was more strongly tied to TM rates than commercial prices, although MA plans tended to pay physicians less than TM. For a mid-level office visit with an established patient (Current Procedural Terminology [CPT] code 99213), the mean MA price was 96.9% (95% CI, 96.7%-97.2%) of TM. Across the common physician services we evaluated, mean MA reimbursement ranged from 91.3% of TM for cataract removal in an ambulatory surgery center (CPT 66984; 95% CI, 90.7%-91.9%) to 102.3% of TM for complex evaluation and management of a patient in the emergency department (CPT 99285; 95% CI, 102.1%-102.6%). However, for laboratory services and durable medical equipment, where commercial prices are lower than TM rates, MA plans take advantage of these lower commercial prices, ranging from 67.4% for a walker (HCPCS code E0143; 95% CI, 66.3%-68.5%) to 75.8% for a complete blood cell count (CPT 85025; 95% CI, 75.0%-76.6%). Traditional Medicare's administratively set rates act as a strong anchor for physician reimbursement in the MA market, although MA plans succeed in negotiating lower prices for other health care services for which TM overpays. Reforms that transition the Medicare program toward some premium support models could substantially affect how physicians and other clinicians are paid.

Implementation of the DPM Monte Carlo code on a parallel architecture for treatment planning applications.

PubMed

Tyagi, Neelam; Bose, Abhijit; Chetty, Indrin J

2004-09-01

We have parallelized the Dose Planning Method (DPM), a Monte Carlo code optimized for radiotherapy class problems, on distributed-memory processor architectures using the Message Passing Interface (MPI). Parallelization has been investigated on a variety of parallel computing architectures at the University of Michigan-Center for Advanced Computing, with respect to efficiency and speedup as a function of the number of processors. We have integrated the parallel pseudo random number generator from the Scalable Parallel Pseudo-Random Number Generator (SPRNG) library to run with the parallel DPM. The Intel cluster consisting of 800 MHz Intel Pentium III processor shows an almost linear speedup up to 32 processors for simulating 1 x 10(8) or more particles. The speedup results are nearly linear on an Athlon cluster (up to 24 processors based on availability) which consists of 1.8 GHz+ Advanced Micro Devices (AMD) Athlon processors on increasing the problem size up to 8 x 10(8) histories. For a smaller number of histories (1 x 10(8)) the reduction of efficiency with the Athlon cluster (down to 83.9% with 24 processors) occurs because the processing time required to simulate 1 x 10(8) histories is less than the time associated with interprocessor communication. A similar trend was seen with the Opteron Cluster (consisting of 1400 MHz, 64-bit AMD Opteron processors) on increasing the problem size. Because of the 64-bit architecture Opteron processors are capable of storing and processing instructions at a faster rate and hence are faster as compared to the 32-bit Athlon processors. We have validated our implementation with an in-phantom dose calculation study using a parallel pencil monoenergetic electron beam of 20 MeV energy. The phantom consists of layers of water, lung, bone, aluminum, and titanium. The agreement in the central axis depth dose curves and profiles at different depths shows that the serial and parallel codes are equivalent in accuracy.

Exercise ASKARI SERPENT: enabling clinical data collection during exercises and operations to support future contingency planning and assurance of category-based reporting systems.

PubMed

Parsons, Iain T; Wheatley, R J; Carter, P

2016-02-01

Exercise ASKARI SERPENT (Ex AS) is a British Army exercise that provides primary healthcare (PHC) to Kenyan civilians in support of local health authorities. It is conducted in partnership with the Kenya Defence Force Medical Services (KDFMS). Accurate epidemiological data is critical in planning the exercise and for any future short-notice contingency operations in similar environments. This paper reports epidemiological data for Ex AS using a novel data collection system. PHC on Ex AS was delivered by trained and validated combat medical technicians (CMTs) using a set of Read-coded protocols. The CMTs were also directly supported and supervised by medical officers and nurses. A total of 3093 consultations were conducted over a 16-day period. Of these, 2707 (87.5%) consultations fell within the remit of the CMT protocols, with only 386 consultations (12.5%) being conducted exclusively by the medical officers or nurses. A Read-coded matrix built on CMT protocols is a simple and useful tool, particularly in civilian populations, for collecting morbidity data with the vast majority of conditions accounted for in the protocols. It is anticipated that such a system can better inform training, manning, medical material and pharmaceutical procurement than current category-based morbidity surveillance systems such as EPINATO (NATO epidemiological data). There is clear advantage to directly linking data capture to treatment algorithms. Accuracy, both in terms of numbers and condition, is likely improved. Data is also captured contemporaneously rather than after indeterminate time. Read coding has the added benefit of being an established electronic standard. In addition, the system would support traditional reporting methods such as EPINATO by providing increased assurance. 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/

Methodology, status and plans for development and assessment of HEXTRAN, TRAB and APROS

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

Vanttola, T.; Rajamaeki, M.; Tiihonen, O.

1997-07-01

A number of transient and accident analysis codes have been developed in Finland during the past twenty years mainly for the needs of their own power plants, but some of the codes have also been utilized elsewhere. The continuous validation, simultaneous development and experiences obtained in commercial applications have considerably improved the performance and range of application of the codes. At present, the methods allow fairly covering accident analysis of the Finnish nuclear power plants.

Observations on Polar Coding with CRC-Aided List Decoding

DTIC Science & Technology

2016-09-01

9 v 1. INTRODUCTION Polar codes are a new type of forward error correction (FEC) codes, introduced by Arikan in [1], in which he...error correction (FEC) currently used and planned for use in Navy wireless communication systems. The project’s results from FY14 and FY15 are...good error- correction per- formance. We used the Tal/Vardy method of [5]. The polar encoder uses a row vector u of length N . Let uA be the subvector

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

Yoo, Jun Soo; Choi, Yong Joon

The RELAP-7 code verification and validation activities are ongoing under the code assessment plan proposed in the previous document (INL-EXT-16-40015). Among the list of V&V test problems in the ‘RELAP-7 code V&V RTM (Requirements Traceability Matrix)’, the RELAP-7 7-equation model has been tested with additional demonstration problems and the results of these tests are reported in this document. In this report, we describe the testing process, the test cases that were conducted, and the results of the evaluation.

AutoLock: a semiautomated system for radiotherapy treatment plan quality control

PubMed Central

Lowe, Matthew; Hardy, Mark J.; Boylan, Christopher J.; Whitehurst, Philip; Rowbottom, Carl G.

2015-01-01

A semiautomated system for radiotherapy treatment plan quality control (QC), named AutoLock, is presented. AutoLock is designed to augment treatment plan QC by automatically checking aspects of treatment plans that are well suited to computational evaluation, whilst summarizing more subjective aspects in the form of a checklist. The treatment plan must pass all automated checks and all checklist items must be acknowledged by the planner as correct before the plan is finalized. Thus AutoLock uniquely integrates automated treatment plan QC, an electronic checklist, and plan finalization. In addition to reducing the potential for the propagation of errors, the integration of AutoLock into the plan finalization workflow has improved efficiency at our center. Detailed audit data are presented, demonstrating that the treatment plan QC rejection rate fell by around a third following the clinical introduction of AutoLock. PACS number: 87.55.Qr PMID:26103498

AutoLock: a semiautomated system for radiotherapy treatment plan quality control.

PubMed

Dewhurst, Joseph M; Lowe, Matthew; Hardy, Mark J; Boylan, Christopher J; Whitehurst, Philip; Rowbottom, Carl G

2015-05-08

A semiautomated system for radiotherapy treatment plan quality control (QC), named AutoLock, is presented. AutoLock is designed to augment treatment plan QC by automatically checking aspects of treatment plans that are well suited to computational evaluation, whilst summarizing more subjective aspects in the form of a checklist. The treatment plan must pass all automated checks and all checklist items must be acknowledged by the planner as correct before the plan is finalized. Thus AutoLock uniquely integrates automated treatment plan QC, an electronic checklist, and plan finalization. In addition to reducing the potential for the propagation of errors, the integration of AutoLock into the plan finalization workflow has improved efficiency at our center. Detailed audit data are presented, demonstrating that the treatment plan QC rejection rate fell by around a third following the clinical introduction of AutoLock.

A new Gamma Knife registered radiosurgery paradigm: Tomosurgery

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

Hu, X.; Maciunas, R. J.; Dean, D.

This study proposes and simulates an inverse treatment planning and a continuous dose delivery approach for the Leksell Gamma Knife registered (LGK, Elekta, Stockholm, Sweden) which we refer to as 'Tomosurgery'. Tomosurgery uses an isocenter that moves within the irradiation field to continuously deliver the prescribed radiation dose in a raster-scanning format, slice by slice, within an intracranial lesion. Our Tomosurgery automated (inverse) treatment planning algorithm utilizes a two-stage optimization strategy. The first stage reduces the current three-dimensional (3D) treatment planning problem to a series of more easily solved 2D treatment planning subproblems. In the second stage, those 2D treatmentmore » plans are assembled to obtain a final 3D treatment plan for the entire lesion. We created Tomosurgery treatment plans for 11 patients who had already received manually-generated LGK treatment plans to treat brain tumors. For the seven cases without critical structures (CS), the Tomosurgery treatment plans showed borderline to significant improvement in within-tumor dose standard deviation (STD) (p<0.058, or p<0.011 excluding case 2) and conformality (p<0.042), respectively. In three of the four cases that presented CS, the Tomosurgery treatment plans showed no statistically significant improvements in dose conformality (p<0.184), and borderline significance in improving within-tumor dose homogeneity (p<0.054); CS damage measured by V{sub 20} or V{sub 30} (i.e., irradiated CS volume that receives {>=}20% or {>=}30% of the maximum dose) showed no significant improvement in the Tomosurgery treatment plans (p<0.345 and p<0.423, respectively). However, the overall CS dose volume histograms were improved in the Tomosurgery treatment plans. In addition, the LGK Tomosurgery inverse treatment planning required less time than standard of care, forward (manual) LGK treatment planning (i.e., 5-35 min vs 1-3 h) for all 11 cases. We expect that LGK Tomosurgery will speed treatment planning and improve treatment quality, especially for large and/or geometrically complex lesions. However, using only 4 mm collimators could greatly increase treatment plan delivery time for a large brain lesion. This issue is subject to further investigation.« less

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

Brualla, Lorenzo, E-mail: lorenzo.brualla@uni-due.de; Zaragoza, Francisco J.; Sempau, Josep

Purpose: External beam radiotherapy is the only conservative curative approach for Stage I non-Hodgkin lymphomas of the conjunctiva. The target volume is geometrically complex because it includes the eyeball and lid conjunctiva. Furthermore, the target volume is adjacent to radiosensitive structures, including the lens, lacrimal glands, cornea, retina, and papilla. The radiotherapy planning and optimization requires accurate calculation of the dose in these anatomical structures that are much smaller than the structures traditionally considered in radiotherapy. Neither conventional treatment planning systems nor dosimetric measurements can reliably determine the dose distribution in these small irradiated volumes. Methods and Materials: The Montemore » Carlo simulations of a Varian Clinac 2100 C/D and human eye were performed using the PENELOPE and PENEASYLINAC codes. Dose distributions and dose volume histograms were calculated for the bulbar conjunctiva, cornea, lens, retina, papilla, lacrimal gland, and anterior and posterior hemispheres. Results: The simulated results allow choosing the most adequate treatment setup configuration, which is an electron beam energy of 6 MeV with additional bolus and collimation by a cerrobend block with a central cylindrical hole of 3.0 cm diameter and central cylindrical rod of 1.0 cm diameter. Conclusions: Monte Carlo simulation is a useful method to calculate the minute dose distribution in ocular tissue and to optimize the electron irradiation technique in highly critical structures. Using a voxelized eye phantom based on patient computed tomography images, the dose distribution can be estimated with a standard statistical uncertainty of less than 2.4% in 3 min using a computing cluster with 30 cores, which makes this planning technique clinically relevant.« less

IMRT head and neck treatment planning with a commercially available Monte Carlo based planning system

NASA Astrophysics Data System (ADS)

Boudreau, C.; Heath, E.; Seuntjens, J.; Ballivy, O.; Parker, W.

2005-03-01

The PEREGRINE Monte Carlo dose-calculation system (North American Scientific, Cranberry Township, PA) is the first commercially available Monte Carlo dose-calculation code intended specifically for intensity modulated radiotherapy (IMRT) treatment planning and quality assurance. In order to assess the impact of Monte Carlo based dose calculations for IMRT clinical cases, dose distributions for 11 head and neck patients were evaluated using both PEREGRINE and the CORVUS (North American Scientific, Cranberry Township, PA) finite size pencil beam (FSPB) algorithm with equivalent path-length (EPL) inhomogeneity correction. For the target volumes, PEREGRINE calculations predict, on average, a less than 2% difference in the calculated mean and maximum doses to the gross tumour volume (GTV) and clinical target volume (CTV). An average 16% ± 4% and 12% ± 2% reduction in the volume covered by the prescription isodose line was observed for the GTV and CTV, respectively. Overall, no significant differences were noted in the doses to the mandible and spinal cord. For the parotid glands, PEREGRINE predicted a 6% ± 1% increase in the volume of tissue receiving a dose greater than 25 Gy and an increase of 4% ± 1% in the mean dose. Similar results were noted for the brainstem where PEREGRINE predicted a 6% ± 2% increase in the mean dose. The observed differences between the PEREGRINE and CORVUS calculated dose distributions are attributed to secondary electron fluence perturbations, which are not modelled by the EPL correction, issues of organ outlining, particularly in the vicinity of air cavities, and differences in dose reporting (dose to water versus dose to tissue type).

A NASPAC-Based Analysis of the Delay and Cost Effects of the Dallas/Fort Worth Metroplex Plan

DTIC Science & Technology

1992-10-01

Federal Aviation Administration Operations Research Service 14. Sponsoring Agency Code Washington, DC 20590 AOR-100 15. Supplementary Notes 16 . Abstract...LIST OF ILLUSTRATIONS Figure Page 1 DFW Area Airports 3 2 Forecasted Number of Daily Operations at DFW 12 3 Annual Savings at DFW with the Plan 16 4...Increase in System Operational Delay Without Plan 24 15 Average System Operational Delay 26 16 System Operational Delay Savings with Plan 26 17 System

40 CFR 92.705 - Remedial plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... POLLUTION FROM LOCOMOTIVES AND LOCOMOTIVE ENGINES Recall Regulations § 92.705 Remedial plan. (a) When any... adequate supply of parts will be available to initiate the repair campaign, the percentage of the total... intact. (3) The label shall contain: (i) The recall campaign number; and (ii) A code designating the...

45 CFR 155.20 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS EXCHANGE ESTABLISHMENT... Care Act of 2010 (Pub. L. 111-148), as amended by the Health Care and Education Reconciliation Act of.... Catastrophic plan means a health plan described in section 1302(e) of the Affordable Care Act. Code means the...

78 FR 65875 - Approval and Promulgation of Air Quality Implementation Plans; Wisconsin; Removal of Gasoline...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

...] Approval and Promulgation of Air Quality Implementation Plans; Wisconsin; Removal of Gasoline Vapor... Administrative Code, Chapter NR 420 Control of Organic Compound Emissions from Petroleum and Gasoline Sources... FROM PETROLEUM AND GASOLINE SOURCES. NR 420.01 as published in the (Wisconsin) Register, February, 1990...

40 CFR 52.1270 - Identification of plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Classification System (NAICS) codes 325193 or 312140,” APC-S-5 incorporated by reference from 40 CFR 52.21(b)(1... 40 Protection of Environment 4 2014-07-01 2014-07-01 false Identification of plan. 52.1270 Section 52.1270 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED...

IET area plot and utilities plan. Includes drainage. Ralph M. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

IET area plot and utilities plan. Includes drainage. Ralph M. Parsons 902-4-ANP-U-310. Date: February 1954. Approved by INEEL Classification Office for public release. INEEL code no. 035-0100-00-693-106898 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

123. ARAI Substation (ARA726) plan, elevation, security fence details, and ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

123. ARA-I Substation (ARA-726) plan, elevation, security fence details, and sections. Norman Engineering Company 961-area/SF-726-E-1. Date: January 1959. Ineel index code no. 068-0726-10-613-102778. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

29. PLAN OF THE ARVFS FIELD TEST FACILITY SHOWING BUNKER, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

29. PLAN OF THE ARVFS FIELD TEST FACILITY SHOWING BUNKER, CABLE CHASE, SHIELDING TANK AND FRAME ASSEMBLY. F.C. TORKELSON DRAWING NUMBER 842-ARVFS-701-1. INEL INDEX CODE NUMBER: 075 0701 851 151970. - Idaho National Engineering Laboratory, Advanced Reentry Vehicle Fusing System, Scoville, Butte County, ID

144. ARAIII Control building (ARA607) Foundation plan. Aerojetgeneral 880area/GCRE607S1. Date: ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

144. ARA-III Control building (ARA-607) Foundation plan. Aerojet-general 880-area/GCRE-607-S-1. Date: February 1958. Ineel index code no. 063-0607-60-013-102568. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

32. ISOMETRIC VIEW OF PIPING PLAN, SHOWING PATH OF CONDUIT ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

32. ISOMETRIC VIEW OF PIPING PLAN, SHOWING PATH OF CONDUIT FROM CONTROL BUNKER TO SHIELDING TANK. F.C. TORKELSON DRAWING NUMBER 842-ARVFS-701-P-1. INEL INDEX CODE NUMBER: 075 0701 60 851 151977. - Idaho National Engineering Laboratory, Advanced Reentry Vehicle Fusing System, Scoville, Butte County, ID

77 FR 41164 - Joint Subcommittee on Aquaculture Research and Development Strategic Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-12

... Development Strategic Plan AGENCIES: Agricultural Research Service (ARS), U.S. Department of Agriculture (USDA... Agricultural Research Service (USDA-ARS) announce on behalf of the Federal Interagency Working Group on... http://www.ars.usda.gov/research/programs/programs.htm?np_code=106&docid=22641 . DATES: Written...

77 FR 20217 - Secondary National Ambient Air Quality Standards for Oxides of Nitrogen and Sulfur

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-03

... Planning and Standards (OAQPS), U.S. Environmental Protection Agency, Mail Code C504-06, Research Triangle... of Research 3. Implementation Challenges 4. Monitoring Plan Development and Stakeholder Participation B. Summary of Proposed Evaluation of Monitoring Methods C. Comments on Field Pilot Program and...

Planned Contrasts: An Overview of Comparison Methods.

ERIC Educational Resources Information Center

Chatham, Kathy

Contrasts or comparisons can be used to investigate specific differences between means. Contrasts, as explained by B. Thompson (1985, 1994) are coding vectors that mathematically express hypotheses. The most basic categories of contrasts are planned and unplanned. The purpose of this paper is to explain the relative advantages of using planned…

153. ARAIII Reactor building (ARA608) Foundation plan. Aerojetgeneral 880area/GCRE608S1. Date: ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

153. ARA-III Reactor building (ARA-608) Foundation plan. Aerojet-general 880-area/GCRE-608-S-1. Date: February 1958. Ineel index code no. 063-0608-60-013-102653. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

75 FR 65594 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Particulate Matter Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... Promulgation of Air Quality Implementation Plans; Ohio; Particulate Matter Standards AGENCY: Environmental... in Ohio Administrative Code (OAC) Chapter 3745-17, ``Particulate Matter Standards.'' The revisions were submitted by Ohio EPA to satisfy the State's 5-year review requirements. The particulate matter...

75 FR 57412 - Approval and Promulgation of Implementation Plans Alabama: Volatile Organic Compounds

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-21

...] Approval and Promulgation of Implementation Plans Alabama: Volatile Organic Compounds AGENCY: Environmental... compounds'' (VOCs) found at Alabama Administrative Code section 335-3-1-.02(gggg). Specifically, the revision would add two compounds (propylene carbonate and dimethyl carbonate) to the list of those excluded...

18 CFR 430.9 - Comprehensive plan policies.

Code of Federal Regulations, 2011 CFR

2011-04-01

....20.4 of the Water Code of the Delaware River Basin shall be applied using the following definition of... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Comprehensive plan policies. 430.9 Section 430.9 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION...

Ready for "Code Red"? Pre-Plan for Safety

ERIC Educational Resources Information Center

Baker, Davis E.

2006-01-01

In this article, the author, a principal of Buckeye Valley High School, Delaware, Ohio, focuses on how to generate a building readiness plan. He suggests that school administrators should have a readily available notebook of emergency response procedures to ensure students' safety. Among other things, he recommends creation of a building…

PBF Reactor Building (PER620) Cubicle 13. Plan, section, details. Note ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

PBF Reactor Building (PER-620) Cubicle 13. Plan, section, details. Note "quality assurance" code at bottom of drawing. Aerojet Nuclear Company. Date: May 1976. INEEL index no. 761-0620-00-400-195279 - Idaho National Engineering Laboratory, SPERT-I & Power Burst Facility Area, Scoville, Butte County, ID

29 CFR 4043.28 - Plan merger, consolidation, or transfer.

Code of Federal Regulations, 2012 CFR

2012-07-01

... TERMINATIONS REPORTABLE EVENTS AND CERTAIN OTHER NOTIFICATION REQUIREMENTS Post-Event Notice of Reportable Events § 4043.28 Plan merger, consolidation, or transfer. (a) Reportable event. A reportable event occurs... section 414(1) of the Code. (b) Waivers. Notice is waived for this event. However, notice may be required...

29 CFR 4043.28 - Plan merger, consolidation, or transfer.

Code of Federal Regulations, 2011 CFR

2011-07-01

... TERMINATIONS REPORTABLE EVENTS AND CERTAIN OTHER NOTIFICATION REQUIREMENTS Post-Event Notice of Reportable Events § 4043.28 Plan merger, consolidation, or transfer. (a) Reportable event. A reportable event occurs... section 414(1) of the Code. (b) Waivers. Notice is waived for this event. However, notice may be required...

29 CFR 4043.28 - Plan merger, consolidation, or transfer.

Code of Federal Regulations, 2014 CFR

2014-07-01

... TERMINATIONS REPORTABLE EVENTS AND CERTAIN OTHER NOTIFICATION REQUIREMENTS Post-Event Notice of Reportable Events § 4043.28 Plan merger, consolidation, or transfer. (a) Reportable event. A reportable event occurs... section 414(1) of the Code. (b) Waivers. Notice is waived for this event. However, notice may be required...

29 CFR 4043.28 - Plan merger, consolidation, or transfer.

Code of Federal Regulations, 2013 CFR

2013-07-01

... TERMINATIONS REPORTABLE EVENTS AND CERTAIN OTHER NOTIFICATION REQUIREMENTS Post-Event Notice of Reportable Events § 4043.28 Plan merger, consolidation, or transfer. (a) Reportable event. A reportable event occurs... section 414(1) of the Code. (b) Waivers. Notice is waived for this event. However, notice may be required...

29 CFR 4043.28 - Plan merger, consolidation, or transfer.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TERMINATIONS REPORTABLE EVENTS AND CERTAIN OTHER NOTIFICATION REQUIREMENTS Post-Event Notice of Reportable Events § 4043.28 Plan merger, consolidation, or transfer. (a) Reportable event. A reportable event occurs... section 414(1) of the Code. (b) Waivers. Notice is waived for this event. However, notice may be required...

75 FR 65572 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality Standards AGENCY... Ohio Administrative Code (OAC) relating to the consolidation of Ohio's Ambient Air Quality Standards... apply to Ohio's SIP. Incorporating the air quality standards into Ohio's SIP helps assure that...

78 FR 52477 - Promulgation of State Implementation Plan Revisions; Revision to Prevention of Significant...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-23

...), Region 8, Mail Code 8P-AR, 1595 Wynkoop Street, Denver, Colorado 80202-1129. Hand Delivery: Director, Air Program, Environmental Protection Agency (EPA), Region 8, Mail Code 8P-AR, 1595 Wynkoop Street, Denver... Agency (EPA), Region 8, 1595 Wynkoop Street, Denver, Colorado 80202-1129. EPA requests that if at all...

76 FR 30081 - National Oil and Hazardous Substances Pollution Contingency Plan; National Priorities List...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

... Code 8EPR-SR, 1595 Wynkoop Street, Denver, CO 80202-1129 Hand delivery: Environmental Protection Agency, Region 8, Mail Code 8EPR-SR, 1595 Wynkoop Street, Denver, CO 80202-1129. Such deliveries are only... deliveries of boxed information. Instructions: Direct your comments to Docket ID no. EPA-HQ-SFUND- 1983-0002...

76 FR 27622 - Approval and Promulgation of State Implementation Plan Revisions; Infrastructure Requirements for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-12

...), Region 8, Mail Code 8P-AR, 1595 Wynkoop Street, Denver, Colorado 80202-1129. Hand Delivery: Director, Air Program, Environmental Protection Agency (EPA), Region 8, Mail Code 8P-AR, 1595 Wynkoop Street, Denver..., Denver, Colorado 80202-1129. EPA requests that if at all possible, you contact the individual listed in...

14 CFR 93.341 - Aircraft operations in the DC FRZ.

Code of Federal Regulations, 2010 CFR

2010-01-01

...-assigned discrete transponder code. The pilot must monitor VHF frequency 121.5 or UHF frequency 243.0. (d... authorization must file and activate an IFR or a DC FRZ or a DC SFRA flight plan and transmit a discrete transponder code assigned by an Air Traffic Control facility. Aircraft must transmit the discrete transponder...

Code Pulse: Software Assurance (SWA) Visual Analytics for Dynamic Analysis of Code

DTIC Science & Technology

2014-09-01

31 4.5.1 Market Analysis...competitive market analysis to assess the tool potential. The final transition targets were selected and expressed along with our research on the topic...public release milestones. Details of our testing methodology is in our Software Test Plan deliv- erable, CP- STP -0001. A summary of this approach is

DSN telemetry system performance with convolutionally code data

NASA Technical Reports Server (NTRS)

Mulhall, B. D. L.; Benjauthrit, B.; Greenhall, C. A.; Kuma, D. M.; Lam, J. K.; Wong, J. S.; Urech, J.; Vit, L. D.

1975-01-01

The results obtained to date and the plans for future experiments for the DSN telemetry system were presented. The performance of the DSN telemetry system in decoding convolutionally coded data by both sequential and maximum likelihood techniques is being determined by testing at various deep space stations. The evaluation of performance models is also an objective of this activity.

76 FR 28890 - Treatment of Property Used To Acquire Parent Stock or Securities in Certain Triangular...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-19

... Treatment of Property Used To Acquire Parent Stock or Securities in Certain Triangular Reorganizations... 367 of the Internal Revenue Code (Code) relating to the treatment of property used to acquire parent... subsidiary (S) purchases, in connection with the reorganization, stock of its parent corporation (P) in...

HIV/AIDS National Strategic Plans of Sub-Saharan African countries: an analysis for gender equality and sex-disaggregated HIV targets.

PubMed

Sherwood, Jennifer; Sharp, Alana; Cooper, Bergen; Roose-Snyder, Beirne; Blumenthal, Susan

2017-12-01

National Strategic Plans (NSPs) for HIV/AIDS are country planning documents that set priorities for programmes and services, including a set of targets to quantify progress toward national and international goals. The inclusion of sex-disaggregated targets and targets to combat gender inequality is important given the high disease burden among young women and adolescent girls in Sub-Saharan Africa, yet no comprehensive gender-focused analysis of NSP targets has been performed. This analysis quantitatively evaluates national HIV targets, included in NSPs from eighteen Sub-Saharan African countries, for sex-disaggregation. Additionally, NSP targets aimed at reducing gender-based inequality in health outcomes are compiled and inductively coded to report common themes. On average, in the eighteen countries included in this analysis, 31% of NSP targets include sex-disaggregation (range 0-92%). Three countries disaggregated a majority (>50%) of their targets by sex. Sex-disaggregation in data reporting was more common for targets related to the early phases of the HIV care continuum: 83% of countries included any sex-disaggregated targets for HIV prevention, 56% for testing and linkage to care, 22% for improving antiretroviral treatment coverage, and 11% for retention in treatment. The most common target to reduce gender inequality was to prevent gender-based violence (present in 50% of countries). Other commonly incorporated target areas related to improving women's access to family planning, human and legal rights, and decision-making power. The inclusion of sex-disaggregated targets in national planning is vital to ensure that programmes make progress for all population groups. Improving the availability and quality of indicators to measure gender inequality, as well as evaluating programme outcomes by sex, is critical to tracking this progress. This analysis reveals an urgent need to set specific and separate targets for men and women in order to achieve an equitable and effective HIV response and align government planning with international priorities for gender equality. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Implementation of a volumetric modulated arc therapy treatment planning solution for kidney and adrenal stereotactic body radiation therapy

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

Sonier, Marcus, E-mail: Marcus.Sonier@bccancer.bc.ca; Chu, William; Department of Radiation Oncology, University of Toronto, Toronto, ON

To develop a volumetric modulated arc therapy (VMAT) treatment planning solution in the treatment of primary renal cell carcinoma and oligometastatic adrenal lesions with stereotactic body radiation therapy. Single-arc VMAT plans (n = 5) were compared with clinically delivered step-and-shoot intensity-modulated radiotherapy (IMRT) with planning target volume coverage normalized between techniques. Target volume conformity, organ-at-risk (OAR) dose, treatment time, and monitor units were compared. A VMAT planning solution, created from a combination of arc settings and optimization constraints, auto-generated treatment plans in a single optimization. The treatment planning solution was evaluated on 15 consecutive patients receiving kidney and adrenal stereotacticmore » body radiation therapy. Treatment time was reduced from 13.0 ± 2.6 to 4.0 ± 0.9 minutes for IMRT and VMAT, respectively. The VMAT planning solution generated treatment plans with increased target homogeneity, improved 95% conformity index, and a reduced maximum point dose to nearby OARs but with increased intermediate dose to distant OARs. The conformity of the 95% isodose improved from 1.32 ± 0.39 to 1.12 ± 0.05 for IMRT and VMAT treatment plans, respectively. Evaluation of the planning solution showed clinically acceptable dose distributions for 13 of 15 cases with tight conformity of the prescription isodose to the planning target volume of 1.07 ± 0.04, delivering minimal dose to OARs. The introduction of a stereotactic body radiation therapy VMAT treatment planning solution improves the efficiency of planning and delivery time, producing treatment plans of comparable or superior quality to IMRT in the case of primary renal cell carcinoma and oligometastatic adrenal lesions.« less

Iterative dataset optimization in automated planning: Implementation for breast and rectal cancer radiotherapy.

PubMed

Fan, Jiawei; Wang, Jiazhou; Zhang, Zhen; Hu, Weigang

2017-06-01

To develop a new automated treatment planning solution for breast and rectal cancer radiotherapy. The automated treatment planning solution developed in this study includes selection of the iterative optimized training dataset, dose volume histogram (DVH) prediction for the organs at risk (OARs), and automatic generation of clinically acceptable treatment plans. The iterative optimized training dataset is selected by an iterative optimization from 40 treatment plans for left-breast and rectal cancer patients who received radiation therapy. A two-dimensional kernel density estimation algorithm (noted as two parameters KDE) which incorporated two predictive features was implemented to produce the predicted DVHs. Finally, 10 additional new left-breast treatment plans are re-planned using the Pinnacle 3 Auto-Planning (AP) module (version 9.10, Philips Medical Systems) with the objective functions derived from the predicted DVH curves. Automatically generated re-optimized treatment plans are compared with the original manually optimized plans. By combining the iterative optimized training dataset methodology and two parameters KDE prediction algorithm, our proposed automated planning strategy improves the accuracy of the DVH prediction. The automatically generated treatment plans using the dose derived from the predicted DVHs can achieve better dose sparing for some OARs without compromising other metrics of plan quality. The proposed new automated treatment planning solution can be used to efficiently evaluate and improve the quality and consistency of the treatment plans for intensity-modulated breast and rectal cancer radiation therapy. © 2017 American Association of Physicists in Medicine.

Evaluation of a Machine-Learning Algorithm for Treatment Planning in Prostate Low-Dose-Rate Brachytherapy

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

Nicolae, Alexandru; Department of Medical Physics, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Ontario; Morton, Gerard

Purpose: This work presents the application of a machine learning (ML) algorithm to automatically generate high-quality, prostate low-dose-rate (LDR) brachytherapy treatment plans. The ML algorithm can mimic characteristics of preoperative treatment plans deemed clinically acceptable by brachytherapists. The planning efficiency, dosimetry, and quality (as assessed by experts) of preoperative plans generated with an ML planning approach was retrospectively evaluated in this study. Methods and Materials: Preimplantation and postimplantation treatment plans were extracted from 100 high-quality LDR treatments and stored within a training database. The ML training algorithm matches similar features from a new LDR case to those within the trainingmore » database to rapidly obtain an initial seed distribution; plans were then further fine-tuned using stochastic optimization. Preimplantation treatment plans generated by the ML algorithm were compared with brachytherapist (BT) treatment plans in terms of planning time (Wilcoxon rank sum, α = 0.05) and dosimetry (1-way analysis of variance, α = 0.05). Qualitative preimplantation plan quality was evaluated by expert LDR radiation oncologists using a Likert scale questionnaire. Results: The average planning time for the ML approach was 0.84 ± 0.57 minutes, compared with 17.88 ± 8.76 minutes for the expert planner (P=.020). Preimplantation plans were dosimetrically equivalent to the BT plans; the average prostate V150% was 4% lower for ML plans (P=.002), although the difference was not clinically significant. Respondents ranked the ML-generated plans as equivalent to expert BT treatment plans in terms of target coverage, normal tissue avoidance, implant confidence, and the need for plan modifications. Respondents had difficulty differentiating between plans generated by a human or those generated by the ML algorithm. Conclusions: Prostate LDR preimplantation treatment plans that have equivalent quality to plans created by brachytherapists can be rapidly generated using ML. The adoption of ML in the brachytherapy workflow is expected to improve LDR treatment plan uniformity while reducing planning time and resources.« less

Local Education Agency Planning Analyst's Procedures. A Vocational Education Planning System for Local School Districts. Volume III.

ERIC Educational Resources Information Center

Goldman, Charles I.

The manual is part of a series to assist in planning procedures for local and State vocational agencies. It details steps required to process a local education agency's data after the data have been coded onto keypunch forms. Program, course, and overhead data are input into a computer data base and error checks are performed. A computer model is…

DESC (Defense Electronics Supply Center) Total Quality Management Plan

DTIC Science & Technology

1989-04-01

Paoerwort Reduction Proodt(0704.01 ge. Washington. DC 20S03 4. TITLE AND SUBTITLE Api598 . FUNDING NUMBERS DESC Total Quality Management Master Plan...OF PAGES TQM (Total Quality Management ), Continuous Process Improvement,_________ cTainingManagement 16. PRICE CODE 17. SECURITY CLASSIFICATION 18... QUALITY MANAGEMENT As you read the DESC Total Quality Management Plan, I ask each of you to make a commitment to continuously strive for improvement

75 FR 54806 - Approval and Promulgation of Implementation Plans-Maricopa County (Phoenix) PM-10 Nonattainment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

... program is codified in ARS 49-457 and Arizona Administrative Code (AsAC) R18-2-610 and R18-2-611. ARS 49... proposing to fully approve the amendment to ARS-457 which was submitted with the 189(d) plan, we do not... registered with the control officer. These measures are implemented through ARS 49-474.05. See 189(d) plan...

Northern Arabian Sea Circulation - Autonomous Research: Optimal Planning Systems (NASCar-OPS)

DTIC Science & Technology

2015-09-30

vehicles ( gliders , drifters, floats, and/or wave- gliders ) - Provide guidance for persistent optimal sampling, including for long-duration observation...headings and relative operating speeds will be provided to the operational fleets of instruments and vehicles (e.g. gliders , drifters, floats or wave... gliders ). We plan to use models specific to vehicle types (floats, wave- gliders , etc.). We also plan to further parallelize and optimize our codes