WorldWideScience

Sample records for cancer control plans

  1. Planning for cancer control programs: Leadership considerations.

    Science.gov (United States)

    French, John; Sutcliffe, Simon B

    2018-01-01

    Cancer is a significant challenge globally. Reducing the impact of cancer requires a program and plans that address the main aspects of cancer from prevention through to end-of-life care. This article summarizes the requirements of a robust cancer control program and outlines the contextual and leadership considerations that are required to ensure that the planning and implementation of a control program can achieve improved cancer outcomes.

  2. Disparities in Cancer Clinical Trials: An Analysis of Comprehensive Cancer Control Plans

    OpenAIRE

    Moniek Felder, Tisha; Pena, Gabriela D.; Chapital, Bridget F

    2009-01-01

    Introduction Disparities in enrollment of adults in cancer clinical trials are well documented, but little is known about the attention given to this topic in comprehensive cancer control (CCC) plans. We assessed the extent to which CCC plans address disparities in clinical trials and whether jurisdictions whose plans address disparities also mandate third-party reimbursement for clinical trial participation. Methods We analyzed 57 CCC plans identified from Cancer PLANET (Plan, Link, Act, Net...

  3. Evaluating Progress in Radon Control Activities for Lung Cancer Prevention in National Comprehensive Cancer Control Program Plans, 2011-2015.

    Science.gov (United States)

    Acree, Pascal; Puckett, Mary; Neri, Antonio

    2017-04-04

    Radon is the second leading cause of lung cancer among smokers and the leading cause among nonsmokers. The Centers for Disease Control and Prevention's National Comprehensive Cancer Control Program (NCCCP) funds every state, seven tribes, seven territories and the District of Columbia to develop formal cancer plans that focus efforts in cancer control. A 2010 review of cancer plans identified radon-related activities in 27 (42%) plans. Since then, 37 coalitions have updated their plans with new or revised cancer control objectives. There has also been recent efforts to increase awareness about radon among cancer coalitions. This study assesses NCCCP grantees current radon activities and changes since the 2010 review. We reviewed all 65 NCCCP grantee cancer plans created from 2005 to 2015 for radon related search terms and categorized plans by radon activities. The program's most recent annual progress report to CDC was also reviewed. We then compared the results from the updated plans with the findings from the 2010 review to assess changes in radon activities among cancer coalitions. Changes in state radon laws between 2010 and 2015 were also assessed. While a number of cancer plans have added or expanded radon-specific activities since 2010, approximately one-third of NCCCP grantees still do not include radon in their cancer plans. Cancer programs can consider addressing radon through partnership with existing radon control programs to further reduce the risk of lung cancer, especially among non-smokers.

  4. Alcohol Control Efforts in Comprehensive Cancer Control Plans and Alcohol Use Among Adults in the USA

    Science.gov (United States)

    Henley, S. Jane; Kanny, Dafna; Roland, Katherine B.; Grossman, Melissa; Peaker, Brandy; Liu, Yong; Gapstur, Susan M.; White, Mary C.; Plescia, Marcus

    2015-01-01

    Aims To understand how US cancer control plans address alcohol use, an important but frequently overlooked cancer risk factor, and how many US adults are at risk. Methods We reviewed alcohol control efforts in 69 comprehensive cancer control plans in US states, tribes and jurisdictions. Using the 2011 Behavioral Risk Factor Surveillance System, we assessed the prevalence of current alcohol use among US adults and the proportion of these drinkers who exceeded guidelines for moderate drinking. Results Most comprehensive cancer control plans acknowledged alcohol use as a cancer risk factor but fewer than half included a goal, objective or strategy to address alcohol use. More than half of US adults reported current alcohol use in 2011, and two of three drinkers exceeded moderate drinking guidelines at least once in the past month. Many states that did not address alcohol use in comprehensive cancer control plans also had a high proportion of adults at risk. Conclusion Alcohol use is a common cancer risk factor in the USA, but alcohol control strategies are not commonly included in comprehensive cancer control plans. Supporting the implementation of evidence-based strategies to prevent the excessive use of alcohol is one tool the cancer control community can use to reduce the risk of cancer. PMID:25313255

  5. Nutrition and Physical Activity Strategies for Cancer Prevention in Current National Comprehensive Cancer Control Program Plans.

    Science.gov (United States)

    Puckett, Mary; Neri, Antonio; Underwood, J Michael; Stewart, Sherri L

    2016-10-01

    Obesity, diet and physical inactivity are risk factors for some cancers. Grantees of the National Comprehensive Cancer Control Program (NCCCP) in US states, tribes, and territories develop plans to coordinate funding and activities for cancer prevention and control. Including information and goals related to nutrition and physical activity (NPA) is a key opportunity for primary cancer prevention, but it is currently unclear to what extent NCCCP plans address these issues. We reviewed 69 NCCCP plans and searched for terms related to NPA. Plans were coded as (1) knowledge of NPA and cancer link; (2) goals to improve NPA behaviors; and (3) strategies to increase healthy NPA activities, environments, or systems changes. NPA content was consistently included in all cancer plans examined across all years. Only 4 (6 %) outlined only the relationship between NPA and cancer without goals or strategies. Fifty-nine plans (89 %) contained goals or strategies related to NPA, with 53 (82 %) including both. However, numbers of goals, strategies, and detail provided varied widely. All programs recognized the importance of NPA in cancer prevention. Most plans included NPA goals and strategies. Increasing the presence of NPA strategies that can be modified or adapted appropriately locally could help with more widespread implementation and measurement of NPA interventions.

  6. Radon control activities for lung cancer prevention in national comprehensive cancer control program plans, 2005-2011.

    Science.gov (United States)

    Neri, Antonio; Stewart, Sherri L; Angell, William

    2013-08-08

    Radon is the second leading cause of lung cancer among smokers and the leading cause among nonsmokers. The US Environmental Protection Agency recommends that every home be tested for radon. Comprehensive Cancer Control (CCC) programs develop cancer coalitions that coordinate funding and resources to focus on cancer activities that are recorded in cancer plans. Radon tests, remediation, and radon mitigation techniques are relatively inexpensive, but it is unclear whether coalitions recognize radon as an important carcinogen. We reviewed 65 cancer plans created from 2005 through 2011 for the terms "radon," "radiation," or "lung." Plan activities were categorized as radon awareness, home testing, remediation, supporting radon policy activities, or policy evaluation. We also reviewed each CCC program's most recent progress report. Cancer plan content was reviewed to assess alignment with existing radon-specific policies in each state. Twenty-seven of the plans reviewed (42%) had radon-specific terminology. Improving awareness of radon was included in all 27 plans; also included were home testing (n=21), remediation (n=11), support radon policy activities (n=13), and policy evaluation (n=1). Three plans noted current engagement in radon activities. Thirty states had radon-specific laws; most (n=21) were related to radon professional licensure. Eleven states had cancer plan activities that aligned with existing state radon laws. Although several states have radon-specific policies, approximately half of cancer coalitions may not be aware of radon as a public health issue. CCC-developed cancer coalitions and plans should prioritize tobacco control to address lung cancer but should consider addressing radon through partnership with existing radon control programs.

  7. Radon Control Activities for Lung Cancer Prevention in National Comprehensive Cancer Control Program Plans, 2005–2011

    Science.gov (United States)

    Stewart, Sherri L.; Angell, William

    2013-01-01

    Introduction Radon is the second leading cause of lung cancer among smokers and the leading cause among nonsmokers. The US Environmental Protection Agency recommends that every home be tested for radon. Comprehensive Cancer Control (CCC) programs develop cancer coalitions that coordinate funding and resources to focus on cancer activities that are recorded in cancer plans. Radon tests, remediation, and radon mitigation techniques are relatively inexpensive, but it is unclear whether coalitions recognize radon as an important carcinogen. Methods We reviewed 65 cancer plans created from 2005 through 2011 for the terms “radon,” “radiation,” or “lung.” Plan activities were categorized as radon awareness, home testing, remediation, supporting radon policy activities, or policy evaluation. We also reviewed each CCC program’s most recent progress report. Cancer plan content was reviewed to assess alignment with existing radon-specific policies in each state. Results Twenty-seven of the plans reviewed (42%) had radon-specific terminology. Improving awareness of radon was included in all 27 plans; also included were home testing (n = 21), remediation (n = 11), support radon policy activities (n = 13), and policy evaluation (n = 1). Three plans noted current engagement in radon activities. Thirty states had radon-specific laws; most (n = 21) were related to radon professional licensure. Eleven states had cancer plan activities that aligned with existing state radon laws. Conclusion Although several states have radon-specific policies, approximately half of cancer coalitions may not be aware of radon as a public health issue. CCC-developed cancer coalitions and plans should prioritize tobacco control to address lung cancer but should consider addressing radon through partnership with existing radon control programs. PMID:23928457

  8. A case study of the South Puget Intertribal Planning Agency's comprehensive cancer control planning and community mobilization process.

    Science.gov (United States)

    Nass, Carrie; Simmons, John; Bowen, Deborah; Guthrie, Teresa

    2008-04-01

    The high rates of cancer among American Indians and Alaska Natives are of growing concern. In response to high cancer rates, national, state, and tribal organizations have worked to assess knowledge, attitudes, beliefs, and screening practices related to cancer in American Indian and Alaska Native communities and to increase awareness and use of cancer screening. The National Comprehensive Cancer Control Program (NCCCP) of the Centers for Disease Control and Prevention is one such effort. NCCCP's comprehensive cancer control (CCC) planning process provides a new approach to planning and implementing cancer control programs. The CCC process and components for American Indians and Alaska Natives are not yet fully understood because this is a fairly new approach for these communities. Therefore, the purpose of our case study was to describe the CCC process and its outcomes and successes as applied to these communities and to identify key components and lessons learned from the South Puget Intertribal Planning Agency's (SPIPA's) CCC planning and community mobilization process. We used interviews, document reviews, and observations to collect data on SPIPA's CCC planning and community mobilization process. We identified the key components of SPIPA's CCC as funding and hiring key staff, partnering with outside organizations, developing a project management plan and a core planning team, creating community cancer orientations, conducting community cancer surveys, developing a community advisory committee, ongoing training and engaging of the community advisory committee, and supporting the leadership of the communities involved. The CCC planning process is a practicable model, even for groups with little experience or few resources. The principles identified in this case study can be applied to the cancer control planning process for other tribes.

  9. Well-directed inclusion of hematology in African national cancer control plans.

    Science.gov (United States)

    Weaver, Meaghann; Yao, Atteby J J; Renner, Lorna; Harif, Mhamed; Lam, Catherine G

    2017-07-01

    In the context of a convergent call for noncommunicable disease integration in the global agenda, recognizing cross-cutting needs and opportunities in national strategies across disease fields with shared priorities in low- and middle-income settings can enhance sustainable development approaches. We reviewed publicly available cancer control plans in Africa to evaluate for inclusion of hematology needs and shared service priorities. Pediatric data remain sparse in cancer control plans. While continental Africa represents incredible diversity, recognizing shared priorities and opportunity for collaboration between oncology and hematology services and across age groups may guide prioritized cancer control efforts and reduce programmatic redundancies in resource-limited settings. © 2017 Wiley Periodicals, Inc.

  10. Planning cancer control in Latin America and the Caribbean.

    Science.gov (United States)

    Goss, Paul E; Lee, Brittany L; Badovinac-Crnjevic, Tanja; Strasser-Weippl, Kathrin; Chavarri-Guerra, Yanin; St Louis, Jessica; Villarreal-Garza, Cynthia; Unger-Saldaña, Karla; Ferreyra, Mayra; Debiasi, Márcio; Liedke, Pedro E R; Touya, Diego; Werutsky, Gustavo; Higgins, Michaela; Fan, Lei; Vasconcelos, Claudia; Cazap, Eduardo; Vallejos, Carlos; Mohar, Alejandro; Knaul, Felicia; Arreola, Hector; Batura, Rekha; Luciani, Silvana; Sullivan, Richard; Finkelstein, Dianne; Simon, Sergio; Barrios, Carlos; Kightlinger, Rebecca; Gelrud, Andres; Bychkovsky, Vladimir; Lopes, Gilberto; Stefani, Stephen; Blaya, Marcelo; Souza, Fabiano Hahn; Santos, Franklin Santana; Kaemmerer, Alberto; de Azambuja, Evandro; Zorilla, Andres Felipe Cardona; Murillo, Raul; Jeronimo, Jose; Tsu, Vivien; Carvalho, Andre; Gil, Carlos Ferreira; Sternberg, Cinthya; Dueñas-Gonzalez, Alfonso; Sgroi, Dennis; Cuello, Mauricio; Fresco, Rodrigo; Reis, Rui Manuel; Masera, Guiseppe; Gabús, Raúl; Ribeiro, Raul; Knust, Renata; Ismael, Gustavo; Rosenblatt, Eduardo; Roth, Berta; Villa, Luisa; Solares, Argelia Lara; Leon, Marta Ximena; Torres-Vigil, Isabel; Covarrubias-Gomez, Alfredo; Hernández, Andrés; Bertolino, Mariela; Schwartsmann, Gilberto; Santillana, Sergio; Esteva, Francisco; Fein, Luis; Mano, Max; Gomez, Henry; Hurlbert, Marc; Durstine, Alessandra; Azenha, Gustavo

    2013-04-01

    Non-communicable diseases, including cancer, are overtaking infectious disease as the leading health-care threat in middle-income and low-income countries. Latin American and Caribbean countries are struggling to respond to increasing morbidity and death from advanced disease. Health ministries and health-care systems in these countries face many challenges caring for patients with advanced cancer: inadequate funding; inequitable distribution of resources and services; inadequate numbers, training, and distribution of health-care personnel and equipment; lack of adequate care for many populations based on socioeconomic, geographic, ethnic, and other factors; and current systems geared toward the needs of wealthy, urban minorities at a cost to the entire population. This burgeoning cancer problem threatens to cause widespread suffering and economic peril to the countries of Latin America. Prompt and deliberate actions must be taken to avoid this scenario. Increasing efforts towards prevention of cancer and avoidance of advanced, stage IV disease will reduce suffering and mortality and will make overall cancer care more affordable. We hope the findings of our Commission and our recommendations will inspire Latin American stakeholders to redouble their efforts to address this increasing cancer burden and to prevent it from worsening and threatening their societies. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Promoting public health through state cancer control plans: a review of capacity and sustainability.

    Science.gov (United States)

    Ory, Marcia G; Sanner, Brigid; Vollmer Dahlke, Deborah; Melvin, Cathy L

    2015-01-01

    The Centers for Disease Prevention and Control's National Comprehensive Cancer Control (CCC) Program oversee CCC programs designed to develop and implement CCC plans via CCC coalitions, alliances, or consortia of program stakeholders. We reviewed 40 up-to-date plans for states and the District of Columbia in order to assess how capacity building and sustainability, two evidence-based practices necessary for organizational readiness, positive growth, and maintenance are addressed. We employed an electronic key word search, supplemented by full text reviews of each plan to complete a content analysis of the CCC plans. Capacity is explicitly addressed in just over half of the plans (53%), generally from a conceptual point of view, with few specifics as to how capacity will be developed or enhanced. Roles and responsibilities, timelines for action, and measurements for evaluation of capacity building are infrequently mentioned. Almost all (92%) of the 40 up-to-date plans address sustainability on at least a cursory level, through efforts aimed at funding or seeking funding, policy initiatives, and/or partnership development. However, few details as to how these strategies will be implemented are found in the plans. We present the Texas plan as a case study offering detailed insight into how one plan incorporated capacity building and sustainability into its development and implementation. Training, technical assistance, templates, and tools may help CCC coalition members address capacity and sustainability in future planning efforts and assure the inclusion of capacity building and sustainability approaches in CCC plans at the state, tribal, territorial, and jurisdiction levels.

  12. Cancer Nanotechnology Plan

    Science.gov (United States)

    The Cancer Nanotechnology Plan serves as a strategic document to the NCI Alliance for Nanotechnology in Cancer as well as a guiding document to the cancer nanotechnology and oncology fields, as a whole.

  13. Uncomplicated and Cancer-Free Control Probability (UCFCP): A new integral approach to treatment plan optimization in photon radiation therapy.

    Science.gov (United States)

    Sánchez-Nieto, Beatriz; Romero-Expósito, Maite; Terrón, José A; Sánchez-Doblado, Francisco

    2017-10-01

    Biological treatment plan evaluation does not currently consider second cancer induction from peripheral doses associated to photon radiotherapy. The aim is to propose a methodology to characterize the therapeutic window by means of an integral radiobiological approach, which considers not only Tumour Control Probability (TCP) and Normal Tissue Complication Probability (NTCP) but also Secondary Cancer Probability (SCP). Uncomplicated and Cancer-Free Control Probability (UCFCP) function has been proposed assuming a statistically uncorrelated response for tumour and normal tissues. The Poisson's and Lyman's models were chosen for TCP and NTCP calculations, respectively. SCP was modelled as the summation of risks associated to photon and neutron irradiation of radiosensitive organs. For the medium (>4Gy) and low dose regions, mechanistic and linear secondary cancer risks models were used, respectively. Two conformal and intensity-modulated prostate plans at 15MV (same prescription dose) were selected to illustrate the UCFCP features. UCFCP exhibits a bell-shaped behaviour with its maximum inside the therapeutic window. SCP values were not different for the plans analysed (∼2.4%) and agreed with published epidemiological results. Therefore, main differences in UCFCP came from differences in rectal NTCP (18% vs 9% for 3D-CRT and IMRT, respectively). According to UCFCP values, the evaluated IMRT plan ranked first. The level of SCP was found to be similar to that of NTCP complications which reinforces the importance of considering second cancer risks as part of the possible late sequelae due to treatment. Previous concerns about the effect of peripheral radiation, especially neutrons, in the induction of secondary cancers can be evaluated by quantifying the UCFCP. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  14. Cancer control in Bangladesh.

    Science.gov (United States)

    Hussain, Syed Akram; Sullivan, Richard

    2013-12-01

    Cancer is predicted to be an increasingly important cause of morbidity and mortality in Bangladesh in the next few decades. The estimated incidence of 12.7 million new cancer cases will rise to 21.4 million by 2030. More than two-thirds of the total expenditure on health is through out-of-pocket payments. According to the Bangladesh Bureau of Statistics, cancer is the sixth leading cause of death. International Agency for Research on Cancer has estimated cancer-related death rates in Bangladesh to be 7.5% in 2005 and 13% in 2030. The two leading causes are in males are lung and oral cancer and in females are breast cancer and cervical cancer. Bangladesh is now in severe shortage of radiation therapy machines, hospital bed, trained oncologists, medical radiation physicists and technologists. Bangladesh having different cancers associated with smoking and smokeless tobacco use, Human papilloma virus infection, Hepatitis B and C infection, Helicobacter Pylori infection, arsenic contaminated groundwater, availability of chemical carcinogens mainly formalin treated fruits, fish and vegetables at open market, tannery waste contaminated with chromium (which is used for poultry feed and fish feed preparation). A World Health Organization study revealed the annual cost of illnesses in Bangladesh attributable to tobacco usage is US$ 500 million and the total annual benefit from the tobacco sector is US$ 305 million as tax revenue. Bangladesh has developed a National Cancer Control Strategy and Action Plan with the aim of delivering a universal, quality-based and timely service. Cancer prevention through tobacco control, health promotion and vaccination program, cancer early detection program for oral cavity, breast and cervix has initiated. Cancer detection and diagnostic facilities will be made available at medical colleges and district- hospitals and establish a referral chain. National capacity development, more cancer research will allow Bangladesh to deal effectively

  15. Effectiveness, Mediators, and Effect Predictors of Internet Interventions for Chronic Cancer-Related Fatigue: The Design and an Analysis Plan of a 3-Armed Randomized Controlled Trial.

    Science.gov (United States)

    Wolvers, Marije Dj; Bruggeman-Everts, Fieke Z; Van der Lee, Marije L; Van de Schoot, Rens; Vollenbroek-Hutten, Miriam Mr

    2015-06-23

    Internet interventions offer advantages that especially cancer survivors who suffer from fatigue could benefit from. Given the growing number of such patients, Internet interventions could supplement and strengthen currently available health care. This paper describes the design and analysis plan that will be used to study 2 Internet interventions aimed at reducing severe fatigue in cancer survivors: a mobile ambulant activity feedback therapy supported through a weekly email by a physiotherapist and a weekly Web- and mindfulness-based cognitive therapy supported online by a psychologist. The data resulting from this trial will be used to (1) investigate the effectiveness, (2) investigate potential mediators of these interventions, and (3) explore participant characteristics that can predict the effect of these interventions. A 3-armed randomized controlled trial is proposed that compares both Internet interventions with an active control condition that solely consists of receiving psycho-educational emails. The intervention period is 9 weeks for all 3 conditions. Six months after baseline, participants in the control condition can choose to follow 1 of the 2 experimental Internet interventions. Outcomes are measured in terms of fatigue severity, mental health, and self-perceived work ability. All are Web-assessed at baseline, 2 weeks after the intervention period, and at 6 and 12 months after baseline. Fatigue severity, mindfulness, physical activity, expectations and credibility of the intervention, therapeutic working alliance, sleep quality, and sense of control over fatigue are assessed 3 times during the intervention period for identifying mediators of the interventions. Recruitment is performed nationally throughout the Netherlands through patient organizations and their websites, newspapers, and by informing various types of health professionals. All participants register at an open-access website. We aim at including 330 cancer survivors who have finished

  16. A longitudinal, randomized, controlled trial of advance care planning for teens with cancer: anxiety, depression, quality of life, advance directives, spirituality.

    Science.gov (United States)

    Lyon, Maureen E; Jacobs, Shana; Briggs, Linda; Cheng, Yao Iris; Wang, Jichuan

    2014-06-01

    To test the feasibility, acceptability and safety of a pediatric advance care planning intervention, Family-Centered Advance Care Planning for Teens With Cancer (FACE-TC). Adolescent (age 14-20 years)/family dyads (N = 30) with a cancer diagnosis participated in a two-armed, randomized, controlled trial. Exclusion criteria included severe depression and impaired mental status. Acceptability was measured by the Satisfaction Questionnaire. General Estimating Equations models assessed the impact of FACE-TC on 3-month post-intervention outcomes as measured by the Pediatric Quality of Life Inventory 4.0 Generic Core Scale, the Pediatric Quality of Life Inventory 4.0 Cancer-Specific Module, the Beck Depression and Anxiety Inventories, the Spiritual Well-Being Scale of the Functional Assessment of Chronic Illness Therapy-IV, and advance directive completion. Acceptability was demonstrated with enrollment of 72% of eligible families, 100% attendance at all three sessions, 93% retention at 3-month post-intervention, and 100% data completion. Intervention families rated FACE-TC worthwhile (100%), whereas adolescents' ratings increased over time (65%-82%). Adolescents' anxiety decreased significantly from baseline to 3 months post-intervention in both groups (β = -5.6; p = .0212). Low depressive symptom scores and high quality of life scores were maintained by adolescents in both groups. Advance directives were located easily in medical records (100% of FACE-TC adolescents vs. no controls). Oncologists received electronic copies. Total Spirituality scores (β = 8.1; p = .0296) were significantly higher among FACE-TC adolescents versus controls. The FACE-TC adolescents endorsed the best time to bring up end-of-life decisions: 19% before being sick, 19% at diagnosis, none when first ill or hospitalized, 25% when dying, and 38% for all of the above. Family-Centered Advance Care Planning for Teens With Cancer demonstrated feasibility and acceptability. Courageous adolescents

  17. A Randomized Controlled Trial of a Cardiopulmonary Resuscitation Video in Advance Care Planning for Progressive Pancreas and Hepatobiliary Cancer Patients

    Science.gov (United States)

    Volandes, Angelo E.; Chen, Ling Y.; Gary, Kristen A.; Li, Yuelin; Agre, Patricia; Levin, Tomer T.; Reidy, Diane L.; Meng, Raymond D.; Segal, Neil H.; Yu, Kenneth H.; Abou-Alfa, Ghassan K.; Janjigian, Yelena Y.; Kelsen, David P.; O'Reilly, Eileen M.

    2013-01-01

    Abstract Background Cardiopulmonary resuscitation (CPR) is an important advance directive (AD) topic in patients with progressive cancer; however such discussions are challenging. Objective This study investigates whether video educational information about CPR engenders broader advance care planning (ACP) discourse. Methods Patients with progressive pancreas or hepatobiliary cancer were randomized to an educational CPR video or a similar CPR narrative. The primary end-point was the difference in ACP documentation one month posttest between arms. Secondary end-points included study impressions; pre- and post-intervention knowledge of and preferences for CPR and mechanical ventilation; and longitudinal patient outcomes. Results Fifty-six subjects were consented and analyzed. Rates of ACP documentation (either formal ADs or documented discussions) were 40% in the video arm (12/30) compared to 15% in the narrative arm (4/26), OR=3.6 [95% CI: 0.9–18.0], p=0.07. Post-intervention knowledge was higher in both arms. Posttest, preferences for CPR had changed in the video arm but not in the narrative arm. Preferences regarding mechanical ventilation did not change in either arm. The majority of subjects in both arms reported the information as helpful and comfortable to discuss, and they recommended it to others. More deaths occurred in the video arm compared to the narrative arm, and more subjects died in hospice settings in the video arm. Conclusions This pilot randomized trial addressing downstream ACP effects of video versus narrative decision tools demonstrated a trend towards more ACP documentation in video subjects. This trend, as well as other video effects, is the subject of ongoing study. PMID:23725233

  18. Historical controls for metastatic pancreatic cancer: benchmarks for planning and analyzing single-arm phase II trials.

    Science.gov (United States)

    Philip, Philip A; Chansky, Kari; LeBlanc, Michael; Rubinstein, Lawrence; Seymour, Lesley; Ivy, S Percy; Alberts, Steven R; Catalano, Paul J; Crowley, John

    2014-08-15

    We compiled and analyzed a database of cooperative group trials in advanced pancreatic cancer to develop historical benchmarks for overall survival (OS) and progression-free survival (PFS). Such benchmarks are essential for evaluating new therapies in a single-arm setting. The analysis included patients with untreated metastatic pancreatic cancer receiving regimens that included gemcitabine, between 1995 and 2005. Prognostic baseline factors were selected by their significance in Cox regression analysis. Outlier trial arms were identified by comparing individual 6-month OS and PFS rates against the entire group. The dataset selected for the generation of OS and PFS benchmarks was then tested for intertrial arm variability using a logistic-normal model with the selected baseline prognostic factors as fixed effects and the individual trial arm as a random effect. A total of 1,132 cases from eight trials qualified. Performance status and sex were independently significant for OS, and performance status was prognostic for PFS. Outcomes for one trial (NCCTG-034A) were significantly different from the other trial arms. When this trial was excluded, the remaining trial arms were homogeneous for OS and PFS outcomes after adjusting for performance status and sex. Benchmark values for 6-month OS and PFS are reported along with a method for using these values in future study design and analysis. The benchmark survival values were generated from a dataset that was homogeneous between trials. The benchmarks can be used to enable single-arm phase II trials using a gemcitabine platform, especially under certain circumstances. Such circumstances might be when a randomized control arm is not practically feasible, an early signal of activity of an experimental agent is being explored such as in expansion cohorts of phase I studies, and in patients who are not candidates for combination cytotoxic therapy. ©2014 American Association for Cancer Research.

  19. UK Groups Plan Cancer Research Hub.

    Science.gov (United States)

    Colwell, Janet

    2016-04-01

    Two major cancer research groups in the UK have announced plans to create a global cancer center aimed at accelerating drug development and fostering collaboration with industry. The $1.5 billion campus is expected to house 10,000 scientists and clinicians and deliver two additional drug candidates, an increase of 40%, every 5 years. ©2016 American Association for Cancer Research.

  20. A Framework for Healthcare Planning and Control

    NARCIS (Netherlands)

    Hans, Elias W.; van Houdenhoven, Mark; Hulshof, P.J.H.; Hall, Randolph

    2012-01-01

    Rising expenditures spur healthcare organizations to organize their processes more efficiently and effectively. Unfortunately, healthcare planning and control lags behind manufacturing planning and control. We analyze existing planning and control concepts or frameworks for healthcare operations

  1. Effect of Multidisciplinary Cancer Conference on Treatment Plan for Patients With Primary Rectal Cancer.

    Science.gov (United States)

    Snelgrove, Ryan C; Subendran, Jhananiee; Jhaveri, Kartik; Thipphavong, Seng; Cummings, Bernard; Brierley, James; Kirsch, Richard; Kennedy, Erin D

    2015-07-01

    Although multidisciplinary cancer conferences have been reported to lead to improved patient outcomes, few studies have reported results of these for rectal cancer. The purpose of this work was to assess the quality of multidisciplinary cancer conferences, the effect of the conference on the initial treatment plan, compliance with the conference treatment recommendations, and clinical outcomes for rectal cancer. This was a prospective, longitudinal study. The study was conducted at a tertiary care academic hospital. Patients with primary rectal cancer were included in this study. The intervention was a rectal cancer-specific multidisciplinary cancer conference. The quality of the multidisciplinary cancer conference was assessed using the Cancer Care Ontario Multidisciplinary Cancer Conference standards score. A change in treatment plan was defined as a change from the initial treatment plan selected by the treating physician to an alternate treatment plan recommended at the conference. Twenty-five multidisciplinary cancer conferences were conducted over a 10-month study period. The Cancer Care Ontario Multidisciplinary Cancer Conference standards score was 7 (from a maximum score of 9). Forty-two patients with primary rectal cancer were presented, and there was a 29% (12/42) change in the initial treatment plan. A total of 42% (5/12) of these changes were attributed to reinterpretation of the MRI findings. There was 100% compliance with the conference treatment recommendations. The circumferential resection margin was positive in 5.5% (2/36). Selection bias may have led to an overestimate of effect, and there is no control group for comparison of clinical outcomes. A high-quality rectal cancer-specific multidisciplinary cancer conference led to a 29% change in the treatment plan for patients with primary rectal cancer, with almost half of these changes attributed to reinterpretation of the magnetic resonance images.

  2. Your cancer survivorship care plan

    Science.gov (United States)

    ... use to create one: American Society of Clinical Oncology -- www.cancer.net/survivorship/follow-care-after-cancer-treatment/asco- ... your doctor visits. References American Society of Clinical Oncology. Survivorship. Cancer.net. Updated July 2016. www.cancer.net/survivorship . ...

  3. Mechanisms of Cancer - Annual Plan

    Science.gov (United States)

    NCI works to understand the mechanisms of cancer cell growth, survival, and metastasis. Get more information on how NCI supports basic scientific research that will lead to new ways to prevent, detect, and treat cancer.

  4. Land Use Control Implementation Plan

    Science.gov (United States)

    Starr, Andrew Scott

    2015-01-01

    This Land Use Control Implementation Plan (LUCIP) has been prepared to inform current and potential future users of Building M7-505 of institutional controls that have been implemented at the site. Although there are no current unacceptable risks to human health or the environment associated with Building M7-505, institutional land use controls (LUCs) are necessary to prohibit the use of groundwater from the site. LUCs are also necessary to prevent access to soil under electrical equipment in the northwest portion of the site. Controls necessary to prevent human exposure will include periodic inspection, condition certification, and agency notification.

  5. Analytical decision model for sample size and effectiveness projections for use in planning a population-based randomized controlled trial of colorectal cancer screening.

    Science.gov (United States)

    Chiu, Sherry Y-H; Malila, Nea; Yen, Amy M-F; Anttila, Ahti; Hakama, Matti; Chen, H-H

    2011-02-01

    Population-based randomized controlled trials (RCTs) often involve enormous costs and long-term follow-up to evaluate primary end points. Analytical decision-simulated model for sample size and effectiveness projections based on primary and surrogate end points are necessary before planning a population-based RCT. Based on the study design similar to two previous RCTs, transition rates were estimated using a five-state natural history model [normal, preclinical detection phase (PCDP) Dukes' A/B, PCDP Dukes' C/D, Clinical Dukes' A/B and Clinical Dukes' C/D]. The Markov cycle tree was assigned transition parameters, variables related to screening and survival rate that simulated results of 10-year follow-up in the absence of screening for a hypothetical cohort aged 45-74 years. The corresponding screened arm was to simulate the results after the introduction of population-based screening for colorectal cancer with fecal occult blood test with stop screen design. The natural course of mean sojourn time for five-state Markov model were estimated as 2.75 years for preclinical Dukes' A/B and 1.38 years for preclinical Dukes' C/D. The expected reductions in mortality and Dukes' C/D were 13% (95% confidence intervals: 7-19%) and 26% (95% confidence intervals: 20-32%), respectively, given a 70% acceptance rate and a 90% colonoscopy referral rate. Sample sizes required were 86,150 and 65,592 subjects for the primary end point and the surrogate end point, respectively, given an incidence rate up to 0.0020 per year. The sample sizes required for primary and surrogate end points and the projection of effectiveness of fecal occult blood test for colorectal cancer screening were developed. Both are very important to plan a population-based RCT. © 2010 Blackwell Publishing Ltd.

  6. Automatic treatment planning facilitates fast generation of high-quality treatment plans for esophageal cancer

    DEFF Research Database (Denmark)

    Hansen, Christian Rønn; Nielsen, Morten; Bertelsen, Anders Smedegaard

    2017-01-01

    cancer patients. MATERIAL AND METHODS: Thirty-two consecutive inoperable patients with esophageal cancer originally treated with manually (MA) generated volumetric modulated arc therapy (VMAT) plans were retrospectively replanned using an auto-planning engine. All plans were optimized with one full 6MV...... to the lungs. The automation of the planning process generated esophageal cancer treatment plans quickly and with high quality....

  7. Hierarchical Control and Trajectory Planning

    Science.gov (United States)

    Martin, Clyde F.; Horn, P. W.

    1994-01-01

    Most of the time on this project was spent on the trajectory planning problem. The construction is equivalent to the classical spline construction in the case that the system matrix is nilpotent. If the dimension of the system is n then the spline of degree 2n-1 is constructed. This gives a new approach to the construction of splines that is more efficient than the usual construction and at the same time allows the construction of a much larger class of splines. All known classes of splines are reconstructed using the approach of linear control theory. As a numerical analysis tool control theory gives a very good tool for constructing splines. However, for the purposes of trajectory planning it is quite another story. Enclosed in this document are four reports done under this grant.

  8. Evidence-Based Cancer Survivorship Activities for Comprehensive Cancer Control.

    Science.gov (United States)

    Underwood, J Michael; Lakhani, Naheed; Finifrock, DeAnna; Pinkerton, Beth; Johnson, Krystal L; Mallory, Sharon H; Migliore Santiago, Patricia; Stewart, Sherri L

    2015-12-01

    One of six priorities of CDC's National Comprehensive Cancer Control Program (NCCCP) is to address the needs of cancer survivors within the local population served by individually funded states, tribes, and territories. This report examines cancer survivorship activities implemented in five NCCCP grantees, which have initiated evidence-based activities outlined in A National Action Plan for Cancer Survivorship: Advancing Public Health Strategies (NAP). NCCCP action plans, submitted annually to CDC, from 2010 to 2014 were reviewed in February 2015 to assess implementation of cancer survivorship activities and recommended strategies consistent with the NAP. Four state-level and one tribal grantee with specific activities related to one of each of the four NAP strategies were chosen for inclusion. Brief case reports describing the initiation and impact of implemented activities were developed in collaboration with each grantee program director. New Mexico, South Carolina, Vermont, Washington state, and Fond Du Lac Band of Lake Superior Chippewa programs each implemented activities in surveillance and applied research; communication, education, and training; programs, policies, and infrastructure; and access to quality care and services. This report provides examples for incorporating cancer survivorship activities within Comprehensive Cancer Control programs of various sizes, demographic makeup, and resource capacity. New Mexico, South Carolina, Vermont, Washington state, and Fond Du Lac Band developed creative cancer survivorship activities that meet CDC recommendations. NCCCP grantees can follow these examples by implementing evidence-based survivorship interventions that meet the needs of their specific populations. Published by Elsevier Inc.

  9. Kaizen planning, implementing and controlling

    CERN Document Server

    García-Alcaraz, Jorge Luis; Maldonado-Macías, Aidé Aracely

    2017-01-01

    This book reports a literature review on kaizen, its industrial applications, critical success factors, benefits gained, journals that publish about it, main authors (research groups) and universities. Kaizen is treated in this book in three stages: planning, implementation and control. The authors provide a questionnaire designed with activities in every stage, highlighting the benefits gained in each stage. The study has been applied to more than 400 managers and leaders in continuous improvement in Mexican maquiladoras. A univariate analysis is provided to the activities in every stage. Moreover, structural equation models associating those activities with the benefits gained are presented for a statistical validation. Such a relationship between activities and benefits helps managers to identify the most important factor affecting their benefits and financial income.

  10. Project orientated planning, scheduling and controlling technique ...

    African Journals Online (AJOL)

    Project orientated planning, scheduling and controlling technique. ... In the past several years, there has been an explosive growth of management technique to be used for planning and controlling projects. ... Comparison of actual times with available times enables control to be exerted in the performance of the project.

  11. Planning instruments to control urban growth

    DEFF Research Database (Denmark)

    Jørgensen, Gertrud; Nielsen, Thomas Alexander Sick

    2010-01-01

    It is challenging to plan and control urban development in peri-urban areas. But if no planning is done, the result will often be unsustainable, including widespread, dispersed and uncoordinated urban growth. Spatial planning based on zoning remains the most important planning instrument and its...... success depend on regional coordination. Incentive based instruments may contrbute to growth management, but only few examples are available and their effects on urban growth patterns yet to be seen....

  12. Towards Intelligent Manufacturing Planning and Control Systems

    NARCIS (Netherlands)

    Zijm, Willem H.M.

    2000-01-01

    In this paper, we review some well-known manufacturing planning and control (MPC) systems and models, and highlight both their advantages and major drawbacks. The analysis indicates that various important planning and control problems, as they arise in industry, are not properly addressed by current

  13. WRAP process area development control work plan

    Energy Technology Data Exchange (ETDEWEB)

    Leist, K.L., Fluor Daniel Hanford

    1997-02-27

    This work plan defines the manner in which the Waste Receiving and Processing Facility, Module I Process Area will be maintained under development control status. This status permits resolution of identified design discrepancies, control system changes, as-building of equipment, and perform modifications to increase process operability and maintainability as parallel efforts. This work plan maintains configuration control as these efforts are undertaken. This task will end with system testing and reissue of field verified design drawings.

  14. Cancer Control in Bangladesh

    OpenAIRE

    Hussain, Syed Akram; Sullivan, Richard

    2013-01-01

    Cancer is predicted to be an increasingly important cause of morbidity and mortality in Bangladesh in the next few decades. The estimated incidence of 12.7 million new cancer cases will rise to 21.4 million by 2030. More than two-thirds of the total expenditure on health is through out-of-pocket payments. According to the Bangladesh Bureau of Statistics, cancer is the sixth leading cause of death. International Agency for Research on Cancer has estimated cancer-related death rates in Banglade...

  15. Policy and priorities for national cancer control planning in low- and middle-income countries: Lessons from the Association of Southeast Asian Nations (ASEAN) Costs in Oncology prospective cohort study.

    Science.gov (United States)

    2017-03-01

    Evidence to guide policymakers in developing affordable and equitable cancer control plans are scarce in low- and middle-income countries (LMIC). The 2012-2014 ASEAN Costs in Oncology Study prospectively followed-up 9513 newly diagnosed cancer patients from eight LMIC in Southeast Asia for 12 months. Overall and country-specific incidence of financial catastrophe (out-of-pocket health costs ≥ 30% of annual household income), economic hardship (inability to make necessary household payments), poverty (living below national poverty line), and all-cause mortality were determined. Stepwise multinomial regression was used to estimate the extent to which health insurance, cancer stage and treatment explained these outcomes. The one-year incidence of mortality (12% in Malaysia to 45% in Myanmar) and financial catastrophe (24% in Thailand to 68% in Vietnam) were high. Economic hardship was reported by a third of families, including inability to pay for medicines (45%), mortgages (18%) and utilities (12%), with 28% taking personal loans, and 20% selling assets (not mutually exclusive). Out of households that initially reported incomes above the national poverty levels, 4·9% were pushed into poverty at one year. The adverse economic outcomes in this study were mainly attributed to medical costs for inpatient/outpatient care, and purchase of drugs and medical supplies. In all the countries, cancer stage largely explained the risk of adverse outcomes. Stage-stratified analysis however showed that low-income patients remained vulnerable to adverse outcomes even when diagnosed with earlier cancer stages. The LMIC need to realign their focus on early detection of cancer and provision of affordable cancer care, while ensuring adequate financial risk protection, particularly for the poor. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Hornby's principles of fire control planning

    Science.gov (United States)

    H. T. Gisborne

    1939-01-01

    On August 27, 1937, Lloyd G. Hornby died of heart failure on the Toboggan Creek forest fire in the Clearwater National Forest. Few if any men in or out of the U.S. Forest Service have made a greater contribution to fire control planning than did he. In the following article, H. T. Gisborne outlines the principles of fire control planning developed by Mr. Hornby,...

  17. Worksite Cancer Prevention Activities in the National Comprehensive Cancer Control Program.

    Science.gov (United States)

    Nahmias, Zachary; Townsend, Julie S; Neri, Antonio; Stewart, Sherri L

    2016-08-01

    Workplaces are one setting for cancer control planners to reach adults at risk for cancer and other chronic diseases. However, the extent to which Centers for Disease Control and Prevention-funded National Comprehensive Cancer Control Programs (NCCCP) implement interventions in the workplace setting is not well characterized. We conducted a qualitative content analysis of program action plans submitted by NCCCP grantees from 2013 to 2015 to identify and describe cancer prevention objectives and interventions in the workplace setting. Nearly half of NCCCP action reports contained at least one cancer prevention objective or intervention in the workplace setting. Common interventions included education about secondhand smoke exposure in the workplace, and the importance of obtaining colorectal cancer screening. Workplace interventions were relatively common among NCCCP action plans, and serve as one way to address low percentages of CRC screening, and reduce risk for obesity- and tobacco-related cancers.

  18. Land Management and Means of Planning Control

    DEFF Research Database (Denmark)

    Enemark, Stig

    2006-01-01

    or jurisdiction. The paper then identifies the different means of planning control such as a centralized versus a decentralized approach and planning led versus a market marked led approach. This is presented in a European context through a short overview of the various planning systems that reflect...... the historical and cultural developments of the European countries. Finally, the paper presents a short overview of the Danish approach to planning and landuse management as an example of a planning led approach placing the decision-making power especially at the local level. This concept of decentralization...... comprises a finely tuned relationship between a strong national authority and autonomous municipal councils. The purpose is to solve the tasks at the lowest possible level so as to combine responsibility for decision-making with accountability for financial, social, and environmental consequences. To put...

  19. Red Plague Control Plan (RPCP)

    Science.gov (United States)

    Cooke, Robert W.

    2010-01-01

    SCOPE: Prescribes the minimum requirements for the control of cuprous / cupric oxide corrosion (a.k.a. Red Plague) of silver-coated copper wire, cable, and harness assemblies. PURPOSE: Targeted for applications where exposure to assembly processes, environmental conditions, and contamination may promote the development of cuprous / cupric oxide corrosion (a.k.a. Red Plague) in silver-coated copper wire, cable, and harness assemblies. Does not exclude any alternate or contractor-proprietary documents or processes that meet or exceed the baseline of requirements established by this document. Use of alternate or contractor-proprietary documents or processes shall require review and prior approval of the procuring NASA activity.

  20. Environmental Restoration Program Document Control Plan

    Energy Technology Data Exchange (ETDEWEB)

    Montgomery, L.M.

    1993-09-01

    This Environmental Restoration (ER) Program Document Control Plan has been developed to comply with the document control system requirements of the US Department of Energy, Richland Operations Office (RL), the Hanford Federal Facility and the ER Program. One of the five components, or summary subprojects, of the Environmental Restoration (ER) Program is program management and support, which includes both management systems development and information and data management. Efforts within the management systems development area include the creation of a document control plan. Westinghouse Hanford Company (WHC) has developed and established an overall document control system that governs the methods by which all WHC documents are generated, maintained, and disposed of. The ER Program performing organizations within WHC utilize the established WHC document control systems to the maximum extent possible. These systems are discussed in Chapters 3.0 and 4.0 of this plan. In addition, this plan describes the documents that require control within the ER Program and how they will be controlled.

  1. The relationship between the biochemical control outcomes and the quality of planning of high-dose rate brachytherapy as a boost to external beam radiotherapy for locally and locally advanced prostate cancer using the RTOG-ASTRO Phoenix definition.

    Science.gov (United States)

    Pellizzon, Antonio Cassio Assis; Salvajoli, João; Novaes, Paulo; Maia, Maria; Fogaroli, Ricardo; Gides, Doglas; Horriot, Rodrigues

    2008-06-04

    To evaluated prognostic factors and impact of the quality of planning of high dose rate brachytherapy (HDR-BT) for patients with local or locally advanced prostate cancer treated with external beam radiotherapy (EBRT) and HDR-BT. Between 1997 and 2005, 209 patients with biopsy proven prostate adenocarcinoma were treated with localized EBRT and HDR-BT at the Department of Radiation-Oncology, Hospital A. C. Camargo, Sao Paulo, Brazil. Patient's age, Gleason score (GS), clinical stage (CS), initial PSA (iPSA), risk group for biochemical failure (GR), doses of EBRT and HDR-BT, use of three-dimensional planning for HDR-BT (3DHDR) and the Biological Effective Dose (BED) were evaluated as prognostic factors for biochemical control (bC). Median age and median follow-up time were 68 and 5.3 years, respectively. Median EBRT and HDR-BT doses were 45 Gy and 20 Gy. The crude bC at 3.3 year was 94.2%. For the Low, intermediate and high risk patients the bC rates at 3.3 years were 91.5%, 90.2% and 88.5%, respectively. Overall survival (OS) and disease specific survival rates at 3.3 years were 97.8% and 98.4%, respectively. On univariate analysis the prognostic factors related bC were GR (p= 0.040), GS or = 20 Gy (p or = 99 Gy(1.5) (p or = 185 (p or = 20 Gy (p=0.008) and 3DHDR (p<0.001). we observed that the bC rates correlates with the generally accepted risk factors described in the literature. Dose escalation, evaluated through the BED, and the quality of planning of HDR-BT are also important predictive factors when treating prostate cancer.

  2. Experience in the treatment of IMRT in prostate cancer. Planning, dosimetry and quality control; Experiencia en el tratamiento de IMRT en cancer de prostata. Planificacion, dosimetria y control de calidad

    Energy Technology Data Exchange (ETDEWEB)

    Gomez Barrado, A.; Garcia Vicente, F.; Fernandez Bedoya, V.; Bermudez Luna, R.; Perez Gonzalez, L.; Torres Escobar, J. J.

    2011-07-01

    The aim of this study is to review the treatment of prostate cancer at our center. A description of the entire procedure, involving clinical dosimetry, and procedures for verification of treatment, including physical dosimetry and parallel computing system MSure (Standard Imaging, Inc., Middleton) as part of these procedures. This system is based on the model published by trifuente Yang et al. (Yang et al. 2002) for testing treatments regarding the number of monitor unit (MU) given. In addition, this software has a module for the testing of treatments for intensity modulated radiotherapy (IMRT), which will be analyzed in this study.

  3. NASA Project Planning and Control Handbook

    Science.gov (United States)

    Moreland, Robert; Claunch, Cathy L.

    2016-01-01

    This handbook provides an overview of the fundamental principles and explains the functions and products that go into project planning and control. The 2010 Interim Results of the NASA Program Planning and Control (PPC) Study identified seven categories of activities for PPC, and those provide the basis for the seven functions described in this handbook. This handbook maps out the interfaces and interactions between PPC functions, as well as their external interfaces. This integration of information and products within and between functions is necessary to form the whole picture of how a project is progressing. The handbook descriptions are meant to facilitate consistent, common, and comprehensive approaches for providing valued analysis, assessment, and evaluation focused on the project level at NASA. The handbook also describes activities in terms of function rather than the job title or the specific person or organization responsible for the activity, which could differ by Center or size of a project. This handbook is primarily guidance for project planning and control: however, the same principles apply to programs and generally apply to institutional planning and control.

  4. Test, Control and Monitor System maintenance plan

    Science.gov (United States)

    Buehler, David P.; Lougheed, M. J.

    1993-01-01

    The maintenance requirements for Test, Control, and Monitor System (TCMS) and the method for satisfying these requirements prior to First Need Date (FND) of the last TCMS set are described. The method for satisfying maintenance requirements following FND of the last TCMS set will be addressed by a revision to this plan. This maintenance plan serves as the basic planning document for maintenance of this equipment by the NASA Payloads Directorate (CM) and the Payload Ground Operations Contractor (PGOC) at KSC. The terms TCMS Operations and Maintenance (O&M), Payloads Logistics, TCMS Sustaining Engineering, Payload Communications, and Integrated Network Services refer to the appropriate NASA and PGOC organization. For the duration of their contract, the Core Electronic Contractor (CEC) will provide a Set Support Team (SST). One of the primary purposes of this team is to help NASA and PGOC operate and maintain TCMS. It is assumed that SST is an integral part of TCMS O&M. The purpose of this plan is to describe the maintenance concept for TCMS hardware and system software in order to facilitate activation, transition planning, and continuing operation. When software maintenance is mentioned in this plan, it refers to maintenance of TCMS system software.

  5. Planning, scheduling, and control for automatic telescopes

    Science.gov (United States)

    Drummond, Mark; Swanson, Keith; Philips, Andy; Levinson, Rich; Bresina, John

    1992-01-01

    This paper presents an argument for the appropriateness of Entropy Reduction Engine (ERE) technology to the planning, scheduling, and control components of Automatic Photoelectric Telescope (APT) management. The paper is organized as follows. In the next section, we give a brief summary of the planning and scheduling requirements for APTs. Following this, in section 3, we give an ERE project precis, couched primarily in terms of project objectives. Section 4 gives a sketch of the match-up between problem and technology, and section 5 outlines where we want to go with this work.

  6. Effectiveness, Mediators, and Effect Predictors of Internet Interventions for Chronic Cancer-Related Fatigue : The Design and an Analysis Plan of a 3-Armed Randomized Controlled Trial

    NARCIS (Netherlands)

    Wolvers, Marije Dj; Bruggeman-Everts, Fieke Z; Van der Lee, Marije L; Van de Schoot, Rens; Vollenbroek-Hutten, Miriam Mr

    2015-01-01

    BACKGROUND: Internet interventions offer advantages that especially cancer survivors who suffer from fatigue could benefit from. Given the growing number of such patients, Internet interventions could supplement and strengthen currently available health care. OBJECTIVE: This paper describes the

  7. Advancing Public Health in Cancer - Annual Plan

    Science.gov (United States)

    Cancer is the leading cause of death from disease among Americans under 85. Learn how NCI advances public health by conducting research to improve the delivery of quality cancer prevention, screening, and treatment to all Americans.

  8. Dynamic nonprehensile manipulation: Controllability, planning, and experiments

    Energy Technology Data Exchange (ETDEWEB)

    Lynch, K.M. [Northwestern Univ., Evanston, IL (United States). Dept. of Mechanical Engineering; Mason, M.T. [Carnegie Mellon Univ., Pittsburgh, PA (United States). Robotics Inst.

    1999-01-01

    The authors are interested in using low-degree-of-freedom robots to perform complex tasks by nonprehensile manipulation (manipulation without a form- or force-closure grasp). By not grasping, the robot can use gravitational, centrifugal, and Coriolis forces as virtual motors to control more degrees of freedom of the part. The part`s extra motion freedoms are exhibited as rolling, slipping, and free flight. This paper describes controllability, motion planning, and implementation of planar dynamic nonprehensile manipulation. The authors show that almost any planar object is controllable by point contact, and the controlling robot requires only two degrees of freedom (a point translating in the plane). They then focus on a one-joint manipulator (with a two-dimensional state space), and show that even this simplest of robots, by using slipping and rolling, can control a planar object to a full-dimensional subset of its six-0dimensional state space. The authors have developed a one-joint robot to perform a variety of dynamic tasks, including snatching an object from a table, rolling an object on the surface of the arm, and throwing and catching. Nonlinear optimization is used to plan robot trajectories that achieve the desired object motion via coupling forces through the nonprehensile contact.

  9. Task planning as a part of production control

    OpenAIRE

    Junnonen, Juha-Matti; Seppänen, Olli

    2004-01-01

    The execution of a construction project requires production planning and control to be performed with different levels of accuracy. In master plans, the overall progress of the whole construction project is planned and controlled. For practical implementation, site management requires more detailed plans. This can be achieved with the help of task planning, a method of planning which begins from what should be done. and examines in detail how the time, cost, and quality objectives can be achi...

  10. Developing a community action plan to eliminate cancer disparities: lessons learned.

    Science.gov (United States)

    Wynn, Theresa Ann; Anderson-Lewis, Charkarra; Johnson, Rhoda; Hardy, Claudia; Hardin, Gail; Walker, Shundra; Marron, John; Fouad, Mona; Partridge, Edward; Scarinci, Isabel

    2011-01-01

    African Americans bear an unequal burden of breast, cervical, and colorectal cancer. The Deep South Network for Cancer Control (DSN) is a community-academic partnership operating in Alabama and Mississippi that was funded by the National Cancer Institute (NCI) to address cancer disparities using community-based participatory research approaches. In addition to reporting on the plans of this work in progress, we describe the participatory process that local residents and the DSN used to identify needs and priorities, and elaborate on lessons learned from applying a participatory approach to the development of a community action plan. We conducted 24 community discussion groups involving health care professionals, government officials, faith-based leaders, and other stakeholders to identify cancer health disparity needs, community resources/assets, and county priorities to eliminate cancer health disparities. To develop a community action plan, four working groups explored the themes that emerged from the discussion groups, taking into consideration evidence-based strategies and promising community practices. The DSN formulated a community action plan focusing on (1) increasing physical activity by implementing a campaign for individual-level focused activity; (2) increasing the consumption of fruits and vegetables by implementing NCI's Body and Soul Program in local churches; (3) increasing cancer screening by raising awareness through individual, system, and provider agents of change; and (4) training community partners to become effective advocates. A community-academic partnership must involve trust, respect, and an appreciation of partners' strengths and differences. The DSN applied these guiding principles and learned pivotal lessons.

  11. 42 CFR 84.41 - Quality control plans; contents.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Quality control plans; contents. 84.41 Section 84... AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality Control § 84.41 Quality control plans; contents. (a) Each quality control plan shall contain provisions for the...

  12. Cancer in Angola, resources and strategy for its control.

    Science.gov (United States)

    Lopes, Lygia Vieira; Conceição, Ana Vaz; Oliveira, João Blasques; Tavares, António; Domingos, Clarinha; Santos, Lucio Lara

    2012-01-01

    Cancer is an increasingly important health problem in Africa. The number of cancer cases in this region could double, ranging between 700 000 and 1 600 000 new cases in 2030. The mortality rate is higher than 80% and is explained, mainly, by a lack of early detection, diagnostics and treatment resources. In Angola, about 7,000 patients die of cancer every year. Data were derived from open-ended interviews conducted in 2010-11 with health authorities, clinicians, nurses and Administration of Hospitals. According Angola epidemiological data, results of interviews and international published advocacy for cancer control we develop a potential strategy for its control. The objectives are to identify existing resources for cancer control and describe the needs thereto, in order to establish an oncological program to guide the development of Angola cancer control strategies. Malaria remains the leading cause of illness and death in Angola, and other communicable diseases remain a public health problem. However, 9 000 new cases of cancer are diagnosed each year.The most common types of cancer are: cancer of the cervix, breast, prostate, esophagus, stomach and head and neck, as well as cancers with infectious origin, such as Kaposi's sarcoma and liver and bladder cancer. The foundation for developing national cancer control strategies includes: oncological data; investment and training; identifying and removing barriers; guidance and protection of the patient. Angolan National Cancer Centre, Sagrada Esperança Clinic and Girassol Clinic are now developing a cancer program. Improving the economic situation of Angola creates conditions for an increase in life expectancy which in itself is associated with an increased risk of oncological diseases. On the other hand, infectious diseases, associated with the risk of malignant tumors, are endemic. Thus, an increase in patients with malignant disease is expected. A plan is therefore necessary to organize the response to this old

  13. Using the Theory of Planned Behavior to Understand Cervical Cancer Screening Among Latinas.

    Science.gov (United States)

    Roncancio, Angelica M; Ward, Kristy K; Sanchez, Ingrid A; Cano, Miguel A; Byrd, Theresa L; Vernon, Sally W; Fernandez-Esquer, Maria Eugenia; Fernandez, Maria E

    2015-10-01

    To reduce the high incidence of cervical cancer among Latinas in the United States it is important to understand factors that predict screening behavior. The aim of this study was to test the utility of theory of planned behavior in predicting cervical cancer screening among a group of Latinas. A sample of Latinas (N = 614) completed a baseline survey about Pap test attitudes subjective norms, perceived behavioral control, and intention to be screened for cervical cancer. At 6 months postbaseline, cervical cancer screening behavior was assessed. Structural equation modeling was used to test the theory. Model fit statistics indicated good model fit: χ(2)(48) = 54.32, p = .246; comparative fit index = .992; root mean square error of approximation = .015; weighted root mean square residual = .687. Subjective norms (p = .005) and perceived behavioral control (p theory of planned behavior in predicting cervical cancer screening among Latinas. This knowledge can be used to inform the development of a theory of planned behavior-based intervention to increase cervical cancer screening among Latinas and reduce the high incidence of cervical cancer in this group of women. © 2015 Society for Public Health Education.

  14. Birth control, population control, and family planning: an overview.

    Science.gov (United States)

    Critchlow, D T

    1995-01-01

    This overview of the US birth control movement reflects on the emergence of family planning policy due to the efforts of Margaret Sanger, feminists, and the civil rights movement, the eugenics motive to limit "deviant" populations, and the population control movement, which aims to solve social and economic problems through fertility control. Population control moved through three stages: from the cause of "voluntary motherhood" to advance suffrage and women's political and social status, to the concept of "birth control" promoted by socialist feminists to help empower women and the working class, to, from 1920 on, a liberal movement for civil rights and population control. Physicians such as Dr. Robert Latou Dickinson legitimized the movement in the formation of the Committee on Maternal Health in 1925, but the movement remained divided until 1939, when Sanger's group merged with the American Birth Control League, the predecessor of the present Planned Parenthood Federation of America. A key legal decision in 1939 in the United States v. One Package amended the Comstock Act and allowed for the distribution of birth control devices by mail to physicians. Sanger, after a brief retirement, formed the International Planned Parenthood Federation and supported research into the pill. Eugenicists through the Committee on Maternal Health supported Christopher Tietze and others developing the pill. Final constitutional access to contraception based on the right to privacy was granted in Griswold v. Connecticut. The ruling in Eisenstadt v. Baird in 1972 extended this right to unmarried persons. The right to privacy was further extended in the Roe v. Wade decision in 1973 on legal abortion. The argument for improving the quality of the population remained from the formation of the Population Reference Bureau in 1929 through the 1960s. Under the leadership of Rockefeller, population control was defined as justified on a scientific and humanitarian basis. US government support

  15. 49 CFR 236.18 - Software management control plan.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Software management control plan. 236.18 Section... Instructions: All Systems General § 236.18 Software management control plan. (a) Within 6 months of June 6, 2005, each railroad shall develop and adopt a software management control plan for its signal and train...

  16. 46 CFR 116.530 - Fire control plan.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Fire control plan. 116.530 Section 116.530 Shipping... and Embarkation Station Requirements § 116.530 Fire control plan. A fire control plan must be posted... escape routes, areas of refuge, embarkation stations, the location of fire protection/emergency equipment...

  17. Dental treatment planning and management for the mouth cancer patient.

    Science.gov (United States)

    Joshi, Vinod K

    2010-06-01

    The need to deliver cancer treatment promptly often requires modification of ideal dental treatment plans. Treatment planning and preventive care is crucial and needs to be done before radiotherapy in order to avoid complications such as osteoradionecrosis. Rapid delivery of this dental care can only be achieved if oral care is given adequate priority in the patient care pathway. Few cancer centres have the resources to provide comprehensive dental care and thus, in most circumstances, this care has to be provided by the patient's dentist and dental care professional, with advice from the local dental oncology specialist team. Copyright 2010 Elsevier Ltd. All rights reserved.

  18. Nurse's role in controlling cancer pain.

    Science.gov (United States)

    Mahfudh, Salma Said

    2011-10-01

    Nurses spend more time with patients than any other member of the healthcare team. They play a critical, active and very important part in controlling cancer patients' pain and alleviating suffering. In controlling cancer pain the nurse needs to understand the psychological state of the cancer patient, cancer pain, cancer pain treatment, deleterious effects of unrelieved cancer pain and patient's socio cultural background. She needs to understand that there are two types of pain, nociceptive and neuropathic pains and that 80% of the cancer patients in pain could have 2 or more than 4 different pains at the same time. Nurses' role in controlling cancer pain include believing the patient, assessing pain, identifying the root of the problem, planning the care, administering medication, evaluating effectiveness, ensuring good pain control and individualizing treatment. It also includes nursing interventions such as giving tender nursing care, preventing pain, educating, advocating, communicating, comforting, supporting, and counseling the patient. The nurse must use both pharmacological and non pharmacological treatments to individualize treatment, know all the drugs that are used for the treatment of Cancer Pain, how these drugs relieve pain and what their side effects are. She must use the WHO guidelines to treat pain and must choose the right drug, right dose, given at the right times, with the right intervals and to the right patient. She must evaluate effectiveness of treatment, give PRN doses for breakthrough pain and recommend for specific changes. The role of the nurse is to anticipate the patient's pain needs, advocate for the patient for what feels appropriate for him within his cultural context and incorporate the patient's belief. The nurse can physically relieve pain by promoting comfort, support painful area, gentleness in handling the patient and use nursing treatments. The nurse can recommend physiotherapy, (TENS)/Acupuncture, Occupational therapy

  19. Control theoretic splines optimal control, statistical, and path planning

    CERN Document Server

    Egerstedt, Magnus

    2010-01-01

    Splines, both interpolatory and smoothing, have a long and rich history that has largely been application driven. This book unifies these constructions in a comprehensive and accessible way, drawing from the latest methods and applications to show how they arise naturally in the theory of linear control systems. Magnus Egerstedt and Clyde Martin are leading innovators in the use of control theoretic splines to bring together many diverse applications within a common framework. In this book, they begin with a series of problems ranging from path planning to statistics to approximation.

  20. EDITORIAL CERVICAL CANCER CAN BE CONTROLLED Cancer ...

    African Journals Online (AJOL)

    palliative care of invasive cancer(9). But it must also be accepted that even these modest comparisons will mean little to countries where per capita annual expenditure on health is less than five US dollars. This is a realisation that has spurred the search for alternative approaches to cervical cancer screening.

  1. Lung cancer patients' decisions about clinical trials and the theory of planned behavior.

    Science.gov (United States)

    Quinn, Gwendolyn P; Pratt, Christie L; Bryant-George, Kathy; Caraway, Vicki D; Paternoster, Bonnie; Roldan, Tere; Shaffer, Andrea; Shimizu, Cynthia O; Vaughn, Elizabeth J; Williams, Charles; Bepler, Gerold

    2011-12-01

    The theory of planned behavior explores the relationship between behavior, beliefs, attitudes, and intentions presupposing that behavioral intention is influenced by a person's attitude about the behavior and beliefs about whether individuals, who are important to them, approve or disapprove of the behavior (subjective norm). An added dimension to the theory is the idea of perceived behavioral control, or the belief that one has control over performing the behavior. The theory of planned behavior suggests that people may make greater efforts to perform a behavior if they feel they have a high level of control over it. In this examination of data, we explored the application of the theory of planned behavior to patient's decisions about participating in a clinic trial. Twelve respondents in this study had previously participated in a clinical trial for lung cancer and nine respondents had declined a clinical trial for lung cancer. The data were analyzed with regard to the four constructs associated with the theory of planned behavior: behavioral intention, attitude, subjective norm, and perceived behavioral control. Results indicate that the theory of planned behavior may be a useful tool to examine psychosocial needs in relation to behavioral intention of clinical trial participation.

  2. Cancer control and prevention: nutrition and epigenetics.

    Science.gov (United States)

    Verma, Mukesh

    2013-07-01

    To evaluate recent developments in nutritional epigenomics and related challenges, opportunities, and implications for cancer control and prevention. Cancer is one of the leading causes of death worldwide, and understanding the factors that contribute to cancer development may facilitate the development of strategies for cancer prevention and control. Cancer development involves genetic and epigenetic alterations. Genetic marks are permanent, whereas epigenetic marks are dynamic, change with age, and are influenced by the external environment. Thus, epigenetics provides a link between the environment, diet, and cancer development. Proper food selection is imperative for better health and to avoid cancer and other diseases. Nutrients either contribute directly to cancer prevention or support the repair of genomic and epigenomic damage caused by exposure to cancer-causing agents such as toxins, free radicals, radiation, and infectious agents. Nutritional epigenomics provides an opportunity for cancer prevention because selected nutrients have the potential to reverse cancer-associated epigenetic marks in different tumor types. A number of natural foods and their bioactive components have been shown to have methylation-inhibitory and deacetylation-inhibitory properties. Natural foods and bioactive food components have characteristics and functions that are similar to epigenetic inhibitors and therefore have potential in cancer control and prevention.

  3. SU-E-T-471: Improvement of Gamma Knife Treatment Planning Through Tumor Control Probability for Metastatic Brain Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Z [East Carolina University, Greenville, NC (United States); Feng, Y [East Carolina Univ, Rockville, MD (United States); Lo, S [Case Western Reserve University, Cleveland, OH (United States); Grecula, J [Ohio State University, Columbus, OH (United States); Mayr, N; Yuh, W [University of Washington, Seattle, WA (United States)

    2015-06-15

    Purpose: The dose–volume histogram (DVH) has been normally accepted as a tool for treatment plan evaluation. However, spatial information is lacking in DVH. As a supplement to the DVH in three-dimensional treatment planning, the differential DVH (DDVH) provides the spatial variation, the size and magnitude of the different dose regions within a region of interest, which can be incorporated into tumor control probability model. This study was to provide a method in evaluating and improving Gamma Knife treatment planning. Methods: 10 patients with brain metastases from different primary tumors including melanoma (#1,#4,#5, #10), breast cancer (#2), prostate cancer (#3) and lung cancer (#6–9) were analyzed. By using Leksell GammaPlan software, two plans were prepared for each patient. Special attention was given to the DDVHs that were different for different plans and were used for a comparison between two plans. Dose distribution inside target and tumor control probability (TCP) based on DDVH were calculated, where cell density and radiobiological parameters were adopted from literature. The plans were compared based on DVH, DDVH and TCP. Results: Using DVH, the coverage and selectivity were the same between plans for 10 patients. DDVH were different between two plans for each patient. The paired t-test showed no significant difference in TCP between the two plans. For brain metastases from melanoma (#1, #4–5), breast cancer (#2) and lung cancer (#6–8), the difference in TCP was less than 5%. But the difference in TCP was about 6.5% for patient #3 with the metastasis from prostate cancer, 10.1% and 178.7% for two patients (#9–10) with metastasis from lung cancer. Conclusion: Although DVH provides average dose–volume information, DDVH provides differential dose– volume information with respect to different regions inside the tumor. TCP provides radiobiological information and adds additional information on improving treatment planning as well as adaptive

  4. Cancer control-A global perspective.

    Science.gov (United States)

    Olver, I

    2017-01-01

    Disparities in cancer control exist in low- and middle-income countries (LMICs). Many countries do not have cancer registries to record incidence, mortality and prevalence and are reliant on Globocan estimates of their cancer burden. Poorer cancer control within and between countries occurs in those living remotely from urban centres, those in a low socioeconomic group and some ethnic groups who have lifestyle and belief systems which impact on cancer control. High-income countries generally have population screening programmes for cervix, breast and bowel cancer. However, simpler forms of screening for cancer of the cervix like visual inspection with acetic acid have been shown to be feasible in developing nations. The widespread use of vaccines to prevent cancer has been achieved with the Hepatitis B vaccine but the human papilloma virus vaccine to prevent cancer of the cervix is largely only available in high-income countries. Access to and training of oncological surgeons in LMICs is limited, while 70% of patients in these countries cannot access radiotherapy. The World Health Organization has developed a list of essential medicines although access remains poor in LMICs. The United Nations has set targets for the control of non-communicable diseases to improve global cancer control. © 2017 John Wiley & Sons Ltd.

  5. Gynecologic Cancer InterGroup (GCIG) endometrial cancer clinical trials planning meeting: taking endometrial cancer trials into the translational era.

    NARCIS (Netherlands)

    Creutzberg, C.L.; Kitchener, H.C.; Birrer, M.J.; Landoni, F.; Lu, K.H.; Powell, M.; Aghajanian, C.; Edmondson, R.; Goodfellow, P.J.; Quinn, M.; Salvesen, H.B.; Thomas, G.; Ottevanger, N.

    2013-01-01

    OBJECTIVE: The second Gynecologic Cancer InterGroup (GCIG) Endometrial Cancer Clinical Trials Planning Meeting was held on December 1, 2012, and included international multidisciplinary representatives of the 24 member groups. The aims were to review recent advances in molecular pathology of

  6. Form planning Control to growth management

    DEFF Research Database (Denmark)

    Enemark, Stig

    2016-01-01

    The 1950s marked the birth of comprehensive planning in Denmark, when a number of socio-spatial challenges emerged as a result of the country’s rapid economic growth. These challenges were eventually addressed by the administrative reform of 1970 and the following planning reform implemented from...

  7. Sexual Dysfunction in Breast Cancer: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Mandana Ebrahimi

    2015-02-01

    Full Text Available Background: Sexual dysfunction in breast cancer patients is considered as a common and distressing problem. Considering the increasing number of breast cancer survivors living for longer periods of time with the disease and the importance of their quality of life, we conducted the present study to compare the sexual functioning in breast cancer patients with their healthy counterparts.Methods: In this case-control study, breast cancer patients who completed their treatment protocol and were followed up for at least six months were included. The controls were healthy women with normal clinical breast examinations. All subjects filled-in the Persian version of Female Sexual Function Index questionnaire.Results: A total of 165 subjects including 71 breast cancer patients and 94 healthy women were studied. The frequency of sexual dysfunction in cases and controls was 52.6% and 47.4%, respectively (P = 0.09. There were no significant differences between the two groups regarding domain scores, except for vaginal lubrication (P = 0.045. Logistic regression analysis indicated that significant determinants of sexual dysfunction in breast cancer group was patients' age (OR = 4.0, 95%CI: 1.3 – 11.5, P = 0.01 and age of the spouse (OR= 9.8, 95% CI: 1.8-51.9, P= 0.007, while in controls, only emotional relationship with the husband was the significant predictive factor (OR = 6.3, 95%CI: 1.9 – 20.5, P = 0.002.Conclusions: Our findings indicated that sexual dysfunction is prevalent in Iranian women regardless of their physical health status. The frequency of vaginal dryness in breast cancer patients was significantly higher than controls. Age of the patient and the spouse (>40 were the only significant predictors of sexual dysfunction among women with breast cancer. Preventive strategies, sexual education and access to effective treatment should be planned in supportive care of breast cancer patients.

  8. Pancreatic cancer planning: Complex conformal vs modulated therapies

    Energy Technology Data Exchange (ETDEWEB)

    Chapman, Katherine L. [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Witek, Matthew E. [Department of Radiation Oncology, University of Wisconsin School of Medicine School of Medicine and Public Health, Madison, WI (United States); Chen, Hongyu [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Showalter, Timothy N. [Department of Radiation Oncology, University of Virginia, Charlottesville, VA (United States); Bar-Ad, Voichita [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Harrison, Amy S., E-mail: amy.harrison@jefferson.edu [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States)

    2016-07-01

    To compare the roles of intensity-modulated radiation therapy (IMRT) and volumetric- modulated arc therapy (VMAT) therapy as compared to simple and complex 3-dimensional chemoradiotherpy (3DCRT) planning for resectable and borderline resectable pancreatic cancer. In all, 12 patients who received postoperative radiotherapy (8) or neoadjuvant concurrent chemoradiotherapy (4) were evaluated retrospectively. Radiotherapy planning was performed for 4 treatment techniques: simple 4-field box, complex 5-field 3DCRT, 5 to 6-field IMRT, and single-arc VMAT. All volumes were approved by a single observer in accordance with Radiation Therapy Oncology Group (RTOG) Pancreas Contouring Atlas. Plans included tumor/tumor bed and regional lymph nodes to 45 Gy; with tumor/tumor bed boosted to 50.4 Gy, at least 95% of planning target volume (PTV) received the prescription dose. Dose-volume histograms (DVH) for multiple end points, treatment planning, and delivery time were assessed. Complex 3DCRT, IMRT, and VMAT plans significantly (p < 0.05) decreased mean kidney dose, mean liver dose, liver (V{sub 30}, V{sub 35}), stomach (D{sub 10}%), stomach (V{sub 45}), mean right kidney dose, and right kidney (V{sub 15}) as compared with the simple 4-field plans that are most commonly reported in the literature. IMRT plans resulted in decreased mean liver dose, liver (V{sub 35}), and left kidney (V{sub 15}, V{sub 18}, V{sub 20}). VMAT plans decreased small bowel (D{sub 10}%, D{sub 15}%), small bowel (V{sub 35}, V{sub 45}), stomach (D{sub 10}%, D{sub 15}%), stomach (V{sub 35}, V{sub 45}), mean liver dose, liver (V{sub 35}), left kidney (V{sub 15}, V{sub 18}, V{sub 20}), and right kidney (V{sub 18}, V{sub 20}). VMAT plans significantly decreased small bowel (D{sub 10}%, D{sub 15}%), left kidney (V{sub 20}), and stomach (V{sub 45}) as compared with IMRT plans. Treatment planning and delivery times were most efficient for simple 4-field box and VMAT. Excluding patient setup and imaging, average

  9. Spill prevention control and countermeasure plan

    Energy Technology Data Exchange (ETDEWEB)

    1981-01-01

    This report includes facility descriptions for both oil and hazardous chemicals storage. It gives oil spill history; regulatory guideline conformance; local emergency arrangements; evacuation procedures and the contingency plan for oil and hazardous substances. (PSB)

  10. A system architecture for holonic manufacturing planning and control (EtoPlan)

    NARCIS (Netherlands)

    Wullink, Gerhard; Giebels, M.M.T.; Kals, H.J.J.

    2002-01-01

    In this paper, we present the system architecture of a flexible manufacturing planning and control system, named EtoPlan. The concept is based on the holonic control approach of building multiple and temporary hierarchies (holarchies). This paper describes the system architecture for flexible

  11. Animal Control Management Plan: Parker River National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Animal Control Management Plan for Parker River National Wildlife Refuge outlines the procedures for controlling wildlife and fish populations to keep them...

  12. Nuisance Animal Control Plan for Loess Bluffs National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Control Plan will cover control of invasive animal species on Squaw Creek National Wildlife Refuge. The primary nuisance species on Squaw Creek NWR is the...

  13. Managing Air Quality - Multi-Pollutant Planning and Control

    Science.gov (United States)

    Describes how planning controls for multiple pollutants at the same time can save money and time and achieve significant benefits, and how control strategies can address both climate change and air quality.

  14. Validation of Fully Automated VMAT Plan Generation for Library-Based Plan-of-the-Day Cervical Cancer Radiotherapy.

    Science.gov (United States)

    Sharfo, Abdul Wahab M; Breedveld, Sebastiaan; Voet, Peter W J; Heijkoop, Sabrina T; Mens, Jan-Willem M; Hoogeman, Mischa S; Heijmen, Ben J M

    2016-01-01

    To develop and validate fully automated generation of VMAT plan-libraries for plan-of-the-day adaptive radiotherapy in locally-advanced cervical cancer. Our framework for fully automated treatment plan generation (Erasmus-iCycle) was adapted to create dual-arc VMAT treatment plan libraries for cervical cancer patients. For each of 34 patients, automatically generated VMAT plans (autoVMAT) were compared to manually generated, clinically delivered 9-beam IMRT plans (CLINICAL), and to dual-arc VMAT plans generated manually by an expert planner (manVMAT). Furthermore, all plans were benchmarked against 20-beam equi-angular IMRT plans (autoIMRT). For all plans, a PTV coverage of 99.5% by at least 95% of the prescribed dose (46 Gy) had the highest planning priority, followed by minimization of V45Gy for small bowel (SB). Other OARs considered were bladder, rectum, and sigmoid. All plans had a highly similar PTV coverage, within the clinical constraints (above). After plan normalizations for exactly equal median PTV doses in corresponding plans, all evaluated OAR parameters in autoVMAT plans were on average lower than in the CLINICAL plans with an average reduction in SB V45Gy of 34.6% (pImprovements in SB dose delivery with autoVMAT instead of manVMAT were higher for empty bladder PTVs compared to full bladder PTVs, due to differences in concavity of the PTVs. Quality of automatically generated VMAT plans was superior to manually generated plans. Automatic VMAT plan generation for cervical cancer has been implemented in our clinical routine. Due to the achieved workload reduction, extension of plan libraries has become feasible.

  15. Peer-to-Peer Planning for Space Mission Control

    Science.gov (United States)

    Barreiro, Javier; Jones, Grailing, Jr.; Schaffer, Steve

    2009-01-01

    Planning and scheduling for space operations entails the development of applications that embed intimate domain knowledge of distinct areas of mission control, while allowing for significant collaboration among them. The separation is useful because of differences in the planning problem, solution methods, and frequencies of replanning that arise in the different disciplines. For example, planning the activities of human spaceflight crews requires some reasoning about all spacecraft resources at timescales of minutes or seconds, and is subject to considerable volatility. Detailed power planning requires managing the complex interplay of power consumption and production, involves very different classes of constraints and preferences, but once plans are generated they are relatively stable.

  16. Clinical trials focusing on cancer pain educational interventions: core components to include during planning and reporting.

    Science.gov (United States)

    Stiles, Carla R; Biondo, Patricia D; Cummings, Greta; Hagen, Neil A

    2010-08-01

    Robust recommendations on the reporting of methods and results of clinical trials such as therapeutic intervention trials are widely used, such as the Consolidated Standards of Reporting Trials (CONSORT) recommendation. There has not been agreement on analogous publication standards for educational intervention trials, making interpretation of educational intervention studies difficult. The purpose of this report is to describe common deficiencies in reporting of educational intervention trials for cancer pain control, and to offer suggestions for authors to consider as they plan their studies, and report and publish research findings for educational interventions that use randomized controlled trials and other educational trial methodologies. A systematic review of published knowledge translation intervention trials intended to improve cancer pain was undertaken, of which most were educational interventions. Many educational intervention clinical trials designed to improve management of cancer pain appeared methodologically weak, and their results were more difficult to interpret because of reporting deficiencies. In the course of the review, patterns of deficiencies in reporting of methods and trial results were documented. Deficiencies in reporting were compared with the CONSORT recommendations for reporting clinical trials, and parallel recommendations were drafted for educational intervention trials. Patterns of deficiency in reporting cancer pain educational intervention trials were synthesized into seven domains, generically applicable to a range of study designs. Draft recommendations intended to address these deficiencies were constructed to improve communication of educational research results. Development of a standardized reporting template for clinical trials in cancer pain educational interventions could advance knowledge transfer research and thereby increase effectiveness of national and international cancer control policy designed to support cancer

  17. Dosimetric and Radiobiological Evaluation of Hybrid Inverse Planning and Optimization for Cervical Cancer Brachytherapy.

    Science.gov (United States)

    Matias, Lucílio Dos S; Palmqvist, Tomas; Wolke, Jeanette; Nilsson, Josef; Beskow, Catharina; Maphossa, Alexandre M; Toma-Dasu, Iuliana

    2015-11-01

    To compare manual graphical optimization (GrO) with hybrid inverse planning optimization (HIPO) of cervical cancer brachytherapy treatment plans using physical and radiobiological tools. Ten patients suffering from cervical cancer, treated with pulsed brachytherapy using GrO plans, were included in the study. For each patient, four different HIPO class solutions with different dose objectives to the target and constraints to the organs at risk (OAR) produced four optimized plans, that were each compared to the corresponding GrO plan. Class solution in HIPO is a set of parameters consisting of dose constraints and penalty weights, which are used for optimization. The comparison was based on the following dosimetric parameters: conformity index (COIN), minimum dose received by 98% and 90% of the high-risk clinical target volume (represented by D98 and D90, respectively), and the minimum dose imparted to 2 cm(3) (D2cm(3)) of the most exposed OAR i.e. bladder, sigmoid colon or rectum. The HIPO class solution which produced plans with overall better dosimetric parameters was selected and its plans were compared with manual GrO plans from a radiobiological viewpoint based on the calculated complication-free tumour control probability, P+. The average COIN for the GrO and the selected HIPO plans were 0.22 and 0.30, respectively. The median COIN of the GrO and the HIPO plans were not statistically different (p>0.05, Wilcoxon test). The relative percentage difference of the averaged P(+) values between the HIPO and GrO plans evaluated together with the external beam radiation therapy plans was 0.01%, 0.37% and 0.98% for the bladder, sigmoid colon and rectum, respectively. The lowest P+ value for all the plans was 98.44% for sigmoid colon. HIPO presented comparable results in relation to manual planning with respect to dosimetric and radiobiological parameters. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  18. Randomized controlled trials: planning, monitoring, and execution.

    Science.gov (United States)

    Hatfield, Elizabeth; Dicks, Elizabeth; Parfrey, Patrick S

    2015-01-01

    Large integrated multidisciplinary teams have become recognized as an efficient means by which to drive innovation and discovery in clinical research. This chapter describes how to plan, budget and fund these large studies and execute the studies with well-designed governance and monitoring protocols in place, to efficiently manage the large, often dispersed teams involved. Sources of funding are identified, budget development, justification, reporting, financial governance and accountability are described, in addition to the creation and management of the multidisciplinary team that will implement the research plan.

  19. Multiobjective approach in plans for treatment of cancer by radiotherapy

    Directory of Open Access Journals (Sweden)

    Thalita Monteiro Obal

    2013-08-01

    Full Text Available Nowadays the technique of radiotherapy has been one of the main alternatives for the treatment of several types of cancer today. With technological development, especially in the case of 3D conformal radiotherapy, applications involving mathematical techniques and algorithms have been proposed to help the development a good treatment plan. This paper aims at present a model for multiobjective linear programming problem of dose intensity. The focus of the model is to determine the best dose distribution of radiation field, so that the dose delivered to the tumor to be prescribed and that affects the minimum the noble and healthy tissues. A test case of prostate cancer was used as an example of the numerical model and the Pareto-Optimal Frontier was generated using the method of weighted function.

  20. Virtual Factory Framework for Supporting Production Planning and Control.

    Science.gov (United States)

    Kibira, Deogratias; Shao, Guodong

    2017-01-01

    Developing optimal production plans for smart manufacturing systems is challenging because shop floor events change dynamically. A virtual factory incorporating engineering tools, simulation, and optimization generates and communicates performance data to guide wise decision making for different control levels. This paper describes such a platform specifically for production planning. We also discuss verification and validation of the constituent models. A case study of a machine shop is used to demonstrate data generation for production planning in a virtual factory.

  1. Radiobiological Impact of Planning Techniques for Prostate Cancer ...

    African Journals Online (AJOL)

    Background: The radiobiological models describe the effects of the radiation treatment on cancer and healthy cells, and the radiobiological effects are generally characterized by the tumor control probability (TCP) and normal tissue complication probability (NTCP). Aim: The purpose of this study was to assess the ...

  2. Barriers and facilitators to implementing cancer survivorship care plans.

    Science.gov (United States)

    Dulko, Dorothy; Pace, Claire M; Dittus, Kim L; Sprague, Brian L; Pollack, Lori A; Hawkins, Nikki A; Geller, Berta M

    2013-11-01

    To evaluate the process of survivorship care plan (SCP) completion and to survey oncology staff and primary care physicians (PCPs) regarding challenges of implementing SCPs. Descriptive pilot study. Two facilities in Vermont, an urban academic medical center and a rural community academic cancer center. 17 oncology clinical staff created SCPs, 39 PCPs completed surveys, and 58 patients (breast or colorectal cancer) participated in a telephone survey. Using Journey Forward tools, SCPs were created and presented to patients. PCPs received the SCP with a survey assessing its usefulness and barriers to delivery. Oncology staff were interviewed to assess perceived challenges and benefits of SCPs. Qualitative and quantitative data were used to identify challenges to the development and implementation process as well as patient perceptions of the SCP visit. SCP, healthcare provider perception of barriers to completion and implementation, and patient perception of SCP visit. Oncology staff cited the time required to obtain information for SCPs as a challenge. Completing SCPs 3-6 months after treatment ended was optimal. All participants felt advanced practice professionals should complete and review SCPs with patients. The most common challenge for PCPs to implement SCP recommendations was insufficient knowledge of cancer survivor issues. Most patients found the care plan visit very useful, particularly within six months of diagnosis. Creation time may be a barrier to widespread SCP implementation. Cancer survivors find SCPs useful, but PCPs feel insufficient knowledge of cancer survivor issues is a barrier to providing best follow-up care. Incorporating SCPs in electronic medical records may facilitate patient identification, appropriate staff scheduling, and timely SCP creation. Oncology nurse practitioners are well positioned to create and deliver SCPs, transitioning patients from oncology care to a PCP in a shared-care model of optimal wellness. Institution support for

  3. Command and Control Planning and Teamwork: Exploring the Future

    National Research Council Canada - National Science Library

    Sterling, Bruce S; Lickteig, Carl W

    2000-01-01

    .... This paper examines how participant ratings of command and control planning and observer assessments of teamwork were related in a series of futuristic missions conducted by the Mounted Maneuver...

  4. Mingo National Wildlife Refuge : Station Crowd Control Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Crowd Control Plan for Mingo NWR outlines operational procedures in the event of a civil disorder on the Refuge. An inventory of resources is provided, along...

  5. Animal control plan/environmental assessment : Lacreek National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This plan outlines the need for management objectives and safety practices at Lacreek National Wildlife Refuge to require the development of alternative control...

  6. Animal Control Plan Prime Hook National Wildlife Refuge 1987

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This document contains a discussion of programs of the refuge as they relate to animal control and plans for managing these resources at Prime Hook National Wildlife...

  7. [Disease Prevention and Control Plan Swan Lake National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The Disease Prevention and Control Plan for Swan Lake National Wildlife Refuge provides background information on disease surveillance; an inventory of Refuge...

  8. Animal Control Plan for Wapanocca National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This plan for Wapanocca National Wildlife Refuge in 2000 describes animal control priorities and objectives. Target species include, beaver, nutria, raccoon,...

  9. Lean planning and control : principles and practice

    NARCIS (Netherlands)

    Riezebos, Jan; Suer, Gursel; Gen, Mitsuo

    2018-01-01

    A basic characteristic of lean, agile, and responsive production systems are the use of teams instead of functional departments. Another characteristic is the use of rather simple shop floor control methods to manage the flow of orders. The shop floor control methods provide robust and visual

  10. Principles of lean planning and control

    NARCIS (Netherlands)

    Riezebos, J.

    2015-01-01

    Lean production systems use teams instead of functional departments as well as simple shop floor control methods to manage the flow of orders at the shop floor. Lean shop floor control focuses on robust and visual methods that are able to cope with variation in processing times, routing sequences,

  11. Coverage-based treatment planning to accommodate delineation uncertainties in prostate cancer treatment.

    Science.gov (United States)

    Xu, Huijun; Gordon, J James; Siebers, Jeffrey V

    2015-09-01

    To compare two coverage-based planning (CP) techniques with fixed margin-based (FM) planning for high-risk prostate cancer treatments, with the exclusive consideration of the dosimetric impact of delineation uncertainties of target structures and normal tissues. In this work, 19-patient data sets were involved. To estimate structure dose for each delineated contour under the influence of interobserver contour variability and CT image quality limitations, 1000 alternative structures were simulated by an average-surface-of-standard-deviation model, which utilized the patient-specific information of delineated structure and CT image contrast. An IMRT plan with zero planning-target-volume (PTV) margin on the delineated prostate and seminal vesicles [clinical-target-volume (CTV prostate) and CTVSV] was created and dose degradation due to contour variability was quantified by the dosimetric consequences of 1000 alternative structures. When D98 failed to achieve a 95% coverage probability objective D98,95 ≥ 78 Gy (CTV prostate) or D98,95 ≥ 66 Gy (CTVSV), replanning was performed using three planning techniques: (1) FM (PTV prostate margin = 4,5,6 mm and PTVSV margin = 4,5,7 mm for RL, PA, and SI directions, respectively), (2) CPOM which optimized uniform PTV margins for CTV prostate and CTVSV to meet the D98,95 objectives, and (3) CPCOP which directly optimized coverage-based objectives for all the structures. These plans were intercompared by computing percentile dose-volume histograms and tumor-control probability/normal tissue complication probability (TCP/NTCP) distributions. Inherent contour variability resulted in unacceptable CTV coverage for the zero-PTV-margin plans for all patients. For plans designed to accommodate contour variability, 18/19 CP plans were most favored by achieving desirable D98,95 and TCP/NTCP values. The average improvement of probability of complication free control was 9.3% for CPCOP plans and 3.4% for CPOM plans. When the delineation

  12. Understanding Cervical Cancer Screening Intentions Among Latinas Using An Expanded Theory of Planned Behavior Model

    Science.gov (United States)

    Roncancio, Angelica M.; Ward, Kristy K.; Fernandez, Maria E.

    2016-01-01

    We examined the utility of an expanded Theory of Planned Behavior (TPB) model in predicting cervical cancer screening intentions among Latinas. The model included acculturation and past cervical cancer screening behavior along with attitude, subjective norms, and perceived behavioral control. This cross-sectional study included a sample of 206 Latinas who responded to a self-administered survey. Structural equation modeling was employed to test the expanded TPB model. Acculturation (p= .025) and past screening behavior (p= .001) along with attitude (p= .019), subjective norms (p= .028), and perceived behavioral control (p= .014) predicted the intention to be screened for cervical cancer. Our findings suggest that the TPB is a useful model for understanding cervical cancer screening intentions among Latinas when both past behavior and culture are included. This highlights the importance of culture on behavior and indicates a need to develop culturally sensitive, theory-based interventions to encourage screening and reduce cervical cancer-related health disparities in Latinas. PMID:23930898

  13. Environmental Release Prevention and Control Plan

    Energy Technology Data Exchange (ETDEWEB)

    Mamatey, A.; Arnett, M.

    1997-10-01

    During the history of SRS, continual improvements in facilities, process, and operations, and changes in the site`s mission have reduced the amount of radioactive liquid releases. In the early years of SRS (1958 to 1965), the amount of tritium discharged to the Savannah River averaged approximately 61,000 curies a year. During the mid-1980`s (1983 to 1988), liquid releases of tritium averaged 27,000 curies a year. By 1996, liquid releases of tritium are projected to be just 3000 curies for the year. This large projected decrease is the result of the planned shut-down of all reactors and the anticipated significant decline in the amount of tritium migrating from the site seepage basins and the Solid Waste Disposal Facility.

  14. Promoting action control and coping planning to improve hand hygiene.

    Science.gov (United States)

    Reyes Fernández, Benjamín; Lippke, Sonia; Knoll, Nina; Blanca Moya, Emanuel; Schwarzer, Ralf

    2015-09-25

    We examined a brief educational intervention addressing hand hygiene self-regulatory mechanisms, and evaluated which psychological mechanisms may lead to hand hygiene behaviours. Two hundred forty two students (mean age = 21 years, SD = 3.9) received either an experimental (n = 149) or a control condition on action control and planning (n = 93). Hand hygiene, coping planning, and action control were measured at baseline and six weeks later. By applying repeated measures ANOVA, we compared the experimental condition addressing planning to perform hand hygiene with a control condition. Additionally, working mechanisms were evaluated by means of mediation analysis. The intervention had an effect on action control, as reflected by a time by treatment interaction. The direct effect of the intervention on behaviour was, however, non-significant. Changes in action control led to changes in coping planning. These social-cognitive changes mediated the effect of intervention on behaviour, after controlling for gender, baseline behaviour, and classroom membership. In spite of the associations between the intervention and self-regulatory strategies, no direct effect was found of the intervention on behaviour. Further research on how to increase hand sanitizing, involving enviromental characteristics, is required. The intervention led only indirectly to an improvement of hand hygiene via changes in self-regulatory factors. Results indicate the importance of promoting action control and coping planning to initiate changes in hand hygienic behaviours.

  15. Organization, Planning and Control of Marketing Logistics

    National Research Council Canada - National Science Library

    Olga V Grishchenko; Vasiliy S Kireev; Lyudmila I Dubrova; Marina B Yanenko; Ruslan Ya Vakulenko

    2016-01-01

    .... The marketing logistics as the mechanism of the marketing channel control is concentrated on integration of marketing and logistics functions while maintaining the great value of products and services...

  16. Model Predictive Control in UAV Trajectory Planning and Gimbal Control

    OpenAIRE

    Stovner, Bård Bakken

    2014-01-01

    In order to keep a target on the ground in the camera frame of a camera mounted witha pan-tilt gimbal to an unmanned aerial vehicle, three controllers that utilize the modelpredictive control methodology are developed. Through the process of simulating andhardware-in-the-loop testing the controllers, it is shown that one of the controllers canachieve satisfying control of both camera and vehicle. A new controller is proposed forfuture research which is assumed to achieve better control based ...

  17. Planning and control of maintenance systems modelling and analysis

    CERN Document Server

    Duffuaa, Salih O

    2015-01-01

    Analyzing maintenance as an integrated system with objectives, strategies and processes that need to be planned, designed, engineered, and controlled using statistical and optimization techniques, the theme of this book is the strategic holistic system approach for maintenance. This approach enables maintenance decision makers to view maintenance as a provider of a competitive edge not a necessary evil. Encompassing maintenance systems; maintenance strategic and capacity planning, planned and preventive maintenance, work measurements and standards, material (spares) control, maintenance operations and control, planning and scheduling, maintenance quality, training, and others, this book gives readers an understanding of the relevant methodology and how to apply it to real-world problems in industry. Each chapter includes a number exercises and is suitable as a textbook or a reference for a professionals and practitioners whilst being of interest to industrial engineering, mechanical engineering, electrical en...

  18. Targeting deregulated epigenetic control in cancer.

    Science.gov (United States)

    Zaidi, Sayyed K; Van Wijnen, Andre J; Lian, Jane B; Stein, Janet L; Stein, Gary S

    2013-11-01

    Cancer is a multifaceted disease that involves acquisition of genetic mutations, deletions, and amplifications as well as deregulation of epigenetic mechanisms that fine-tune gene regulation. Key epigenetic mechanisms that include histone modifications, DNA methylation, and non-coding RNA-mediated gene silencing are often deregulated in a variety of cancers. Subnuclear localization of key proteins in the interphase nucleus and bookmarking of genes by lineage commitment factors in mitosis-a new dimension to epigenetic control of fundamental biological processes-is also modified in cancer. In this review, we discuss the various aspects of epigenetic control that are operative in a variety of cancers and their potential for risk assessment, early detection, targeted therapy, and personalized medicine. Copyright © 2013 Wiley Periodicals, Inc.

  19. Validation of Fully Automated VMAT Plan Generation for Library-Based Plan-of-the-Day Cervical Cancer Radiotherapy

    Science.gov (United States)

    Breedveld, Sebastiaan; Voet, Peter W. J.; Heijkoop, Sabrina T.; Mens, Jan-Willem M.; Hoogeman, Mischa S.; Heijmen, Ben J. M.

    2016-01-01

    Purpose To develop and validate fully automated generation of VMAT plan-libraries for plan-of-the-day adaptive radiotherapy in locally-advanced cervical cancer. Material and Methods Our framework for fully automated treatment plan generation (Erasmus-iCycle) was adapted to create dual-arc VMAT treatment plan libraries for cervical cancer patients. For each of 34 patients, automatically generated VMAT plans (autoVMAT) were compared to manually generated, clinically delivered 9-beam IMRT plans (CLINICAL), and to dual-arc VMAT plans generated manually by an expert planner (manVMAT). Furthermore, all plans were benchmarked against 20-beam equi-angular IMRT plans (autoIMRT). For all plans, a PTV coverage of 99.5% by at least 95% of the prescribed dose (46 Gy) had the highest planning priority, followed by minimization of V45Gy for small bowel (SB). Other OARs considered were bladder, rectum, and sigmoid. Results All plans had a highly similar PTV coverage, within the clinical constraints (above). After plan normalizations for exactly equal median PTV doses in corresponding plans, all evaluated OAR parameters in autoVMAT plans were on average lower than in the CLINICAL plans with an average reduction in SB V45Gy of 34.6% (p<0.001). For 41/44 autoVMAT plans, SB V45Gy was lower than for manVMAT (p<0.001, average reduction 30.3%), while SB V15Gy increased by 2.3% (p = 0.011). AutoIMRT reduced SB V45Gy by another 2.7% compared to autoVMAT, while also resulting in a 9.0% reduction in SB V15Gy (p<0.001), but with a prolonged delivery time. Differences between manVMAT and autoVMAT in bladder, rectal and sigmoid doses were ≤ 1%. Improvements in SB dose delivery with autoVMAT instead of manVMAT were higher for empty bladder PTVs compared to full bladder PTVs, due to differences in concavity of the PTVs. Conclusions Quality of automatically generated VMAT plans was superior to manually generated plans. Automatic VMAT plan generation for cervical cancer has been implemented in

  20. Residuals Management and Water Pollution Control Planning.

    Science.gov (United States)

    Environmental Protection Agency, Washington, DC. Office of Public Affairs.

    This pamphlet addresses the problems associated with residuals and water quality especially as it relates to the National Water Pollution Control Program. The types of residuals and appropriate management systems are discussed. Additionally, one section is devoted to the role of citizen participation in developing management programs. (CS)

  1. Initial Efficacy Testing of an Autobiographical Memory Intervention on Advance Care Planning for Patients With Terminal Cancer.

    Science.gov (United States)

    Brohard, Cheryl

    2017-11-01

    To test the efficacy of a novel intervention to facilitate advance care planning.
. Exploratory, quasiexperimental pilot study with two independent groups.
. A large hospice located in the southwestern United States. 
. A convenience sample of 50 participants with terminal cancer enrolled in hospice.
. An autobiographical memory (ABM) intervention used the participants' experiences with cancer and end of life for the purpose of directing advance care planning.
. Two domains of advance care planning, decision making and communication, were measured in relation to 11 variables. The ABM intervention was nonthreatening, short in duration, and easily completed with participants as they recalled, without hesitation, specific personal memories of family and friends who had died and their advance care plans. The Mann-Whitney nonparametric test revealed that participants in the experimental group had a higher average rank than those in the control group for communicating the decision about antibiotics, as well as exhibited a trend toward significance for five other advance care planning variables.
. Findings showed that directive ABMs may be effective in influencing the decision making and communication of advance care planning for terminally ill patients with cancer.
. The current level of understanding about using the ABM intervention suggests that nurses can initiate an advance care planning conversation using this approach.

  2. Practical use of cancer control promoters in municipalities in Japan.

    Science.gov (United States)

    Yako-Suketomo, Hiroko; Katanoda, Kota; Sobue, Tomotaka; Imai, Hirohisa

    2014-01-01

    The Cancer Control Act in Japan became effective in 2006. In Ibaraki, Toyama, and Hyogo prefectures, the Cancer Control Promoter (CCP) plan was created to strengthen partnerships for cancer prevention. This study aimed to examine the curre nt status of CCP utilization and analyze relationships with intersectoral collaboration, both within the government and with outside partners. In 2008, we mailed questionnaires to 100 administrators responsible for disease prevention and health promotion in municipal governments of the three prefectures. Ninety-one administrators responded (response rate, 91.0%). We analyzed responses to questions regarding whether or not the municipalities had used CCPs. Items assessing intersectoral collaboration examined municipality characteristics and relationships with outside partners and sectors specializing in areas other than community health. Among 90 administrators with valid data, 33 municipalities (36.7%) used CCPs while 57 (63.3%) did not. The Fisher's exact test revealed that intersectoral collaboration for using CCPs was associated with communication with all of the municipal government sectors not related to health. The present study indicated that CCPs were not consistently used in municipalities. However, we found that intersectoral collaborations, especially within the local government, may be related to the practical use of CCPs. This, in turn, may result in effective cancer control and prevention, as well as improvement in community health.

  3. Optimized planning target volume for intact cervical cancer.

    Science.gov (United States)

    Khan, Alvin; Jensen, Lindsay G; Sun, Shuai; Song, William Y; Yashar, Catheryn M; Mundt, Arno J; Zhang, Fu-Quan; Jiang, Steve B; Mell, Loren K

    2012-08-01

    To model interfraction clinical target volume (CTV) variation in patients with intact cervical cancer and design a planning target volume (PTV) that minimizes normal tissue dose while maximizing CTV coverage. We analyzed 50 patients undergoing external-beam radiotherapy for intact cervical cancer using daily online cone-beam computed tomography (CBCT). The CBCTs (n = 972) for each patient were rigidly registered to the planning CT. The CTV was delineated on the planning CT (CTV(0)) and the set of CBCTs ({CTV(1)-CTV(25)}). Manual (n = 98) and automated (n = 668) landmarks were placed over the surface of CTV(0) with reference to defined anatomic structures. Normal vectors were extended from each landmark, and the minimum length required for a given probability of encompassing CTV(1)-CTV(25) was computed. The resulting expansions were used to generate an optimized PTV. The mean (SD; range) normal vector length to ensure 95% coverage was 4.3 mm (2.7 mm; 1-16 mm). The uniform expansion required to ensure 95% probability of CTV coverage was 13 mm. An anisotropic margin of 20 mm anteriorly and posteriorly and 10 mm superiorly, inferiorly, and laterally also would have ensured a 95% probability of CTV coverage. The volume of the 95% optimized PTV (1470 cm(3)) was significantly lower than both the anisotropic PTV (2220 cm(3)) and the uniformly expanded PTV (2110 cm(3)) (p < 0.001). For a 95% probability of CTV coverage, normal lengths of 1-3 mm were found along the superior and lateral regions of CTV(0), 5-10 mm along the interfaces of CTV(0) with the bladder and rectum, and 10-14 mm along the anterior surface of CTV(0) at the level of the uterus. Optimizing PTV definition according to surface landmarking resulted in a high probability of CTV coverage with reduced PTV volumes. Our results provide data justifying planning margins to use in practice and clinical trials. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Optimized Planning Target Volume for Intact Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Khan, Alvin; Jensen, Lindsay G. [Department of Radiation Oncology, Center for Advanced Radiotherapy Technologies, University of California, San Diego, La Jolla, CA (United States); Sun Shuai [Department of Radiation Oncology, Peking Union Medical College Hospital, Beijing (China); Song, William Y.; Yashar, Catheryn M.; Mundt, Arno J. [Department of Radiation Oncology, Center for Advanced Radiotherapy Technologies, University of California, San Diego, La Jolla, CA (United States); Zhang Fuquan [Department of Radiation Oncology, Peking Union Medical College Hospital, Beijing (China); Jiang, Steve B. [Department of Radiation Oncology, Center for Advanced Radiotherapy Technologies, University of California, San Diego, La Jolla, CA (United States); Mell, Loren K., E-mail: lmell@ucsd.edu [Department of Radiation Oncology, Center for Advanced Radiotherapy Technologies, University of California, San Diego, La Jolla, CA (United States)

    2012-08-01

    Purpose: To model interfraction clinical target volume (CTV) variation in patients with intact cervical cancer and design a planning target volume (PTV) that minimizes normal tissue dose while maximizing CTV coverage. Methods and Materials: We analyzed 50 patients undergoing external-beam radiotherapy for intact cervical cancer using daily online cone-beam computed tomography (CBCT). The CBCTs (n = 972) for each patient were rigidly registered to the planning CT. The CTV was delineated on the planning CT (CTV{sub 0}) and the set of CBCTs ({l_brace}CTV{sub 1}-CTV{sub 25}{r_brace}). Manual (n = 98) and automated (n = 668) landmarks were placed over the surface of CTV{sub 0} with reference to defined anatomic structures. Normal vectors were extended from each landmark, and the minimum length required for a given probability of encompassing CTV{sub 1}-CTV{sub 25} was computed. The resulting expansions were used to generate an optimized PTV. Results: The mean (SD; range) normal vector length to ensure 95% coverage was 4.3 mm (2.7 mm; 1-16 mm). The uniform expansion required to ensure 95% probability of CTV coverage was 13 mm. An anisotropic margin of 20 mm anteriorly and posteriorly and 10 mm superiorly, inferiorly, and laterally also would have ensured a 95% probability of CTV coverage. The volume of the 95% optimized PTV (1470 cm{sup 3}) was significantly lower than both the anisotropic PTV (2220 cm{sup 3}) and the uniformly expanded PTV (2110 cm{sup 3}) (p < 0.001). For a 95% probability of CTV coverage, normal lengths of 1-3 mm were found along the superior and lateral regions of CTV{sub 0}, 5-10 mm along the interfaces of CTV{sub 0} with the bladder and rectum, and 10-14 mm along the anterior surface of CTV{sub 0} at the level of the uterus. Conclusion: Optimizing PTV definition according to surface landmarking resulted in a high probability of CTV coverage with reduced PTV volumes. Our results provide data justifying planning margins to use in practice and

  5. Mobile Robots Control and Path Planning Strategies

    OpenAIRE

    Furci, Michele

    2016-01-01

    Mobile robots gained lots of attention in the last decades. Because of its flexibility and increased capabilities of automation, mobile robots are used in many applications: from domotic, to search and rescue missions, to agriculture, environment protection and many more. The main capability of mobile robots to accomplish a mission is the mobility in the work environment. To move in a certain environment the robots should achieve: guidance, navigation and control. This thesis focuses on...

  6. 30 CFR 28.31 - Quality control plans; contents.

    Science.gov (United States)

    2010-07-01

    ...) Each quality control plan shall contain provisions for the management of quality, including: (1... engineering drawings, documentations, and changes; (3) Control and calibration of measuring and test equipment..., except that the continuity and/or resistance characteristics of each fuse shall be tested. Military...

  7. Livermore Site Spill Prevention, Control, and Countermeasures Plan, May 2017

    Energy Technology Data Exchange (ETDEWEB)

    Griffin, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Mertesdorf, E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-05-01

    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.

  8. The Paradox of Planning: The Controlled Materials Plan of World War II

    OpenAIRE

    John Landon-Lane; Hugh Rockoff

    1996-01-01

    According to most standard accounts of the mobilization of the U.S. economy in World War II, things started out badly because the agency nominally in charge, the War Production Board, lacked sufficient authority and relied on faulty techniques. But then the War Production Board installed the famous Controlled Materials Plan, a form of central planning, which solved the major problems and turned disaster into triumph. Here we re-examine the Plan and argue that it was too little and too late to...

  9. Development and clinical introduction of automated radiotherapy treatment planning for prostate cancer

    Science.gov (United States)

    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.

  10. R and D plans for advanced computer and control technologies

    Energy Technology Data Exchange (ETDEWEB)

    Sopocy, D.M. (Sargent and Lundy, Chicago, IL (USA))

    1990-02-01

    This volume is the Executive Summary of the EPRI R D plans in three related areas of fossil-fired power plant design and operation: controls and instrumentation; expert systems; and automation and simulators. Volumes 2, 3, and 4 of this series individually discuss these three research areas. Both short- and long-term R D needs of the utility industry are addressed in these plans. 14 refs., 15 figs., 3 tabs.

  11. 3-Dimentional radiotherapy versus conventional treatment plans for gastric cancer

    Directory of Open Access Journals (Sweden)

    Aghili M

    2010-11-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: The current standard of adjuvant management for gastric cancer after curative resection based on the results of intergroup 0116 is concurrent chemoradiation. Current guidelines for designing these challenging fields still include two-dimensional simulation with simple AP-PA parallel opposed design. However, the implementation of radiotherapy (RT remains a concern. Our objective was to compare three-dimensional (3D techniques to the more commonly used AP-PA technique."n"nMethods: A total of 24 patients with stages II-IV adenocarcinoma of the stomach were treated with adjuvant postoperative chemoradiation with simple AP-PA technique, using Cobalt-60. Total radiation dose was 50.4Gy. Landmark-based fields were simulated to assess PTV coverage. For each patient, three additional radiotherapy treatment plans were generated using three-dimensional (3D technique. The four treatment plans were then compared for target volume coverage and dose to normal tissues (liver, spinal cord, kidneys using dose volume histogram (DVH analysis."n"nResults: The three-dimensional planning techniques provided 10% superior PTV coverage compared to conventional AP-PA fields (p<0.001. Comparative DVHs for the right kidney, left kidney

  12. An action plan for translating cancer survivorship research into care.

    Science.gov (United States)

    Alfano, Catherine M; Smith, Tenbroeck; de Moor, Janet S; Glasgow, Russell E; Khoury, Muin J; Hawkins, Nikki A; Stein, Kevin D; Rechis, Ruth; Parry, Carla; Leach, Corinne R; Padgett, Lynne; Rowland, Julia H

    2014-11-01

    To meet the complex needs of a growing number of cancer survivors, it is essential to accelerate the translation of survivorship research into evidence-based interventions and, as appropriate, recommendations for care that may be implemented in a wide variety of settings. Current progress in translating research into care is stymied, with results of many studies un- or underutilized. To better understand this problem and identify strategies to encourage the translation of survivorship research findings into practice, four agencies (American Cancer Society, Centers for Disease Control and Prevention, LIVE STRONG: Foundation, National Cancer Institute) hosted a meeting in June, 2012, titled: "Biennial Cancer Survivorship Research Conference: Translating Science to Care." Meeting participants concluded that accelerating science into care will require a coordinated, collaborative effort by individuals from diverse settings, including researchers and clinicians, survivors and families, public health professionals, and policy makers. This commentary describes an approach stemming from that meeting to facilitate translating research into care by changing the process of conducting research-improving communication, collaboration, evaluation, and feedback through true and ongoing partnerships. We apply the T0-T4 translational process model to survivorship research and provide illustrations of its use. The resultant framework is intended to orient stakeholders to the role of their work in the translational process and facilitate the transdisciplinary collaboration needed to translate basic discoveries into best practices regarding clinical care, self-care/management, and community programs for cancer survivors. Finally, we discuss barriers to implementing translational survivorship science identified at the meeting, along with future directions to accelerate this process. Published by Oxford University Press 2014.

  13. Hybrid control and motion planning of dynamical legged locomotion

    CERN Document Server

    2012-01-01

    "This book provides a comprehensive presentation of issues and challenges faced by researchers and practicing engineers in motion planning and hybrid control of dynamical legged locomotion. The major features range from offline and online motion planning algorithms to generate desired feasible periodic walking and running motions and tow-level control schemes, including within-stride feedback laws, continuous time update laws and event-based update laws, to asymptotically stabilize the generated desired periodic orbits. This book describes the current state of the art and future directions across all domains of dynamical legged locomotion so that readers can extend proposed motion planning algorithms and control methodologies to other types of planar and 3D legged robots".

  14. [Plan to improve malaria control towards its elimination in Mesoamerica].

    Science.gov (United States)

    Rodríguez, Mario Henry; Betanzos-Reyes, Angel Francisco

    2011-01-01

    To develop a plan to strengthen the control of malaria towards its elimination. In 2009, under the coordination of the National Public HealthInstitute ofMexico, atransdisciplinary equipment of technical and operative experts was conformed to carry out a situational analysis of malaria and control programs and for the selection of effective practices of intervention that would be incorporated to the plan, within the framework of an exercise in Theory of Change. Criteria for thestratificationof thelocalities, based ontheirtransmission characteristics were established. The structural and operative limitations of the control programs were identified. A plan of interventions was elaborated to improve the coverage of epidemiological surveillance, anti-malaria interventions and opportune diagnosis and treatment of cases. The plan delineates progressive phases of implementation: reorganization, intensification of interventions and evaluation of elimination feasibility. The adoption of a regional strategic plan will provide guidance and administrative elements to conform a system that coordinates the activities of the national control programs and facilitate the elimination of malaria in the region.

  15. Iterative dataset optimization in automated planning: Implementation for breast and rectal cancer radiotherapy.

    Science.gov (United States)

    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 Pinnacle3 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.

  16. Site 300 Spill Prevention, Control, and Countermeasures (SPCC) Plan

    Energy Technology Data Exchange (ETDEWEB)

    Griffin, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Mertesdorf, E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-12-01

    This Spill Prevention, Control, and Countermeasure (SPCC) Plan describes the measures that are taken at Lawrence Livermore National Laboratory’s (LLNL) Experimental Test Site (Site 300) near Tracy, 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, 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 of 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 Site 300. This SPCC Plan has been prepared for the entire Site 300 facility and replaces the three previous plans prepared for Site 300: LLNL SPCC for Electrical Substations Near Buildings 846 and 865 (LLNL 2015), LLNL SPCC for Building 883 (LLNL 2015), and LLNL SPCC for Building 801 (LLNL 2014).

  17. Sustainability in a state comprehensive cancer control coalition: lessons learned.

    Science.gov (United States)

    Desmond, Renee A; Chapman, Kathryn; Graf, Gavin; Stanfield, Bret; Waterbor, John W

    2014-03-01

    The Alabama Comprehensive Cancer Control Coalition (ACCCC) has developed an integrated and coordinated approach to reducing cancer incidence, morbidity, and mortality, and to improving the quality of life for cancer survivors, their families, and their caregivers. The ACCCC is currently in a maintenance phase and a formal plan for sustainability of the coalition was needed to keep the members engaged and productive. A training session in coalition sustainability conducted in 2013 identified the following elements as essential to success: (1) increased marketing of the coalition by simplifying its mission; (2) improved networking including flexibility in coalition meeting location and attendance; (3) increased membership satisfaction through transformational leadership; (4) revision of the working structure of committees and improved accountability; and (5) enhancement of partner satisfaction with coalition activities designed to recruit and retain new partners. A self-administered membership satisfaction survey was given to assess coalition mission, meeting logistics, organization, capacity building, and coalition goals. Results indicated that the subcategories of communication, mission, and meeting logistics were rated satisfied to very satisfied on a five-point scale. Although the ACCCC had clearly written goals, improvement could be made in leadership participation and new member orientation could be improved. Most members rated their parent organization as highly involved with the ACCCC and many offered suggestions on capacity building. Results of the sustainability training have clarified the ACCCC's plans to ensure coalition viability and improve strategies to inform stakeholders of the benefits of participation in the coalition.

  18. Modeling the Aneuploidy Control of Cancer

    Directory of Open Access Journals (Sweden)

    Wang Zhong

    2010-07-01

    Full Text Available Abstract Background Aneuploidy has long been recognized to be associated with cancer. A growing body of evidence suggests that tumorigenesis, the formation of new tumors, can be attributed to some extent to errors occurring at the mitotic checkpoint, a major cell cycle control mechanism that acts to prevent chromosome missegregation. However, so far no statistical model has been available quantify the role aneuploidy plays in determining cancer. Methods We develop a statistical model for testing the association between aneuploidy loci and cancer risk in a genome-wide association study. The model incorporates quantitative genetic principles into a mixture-model framework in which various genetic effects, including additive, dominant, imprinting, and their interactions, are estimated by implementing the EM algorithm. Results Under the new model, a series of hypotheses tests are formulated to explain the pattern of the genetic control of cancer through aneuploid loci. Simulation studies were performed to investigate the statistical behavior of the model. Conclusions The model will provide a tool for estimating the effects of genetic loci on aneuploidy abnormality in genome-wide studies of cancer cells.

  19. [Strengthen the cancer surveillance to promote cancer prevention and control in China].

    Science.gov (United States)

    He, J

    2018-01-23

    Cancer is a major chronic disease threatening the people's health in China. We reviewed the latest advances on cancer surveillance, prevention and control in our country, which may provide important clues for future cancer control. We used data from the National Central Cancer Registry, to describe and analyze the latest cancer statistics in China. We summarized updated informations on cancer control policies, conducting network, as well as programs in the country. We provided important suggestions on the future strategies of cancer prevention and control. The overall cancer burden in China has been increasing during the past decades. In 2014, there were about 3 804 000 new cancer cases and 2 296 000 cancer deaths in China. The age-standardized cancer incidence and mortality rates were 190.63/100 000 and 106.98/100 000, respectively. China has formed a comprehensive network on cancer prevention and control. Nationwide population-based cancer surveillance has been built up. The population coverage of cancer surveillance has been expanded, and the data quality has been improved. As the aging population is increasing and unhealthy life styles persist in our country, there will be an unnegligible cancer burden in China. Based on the comprehensive rationale of cancer control and prevention, National Cancer Center of China will perform its duty for future precise cancer control and prevention, based on cancer surveillance statistics.

  20. Vaccines to Prevent Cancers Not Caused by Viruses - Annual Plan

    Science.gov (United States)

    We have vaccines against viruses that cause cancer, but what about vaccines for cancers not caused by viruses? Learn about NCI's development of safe and effective vaccines for cancers not caused by infectious agents.

  1. A Total Quality-Control Plan with Right-Sized Statistical Quality-Control.

    Science.gov (United States)

    Westgard, James O

    2017-03-01

    A new Clinical Laboratory Improvement Amendments option for risk-based quality-control (QC) plans became effective in January, 2016. Called an Individualized QC Plan, this option requires the laboratory to perform a risk assessment, develop a QC plan, and implement a QC program to monitor ongoing performance of the QC plan. Difficulties in performing a risk assessment may limit validity of an Individualized QC Plan. A better alternative is to develop a Total QC Plan including a right-sized statistical QC procedure to detect medically important errors. Westgard Sigma Rules provides a simple way to select the right control rules and the right number of control measurements. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Automation of radiation treatment planning : Evaluation of head and neck cancer patient plans created by the Pinnacle3scripting and Auto-Planning functions.

    Science.gov (United States)

    Speer, Stefan; Klein, Andreas; Kober, Lukas; Weiss, Alexander; Yohannes, Indra; Bert, Christoph

    2017-08-01

    Intensity-modulated radiotherapy (IMRT) techniques are now standard practice. IMRT or volumetric-modulated arc therapy (VMAT) allow treatment of the tumor while simultaneously sparing organs at risk. Nevertheless, treatment plan quality still depends on the physicist's individual skills, experiences, and personal preferences. It would therefore be advantageous to automate the planning process. This possibility is offered by the Pinnacle 3 treatment planning system (Philips Healthcare, Hamburg, Germany) via its scripting language or Auto-Planning (AP) module. AP module results were compared to in-house scripts and manually optimized treatment plans for standard head and neck cancer plans. Multiple treatment parameters were scored to judge plan quality (100 points = optimum plan). Patients were initially planned manually by different physicists and re-planned using scripts or AP. Script-based head and neck plans achieved a mean of 67.0 points and were, on average, superior to manually created (59.1 points) and AP plans (62.3 points). Moreover, they are characterized by reproducibility and lower standard deviation of treatment parameters. Even less experienced staff are able to create at least a good starting point for further optimization in a short time. However, for particular plans, experienced planners perform even better than scripts or AP. Experienced-user input is needed when setting up scripts or AP templates for the first time. Moreover, some minor drawbacks exist, such as the increase of monitor units (+35.5% for scripted plans). On average, automatically created plans are superior to manually created treatment plans. For particular plans, experienced physicists were able to perform better than scripts or AP; thus, the benefit is greatest when time is short or staff inexperienced.

  3. Guidance and Control Software Project Data - Volume 1: Planning Documents

    Science.gov (United States)

    Hayhurst, Kelly J. (Editor)

    2008-01-01

    The Guidance and Control Software (GCS) project was the last in a series of software reliability studies conducted at Langley Research Center between 1977 and 1994. The technical results of the GCS project were recorded after the experiment was completed. Some of the support documentation produced as part of the experiment, however, is serving an unexpected role far beyond its original project context. Some of the software used as part of the GCS project was developed to conform to the RTCA/DO-178B software standard, "Software Considerations in Airborne Systems and Equipment Certification," used in the civil aviation industry. That standard requires extensive documentation throughout the software development life cycle, including plans, software requirements, design and source code, verification cases and results, and configuration management and quality control data. The project documentation that includes this information is open for public scrutiny without the legal or safety implications associated with comparable data from an avionics manufacturer. This public availability has afforded an opportunity to use the GCS project documents for DO-178B training. This report provides a brief overview of the GCS project, describes the 4-volume set of documents and the role they are playing in training, and includes the planning documents from the GCS project. Volume 1 contains five appendices: A. Plan for Software Aspects of Certification for the Guidance and Control Software Project; B. Software Development Standards for the Guidance and Control Software Project; C. Software Verification Plan for the Guidance and Control Software Project; D. Software Configuration Management Plan for the Guidance and Control Software Project; and E. Software Quality Assurance Activities.

  4. [Promotion plan for the promotion of cancer: coping measures at Matsuyama Red Cross Hospital in Ehime prefecture - the current state of affairs at the hospital's cancer treatment promotion office].

    Science.gov (United States)

    Fujii, Motohiro

    2013-05-01

    Recent cancer control strategies in Japan have been aimed at lowering morbidity and mortality rates, based on the Thirdterm Comprehensive 10-year Strategy for Cancer Control initiated by the Japanese government. In April 2007, the Cancer Control Basic Law was promulgated to necessitate promotion of cancer control by national and local authorities. In June 2007, the Japanese Health Ministry released a plan for the promotion of measures to cope with cancer. The cancer control measures adopted by the Matsuyama Red Cross Hospital(MRCH)in Ehime Prefecture were as follows: ·Progress in the promotion of measures to cope with cancer in Ehime, including a review of 2012, problems with new treatment methods for childhood cancer, employment of cancer patients, and promotion of home care. ·Cancer treatment measures adopted by MRCH as a hub medical institution for the past 5 years. ·The distinctive efforts of the intensive professionals team at the Cancer Treatment Promotion Office for cancer treatment at MRCH, and its work on cancer care from the 4 perspectives of the balanced scorecard in accordance with the basic policy of MRCH.

  5. Urgent need to strengthen and expand screening and other cancer control programs in the CARICOM Caribbean.

    Science.gov (United States)

    Franklin, Renee A; Simeon, Donald T

    2017-11-01

    With high mortality in breast, cervical, prostate, and colorectal cancers in Caribbean Community (CARICOM) countries, we examined cancer control initiatives including screening as well as the implementation of relevant international and regional mandates. Secondary data were used to examine cancer control initiatives, which included the presence of national policies, programs, and screening services as well as the implementation of international and regional mandates. To identify the data, an on-line search was conducted using Google/Google Scholar. Data were available for 14 of the 15 full members of CARICOM. Although only six countries had distinct cancer control policies, strategies or action plans, all 14 had key elements of cancer control programs. Screening services were available in the 14 countries for cervical, in 12 countries for breast and in 11 for colorectal cancer. However, only four countries had screening policies. In addition, screening guidelines were available for cervical cancer in nine countries, in one country for breast and in none for colorectal cancer. Selected tobacco control policies were present in the 14 countries and immunization policies for human papillomavirus (HPV) in 13. Treatment services included chemotherapy in 10 countries and radiotherapy in six. Nine countries had palliative care services for patients with advanced disease. The countries were at different stages of implementation/compliance with international and regional mandates and frameworks. There is an urgent need to develop and implement comprehensive and customized cancer control policies addressing screening programs, treatment and palliative care.

  6. Production planning and control in SMEs : time for change

    NARCIS (Netherlands)

    Land, M.J.; Gaalman, G.J.C.

    2009-01-01

    This study aims to provide a profound picture of where existing production planning and control (PPC) concepts fail in small to medium sized make-to-order (MTO) companies. While several studies have discussed the specific requirements of small and medium sized enterprises (SMEs) through surveys or

  7. Animal Control Plan for Bayou Sauvage National Wildlife Refuge - 1992

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — For the purposes of this control plan, the term feral hog shall be used to refer to both domestic pigs which are now free living and not under the ownership of...

  8. A case cancer control study of reproductive in breast cancer.

    OpenAIRE

    Mukherjee B; Chaudhury S; Sengupta S

    1994-01-01

    The role of reproductive factors, such as, parity, age at menarche, age at first child′s birth have been investigated in a hospital based case-control study, for their independent as well as combined influences on the incidence of female breast cancer. The study indicates that except for parity, these factors have no influence on the age at onset of the disease. Parity is positively correlated with age at onset. The patient and the control groups were found to be similar in respect of ...

  9. Gynecologic cancer prevention and control in the National Comprehensive Cancer Control Program: progress, current activities, and future directions.

    Science.gov (United States)

    Stewart, Sherri L; Lakhani, Naheed; Brown, Phaeydra M; Larkin, O Ann; Moore, Angela R; Hayes, Nikki S

    2013-08-01

    Gynecologic cancer confers a large burden among women in the United States. Several evidence-based interventions are available to reduce the incidence, morbidity, and mortality from these cancers. The National Comprehensive Cancer Control Program (NCCCP) is uniquely positioned to implement these interventions in the US population. This review discusses progress and future directions for the NCCCP in preventing and controlling gynecologic cancer.

  10. Modes of executive control in sequence learning: from stimulus-based to plan-based control.

    Science.gov (United States)

    Tubau, Elisabet; Hommel, Bernhard; López-Moliner, Joan

    2007-02-01

    The authors argue that human sequential learning is often but not always characterized by a shift from stimulus- to plan-based action control. To diagnose this shift, they manipulated the frequency of 1st-order transitions in a repeated manual left-right sequence, assuming that performance is sensitive to frequency-induced biases under stimulus- but not plan-based control. Indeed, frequency biases tended to disappear with practice, but only for explicit learners. This tendency was facilitated by visual-verbal target stimuli, response-contingent sounds, and intentional instructions and hampered by auditory (but not visual) noise. Findings are interpreted within an event-coding model of action control, which holds that plans for sequences of discrete actions are coded phonetically, integrating order and relative timing. The model distinguishes between plan acquisition, linked to explicit knowledge, and plan execution, linked to the action control mode. ((c) 2007 APA, all rights reserved).

  11. Survivorship care planning in skin cancer: An unbiased statistical approach to identifying patterns of care-plan use.

    Science.gov (United States)

    Benci, Joseph L; Minn, Andy J; Vachani, Carolyn C; Bach, Christina; Arnold-Korzeniowski, Karen; Hampshire, Margaret K; Metz, James M; Hill-Kayser, Christine E

    2017-09-08

    Nearly 1 in 5 Americans will develop skin cancer, and as a result, survivors of skin cancer compose one of the largest groups of cancer survivors. Survivorship care plans (SCPs) are an important tool for improving patient outcomes and provide critical information to both survivors and health care professionals. Recent efforts have been made to expand SCP utilization; however, which patients currently receive SCPs is poorly understood. This study used 596 individuals with a diagnosis of melanoma (n = 391) or nonmelanoma skin cancer (n = 205) who had used an Internet-based SCP tool from May 2010 to December 2016 to model the patient and provider characteristics that determine SCP utilization. Survivors were predominantly white (95.3%) and female (56.5%). Survivors who received a treatment summary were more likely to also receive an SCP. University and nonuniversity cancer centers used SCPs at a higher rate than other care settings. Survivors whose care was managed by a team rather than just an individual physician were also more likely to receive an SCP. Survivors older than 70 years at diagnosis were almost twice as likely to receive a plan as survivors who were diagnosed at a younger age. With a convenience sample of skin cancer survivors, it is possible to model factors that predict the receipt of SCPs. Important variables include the diagnosis age, treatment setting, physician type, and treatment-summary utilization. A closer examination of these variables identified several disparities in care-plan use and, therefore, opportunities to improve the distribution of SCPs. Further validation in additional cohorts of survivors is necessary to confirm these conclusions. Cancer 2017. © 2017 American Cancer Society. © 2017 American Cancer Society.

  12. Colon cancer controls versus population controls in case-control studies of occupational risk factors

    Directory of Open Access Journals (Sweden)

    Sabroe Svend

    2004-04-01

    Full Text Available Abstract Background Since updated population registers do not exist in many countries it is often difficult to sample valid population controls from the study base to a case-control study. Use of patient controls is an alternative option if the exposure experience under study for these patients are interchangeable with the experience for population controls. Patient controls may even be preferable from population controls under certain conditions. In this study we examine if colon cancer patients can serve as surrogates for proper population controls in case-control studies of occupational risk factors. Methods The study was conducted from 1995 to 1997. Incident colon cancer controls (N = 428 aged 35–69 years with a histological verified diagnosis and population controls (N = 583 were selected. Altogether 254 (59% of the colon cancer controls and 320 (55% of the population controls were interviewed about occupational, medical and life style conditions. Results No statistical significant difference for educational level, medical history or smoking status was seen between the two control groups. There was evidence of a higher alcohol intake, less frequent work as a farmer and less exposure to pesticides among colon cancer controls. Conclusions Use of colon cancer controls may provide valid exposure estimates in studies of many occupational risk factors for cancer, but not for studies on exposure related to farming.

  13. A new plan-scoring method using normal tissue complication probability for personalized treatment plan decisions in prostate cancer

    Science.gov (United States)

    Kim, Kwang Hyeon; Lee, Suk; Shim, Jang Bo; Yang, Dae Sik; Yoon, Won Sup; Park, Young Je; Kim, Chul Yong; Cao, Yuan Jie; Chang, Kyung Hwan

    2018-01-01

    The aim of this study was to derive a new plan-scoring index using normal tissue complication probabilities to verify different plans in the selection of personalized treatment. Plans for 12 patients treated with tomotherapy were used to compare scoring for ranking. Dosimetric and biological indexes were analyzed for the plans for a clearly distinguishable group ( n = 7) and a similar group ( n = 12), using treatment plan verification software that we developed. The quality factor ( QF) of our support software for treatment decisions was consistent with the final treatment plan for the clearly distinguishable group (average QF = 1.202, 100% match rate, n = 7) and the similar group (average QF = 1.058, 33% match rate, n = 12). Therefore, we propose a normal tissue complication probability (NTCP) based on the plan scoring index for verification of different plans for personalized treatment-plan selection. Scoring using the new QF showed a 100% match rate (average NTCP QF = 1.0420). The NTCP-based new QF scoring method was adequate for obtaining biological verification quality and organ risk saving using the treatment-planning decision-support software we developed for prostate cancer.

  14. Intelligent Planning and Scheduling for Controlled Life Support Systems

    Science.gov (United States)

    Leon, V. Jorge

    1996-01-01

    Planning in Controlled Ecological Life Support Systems (CELSS) requires special look ahead capabilities due to the complex and long-term dynamic behavior of biological systems. This project characterizes the behavior of CELSS, identifies the requirements of intelligent planning systems for CELSS, proposes the decomposition of the planning task into short-term and long-term planning, and studies the crop scheduling problem as an initial approach to long-term planning. CELSS is studied in the realm of Chaos. The amount of biomass in the system is modeled using a bounded quadratic iterator. The results suggests that closed ecological systems can exhibit periodic behavior when imposed external or artificial control. The main characteristics of CELSS from the planning and scheduling perspective are discussed and requirements for planning systems are given. Crop scheduling problem is identified as an important component of the required long-term lookahead capabilities of a CELSS planner. The main characteristics of crop scheduling are described and a model is proposed to represent the problem. A surrogate measure of the probability of survival is developed. The measure reflects the absolute deviation of the vital reservoir levels from their nominal values. The solution space is generated using a probability distribution which captures both knowledge about the system and the current state of affairs at each decision epoch. This probability distribution is used in the context of an evolution paradigm. The concepts developed serve as the basis for the development of a simple crop scheduling tool which is used to demonstrate its usefulness in the design and operation of CELSS.

  15. Technique for histological control of surgical margins in lip cancer.

    Science.gov (United States)

    Aoyagi, Satoru; Hata, Hiroo; Homma, Erina; Shimizu, Hiroshi

    2014-04-01

    To preserve oral function and achieve acceptable cosmetic results, intraoperative control of surgical margins with frozen section evaluation may help to determine surgical technique in lip cancer. However, frozen section analysis is usually limited to suspicious areas and has not been systematically performed among surgeons. The accuracy of such analysis for detecting histological surgical margins is highly dependent on the methods used to obtain and analyze the margins. Improving the pathodiagnostic reliability of conventional intraoperative frozen section evaluation is the most important goal of surgical management in our method. We describe the successful use of the "double-blade method" in lip cancer treatment. The technique we describe has the advantage of histologically confirming clear margins in lip cancer. This method appears to be time-saving and easy to apply with existing surgical systems. In addition, this method may be used as an alternative to complete evaluation of lateral surgical margins that is important in planning a suitable surgical reconstruction procedure in lip cancer at many institutions where Mohs micrographic surgery is difficult to perform. © 2014 Japanese Dermatological Association.

  16. Automatic Scheduling and Planning (ASAP) in future ground control systems

    Science.gov (United States)

    Matlin, Sam

    1988-01-01

    This report describes two complementary approaches to the problem of space mission planning and scheduling. The first is an Expert System or Knowledge-Based System for automatically resolving most of the activity conflicts in a candidate plan. The second is an Interactive Graphics Decision Aid to assist the operator in manually resolving the residual conflicts which are beyond the scope of the Expert System. The two system designs are consistent with future ground control station activity requirements, support activity timing constraints, resource limits and activity priority guidelines.

  17. Gynecologic Cancer InterGroup (GCIG) Endometrial Cancer Clinical Trials Planning Meeting: taking endometrial cancer trials into the translational era.

    Science.gov (United States)

    Creutzberg, Carien L; Kitchener, Henry C; Birrer, Michael J; Landoni, Fabio; Lu, Karen H; Powell, Melanie; Aghajanian, Carol; Edmondson, Richard; Goodfellow, Paul J; Quinn, Michael; Salvesen, Helga B; Thomas, Gillian

    2013-10-01

    The second Gynecologic Cancer InterGroup (GCIG) Endometrial Cancer Clinical Trials Planning Meeting was held on December 1, 2012, and included international multidisciplinary representatives of the 24 member groups. The aims were to review recent advances in molecular pathology of endometrial cancer, focusing on molecular-based therapy, and to identify key hypotheses and issues to be addressed through international collaborative clinical trials. Reviews and summaries of current knowledge were presented followed by parallel working group sessions for surgery, adjuvant and systemic therapy, and translational research. Plenary discussions were held to integrate translational and clinical issues, and a final discussion session to agree on key trial concepts. Proposals to take forward on the following trials were agreed: (1) lymphadenectomy to direct adjuvant treatment in women with high-risk endometrial cancer, including a sentinel node substudy; (2) conservative therapy for low-risk endometrial cancers in morbidly obese women with high surgical risks and for fertility-sparing treatment in premenopausal patients; (3) adjuvant therapy for women with early-stage carcinosarcoma. A proposal was made that a GCIG Early Phase Consortium be developed to serve as an international platform for rapid assessment of biomarkers.

  18. Doctor, what are my options? A prospective cohort study of an individualized care plan for patients with gastrointestinal cancer.

    Science.gov (United States)

    Hird, A E; Lemke, M; Turovsky, M; Malecki, V; Kumar, K; DeAngelis, C; Chow, E; Ko, Y J

    2015-06-01

    For cancer patients, information about their disease and its treatment is often delivered within a short time period, potentially leading to patient misunderstanding, which can impede optimal patient care. In this 3-part clinical study, we investigated the utility of an individualized care plan for patients with gastrointestinal (gi) cancer starting a new treatment. In part 1, a comprehensive literature search identified items for potential inclusion in the care plan. Those items were formatted into a questionnaire. The questionnaire was then administered to patients as a structured interview. In part 2, health care professionals involved in the care of patients with gi cancer evaluated the resulting care plan for content and relevancy. In part 3, a 20-week prospective cohort study (10 weeks using standard of care, 10 weeks using individualized care plans) was conducted. Outcomes were assessed at baseline and at 2-4 weeks after administration of the care plan. In part 1, a 73-item questionnaire was developed and completed by 20 patients in semi-structured interviews. In part 2, long and short versions of the care plan were created. Most health care professionals preferred the long version. Based on their comments, a final version of the care plan was created. The part 3 study enrolled 104 patients. Overall satisfaction scores were significantly higher in the intervention group at baseline (p = 0.010) and follow-up (p = 0.005). Compared with control patients, the intervention cohort also reported significantly higher overall quality of life (p = 0.044) and fewer symptoms of anxiety (p = 0.048) at follow-up. Provision of an individualized care plan resulted in improvements in outcome measures at both baseline and follow-up. Future studies are needed to confirm these findings.

  19. The National LGBT Cancer Action Plan: A White Paper of the 2014 National Summit on Cancer in the LGBT Communities

    Science.gov (United States)

    Margolies, Liz; Sigurdsson, Hrafn Oli; Walland, Jonathan; Radix, Asa; Rice, David; Buchting, Francisco O.; Sanchez, Nelson F.; Bare, Michael G.; Boehmer, Ulrike; Cahill, Sean; Griebling, Tomas L.; Bruessow, Diane; Maingi, Shail

    2016-01-01

    Abstract Despite growing social acceptance of lesbians, gay men, bisexuals, and transgender (LGBT) persons and the extension of marriage rights for same-sex couples, LGBT persons experience stigma and discrimination, including within the healthcare system. Each population within the LGBT umbrella term is likely at elevated risk for cancer due to prevalent, significant cancer risk factors, such as tobacco use and human immunodeficiency virus infection; however, cancer incidence and mortality data among LGBT persons are lacking. This absence of cancer incidence data impedes research and policy development, LGBT communities' awareness and activation, and interventions to address cancer disparities. In this context, in 2014, a 2-day National Summit on Cancer in the LGBT Communities was convened by a planning committee for the purpose of accelerating progress in identifying and addressing the LGBT communities' concerns and needs in the spheres of cancer research, clinical cancer care, healthcare policy, and advocacy for cancer survivorship and LGBT health equity. Summit participants were 56 invited persons from the United States, United Kingdom, and Canada, representatives of diverse identities, experiences, and knowledge about LGBT communities and cancer. Participants shared lessons learned and identified gaps and remedies regarding LGBT cancer concerns across the cancer care continuum from prevention to survivorship. This white paper presents background on each of the Summit themes and 16 recommendations covering the following: sexual orientation and gender identity data collection in national and state health surveys and research on LGBT communities and cancer, the clinical care of LGBT persons, and the education and training of healthcare providers.

  20. REHABILITATION NEEDS AND PLANS AMONG PATIENTS WITH CANCER, ASSESSED AT HOSPITALS AND WHEN REHABILITATION BEGINS

    DEFF Research Database (Denmark)

    Handberg, Charlotte; Maribo, Thomas; Jensen, Charlotte Maria

    , completing rehabilitation plans and enable referral to rehabilitation. The ICF framework proved useful in gaining insight into the distribution and specifics of stated needs and plans and further seemed potential as a framework to studies within cancer rehabilitation. Gaining knowledge on needs assessment...... and the specifics of needs and plans facilitates targeted rehabilitation interventions. Implications: Systematic needs assessment in cancer rehabilitation unveil the requirement of physical rehabilitation. Supervised physical activity renders an intervention possible tailored the special needs cancer patients have......Background: Systematic assessment of rehabilitation needs is prerequisite for sufficient rehabilitation, but little is known about patients' needs. Purpose: The aim of this study was to describe specific stated rehabilitation needs and plans among patients with cancer at hospitals when diagnosed...

  1. Planning Framework for Mesolevel Optimization of Urban Runoff Control Schemes

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Qianqian; Blohm, Andrew; Liu, Bo

    2017-04-01

    A planning framework is developed to optimize runoff control schemes at scales relevant for regional planning at an early stage. The framework employs less sophisticated modeling approaches to allow a practical application in developing regions with limited data sources and computing capability. The methodology contains three interrelated modules: (1)the geographic information system (GIS)-based hydrological module, which aims at assessing local hydrological constraints and potential for runoff control according to regional land-use descriptions; (2)the grading module, which is built upon the method of fuzzy comprehensive evaluation. It is used to establish a priority ranking system to assist the allocation of runoff control targets at the subdivision level; and (3)the genetic algorithm-based optimization module, which is included to derive Pareto-based optimal solutions for mesolevel allocation with multiple competing objectives. The optimization approach describes the trade-off between different allocation plans and simultaneously ensures that all allocation schemes satisfy the minimum requirement on runoff control. Our results highlight the importance of considering the mesolevel allocation strategy in addition to measures at macrolevels and microlevels in urban runoff management. (C) 2016 American Society of Civil Engineers.

  2. Livermore Site Spill Prevention, Control, and Countermeasures (SPCC) Plan

    Energy Technology Data Exchange (ETDEWEB)

    Bellah, W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Griffin, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Mertesdorf, E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-09-21

    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 of 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.

  3. Combining Drugs to Treat Ovarian Cancer - Annual Plan

    Science.gov (United States)

    Approximately 70 percent of women diagnosed with ovarian cancer will die from the disease. Read about the NCI-funded combination drug trial that has successfully treated Betsy Brauser's recurrent cancer.

  4. Using the Theory of Planned Behavior to Understand Cervical Cancer Screening among Latinas

    Science.gov (United States)

    Roncancio, Angelica M.; Ward, Kristy K.; Sanchez, Ingrid A.; Cano, Miguel A.; Byrd, Theresa L.; Vernon, Sally W.; Fernandez-Esquer, Maria Eugenia; Fernandez, Maria E.

    2015-01-01

    To reduce the high incidence of cervical cancer among Latinas in the United States it is important to understand factors that predict screening behavior. The aim of this study was to test the utility of theory of planned behavior in predicting cervical cancer screening among a group of Latinas. A sample of Latinas (N = 614) completed a baseline…

  5. Radiobiological Impact of Planning Techniques for Prostate Cancer ...

    African Journals Online (AJOL)

    single arc (SA) plan was created using one full arc. All treatment plans were ... delivery time and decrement in the number of monitor units.[3-5]. Several authors have ..... Table 3: EUD and TCP for prostate tumor in SA and DA plans. Prostate.

  6. Early rehabilitation of cancer patients - a randomized controlled intervention study.

    Science.gov (United States)

    Arving, Cecilia; Thormodsen, Inger; Brekke, Guri; Mella, Olav; Berntsen, Sveinung; Nordin, Karin

    2013-01-07

    Faced with a life-threatening illness, such as cancer, many patients develop stress symptoms, i.e. avoidance behaviour, intrusive thoughts and worry. Stress management interventions have proven to be effective; however, they are mostly performed in group settings and it is commonly breast cancer patients who are studied. We hereby present the design of a randomized controlled trial (RCT) evaluating the effectiveness and cost-effectiveness of an individual stress-management intervention with a stepped-care approach in several cancer diagnoses. Patients (≥ 18 years) with a recent diagnosis of breast cancer, colorectal cancer, lymphoma, prostate cancer or testicle cancer and scheduled for adjuvant/curative oncology treatment, will consecutively be included in the study. In this prospective longitudinal intervention study with a stepped-care approach, patients will be randomized to control, treatment as usual, or an individual stress-management intervention in two steps. The first step is a low-intensity stress-management intervention, given to all patients randomized to intervention. Patients who continue to report stress symptoms after the first step will thereafter be given more intensive treatment at the second step of the programme. In the intervention patients will also be motivated to be physically active. Avoidance and intrusion are the primary outcomes. According to the power analyses, 300 patients are planned to be included in the study and will be followed for two years. Other outcomes are physical activity level, sleep duration and quality recorded objectively, and anxiety, depression, quality of life, fatigue, stress in daily living, and patient satisfaction assessed using valid and standardized psychometric tested questionnaires. Utilization of hospital services will be derived from the computerized patient administration systems used by the hospital. The cost-effectiveness of the intervention will be evaluated through a cost-utility analysis. This RCT

  7. RapidArc volumetric modulated therapy planning for prostate cancer patients

    DEFF Research Database (Denmark)

    Kjaer-Kristoffersen, Flemming; Ohlhues, Lars; Medin, Joakim

    2009-01-01

    into clinical practice in May 2008 for treatment of prostate cancer patients. We report here our experiences with performing treatment planning using the Eclipse RapidArc optimization software for this patient group. MATERIAL AND METHODS: A stand-alone installation of Eclipse 8.5 with RapidArc optimization...... capability was performed at Rigshospitalet. Patient data for 8 prostate cancer patients were imported, most of whom were previously treated at Rigshospitalet using IMRT. Three of the patients were treated at Rigshospitalet using the RapidArc technique. Treatment plans were optimized using objectives as given...... by standard guidelines for clinical treatment planning. RapidArc plans were compared to the IMRT plans by which the patients were actually treated or in the three cases treated with the RapidArc technique to IMRT plans achieved using standard guidelines. Comparison was done with respect to target coverage...

  8. Chemical Spill Prevention, Control, and Countermeasures Plan: 100 Areas

    Energy Technology Data Exchange (ETDEWEB)

    Chien, Y.M.

    1989-06-01

    The purpose of this Chemical Spill Prevention, Control, and Countermeasures (SPCC) Plan is to identify the chemical spill control practices, procedures, and containment devices Westinghouse Hanford Company (Westinghouse Hanford) employs to prevent a reportable quantity (RQ) of a hazardous substance (as defined in 40 CFR Part 302) from being released to the environment. The chemical systems and chemical storage facilities in the 100 Areas are described. This document traces the ultimate fate of accidental chemical spills at the 100 Areas. Also included in the document destinations, spill containment devices, and systems surveillance frequencies. 2 tabs.

  9. The Utility of PET/CT in External Radiation Therapy Planning of Prostate Cancer.

    Science.gov (United States)

    Calais, Jeremie; Cao, Minsong; Nickols, Nicholas G

    2018-01-04

    Radiotherapy and radical prostatectomy are the definitive treatment options for patients with localized prostate cancer. A rising PSA after radical prostatectomy indicates prostate cancer recurrence, and these patients may still be cured with salvage radiotherapy. To maximize chance for cure, irradiated volumes should completely encompass the extent of disease. Therefore, accurate estimation of the location of disease is critical for radiotherapy planning in both the definitive and salvage settings. Conventional imaging for prostate cancer has limited sensitivity for detection of disease both at initial staging and at biochemical recurrence. Integration of Positron Emission Tomography (PET) into routine evaluation of prostate cancer patients may improve both staging accuracy and radiotherapy planning. 18F-fluorodeoxyglucose (FDG) PET/CT is now routinely used in radiation planning for several cancer types. However, FDG-PET/CT has low sensitivity for prostate cancer. Additional PET probes evaluated in prostate cancer include 18F-sodium fluoride (Na-F), 11C-acetate, 11C- or 18F-choline, 18F-FACBC (fluciclovine, [Axumin™]), and 68Ga- or 18F- labeled ligands that bind prostate specific membrane antigen (PSMA). PSMA ligands appear to be the most sensitive and specific, but are not yet approved for use in the Untied States. Retrospective and prospective investigations suggest a potential major impact of PET/CT on prostate radiation treatment planning. Prospective trials randomizing patients to routine radiotherapy planning versus PET/CT aided planning may show meaningful clinical outcomes. Prospective clinical trials evaluating the addition of fluciclovine-PET/CT for planning of salvage radiotherapy with clinical endpoints are underway. Prospective trials evaluating the clinical impact of PSMA PET/CT on prostate radiation planning are indicated. Copyright © 2018 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  10. Radiotherapy and local control in rectal cancer.

    Science.gov (United States)

    Valentini, V; Rosetto, M E; Fares, C; Mantini, G; Salvi, G; Turriziani, A

    1998-01-01

    Recurrence is a stage in the natural history of rectal cancer. Preoperative radiotherapy or postoperative radiochemotherapy lower the rate of recurrence, improving local control. From 1980 to 1997, at the "Divisione di Radioterapia" of the "Università Cattolica del S. Cuore" of Rome 380 patients with rectal cancer of early clinical stage T2-3, candidates for surgery for cure, underwent radiation therapy. 119 patients underwent postoperative radiotherapy (45-50 Gy); 45 patients underwent "sandwich" radiotherapy (45 Gy:27 Gy before and 28 Gy after surgery), of whom 7 were treated with preoperative radiotherapy alone; 145 patients underwent preoperative concomitant radiochemotherapy according to 3 different protocols, radiotherapy (38 Gy) combined with mitomycin C and 5-FU; radiotherapy (50.4 Gy) combined with cisplatin and 5-FU; radiotherapy (45 Gy) combined with 5-FU and folinic acid. 71 patients were treated with preoperative radiotherapy (38 Gy) combined with IORT (10 Gy). Median follow-up was 6 years. Overall local control was 85% at 3 years, 83% at 5 years, 81% at 10 years. The rate of local control at 5 years was: 76% for postoperative radiotherapy, 83% for "sandwich" radiotherapy, 84% for preoperative radiochemotherapy and 93% for preoperative radiotherapy combined with IORT. Local control was shown to be significantly better with preoperative treatment as compared to postoperative treatment (p = 0.02). The incidence of metastases was 35% in the patients with local recurrence and 16% in those with local control. The difference in survival was highly significant in patients with local control as compared to those with local recurrence: at 5 years 87% and 32% respectively. Patients with local control showed a lower incidence of metastasis and a better survival.

  11. Incremental planning to control a blackboard-based problem solver

    Science.gov (United States)

    Durfee, E. H.; Lesser, V. R.

    1987-01-01

    To control problem solving activity, a planner must resolve uncertainty about which specific long-term goals (solutions) to pursue and about which sequences of actions will best achieve those goals. A planner is described that abstracts the problem solving state to recognize possible competing and compatible solutions and to roughly predict the importance and expense of developing these solutions. With this information, the planner plans sequences of problem solving activities that most efficiently resolve its uncertainty about which of the possible solutions to work toward. The planner only details actions for the near future because the results of these actions will influence how (and whether) a plan should be pursued. As problem solving proceeds, the planner adds new details to the plan incrementally, and monitors and repairs the plan to insure it achieves its goals whenever possible. Through experiments, researchers illustrate how these new mechanisms significantly improve problem solving decisions and reduce overall computation. They briefly discuss current research directions, including how these mechanisms can improve a problem solver's real-time response and can enhance cooperation in a distributed problem solving network.

  12. Computed Tomography–Planned High-Dose-Rate Brachytherapy for Treating Uterine Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zolciak-Siwinska, Agnieszka, E-mail: agnieszka.zolciak@wp.pl [Department of Brachytherapy, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Gruszczynska, Ewelina; Bijok, Michal [Department of Medical Physics, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Jonska-Gmyrek, Joanna [Department of Teleradiotherapy, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Dabkowski, Mateusz [Department of Brachytherapy, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Staniaszek, Jagna [Department of Teleradiotherapy, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Michalski, Wojciech [Department of Clinical Trials and Biostatistics, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Kowalczyk, Adam; Milanowska, Katarzyna [Department of Medical Physics, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland)

    2016-09-01

    Purpose: To evaluate the long-term results of computed tomography (CT)–planned high-dose-rate (HDR) brachytherapy (BT) for treating cervical cancer patients. Methods and Materials: CT-planned HDR BT was performed according to the adapted Group European de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) recommendations in 216 consecutive patients with locally advanced cervical cancer, International Federation of Gynecology and Obstetrics (FIGO) stage IB to IVA, who were treated with conformal external beam radiation therapy and concomitant chemotherapy. We analyzed outcomes and late side effects evaluated according to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer and Subjective, Objective, Management, Analysis evaluation scoring system and compared them with the results from a historical group. Results: The median age was 56 years (range, 32-83 years). The median follow-up time for living patients was 52 months (range 37-63 months). The 5-year cumulative incidence function for the local recurrence rate for patients with FIGO II and III was 5.5% and 20%, respectively (P=.001). The 5-year rates of overall survival (OS) and disease-free survival (DFS) were 66.4% and 58.5%, respectively. The relative risk of failure for OS and DFS for FIGO III in relation to FIGO II was 2.24 (P=.003) and 2.6 (P=.000) and for lymph node enlargement was 2.3 (P=.002) and 2 (P=.006), respectively. In 2 patients, rectovaginal fistula occurred, and in 1 patient, vesicovaginal fistula occurred without local progression. Comparison of late adverse effects in patients treated according to the GEC-ESTRO recommendations and in the historical group revealed a reduction in fistula formation of 59% and also a reduction in rectal grade 3 to 4 late toxicity of >59%. Conclusions: This is the largest report with mature data of CT-planned BT HDR for the treatment of cervical cancer with good local control and

  13. Human movement data for malaria control and elimination strategic planning.

    Science.gov (United States)

    Pindolia, Deepa K; Garcia, Andres J; Wesolowski, Amy; Smith, David L; Buckee, Caroline O; Noor, Abdisalan M; Snow, Robert W; Tatem, Andrew J

    2012-06-18

    Recent increases in funding for malaria control have led to the reduction in transmission in many malaria endemic countries, prompting the national control programmes of 36 malaria endemic countries to set elimination targets. Accounting for human population movement (HPM) in planning for control, elimination and post-elimination surveillance is important, as evidenced by previous elimination attempts that were undermined by the reintroduction of malaria through HPM. Strategic control and elimination planning, therefore, requires quantitative information on HPM patterns and the translation of these into parasite dispersion. HPM patterns and the risk of malaria vary substantially across spatial and temporal scales, demographic and socioeconomic sub-groups, and motivation for travel, so multiple data sets are likely required for quantification of movement. While existing studies based on mobile phone call record data combined with malaria transmission maps have begun to address within-country HPM patterns, other aspects remain poorly quantified despite their importance in accurately gauging malaria movement patterns and building control and detection strategies, such as cross-border HPM, demographic and socioeconomic stratification of HPM patterns, forms of transport, personal malaria protection and other factors that modify malaria risk. A wealth of data exist to aid filling these gaps, which, when combined with spatial data on transport infrastructure, traffic and malaria transmission, can answer relevant questions to guide strategic planning. This review aims to (i) discuss relevant types of HPM across spatial and temporal scales, (ii) document where datasets exist to quantify HPM, (iii) highlight where data gaps remain and (iv) briefly put forward methods for integrating these datasets in a Geographic Information System (GIS) framework for analysing and modelling human population and Plasmodium falciparum malaria infection movements.

  14. Human movement data for malaria control and elimination strategic planning

    Directory of Open Access Journals (Sweden)

    Pindolia Deepa K

    2012-06-01

    Full Text Available Abstract Recent increases in funding for malaria control have led to the reduction in transmission in many malaria endemic countries, prompting the national control programmes of 36 malaria endemic countries to set elimination targets. Accounting for human population movement (HPM in planning for control, elimination and post-elimination surveillance is important, as evidenced by previous elimination attempts that were undermined by the reintroduction of malaria through HPM. Strategic control and elimination planning, therefore, requires quantitative information on HPM patterns and the translation of these into parasite dispersion. HPM patterns and the risk of malaria vary substantially across spatial and temporal scales, demographic and socioeconomic sub-groups, and motivation for travel, so multiple data sets are likely required for quantification of movement. While existing studies based on mobile phone call record data combined with malaria transmission maps have begun to address within-country HPM patterns, other aspects remain poorly quantified despite their importance in accurately gauging malaria movement patterns and building control and detection strategies, such as cross-border HPM, demographic and socioeconomic stratification of HPM patterns, forms of transport, personal malaria protection and other factors that modify malaria risk. A wealth of data exist to aid filling these gaps, which, when combined with spatial data on transport infrastructure, traffic and malaria transmission, can answer relevant questions to guide strategic planning. This review aims to (i discuss relevant types of HPM across spatial and temporal scales, (ii document where datasets exist to quantify HPM, (iii highlight where data gaps remain and (iv briefly put forward methods for integrating these datasets in a Geographic Information System (GIS framework for analysing and modelling human population and Plasmodium falciparum malaria infection movements.

  15. Cancer survivorship care-planning: Practice, research, and policy implications for social work.

    Science.gov (United States)

    Wagner, Richard W; Pritzker, Suzanne

    2016-01-01

    Increasing numbers of cancer survivors are living longer than 5 years from their diagnosis date. This has resulted in a growing population of cancer survivors, expected to reach 19 million by 2024. Survivors frequently experience late effects caused by cancer and its treatment, reducing survivors' quality of life in multiple domains. Survivorship care-plans may aid the many physical, psychosocial, and financial needs that emerge posttreatment. However, the lack of reimbursement mechanisms, the limited amount of effectiveness research, and minimal guidelines for content and delivery are barriers to the widespread provision of survivorship care-plans. Challenges and opportunities for social work practice, research, and policy are identified and discussed.

  16. Light Water Reactor Sustainability Program A Reference Plan for Control Room Modernization: Planning and Analysis Phase

    Energy Technology Data Exchange (ETDEWEB)

    Jacques Hugo; Ronald Boring; Lew Hanes; Kenneth Thomas

    2013-09-01

    The U.S. Department of Energy’s Light Water Reactor Sustainability (LWRS) program is collaborating with a U.S. nuclear utility to bring about a systematic fleet-wide control room modernization. To facilitate this upgrade, a new distributed control system (DCS) is being introduced into the control rooms of these plants. The DCS will upgrade the legacy plant process computer and emergency response facility information system. In addition, the DCS will replace an existing analog turbine control system with a display-based system. With technology upgrades comes the opportunity to improve the overall human-system interaction between the operators and the control room. To optimize operator performance, the LWRS Control Room Modernization research team followed a human-centered approach published by the U.S. Nuclear Regulatory Commission. NUREG-0711, Rev. 3, Human Factors Engineering Program Review Model (O’Hara et al., 2012), prescribes four phases for human factors engineering. This report provides examples of the first phase, Planning and Analysis. The three elements of Planning and Analysis in NUREG-0711 that are most crucial to initiating control room upgrades are: • Operating Experience Review: Identifies opportunities for improvement in the existing system and provides lessons learned from implemented systems. • Function Analysis and Allocation: Identifies which functions at the plant may be optimally handled by the DCS vs. the operators. • Task Analysis: Identifies how tasks might be optimized for the operators. Each of these elements is covered in a separate chapter. Examples are drawn from workshops with reactor operators that were conducted at the LWRS Human System Simulation Laboratory HSSL and at the respective plants. The findings in this report represent generalized accounts of more detailed proprietary reports produced for the utility for each plant. The goal of this LWRS report is to disseminate the technique and provide examples sufficient to

  17. Hospice Family Caregiver Involvement in Care Plan Meetings: A Mixed-Methods Randomized Controlled Trial.

    Science.gov (United States)

    Parker Oliver, Debra; Demiris, George; Washington, Karla; Kruse, Robin L; Petroski, Greg

    2017-11-01

    Untrained family caregivers struggle with complicated medical management regimens for hospice patients. An intervention was tested to improve caregiver's perception of pain management and patient's pain. The intervention was tested with a 2-group (usual care vs intervention) randomized controlled trial using parallel mixed-methods analysis of 446 caregivers in 3 Midwestern hospice programs representing rural and urban settings. Web conferencing or telephones were used to connect caregivers with the hospice care team during care plan meetings. Caregiver's perceptions of pain management were the primary outcome. Secondary outcomes included caregiver quality of life, patient's pain, and anxiety. Video recordings, field notes, and caregiver and staff interviews provided qualitative data. The overall perception of pain management was not changed by the participation in hospice team meetings. Perceptions of fatalism improved for intervention participants, and the intervention participants perceived their patients' pain was better controlled than those in the control group. The intervention was found to be feasible to deliver in rural areas. Caregiver's anxiety and patient's pain were correlated ( r = .18; P = .003), and subanalysis indicated that caregivers of patients with cancer may benefit more from the intervention than other hospice caregivers. Qualitative analyses provided understanding of caregiver's perceptions of pain, cost, and facilitators and barriers to routine involvement of family in care plan meetings. Limitations and Conclusion: The hospice philosophy is supportive of caregiver involvement in care planning, and technology makes this feasible; the intervention needs modification to become translational as well as additional measurement to assess effectiveness. Caregiver education and emotional support should occur outside the meeting, and a strong leader should facilitate the meeting to control efficiency. Finally, the intervention may benefit caregivers

  18. A review of plan library approaches in adaptive radiotherapy of bladder cancer.

    Science.gov (United States)

    Collins, Shane D; Leech, Michelle M

    2018-01-04

    Large variations in the shape and size of the bladder volume are commonly observed in bladder cancer radiotherapy (RT). The clinical target volume (CTV) is therefore frequently inadequately treated and large isotropic margins are inappropriate in terms of dose to organs at risk (OAR); thereby making adaptive radiotherapy (ART) attractive for this tumour site. There are various methods of ART delivery, however, for bladder cancer, plan libraries are frequently used. A review of published studies on plan libraries for bladder cancer using four databases (Pubmed, Science Direct, Embase and Cochrane Library) was conducted. The endpoints selected were accuracy and feasibility of initiation of a plan library strategy into a RT department. Twenty-four articles were included in this review. The majority of studies reported improvement in accuracy with 10 studies showing an improvement in planning target volume (PTV) and CTV coverage with plan libraries, some by up to 24%. Seventeen studies showed a dose reduction to OARs, particularly the small bowel V45Gy, V40Gy, V30Gy and V10Gy, and the rectal V30Gy. However, the occurrence of no suitable plan was reported in six studies, with three studies showing no significant difference between adaptive and non-adaptive strategies in terms of target coverage. In addition, inter-observer variability in plan selection appears to remain problematic. The additional resources, education and technology required for the initiation of plan library selection for bladder cancer may hinder its routine clinical implementation, with eight studies illustrating increased treatment time required. While there is a growing body of evidence in support of plan libraries for bladder RT, many studies differed in their delivery approach. The advent of the clinical use of the MRI-linear accelerator will provide RT departments with the opportunity to consider daily online adaption for bladder cancer as an alternate to plan library approaches.

  19. Control mechanisms in the third-generation planning. Case study: Control to realize sustainable cities

    Science.gov (United States)

    Wicaksono, A. D.

    2017-06-01

    Since the last few years, Indonesia has experienced important events that bring significant changes to the social, political and economic life. The changes directly or indirectly impact the field of planning. With the challenging condition which grows fast and is more complex ahead, and the greater demands on the role of planning, it is required that planning should have higher quality. This paper seeks to answer some questions as follows: (i) How are changes in paradigm and also the development of planning model for the current transition era?, (ii) What is the best way to improve the quality of planning control on the last generation planning model to realize sustainable city?. Analysis steps that will be used to achieve the paper objectives are: (i) Review of planning and sustainable cities theory, (ii) Pattern recognition, (iii) Identifying control mechanisms and sustainable urban forms, (iv) conceptualization. Based on discussion about sustainable cities and control mechanism, some conclusions can be generated as follows: (i) The third generation planning model is based on the theory of expanded system, emphasizing on the constraint of capacity and the ability of planners within the context of larger environment, (ii) There are various theoretical studies that recommend prescriptive model or solution for sustainable urban form and structure. The concepts of Sustainable Cities can be grouped in Neotraditional Development, Urban Containment, Compact City and The Eco-City. The four models above have criteria, namely (i) high density; (ii) a high level of diversity; (iii) mixed land use; (iv) compactness; (5) sustainable transport; (6) passive solar design; (7) Greening Ecological Design. The three main activities in control mechanisms are: Monitoring and Recommendation; a comparative review of the facts (conditions that exist or are developing) with the purpose (expected conditions, set out in urban planning) and recommendations; Evaluation, a review on the

  20. Diverse Planning for UAV Control and Remote Sensing.

    Science.gov (United States)

    Tožička, Jan; Komenda, Antonín

    2016-12-21

    Unmanned aerial vehicles (UAVs) are suited to various remote sensing missions, such as measuring air quality. The conventional method of UAV control is by human operators. Such an approach is limited by the ability of cooperation among the operators controlling larger fleets of UAVs in a shared area. The remedy for this is to increase autonomy of the UAVs in planning their trajectories by considering other UAVs and their plans. To provide such improvement in autonomy, we need better algorithms for generating alternative trajectory variants that the UAV coordination algorithms can utilize. In this article, we define a novel family of multi-UAV sensing problems, solving task allocation of huge number of tasks (tens of thousands) to a group of configurable UAVs with non-zero weight of equipped sensors (comprising the air quality measurement as well) together with two base-line solvers. To solve the problem efficiently, we use an algorithm for diverse trajectory generation and integrate it with a solver for the multi-UAV coordination problem. Finally, we experimentally evaluate the multi-UAV sensing problem solver. The evaluation is done on synthetic and real-world-inspired benchmarks in a multi-UAV simulator. Results show that diverse planning is a valuable method for remote sensing applications containing multiple UAVs.

  1. Diverse Planning for UAV Control and Remote Sensing

    Directory of Open Access Journals (Sweden)

    Jan Tožička

    2016-12-01

    Full Text Available Unmanned aerial vehicles (UAVs are suited to various remote sensing missions, such as measuring air quality. The conventional method of UAV control is by human operators. Such an approach is limited by the ability of cooperation among the operators controlling larger fleets of UAVs in a shared area. The remedy for this is to increase autonomy of the UAVs in planning their trajectories by considering other UAVs and their plans. To provide such improvement in autonomy, we need better algorithms for generating alternative trajectory variants that the UAV coordination algorithms can utilize. In this article, we define a novel family of multi-UAV sensing problems, solving task allocation of huge number of tasks (tens of thousands to a group of configurable UAVs with non-zero weight of equipped sensors (comprising the air quality measurement as well together with two base-line solvers. To solve the problem efficiently, we use an algorithm for diverse trajectory generation and integrate it with a solver for the multi-UAV coordination problem. Finally, we experimentally evaluate the multi-UAV sensing problem solver. The evaluation is done on synthetic and real-world-inspired benchmarks in a multi-UAV simulator. Results show that diverse planning is a valuable method for remote sensing applications containing multiple UAVs.

  2. Inverse Planned High-Dose-Rate Brachytherapy for Locoregionally Advanced Cervical Cancer: 4-Year Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Tinkle, Christopher L.; Weinberg, Vivian [Department of Radiation Oncology, University of California, San Francisco, California (United States); Chen, Lee-May [Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California (United States); Littell, Ramey [Gynecologic Oncology, The Permanente Medical Group, San Francisco, California (United States); Cunha, J. Adam M.; Sethi, Rajni A. [Department of Radiation Oncology, University of California, San Francisco, California (United States); Chan, John K. [Gynecologic Oncology, California Pacific Medical Center, San Francisco, California (United States); Hsu, I-Chow, E-mail: ichow.hsu@ucsf.edu [Department of Radiation Oncology, University of California, San Francisco, California (United States)

    2015-08-01

    Purpose: Evaluate the efficacy and toxicity of image guided brachytherapy using inverse planning simulated annealing (IPSA) high-dose-rate brachytherapy (HDRB) boost for locoregionally advanced cervical cancer. Methods and Materials: From December 2003 through September 2009, 111 patients with primary cervical cancer were treated definitively with IPSA-planned HDRB boost (28 Gy in 4 fractions) after external radiation at our institution. We performed a retrospective review of our experience using image guided brachytherapy. Of the patients, 70% had a tumor size >4 cm, 38% had regional nodal disease, and 15% had clinically evident distant metastasis, including nonregional nodal disease, at the time of diagnosis. Surgical staging involving pelvic lymph node dissection was performed in 15% of patients, and 93% received concurrent cisplatin-based chemotherapy. Toxicities are reported according to the Common Terminology Criteria for Adverse Events version 4.0 guidelines. Results: With a median follow-up time of 42 months (range, 3-84 months), no acute or late toxicities of grade 4 or higher were observed, and grade 3 toxicities (both acute and late) developed in 8 patients (1 constitutional, 1 hematologic, 2 genitourinary, 4 gastrointestinal). The 4-year Kaplan-Meier estimate of late grade 3 toxicity was 8%. Local recurrence developed in 5 patients (4 to 9 months after HDRB), regional recurrence in 3 (6, 16, and 72 months after HDRB), and locoregional recurrence in 1 (4 months after HDR boost). The 4-year estimates of local, locoregional, and distant control of disease were 94.0%, 91.9%, and 69.1%, respectively. The overall and disease-free survival rates at 4 years were 64.3% (95% confidence interval [CI] of 54%-73%) and 61.0% (95% CI, 51%-70%), respectively. Conclusions: Definitive radiation by use of inverse planned HDRB boost for locoregionally advanced cervical cancer is well tolerated and achieves excellent local control of disease. However, overall

  3. Repetitive motion planning and control of redundant robot manipulators

    CERN Document Server

    Zhang, Yunong

    2013-01-01

    Repetitive Motion Planning and Control of Redundant Robot Manipulators presents four typical motion planning schemes based on optimization techniques, including the fundamental RMP scheme and its extensions. These schemes are unified as quadratic programs (QPs), which are solved by neural networks or numerical algorithms. The RMP schemes are demonstrated effectively by the simulation results based on various robotic models; the experiments applying the fundamental RMP scheme to a physical robot manipulator are also presented. As the schemes and the corresponding solvers presented in the book have solved the non-repetitive motion problems existing in redundant robot manipulators, it is of particular use in applying theoretical research based on the quadratic program for redundant robot manipulators in industrial situations. This book will be a valuable reference work for engineers, researchers, advanced undergraduate and graduate students in robotics fields. Yunong Zhang is a professor at The School of Informa...

  4. Optimal control of multiplicative control systems arising from cancer therapy

    Science.gov (United States)

    Bahrami, K.; Kim, M.

    1975-01-01

    This study deals with ways of curtailing the rapid growth of cancer cell populations. The performance functional that measures the size of the population at the terminal time as well as the control effort is devised. With use of the discrete maximum principle, the Hamiltonian for this problem is determined and the condition for optimal solutions are developed. The optimal strategy is shown to be a bang-bang control. It is shown that the optimal control for this problem must be on the vertices of an N-dimensional cube contained in the N-dimensional Euclidean space. An algorithm for obtaining a local minimum of the performance function in an orderly fashion is developed. Application of the algorithm to the design of antitumor drug and X-irradiation schedule is discussed.

  5. Automated Volumetric Modulated Arc Therapy Treatment Planning for Stage III Lung Cancer: How Does It Compare With Intensity-Modulated Radio Therapy?

    Energy Technology Data Exchange (ETDEWEB)

    Quan, Enzhuo M. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chang, Joe Y.; Liao Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Xia Tingyi [Department of Radiation Oncology, Beijing 301 Hospital, Beijing (China); Yuan Zhiyong [Department of Radiation Oncology, Tianjin Medical University Cancer Hospital and Institute, Tianjin (China); Liu Hui [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, Zhongshan University Hospital, Guangzhou (China); Li, Xiaoqiang; Wages, Cody A.; Mohan, Radhe [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zhang Xiaodong, E-mail: xizhang@mdanderson.org [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-09-01

    Purpose: To compare the quality of volumetric modulated arc therapy (VMAT) or intensity-modulated radiation therapy (IMRT) plans generated by an automated inverse planning system with that of dosimetrist-generated IMRT treatment plans for patients with stage III lung cancer. Methods and Materials: Two groups of 8 patients with stage III lung cancer were randomly selected. For group 1, the dosimetrists spent their best effort in designing IMRT plans to compete with the automated inverse planning system (mdaccAutoPlan); for group 2, the dosimetrists were not in competition and spent their regular effort. Five experienced radiation oncologists independently blind-reviewed and ranked the three plans for each patient: a rank of 1 was the best and 3 was the worst. Dosimetric measures were also performed to quantitatively evaluate the three types of plans. Results: Blind rankings from different oncologists were generally consistent. For group 1, the auto-VMAT, auto-IMRT, and manual IMRT plans received average ranks of 1.6, 2.13, and 2.18, respectively. The auto-VMAT plans in group 1 had 10% higher planning tumor volume (PTV) conformality and 24% lower esophagus V70 (the volume receiving 70 Gy or more) than the manual IMRT plans; they also resulted in more than 20% higher complication-free tumor control probability (P+) than either type of IMRT plans. The auto- and manual IMRT plans in this group yielded generally comparable dosimetric measures. For group 2, the auto-VMAT, auto-IMRT, and manual IMRT plans received average ranks of 1.55, 1.75, and 2.75, respectively. Compared to the manual IMRT plans in this group, the auto-VMAT plans and auto-IMRT plans showed, respectively, 17% and 14% higher PTV dose conformality, 8% and 17% lower mean lung dose, 17% and 26% lower mean heart dose, and 36% and 23% higher P+. Conclusions: mdaccAutoPlan is capable of generating high-quality VMAT and IMRT treatment plans for stage III lung cancer. Manual IMRT plans could achieve quality

  6. Usefulness and engagement with a guided workbook intervention (WorkPlan) to support work related goals among cancer survivors.

    Science.gov (United States)

    Schumacher, Lauren; Armaou, Maria; Rolf, Pauline; Sadhra, Steven; Sutton, Andrew John; Zarkar, Anjali; Grunfeld, Elizabeth A

    2017-10-04

    Returning to work after cancer is associated with improved physical and psychological functioning, but managing this return can be a challenging process. A workbook based intervention (WorkPlan) was developed to support return-to-work among cancer survivors. The aim of this study was to explore how participants using the workbook engaged with the intervention and utilised the content of the intervention in their plan to return-to-work. As part of a feasibility randomised controlled trial, 23 participants from the intervention group were interviewed 4-weeks post intervention. Interviews focussed on intervention delivery and data was analysed using Framework analysis. Participants revealed a sense of empowerment and changes in their outlook as they transitioned from patient to employee, citing the act of writing as a medium for creating their own return-to-work narrative. Participants found the generation of a return-to-work plan useful for identifying potential problems and solutions, which also served as a tool for aiding discussion with the employer on return-to-work. Additionally, participants reported feeling less uncertain and anxious about returning to work. Timing of the intervention in coordination with ongoing cancer treatments was crucial to perceived effectiveness; participants identified the sole or final treatment as the ideal time to receive the intervention. The self-guided workbook supports people diagnosed with cancer to build their communication and planning skills to successfully manage their return-to-work. Further research could examine how writing plays a role in this process. Current Controlled Trials ISRCTN56342476 . Retrospectively registered 14 October 2015.

  7. Gait Planning and Stability Control of a Quadruped Robot

    Directory of Open Access Journals (Sweden)

    Junmin Li

    2016-01-01

    Full Text Available In order to realize smooth gait planning and stability control of a quadruped robot, a new controller algorithm based on CPG-ZMP (central pattern generator-zero moment point is put forward in this paper. To generate smooth gait and shorten the adjusting time of the model oscillation system, a new CPG model controller and its gait switching strategy based on Wilson-Cowan model are presented in the paper. The control signals of knee-hip joints are obtained by the improved multi-DOF reduced order control theory. To realize stability control, the adaptive speed adjustment and gait switch are completed by the real-time computing of ZMP. Experiment results show that the quadruped robot’s gaits are efficiently generated and the gait switch is smooth in the CPG control algorithm. Meanwhile, the stability of robot’s movement is improved greatly with the CPG-ZMP algorithm. The algorithm in this paper has good practicability, which lays a foundation for the production of the robot prototype.

  8. Gait Planning and Stability Control of a Quadruped Robot.

    Science.gov (United States)

    Li, Junmin; Wang, Jinge; Yang, Simon X; Zhou, Kedong; Tang, Huijuan

    2016-01-01

    In order to realize smooth gait planning and stability control of a quadruped robot, a new controller algorithm based on CPG-ZMP (central pattern generator-zero moment point) is put forward in this paper. To generate smooth gait and shorten the adjusting time of the model oscillation system, a new CPG model controller and its gait switching strategy based on Wilson-Cowan model are presented in the paper. The control signals of knee-hip joints are obtained by the improved multi-DOF reduced order control theory. To realize stability control, the adaptive speed adjustment and gait switch are completed by the real-time computing of ZMP. Experiment results show that the quadruped robot's gaits are efficiently generated and the gait switch is smooth in the CPG control algorithm. Meanwhile, the stability of robot's movement is improved greatly with the CPG-ZMP algorithm. The algorithm in this paper has good practicability, which lays a foundation for the production of the robot prototype.

  9. Forward versus inverse planning in oropharyngeal cancer: A comparative study using physical and biological indices

    Directory of Open Access Journals (Sweden)

    T Sundaram

    2013-01-01

    Full Text Available Context: Possible benefits of inverse planning. Aims: To analyze possible benefits of inverse planning intensity modulated radiation therapy (IMRT over field-in-field 3D conformal radiation therapy (FIF-3DCRT and to evaluate the differences if any, between low (6 Million Volts and high energy (15 Million Volts IMRT plans. Materials and Methods: Ten patients with squamous cell carcinoma of oropharynx, previously treated with 6 MV step and shoot IMRT were studied. V 100 , V 33 , V 66 , mean dose and normal tissue complication probabilities (NTCP were evaluated for parotid glands. Maximum dose and NTCP were the parameters for spinal cord. Statistical Analysis Used: A two-tailed t-test was applied to analyze statistical significance between the different techniques. Results: For combined parotid gland, a reduction of 4.374 Gy, 9.343 Gy and 7.883 Gy were achieved for D 100 , D 66 and D 33 , respectively in 6 MV-IMRT when compared with FIF-3DCRT. Spinal cord sparing was better in 6 MV-IMRT (40.963 ± 2.650, with an average reduction of maximum spinal cord dose by 7.355 Gy from that using the FIF-3DCRT technique. The uncomplicated tumor control probabilities values were higher in IMRT plans thus leading to a possibility of dose escalation. Conclusions: Though low-energy IMRT is the preferred choice for treatment of oropharyngeal cancers, FIF-3DCRT must be given due consideration as a second choice for its well established advantages over traditional conventioan technique.

  10. The effect of photon energy on the intensity-modulated radiation therapy plan for prostate cancer: a planning study

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Jin-Beom; Kim, Jae-Sung; Kim, In-Ah [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Lee, Jeong-Woo [Konkuk University Hospital, Seoul (Korea, Republic of); Korea University, Seoul (Korea, Republic of); Cho, Woong; Suh, Tae-Suk [The Catholic University of Korea, Seoul (Korea, Republic of)

    2011-07-15

    In this study, the effect of the beam energy on the intensity modulated radiation therapy (IMRT) plan for prostate cancer was studied for competing IMRT plans optimized for delivery with either 6- or 15-MV photons. This retrospective planning study included 10 patients treated for localized prostate cancer at the Seoul National University Bundang Hospital. A dose of 66 Gy was prescribed in 33 daily fractions of 2 Gy. For inverse IMRT treatment planning, we used a 7-coplanar non-opposed beam arrangement at 0, 50, 100, 150, 210, 260, and 310 degree angles. To ensure that differences among the plans were due only to energy selection, the beam arrangement, number of beam, and dose constraints were kept constant for all plans. The dose volume histograms (DVHs) for the 6- and 15-MV plans were compared for the planning target volume (PTV) and for organs at risk (OAR), such as the rectum, bladder and both femoral heads. The conformal index was defined as the ratio of the 95% isodose volume divided by the PTV volume enclosed by the 95% isodose line, because we selected the 95% isodose line as our reference. Doses received by the 95% and 5% volume of the PTV were less than or equal to 1% for 6-MV compared to the 15-MV IMRT plan for 10 patients. Percentage of doses received by the 10% volume of the bladder and rectum were less than or equal to 1%. Percentage of doses received by the 30 and 50% volume of bladder and rectum were 1 {approx} 2% higher for 6-MV photons. Also, percentage of dose received by the 10% and 50% volume of the right and the left femur heads were 4 {approx} 5% higher for 6-MV photons. The mean homogeneity index for the 6-MV and 15-MV photon plans was 1.06. The mean conformity index of 95% was 1.04 {+-} 0.01 and 1.12 {+-} 0.02 for 6-MV and 15-MV, respectively, but this difference was not statistically significant. The mean monitor unit was 812 {+-} 40 and 716 {+-} 33 for the 6-MV and the 15-MV photon plans, respectively. The 6-MV photon plan delivers 13

  11. First-of-A-Kind Control Room Modernization Project Plan

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, Kenneth David [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-02-01

    This project plan describes a comprehensive approach to the design of an end-state concept for a modernized control room for Palo Verde. It describes the collaboration arrangement between the DOE LWRS Program Control Room Modernization Project and the APS Palo Verde Nuclear Generating Station. It further describes the role of other collaborators, including the Institute for Energy Technology (IFE) and the Electric Power Research Institute (EPRI). It combines advanced tools, methodologies, and facilities to enable a science-based approach to the validation of applicable engineering and human factors principles for nuclear plant control rooms. It addresses the required project results and documentation to demonstrate compliance with regulatory requirements. It describes the project tasks that will be conducted in the project, and the deliverable reports that will be developed through these tasks. This project plan will be updated as new tasks are added and as project milestones are completed. It will serve as an ongoing description on the project both for project participants and for industry stakeholders.

  12. Effect of Crisis Plans on Admissions and Emergency Visits: A Randomized Controlled Trial

    NARCIS (Netherlands)

    Ruchlewska, A.; Wierdsma, A.I.; Kamperman, A.; van der Gaag, M.; Smulders, R.; Roosenschoon, B.J.; Mulder, C.L.

    2014-01-01

    Objective: To establish whether patients with a crisis plan had fewer voluntary or involuntary admissions, or fewer outpatient emergency visits, than patients without such a plan. Design: Multicenter randomized controlled trial with two intervention conditions and one control condition.

  13. Human Systems Integration: Unmanned Aircraft Control Station Certification Plan Guidance

    Science.gov (United States)

    2005-01-01

    This document provides guidance to the FAA on important human factors considerations that can be used to support the certification of a UAS Aircraft Control Station (ACS). This document provides a synopsis of the human factors analysis, design and test activities to be performed to provide a basis for FAA certification. The data from these analyses, design activities, and tests, along with data from certification/qualification tests of other key components should be used to establish the ACS certification basis. It is expected that this information will be useful to manufacturers in developing the ACS Certification Plan,, and in supporting the design of their ACS.

  14. Microgrids and distributed generation systems: Control, operation, coordination and planning

    Science.gov (United States)

    Che, Liang

    Distributed Energy Resources (DERs) which include distributed generations (DGs), distributed energy storage systems, and adjustable loads are key components in microgrid operations. A microgrid is a small electric power system integrated with on-site DERs to serve all or some portion of the local load and connected to the utility grid through the point of common coupling (PCC). Microgrids can operate in both grid-connected mode and island mode. The structure and components of hierarchical control for a microgrid at Illinois Institute of Technology (IIT) are discussed and analyzed. Case studies would address the reliable and economic operation of IIT microgrid. The simulation results of IIT microgrid operation demonstrate that the hierarchical control and the coordination strategy of distributed energy resources (DERs) is an effective way of optimizing the economic operation and the reliability of microgrids. The benefits and challenges of DC microgrids are addressed with a DC model for the IIT microgrid. We presented the hierarchical control strategy including the primary, secondary, and tertiary controls for economic operation and the resilience of a DC microgrid. The simulation results verify that the proposed coordinated strategy is an effective way of ensuring the resilient response of DC microgrids to emergencies and optimizing their economic operation at steady state. The concept and prototype of a community microgrid that interconnecting multiple microgrids in a community are proposed. Two works are conducted. For the coordination, novel three-level hierarchical coordination strategy to coordinate the optimal power exchanges among neighboring microgrids is proposed. For the planning, a multi-microgrid interconnection planning framework using probabilistic minimal cut-set (MCS) based iterative methodology is proposed for enhancing the economic, resilience, and reliability signals in multi-microgrid operations. The implementation of high-reliability microgrids

  15. PET/CT fusion in radiotherapy planning for lung cancer - case reports

    Directory of Open Access Journals (Sweden)

    Erak Marko Đ.

    2016-01-01

    Full Text Available Introduction. Application of imaging methods, namely computed tomography (CT, magnetic resonance imaging (MRI and in recent years positron emission tomography-computed tomography (PET/CT, and the progress of computer technology have allowed the construction of effective computerized systems for treatment planning (TPS and introducing the concept of virtual simulation in 3D conformal radiotherapy planning. Case report. We hereby presented two patients with the diagnosis of non-small cell lung cancer who did PET/CT examination. Both patients had surgery earlier and local recidives are diagnosed with PET/CT. PET/CT of the first patient described the focus of intense fluorodeoxyglucose (FDG accumulation 2.99 × 2.9 × 2.1cm in diameter in the projection of soft-tissue volume in the left corner, at operating clips height, corresponding to metabolically active recurrence of the tumor. Mediastinum and right lung parenchyma were without focal accumulation of FDG. Control PET/CT after 3 months was without detectable focus of intense pathological FDG accumulation - good therapeutic response, (metabolic disease remission. On the other hand, in the second case PET/CT showed a focus of intense FDG accumulation screening in the scar tissue of the apical part of the right lung, 20 × 16 mm, corresponding to metabolically active tumor recurrence. In the lung parenchyma on the left and in the mediastinum no visible focus of intense FDG accumulation was descrbed. Radiography included using 3D conformal radiotherapy with fusion PET/CT scan and CT simulations. Conclusion. PET/CT provides important information for planning conformal radiotherapy, especially in dose escalation, sparing of organ at risk and better locoregional control of the disease.

  16. Utilization of Cancer Information System for Breast Cancer Control in ...

    African Journals Online (AJOL)

    Introduction: there is a substantial increase in the incidence of breast cancer in Nigeria usually with the late stage presentations and subsequent poor rates of survival attributed mainly to a low level of cancer awareness and ignorance amongst patients. Cancer information system (CIS) is now assuming an emerging role in ...

  17. 21 CFR 123.6 - Hazard analysis and Hazard Analysis Critical Control Point (HACCP) plan.

    Science.gov (United States)

    2010-04-01

    ... Control Point (HACCP) plan. 123.6 Section 123.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Provisions § 123.6 Hazard analysis and Hazard Analysis Critical Control Point (HACCP) plan. (a) Hazard... fish or fishery product being processed in the absence of those controls. (b) The HACCP plan. Every...

  18. An in silico comparison between margin-based and probabilistic target-planning approaches in head and neck cancer patients

    NARCIS (Netherlands)

    Fontanarosa, Davide; van der Laan, Hans Paul; Witte, Marnix; Shakirin, Georgy; Roelofs, Erik; Langendijk, Johannes; Larnbin, Philippe; van Herk, Marcel

    2013-01-01

    Background and purpose: To apply target probabilistic planning (TPP) approach to intensity modulated radiotherapy (IMRT) plans for head and neck cancer (HNC) patients. Material and methods: Twenty plans of HNC patients were re-planned replacing the simultaneous integrated boost IMRT optimization

  19. An in silico comparison between margin-based and probabilistic target-planning approaches in head and neck cancer patients

    NARCIS (Netherlands)

    Fontanarosa, Davide; van der Laan, Hans Paul; Witte, Marnix; Shakirin, Georgy; Roelofs, Erik; Langendijk, Johannes A.; Lambin, Philippe; van Herk, Marcel

    2013-01-01

    To apply target probabilistic planning (TPP) approach to intensity modulated radiotherapy (IMRT) plans for head and neck cancer (HNC) patients. Twenty plans of HNC patients were re-planned replacing the simultaneous integrated boost IMRT optimization objectives for minimum dose on the boost target

  20. Optimal Control Approaches to the Aggregate Production Planning Problem

    Directory of Open Access Journals (Sweden)

    Yasser A. Davizón

    2015-12-01

    Full Text Available In the area of production planning and control, the aggregate production planning (APP problem represents a great challenge for decision makers in production-inventory systems. Tradeoff between inventory-capacity is known as the APP problem. To address it, static and dynamic models have been proposed, which in general have several shortcomings. It is the premise of this paper that the main drawback of these proposals is, that they do not take into account the dynamic nature of the APP. For this reason, we propose the use of an Optimal Control (OC formulation via the approach of energy-based and Hamiltonian-present value. The main contribution of this paper is the mathematical model which integrates a second order dynamical system coupled with a first order system, incorporating production rate, inventory level, and capacity as well with the associated cost by work force in the same formulation. Also, a novel result in relation with the Hamiltonian-present value in the OC formulation is that it reduces the inventory level compared with the pure energy based approach for APP. A set of simulations are provided which verifies the theoretical contribution of this work.

  1. Comparison of 2D and 3D brachytherpay planning for cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Hoom [Dept. of Radiation Oncology, KonYang University Hospital, Daejeon (Korea, Republic of)

    2017-06-15

    To evaluate the usefulness of 3-dimensional brachytherapy(BT) planning technique based on CT in cervical cancer. Patients with cervical cancer underwent 2-D BT treatment planning and then CT scan with HDR intracavitary applicators in place with same positions. Dose was prescribed to Point A with 5Gy per fraction on 2-D BT planning. For 3-D BT planning, and dose was prescribed to the High risk CTV for BT (HR CTV) with 5Gy. The 3-D BT planning goal was to cover at least 90% of the HR CTV with target 5Gy isodose surface while limiting the dose to 2 cm3 of bladder to less than 7.5 Gy, and 2cm{sup 3} of rectum to less than 5Gy. In one patient of 10 patients, D2cm3 of rectal dose was over 5Gy and 6 patients at D2cm{sup 3} of bladder dose on 2-D BT planning. There was a tendency to underestimate ICRU bladder dose than ICRU rectal dose. CT based 3-D BT planning for cervical cancer will enable evaluation of dose distributions for tumor and critical organs at risk. So, rectal and bladder morbidity as well as geographic miss will be reduced in case of the bulky disease or uterine malposition.

  2. Adaptive Stereotactic Body Radiation Therapy Planning for Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Qin, Yujiao [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Zhang, Fan [Occupational and Environmental Safety Office, Duke University Medical Center, Durham, North Carolina (United States); Yoo, David S.; Kelsey, Chris R. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Yin, Fang-Fang [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Cai, Jing, E-mail: jing.cai@duke.edu [Medical Physics Graduate Program, Duke University, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)

    2013-09-01

    Purpose: To investigate the dosimetric effects of adaptive planning on lung stereotactic body radiation therapy (SBRT). Methods and Materials: Forty of 66 consecutive lung SBRT patients were selected for a retrospective adaptive planning study. CBCT images acquired at each fraction were used for treatment planning. Adaptive plans were created using the same planning parameters as the original CT-based plan, with the goal to achieve comparable comformality index (CI). For each patient, 2 cumulative plans, nonadaptive plan (P{sub NON}) and adaptive plan (P{sub ADP}), were generated and compared for the following organs-at-risks (OARs): cord, esophagus, chest wall, and the lungs. Dosimetric comparison was performed between P{sub NON} and P{sub ADP} for all 40 patients. Correlations were evaluated between changes in dosimetric metrics induced by adaptive planning and potential impacting factors, including tumor-to-OAR distances (d{sub T-OAR}), initial internal target volume (ITV{sub 1}), ITV change (ΔITV), and effective ITV diameter change (Δd{sub ITV}). Results: 34 (85%) patients showed ITV decrease and 6 (15%) patients showed ITV increase throughout the course of lung SBRT. Percentage ITV change ranged from −59.6% to 13.0%, with a mean (±SD) of −21.0% (±21.4%). On average of all patients, P{sub ADP} resulted in significantly (P=0 to .045) lower values for all dosimetric metrics. Δd{sub ITV}/d{sub T-OAR} was found to correlate with changes in dose to 5 cc (ΔD5cc) of esophagus (r=0.61) and dose to 30 cc (ΔD30cc) of chest wall (r=0.81). Stronger correlations between Δd{sub ITV}/d{sub T-OAR} and ΔD30cc of chest wall were discovered for peripheral (r=0.81) and central (r=0.84) tumors, respectively. Conclusions: Dosimetric effects of adaptive lung SBRT planning depend upon target volume changes and tumor-to-OAR distances. Adaptive lung SBRT can potentially reduce dose to adjacent OARs if patients present large tumor volume shrinkage during the treatment.

  3. Volumetric modulated arc therapy planning for primary prostate cancer with selective intraprostatic boost determined by 18F-choline PET/CT

    Science.gov (United States)

    Kuang, Yu; Wu, Lili; Hirata, Emily; Miyazaki, Kyle; Sato, Miles; Kwee, Sandi A.

    2015-01-01

    Objective Evaluate expected tumor control and normal tissue toxicity for prostate volumetric modulated arc therapy (VMAT) with and without radiation boost to an intraprostatic dominant lesion (IDL) defined by 18F-fluorocholine PET/CT. Methods Thirty patients with localized prostate cancer underwent 18F-fluorocholine PET/CT before treatment. Two VMAT plans, plan79Gy and plan100-105Gy, were compared for each patient. The whole-prostate planning target volume (PTVprostate) was prescribed 79 Gy in both plans, however plan100-105Gy added simultaneous boost doses of 100 Gy and 105 Gy prescribed to IDLs defined by 60% and 70% of maximum prostatic uptake on 18F-fluorocholine PET (IDLsuv60% and IDLsuv70%, respectively, with IDLsuv70% nested inside IDLsuv60% to potentially enhance tumor specificity of the maximum point dose). Plan evaluations included histopathologic correspondence, isodose distributions, dose-volume histograms, tumor control probability (TCP), and normal tissue complication probability (NTCP). Results Planning objectives and dose constraints proved feasible in 30/30 cases. Prostate sextant histopathology was available from 28 cases, confirming that IDLsuv60% adequately covered all tumor-bearing prostate sextants in 27 cases and provided partial coverage in one case. Plan100-105Gy had significantly higher TCP than Plan79Gy across all prostate regions for α/β ratios ranging from 1.5 Gy to 10Gy (p < 0.001 each case). There were no significant differences in bladder and femoral head NTCP between plans, and slightly lower rectal NTCP (endpoint: grade 2+ late toxicity or rectal bleeding) for plan100-105Gy. Conclusion VMAT can potentially increase the likelihood of tumor control in primary prostate cancer while observing normal tissue tolerances through simultaneous delivery of a steep radiation boost to an 18F-fluorocholine PET-defined IDL. PMID:25832692

  4. Experience on IMRT treatment for prostate cancer. Planning, dosimetry and quality assurance; Experiencia en el tratamiento de IMRT en cancer de prostata. Planificacion, dosimetria y garantia de calidad

    Energy Technology Data Exchange (ETDEWEB)

    Gomez Barrado, A.; Garcia Vicente, F.; Fernandez Bedoya, V.; Zapatero Laborda, A.; Fernandez, I.; Bermudez Luna, R.; Perez Gonzalez, L.; Torres Escobar, J. J.

    2011-07-01

    In this study a revision concerning the treatment of prostate cancer with intensity-modulated radiation therapy (IMRT) is performed. Planning and verification of treatments involving dose calculations and image positioning are considered. A set of 110 patients is analysed concerning dosimetry and 92 considering image verification. Dose calculation is verified both experimentally and by means of a monitor unit (MU) calculation system. Positioning control of the prostate is achieved using intraprostatic fiducial markers and digitally reconstructed radiographs (DRRs) as well as a home-made software. All patients studied were consistent with the specifications of the treatment protocol regarding dose prescription in planning target volume (PTV), organ at risk (OAR) dose limitations, dosimetric quality assurance and positioning control. The procedure includes a learning curve considering every aspect of the treatment. The MU calculation system itself has been proved as an effective and functional tool for treatment verification. (Author) 12 refs.

  5. Can the National Health Service Cancer Plan timeline be applied to colorectal hepatic metastases?

    LENUS (Irish Health Repository)

    Jones, Claire

    2012-02-01

    INTRODUCTION: The National Health Service (NHS) Cancer Plan guidelines recommend a maximum 2-week wait from referral to first appointment, and 2 months from referral to treatment for primary cancers. However, there are currently no guidelines available for metastatic disease. In the UK, nearly half of all colorectal cancer patients develop hepatic metastases. Timely, surgical resection offers the potential for cure. The aim of this study was to audit current practice for colorectal liver metastases in a regional hepatobiliary unit, and compare this to the NHS Cancer Plan standards for primary disease. PATIENTS AND METHODS: A retrospective review of the unit\\'s database was performed for all hepatic metastases referrals from January 2006 to December 2008. The dates of referral, first appointment, investigations and initiation of treatment, along with patient\\'s age and sex, were recorded on Microsoft Excel and analysed. Time was expressed as mean +\\/- SD in days. RESULTS: A total of 102 patients with hepatic metastases were identified. Five were excluded due to incomplete data. The average time from referral to first appointment was 10.6 +\\/- 9.4 days and the average time from referral to treatment was 38.5 +\\/- 28.6 days. Seventy-five (72.7%) had surgical intervention, of whom 37 also had chemotherapy. CONCLUSIONS: The data compare favourably to the NHS Cancer Plan guidelines for primary malignancy, demonstrating that a regional hepatobiliary unit is capable of delivering a service for colorectal liver metastases that adheres to the NHS Cancer Plan. Therefore, the NHS Cancer Plan can be applied to this cohort.

  6. Induced abortion and breast cancer: results from a population-based case control study in China.

    Science.gov (United States)

    Wu, Jun-Qing; Li, Yu-Yan; Ren, Jing-Chao; Zhao, Rui; Zhou, Ying; Gao, Er-Sheng

    2014-01-01

    To determine whether induced abortion (IA) increases breast cancer (BC) risk. A population-based case-control study was performed from Dec, 2000 to November, 2004 in Shanghai, China, where IA could be verified through the family planning network and client medical records. Structured questionnaires were completed by 1,517 cases with primary invasive epithelial breast cancer and 1,573 controls frequency- matched to cases for age group. The information was supplemented and verified by the family planning records. Statistical analysis was conducted with SAS 9.0. After adjusting for potential confounders, induced abortions were not found to be associated with breast cancer with OR=0.94 (95%CI= 0.79-1.11). Compared to parous women without induced abortion, parous women with 3 or more times induced abortion (OR=0.66, 95%CI=0.46 to 0.95) and women with 3 or more times induced abortion after the first live birth (OR=0.66, 95%CI =0.45 to 0.97) showed a lower risk of breast cancer, after adjustment for age, level of education, annual income per capita, age at menarche, menopause, parity times, spontaneous abortion, age at first live birth, breast-feeding, oral contraceptives, hormones drug, breast disease, BMI, drinking alcohol, drinking tea, taking vitamin/calcium tablet, physical activity, vocation, history of breast cancer, eating the bean. The results suggest that a history of induced abortions may not increase the risk of breast cancer.

  7. Adaptive plan selection vs. re-optimisation in radiotherapy for bladder cancer: a dose accumulation comparison.

    Science.gov (United States)

    Vestergaard, Anne; Muren, Ludvig Paul; Søndergaard, Jimmi; Elstrøm, Ulrik Vindelev; Høyer, Morten; Petersen, Jørgen B

    2013-12-01

    Patients with urinary bladder cancer are obvious candidates for adaptive radiotherapy (ART) due to large inter-fractional variation in bladder volumes. In this study we have compared the normal tissue sparing potential of two ART strategies: daily plan selection (PlanSelect) and daily plan re-optimisation (ReOpt). Seven patients with bladder cancer were included in the study. For the PlanSelect strategy, a patient-specific library of three plans was generated, and the most suitable plan based on the pre-treatment cone beam CT (CBCT) was selected. For the daily ReOpt strategy, plans were re-optimised based on the CBCT from each daily fraction. Bladder contours were propagated to the CBCT scan using deformable image registration (DIR). Accumulated dose distributions for the ART strategies as well as the non-adaptive RT were calculated. A considerable sparing of normal tissue was achieved with both ART approaches, with ReOpt being the superior technique. Compared to non-adaptive RT, the volume receiving more than 57 Gy (corresponding to 95% of the prescribed dose) was reduced to 66% (range 48-100%) for PlanSelect and to 41% (range 33-50%) for ReOpt. This study demonstrated a considerable normal tissue sparing potential of ART for bladder irradiation, with clearly superior results by daily adaptive re-optimisation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Effect of glycemic control on the risk of pancreatic cancer

    OpenAIRE

    Er, Kian-Ching; Hsu, Chen-Yang; Lee, Yi-Kung; Huang, Ming-Yuan; Su, Yung-Cheng

    2016-01-01

    Abstract Although the relationship between diabetes and pancreatic cancer has been studied, the effects of glycemic control on pancreatic cancer have never been evaluated. This study investigates the relationship between glycemic control and pancreatic cancer. Data from 1 million National Health Insurance beneficiaries were screened. The study cohort consisted of 46,973 diabetic patients and 652,142 nondiabetic subjects. Of the patients with diabetes, 1114 who had been admitted for hyperglyce...

  9. Cancer Prevention and Control Research Manpower Development

    Science.gov (United States)

    1998-09-01

    is conclusive evidence that screening will decrease morality . The methods used to screen for breast cancer include Self Breast Examination, Clinical...Raciathnic Pattern of Cancer in United States. MMWR. 1991;40:754-757. the United States, 1973-1993. Rockville, Md: National Cancer 11. Escobedo LG

  10. Plan selection strategy for rectum cancer patients: An interobserver study to assess clinical feasibility.

    Science.gov (United States)

    de Jong, Rianne; Lutkenhaus, Lotte; van Wieringen, Niek; Visser, Jorrit; Wiersma, Jan; Crama, Koen; Geijsen, Debby; Bel, Arjan

    2016-08-01

    In radiotherapy for rectum cancer, the target volume is highly deformable. An adaptive plan selection strategy can mitigate the effect of these variations. The purpose of this study was to evaluate the feasibility of an adaptive strategy by assessing the interobserver variation in CBCT-based plan selection. Eleven patients with rectum cancer, treated with a non-adaptive strategy, were selected. Five CBCT scans were available per patient. To simulate the plan selection strategy, per patient three PTVs were created by varying the anterior upper mesorectum margin. For each CBCT scan, twenty observers selected the smallest PTV that encompassed the target volume. After this initial baseline measurement, the gold standard was determined during a consensus meeting, followed by a second measurement one month later. Differences between both measurements were assessed using the Wilcoxon signed-rank test. In the baseline measurement, the concordance with the gold standard was 69% (range: 60-82%), which improved to 75% (range: 60-87%) in the second measurement (p=0.01). For the second measurement, 10% of plan selections were smaller than the gold standard. With a plan selection consistency between observers of 75%, a plan selection strategy for rectum cancer patients is feasible. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Quality control of brachytherapy system module Oncentra MasterPlan V3.3 planning; Control de calidad del modulo de braquiterapia del sistema de planificacion Oncentra MasterPlan V3.3

    Energy Technology Data Exchange (ETDEWEB)

    Monja Ray, P. de la; Torres Pozas, S.; Sanchez Carrascal, M.; Macias Verde, D.; Martin Oliva, R.

    2011-07-01

    We present the results of quality control carried out the planning system (SP) MasterPlan Oncentra Brachy, version 3.3 (Nucletron), on the occasion of its launch, following the recommendations proposed in the Protocol for quality control in planning systems therapy with ionizing radiation [SEFM, published by the Spanish Society of Medical Physics (SEFM) in 2005].

  12. Treatment plan comparison of Linac step and shoot,Tomotherapy, RapidArc, and Proton therapy for prostate cancer using dosimetrical and biological index

    CERN Document Server

    Lee, Suk; Chang, Kyung Hwan; Shim, Jang Bo; Kim, Kwang Hyeon; Lee, Nam Kwon; Park, Young Je; Kim, Chul Yong; Cho, Sam Ju; Lee, Sang Hoon; Min, Chul Kee; Kim, Woo Chul; Cho, Kwang Hwan; Huh, Hyun Do; Lim, Sangwook; Shin, Dongho

    2015-01-01

    The purpose of this study was to use various dosimetrical indices to determine the best IMRT modality technique for treating patients with prostate cancer. Ten patients with prostate cancer were included in this study. Intensity modulated radiation therapy plans were designed to include different modalities, including the linac step and shoot, Tomotherapy, RapidArc, and Proton systems. Various dosimetrical indices, like the prescription isodose to target volume (PITV) ratio, conformity index (CI), homogeneity index (HI), target coverage index (TCI), modified dose homogeneity index (MHI), conformation number (CN), critical organ scoring index (COSI), and quality factor (QF) were determined to compare the different treatment plans. Biological indices such as the generalized equivalent uniform dose (gEUD), based tumor control probability (TCP), and normal tissue complication probability (NTCP) were also calculated and used to compare the treatment plans. The RapidArc plan attained better PTV coverage, as evidenc...

  13. Health Beliefs and Locus of Control as Predictors of Cancer ...

    African Journals Online (AJOL)

    OR= 0.35, p < 0.05), internal locus of control (OR = 1.43, p < 0.05) and health risks behaviour (OR= 0.42, p < 0.05) all significantly predicted cervical cancer screening behaviour of women. Keywords: Health beliefs, Health locus of control, cancer ...

  14. Child Cancer Control. Report on a Working Group.

    Science.gov (United States)

    World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

    This World Health Organization (WHO) report on the proceedings of a Working Group on Child Cancer Control was prepared by the WHO Regional Office for Europe. The working group met in Prague in April 1977 and was comprised of representatives from 14 European countries. Its task was to review existing methods of child cancer control, the efficacy of…

  15. Perceived control, adjustment, and communication problems in laryngeal cancer survivors.

    Science.gov (United States)

    Blood, G W; Dineen, M; Kauffman, S M; Raimondi, S C; Simpson, K C

    1993-12-01

    Health locus of control, adjustment to cancer, and communication experiences after a laryngectomy were investigated in 63 laryngeal cancer survivors. Survivors who showed internal control also scored as better adjusted and had fewer communication problems. Scales were intercorrelated (.68 to .92).

  16. Automation of radiation treatment planning. Evaluation of head and neck cancer patient plans created by the Pinnacle{sup 3} scripting and Auto-Planning functions

    Energy Technology Data Exchange (ETDEWEB)

    Speer, Stefan; Weiss, Alexander; Bert, Christoph [Universitaetsklinikum Erlangen, Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Department of Radiation Oncology, Erlangen (Germany); Klein, Andreas [EKS Engineering GmbH, Fuerth (Germany); Kober, Lukas [Strahlentherapie Tauber-Franken, Bad Mergentheim (Germany); Yohannes, Indra [Rinecker Proton Therapy Center, Munich (Germany)

    2017-08-15

    Intensity-modulated radiotherapy (IMRT) techniques are now standard practice. IMRT or volumetric-modulated arc therapy (VMAT) allow treatment of the tumor while simultaneously sparing organs at risk. Nevertheless, treatment plan quality still depends on the physicist's individual skills, experiences, and personal preferences. It would therefore be advantageous to automate the planning process. This possibility is offered by the Pinnacle{sup 3} treatment planning system (Philips Healthcare, Hamburg, Germany) via its scripting language or Auto-Planning (AP) module. AP module results were compared to in-house scripts and manually optimized treatment plans for standard head and neck cancer plans. Multiple treatment parameters were scored to judge plan quality (100 points = optimum plan). Patients were initially planned manually by different physicists and re-planned using scripts or AP. Script-based head and neck plans achieved a mean of 67.0 points and were, on average, superior to manually created (59.1 points) and AP plans (62.3 points). Moreover, they are characterized by reproducibility and lower standard deviation of treatment parameters. Even less experienced staff are able to create at least a good starting point for further optimization in a short time. However, for particular plans, experienced planners perform even better than scripts or AP. Experienced-user input is needed when setting up scripts or AP templates for the first time. Moreover, some minor drawbacks exist, such as the increase of monitor units (+35.5% for scripted plans). On average, automatically created plans are superior to manually created treatment plans. For particular plans, experienced physicists were able to perform better than scripts or AP; thus, the benefit is greatest when time is short or staff inexperienced. (orig.) [German] Intensitaetsmodulierte Strahlentherapie (IMRT) hat sich als Standard durchgesetzt. Mit IMRT oder volumenmodulierter Arc-Therapie (VMAT) lassen sich

  17. Implementation of Logic Flow in Planning and Production Control

    Directory of Open Access Journals (Sweden)

    Ulewicz Robert

    2016-03-01

    Full Text Available The article presents the results of analysis, the use of continuous flow of logic at the stage of production planning and control of the company producing furniture. The concept of continuous flow tends to regulate the flow of materials in a manner that provides the shortest flow path without unnecessary activities (Muda is a Japanese word meaning waste, a constant takt and defined throughput at constant resource requirements for the so-called transfer of material through the whole process. In the study Glenday’d sieve method was used to identify the correct area, which requires the value stream mapping, and areas called excessive complexity, which do not provide added value. The use of Glenday’s sieve method made it possible to identify areas in which it must be improve production capacity.

  18. Modeling Social Influence via Combined Centralized and Distributed Planning Control

    Science.gov (United States)

    Vaccaro, James; Guest, Clark

    2010-01-01

    Real world events are driven by a mixture of both centralized and distributed control of individual agents based on their situational context and internal make up. For example, some people have partial allegiances to multiple, contradictory authorities, as well as to their own goals and principles. This can create a cognitive dissonance that can be exploited by an appropriately directed psychological influence operation (PSYOP). An Autonomous Dynamic Planning and Execution (ADP&E) approach is proposed for modeling both the unperturbed context as well as its reaction to various PSYOP interventions. As an illustrative example, the unrest surrounding the Iranian elections in the summer of 2009 is described in terms applicable to an ADP&E modeling approach. Aspects of the ADP&E modeling process are discussed to illustrate its application and advantages for this example.

  19. Planning and control in fresh food supply chains

    DEFF Research Database (Denmark)

    Damgaard, Cecilie Maria; Chabada, Lukas; Dukovska-Popovska, Iskra

    2013-01-01

    directions. Design/methodology/approach The paper is based on a structured literature review of articles with the main focus on P&C of fresh food products. The review is based on a range of published works from main journals on supply chain management over the last 10 years. The gaps and challenges......Purpose The purpose of this paper is to determine the current state of research in the planning and control (P&C) literature in regards to fresh food supply chains (FFSC). Based on the literature review, important research areas are identified and serve as guidelines for defining future research...... in the literature are highlighted and used as a basis for discussion on future research. Findings The paper identifies seven major categories in the current research on P&C in FFSCs and proposes six areas for future research directions, namely balance between demand and supply, supply chain P&C, characteristics...

  20. [An endoscopy-guided plan of radiotherapy for detecting esophageal cancer using a lugol staining].

    Science.gov (United States)

    Kobayashi, H; Itoh, T; Kato, T; Fujita, Y; Murata, R; Tanabe, M; Kinashi, Y; Ono, K; Abe, M

    1990-04-01

    The Lugol staining method has lately come to play an important role in the detection of superficial esophageal cancers which are extremely difficult to detect by using only a barium double-contrasted esophagiogram and conventional esophagioscopy. Thus we have tested an endoscopy-guided plan of radiotherapy for detecting an esophageal cancer using Lugol stain. This method was found useful in detecting intraepithelial small lesions, such as intramural metastasis or multiple origin cancers. Additionally, it has been found useful in determining the definite shape of superficial malignant lesions by evaluating biopsy specimens taken from the border of the non-stained regions.

  1. 30 CFR 71.301 - Respirable dust control plan; approval by District Manager and posting.

    Science.gov (United States)

    2010-07-01

    ... District Manager and posting. 71.301 Section 71.301 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION... plan; approval by District Manager and posting. (a) The District Manager will approve respirable dust control plans on a mine-by-mine basis. When approving respirable dust control plans, the District Manager...

  2. Motion Planning and Dynamic Control of the Nomad 200 Mobile Robot in a Laboratory Environment.

    Science.gov (United States)

    1996-06-01

    Motion planning and control of a Nomad 200 mobile robot are studied in this thesis. The objective is to develop a motion planning and control...potential field algorithm is then combined with Dubin’s algorithm to incorporate orientation into motion planning . The combined algorithm is able to avoid

  3. Access to Accredited Cancer Hospitals Within Federal Exchange Plans Under the Affordable Care Act.

    Science.gov (United States)

    Kehl, Kenneth L; Liao, Kai-Ping; Krause, Trudy M; Giordano, Sharon H

    2017-02-20

    Purpose The Affordable Care Act expanded access to health insurance in the United States, but concerns have arisen about access to specialized cancer care within narrow provider networks. To characterize the scope and potential impact of this problem, we assessed rates of inclusion of Commission on Cancer (CoC) -accredited hospitals and National Cancer Institute (NCI) -designated cancer centers within federal exchange networks. Methods We downloaded publicly available machine-readable network data and public use files for individual federal exchange plans from the Centers for Medicare and Medicaid Services for the 2016 enrollment year. We linked this information to National Provider Identifier data, identified a set of distinct provider networks, and assessed the rates of inclusion of CoC-accredited hospitals and NCI-designated centers. We measured variation in these rates according to geography, plan type, and metal level. Results Of 4,058 unique individual plans, network data were available for 3,637 (90%); hospital information was available for 3,531 (87%). Provider lists for these plans reduced into 295 unique networks for analysis. Ninety-five percent of networks included at least one CoC-accredited hospital, but just 41% of networks included NCI-designated centers. States and counties each varied substantially in the proportion of networks listed that included NCI-designated centers (range, 0% to 100%). The proportion of networks that included NCI-designated centers also varied by plan type (range, 31% for health maintenance organizations to 49% for preferred provider organizations; P = .04) but not by metal level. Conclusion A large majority of federal exchange networks contain CoC-accredited hospitals, but most do not contain NCI-designated cancer centers. These results will inform policy regarding access to cancer care, and they reinforce the importance of promoting access to clinical trials and specialized care through community sites.

  4. Prioritizing strategies for comprehensive liver cancer control in Asia: a conjoint analysis.

    Science.gov (United States)

    Bridges, John F P; Dong, Liming; Gallego, Gisselle; Blauvelt, Barri M; Joy, Susan M; Pawlik, Timothy M

    2012-10-30

    Liver cancer is a complex and burdensome disease, with Asia accounting for 75% of known cases. Comprehensive cancer control requires the use of multiple strategies, but various stakeholders may have different views as to which strategies should have the highest priority. This study identified priorities across multiple strategies for comprehensive liver cancer control (CLCC) from the perspective of liver cancer clinical, policy, and advocacy stakeholders in China, Japan, South Korea and Taiwan. Concordance of priorities was assessed across the region and across respondent roles. Priorities for CLCC were examined as part of a cross-sectional survey of liver cancer experts. Respondents completed several conjoint-analysis choice tasks to prioritize 11 strategies. In each task, respondents judged which of two competing CLCC plans, consisting of mutually exclusive and exhaustive subsets of the strategies, would have the greatest impact. The dependent variable was the chosen plan, which was then regressed on the strategies of different plans. The restricted least squares (RLS) method was utilized to compare aggregate and stratified models, and t-tests and Wald tests were used to test for significance and concordance, respectively. Eighty respondents (69.6%) were eligible and completed the survey. Their primary interests were hepatitis (26%), hepatocellular carcinoma (HCC) (58%), metastatic liver cancer (10%) and transplantation (6%). The most preferred strategies were monitoring at-risk populations (peducation (pChina, measuring social burden (p=0.037) was valued higher in Taiwan, and national guidelines (p=0.025) was valued higher in China. Priorities did not differ across stakeholder groups (p=0.438). Priorities for CLCC in Asia include monitoring at-risk populations, clinician education, national guidelines, multidisciplinary management, public awareness and centers of excellence. As most priorities are relatively concordant across the region, multilateral approaches

  5. An investigation of the effects of therapeutic touch plan on acute chemotherapy-induced nausea in women with breast cancer in Isfahan, Iran, 2012-2013.

    Science.gov (United States)

    Matourypour, Pegah; Zare, Zahra; Mehrzad, Valiolah; Musarezaie, Amir; Dehghan, Mojtaba; Vanaki, Zohre

    2015-01-01

    Nausea is the worst and most prevalent chemotherapy-induced complication experienced by 70-80% of patients despite mediation therapy. Reduction of nausea is one of the most important roles of oncologist nurses. Today, complementary therapies in addition to classic medicine, because of their lower costs, receive much attention. Nonetheless, their safety and effectiveness are not yet proven. The purpose of this research was to investigate the effect of therapeutic touch plan as a complementary therapy on acute nausea in women with breast cancer in 2012-2013 in Isfahan, Iran. A quasi-experimental, single-blind, randomized control trial with three groups (control, placebo and intervention) was performed at the Isfahan Seyedolshohada (AS) Teaching Hospital, Isfahan, in 2012-2013. The intervention was therapeutic touch plan on women with breast cancer, with the three groups receiving the same medicine regimen. Information was recorded by a checklist after infusion of chemotherapy drugs. Data analysis was performed by SPSS, ANOVA and Kruskal-Wallis tests. The ANOVA test showed that the therapeutic touch plan was significantly effective in reducing the duration of nausea compared with the control and placebo groups (P touch plan was significantly effective in delaying the onset of nausea compared with the control and placebo groups (P touch plan is effective in reducing acute chemotherapy-induced nausea; thus, education and implementation of the therapeutic touch plan is proposed for clinical nurses.

  6. An investigation of the effects of therapeutic touch plan on acute chemotherapy-induced nausea in women with breast cancer in Isfahan, Iran, 2012–2013

    Science.gov (United States)

    Matourypour, Pegah; Zare, Zahra; Mehrzad, Valiolah; Musarezaie, Amir; Dehghan, Mojtaba; Vanaki, Zohre

    2015-01-01

    Introduction: Nausea is the worst and most prevalent chemotherapy-induced complication experienced by 70–80% of patients despite mediation therapy. Reduction of nausea is one of the most important roles of oncologist nurses. Today, complementary therapies in addition to classic medicine, because of their lower costs, receive much attention. Nonetheless, their safety and effectiveness are not yet proven. The purpose of this research was to investigate the effect of therapeutic touch plan as a complementary therapy on acute nausea in women with breast cancer in 2012–2013 in Isfahan, Iran. Materials and Methods: A quasi-experimental, single-blind, randomized control trial with three groups (control, placebo and intervention) was performed at the Isfahan Seyedolshohada (AS) Teaching Hospital, Isfahan, in 2012–2013. The intervention was therapeutic touch plan on women with breast cancer, with the three groups receiving the same medicine regimen. Information was recorded by a checklist after infusion of chemotherapy drugs. Data analysis was performed by SPSS, ANOVA and Kruskal–Wallis tests. Results: The ANOVA test showed that the therapeutic touch plan was significantly effective in reducing the duration of nausea compared with the control and placebo groups (P touch plan was significantly effective in delaying the onset of nausea compared with the control and placebo groups (P touch plan is effective in reducing acute chemotherapy-induced nausea; thus, education and implementation of the therapeutic touch plan is proposed for clinical nurses. PMID:26430688

  7. Cost effectiveness of a survivorship care plan for breast cancer survivors.

    Science.gov (United States)

    Coyle, Doug; Grunfeld, Eva; Coyle, Kathryn; Pond, Gregory; Julian, Jim A; Levine, Mark N

    2014-03-01

    Survivorship care plans (SCPs) are recommended for patients who have completed primary treatment and are transitioning to routine follow-up care. However, SCPs may be costly, and their effectiveness is unproven. The study objective was to assess the cost effectiveness of an SCP for breast cancer survivors transitioning to routine follow-up care with their own primary care physician (PCP) using data from a recent randomized controlled trial (RCT). Resource use and utility data for 408 patients with breast cancer enrolled in the RCT comparing an SCP with standard care (no SCP) were used. The intervention group received a 30-minute educational session with a nurse and their SCP, and their PCPs received the SCP plus a full guideline on follow-up. Analysis assessed the societal costs and quality-adjusted life years (QALYs) for the intervention group and the control group over the 2-year follow-up of the RCT. Uncertainty concerning cost effectiveness was assessed through nonparametric bootstrapping and deterministic sensitivity analysis. The no-SCP group had better outcomes than the SCP group: total costs per patient were lower for standard care (Canadian $698 v $765), and total QALYs were almost equivalent (1.42 for standard care v 1.41 for the SCP). The probability that the SCP was cost effective was 0.26 at a threshold value of a QALY of $50,000. A variety of sensitivity analyses did not change the conclusions of the analysis. This SCP would be costly to introduce and would not be a cost effective use of scarce health care resources.

  8. Optimized planning target volume margin in helical tomotherapy for prostate cancer: is there a preferred method?

    CERN Document Server

    Cao, Yuan Jie; Chang, Kyung Hwan; Shim, Jang Bo; Kim, Kwang Hyeon; Jang, Min Sun; Yoon, Won Sup; Yang, Dae Sik; Park, Young Je; Kim, Chul Yong

    2015-01-01

    To compare the dosimetrical differences between plans generated by helical tomotherapy using 2D or 3D margining technique in in prostate cancer. Ten prostate cancer patients were included in this study. For 2D plans, planning target volume (PTV) was created by adding 5 mm (lateral/anterior-posterior) to clinical target volume (CTV). For 3D plans, 5 mm margin was added not only in lateral/anterior-posterior, but also in superior-inferior to CTV. Various dosimetrical indices, including the prescription isodose to target volume (PITV) ratio, conformity index (CI), homogeneity index (HI), target coverage index (TCI), modified dose homogeneity index (MHI), conformation number (CN), critical organ scoring index (COSI), and quality factor (QF) were determined to compare the different treatment plans. Differences between 2D and 3D PTV indices were not significant except for CI (p = 0.023). 3D margin plans (11195 MUs) resulted in higher (13.0%) monitor units than 2D margin plans (9728 MUs). There were no significant d...

  9. Oral cancer prevention and control--the approach of the World Health Organization.

    Science.gov (United States)

    Petersen, Poul Erik

    2009-01-01

    Cancer is one of the most common causes of morbidity and mortality today. It is estimated that around 43% of cancer deaths are due to tobacco use, unhealthy diets, alcohol consumption, inactive lifestyles and infection. Low-income and disadvantaged groups are generally more exposed to avoidable risk factors such as environmental carcinogens, alcohol, infectious agents, and tobacco use. These groups also have less access to the health services and health education that would empower them to make decisions to protect and improve their own health. Oro-pharyngeal cancer is significant component of the global burden of cancer. Tobacco and alcohol are regarded as the major risk factors for oral cancer. The population-attributable risks of smoking and alcohol consumption have been estimated to 80% for males, 61% for females, and 74% overall. The evidence that smokeless tobacco causes oral cancer was confirmed recently by the International Agency for Research on Cancer. Studies have shown that heavy intake of alcoholic beverages is associated with nutrient deficiency, which appears to contribute independently to oral carcinogenesis. Oral cancer is preventable through risk factors intervention. Prevention of HIV infection will also reduce the incidence of HIV/AIDS-related cancers such as Kaposi sarcoma and lymphoma. The WHO Global Oral Health Programme is committed to work for country capacity building in oral cancer prevention, inter-country exchange of information and experiences from integrated approaches in prevention and health promotion, and the development of global surveillance systems for oral cancer and risk factors. The WHO Global Oral Health Programme has established a global surveillance system of oral cavity cancer in order to assess risk factors and to help the planning of effective national intervention programmes. Epidemiological data on oral cancer (ICD-10: C00-C08) incidence and mortality are stored in the Global Oral Health Data Bank. In 2007, the World

  10. SU-E-T-460: Comparison of Proton and IMRT Planning for Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fontenla, S; Zhou, Y; Kowalski, A [Memorial Sloan Kettering Cancer Center, NY, NY (United States); Mah, D [Procure Treatment Center, Somerset, NJ (United States); Leven, T [Procure Proton Therapy Cneter, Somerset, New Jersey (United States); Cahlon, O [ProCure Proton Therapy, Somerset, New Jersey (United States); Lee, N [Memorial Sloan Kettering cancer center, NY, NY (United States); Hunt, M [Mem Sloan-Kettering Cancer Ctr, NY, NY (United States); Mechalakos, J [Memorial Sloan-Kettering Cancer Center, NY, NY (United States)

    2014-06-01

    Purpose: A retrospective study comparing proton and intensity-modulated radiation therapy (IMRT) for head and neck cancer Methods: This study consists of six H and N cancer patients that underwent proton as well as IMRT planning. Patients analyzed had unilateral target volumes, one had prior RT. 3D-conformal proton therapy (3D-CPT) plans with multiple field uniform scanning were generated for delivery on the inclined beam line. IMRT was planned using fixed field sliding window. Final plan evaluations were performed by a radiation oncologist and a physicist. Metrics for comparison included tumor coverage, organ sparing with respect to spinal cord, brainstem, parotids, submandibulars, oral cavity, larynx, brachial plexus, cochleas, normal brain tissue, and skin using relevant indices for these structures. Dose volume histograms were generated as well as a qualitative comparison of isodose distributions between the two modalities. Planning and treatment delivery times were compared. Results: Results showed that IMRT plans offered better conformality in the high dose region as demonstrated by the conformality index for each plan. Ipsilateral cochlea, submandibular gland, and skin doses were lower with IMRT than proton therapy. There was significant sparing of larynx, oral cavity, and brainstem with proton therapy compared to IMRT. This translated into direct patient benefit with no evidence of hoarseness, mucositis, or nausea. Contralateral parotid and submandibular glands were equally spared. IMRT had shorter planning/parts fabrication and treatment times which needs to be taken into account when deciding modality. Conclusion: Sparing of clinically significant normal tissue structures such as oral cavity and larynx for unilateral H and N cancers was seen with 3D-CPT versus IMRT. However, this is at the expense of less conformality at the high dose region and higher skin dose. Future studies are needed with full gantry systems and pencil beam scanning as these

  11. Dosimetric benefit of adaptive re-planning in pancreatic cancer stereotactic body radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Li, Yongbao [Department of Engineering Physics, Tsinghua University, Key Laboratory of Particle & Radiation Imaging (Tsinghua University), Ministry of Education, Beijing (China); Center for Advanced Radiotherapy Technologies University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX (United States); Hoisak, Jeremy D.P.; Li, Nan; Jiang, Carrie [Center for Advanced Radiotherapy Technologies University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Tian, Zhen [Center for Advanced Radiotherapy Technologies University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX (United States); Gautier, Quentin; Zarepisheh, Masoud [Center for Advanced Radiotherapy Technologies University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Wu, Zhaoxia; Liu, Yaqiang [Department of Engineering Physics, Tsinghua University, Key Laboratory of Particle & Radiation Imaging (Tsinghua University), Ministry of Education, Beijing (China); Jia, Xun [Center for Advanced Radiotherapy Technologies University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of California San Diego, La Jolla, CA (United States); Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX (United States); and others

    2015-01-01

    Stereotactic body radiotherapy (SBRT) shows promise in unresectable pancreatic cancer, though this treatment modality has high rates of normal tissue toxicity. This study explores the dosimetric utility of daily adaptive re-planning with pancreas SBRT. We used a previously developed supercomputing online re-planning environment (SCORE) to re-plan 10 patients with pancreas SBRT. Tumor and normal tissue contours were deformed from treatment planning computed tomographies (CTs) and transferred to daily cone-beam CT (CBCT) scans before re-optimizing each daily treatment plan. We compared the intended radiation dose, the actual radiation dose, and the optimized radiation dose for the pancreas tumor planning target volume (PTV) and the duodenum. Treatment re-optimization improved coverage of the PTV and reduced dose to the duodenum. Within the PTV, the actual hot spot (volume receiving 110% of the prescription dose) decreased from 4.5% to 0.5% after daily adaptive re-planning. Within the duodenum, the volume receiving the prescription dose decreased from 0.9% to 0.3% after re-planning. It is noteworthy that variation in the amount of air within a patient's stomach substantially changed dose to the PTV. Adaptive re-planning with pancreas SBRT has the ability to improve dose to the tumor and decrease dose to the nearby duodenum, thereby reducing the risk of toxicity.

  12. Impact of field number and beam angle on functional image-guided lung cancer radiotherapy planning

    Science.gov (United States)

    Tahir, Bilal A.; Bragg, Chris M.; Wild, Jim M.; Swinscoe, James A.; Lawless, Sarah E.; Hart, Kerry A.; Hatton, Matthew Q.; Ireland, Rob H.

    2017-09-01

    To investigate the effect of beam angles and field number on functionally-guided intensity modulated radiotherapy (IMRT) normal lung avoidance treatment plans that incorporate hyperpolarised helium-3 magnetic resonance imaging (3He MRI) ventilation data. Eight non-small cell lung cancer patients had pre-treatment 3He MRI that was registered to inspiration breath-hold radiotherapy planning computed tomography. IMRT plans that minimised the volume of total lung receiving  ⩾20 Gy (V20) were compared with plans that minimised 3He MRI defined functional lung receiving  ⩾20 Gy (fV20). Coplanar IMRT plans using 5-field manually optimised beam angles and 9-field equidistant plans were also evaluated. For each pair of plans, the Wilcoxon signed ranks test was used to compare fV20 and the percentage of planning target volume (PTV) receiving 90% of the prescription dose (PTV90). Incorporation of 3He MRI led to median reductions in fV20 of 1.3% (range: 0.2-9.3% p  =  0.04) and 0.2% (range: 0 to 4.1%; p  =  0.012) for 5- and 9-field arrangements, respectively. There was no clinically significant difference in target coverage. Functionally-guided IMRT plans incorporating hyperpolarised 3He MRI information can reduce the dose received by ventilated lung without comprising PTV coverage. The effect was greater for optimised beam angles rather than uniformly spaced fields.

  13. Impact of grid size on uniform scanning and IMPT plans in XiO treatment planning system for brain cancer.

    Science.gov (United States)

    Rana, Suresh; Zheng, Yuanshui

    2015-09-08

    The main purposes of this study are to: 1) evaluate the accuracy of XiO treatment planning system (TPS) for different dose calculation grid size based on head phan-tom measurements in uniform scanning proton therapy (USPT); and 2) compare the dosimetric results for various dose calculation grid sizes based on real computed tomography (CT) dataset of pediatric brain cancer treatment plans generated by USPT and intensity-modulated proton therapy (IMPT) techniques. For phantom study, we have utilized the anthropomorphic head proton phantom provided by Imaging and Radiation Oncology Core (IROC). The imaging, treatment planning, and beam delivery were carried out following the guidelines provided by the IROC. The USPT proton plan was generated in the XiO TPS, and dose calculations were performed for grid size ranged from 1 to 3 mm. The phantom containing thermoluminescent dosimeter (TLDs) and films was irradiated using uniform scanning proton beam. The irradiated TLDs were read by the IROC. The calculated doses from the XiO for different grid sizes were compared to the measured TLD doses provided by the IROC. Gamma evaluation was done by comparing calculated planar dose distribution of 3 mm grid size with measured planar dose distribution. Additionally, IMPT plan was generated based on the same CT dataset of the IROC phantom, and IMPT dose calculations were performed for grid size ranged from 1 to 3 mm. For comparative purpose, additional gamma analysis was done by comparing the planar dose distributions of standard grid size (3 mm) with that of other grid sizes (1, 1.5, 2, and 2.5 mm) for both the USPT and IMPT plans. For patient study, USPT plans of three pediatric brain cancer cases were selected. IMPT plans were generated for each of three pediatric cases. All patient treatment plans (USPT and IMPT) were generated in the XiO TPS for a total dose of 54 Gy (relative biological effectiveness [RBE]). Treatment plans (USPT and IMPT) of each case was recalculated for grid

  14. Prostate Cancer Disparities throughout the Cancer Control Continuum

    Directory of Open Access Journals (Sweden)

    Kyle J. Dalton

    2013-11-01

    Full Text Available Prostate cancer (PCa is the most commonly diagnosed malignancy and the second leading cause of cancer deaths among men in the United States. The American Cancer Society estimates that 238,590 U.S. men will develop PCa and 29,720 men will die from the disease in 2013. PCa exhibits the most profound racial disparities of all cancers with African American men having a 70% higher incidence rate and more than two times higher mortality rate than Caucasian men. Published research on PCa disparities focuses on singular outcomes such as incidence, mortality or quality of life. The objective of this paper is to provide a comprehensive summary of the racial disparities found at each stage of the PCa Care Continuum which includes prevention, detection, treatments, and outcomes and survival. It focuses primarily on disparities among Caucasian (white and African American men.

  15. The history and use of cancer registry data by public health cancer control programs in the United States.

    Science.gov (United States)

    White, Mary C; Babcock, Frances; Hayes, Nikki S; Mariotto, Angela B; Wong, Faye L; Kohler, Betsy A; Weir, Hannah K

    2017-12-15

    Because cancer registry data provide a census of cancer cases, registry data can be used to: 1) define and monitor cancer incidence at the local, state, and national levels; 2) investigate patterns of cancer treatment; and 3) evaluate the effectiveness of public health efforts to prevent cancer cases and improve cancer survival. The purpose of this article is to provide a broad overview of the history of cancer surveillance programs in the United States, and illustrate the expanding ways in which cancer surveillance data are being made available and contributing to cancer control programs. The article describes the building of the cancer registry infrastructure and the successful coordination of efforts among the 2 federal agencies that support cancer registry programs, the Centers for Disease Control and Prevention and the National Cancer Institute, and the North American Association of Central Cancer Registries. The major US cancer control programs also are described, including the National Comprehensive Cancer Control Program, the National Breast and Cervical Cancer Early Detection Program, and the Colorectal Cancer Control Program. This overview illustrates how cancer registry data can inform public health actions to reduce disparities in cancer outcomes and may be instructional for a variety of cancer control professionals in the United States and in other countries. Cancer 2017;123:4969-76. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  16. CT images and radiotherapy treatment planning of patients with breast cancer: A dataset

    Directory of Open Access Journals (Sweden)

    Mohammad Rezaei

    2017-08-01

    Full Text Available The data presented here were originally collected for the research project “CT-Scan processing and analysis in patient with breast cancer after radiotherapy”. Also, it reported in our study “Prediction of Lung Tissue Damage by Evaluating Clinical and Dosimetric Parameters in Breast Cancer Patients” (Hasanabdali et al., 2016 [1]. This article describes and directly links to 52 subjects referred to Mahdieh Oncology and Radiotherapy Center from February to August 2015. Treatment planning was done for delivering 50 Gy dose to PTV in 25 fractions. the lungs and heart objects were extracted from CT images along with compliance Dose plan. Dose-volume histogram (DVH and Dose-mass histogram (DMH extracted using CT images and dose plan matrix. Moreover, the complete clinical and dosimetric specifications of subjects is attached.

  17. Feasibility of preference-driven radiotherapy dose treatment planning to support shared decision making in anal cancer

    DEFF Research Database (Denmark)

    Rønde, Heidi S; Wee, Leonard; Pløen, John

    2017-01-01

    dose plans must be simultaneously explored. We quantified the degree to which different toxicity priorities might be incorporated into treatment plan selection, to elucidate the feasible decision space for shared decision making in anal cancer radiotherapy. MATERIAL AND METHODS: Retrospective plans...... that preference-informed dose planning is feasible for clinical studies utilizing shared decision making.......PURPOSE/OBJECTIVE: Chemo-radiotherapy is an established primary curative treatment for anal cancer, but clinically equal rationale for different target doses exists. If joint preferences (physician and patient) are used to determine acceptable tradeoffs in radiotherapy treatment planning, multiple...

  18. Pregnancy after breast cancer: the importance of active counselling and planning.

    Science.gov (United States)

    Rippy, E E; Karat, I F; Kissin, M W

    2009-12-01

    To investigate the effect of breast cancer, its treatment and counselling on future pregnancy and fertility. Three hundred and four women 45 years and younger at the time of diagnosis of breast cancer were identified from one breast unit from 1997 to 2006. A questionnaire was sent to all patients asking about pregnancy, counselling and fertility issues. Of 304 women, 248 were still alive and not lost to follow up. The questionnaire response rate was 66% and the average follow up was 60 months. By questionnaire response, 39 women had wanted children before diagnosis, and 24 still wanted them post treatment, giving a successful pregnancy rate of 75%. Eighteen patients have become pregnant, 4 with more than one pregnancy. 107 patients were specifically counselled about fertility prior to breast cancer treatment. The mortality due to breast cancer was 10% in non-pregnant patients and 6% in patients who became pregnant after breast cancer. Pregnancy after breast cancer does not confer a poor prognosis. A higher rate of pregnancy than expected was found after treatment, possibly due to newer treatments including fertility preservation and also possibly due to the active counselling programme in this unit. Patients should have active counselling about fertility when planning treatment and fertility conservation can then be incorporated into a treatment plan.

  19. 75 FR 59179 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

    Science.gov (United States)

    2010-09-27

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control Techniques Guidelines for Flexible Packaging Printing AGENCY: Environmental Protection... Available Control Technology (RACT) for sources covered by EPA's Control Techniques Guidelines (CTG) for...

  20. Cervical cancer control, priorities and new directions.

    NARCIS (Netherlands)

    Monsonego, J; Bosch, F.X.; Coursaget, P.; Cox, JT; Franco, E; Frazer, I; Sankaranarayanan, R; Schiller, J; Singer, A; Wright, TCJr; Kinney, W; Meijer, C.J.L.M.; Linder, J

    2004-01-01

    99% of cervical cancer is initiated by HPV infection. The estimated lifetime risk of cervical cancer is nevertheless relatively low (less than 1 in 20 for most community based studies). Although sensitivity and specificity of the available diagnostic techniques are suboptimal, screening for

  1. Strategic planning by the palliative care steering committee of the Middle East Cancer Consortium.

    Science.gov (United States)

    Moore, Shannon Y; Pirrello, Rosene D; Christianson, Sonya K; Ferris, Frank D

    2011-04-01

    High quality comprehensive palliative care is a critical need for millions of patients and families, but remains only a dream in many parts of the world. The failure to do a strategic planning process is one obstacle to advancing education and pain prevention and relief. The Middle Eastern Cancer Consortium Steering Committee attendees completed an initial strategic planning process and identified "developmental steps" to advance palliative care. Underscoring the multi-disciplinary nature of comprehensive palliative care, discipline-specific planning was done (adult and pediatric cancer and medicine, pharmacy, nursing) in a separate process from country-specific planning. Delineating the layers of intersection and differences between disciplines and countries was very powerful. Finding the common strengths and weaknesses in the status quo creates the potential for a more powerful regional response to the palliative care needs. Implementing and refining these preliminary strategic plans will augment and align the efforts to advance palliative care education and pain management in the Middle East. The dream to prevent and relieve suffering for millions of patients with advanced disease will become reality with a powerful strategic planning process well implemented.

  2. MRI-alone radiation therapy planning for prostate cancer: Automatic fiducial marker detection

    Energy Technology Data Exchange (ETDEWEB)

    Ghose, Soumya, E-mail: soumya.ghose@case.edu; Mitra, Jhimli [Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106 and CSIRO Health and Biosecurity, The Australian e-Health & Research Centre, Herston, QLD 4029 (Australia); Rivest-Hénault, David; Fazlollahi, Amir; Fripp, Jurgen; Dowling, Jason A. [CSIRO Health and Biosecurity, The Australian e-Health & Research Centre, Herston, QLD 4029 (Australia); Stanwell, Peter [School of health sciences, The University of Newcastle, Newcastle, NSW 2308 (Australia); Pichler, Peter [Department of Radiation Oncology, Cavalry Mater Newcastle Hospital, Newcastle, NSW 2298 (Australia); Sun, Jidi; Greer, Peter B. [School of Mathematical and Physical Sciences, The University of Newcastle, Newcastle, NSW 2308, Australia and Department of Radiation Oncology, Cavalry Mater Newcastle Hospital, Newcastle, NSW 2298 (Australia)

    2016-05-15

    Purpose: The feasibility of radiation therapy treatment planning using substitute computed tomography (sCT) generated from magnetic resonance images (MRIs) has been demonstrated by a number of research groups. One challenge with an MRI-alone workflow is the accurate identification of intraprostatic gold fiducial markers, which are frequently used for prostate localization prior to each dose delivery fraction. This paper investigates a template-matching approach for the detection of these seeds in MRI. Methods: Two different gradient echo T1 and T2* weighted MRI sequences were acquired from fifteen prostate cancer patients and evaluated for seed detection. For training, seed templates from manual contours were selected in a spectral clustering manifold learning framework. This aids in clustering “similar” gold fiducial markers together. The marker with the minimum distance to a cluster centroid was selected as the representative template of that cluster during training. During testing, Gaussian mixture modeling followed by a Markovian model was used in automatic detection of the probable candidates. The probable candidates were rigidly registered to the templates identified from spectral clustering, and a similarity metric is computed for ranking and detection. Results: A fiducial detection accuracy of 95% was obtained compared to manual observations. Expert radiation therapist observers were able to correctly identify all three implanted seeds on 11 of the 15 scans (the proposed method correctly identified all seeds on 10 of the 15). Conclusions: An novel automatic framework for gold fiducial marker detection in MRI is proposed and evaluated with detection accuracies comparable to manual detection. When radiation therapists are unable to determine the seed location in MRI, they refer back to the planning CT (only available in the existing clinical framework); similarly, an automatic quality control is built into the automatic software to ensure that all gold

  3. Comprehensive Cancer Control Partners’ Use of and Attitudes About Evidence-Based Practices

    Science.gov (United States)

    Rose, John M.; Townsend, Julie S.; Fonseka, Jamila; Richardson, Lisa C.; Chovnick, Gary

    2015-01-01

    Introduction National Comprehensive Cancer Control Program (NCCCP) awardees are encouraged to work with partners (eg, nonprofit organizations) to develop and implement plans to reduce the cancer burden in their jurisdictions using evidence-based practices (EBPs). However, the extent of EBP use among awardees and their partners is not well understood. Methods From March through July 2012, we conducted a web-based survey of program partners referred by NCCCP program directors who were involved in implementation of cancer control plans. Results Approximately 53% of referred partners (n = 83) completed surveys, 91.6% of whom represented organizations. Most partners reported involvement in helping to identify (80.5%), adapt (81.7%), implement (90.4%), and evaluate (81.9%) EBPs. The factors rated most frequently as very important when selecting EBPs were “consistent with our organization’s mission” (89.2%) and “cost-effective” (81.9%). Although most respondents said that their organizations understood the importance of using EBPs (84.3%) and had adequate access to cancer registry data (74.7%), few reported having sufficient financial resources to develop new EBPs (7.9%). The most frequently mentioned benefit of using EBPs was that they are proven to work. Resource limitations and difficulty adapting EBPs for specific populations and settings were challenges. Conclusions Our findings help indicate how NCCCP partners are involved in using EBPs and can guide ongoing efforts to encourage the use of EBPs for cancer control. The challenges of using EBPs that partners identified highlight the need to improve strategies to translate cancer prevention and control research into practice in real-world settings and for diverse populations. PMID:26182148

  4. Comprehensive Cancer Control Partners' Use of and Attitudes About Evidence-Based Practices.

    Science.gov (United States)

    Steele, C Brooke; Rose, John M; Townsend, Julie S; Fonseka, Jamila; Richardson, Lisa C; Chovnick, Gary

    2015-07-16

    National Comprehensive Cancer Control Program (NCCCP) awardees are encouraged to work with partners (eg, nonprofit organizations) to develop and implement plans to reduce the cancer burden in their jurisdictions using evidence-based practices (EBPs). However, the extent of EBP use among awardees and their partners is not well understood. From March through July 2012, we conducted a web-based survey of program partners referred by NCCCP program directors who were involved in implementation of cancer control plans. Approximately 53% of referred partners (n = 83) completed surveys, 91.6% of whom represented organizations. Most partners reported involvement in helping to identify (80.5%), adapt (81.7%), implement (90.4%), and evaluate (81.9%) EBPs. The factors rated most frequently as very important when selecting EBPs were "consistent with our organization's mission" (89.2%) and "cost-effective" (81.9%). Although most respondents said that their organizations understood the importance of using EBPs (84.3%) and had adequate access to cancer registry data (74.7%), few reported having sufficient financial resources to develop new EBPs (7.9%). The most frequently mentioned benefit of using EBPs was that they are proven to work. Resource limitations and difficulty adapting EBPs for specific populations and settings were challenges. Our findings help indicate how NCCCP partners are involved in using EBPs and can guide ongoing efforts to encourage the use of EBPs for cancer control. The challenges of using EBPs that partners identified highlight the need to improve strategies to translate cancer prevention and control research into practice in real-world settings and for diverse populations.

  5. 21 CFR 120.8 - Hazard Analysis and Critical Control Point (HACCP) plan.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Hazard Analysis and Critical Control Point (HACCP... SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION HAZARD ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS General Provisions § 120.8 Hazard Analysis and Critical Control Point (HACCP) plan. (a) HACCP plan. Each...

  6. 75 FR 59084 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Control Technique...

    Science.gov (United States)

    2010-09-27

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Maryland; Control... Plan (SIP) revision submitted by the State of Maryland. This SIP revision pertains to the control of... amending its regulations by adopting the requirements of EPA's Control Technique Guidelines (CTG) for Paper...

  7. 75 FR 59180 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Control Technique...

    Science.gov (United States)

    2010-09-27

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Maryland; Control... and Promulgation of Air Quality Implementation Plans; Maryland; Control Technique Guidelines for Paper... adopting the requirements of EPA's Control Technique Guidelines (CTG) for paper, film, and foil coatings...

  8. 40 CFR 93.120 - Consequences of control strategy implementation plan failures.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Consequences of control strategy... Consequences of control strategy implementation plan failures. (a) Disapprovals. (1) If EPA disapproves any submitted control strategy implementation plan revision (with or without a protective finding), the...

  9. A study of the plan dosimetric evaluation on the rectal cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Hyun Hak; An, Beom Seok; Kim, Dae Il; Lee, Yang Hoon; Lee, Je Hee [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-12-15

    In order to minimize the dose of femoral head as an appropriate treatment plan for rectal cancer radiation therapy, we compare and evaluate the usefulness of 3-field 3D conformal radiation therapy(below 3fCRT), which is a universal treatment method, and 5-field 3D conformal radiation therapy(below 5fCRT), and Volumetric Modulated Arc Therapy (VMAT). The 10 cases of rectal cancer that treated with 21EX were enrolled. Those cases were planned by Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28) and AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). 3fCRT and 5fCRT plan has 0 degrees, 270 degrees, 90 degrees and 0 degrees, 95 degrees, 45 degrees, 315 degrees, 265 degrees gantry angle, respectively. VMAT plan parameters consisted of 15MV coplanar 360 degrees 1 arac. Treatment prescription was employed delivering 54Gy to recum in 30 fractions. To minimize the dose difference that shows up randomly on optimizing, VMAT plans were optimized and calculated twice, and normalized to the target V100%=95%. The indexes of evaluation are D of Both femoral head and aceta fossa, total MU, H.I.(Homogeneity index) and C.I.(Conformity index) of the PTV. All VMAT plans were verified by gamma test with portal dosimetry using EPID. D of Rt. femoral head was 53.08 Gy, 50.27 Gy, and 30.92 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. D of Rt. aceta fossa was 54.86 Gy, 52.40 Gy, 30.37 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. The maximum dose of both femoral head and aceta fossa was higher in the order of 3fCRT, 5fCRT, and VMAT treatment plan. C.I. showed the lowest VMAT treatment plan with an average of 1.64, 1.48, and 0.99 in the order of 3fCRT, 5fCRT, and VMAT treatment plan. There was no significant difference on H

  10. PENGUJIAN PERSONAL FINANCIAL BEHAVIOR, PLANNED BEHAVIOR TERHADAP SELF CONTROL BEHAVIOR DENGAN THEORY PLANNED OF BEHAVIOR

    Directory of Open Access Journals (Sweden)

    Adrie Putra

    2014-07-01

    Full Text Available Penelitian ini bertujuan untuk memberikan gambaran dan bukti tentang pentingnya perilakupengelolaan keuangan. Pengelolaan keuangan yang baik pada dasarnya sangat dibutuhkan karena dengan pengelolaan keuangan yang baik akan meningkatkan kesejahteraan. Berdasarkan data dari Badan Pusat Statistik (BPS peningkatan kesejahteraan baik barang maupun konsumsi pangan meningkat dari 47,71% menjadi 50,66%, hal ini menjadi cermin pentingnya pengelolaan keuangan. Didasarkan pada Theory Planned of Behavior, bahwa perilaku merupakan fungsi dari informasi atau keyakinan yang menonjol mengenai perilaku tersebut. Orang dapat saja memiliki berbagai macam keyakinan terhadap suatu perilaku, namun ketika dihadapkan pada suatu kejadian tertentu, hanya sedikit dari keyakinan tersebut yang timbul untuk memengaruhi perilaku. Sedikit keyakinan inilah yang menonjol dalam memengaruhi perilaku individu. Berdasarkan pentingnya pengelolaan keuangan tersebut, penelitian ini bermaksud untuk memberikan bukti tentang perilaku pengelolaan keuangan,yang tercermin dari perilaku dan sikap yang digambarkan dengan variable ; power prestige, retention time, subjective norms, behavioral control, intentions, behaviors dan conscientiousness. Penelitian ini menggunakan analisis jalur dimana objek pada penelitian ini adalah mahasiswa aktif yang ada pada Universitas di Jakarta.

  11. Planning and control of automated material handling systems: The merge module

    OpenAIRE

    Haneyah, S.W.A.; Johann L. Hurink; Schutten, Johannes M.J.; Zijm, Willem H.M.; Schuur, Peter; Hu, Bo; Morasch, Karl; Pickl, Stefan; Siegle, Markus

    2011-01-01

    We address the field of internal logistics, embodied in Automated Material Handling Systems (AMHSs), which are complex installations employed in sectors such as Baggage Handling, Physical Distribution, and Parcel & Postal. We work on designing an integral planning and real-time control architecture, and a set of generic algorithms for AMHSs. Planning and control of these systems need to be robust, and to yield close-to-optimal system performance. Currently, planning and control of AMHSs is hi...

  12. The Lancet Oncology's Cancer Control in Africa | Michael | Annals of ...

    African Journals Online (AJOL)

    In April 2013 the Lancet Oncology published a series on cancer control in Africa comprising 7 papers (Lancet Oncology vol 14 number 4). The significance of these papers to Africa's attempts at tackling the rapidly rising prevalence of cancer cannot be over-emphasized. Potentially, these papers will form the basis of ...

  13. THE LANCET ONCOLOGY'S CANCER CONTROL IN AFRICA O.S. ...

    African Journals Online (AJOL)

    In April 2013 the Lancet Oncology published a series on cancer control in Africa comprising 7 papers (Lancet Oncology vol 14 number 4). The significance of these papers to Africa's attempts at tackling the rapidly rising prevalence of cancer cannot be over-emphasized. Potentially, these papers will form the basis of ...

  14. Regional Cancer Control in South-Eastern Nigeria: A Proposal ...

    African Journals Online (AJOL)

    There is an impending cancer epidemic in Africa. In Nigeria, this disease is causing untold devastation, and control measures are desperately needed. Breast, cervical, prostate, and liver cancers are the most common types in Nigerian adults. In children, the predominant malignant diseases are Burkitt's lymphoma, acute ...

  15. Control of breast cancer using health education | Nzarubara | East ...

    African Journals Online (AJOL)

    Objective: Todetermine theefficacy of massscreening in the control of primary breast cancer among a selected group of women from Mpigi district, Uganda. Design: Qualitative study by comparing the level of knowledge of risk factors, attitude and practice to breast cancer and the ability to carry out self breast examination ...

  16. Constrained motion control on a hemispherical surface: path planning.

    Science.gov (United States)

    Berman, Sigal; Liebermann, Dario G; McIntyre, Joseph

    2014-03-01

    Surface-constrained motion, i.e., motion constraint by a rigid surface, is commonly found in daily activities. The current work investigates the choice of hand paths constrained to a concave hemispherical surface. To gain insight regarding paths and their relationship with task dynamics, we simulated various control policies. The simulations demonstrated that following a geodesic path (the shortest path between 2 points on a sphere) is advantageous not only in terms of path length but also in terms of motor planning and sensitivity to motor command errors. These stem from the fact that the applied forces lie in a single plane (that of the geodesic path). To test whether human subjects indeed follow the geodesic, and to see how such motion compares to other paths, we recorded movements in a virtual haptic-visual environment from 11 healthy subjects. The task comprised point-to-point motion between targets at two elevations (30° and 60°). Three typical choices of paths were observed from a frontal plane projection of the paths: circular arcs, straight lines, and arcs close to the geodesic path for each elevation. Based on the measured hand paths, we applied k-means blind separation to divide the subjects into three groups and compared performance indicators. The analysis confirmed that subjects who followed paths closest to the geodesic produced faster and smoother movements compared with the others. The "better" performance reflects the dynamical advantages of following the geodesic path and may also reflect invariant features of control policies used to produce such a surface-constrained motion.

  17. Dosimetric evaluation of synthetic CT for magnetic resonance-only based radiotherapy planning of lung cancer.

    Science.gov (United States)

    Wang, Hesheng; Chandarana, Hersh; Block, Kai Tobias; Vahle, Thomas; Fenchel, Matthias; Das, Indra J

    2017-06-26

    Interest in MR-only treatment planning for radiation therapy is growing rapidly with the emergence of integrated MRI/linear accelerator technology. The purpose of this study was to evaluate the feasibility of using synthetic CT images generated from conventional Dixon-based MRI scans for radiation treatment planning of lung cancer. Eleven patients who underwent whole-body PET/MR imaging following a PET/CT exam were randomly selected from an ongoing prospective IRB-approved study. Attenuation maps derived from the Dixon MR Images and atlas-based method was used to create CT data (synCT). Treatment planning for radiation treatment of lung cancer was optimized on the synCT and subsequently copied to the registered CT (planCT) for dose calculation. Planning target volumes (PTVs) with three sizes and four different locations in the lung were planned for irradiation. The dose-volume metrics comparison and 3D gamma analysis were performed to assess agreement between the synCT and CT calculated dose distributions. Mean differences between PTV doses on synCT and CT across all the plans were -0.1% ± 0.4%, 0.1% ± 0.5%, and 0.4% ± 0.5% for D95, D98 and D100, respectively. Difference in dose between the two datasets for organs at risk (OARs) had average differences of -0.14 ± 0.07 Gy, 0.0% ± 0.1%, and -0.1% ± 0.2% for maximum spinal cord, lung V20, and heart V40 respectively. In patient groups based on tumor size and location, no significant differences were observed in the PTV and OARs dose-volume metrics (p > 0.05), except for the maximum spinal-cord dose when the target volumes were located at the lung apex (p = 0.001). Gamma analysis revealed a pass rate of 99.3% ± 1.1% for 2%/2 mm (dose difference/distance to agreement) acceptance criteria in every plan. The synCT generated from Dixon-based MRI allows for dose calculation of comparable accuracy to the standard CT for lung cancer treatment planning. The dosimetric agreement

  18. Use of Positron Emission Tomography/Computed Tomography in Radiation Treatment Planning for Lung Cancer

    Directory of Open Access Journals (Sweden)

    Kezban Berberoğlu

    2016-06-01

    Full Text Available Radiotherapy (RT plays an important role in the treatment of lung cancer. Accurate diagnosis and staging are crucial in the delivery of RT with curative intent. Target miss can be prevented by accurate determination of tumor contours during RT planning. Currently, tumor contours are determined manually by computed tomography (CT during RT planning. This method leads to differences in delineation of tumor volume between users. Given the change in RT tools and methods due to rapidly developing technology, it is now more significant to accurately delineate the tumor tissue. F18 fluorodeoxyglucose positron emission tomography/CT (F18 FDG PET/CT has been established as an accurate method in correctly staging and detecting tumor dissemination in lung cancer. Since it provides both anatomic and biologic information, F18 FDG PET decreases interuser variability in tumor delineation. For instance, tumor volumes may be decreased as atelectasis and malignant tissue can be more accurately differentiated, as well as better evaluation of benign and malignant lymph nodes given the difference in FDG uptake. Using F18 FDG PET/CT, the radiation dose can be escalated without serious adverse effects in lung cancer. In this study, we evaluated the contribution of F18 FDG PET/CT for RT planning in lung cancer.

  19. Current concepts in F18 FDG PET/CT-based Radiation Therapy planning for Lung Cancer

    Directory of Open Access Journals (Sweden)

    Percy eLee

    2012-07-01

    Full Text Available Radiation therapy is an important component of cancer therapy for early stage as well as locally advanced lung cancer. The use of F18 FDG PET/CT has come to the forefront of lung cancer staging and overall treatment decision-making. FDG PET/CT parameters such as standard uptake value and metabolic tumor volume provide important prognostic and predictive information in lung cancer. Importantly, FDG PET/CT for radiation planning has added biological information in defining the gross tumor volume as well as involved nodal disease. For example, accurate target delineation between tumor and atelectasis is facilitated by utilizing PET and CT imaging. Furthermore, there has been meaningful progress in incorporating metabolic information from FDG PET/CT imaging in radiation treatment planning strategies such as radiation dose escalation based on standard uptake value thresholds as well as using respiratory gated PET and CT planning for improved target delineation of moving targets. In addition, PET/CT based follow-up after radiation therapy has provided the possibility of early detection of local as well as distant recurrences after treatment. More research is needed to incorporate other biomarkers such as proliferative and hypoxia biomarkers in PET as well as integrating metabolic information in adaptive, patient-centered, tailored radiation therapy.

  20. Integrated Motion Planning and Autonomous Control Technology for Autonomous ISR Project

    Data.gov (United States)

    National Aeronautics and Space Administration — SSCI and MIT propose to design, implement and test a comprehensive Integrated Mission Planning & Autonomous Control Technology (IMPACT) for Autonomous ISR...

  1. Evaluating efficiency of split VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes

    Energy Technology Data Exchange (ETDEWEB)

    Mun, Jun Ki; Son, Sang Jun; Kim, Dae Ho; Seo, Seok Jin [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2015-12-15

    The purpose of this study is to evaluate the efficiency of Split VMAT planning(Contouring rectum divided into an upper and a lower for reduce rectum dose) compare to Conventional VMAT planning(Contouring whole rectum) for prostate cancer radiotherapy involving pelvic lymph nodes. A total of 9 cases were enrolled. Each case received radiotherapy with Split VMAT planning to the prostate involving pelvic lymph nodes. Treatment was delivered using TrueBeam STX(Varian Medical Systems, USA) and planned on Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28), AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). Lower rectum contour was defined as starting 1 cm superior and ending 1 cm inferior to the prostate PTV, upper rectum is a part, except lower rectum from the whole rectum. Split VMAT plan parameters consisted of 10 MV coplanar 360° arcs. Each arc had 30° and 30° collimator angle, respectively. An SIB(Simultaneous Integrated Boost) treatment prescription was employed delivering 50.4 Gy to pelvic lymph nodes and 63- 70 Gy to the prostate in 28 fractions. D{sub mean} of whole rectum on Split VMAT plan was applied for DVC(Dose Volume Constraint) of the whole rectum for Conventional VMAT plan. In addition, all parameters were set to be the same of existing treatment plans. To minimize the dose difference that shows up randomly on optimizing, all plans were optimized and calculated twice respectively using a 0.2 cm grid. All plans were normalized to the prostate PTV{sub 100%} = 90% or 95%. A comparison of D{sub mean} of whole rectum, upperr ectum, lower rectum, and bladder, V{sub 50%} of upper rectum, total MU and H.I.(Homogeneity Index) and C.I.(Conformity Index) of the PTV was used for technique evaluation. All Split VMAT plans were verified by gamma test with portal dosimetry using EPID. Using DVH analysis, a difference between the Conventional and the Split VMAT plans was demonstrated. The Split VMAT plan demonstrated better in the D

  2. The Polaris Oncology Survivorship Transition (POST) System: A Patient- and Provider-Driven Cancer Survivorship Planning Program.

    Science.gov (United States)

    O'Hea, Erin; Wu, Juliet; Dietzen, Laura; Harralson, Tina; Boudreaux, Edwin D

    2016-11-01

    It is strongly recommended that individuals ending treatment for cancer have a "survivorship plan," and new standards require survivorship planning for accreditation, However, a comprehensive plan is often neglected. To present the development and field test results of a web-based, breast cancer survivorship care planning system. The Polaris Oncology Survivorship Transition (POST) blends input from the electronic health record (EHR), oncology care providers (OCPs), and patients to create a survivorship care plan (SCP). The content of the POST program was created with the assistance of end-user input (patients, oncologists, and primary care providers (PCPs)) and the full program was piloted on women ending treatment for breast cancer. This paper presents the pilot study that field-tested the POST In a clinical setting. Patients were recruited from outpatient care clinics and chemotherapy units in a comprehensive care center. The study included 25 women ending treatment for breast cancer in the past year, 4 OCPs, and PCPs. Patients received the POST computeπzed assessment and a tailored SCP. The POST assists providers in crafting efficient and comprehensive SCPs and was rated highly satisfactory by all end-users. The POST program can be used as a cancer survivorship planning program to assist OCPs in care planning for their patients ending treatment for breast cancer. This study provides support for Incorporating computerized SCP programs into clinical practice. Use of the POST in clinical practice has the potential to improve survivorship planning.

  3. Effect of education on knowledge, attitude and behavioral intention in family relative with colorectal cancer patients based on theory of planned behavior.

    Science.gov (United States)

    Baghianimoghadam, Mohammad Hosein; Ardakani, Mojtaba Fattahi; Akhoundi, Mohsen; Mortazavizadeh, Mohammad Reza; Fallahzadeh, Mohammad Hosein; Baghianimoghadam, Behnam

    2012-01-01

    Colorectal cancer is one of most common cancers in women and men and one of the major causes of death due to neoplasia. Colonoscopy is considered as the most accurate diagnostic procedure to detect colorectal cancer at the earlier stages. The current study aimed to evaluate the effects of an education program using the Theory of Planned Behavior on promoting behavioral intention among first degree relatives of colorectal cancer patients. A quasi-experimental study conducted to evaluate the effectiveness of an educational program to promote attitudinal factors associated with early detection of colorectal cancer in 99 first degree relatives of colorectal cancer patients aged more than 20 years in Yazd city, Iran. A researcher made questionnaire forwhich validity and reliability were confirmed by expert point of view and pilot testing was employed for data collection. Questionnaires were filled in before and after educational intervention. The registered data were transferred to SPSS 19 and analyzed by paired T-test, Man-Whitney and Wilcaxon. Mean scores of knowledge, attitude, perceived behavioral control and intention regarding colorectal cancer increased after education significantly (PTheory of Planned Behavior has positive influence on promoting intention behavior. It is therefore recommended to apply educational programs to promote behavioral intention.

  4. NRE70/9: Plan de Control Interno, auditorias y otras actividades a desarrollar por la Oficina de Control Interno

    OpenAIRE

    Universidad de Granada

    2013-01-01

    Resoluci??n del Rectorado de la Universidad de Granada por la que se aprueba el Plan de Control Interno, auditorias y otras actividades a desarrollar por la Oficina de Control Interno durante el ejercicio 2013.

  5. SU-F-J-101: Stereotactic Body Radiation Therapy Planning for Primary Prostate Cancer with Selective Intraprostatic Boost Determined by 18F-Choline PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Wu, L [Cancer Hospital of Shantou University Medical College, Shantou, Guangdong (China); Wang, H; Kuang, Y [University of Nevada Las Vegas, Las Vegas, NV (United States); Hirata, E; Kwee, S [Queen’s Medical Center, Honolulu, HI (United States)

    2016-06-15

    Purpose: To investigate the utility of {sup 18}F-choline positron emission tomography (PET) scans guidance for SBRT dose painting in patients with prostate cancer and its impact on tumor control probability (TCP) and normal tissue complication probability (NTCP). Methods: Twenty seven patients with localized prostate cancer who had {sup 18}F-choline PET/CT scan prior to treatment were included. A pair of nested intraprostatic dominant lesion (IDL) contours (IDL{sub suv60%} and IDL{sub suv70%}) were generated for each patient based on 60% and 70% of maximum prostate uptake on the {sup 18}F-choline PET images. GTV{sub reg} was delineated on prostate according to the gland boundary seen on CT images. The PTVs (PTV{sub suv60%} and PTV{sub suv70%}) were defined as respective IDLs with a 3-mm margin posteriorly and 5 mm in all other dimensions. Two 5-fraction SBRT plans using VMAT technique along with 10 MV FFF beams, plan{sub 36Gy} and plan{sub 50–55Gy}, were generated for each patient. All plans included a dose of 36.25 Gy prescribed to PTV{sub reg}. The Plan{sub 50–55Gy} also included a simultaneous boost dose of 50 Gy and 55 Gy prescribed to the PTV{sub suv60%} and PTV{sub suv70%}, respectively. The utility of {sup 18}F-Choline PET-guided SBRT dose escalation was evaluated by its ability to achieve the prescription dose objectives while adhering to organ-at-risk (OAR) dose constraints. The TCP and NTCP calculated by radiological models were also compared between two plans for each patient. Results: In all 54 SBRT plans generated, the planning objectives and dose constraints were met without exception. Plan{sub 50–55Gy} had a significantly higher dose in PTV{sub suv60%} and PTV{sub suv70%} than those in Plan{sub 36Gy} (p < 0.05), respectively, while still maintaining a safe OAR sparing profile. In addition, plan{sub 50–55Gy} had significantly higher TCP than plan{sub 36Gy}. Conclusion: Using VMAT with FFF beams to incorporate a simultaneous {sup 18}F

  6. Path Planning and Trajectory Control of Collaborative Mobile Robots Using Hybrid Control Architecture

    Directory of Open Access Journals (Sweden)

    Trevor Davies

    2008-08-01

    Full Text Available This paper presents the development and implementation a hybrid control architecture to direct a collective of three X80 mobile robots to multiple user-defined waypoints. The Genetic Algorithm Path Planner created an optimized, reduction in the time to complete the task, path plan for each robot in the collective such that each waypoint was visited once without colliding with a priori obstacles. The deliberative Genetic Algorithm Path Planner was then coupled with a reactive Potential Field Trajectory Planner and kinematic based controller to create a hybrid control architecture allowing the mobile robot to navigate between multiple user-defined waypoints, while avoiding a priori obstacles and obstacles detected using the robots' range sensors. The success of this hybrid control architecture was proven through simulation and experimentation using three of Dr. Robot's ™ wireless X80 mobile robots.

  7. Pain Control: Support for People with Cancer

    Science.gov (United States)

    ... do, this booklet includes tips about managing your pain with medicine and other treatments. PDF Kindle ePub This booklet covers: The types and causes of cancer pain How to talk about your pain with your ...

  8. Cancer Prevention and Control Research Manpower Development

    Science.gov (United States)

    1999-10-01

    Gestational Diabetes , Sickle Cell Anemia in the laboratories of Jayduff Vadgama, P.D. and of Steven Taylor, M.D. at Charles Drew University of Medicine...Ethnic differences in food consumption in the U-S:Relevance to cancer prevalence . In: Diet, Nutrition and Cancer, proceedings of the Fourth Annual...life events such as sick- nessanddeah (agaw-Siger 198).ment was found-the Suinn-Lew Asian Self-Identity Wes Acculturation Scale (Suinn, Ahuman, & Khoo

  9. Comparison of the dose distribution obtained from dosimetric systems with intensity modulated radiotherapy planning system in the treatment of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gökçe, M., E-mail: mgokce@adu.edu.tr; Uslu, D. Koçyiğit [Adnan Menderes University Faculty of Arts and Sciences, Department of Physics, Aydın (Turkey); Ertunç, C. [Pamukkale University Faculty of Medicine, Department of Radiation Oncology, Denizli (Turkey); Karalı, T. [Ege University Institute of Nuclear Sciences, Izmir (Turkey)

    2016-03-25

    The aim of this study is to compare Intensity Modulated Radiation Therapy (IMRT) plan of prostate cancer patients with different dose verification systems in dosimetric aspects and to compare these systems with each other in terms of reliability, applicability and application time. Dosimetric control processes of IMRT plan of three prostate cancer patients were carried out using thermoluminescent dosimeter (TLD), ion chamber (IC) and 2D Array detector systems. The difference between the dose values obtained from the dosimetric systems and treatment planning system (TPS) were found to be about % 5. For the measured (TLD) and calculated (TPS) doses %3 percentage differences were obtained for the points close to center while percentage differences increased at the field edges. It was found that TLD and IC measurements will increase the precision and reliability of the results of 2D Array.

  10. Trajectories of personal control in cancer patients receiving psychological care

    NARCIS (Netherlands)

    Zhu, Lei; Schroevers, Maya J.; van der Lee, Marije; Garssen, Bert; Stewart, Roy E.; Sanderman, Robbert; Ranchor, A.V.

    2015-01-01

    Objective This study aimed to (1) identify subgroups of cancer patients with distinct personal control trajectories during psychological care, (2) examine whether socio-demographic, clinical, and psychological care characteristics could distinguish trajectories, and (3) examine differential patterns

  11. Trajectories of personal control in cancer patients receiving psychological care

    NARCIS (Netherlands)

    Zhu, Lei; Schroevers, Maya J.; van der Lee, Marije; Garssen, Bert; Stewart, Roy E.; Sanderman, Robbert; Ranchor, Adelita V.

    Objective: This study aimed to (1) identify subgroups of cancer patients with distinct personal control trajectories during psychological care, (2) examine whether socio-demographic, clinical, and psychological care characteristics could distinguish trajectories, and (3) examine differential

  12. Risk Factors for Pancreatic Cancer in China: A Multicenter Case-Control Study

    OpenAIRE

    Zhaoxu Zheng

    2016-01-01

    Background: Despite having one of the highest mortality rates of all cancers, the risk factors of pancreatic cancer remain unclear. We assessed risk factors of pancreatic cancer in China. Methods: A case-control study design was conducted using data from four hospital-based cancer registries (Henan Provincial Cancer Hospital, Beijing Cancer Hospital, Hebei Provincial Cancer Hospital, and Cancer Hospital of Chinese Academy of Medical Sciences). Controls were equally matched and selected fro...

  13. Quality control for cervical cancer treatments on Hdr brachytherapy with Ir-192

    Energy Technology Data Exchange (ETDEWEB)

    Alvarino B, G.; Cogollo P, R.; Paez M, M., E-mail: lvarinog@hotmail.com [Universidad de Cordoba, Physics and Electronics Department, Carrera 6 No. 76-103, Monteria, Cordoba (Colombia)

    2013-10-01

    This work, developed at the National Cancer Institute in partnership with Universidad Nacional de Colombia located in Bogota, Colombia, presents the results of simulations of cervical cancer treatments, on Hdr brachytherapy with Ir-192, using as a physical simulator a natural female pelvis bone with soft tissue elaborated with the experimental material JJT. The doses were measured experimentally, prior to dosimetric characterization, with crystal thermoluminescence 100 LiF: Mg, Ti, located in the organs at risk: rectum and bladder. On the other hand, these treatments were planned and calculated theoretically by the system Micro-Selectron Hdr, with Plato brachytherapy software V 14.1 from the Netherlands Nucletron, and doses obtained in the same organs were compared with experimental results using dosimeters. The comparison of these results shows the correlation degree between the planning of dosimetric treatments and the experimental results, making the process in a form of quality control in vivo, of this type of procedure. (Author)

  14. Current academic clinical trials in ovarian cancer: Gynecologic Cancer Intergroup and US National Cancer Institute Clinical Trials Planning Meeting, May 2009.

    Science.gov (United States)

    Trimble, Edward L; Birrer, Michael J; Hoskins, William J; Marth, Christian; Petryshyn, Ray; Quinn, Michael; Thomas, Gillian M; Kitchener, Henry C; Aghajanian, Carol; Alberts, David S; Armstrong, Deborah; Brown, Jubilee; Coleman, Robert L; Colombo, Nicoletta; Eisenhauer, Elizabeth; Friedlander, Michael; Fujiwara, Keiichi; Hunsberger, Sally; Kaye, Stan; Ledermann, Jonathan A; Lee, Susanna; Look, Katherine; Mannel, Robert; McNeish, Iain A; Minasian, Lori; Oza, Amit; Paul, Jim; Poveda, Andres; Pujade-Lauraine, Eric; Schoenfeldt, Mason; Swart, Ann Marie; von Gruenigen, Vivian; Wenzel, Lari

    2010-10-01

    To review the current status of large phase academic clinical trials for women with ovarian cancer, address cross-cutting issues, and identify promising areas for future collaboration. In May 2009, the Gynecologic Cancer Intergroup, which represents 19 Cooperative Groups conducting trials for women with gynecologic cancer, and the US National Cancer Institute convened a Clinical Trials Planning Meeting. The topics covered included the impact of new developments in cancer biology upon molecular targets and novel agents, pharmacogenomics, advances in imaging, the potential benefit of diet and exercise to reduce the risk of recurrence, academic partnership with industry, statistical considerations for phases 2 and 3 trials, trial end points, and symptom benefit and health-related quality-of-life issues. The clinical trials discussed spanned the spectrum of ovarian cancer from initial diagnosis, staging, and cytoreductive surgery to consolidation chemotherapy, and treatment of recurrent disease. Ongoing and effective collaboration with industry, government, and patients aims to ensure that the most important scientific questions can be answered rapidly. We encourage women with ovarian cancer and their oncologists to consider participation in the academic clinical trials conducted by the member groups of the Gynecologic Cancer Intergroup.

  15. When Planning Results in Loss of Control: Intention-Based Reflexivity and Working-Memory

    Directory of Open Access Journals (Sweden)

    Nachshon eMeiran

    2012-05-01

    Full Text Available In this review, the authors discuss the seemingly paradoxical loss of control associated with states of high readiness to execute a plan, termed intention-based reflexivity. The review suggests that the neuro-cognitive systems involved in the preparation of novel plans are different than those involved in preparation of practiced plans (i.e., those that have been executed beforehand. When the plans are practiced, intention based reflexivity depends on the prior availability of response codes in long-term memory. When the plans are novel, reflexivity is observed when the plan is pending and the goal has not yet been achieved. Intention-based reflexivity also depends on the availability of working memory limited resources and the motivation to prepare. Reflexivity is probably related to the fact that, unlike reactive control (once a plan is prepared, proactive control tends to be relatively rigid.

  16. When planning results in loss of control: intention-based reflexivity and working-memory.

    Science.gov (United States)

    Meiran, Nachshon; Cole, Michael W; Braver, Todd S

    2012-01-01

    In this review, the authors discuss the seemingly paradoxical loss of control associated with states of high readiness to execute a plan, termed "intention-based reflexivity." The review suggests that the neuro-cognitive systems involved in the preparation of novel plans are different than those involved in preparation of practiced plans (i.e., those that have been executed beforehand). When the plans are practiced, intention-based reflexivity depends on the prior availability of response codes in long-term memory (LTM). When the plans are novel, reflexivity is observed when the plan is pending and the goal has not yet been achieved. Intention-based reflexivity also depends on the availability of working-memory (WM) limited resources and the motivation to prepare. Reflexivity is probably related to the fact that, unlike reactive control (once a plan is prepared), proactive control tends to be relatively rigid.

  17. When planning results in loss of control: intention-based reflexivity and working-memory

    OpenAIRE

    Meiran, Nachshon; Cole, Michael W.; Braver, Todd S.

    2012-01-01

    In this review, the authors discuss the seemingly paradoxical loss of control associated with states of high readiness to execute a plan, termed “intention-based reflexivity.” The review suggests that the neuro-cognitive systems involved in the preparation of novel plans are different than those involved in preparation of practiced plans (i.e., those that have been executed beforehand). When the plans are practiced, intention-based reflexivity depends on the prior availability of response cod...

  18. Clinical implementation of coverage probability planning for nodal boosting in locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Ramlov, Anne; Assenholt, Marianne S; Jensen, Maria F

    2017-01-01

    PURPOSE: To implement coverage probability (CovP) for dose planning of simultaneous integrated boost (SIB) of pathologic lymph nodes in locally advanced cervical cancer (LACC). MATERIAL AND METHODS: CovP constraints for SIB of the pathological nodal target (PTV-N) with a central dose peak...... regression during EBRT. Total EBRT and BT D98 was >57 GyEQD2 in 98% of the visible nodes. Compared to treatment plans aiming for full PTV-N coverage, CovP significantly reduced V50 of body, bones and bowel (pclinically feasible for SIB of pathological nodes and significantly...

  19. Radiobiological Impact of Planning Techniques for Prostate Cancer ...

    African Journals Online (AJOL)

    Department of Medical Physics,. Pro Cure Proton Therapy Center,. 5901 West Memorial Road, Oklahoma. City 73142, USA. E‑mail: suresh.rana@gmail.com. Introduction. The primary objective of radiation therapy is to deliver enough radiation to the tumor to control it without irradiating normal tissues to a dose that will lead ...

  20. Anti-viral treatment and cancer control.

    Science.gov (United States)

    Shih, Wei-Liang; Fang, Chi-Tai; Chen, Pei-Jer

    2014-01-01

    Hepatitis B virus (HBV), hepatitis C virus (HCV), human papillomavirus (HPV), and Epstein-Barr virus (EBV) contribute to about 10-15 % global burden of human cancers. Conventional chemotherapy or molecular target therapies have been used to treat virus-associated cancers. However, a more proactive approach would be the use of antiviral treatment to suppress or eliminate viral infections to prevent the occurrence of cancer in the first place. Antiviral treatments against chronic HBV and HCV infections have achieved this goal, with significant reduction in the incidence of hepatocellular carcinoma in treated patients. Antiviral treatments for EBV, Kaposi's sarcoma-associated herpesvirus (KSHV), and human T-cell lymphotropic virus type 1 (HTLV-1) had limited success in treating refractory EBV-associated lymphoma and post-transplant lymphoproliferative disorder, KSHV-associated Kaposi's sarcoma in AIDS patients, and HTLV-1-associated acute, chronic, and smoldering subtypes of adult T-cell lymphoma, respectively. Therapeutic HPV vaccine and RNA-interference-based therapies for treating HPV-associated cervical cancers also showed some encouraging results. Taken together, antiviral therapies have yielded promising results in cancer prevention and treatment. More large-scale studies are necessary to confirm the efficacy of antiviral therapy. Further investigation for more effective and convenient antiviral regimens warrants more attention.

  1. Animal Control Plan Iroquois National Wildlife refuge 1969

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Waterfowl production objectives, according to the Iroquois National Wildlife Refuge Master Plan, are to create habitat supporting the production of 8,000 ducks and...

  2. Bombay Hook National Wildlife Refuge Animal Control Management Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The Bombay Hook National Wildlife Furbearer Management Plan directs the management and regulation of trapping. The furbearer management program directly supports the...

  3. Dosimetric advantages of generalised equivalent uniform dose-based optimisation on dose–volume objectives in intensity-modulated radiotherapy planning for bilateral breast cancer

    Science.gov (United States)

    Lee, T-F; Ting, H-M; Chao, P-J; Wang, H-Y; Shieh, C-S; Horng, M-F; Wu, J-M; Yeh, S-A; Cho, M-Y; Huang, E-Y; Huang, Y-J; Chen, H-C; Fang, F-M

    2012-01-01

    Objective We compared and evaluated the differences between two models for treating bilateral breast cancer (BBC): (i) dose–volume-based intensity-modulated radiation treatment (DV plan), and (ii) dose–volume-based intensity-modulated radiotherapy with generalised equivalent uniform dose-based optimisation (DV-gEUD plan). Methods The quality and performance of the DV plan and DV-gEUD plan using the Pinnacle3® system (Philips, Fitchburg, WI) were evaluated and compared in 10 patients with stage T2–T4 BBC. The plans were delivered on a Varian 21EX linear accelerator (Varian Medical Systems, Milpitas, CA) equipped with a Millennium 120 leaf multileaf collimator (Varian Medical Systems). The parameters analysed included the conformity index, homogeneity index, tumour control probability of the planning target volume (PTV), the volumes V20 Gy and V30 Gy of the organs at risk (OAR, including the heart and lungs), mean dose and the normal tissue complication probability. Results Both plans met the requirements for the coverage of PTV with similar conformity and homogeneity indices. However, the DV-gEUD plan had the advantage of dose sparing for OAR: the mean doses of the heart and lungs, lung V20 Gy, and heart V30 Gy in the DV-gEUD plan were lower than those in the DV plan (p<0.05). Conclusions A better result can be obtained by starting with a DV-generated plan and then improving it by adding gEUD-based improvements to reduce the number of iterations and to improve the optimum dose distribution. Advances to knowledge The DV-gEUD plan provided superior dosimetric results for treating BBC in terms of PTV coverage and OAR sparing than the DV plan, without sacrificing the homogeneity of dose distribution in the PTV. PMID:23091290

  4. 75 FR 59086 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

    Science.gov (United States)

    2010-09-27

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control Techniques Guidelines for Flexible Packaging Printing AGENCY: Environmental Protection... Processes, and meets the requirement to adopt Reasonably Available Control Technology (RACT) for sources...

  5. \\t Capital Planning and Investment Control (CPIC) for the Management of Information Technology Investments

    Science.gov (United States)

    Capital Planning and Investment Control (CPIC) is the Information Technology (IT) governance and management methodology in use at EPA for selecting, controlling and evaluating the performance of EPA IT investments throughout the full lifecycle.

  6. 78 FR 34306 - Approval and Promulgation of Air Quality Implementation Plans: North Carolina; Control Techniques...

    Science.gov (United States)

    2013-06-07

    ... From the Federal Register Online via the Government Publishing Office ] ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans: North Carolina; Control Techniques Guidelines and Reasonably Available Control Technology AGENCY: Environmental Protection...

  7. 76 FR 27622 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

    Science.gov (United States)

    2011-05-12

    ... Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control Techniques Guidelines for Large... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control Techniques Guidelines for Large Appliance Coatings AGENCY: Environmental Protection Agency...

  8. Effect of crisis plans on admissions and emergency visits: A randomized controlled trial

    NARCIS (Netherlands)

    A. Ruchlewska (Asia); A.I. Wierdsma (André); A.M. Kamperman (Astrid); M. van der Gaag (Mark); R. Smulders (Renee); B.J. Roosenschoon (Bert); C.L. Mulder (Niels)

    2014-01-01

    textabstractObjective: To establish whether patients with a crisis plan had fewer voluntary or involuntary admissions, or fewer outpatient emergency visits, than patients without such a plan. Design: Multicenter randomized controlled trial with two intervention conditions and one control condition.

  9. Assisted Perception, Planning and Control for Remote Mobility and Dexterous Manipulation

    Science.gov (United States)

    2017-04-01

    ASSISTED PERCEPTION , PLANNING AND CONTROL FOR REMOTE MOBILITY AND DEXTEROUS MANIPULATION MASSACHUSETTS INSTITUTE OF TECHNOLOGY APRIL 2017 FINAL...including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing...DATES COVERED (From - To) SEP 2012 – AUG 2016 4. TITLE AND SUBTITLE ASSISTED PERCEPTION , PLANNING AND CONTROL FOR REMOTE MOBILITY AND DEXTEROUS

  10. Dose planning objectives in anal canal cancer IMRT: the TROG ANROTAT experience

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Elizabeth, E-mail: elizabeth@mebrown.net [Princess Alexandra Hospital, Brisbane, Queensland (Australia); Cray, Alison [Peter MacCallum Cancer Cancer Centre, Box Hill, Victoria (Australia); Haworth, Annette [Peter MacCallum Cancer Cancer Centre, Box Hill, Victoria (Australia); University of Melbourne, Melbourne, Victoria (Australia); Chander, Sarat [Peter MacCallum Cancer Cancer Centre, Box Hill, Victoria (Australia); Lin, Robert [Medica Oncology, Hurstville, New South Wales (Australia); Subramanian, Brindha; Ng, Michael [Radiation Oncology Victoria, Melbourne, Victoria (Australia); Princess Alexandra Hospital, Brisbane, Queensland (Australia)

    2015-06-15

    Intensity modulated radiotherapy (IMRT) is ideal for anal canal cancer (ACC), delivering high doses to irregular tumour volumes whilst minimising dose to surrounding normal tissues. Establishing achievable dose objectives is a challenge. The purpose of this paper was to utilise data collected in the Assessment of New Radiation Oncology Treatments and Technologies (ANROTAT) project to evaluate the feasibility of ACC IMRT dose planning objectives employed in the Australian situation. Ten Australian centres were randomly allocated three data sets from 15 non-identifiable computed tomography data sets representing a range of disease stages and gender. Each data set was planned by two different centres, producing 30 plans. All tumour and organ at risk (OAR) contours, prescription and dose constraint details were provided. Dose–volume histograms (DVHs) for each plan were analysed to evaluate the feasibility of dose planning objectives provided. All dose planning objectives for the bone marrow (BM) and femoral heads were achieved. Median planned doses exceeded one or more objectives for bowel, external genitalia and bladder. This reached statistical significance for bowel V30 (P = 0.04), V45 (P < 0.001), V50 (P < 0.001), external genitalia V20 (P < 0.001) and bladder V35 (P < 0.001), V40 (P = 0.01). Gender was found to be the only significant factor in the likelihood of achieving the bowel V50 (P = 0.03) and BM V30 constraints (P = 0.04). The dose planning objectives used in the ANROTAT project provide a good starting point for ACC IMRT planning. To facilitate clinical implementation, it is important to prioritise OAR objectives and recognise factors that affect the achievability of these objectives.

  11. 'Admission into a helping plan': a watershed between positive and negative experiences in breast cancer.

    Science.gov (United States)

    Lilliehorn, Sara; Hamberg, Katarina; Kero, Anneli; Salander, Pär

    2010-08-01

    Cancer patients are in an exposed situation that raises certain psychosocial needs in contact with health care. Previous studies have mainly investigated these needs by assessments on pre-defined categories. The purpose of the present study is, from the patients' perspective, to identify breast cancer patients' psychosocial needs, and to synthesise them in a model reflecting the core of these needs. Seventy-one patients treated with radiation therapy were consecutively included and repeatedly interviewed about their experiences of health care. 'Critical incidents' where identified from the interviews and analysed due to the similarities-differences technique in grounded theory. Four categories of needs where detected: 'access', 'information', 'treatment' and 'how approached'. These categories and their properties merged into a core category--'admission into a helping plan'. These findings are well understood in terms of attachment theory. In times of imminent danger and stress people strive to find a 'safe haven' to attach to. Cancer patients' 'safe haven' can be described as 'a helping plan'. It is not the result of a separate patient-caregiver relationship but is created by a pattern of individual experiences from all kind of contacts with the health-care system as a whole. The presented model of patients needs as converging into 'admission into a helping plan' may serve as an easily comprehendible model for caregivers, guiding them to contribute to the patient's feeling of security and trust, and thus to the patient's own 'hope work'. (c) 2009 John Wiley & Sons, Ltd.

  12. Control of cervical cancer: women's options and rights.

    Science.gov (United States)

    Cain, Joanna M; Ngan, Hextan; Garland, Suzanne; Wright, Thomas

    2009-08-01

    Cervical cancer takes the lives of more than 250,000 women each year globally, particularly in under-resourced areas of low-, middle-, and high-income countries. Options for cancer control and treatment have reached a point that there are interventions for control that could be adopted for virtually every resource and demographic situation. Women die despite the availability of attractive control options, which means that educating policy makers, women's health professionals, as well as women themselves, must become a major focus for ongoing control of this disease. The human right to life, to prevention of suffering, and to education are all key rights linked to improving the control of cervical cancer and saving the lives of women, particularly in resource-poor parts of the world.

  13. Geospatial Approaches to Cancer Control and Population Sciences.

    Science.gov (United States)

    Schootman, Mario; Gomez, Scarlett Lin; Henry, Kevin A; Paskett, Electra D; Ellison, Gary L; Oh, April; Taplin, Stephen H; Tatalovich, Zaria; Berrigan, David A

    2017-04-01

    Cancer incidence and mortality display strong geographic patterns worldwide and in the United States (1, 2). The environment where individuals live, work, and play is increasingly being recognized as important across the cancer control continuum, including the risk of cancer development, detection, diagnosis, treatment, mortality, and survivorship (3-5). At the same time, emergent technological capacity in geographic information systems (GIS) and mapping, along with increasing sophistication in applied spatial methods, has resulted in a growing research community developing and applying geospatial approaches in health research (5). Through collaborative, transdisciplinary efforts, and continued data collection efforts, there is great potential to apply these emerging geospatial approaches to various aspects of cancer prevention and control to inform etiology and target interventions and implementation of efficacious risk-reducing strategies. Cancer Epidemiol Biomarkers Prev; 26(4); 472-5. ©2017 AACRSee all the articles in this CEBP Focus section, "Geospatial Approaches to Cancer Control and Population Sciences." ©2017 American Association for Cancer Research.

  14. Radiation therapy planning with photons and protons for early and advanced breast cancer: an overview

    Directory of Open Access Journals (Sweden)

    Lomax Antony J

    2006-07-01

    Full Text Available Abstract Postoperative radiation therapy substantially decreases local relapse and moderately reduces breast cancer mortality, but can be associated with increased late mortality due to cardiovascular morbidity and secondary malignancies. Sophistication of breast irradiation techniques, including conformal radiotherapy and intensity modulated radiation therapy, has been shown to markedly reduce cardiac and lung irradiation. The delivery of more conformal treatment can also be achieved with particle beam therapy using protons. Protons have superior dose distributional qualities compared to photons, as dose deposition occurs in a modulated narrow zone, called the Bragg peak. As a result, further dose optimization in breast cancer treatment can be reasonably expected with protons. In this review, we outline the potential indications and benefits of breast cancer radiotherapy with protons. Comparative planning studies and preliminary clinical data are detailed and future developments are considered.

  15. Transoral resection of pharyngeal cancer: summary of a National Cancer Institute Head and Neck Cancer Steering Committee Clinical Trials Planning Meeting, November 6-7, 2011, Arlington, Virginia.

    Science.gov (United States)

    Adelstein, David J; Ridge, John A; Brizel, David M; Holsinger, F Christopher; Haughey, Bruce H; O'Sullivan, Brian; Genden, Eric M; Beitler, Jonathan J; Weinstein, Gregory S; Quon, Harry; Chepeha, Douglas B; Ferris, Robert L; Weber, Randal S; Movsas, Benjamin; Waldron, John; Lowe, Val; Ramsey, Scott; Manola, Judith; Yueh, Bevan; Carey, Thomas E; Bekelman, Justin E; Konski, Andre A; Moore, Eric; Forastiere, Arlene; Schuller, David E; Lynn, Jean; Ullmann, Claudio Dansky

    2012-12-01

    Recent advances now permit resection of many pharyngeal tumors through the open mouth, an approach that can greatly reduce the morbidity of surgical exposure. These transoral techniques are being rapidly adopted by the surgical community and hold considerable promise. On November 6-7, 2011, the National Cancer Institute sponsored a Clinical Trials Planning Meeting to address how to further investigate the use of transoral surgery, both in the good prognosis human papillomavirus (HPV)-initiated oropharyngeal cancers, and in those with HPV-unrelated disease. The proceedings of this meeting are summarized. Copyright © 2012 Wiley Periodicals, Inc.

  16. Irradiation with protons for the individualized treatment of patients with locally advanced rectal cancer: a planning study with clinical implications.

    Science.gov (United States)

    Wolff, Hendrik Andreas; Wagner, Daniela Melanie; Conradi, Lena-Christin; Hennies, Steffen; Ghadimi, Michael; Hess, Clemens Friedrich; Christiansen, Hans

    2012-01-01

    Ongoing clinical trials aim to improve local control and overall survival rates by intensification of therapy regimen for patients with locally advanced rectal cancer. It is well known that whenever treatment is intensified, risk of therapy-related toxicity rises. An irradiation with protons could possibly present an approach to solve this dilemma by lowering the exposure to the organs-at-risk (OAR) without compromising tumor response. Twenty five consecutive patients were treated from 04/2009 to 5/2010. For all patients, four different treatment plans including protons, RapidArc, IMRT and 3D-conformal-technique were retrospectively calculated and analyzed according to dosimetric aspects. Detailed DVH-analyses revealed that protons clearly reduced the dose to the OAR and entire normal tissue when compared to other techniques. Furthermore, the conformity index was significantly better and target volumes were covered consistent with the ICRU guidelines. Planning results suggest that treatment with protons can improve the therapeutic tolerance for the irradiation of rectal cancer, particularly for patients scheduled for an irradiation with an intensified chemotherapy regimen and identified to be at high risk for acute therapy-related toxicity. However, clinical experiences and long-term observation are needed to assess tumor response and related toxicity rates. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  17. Case-control study of fetal microchimerism and breast cancer.

    Directory of Open Access Journals (Sweden)

    Vijayakrishna K Gadi

    2008-03-01

    Full Text Available Prior pregnancy is known to protect against development of breast cancer. Recent studies have demonstrated that pregnancy has the capacity to establish small numbers of immunologically active fetal-derived cells in the mother, a phenomenon known as fetal microchimerism (FMc. We asked whether presence of FMc, routinely acquired during pregnancy, is a protective factor for breast cancer.DNA extracts from peripheral blood specimens were obtained from a population-based case-control study of risk factors for breast cancer in women 21 to 45 years old. Specimens were tested with quantitative PCR for presence and concentrations of male DNA presumed to derive from prior pregnancies with a male fetus. Odds ratios (OR and 95% confidence intervals (CI were estimated with consideration of multiple established reproductive and environmental risk factors for breast cancer. FMc results were generated on 99 parous women, 54 with primary invasive breast cancer and 45 general population controls. FMc prevalence was 56% (25/45 and 26% (14/54 in controls and cases, respectively. Women harboring FMc were less likely to have had breast cancer (OR = 0.29, 95% CI 0.11-0.83; p = 0.02, adjusting for age, number of children, birth of a son, history of miscarriage, and total DNA tested. In addition, FMc concentrations were higher in controls versus cases (p = 0.01. Median concentrations were 2 (0-78 and 0 (0-374 fetal genomes/10(6 maternal genomes in controls and cases, respectively.Results suggest that the enigma of why some parous women are not afforded protection from breast cancer by pregnancy might in part be explained by differences in FMc. Mechanistic studies of FMc-derived protection against breast cancer are warranted.

  18. SU-E-T-266: Proton PBS Plan Design and Robustness Evaluation for Head and Neck Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Liang, X; Tang, S; Zhai, H; Kirk, M; Kalbasi, A; Lin, A; Ahn, P; Tochner, Z; McDonough, J; Both, S [University of Pennsylvania, Philadelphia, PA (United States)

    2014-06-01

    Purpose: To describe a newly designed proton pencil beam scanning (PBS) planning technique for radiotherapy of patients with bilateral oropharyngeal cancer, and to assess plan robustness. Methods: We treated 10 patients with proton PBS plans using 2 posterior oblique field (2F PBS) comprised of 80% single-field uniform dose (SFUD) and 20% intensity-modulated proton therapy (IMPT). All patients underwent weekly CT scans for verification. Using dosimetric indicators for both targets and organs at risk (OARs), we quantitatively compared initial plans and verification plans using student t-tests. We created a second proton PBS plan for each patient using 2 posterior oblique plus 1 anterior field comprised of 100% SFUD (3F PBS). We assessed plan robustness for both proton plan groups, as well as a photon volumetric modulated arc therapy (VMAT) plan group by comparing initial and verification plans. Results: The 2F PBS plans were not robust in target coverage. D98% for clinical target volume (CTV) degraded from 100% to 96% on average, with maximum change Δ D98% of −24%. Two patients were moved to photon VMAT treatment due to insufficient CTV coverage on verification plans. Plan robustness was especially weak in the low-anterior neck. The 3F PBS plans, however, demonstrated robust target coverage, which was comparable to the VMAT photon plan group. Doses to oral cavity were lower in the Proton PBS plans compared to photon VMAT plans due to no lower exit dose to the oral cavity. Conclusion: Proton PBS plans using 2 posterior oblique fields were not robust for CTV coverage, due to variable positioning of redundant soft tissue in the posterior neck. We designed 3-field proton PBS plans using an anterior field to avoid long heterogeneous paths in the low neck. These 3-field proton PBS plans had significantly improved plan robustness, and the robustness is comparable to VMAT photon plans.

  19. Evaluation of adaptive treatment planning for patients with non-small cell lung cancer

    Science.gov (United States)

    Zhong, Hualiang; Siddiqui, Salim M.; Movsas, Benjamin; Chetty, Indrin J.

    2017-06-01

    The purpose of this study was to develop metrics to evaluate uncertainties in deformable dose accumulation for patients with non-small cell lung cancer (NSCLC). Initial treatment plans (primary) and cone-beam CT (CBCT) images were retrospectively processed for seven NSCLC patients, who showed significant tumor regression during the course of treatment. Each plan was developed with IMRT for 2 Gy  ×  33 fractions. A B-spline-based DIR algorithm was used to register weekly CBCT images to a reference image acquired at fraction 21 and the resultant displacement vector fields (DVFs) were then modified using a finite element method (FEM). The doses were calculated on each of these CBCT images and mapped to the reference image using a tri-linear dose interpolation method, based on the B-spline and FEM-generated DVFs. Contours propagated from the planning image were adjusted to the residual tumor and OARs on the reference image to develop a secondary plan. For iso-prescription adaptive plans (relative to initial plans), mean lung dose (MLD) was reduced, on average from 17.3 Gy (initial plan) to 15.2, 14.5 and 14.8 Gy for the plans adapted using the rigid, B-Spline and FEM-based registrations. Similarly, for iso-toxic adaptive plans (considering MLD relative to initial plans) using the rigid, B-Spline and FEM-based registrations, the average doses were 69.9  ±  6.8, 65.7  ±  5.1 and 67.2  ±  5.6 Gy in the initial volume (PTV1), and 81.5  ±  25.8, 77.7  ±  21.6, and 78.9  ±  22.5 Gy in the residual volume (PTV21), respectively. Tumor volume reduction was correlated with dose escalation (for isotoxic plans, correlation coefficient  =  0.92), and with MLD reduction (for iso-fractional plans, correlation coefficient  =  0.85). For the case of the iso-toxic dose escalation, plans adapted with the B-Spline and FEM DVFs differed from the primary plan adapted with rigid registration by 2.8  ±  1

  20. Summary and Recommendations from the National Cancer Institute's Clinical Trials Planning Meeting on Novel Therapeutics for Non-Muscle Invasive Bladder Cancer

    NARCIS (Netherlands)

    Lerner, S.P.; Bajorin, D.F.; Dinney, C.P.; Efstathiou, J.A.; Groshen, S.; Hahn, N.M.; Hansel, D.; Kwiatkowski, D.; O'Donnell, M.; Rosenberg, J.; Svatek, R.; Abrams, J.S.; Al-Ahmadie, H.; Apolo, A.B.; Bellmunt, J.; Callahan, M.; Cha, E.K.; Drake, C.; Jarow, J.; Kamat, A.; Kim, W.; Knowles, M.; Mann, B.; Marchionni, L.; McConkey, D.; McShane, L.; Ramirez, N.; Sharabi, A.; Sharpe, A.H.; Solit, D.; Tangen, C.M.; Amiri, A.T.; Allen, E. Van; West, P.J.; Witjes, J.A.; Quale, D.Z.

    2016-01-01

    The NCI Bladder Cancer Task Force convened a Clinical Trials Planning Meeting (CTPM) Workshop focused on Novel Therapeutics for Non-Muscle Invasive Bladder Cancer (NMIBC). Meeting attendees included a broad and multi-disciplinary group of clinical and research stakeholders and included leaders from

  1. [Family planning programs and birth control in the third world].

    Science.gov (United States)

    Wohlschlagl, H

    1991-01-01

    The population explosion has been abating since the 2nd half of the 1960s. The birth rate of the 3rd World dropped from 45/1000 during 1950-55 to 31/1000 during 1985-90. From the 1st half of the 1960s to the 1st half of the 1980s the total fertility of such countries dropped from 6.1 to 4.2 children/woman. In Taiwan, Singapore, Hong Kong, South Korea, and Malaysia living standards improved as a result of industrialization, and fertility decreased significantly. In Sri Lanka, China, North Vietnam, and Thailand the drop of fertility is explained by cultural and religious factors. In 1982 about 78% of the population of developing countries lived in 39 states that followed an official policy aimed at reducing the population. Another 16% lived in countries supporting the concept of a desired family size. However, World Bank data showed that in the mid-1980s in 27 developing countries no state family planning (FP) programs existed. India adopted an official FP program in 1952, Pakistan followed suit in 1960, South Korea in 1961, and China in 1962. In Latin America a split policy manifested itself: in Brazil birth control was rejected, only Colombia had a FP policy. In 1986 the governments of 68 of 131 developing countries representing 3.1 billion people considered the number of children per woman too high. 31 of these countries followed concrete population control policies. On the other hand, in 1986 24 countries of Africa with 40% of the continent's population took no measures to influence population growth. In Latin America and the Caribbean 18 of 33 countries were idle, except for Mexico that had a massive state FP program. These programs also improve maternal and child health with birth spacing of at least 2 years, and the prevention of pregnancies of too young women or those over 40. The evaluation of rapidly spreading FP programs in the 1970s was carried out by the World Fertility Survey in 41 countries. The impact of FP programs was more substantial than

  2. Dosimetric advantages of generalised equivalent uniform dose-based optimisation on dose-volume objectives in intensity-modulated radiotherapy planning for bilateral breast cancer.

    Science.gov (United States)

    Lee, T-F; Ting, H-M; Chao, P-J; Wang, H-Y; Shieh, C-S; Horng, M-F; Wu, J-M; Yeh, S-A; Cho, M-Y; Huang, E-Y; Huang, Y-J; Chen, H-C; Fang, F-M

    2012-11-01

    We compared and evaluated the differences between two models for treating bilateral breast cancer (BBC): (i) dose-volume-based intensity-modulated radiation treatment (DV plan), and (ii) dose-volume-based intensity-modulated radiotherapy with generalised equivalent uniform dose-based optimisation (DV-gEUD plan). The quality and performance of the DV plan and DV-gEUD plan using the Pinnacle(3) system (Philips, Fitchburg, WI) were evaluated and compared in 10 patients with stage T2-T4 BBC. The plans were delivered on a Varian 21EX linear accelerator (Varian Medical Systems, Milpitas, CA) equipped with a Millennium 120 leaf multileaf collimator (Varian Medical Systems). The parameters analysed included the conformity index, homogeneity index, tumour control probability of the planning target volume (PTV), the volumes V(20 Gy) and V(30 Gy) of the organs at risk (OAR, including the heart and lungs), mean dose and the normal tissue complication probability. Both plans met the requirements for the coverage of PTV with similar conformity and homogeneity indices. However, the DV-gEUD plan had the advantage of dose sparing for OAR: the mean doses of the heart and lungs, lung V(20) (Gy), and heart V(30) (Gy) in the DV-gEUD plan were lower than those in the DV plan (pplan and then improving it by adding gEUD-based improvements to reduce the number of iterations and to improve the optimum dose distribution. Advances to knowledge The DV-gEUD plan provided superior dosimetric results for treating BBC in terms of PTV coverage and OAR sparing than the DV plan, without sacrificing the homogeneity of dose distribution in the PTV.

  3. P27 in cell cycle control and cancer

    DEFF Research Database (Denmark)

    Møller, Michael Boe

    2000-01-01

    In order to survive, cells need tight control of cell cycle progression. The control mechanisms are often lost in human cancer cells. The cell cycle is driven forward by cyclin-dependent kinases (CDKs). The CDK inhibitors (CKIs) are important regulators of the CDKs. As the name implies, CKIs were...

  4. Baldness and testicular cancer: the EPSAM case-control study.

    Science.gov (United States)

    Moirano, G; Zugna, D; Grasso, C; Lista, P; Ciuffreda, L; Segnan, N; Merletti, F; Richiardi, L

    2016-03-01

    The etiology of testicular cancer is largely unexplained. Research has mainly focused on prenatal exposures, especially to sex hormones, while less attention has been paid to exposures that may act also postnatally. As baldness has been previously associated with testicular cancer risk we focused on baldness and body hairiness, which are both associated with androgen activity. We used data of the Postnatal Exposures and Male Health (EPSAM) study, a case-control study on testicular cancer conducted in the Province of Turin, Italy, involving cases diagnosed between 1997 and 2008. Information was collected using mailed questionnaires. Analyses included 255 cases and 459 controls. We calculated ORs and 95% CIs to estimate testicular cancer risk among those who developed baldness and among those with body hairiness. We found an inverse association between testicular cancer and baldness (OR: 0.67, 95% CI: 0.46-0.98) and body hairiness (OR: 0.78, 95% CI: 0.53-1.16), although the latter had wider CIs. The inverse association between baldness and testicular cancer is consistent with the results from previous studies. These results suggest that androgens activity may influence testicular cancer risk. © 2016 American Society of Andrology and European Academy of Andrology.

  5. Mental fatigue and task control : Planning and preparation

    NARCIS (Netherlands)

    Lorist, MM; Klein, Martin; Nieuwenhuis, S; De Jong, R; Mulder, G; Meijman, TF

    The effects of mental fatigue on planning and preparation for future actions were examined, using a task switching paradigm. Fatigue was induced by "time on task," with subjects performing a switch task continuously for 2 hr. Subjects had to alternate between tasks on every second trial, so that a

  6. National Tuberculosis Control Plan 2016-2020 : Towards elimination

    NARCIS (Netherlands)

    de Vries G; Riesmeijer R; RGI; I&V

    2016-01-01

    Het Nationaal plan tuberculosebestrijding 2016-2020 geeft aan welke maatregelen de komende vijf jaar nodig zijn om de tuberculosebestrijding in Nederland verder te verbeteren. Het doel is om de overdracht van tuberculose en het aantal patiënten de komende vijf jaar met 25 procent terug te dringen.

  7. Risk control for staff planning in e-commerce warehouses

    NARCIS (Netherlands)

    Wruck, Susanne; Vis, Iris F A; Boter, Jaap

    2016-01-01

    Internet sale supply chains often need to fulfil quickly small orders for many customers. The resulting high demand and planning uncertainties pose new challenges for e-commerce warehouse operations. Here, we develop a decision support tool to assist managers in selecting appropriate risk policies

  8. Enhancing cancer screening in primary care: rationale, design, analysis plan, and recruitment results.

    Science.gov (United States)

    Murray, David M; Katz, Mira L; Post, Doug M; Pennell, Michael L; Young, Gregory S; Tatum, Cathy M; Paskett, Electra D

    2013-03-01

    Colorectal cancer (CRC) is the third leading type of cancer and the third leading cause of cancer death in the United States. National policy-making organizations recognize and support a variety of CRC screening strategies among average-risk adults aged 50 and older based on strong evidence showing that screening decreases mortality from CRC and can also reduce the incidence of the disease. The goal of this study was to test a multi-level stepped intervention to increase CRC screening rates. We used a group-randomized trial design where the units of assignment were clinics and the units of observation were eligible patients receiving care at those clinics, with stratified random assignment of clinics to study conditions. The primary analysis was planned as a mixed-model logistic regression to account for the expected positive intraclass correlation associated with clinics. Our recruitment experience reflected the difficulties of conducting research in the real world where changes in economic conditions, staff turnover/layoff, inadequate medical records, and poor acceptance of research can significantly impact study plans. It demonstrated the problems that can emerge when procedures used in the study depart from those used in the pilot work to generate parameter estimates for power analysis. It also demonstrated the importance of allowing for attrition at the group and patient levels so that if recruitment falls short, it is possible to maintain adequate power with only a slight increase in the detectable difference. This experience should assist others planning group-randomized trials, whether in cancer screening or in other areas. Published by Elsevier Inc.

  9. Volumetric Modulated Arc Therapy Planning for Primary Prostate Cancer With Selective Intraprostatic Boost Determined by {sup 18}F-Choline PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kuang, Yu [Department of Medical Physics, University of Nevada Las Vegas, Las Vegas, Nevada (United States); Wu, Lili [Department of Medical Physics, University of Nevada Las Vegas, Las Vegas, Nevada (United States); Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong (China); Hirata, Emily; Miyazaki, Kyle; Sato, Miles [Hamamatsu/Queen' s PET Imaging Center and Departments of Radiation Oncology and Oncology Research, The Queen' s Medical Center, Honolulu, Hawaii (United States); Kwee, Sandi A., E-mail: kwee@hawaii.edu [Hamamatsu/Queen' s PET Imaging Center and Departments of Radiation Oncology and Oncology Research, The Queen' s Medical Center, Honolulu, Hawaii (United States); John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii (United States)

    2015-04-01

    Purpose: This study evaluated expected tumor control and normal tissue toxicity for prostate volumetric modulated arc therapy (VMAT) with and without radiation boosts to an intraprostatically dominant lesion (IDL), defined by {sup 18}F-choline positron emission tomography/computed tomography (PET/CT). Methods and Materials: Thirty patients with localized prostate cancer underwent {sup 18}F-choline PET/CT before treatment. Two VMAT plans, plan{sub 79} {sub Gy} and plan{sub 100-105} {sub Gy}, were compared for each patient. The whole-prostate planning target volume (PTV{sub prostate}) prescription was 79 Gy in both plans, but plan{sub 100-105} {sub Gy} added simultaneous boost doses of 100 Gy and 105 Gy to the IDL, defined by 60% and 70% of maximum prostatic uptake on {sup 18}F-choline PET (IDL{sub suv60%} and IDL{sub suv70%}, respectively, with IDL{sub suv70%} nested inside IDL{sub suv60%} to potentially enhance tumor specificity of the maximum point dose). Plan evaluations included histopathological correspondence, isodose distributions, dose-volume histograms, tumor control probability (TCP), and normal tissue complication probability (NTCP). Results: Planning objectives and dose constraints proved feasible in 30 of 30 cases. Prostate sextant histopathology was available for 28 cases, confirming that IDL{sub suv60%} adequately covered all tumor-bearing prostate sextants in 27 cases and provided partial coverage in 1 case. Plan{sub 100-105} {sub Gy} had significantly higher TCP than plan{sub 79} {sub Gy} across all prostate regions for α/β ratios ranging from 1.5 Gy to 10 Gy (P<.001 for each case). There were no significant differences in bladder and femoral head NTCP between plans and slightly lower rectal NTCP (endpoint: grade ≥ 2 late toxicity or rectal bleeding) was found for plan{sub 100-105} {sub Gy}. Conclusions: VMAT can potentially increase the likelihood of tumor control in primary prostate cancer while observing normal tissue tolerances through

  10. Clinical Outcomes of Computed Tomography–Based Volumetric Brachytherapy Planning for Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, Daniel R., E-mail: drsimpson@ucsd.edu [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Scanderbeg, Daniel J.; Carmona, Ruben; McMurtrie, Riley M.; Einck, John; Mell, Loren K. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); McHale, Michael T.; Saenz, Cheryl C.; Plaxe, Steven C.; Harrison, Terry [Department of Gynecologic Oncology, University of California San Diego, La Jolla, California (United States); Mundt, Arno J.; Yashar, Catheryn M. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States)

    2015-09-01

    Purpose/Objectives: A report of clinical outcomes of a computed tomography (CT)-based image guided brachytherapy (IGBT) technique for treatment of cervical cancer. Methods and Materials: Seventy-six women with International Federation of Gynecology and Obstetrics stage IB to IVA cervical carcinoma diagnosed between 2007 and 2014 were treated with definitive external beam radiation therapy (EBRT) with or without concurrent chemotherapy followed by high-dose-rate (HDR) IGBT. All patients underwent planning CT simulation at each implantation. A high-risk clinical target volume (HRCTV) encompassing any visible tumor and the entire cervix was contoured on the simulation CT. When available, magnetic resonance imaging (MRI) was performed at implantation to assist with tumor delineation. The prescription dose was prescribed to the HRCTV. Results: The median follow-up time was 17 months. Thirteen patients (17%) had an MRI done before brachytherapy, and 16 patients (21%) were treated without MRI guidance. The mean EBRT/IGBT sum 2-Gy equivalent dose (EQD2) delivered to the 90% volume of the HRCTV was 86.3 Gy. The mean maximum EQD2s delivered to 2 cm{sup 3} of the rectum, sigmoid, and bladder were 67.5 Gy, 66.2 Gy, and 75.3 Gy, respectively. The 2-year cumulative incidences of local, locoregional, and distant failure were 5.8% (95% confidence interval [CI]: 1.4%-14.8%), 15.1% (95% CI: 5.4%-29.4%), and 24.3% (95% CI: 12.1%-38.9%), respectively. The 2-year overall and disease-free survival rates were 75% (95% CI, 61%-91%) and 73% (95% CI, 60%-90%), respectively. Twenty-nine patients (38%) experienced grade ≥2 acute toxicity, with 5 cases of acute grade 3 toxicity and no grade ≥4 toxicities. One patient experienced grade 3 gastrointestinal toxicity. No other late grade ≥3 events were observed. Conclusions: This is the largest report to date of CT/MRI-based IGBT for the treatment of cervical cancer. The results are promising, with excellent local control and acceptable

  11. Cancer Pain Control for Advanced Cancer Patients by Using Autonomic Nerve Pharmacopuncture

    Directory of Open Access Journals (Sweden)

    Hwi-joong Kang

    2014-09-01

    Full Text Available Objectives: The purpose of this study is to report a case series of advanced cancer patients whose cancer pain was relieved by using autonomic nerve pharmacopuncture (ANP treatment. ANP is a subcutaneous injection therapy of mountain ginseng pharmacopuncture (MGP along the acupoints on the spine (Hua-Tuo-Jia-Ji-Xue; 0.5 cun lateral to the lower border of the spinous processes of vertebrae to enhance the immune system and to balance autonomic nerve function. Methods: Patients with three different types of cancer (gastric cancer, lung cancer, colon cancer with distant metastases with cancer pain were treated with ANP. 1 mL of MGP was injected into the bilateral Hua-Tuo-Jia-Ji-Xue on the T1-L5 sites (total 12 ─ 20 mL injection of each patient’s dorsum by using the principle of symptom differentiation. During ANP treatment, the visual analogue scale (VAS for pain was used to assess their levels of cancer pain; also, the dosage and the frequency of analgesic use were measured. Results: The cancer pain levels of all three patients improved with treatment using ANP. The VAS scores of the three patients decreased as the treatment progressed. The dosage and the frequency of analgesics also gradually decreased during the treatment period. Significantly, no related adverse events were found. Conclusion: ANP has shown benefit in controlling cancer pain for the three different types of cancer investigated in this study and in reducing the dosage and the frequency of analgesics. ANP is expected to be beneficial for reducing cancer pain and, thus, to be a promising new treatment for cancer pain.

  12. Evaluation of a Knowledge-Based Planning Solution for Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tol, Jim P., E-mail: j.tol@vumc.nl; Delaney, Alexander R.; Dahele, Max; Slotman, Ben J.; Verbakel, Wilko F.A.R.

    2015-03-01

    Purpose: Automated and knowledge-based planning techniques aim to reduce variations in plan quality. RapidPlan uses a library consisting of different patient plans to make a model that can predict achievable dose-volume histograms (DVHs) for new patients and uses those models for setting optimization objectives. We benchmarked RapidPlan versus clinical plans for 2 patient groups, using 3 different libraries. Methods and Materials: Volumetric modulated arc therapy plans of 60 recent head and neck cancer patients that included sparing of the salivary glands, swallowing muscles, and oral cavity were evenly divided between 2 models, Model{sub 30A} and Model{sub 30B}, and were combined in a third model, Model{sub 60}. Knowledge-based plans were created for 2 evaluation groups: evaluation group 1 (EG1), consisting of 15 recent patients, and evaluation group 2 (EG2), consisting of 15 older patients in whom only the salivary glands were spared. RapidPlan results were compared with clinical plans (CP) for boost and/or elective planning target volume homogeneity index, using HI{sub B}/HI{sub E} = 100 × (D2% − D98%)/D50%, and mean dose to composite salivary glands, swallowing muscles, and oral cavity (D{sub sal}, D{sub swal}, and D{sub oc}, respectively). Results: For EG1, RapidPlan improved HI{sub B} and HI{sub E} values compared with CP by 1.0% to 1.3% and 1.0% to 0.6%, respectively. Comparable D{sub sal} and D{sub swal} values were seen in Model{sub 30A}, Model{sub 30B}, and Model{sub 60}, decreasing by an average of 0.1, 1.0, and 0.8 Gy and 4.8, 3.7, and 4.4 Gy, respectively. However, differences were noted between individual organs at risk (OARs), with Model{sub 30B} increasing D{sub oc} by 0.1, 3.2, and 2.8 Gy compared with CP, Model{sub 30A}, and Model{sub 60}. Plan quality was less consistent when the patient was flagged as an outlier. For EG2, RapidPlan decreased D{sub sal} by 4.1 to 4.9 Gy on average, whereas HI{sub B} and HI{sub E} decreased by 1.1% to

  13. Individualized Quality Control Plan (IQCP): Is It Value-Added for Clinical Microbiology?

    OpenAIRE

    Sharp, Susan E.; Miller, Melissa B.; Hindler, Janet

    2015-01-01

    The Center for Medicaid and Medicare Services (CMS) recently published their Individualized Quality Control Plan (IQCP [https://www.cms.gov/regulations-and-guidance/legislation/CLIA/Individualized_Quality_Control_Plan_IQCP.html]), which will be the only option for quality control (QC) starting in January 2016 if laboratories choose not to perform Clinical Laboratory Improvement Act (CLIA) [U.S. Statutes at Large 81(1967):533] default QC. Laboratories will no longer be able to use “equivalent ...

  14. SU-F-T-355: Evaluation of Knowledge-Based Planning Model for the Cervical Cancer Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Chen, X; Wang, J; Hu, W [Fudan University Shanghai Cancer Center, Shanghai, Shanghai (China)

    2016-06-15

    Purpose: The Varian RapidPlan™ is a commercial knowledge-based optimization process which uses a set of clinically used treatment plans to train a model that can predict individualized dose-volume objectives. The purpose of this study is to evaluate the performance of RapidPlan to generate intensity modulated radiation therapy (IMRT) plans for cervical cancer. Methods: Totally 70 IMRT plans for cervical cancer with varying clinical and physiological indications were enrolled in this study. These patients were all previously treated in our institution. There were two prescription levels usually used in our institution: 45Gy/25 fractions and 50.4Gy/28 fractions. 50 of these plans were selected to train the RapidPlan model for predicting dose-volume constraints. After model training, this model was validated with 10 plans from training pool(internal validation) and additional other 20 new plans(external validation). All plans used for the validation were re-optimized with the original beam configuration and the generated priorities from RapidPlan were manually adjusted to ensure that re-optimized DVH located in the range of the model prediction. DVH quantitative analysis was performed to compare the RapidPlan generated and the original manual optimized plans. Results: For all the validation cases, RapidPlan based plans (RapidPlan) showed similar or superior results compared to the manual optimized ones. RapidPlan increased the result of D98% and homogeneity in both two validations. For organs at risk, the RapidPlan decreased mean doses of bladder by 1.25Gy/1.13Gy (internal/external validation) on average, with p=0.12/p<0.01. The mean dose of rectum and bowel were also decreased by an average of 2.64Gy/0.83Gy and 0.66Gy/1.05Gy,with p<0.01/ p<0.01and p=0.04/<0.01 for the internal/external validation, respectively. Conclusion: The RapidPlan model based cervical cancer plans shows ability to systematically improve the IMRT plan quality. It suggests that RapidPlan has

  15. Automatic MRI Atlas-Based External Beam Radiation Therapy Treatment Planning for Prostate Cancer

    Science.gov (United States)

    Dowling, Jason; Lambert, Jonathan; Parker, Joel; Greer, Peter B.; Fripp, Jurgen; Denham, James; Ourselin, Sébastien; Salvado, Olivier

    Prostate radiation therapy dose planning currently requires computed tomography (CT) scans as they contain electron density information needed for patient dose calculations. However magnetic resonance imaging (MRI) images have significantly superior soft-tissue contrast for segmenting organs of interest and determining the target volume for treatment. This paper describes work on the development of an alternative treatment workflow enabling both organ delineation and dose planning to be performed using MRI alone. This is achieved by atlas based segmentation and the generation of pseudo-CT scans from MRI. Planning and dosimetry results for three prostate cancer patients from Calvary Mater Newcastle Hospital (Australia) are presented supporting the feasibility of this workflow. Good DSC scores were found for the atlas based segmentation of the prostate (mean 0.84) and bones (mean 0.89). The agreement between MRI/pseudo-CT and CT planning was quantified by dose differences and distance to agreement in corresponding voxels. Dose differences were found to be less than 2%. Chi values indicate that the planning CT and pseudo-CT dose distributions are equivalent.

  16. Highly Efficient Training, Refinement, and Validation of a Knowledge-based Planning Quality-Control System for Radiation Therapy Clinical Trials.

    Science.gov (United States)

    Li, Nan; Carmona, Ruben; Sirak, Igor; Kasaova, Linda; Followill, David; Michalski, Jeff; Bosch, Walter; Straube, William; Mell, Loren K; Moore, Kevin L

    2017-01-01

    To demonstrate an efficient method for training and validation of a knowledge-based planning (KBP) system as a radiation therapy clinical trial plan quality-control system. We analyzed 86 patients with stage IB through IVA cervical cancer treated with intensity modulated radiation therapy at 2 institutions according to the standards of the INTERTECC (International Evaluation of Radiotherapy Technology Effectiveness in Cervical Cancer, National Clinical Trials Network identifier: 01554397) protocol. The protocol used a planning target volume and 2 primary organs at risk: pelvic bone marrow (PBM) and bowel. Secondary organs at risk were rectum and bladder. Initial unfiltered dose-volume histogram (DVH) estimation models were trained using all 86 plans. Refined training sets were created by removing sub-optimal plans from the unfiltered sample, and DVH estimation models… and DVH estimation models were constructed by identifying 30 of 86 plans emphasizing PBM sparing (comparing protocol-specified dosimetric cutpoints V 10 (percentage volume of PBM receiving at least 10 Gy dose) and V 20 (percentage volume of PBM receiving at least 20 Gy dose) with unfiltered predictions) and another 30 of 86 plans emphasizing bowel sparing (comparing V 40 (absolute volume of bowel receiving at least 40 Gy dose) and V 45 (absolute volume of bowel receiving at least 45 Gy dose), 9 in common with the PBM set). To obtain deliverable KBP plans, refined models must inform patient-specific optimization objectives and/or priorities (an auto-planning "routine"). Four candidate routines emphasizing different tradeoffs were composed, and a script was developed to automatically re-plan multiple patients with each routine. After selection of the routine that best met protocol objectives in the 51-patient training sample (KBP FINAL ), protocol-specific DVH metrics and normal tissue complication probability were compared for original versus KBP FINAL plans across the 35-patient validation set

  17. Immunotherapy of head and neck cancer: Emerging clinical trials from a National Cancer Institute Head and Neck Cancer Steering Committee Planning Meeting.

    Science.gov (United States)

    Bauman, Julie E; Cohen, Ezra; Ferris, Robert L; Adelstein, David J; Brizel, David M; Ridge, John A; O'Sullivan, Brian; Burtness, Barbara A; Butterfield, Lisa H; Carson, William E; Disis, Mary L; Fox, Bernard A; Gajewski, Thomas F; Gillison, Maura L; Hodge, James W; Le, Quynh-Thu; Raben, David; Strome, Scott E; Lynn, Jean; Malik, Shakun

    2017-04-01

    Recent advances have permitted successful therapeutic targeting of the immune system in head and neck squamous cell carcinoma (HNSCC). These new immunotherapeutic targets and agents are being rapidly adopted by the oncologic community and hold considerable promise. The National Cancer Institute sponsored a Clinical Trials Planning Meeting to address the issue of how to further investigate the use of immunotherapy in patients with HNSCC. The goals of the meeting were to consider phase 2 or 3 trial designs primarily in 3 different patient populations: those with previously untreated, human papillomavirus-initiated oropharyngeal cancers; those with previously untreated, human papillomavirus-negative HNSCC; and those with recurrent/metastatic HNSCC. In addition, a separate committee was formed to develop integrative biomarkers for the clinical trials. The meeting started with an overview of key immune components and principles related to HNSCC, including immunosurveillance and immune escape. Four clinical trial concepts were developed at the meeting integrating different immunotherapies with existing standards of care. These designs were presented for implementation by the head and neck committees of the National Cancer Institute-funded National Clinical Trials Network. This article summarizes the proceedings of this Clinical Trials Planning Meeting, the purpose of which was to facilitate the rigorous development and design of randomized phase 2 and 3 immunotherapeutic trials in patients with HNSCC. Although reviews usually are published immediately after the meeting is held, this report is unique because there are now tangible clinical trial designs that have been funded and put into practice and the studies are being activated to accrual. Cancer 2017;123:1259-1271. © 2016 American Cancer Society. © 2016 American Cancer Society.

  18. DNA damage among thyroid cancer and multiple cancer cases, controls, and long-lived individuals

    Energy Technology Data Exchange (ETDEWEB)

    Sigurdson, A J; Hauptmann, M; Alexander, B J; Doody, M M; Thomas, C B; Struewing, J P; Jones, I M

    2004-08-24

    Variation in the detection, signaling, and repair of DNA damage contributes to human cancer risk. To assess capacity to modulate endogenous DNA damage among radiologic technologists who had been diagnosed with breast cancer and another malignancy (breast-other; n=42), early-onset breast cancer (early-onset, age {<=} 35; n=38), thyroid cancer (n=68), long-lived cancer-free individuals (hyper-normals; n=20) and cancer-free controls (n=49) we quantified DNA damage (single strand breaks and abasic sites) in untreated lymphoblastoid cell lines using the alkaline comet assay. Komet{trademark} software provided comet tail length, % DNA in tail (tail DNA), comet distributed moment (CDM), and Olive tail moment (OTM) summarized as the geometric mean of 100 cells. Category cut-points (median and 75th percentile) were determined from the distribution among controls. Tail length (for {>=} 75% vs. below the median, age adjusted) was most consistently associated with the highest odds ratios in the breast-other, early-onset, and thyroid cancer groups (with risk increased 10-, 5- or 19-fold, respectively, with wide confidence intervals) and decreased risk among the hyper-normal group. For the other three Comet measures, risk of breast-other was elevated approximately three-fold. Risk of early-onset breast cancer was mixed and risk of thyroid cancer ranged from null to a two-fold increase. The hyper-normal group showed decreased odds ratios for tail DNA and OTM, but not CDM. DNA damage, as estimated by all Comet measures, was relatively unaffected by survival time, reproductive factors, and prior radiation treatment. We detected a continuum of endogenous DNA damage that was highest among cancer cases, less in controls, and suggestively lowest in hyper-normal individuals. Measuring this DNA damage phenotype may contribute to the identification of susceptible sub-groups. Our observations require replication in a prospective study with a large number of pre-diagnostic samples.

  19. Carevive Survivor Care Planning System in Improving Quality of Life in Breast Cancer Survivors

    Science.gov (United States)

    2017-09-05

    Stage I Breast Cancer; Stage I Cervical Cancer; Stage I Ovarian Cancer; Stage I Uterine Corpus Cancer; Stage IA Breast Cancer; Stage IA Cervical Cancer; Stage IA Ovarian Cancer; Stage IA Uterine Corpus Cancer; Stage IB Breast Cancer; Stage IB Cervical Cancer; Stage IB Ovarian Cancer; Stage IB Uterine Corpus Cancer; Stage IC Ovarian Cancer; Stage II Breast Cancer; Stage II Cervical Cancer; Stage II Ovarian Cancer; Stage II Uterine Corpus Cancer; Stage IIA Breast Cancer; Stage IIA Cervical Cancer; Stage IIA Ovarian Cancer; Stage IIB Breast Cancer; Stage IIB Cervical Cancer; Stage IIB Ovarian Cancer; Stage IIC Ovarian Cancer; Stage III Breast Cancer; Stage III Cervical Cancer; Stage III Ovarian Cancer; Stage III Uterine Corpus Cancer; Stage IIIA Breast Cancer; Stage IIIA Cervical Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Breast Cancer; Stage IIIB Cervical Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Breast Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Uterine Corpus Cancer

  20. Information Technology Management: Global Command and Control System Joint Operation Planning and Execution System

    Science.gov (United States)

    2003-04-15

    Information Technology Management Department of Defense Office of the Inspector General April 15, 2003 AccountabilityIntegrityQuality Global Command...Dates Covered (from... to) - Title and Subtitle Information Technology Management : Global Command and Control System Joint Operation Planning and...September 7, 1999; “GCCS Strategic Plan 1999-2002,” December 27, 1999; “JOPES Strategic Plan,” April 2000; “Information Technology Management Reform Act

  1. Computational modeling and real-time control of patient-specific laser treatment of cancer.

    Science.gov (United States)

    Fuentes, D; Oden, J T; Diller, K R; Hazle, J D; Elliott, A; Shetty, A; Stafford, R J

    2009-04-01

    An adaptive feedback control system is presented which employs a computational model of bioheat transfer in living tissue to guide, in real-time, laser treatments of prostate cancer monitored by magnetic resonance thermal imaging. The system is built on what can be referred to as cyberinfrastructure-a complex structure of high-speed network, large-scale parallel computing devices, laser optics, imaging, visualizations, inverse-analysis algorithms, mesh generation, and control systems that guide laser therapy to optimally control the ablation of cancerous tissue. The computational system has been successfully tested on in vivo, canine prostate. Over the course of an 18 min laser-induced thermal therapy performed at M.D. Anderson Cancer Center (MDACC) in Houston, Texas, the computational models were calibrated to intra-operative real-time thermal imaging treatment data and the calibrated models controlled the bioheat transfer to within 5 degrees C of the predetermined treatment plan. The computational arena is in Austin, Texas and managed at the Institute for Computational Engineering and Sciences (ICES). The system is designed to control the bioheat transfer remotely while simultaneously providing real-time remote visualization of the on-going treatment. Post-operative histology of the canine prostate reveal that the damage region was within the targeted 1.2 cm diameter treatment objective.

  2. Research on Skin Cancer-Related Behaviors and Outcomes in the NIH Grant Portfolio, 2000-2014: Skin Cancer Intervention Across the Cancer Control Continuum (SCI-3C).

    Science.gov (United States)

    Perna, Frank M; Dwyer, Laura A; Tesauro, Gina; Taber, Jennifer M; Norton, Wynne E; Hartman, Anne M; Geller, Alan C

    2017-05-01

    The Surgeon General's Call to Action to Prevent Skin Cancer broadly identified research gaps, but specific objectives are needed to further behavioral intervention research. To review National Institute of Health (NIH) grants targeting skin cancer-related behaviors and relevant outcomes. A portfolio analysis of the title, abstract, specific aims, and research plans of identified grant applications from 2000 to 2014 targeting skin cancer-related behaviors or testing behavioral intervention effects on cancer-relevant outcomes along the cancer continuum. Funding trends were compared along the cancer control continuum, with respect to investigator demographics and use of theory, technology, policy, and changes to environmental surroundings (built environment). A total of 112 submitted applications met inclusion criteria; of these, 40 (35.7%) were funded, and 31 of the 40 were interventions. Comparing the 40 funded grants with the 72 unfunded grants, the overall success rates did not differ significantly between male (33.3%) and female (37.3%) investigators, nor did the frequency of R01 awards (36.7% and 28.1%, respectively). Among intervention awards, most (24 of 31) addressed prevention. Fewer awards targeted detection alone or in conjunction with prevention (3) or cancer survivorship (4), and no grant addressed emotional sequelae or adherence behavior related to diagnosis or treatment. Fewer than half of funded grants aimed for clinically related targets (eg, sunburn reduction). Use of theory and technology occurred in more than 75% of grants. However, the full capability of proposed technology was infrequently used, and rarely did constructs of the proposed behavior change theory clearly and comprehensively drive the intervention approach. Policy or environmental manipulation was present in all dissemination grants but was rarely used elsewhere, and 19.4% included policy implementation and 25.8% proposed changes in built environment. Grant success rate in skin

  3. Virtual planning for vertical control using temporary anchorage devices

    Directory of Open Access Journals (Sweden)

    Mauricio Accorsi

    2015-01-01

    Full Text Available The new and innovative technologies are unprecedentedly improving the level of proficiency in orthodontics in the recent history of this area of expertise. The proliferation of advances, such as self-ligating systems, temporary anchorage devices, shape-memory wires, robotically wire bending, intraoral scanners, cone-beam computed tomography, bring the virtual planning, and confection of dental devices through CAD/CAM systems to the real world. In order to get efficiency and efficacy in orthodontics with these new technologies, we must understand the importance of systemically managed clinical information, medical, and dentistry history of the patients, including the images resources, which ensures the use of a communication that is assisted by the technology, with an interdisciplinary team so that the database is able to help and support the process of therapeutic decision-making. This paper presents the clinical case of a borderline patient for orthognathic surgery who had his final treatment planning supported by these new tools for three-dimensional diagnosis and virtual planning.

  4. Tobacco control: National Action Plan for NCD Prevention, Control and Health Promotion in Pakistan.

    Science.gov (United States)

    Nishtar, Sania; Mirza, Zafar; Mohamud, Khalif Bile; Latif, Ehsan; Ahmed, Ashfaq; Jafarey, Naeem A

    2004-12-01

    Reliance on revenue generated from tobacco is one of the fundamental barriers to effective tobacco control in Pakistan. The tobacco control component of the National Action Plan for Non-Communicable Diseases Prevention, Control and Health Promotion in Pakistan (NAP-NCD) deems it critical to address this issue. A range of policy and environmental strategies are part of this comprehensive effort; these involve regulating access and limiting demand through restrictions on advertising, marketing, promotion and through price and taxation. The NAP-NCD also encompasses community and school interventions, enforcement of tobacco control policies, cessation programmes, mass media counter-marketing campaigns for both prevention and cessation, and surveillance and evaluation of efforts. As part of NAP-NCD, surveillance of tobacco use has been integrated with a population-based NCD surveillance system. Featuring tobacco prominently as part of an NCD behavioural change strategy and providing wide-ranging information relevant to all aspects of tobacco prevention and control and smoking cessation have been identified as priority area in NAP-NCD. Other priority areas include the gradual phasing out of all types of advertising and eventually a complete ban on advertising; allocation of resources for policy and operational research around tobacco and building capacity in the health system in support of tobacco control. NAP-NCD also stresses on the need to develop and enforce legislation on smuggling contrabands and counterfeiting and legislation to subject tobacco to stringent regulations governing pharmaceutical products. The adoption of measures to discourage tobacco cultivation and assist with crop diversification; integration of guidance on tobacco use cessation into health services and insuring the availability and access to nicotine replacement therapy are also part of NAP-NCD.

  5. A three-dimensional visualisation preoperative treatment planning system in microwave ablation for liver cancer: a preliminary clinical application.

    Science.gov (United States)

    Liu, Fangyi; Liang, Ping; Yu, Xiaoling; Lu, Tong; Cheng, Zhigang; Lei, Chenglong; Han, Zhiyu

    2013-11-01

    The aim of this study was to evaluate the clinical application value of a 3D visualisation preoperative treatment planning system in microwave ablation for liver cancer. From December 2011 to November 2012, 94 enrolment patients of liver cancer were divided into two groups. The 3D preoperative planning group included 36 patients with 44 lesions, who underwent microwave ablation with the aid of the self-developed 3D visualisation preoperative treatment planning system. The 2D preoperative planning group included 58 patients with 64 lesions, who underwent microwave ablation according to conventional 2D image preoperative planning methods. After microwave ablation, therapeutic efficacy was assessed by contrast-enhanced imaging during follow-up. The 3D preoperative planning group had a higher success rate of first ablation than the 2D preoperative planning group (p = 0.01). There were more sessions in the 2D preoperative planning group than in the 3D preoperative planning group (p = 0.002). There were no significant differences in technique effectiveness rate between the 2D preoperative planning group (96.55%) and the 3D preoperative planning group (100%) according to the contrast-enhanced imaging follow-up after microwave ablation (p = 0.64). There were no significant differences in the rate of LTP between the 2D preoperative planning group and the 3D preoperative planning group (p = 0.64) during 3-12 months follow up (median 6 months). Compared with the 2D preoperative planning group, the 3D preoperative planning group had a higher success rate of first ablation and fewer sessions. Therefore, the 3D visualisation preoperative treatment planning system has a relatively high clinical application value.

  6. Facility control keys to long-term strategic planning

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1998-07-01

    Mount Saint Vincent University in Halifax, Nova Scotia has improved the energy efficiency of its campus by upgrading the control and monitoring of its physical plant. The first energy efficiency project on campus was in 1993 when the existing electronic and pneumatic HVAC controls was replaced with Direct Digital Control technology which was used in the replacement of fume hood controllers and temperature pressurization controls in seven laboratories. Several other projects followed, all using the System 600 building automation system (BAS) by Landis and Staefa Ltd. Today, the BAS controls and monitors over 1000 physical and virtual points, comprises 13 modular building controllers and a series of unitary and fume hood controllers, two Insight workstations, a steam plant terminal and the Visaplex paging system. These improvements have helped the university to balance its operating budget. 2 figs.

  7. Treatment Planning for Minimizing Carotid Artery Dose in the Radiotherapy of Early Glottic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ki, Yong Kan; Kim, Won Taek; Nam, Ji Ho; Kim, Dong Hyun; Lee, Ju Hye; Park, Dal; Kim, Dong Won [Pusan National University School of Medicine, Busan (Korea, Republic of)

    2011-06-15

    To examine the feasibility of the treatment planning for minimizing carotid artery dose in the radiotherapy of early glottic cancer. From 2007 to 2010, computed tomography simulation images of 31 patients treated by radiotherapy for early glottic cancer were analyzed. The virtual planning was used to compare the parallel-opposing fields (POF) with the modified oblique fields (MOF) placed at angles to exclude the ipsilateral carotid arteries. Planning target volume (PTV), irradiated volume, carotid artery, and spinal cord were analyzed at a mean dose, V{sub 35}, V{sub 40}, V{sub 50} and with a percent dose-volume. The beam angles were arranged 25 degrees anteriorly in 23 patients and 30 degrees anteriorly in 8 patients. The percent dose-volume of PTV shows no statistical difference. Conversely, the cumulative percent dose-volume of carotid artery shows the significant difference (p<0.001). The mean doses of carotid artery were 38.5 Gy for POF and 26.3 Gy for MOF and the difference was statistically significant (p=0.012). Similarly, V{sub 35}, V{sub 40}, and V{sub 50} also showed significant differences between POF and MOF. The modified oblique field was respected to prevent a carotid artery stenosis and reduce the incidence of a stroke based on these results.

  8. 4D FDG-PET based treatment planning for IGRT in the treatment of lung cancer

    Directory of Open Access Journals (Sweden)

    Alexander eChi

    2014-08-01

    Full Text Available 18F fluorodeoxyglucose positron emission tomography (FDG-PET has changed the staging of, and the treatment response assessment for lung cancer over the past decades dramatically. The improved accuracy in tumor identification with FDG-PET has led to its increased utilization in target volume delineation for radiotherapy treatment planning in the treatment of lung cancer. Despite the increased ability to distinguish tumor and normal tissue with the help of PET/CT registration, how to best delineate the PET avid tumor volume continues to be controversial as the PET intensity can be influenced by multiple machine and patient related factors. One major factor influencing the PET intensity and image resolution in the thorax is respiratory motion. This problem may be minimized by 4D FDG-PET based treatment planning, which can further improve the resolution of tumor extent, and the delineation of the internal target volume. Here, we offer our perspectives on the utilization of 4D FDG-PET based treatment planning for thoracic image-guided radiotherapy.

  9. Integrated production planning and control: A multi-objective optimization model

    Directory of Open Access Journals (Sweden)

    Cheng Wang

    2013-09-01

    Full Text Available Purpose: Production planning and control has crucial impact on the production and business activities of enterprise. Enterprise Resource Planning (ERP is the most popular resources planning and management system, however there are some shortcomings and deficiencies in the production planning and control because its core component is still the Material Requirements Planning (MRP. For the defects of ERP system, many local improvement and optimization schemes have been proposed, and improve the feasibility and practicality of the plan in some extent, but study considering the whole planning system optimization in the multiple performance management objectives and achieving better application performance is less. The purpose of this paper is to propose a multi-objective production planning optimization model Based on the point of view of the integration of production planning and control, in order to achieve optimization and control of enterprise manufacturing management. Design/methodology/approach: On the analysis of ERP planning system’s defects and disadvantages, and related research and literature, a multi-objective production planning optimization model is proposed, in addition to net demand and capacity, multiple performance management objectives, such as on-time delivery, production balance, inventory, overtime production, are considered incorporating into the examination scope of the model, so that the manufacturing process could be management and controlled Optimally between multiple objectives. The validity and practicability of the model will be verified by the instance in the last part of the paper. Findings: The main finding is that production planning management of manufacturing enterprise considers not only the capacity and materials, but also a variety of performance management objectives in the production process, and building a multi-objective optimization model can effectively optimize the management and control of enterprise

  10. 78 FR 78315 - Revision to the Idaho State Implementation Plan; Approval of Fine Particulate Matter Control...

    Science.gov (United States)

    2013-12-26

    ... AGENCY 40 CFR Part 52 Revision to the Idaho State Implementation Plan; Approval of Fine Particulate Matter Control Measures; Franklin County AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed... revision to the State Implementation Plan (SIP) to address Clean Air Act (CAA) requirements for the Idaho...

  11. Informap... a computerized information system for fire planning and fire control

    Science.gov (United States)

    Theodore G. Storey; Ross D. Carder; Ernest T. Tolin

    1969-01-01

    INFORMAP (Information Necessary for Optimum Resource Management and Protection) is a computerized system under development for storing, manipulating, retrieving, and displaying data for fire planning and fire control. A prototype for planning applications has been developed and tested. It is programed in Fortran IV for the IBM 7040 computer, and displays information in...

  12. 18F-Fdg-PET-guided Planning and Re-Planning (Adaptive) Radiotherapy in Head and Neck Cancer: Current State of Art.

    Science.gov (United States)

    Farina, Eleonora; Ferioli, Martina; Castellucci, Paolo; Farina, Arianna; Zanirato Rambaldi, Giuseppe; Cilla, Savino; Cammelli, Silvia; Fanti, Stefano; Morganti, Alessio G

    2017-12-01

    A review of the literature is proposed as a contribution to current knowledge on technical, physical, and clinical issues about PET-guided planning and re-planning radiotherapy (RT) in head and neck cancer. PubMed and Scopus electronic databases were searched for articles including clinical trials. Search terms were "gross tumor volume (GTV) delineation", "head and neck cancer", "radiotherapy", "adaptive radiotherapy" in combination with "PET". A 18F-FDG-PET and CT-scan comparison in GTV definition for RT planning of head and neck cancer was shown in twenty-seven clinical trials with a total of 712 patients. Only two clinical trials focused on PET-guided adaptive radiotherapy (ART) with a total of 31 patients. 18F-FDG-PET is able to achieve an accurate and precise definition of GTV boundaries during RT planning, especially in combination with CT-scan. ART strategies are proposed to evaluate tumor volume changes, plan boost irradiation on metabolically active residual neoplasm and protect organs at risk (OaRs). Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  13. An investigation into the relevance of action planning, theory of planned behaviour concepts, and automaticity for fruit intake action control.

    Science.gov (United States)

    de Bruijn, Gert-Jan; Wiedemann, Amelie; Rhodes, Ryan E

    2014-09-01

    In the action control framework, intention-behaviour discordance is studied around public health guidelines. Although this framework has been applied to physical activity behaviours, it has only seen very limited attention regarding fruit intake. The purpose of this study was therefore to investigate distributions and predictors of fruit intake intention-behaviour discordance. Prospective correlational design. Data were obtained from undergraduate students (n = 413) using validated questionnaires. Variables from the theory of planned behaviour, automaticity, and action planning were assessed at baseline, and fruit intake was assessed 2 weeks later. Data were analysed using discriminant function analyses and analyses of variance. The proportion of unsuccessful intenders ranged from 39.2% to 80.8%. There was a larger proportion of fruit intake intenders amongst those who reported strong automatic fruit intake. Action control was predicted by fruit intake automaticity and affective attitudes, but the strongest predictor was perceived behavioural control. No action planning items were related to fruit intake action control. There is considerable asymmetry in the intention-fruit intake relationship. An application of the action control framework may stimulate debate on the applicability of intention-based models at the public health level. What is already known on this subject? Intention is theorized to be a key construct in fruit intake. Studies in the physical activity domain indicate that nearly half of the people with positive intentions fail to subsequently act. What does this study add? The proportion of unsuccessful intenders ranged from 39.2% to 80.8%. Holding positive intentions is not sufficient to consume fruit at suggested public health guidelines. Perceived behavioural control is the most important predictor of fruit intake action control. © 2013 The British Psychological Society.

  14. Light Duty Utility Arm interface control document plan

    Energy Technology Data Exchange (ETDEWEB)

    Engstrom, J.W.

    1994-12-27

    This document describes the interface control documents that will be used to identify and control interface features throughout all phases of the Light Duty Utility Arm (LDUA) development and design. After the system is built, delivered and installed in the Cold Test Facility and later at the tank farm, the Interface Control Documents can be used in maintaining the configuration control process. The Interface Control Document will consist of Interface Control Drawings and a data base directly tied to the Interface Control Drawings. The data base can be used as an index to conveniently find interface information. Design drawings and other text documents that contain interface information will appear in the database. The Interface Control Drawings will be used to document and control the data and information that define the interface boundaries between systems, subsystems and equipment. Also, the interface boundaries will define the areas of responsibility for systems and subsystems. The drawing will delineate and identify all the physical and functional interfaces that required coordination to establish and maintain compatibility between the co-functioning equipment, computer software, and the tank farm facilities. An appendix contains the Engineering interface control database system riser manual.

  15. [Cancer plans apply to surgical treatment of prostate cancer: A geographically isolated center balance].

    Science.gov (United States)

    Mondet, F; Alimi, J-C; Boyer, C

    2017-05-01

    Since 2003, fight against cancer was structured by 3 national cancer programs (CP). The objective of this study is to evaluate the application of these measures in the case of surgical prostate cancer (PCa) treatment in a geographically isolated center. Monocentric retrospective study carried in a 100-bed clinic located 2hours away from a Cancer Regional Reference Center. Between August 2009 and December 2014, 251 consecutive patients were treated by total laparoscopic prostatectomy (TLP). Fifty-seven patients (22.7 %) received a secondary treatment after TLP. The study focused on the delay between prostate biopsies and PTL, the traceability of AD elements, the return of active patients, inclusion in clinical trials (GETUG 17, GETUG 20 and GETUG 22). Data were collected in September 2016. The follow-up defined by the time between the date of the last visit and the prostate biopsy allows a median follow-up of 43.1 months (2.4-80.5). All elements of the CAP are totally gathered on 45 % of the patients (113/251). Thirty-four (13.5 %) patients were active at the time of the intervention. Thirty-one (91.2 %) will return to an identical activity after a median work stoppage of 1.7 month (0.25-6). Fourteen percent (35/251) of the patients are eligible to a clinical trial. Seventeen percent (6/35) of them were proposed to one of a trial after multidisciplinary meeting and 5.7 % (2/35) are eventually included in one trial. CP define a course of high quality care. A better transparency of the founding of the enforceable measures and a better consideration for the local specificities should facilitate their application. The TLP treat the PCa with the reasonable objective of a return to an identical professional activity. The multidisciplinary meeting does not guarantee the participation to clinical trial, which depends mainly on distance from the Cancer Regional Reference Center and the vigilance of the Urologist. 4. Copyright © 2017 Elsevier Masson SAS. All rights

  16. Multi-assortment rhythmic production planning and control

    Science.gov (United States)

    Skolud, B.; Krenczyk, D.; Zemczak, M.

    2015-11-01

    A method for production planning in a repetitive manufacturing system which allows for estimating the possibility of processing work orders in due time is presented. The difference between two approaches are presented; the first one one-piece flow elaborated in Toyota and the second one elaborated by authors that consists in defining sufficient conditions to filter all solutions and providing a set of admissible solutions for both the client and the producer. In the paper attention is focused on the buffer allocation. Illustrative examples are presented.

  17. Predictive Control, Competitive Model Business Planning, and Innovation ERP

    DEFF Research Database (Denmark)

    Nourani, Cyrus F.; Lauth, Codrina

    2015-01-01

    Loops, are applied to complex management decisions. Predictive modeling specifics are briefed. A preliminary optimal game modeling technique is presented in brief with applications to innovation and R&D management. Conducting gap and risk analysis can assist with this process. Example application areas......New optimality principles are put forth based on competitive model business planning. A Generalized MinMax local optimum dynamic programming algorithm is presented and applied to business model computing where predictive techniques can determine local optima. Based on a systems model an enterprise...... to e-commerce with management simulation models are examined....

  18. SU-E-J-239: IMRT Planning of Prostate Cancer for a MRI-Linac Based On MRI Only

    Energy Technology Data Exchange (ETDEWEB)

    Chen, X; Prior, P; Paulson, E; Lawton, C; Li, X [Medical College of Wisconsin, Milwaukee, WI (United States)

    2014-06-01

    Purpose: : To investigate dosimetric differences between MRI- and CT-based IMRT planning for prostate cancer, the impact of a magnetic field in a MRI-Linac, and to explore the feasibility of IMRT planning based on MRI alone. Methods: IMRT plans were generated based on CT and MRI images acquired on two representative prostate-cancer patients using clinical dose volume constraints. A research planning system (Monaco, Elekta), which employs a Monte Carlo dose engine and includes a perpendicular magnetic field of 1.5T from an MRI-Linac, was used. Bulk electron density assignments based on organ-specific values from ICRU 46 were used to convert MRI (T2) to pseudo CT. With the same beam configuration as in the original CT plan, 5 additional plans were generated based on CT or MRI, with or without optimization (i.e., just recalculation) and with or without the magnetic field. The plan quality in terms of commonly used dose volume (DV) parameters for all plans was compared. The statistical uncertainty on dose was < 1%. Results: For plans with the same contour set but without re-optimization, the DV parameters were different from those for the original CT plan, mostly less than 5% with a few exceptions. These differences were reduced to mostly less than 3% when the plans were re-optimized. For plans with contours from MRI, the differences in the DV parameters varied depending on the difference in the contours as compared to CT. For the optimized plans with contours from MR, the differences for PTV were less than 3%. Conclusion: The prostate IMRT plans based on MRI-only for a MR-Linac were practically similar as compared to the CT plan under the same beam and optimization configuration if the difference on the structure delineation is excluded, indicating the feasibility of using MRI-only for prostate IMRT.

  19. The combined use of senometry and ultrasonography for breast cancer surgical planning

    Directory of Open Access Journals (Sweden)

    Ștefan Voiculescu

    2017-11-01

    Full Text Available Ultrasound exerts an important role in breast cancer diagnosis protocol, but the use of eco-senometry can also improve therapeutic options, surgical planning and technique. We describe various measurement formulas and techniques that are applied in order to acquire important information regarding the breast and its lesions. Senometry and ultrasonography have been proven to be very effective, reaching up to reliability levels as high as 0.997 and accuracy levels as high as 99.6%. Senometry and ultrasonography have clearly demonstrated their value in breast cancer diagnosis and treatment. These methods are reliable, inexpensive and can be easily performed by the surgeon. More advances in the domain are expected in the future.

  20. Integrating Planning and Control for Constrained Dynamical Systems

    Science.gov (United States)

    2007-12-01

    Computer Science, 1994. [28] DARPA. Urban Grand Challenge, 2007. [Online; accessed 19-November-2007]. [29] C. Canudas de Wit and R. Roskam . Path Following...Collins, and Jan H. van Schuppen. Reachability and Control Synthesis for Piecewise-affine Hybrid Systems on Simplices. IEEE Trans. Automatic Control...51(6):938–948, June 2006. c© 2007 David C. Conner 219 [45] Luc C. G. J. M. Habets and Jan H. van Schuppen. Control of Piecewise-Linear Hybrid Sys- tems

  1. A neo-strategic planning approach to enhance local tobacco control programs.

    Science.gov (United States)

    Douglas, Malinda R; Carter, Sara Sally R; Wilson, Andrew P; Chan, Andie

    2015-01-01

    Research in tobacco control demonstrating best practices is widely disseminated; however, application at the local level is often difficult. Translating research into practice requires a concerted effort to develop an understanding of the evidence and how it can be applied within diverse contexts. A strategic planning infrastructure was developed to support the translation of evidence-based interventions into community practice. This paper highlights the strategic process of turning "know-what" into "know-how" to facilitate the strategic planning and implementation of tobacco control best practices at the local level. The purpose, people, process, and product strategies of knowledge management and translation provided a framework for the strategic planning infrastructure. The knowledge translation concepts of audience, motivations, and mechanisms were synergized in the neo-strategic planning component design. The participants were 20 community coalitions funded to implement local tobacco control programs. From 2004 to 2011, the strategic planners facilitated a cyclical process to translate research into practice using a trio of integrated tools, skill-building workshops on strategic planning, and grantee-driven technical assistance and consultation. In the short term, the usefulness of the strategic planning components to the programs was measured. The intermediate outcome was the successful movement of the community programs from the planning stage to the implementation stage. The achievement of community-level changes in planned tobacco control efforts was the overall outcome measure for the success of the local coalitions. Seventeen of 20 communities that began the planning process implemented strategic plans. All 17 of the programs implemented evidence-based practices, resulting in numerous tobacco-free policies, increased cessation, and increased support from the media and community. Bridging the gap between research and practice can enhance the practicality

  2. Retrospective estimate of the quality of intensity-modulated radiotherapy plans for lung cancer

    Science.gov (United States)

    Koo, Jihye; Yoon, Myonggeun; Chung, Weon Kuu; Kim, Dong Wook

    2015-07-01

    This study estimated the planning quality of intensity-modulated radiotherapy in 42 lung cancer cases to provide preliminary data for the development of a planning quality assurance algorithm. Organs in or near the thoracic cavity (ipsilateral lung, contralateral lung, heart, liver, esophagus, spinal cord, and bronchus) were selected as organs at risk (OARs). Radiotherapy plans were compared by using the conformity index (CI), coverage index (CVI), and homogeneity index (HI) of the planning target volume (PTV), the OAR-PTV distance and the OAR-PTV overlap volume, and the V10 Gy , V20 Gy , and equivalent uniform dose (EUD) of the OARs. The CI, CVI, and HI of the PTV were 0.54-0.89 (0.77 ± 0.08), 0.90-1.00 (0.98 ± 0.02), and 0.11-0.41, (0.15 ± 0.05), respectively. The mean EUDs (V10 Gy , V20 Gy ) of the ipsilateral lung, contralateral lung, esophagus, cord, liver, heart, and bronchus were 8.07 Gy (28.06, 13.17), 2.59 Gy (6.53, 1.18), 7.02 Gy (26.17, 12.32), 3.56 Gy (13.56, 4.48), 0.72 Gy (2.15, 0.91), 5.14 Gy (19.68, 8.62), and 10.56 Gy (36.08, 19.79), respectively. EUDs tended to decrease as the OAR-PTV distance increased and the OAR-PTV overlap volume decreased. Because the plans in this study were from a single department, relatively few people were involved in treatment planning. Differences in treatment results for a given patient would be much more pronounced if many departments were involved.

  3. Robust Control and Motion Planning for Nonlinear Underactuated Systems Using H infinity Techniques

    National Research Council Canada - National Science Library

    Toussaint, Gregory

    2000-01-01

    This thesis presents new techniques for planning and robustly controlling the motion of nonlinear underactuated vehicles when disturbances are present and only imperfect state measurements are available for feedback...

  4. 76 FR 3178 - Proposed Extension of Existing Information Collection; Rock Burst Control Plan, Metal and...

    Science.gov (United States)

    2011-01-19

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Mine Safety and Health Administration Proposed Extension of Existing Information Collection; Rock Burst Control Plan, Metal and Nonmetal Mines AGENCY: Mine Safety and Health Administration, Labor. ACTION...

  5. R D plans for advanced computer and control technologies

    Energy Technology Data Exchange (ETDEWEB)

    Duggan, P. (Expert-EASE Systems, Inc., Belmont, CA (USA)); Sopocy, P.M. (Sargent and Lundy, Chicago, IL (USA)); Kozlik, G. (Northern Indiana Public Service Co., Hammond, IN (USA)); Sudduth, A.; Davis, J. (Duke Power Co., Charlotte, NC (USA)); Guy, K. (Public Service Co. of Indiana, Inc., Plainfield, IN (USA)); Anzolut, T. (Consolidated Edison Co. of New York, Inc., New York, NY (USA)); Mitchell, P.

    1990-02-01

    Power plant management is finding it increasingly challenging to meet the combined goals of net generated output, efficiency, reliability, and availability. Realizing these goals is becoming increasingly difficult for utilities in light of the continually increasing targets for these goals that must be set across the industry in response to today's more competitive market and demanding regulatory overview. The amount of information that must be digested, interpreted, and acted upon by plant operators to command the maximum performance from a plant while remaining responsive to all of these goals is becoming overwhelming and is rapidly expanding. Implementation of expert systems technology promises to help utilities reach these goals by assisting personnel in the management and interpretation of today's information explosion. This report provides a plan for an organized program of expert system application development that is designed to advance the implementation of expert systems technology throughout the utility industry. This plan has been developed through the efforts of a formal working group comprised of key representatives of utilities, manufacturers, architect/engineers, and consultants having experience in expert systems development. The results of a screening process by which the best prospective expert system applications were identified are presented in the form of summaries that address the need, advantages, limitations, research methodology, estimated costs and benefits, and commercialization potential of each application. Detailed ratings are presented for each of these applications, along with a resultant ranking and prioritization for development and implementation.

  6. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... about Your Advanced Cancer Coping with Your Feelings Planning for Advanced Cancer Advanced Cancer and Caregivers Questions ... Talking About Advanced Cancer Coping With Your Feelings Planning for Advanced Cancer Advanced Cancer & Caregivers Managing Cancer ...

  7. Retrospective Estimation of the Quality of Intensity-Modulated Radiotherapy Plans for Lung Cancer

    CERN Document Server

    Koo, Jihye; Chung, Weon Kuu; Kim, Dong Wook

    2015-01-01

    This study estimated the planning quality of intensity-modulated radiotherapy in 42 lung cancer cases to provide preliminary data for the development of a planning quality assurance algorithm. Organs in or near the thoracic cavity (ipsilateral lung, contralateral lung, heart, liver, esophagus, spinal cord, and bronchus) were selected as organs at risk (OARs). Radiotherapy plans were compared using the conformity index (CI), coverage index (CVI), and homogeneity index (HI) of the planning target volume (PTV), OAR-PTV distance and OAR-PTV overlap volume, and the V10Gy, V20Gy, and equivalent uniform dose (EUD) of the OARs. The CI, CVI, and HI of the PTV were 0.54 - 0.89 , 0.90 - 1.00 , and 0.11 - 0.41, respectively. The mean EUDs (V10Gy, V20Gy) of the ipsilateral lung, contralateral lung, esophagus, cord, liver, heart, and bronchus were 8.07 Gy (28.06, 13.17), 2.59 Gy (6.53, 1.18), 7.02 Gy (26.17, 12.32), 3.56 Gy (13.56, 4.48), 0.72 Gy (2.15, 0.91), 5.14 Gy (19.68, 8.62), and 10.56 Gy (36.08, 19.79), respectivel...

  8. An Automated Treatment Plan Quality Control Tool for Intensity-Modulated Radiation Therapy Using a Voxel-Weighting Factor-Based Re-Optimization Algorithm.

    Directory of Open Access Journals (Sweden)

    Ting Song

    Full Text Available Intensity-modulated radiation therapy (IMRT currently plays an important role in radiotherapy, but its treatment plan quality can vary significantly among institutions and planners. Treatment plan quality control (QC is a necessary component for individual clinics to ensure that patients receive treatments with high therapeutic gain ratios. The voxel-weighting factor-based plan re-optimization mechanism has been proved able to explore a larger Pareto surface (solution domain and therefore increase the possibility of finding an optimal treatment plan. In this study, we incorporated additional modules into an in-house developed voxel weighting factor-based re-optimization algorithm, which was enhanced as a highly automated and accurate IMRT plan QC tool (TPS-QC tool. After importing an under-assessment plan, the TPS-QC tool was able to generate a QC report within 2 minutes. This QC report contains the plan quality determination as well as information supporting the determination. Finally, the IMRT plan quality can be controlled by approving quality-passed plans and replacing quality-failed plans using the TPS-QC tool. The feasibility and accuracy of the proposed TPS-QC tool were evaluated using 25 clinically approved cervical cancer patient IMRT plans and 5 manually created poor-quality IMRT plans. The results showed high consistency between the QC report quality determinations and the actual plan quality. In the 25 clinically approved cases that the TPS-QC tool identified as passed, a greater difference could be observed for dosimetric endpoints for organs at risk (OAR than for planning target volume (PTV, implying that better dose sparing could be achieved in OAR than in PTV. In addition, the dose-volume histogram (DVH curves of the TPS-QC tool re-optimized plans satisfied the dosimetric criteria more frequently than did the under-assessment plans. In addition, the criteria for unsatisfied dosimetric endpoints in the 5 poor-quality plans could

  9. Safety and Efficacy of Pazopanib Therapy Prior to Planned Nephrectomy in Metastatic Clear Cell Renal Cancer.

    Science.gov (United States)

    Powles, Thomas; Sarwar, Naveed; Stockdale, Andrew; Sarker, Shah-Jalal; Boleti, Ekaterini; Protheroe, Andrew; Jones, Robert; Chowdhury, Simon; Peters, John; Oades, Grenville; O'Brien, Tim; Sullivan, Mark; Aitchison, Michael; Beltran, Luis; Worth, Daniel; Smith, Kate; Michel, Constance; Trevisan, Giorgia; Harvey-Jones, Elizabeth; Wimalasingham, Akhila; Sahdev, Anju; Ackerman, Charlotte; Crabb, Simon

    2016-10-01

    The role of cytoreductive nephrectomy in patients with metastatic renal cancer in the era of targeted therapy is uncertain. To establish the safety and efficacy of upfront pazopanib therapy prior to cytoreductive nephrectomy in previously untreated patients with metastatic clear cell renal cancer. Single-arm phase 2 study of 104 previously untreated patients with metastatic clear cell renal cancer recruited between June 2008 and October 2012 at cancer treatment centers with access to nephrectomy services. The minimum follow-up was 30 months. Patients received 12 to 14 weeks of preoperative pazopanib therapy prior to planned cytoreductive nephrectomy and continued pazopanib therapy after surgery. Treatment was stopped at disease progression. The primary end point was clinical benefit (using Response Evaluation Criteria in Solid Tumors, version 1.1) prior to surgery (at 12-14 weeks). Secondary end points included surgical complications, progression-free survival (PFS), overall survival (OS), and biomarker analysis. Of 104 patients recruited, 100 patients were assessable for clinical benefit prior to planned nephrectomy; 80 of 104 (76.9%) were men; median [interquartile range] age, 64 [56-71] years). Overall, 84 of 100 (84% [95% CI, 75%-91%]) gained clinical benefit before planned nephrectomy. The median reduction in the size of the primary tumor was 14.4% (interquartile range, 1.4%-21.1%). No patients were unable to undergo surgery as a result of local progression of disease. Nephrectomy was performed in 63 (61%) of patients; 14 (22%) reported surgical complications. The 2 most common reasons for not undergoing surgery were progression of disease (n = 13) and patient choice (n = 9). There was 1 postoperative surgical death. The median PFS and OS for the whole cohort were 7.1 (95% CI, 6.0-9.2) and 22.7 (95% CI, 14.3-not estimable) months, respectively. Patients with MSKCC poor-risk disease or progressive disease prior to surgery had a poor outcome (median OS

  10. Broadcasting Birth Control: mass media and family planning

    NARCIS (Netherlands)

    Parry, M.

    2013-01-01

    This book explores the use of media by American birth control movement since the early twentieth century, as they built support for fertility control and the availability of contraception. Though these public efforts in advertising and education were undertaken initially by leading advocates,

  11. Coordinating robot motion, sensing, and control in plans. LDRD project final report

    Energy Technology Data Exchange (ETDEWEB)

    Xavier, P.G.; Brown, R.G.; Watterberg, P.A. [Sandia National Labs., Albuquerque, NM (United States). Intelligent Systems and Robotics Center

    1997-08-01

    The goal of this project was to develop a framework for robotic planning and execution that provides a continuum of adaptability with respect to model incompleteness, model error, and sensing error. For example, dividing robot motion into gross-motion planning, fine-motion planning, and sensor-augmented control had yielded productive research and solutions to individual problems. Unfortunately, these techniques could only be combined by hand with ad hoc methods and were restricted to systems where all kinematics are completely modeled in planning. The original intent was to develop methods for understanding and autonomously synthesizing plans that coordinate motion, sensing, and control. The project considered this problem from several perspectives. Results included (1) theoretical methods to combine and extend gross-motion and fine-motion planning; (2) preliminary work in flexible-object manipulation and an implementable algorithm for planning shortest paths through obstacles for the free-end of an anchored cable; (3) development and implementation of a fast swept-body distance algorithm; and (4) integration of Sandia`s C-Space Toolkit geometry engine and SANDROS motion planer and improvements, which yielded a system practical for everyday motion planning, with path-segment planning at interactive speeds. Results (3) and (4) have either led to follow-on work or are being used in current projects, and they believe that (2) will eventually be also.

  12. Prospective study evaluating the use of IV contrast on IMRT treatment planning for lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Li, Hua, E-mail: huli@radonc.wustl.edu; Bottani, Beth; DeWees, Todd; Michalski, Jeff M.; Mutic, Sasa; Bradley, Jeffrey D.; Robinson, Clifford G. [Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, Missouri 63110 (United States); Low, Daniel A. [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California 90095 (United States)

    2014-03-15

    Purpose: To investigate the impact of exclusively using intravenous (IV) contrast x-ray computed tomography (CT) scans on lung cancer intensity-modulated radiation therapy (IMRT) treatment planning. Methods: Eight patients with lung cancer (one small cell, seven nonsmall cell) scheduled to receive IMRT consented to acquisition of simulation CT scans with and without IV contrast. Clinical treatment plans optimized on the noncontrast scans were recomputed on contrast scans and dose coverage was compared, along with the γ passing rates. Results: IV contrast enhanced scans provided better target and critical structure conspicuity than the noncontrast scans. Using noncontrast scan as a reference, the median absolute/relative differences in mean, maximum, and minimum doses to the planning target volume (PTV) were −4.5 cGy/−0.09%, 41.1 cGy/0.62%, and −19.7 cGy/−0.50%, respectively. Regarding organs-at-risk (OARs), the median absolute/relative differences of maximum dose to heart was −13.3 cGy/−0.32%, to esophagus was −63.4 cGy/−0.89%, and to spinal cord was −16.3 cGy/−0.46%. The median heart region of interest CT Hounsfield Unit (HU) number difference between noncontrast and contrast scans was 136.4 HU (range, 94.2–161.8 HU). Subjectively, the regions with absolute dose differences greater than 3% of the prescription dose were small and typically located at the patient periphery and/or at the beam edges. The median γ passing rate was 0.9981 (range, 0.9654–0.9999) using 3% absolute dose difference/3 mm distance-to-agreement criteria. Overall, all evaluated cases were found to be clinically equivalent. Conclusions: PTV and OARs dose differences between noncontrast and contrast scans appear to be minimal for lung cancer patients undergoing IMRT. Using IV contrast scans as the primary simulation dataset could increase treatment planning efficiency and accuracy by avoiding unnecessary scans, manually region overriding, and planning errors caused by

  13. 76 FR 4578 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

    Science.gov (United States)

    2011-01-26

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control Techniques Guidelines for Flat Wood Paneling Coatings AGENCY: Environmental Protection... Available Control Technology (RACT) for sources covered by EPA's Control Techniques Guidelines (CTG) for...

  14. 75 FR 6307 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Control of Carbon...

    Science.gov (United States)

    2010-02-09

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Maryland; Control of... current SIP requirements for the control of carbon monoxide (CO) emissions from basic oxygen furnaces... requirements for the control of CO emissions from BOFs, which Maryland had previously withdrawn from the Code...

  15. Sunway Medical Laboratory Quality Control Plans Based on Six Sigma, Risk Management and Uncertainty.

    Science.gov (United States)

    Jairaman, Jamuna; Sakiman, Zarinah; Li, Lee Suan

    2017-03-01

    Sunway Medical Centre (SunMed) implemented Six Sigma, measurement uncertainty, and risk management after the CLSI EP23 Individualized Quality Control Plan approach. Despite the differences in all three approaches, each implementation was beneficial to the laboratory, and none was in conflict with another approach. A synthesis of these approaches, built on a solid foundation of quality control planning, can help build a strong quality management system for the entire laboratory. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Intercenter validation of a knowledge based model for automated planning of volumetric modulated arc therapy for prostate cancer. The experience of the German RapidPlan Consortium.

    Directory of Open Access Journals (Sweden)

    Carolin Schubert

    Full Text Available To evaluate the performance of a model-based optimisation process for volumetric modulated arc therapy applied to prostate cancer in a multicentric cooperative group. The RapidPlan (RP knowledge-based engine was tested for the planning of Volumetric modulated arc therapy with RapidArc on prostate cancer patients. The study was conducted in the frame of the German RapidPlan Consortium (GRC.43 patients from one institute of the GRC were used to build and train a RP model. This was further shared with all members of the GRC plus an external site from a different country to increase the heterogeneity of the patient's sampling. An in silico multicentric validation of the model was performed at planning level by comparing RP against reference plans optimized according to institutional procedures. A total of 60 patients from 7 institutes were used.On average, the automated RP based plans resulted fully consistent with the manually optimised set with a modest tendency to improvement in the medium-to-high dose region. A per-site stratification allowed to identify different patterns of performance of the model with some organs at risk resulting better spared with the manual or with the automated approach but in all cases the RP data fulfilled the clinical acceptability requirements. Discrepancies in the performance were due to different contouring protocols or to different emphasis put in the optimization of the manual cases.The multicentric validation demonstrated that it was possible to satisfactorily optimize with the knowledge based model patients from all participating centres. In the presence of possibly significant differences in the contouring protocols, the automated plans, though acceptable and fulfilling the benchmark goals, might benefit from further fine tuning of the constraints. The study demonstrates that, at least for the case of prostate cancer patients, it is possibile to share models among different clinical institutes in a cooperative

  17. Population versus hospital controls for case-control studies on cancers in Chinese hospitals

    Directory of Open Access Journals (Sweden)

    Li Lin

    2011-12-01

    Full Text Available Abstract Background Correct control selection is crucial to the internal validity of case-control studies. Little information exists on differences between population and hospital controls in case-control studies on cancers in Chinese hospital setting. Methods We conducted three parallel case-control studies on leukemia, breast and colorectal cancers in China between 2009 and 2010, using population and hospital controls to separately match 540 incident cases by age, gender and residency at a 1:1 ratio. Demographic and lifestyle factors were measured using a validated questionnaire in face-to-face interview. Odds ratios (ORs and 95% confidence intervals (CIs were obtained using conditional logistic regression analyses. Results The two control groups had closely similar exposure distributions of 15 out of 16 factors, with the only exception being that hospital controls were less likely to have a BMI ≥ 25 (OR = 0.71, 95% CI: 0.54, 0.93. For exposure of green tea drinking, the adjusted ORs (95% CIs comparing green tealeaves intake ≥ 1000 grams annually with non-drinkers were 0.51 (0.31, 0.83 and 0.21 (0.27, 0.74 for three cancers combined, 0.06 (0.01, 0.61 and 0.07 (0.01, 0.47 for breast cancer, 0.52 (0.29, 0.94 and 0.45 (0.25, 0.82 for colorectal cancer, 0.65 (0.08, 5.63 and 0.57 (0.07, 4.79 for leukemia using hospital and population controls respectively. Conclusions The study found that hospital controls were comparable with population controls for most demographic characteristics and lifestyle factors measured, but there was a slight difference between the two control groups. Hospital outpatients provide a satisfactory control group in hospital-based case-control study in the Chinese hospital setting.

  18. Blocking protein quality control to counter hereditary cancers

    DEFF Research Database (Denmark)

    Kampmeyer, Caroline; Nielsen, Sofie V.; Clausen, Lene

    2017-01-01

    imbalance, which makes them more dependent on protein quality control (PQC) mechanisms than normal cells. Accordingly, blocking PQC, e.g. by proteasome inhibitors, may cause a lethal proteotoxic crisis in cancer cells, while leaving normal cells unaffected. Evidence, however, suggests that the PQC system...

  19. Cervical cancer control and prevention in Malawi: need for policy ...

    African Journals Online (AJOL)

    The paper presents finding on a qualitative study which carried out to determine the suitability of the national sexual and reproductive health and rights [SRHR] in mitigating challenges in cervical cancer control and prevention. Methods: a desk review of the Malawi National Sexual and Reproductive Health and Rights ...

  20. Thoracoscopic Splanchnicectomy for Pain Control in Irresectable Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Alireza Tavassoli

    2013-08-01

    Full Text Available Introduction : Severepain is a major problem in patients with unresectable pancreatic cancer. The goal of this study is to evaluate the effects of Thoracoscopic Splanchnicectomy (TS on pain control in these patients suffering from unresectable pancreatic cancer. Methods:Between years 2000 to 2011, 20 patients suffering from unresectable pancreatic cancer underwent TS due to severe pain. They were studied in terms of age, sex, location of pancreas tumor, history of previous surgery, response to treatments for pain control (assessed with VAS scoring system and complications of surgery. Results:M/F = 14/6 with a mean age of 63 years. The most common tumour site was at the pancreas head (in 8 patients. The most cause of unresectability was local expansion to critical adjacent elements (in 10 patients. Surgery was performed successfully in all patients. Post-operative complication included only pleural effusion on the left side which was cured by proper treatment. There were no post-op mortalities.  15 patients had acceptable levels of pain at the end of a six month follow-up period. ConclusionTS provides good pain control, little side effects and minimal invasiveness, the technique is recommended for pain control in patients with unresectable pancreatic cancer.

  1. Animal Control Chapter Management Plans: Shiawassee National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This document will define station scope, objectives, and procedures for animal control activities specific to the overall station Objectives and Management Strategy...

  2. Planning for organization development in operations control centers.

    Science.gov (United States)

    2012-06-01

    The first step in a proposed program of organization development (OD) was to assess organizational processes within the : Technical Operations Services (TechOps) Operations Control Centers (OCCs). The aim of the OD program was to : improve effectiven...

  3. Patient-centered cancer treatment planning: improving the quality of oncology care. Summary of an Institute of Medicine workshop.

    Science.gov (United States)

    Balogh, Erin P; Ganz, Patricia A; Murphy, Sharon B; Nass, Sharyl J; Ferrell, Betty R; Stovall, Ellen

    2011-01-01

    The Institute of Medicine's National Cancer Policy Forum recently convened a workshop on patient-centered cancer treatment planning, with the aim of raising awareness about this important but often overlooked aspect of cancer treatment. A primary goal of patient-centered treatment planning is to engage patients and their families in meaningful, thorough interactions with their health care providers to develop an accurate, well-conceived treatment plan, using all available medical information appropriately while also considering the medical, social, and cultural needs and desires of the patient and family. A cancer treatment plan can be shared among the patient, family, and care team in order to facilitate care coordination and provide a roadmap to help patients navigate the path of cancer treatment. There are numerous obstacles to achieving patient-centered cancer treatment planning in practice. Some of these challenges stem from the patient and include patients' lack of assertiveness, health literacy, and numeracy, and their emotional state and concurrent illnesses. Others are a result of physician limitations, such as a lack of time to explain complex information and a lack of tools to facilitate treatment planning, as well as insensitivity to patients' informational, cultural, and emotional needs. Potential solutions to address these obstacles include better training of health care providers and patients in optimal communication and shared decision making, and greater use of support services and tools such as patient navigation and electronic health records. Other options include greater use of quality metrics and reimbursement for the time it takes to develop, discuss, and document a treatment plan.

  4. An ongoing case-control study to evaluate the NHS Bowel Cancer Screening Programme.

    Science.gov (United States)

    Massat, Nathalie J; Sasieni, Peter D; Parmar, Dharmishta; Duffy, Stephen W

    2014-12-13

    Colorectal cancer is the third most common cause of cancer death in both males and females in England. A national bowel cancer screening programme was rolled out in England between 2006 and 2010. In the post-randomised controlled trials epoch, assessment of the impact of the programme using observational studies is needed. This study protocol was set up at the request of the UK Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis to evaluate the effect of the current bowel cancer screening programme on incidence of advanced primary colorectal cancer. All incident cases of primary colorectal cancer in England will be included. Cases will be matched to controls with respect to sex, age, area of registration and year of first invitation to screening. Each evaluation round will cover a 2-year period, starting from January 2012, and ongoing thereafter. In the first instance, a pilot will be carried out in a single region. Variables related to colorectal tumour pathology will be obtained to enable selection and matching of cases and controls, and to allow analyses stratification by anatomical subsite within the bowel. Cases at Duke's stage B or worse will be considered as "advanced stage". The influence of sex will also be investigated. The incidence ratio observed in randomised controlled trials between controls (not invited) and non-attender invitees will be used to correct for self-selection bias overall. Screening participation at other national screening programmes (cervical, breast) will also be collected to derive a more contemporaneous adjustment factor for self-selection bias and assess consistency in self-selection correction in female patients.Full ethical approval was obtained from the Health Research Authority. The case-control design is potentially prone to a number of biases. The size of the planned study, the design specifications and the development of analytical strategies to cope with bias should enable us to obtain accurate

  5. Advanced Instrumentation, Information, and Control Systems Technologies Technical Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    Bruce Hallbert

    2012-09-01

    Reliable instrumentation, information, and control (II&C) systems technologies are essential to ensuring safe and efficient operation of the U.S. light water reactor (LWR) fleet. These technologies affect every aspect of nuclear power plant (NPP) and balance-of-plant operations. In 1997, the National Research Council conducted a study concerning the challenges involved in modernization of digital instrumentation and control systems in NPPs. Their findings identified the need for new II&C technology integration.

  6. Effect of crisis plans on admissions and emergency visits: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Asia Ruchlewska

    Full Text Available To establish whether patients with a crisis plan had fewer voluntary or involuntary admissions, or fewer outpatient emergency visits, than patients without such a plan.Multicenter randomized controlled trial with two intervention conditions and one control condition.Adult outpatients diagnosed with psychotic or bipolar disorder who had experienced at least one psychiatric crisis in the previous two years.Two types of advance statement were used: (1 a crisis plan formulated by the patient with the help of a patient advocate (Patient Advocate Crisis Plan: PACP; and (2 a crisis plan developed together with the clinician (Clinician-facilitated Crisis Plan: CCP.The percentages of patients admitted voluntarily or involuntarily (on an emergency basis or by court order, and the percentage who made outpatient emergency visits over an 18-month follow-up period.A total of 212 patients were included: 69 in the PACP condition, 70 in the CCP condition, and 73 in the control condition. No effects of the two interventions were found on the numbers of voluntary admissions, involuntary admissions and emergency visits. Regarding involuntary admissions, there was no significant effect on emergency admissions, which were 17% (12/69 in the PACP condition, 10% (7/70 in the CCP condition, and 19% (14/73 in the control condition. There was a significant effect on planned court-ordered admissions, with 16% (11/69 in the PACP condition, 10% (7/70 in the CCP condition, and 26% (19/73 in the control condition. Finally, the interventions had no effect on outpatient emergency visits, with 32% (22/69 in the PACP group, 31% (22/70 in the CCP group, and 34% (25/73 in the control group.Crisis plans may be an effective intervention for reducing court-ordered admissions in patients with psychotic and bipolar disorders.Current Controlled Trails NTR1166.

  7. Enhancing a cancer prevention and control curriculum through interactive group discussions.

    Science.gov (United States)

    Forsythe, L P; Gadalla, S M; Hamilton, J G; Heckman-Stoddard, B M; Kent, E E; Lai, G Y; Lin, S W; Luhn, P; Faupel-Badger, J M

    2012-06-01

    The Principles and Practice of Cancer Prevention and Control course (Principles course) is offered annually by the National Cancer Institute Cancer Prevention Fellowship Program. This 4-week postgraduate course covers the spectrum of cancer prevention and control research (e.g., epidemiology, laboratory, clinical, social, and behavioral sciences) and is open to attendees from medical, academic, government, and related institutions across the world. In this report, we describe a new addition to the Principles course syllabus, which was exclusively a lecture-based format for over 20 years. In 2011, cancer prevention fellows and staff designed and implemented small group discussion sessions as part of the curriculum. The goals of these sessions were to foster an interactive environment, discuss concepts presented during the Principles course, exchange ideas, and enhance networking among the course participants and provide a teaching and leadership opportunity to current cancer prevention fellows. Overall, both the participants and facilitators who returned the evaluation forms (n=61/87 and 8/10, respectively) reported a high satisfaction with the experience for providing both an opportunity to explore course concepts in a greater detail and to network with colleagues. Participants (93%) and facilitators (100%) stated that they would like to see this component remain a part of the Principles course curriculum, and both groups provided recommendations for the 2012 program. The design, implementation, and evaluation of this initial discussion group component of the Principles course are described herein. The findings in this report will not only inform future discussion group sessions in the Principles course but may also be useful to others planning to incorporate group learning into large primarily lecture-based courses.

  8. Enhancing a Cancer Prevention and Control Curriculum through Interactive Group Discussions

    Science.gov (United States)

    Forsythe, L.P.; Gadalla, S.M.; Hamilton, J.G.; Heckman-Stoddard, B.M.; Kent, E.E.; Lai, G.Y.; Lin, S.W.; Luhn, P.; Faupel-Badger, J.M.

    2012-01-01

    The Principles and Practice of Cancer Prevention and Control course (Principles course) is offered annually by the National Cancer Institute Cancer Prevention Fellowship Program. This four-week post-graduate course covers the spectrum of cancer prevention and control research (e.g. epidemiology, laboratory, clinical, social, and behavioral sciences) and is open to attendees from medical, academic, government, and related institutions across the world. In this report, we describe a new addition to the Principles course syllabus, which was exclusively a lecture-based format for over 20 years. In 2011, Cancer Prevention Fellows and staff designed and implemented small group discussion sessions as part of the curriculum. The goals of these sessions were to foster an interactive environment, discuss concepts presented during the Principles course, exchange ideas, and enhance networking amongst the course participants, and provide a teaching and leadership opportunity to current Cancer Prevention Fellows. Overall, both the participants and facilitators who returned the evaluation forms (n=61/87, and 8/10, respectively), reported high satisfaction with the experience for providing both an opportunity to explore course concepts in greater detail and to network with colleagues. Participants (93%) and facilitators (100%) stated they would like to see this component remain a part of the Principles course curriculum, and both groups provided recommendations for the 2012 program. The design, implementation, and evaluation of this initial discussion group component of the Principles course are described herein. The findings in this report will not only inform future discussion group sessions in the Principles course but may also be useful to others planning to incorporate group learning into large primarily lecture-based courses. PMID:22661264

  9. Trajectories of personal control in cancer patients receiving psychological care.

    Science.gov (United States)

    Zhu, Lei; Schroevers, Maya J; van der Lee, Marije; Garssen, Bert; Stewart, Roy E; Sanderman, Robbert; Ranchor, Adelita V

    2015-05-01

    This study aimed to (1) identify subgroups of cancer patients with distinct personal control trajectories during psychological care, (2) examine whether socio-demographic, clinical, and psychological care characteristics could distinguish trajectories, and (3) examine differential patterns of psychological symptoms between trajectories. This naturalistic study focused on 241 cancer patients receiving psychological care at psycho-oncology institutions. Data were collected before the initiation of psychological care, and 3 and 9 months thereafter. Latent class growth analysis was applied to identify personal control trajectories. Three personal control trajectories were identified: enduring improvement (41%), temporary improvement (50%), and deterioration (9%). Education and baseline physical symptoms distinguished these trajectories. In the whole group, improvements in personal control were associated with improvements in psychological symptoms. Patients at distinct trajectories reported different levels of psychological symptoms, but did not differ in their courses of psychological symptoms. Patients in the enduring and temporary control improvement groups experienced significant psychological symptoms reductions over time, whereas patients in the control deterioration group maintained high psychological symptoms. Improvements in personal control seem to depend on initial control level: those who start with the highest control levels show subsequent improvements, whereas those with the lowest control levels show subsequent deterioration. Copyright © 2014 John Wiley & Sons, Ltd.

  10. Reproductive Risk Factors for Breast Cancer: A Case Control Study

    Directory of Open Access Journals (Sweden)

    Meshram II

    2009-11-01

    Full Text Available Background: Breast cancer is second most important cancer among Indian women. Although risk factors are not much prevalent as in western countries, incidence rate is increasing in India. The study was undertaken to study various risk factors associated with breast cancer. Methods: A hospital based group matched case control study was undertaken to identify risk factors. The study consisted of 105 hospitalized cases confirmed on histopathology and 210 group matched controls selected from urban field practice area, Sadar, without any malignancy. Bivariate analyses included odds ratio (OR, 95% confidence interval (CI for odds ratio. Results: Earlier age at menarche ≤ 12 years of age, late age at first full term delivery, nulliparity, Lack of breast-feeding were found to be significantly associated with the risk of breast cancer in both pre menopausal & post menopausal women while age at menopause at or after 50 years was significantly associated with the risk in post menopausal women. Conclusions: Study suggests that the changes in menstrual and reproductive patterns among women i.e. early age at menarche and late age at first childbirth and some environmental factors in Central India may have contributed to the increase in breast cancer risk, particularly among younger women.

  11. [Occupational risks for laryngeal cancer: a case-control study].

    Science.gov (United States)

    Sartor, Sergio Guerra; Eluf-Neto, José; Travier, Noemie; Wünsch Filho, Victor; Arcuri, Arline Sydneia Abel; Kowalski, Luís Paulo; Boffetta, Paolo

    2007-06-01

    The most solidly established risk factors for laryngeal cancer are tobacco and alcohol. As for occupational factors, the only established carcinogen is exposure to strong inorganic acid mists. However, asbestos, pesticides, paints, gasoline, diesel engine emissions, dusts, and other factors have been reported in the literature as occupational agents that increase the risk of laryngeal cancer. A hospital-based case-control study was conducted to investigate occupational risk factors for laryngeal cancer. Detailed data on smoking, alcohol consumption, and occupational history were collected for 122 laryngeal cancers and 187 controls matched by frequency (according to sex and age). Laryngeal cancer was associated with exposure to respirable free crystalline silica (OR = 1.83; 95%CI: 1.00-3.36), soot (from coal, coke, fuel oil, or wood) (odds ratio - OR = 1.78; 95% confidence interval - 95%CI: 1.03-3.03), fumes (OR = 2.55; 95%CI: 1.14-5.67), and live animals (OR = 1.80; 95%CI: 1.02-3.19).

  12. Spatial analysis of childhood cancer: a case/control study.

    Directory of Open Access Journals (Sweden)

    Rebeca Ramis

    Full Text Available Childhood cancer was the leading cause of death among children aged 1-14 years for 2012 in Spain. Leukemia has the highest incidence, followed by tumors of the central nervous system (CNS and lymphomas (Hodgkin lymphoma, HL, and Non-Hodgkin's lymphoma, NHL. Spatial distribution of childhood cancer cases has been under concern with the aim of identifying potential risk factors.The two objectives are to study overall spatial clustering and cluster detection of cases of the three main childhood cancer causes, looking to increase etiological knowledge.We ran a case-control study. The cases were children aged 0 to 14 diagnosed with leukemia, lymphomas (HL and NHL or CNS neoplasm in five Spanish regions for the period 1996-2011. As a control group, we used a sample from the Birth Registry matching every case by year of birth, autonomous region of residence and sex with six controls. We geocoded and validated the address of the cases and controls. For our two objectives we used two different methodologies. For the first, for overall spatial clustering detection, we used the differences of K functions from the spatial point patterns perspective proposed by Diggle and Chetwynd and the second, for cluster detection, we used the spatial scan statistic proposed by Kulldorff with a level for statistical significance of 0.05.We had 1062 cases of leukemia, 714 cases of CNS, 92 of HL and 246 of NHL. Accordingly we had 6 times the number of controls, 6372 controls for leukemia, 4284 controls for CNS, 552 controls for HL and 1476 controls for NHL. We found variations in the estimated empirical D(s for the different regions and cancers, including some overall spatial clustering for specific regions and distances. We did not find statistically significant clusters.The variations in the estimated empirical D(s for the different regions and cancers could be partially explained by the differences in the spatial distribution of the population; however, according to the

  13. The voice of experience: results from Cancer Control New Zealand's first national cancer care survey.

    Science.gov (United States)

    O'Brien, Inga; Britton, Emma; Sarfati, Diana; Naylor, Wayne; Borman, Barry; Ellison-Loschmann, Lis; Simpson, Andrew; Tamblyn, Craig; Atkinson, Chris

    2010-11-05

    The 2009 Cancer Care Survey aimed to gather information from patients about their experiences receiving outpatient cancer care. In mid-2009, Cancer Control New Zealand sent an NRC+Picker postal survey to a stratified sample of 3251 eligible adults, who had received outpatient cancer care between October 2008 and March 2009. Eight cancer treatment facilities across New Zealand provided patient lists from which potential respondents were selected. The final response rate to the survey was 68%. Most of the patients surveyed responded very positively to questions related to specialist care coordination (91% positive response; 95%CI: 90-93), the level of privacy (87% positive response; 95%CI: 85-89), and the dignity and respect provided by healthcare professionals (86% positive response; 95%CI: 85-88). However, patients tended to be much less positive about the level of information they received on the effects of cancer treatment on their day-to-day life (responses ranging between 30% and 40% positive) and the level of emotional support provided (36% positive response; 95%CI: 33-39). Responses from different cancer services tended to follow similar patterns, although for twelve questions there was at least a 20% difference in response between services. Overall, patients rated their outpatient cancer care experiences as positive, but important gaps exist in the provision of information, emotional support, and treating patients within the context of their living situation. Cancer patient experience surveys can achieve high response rates and generate useful information on patient perceptions of their care. This data can be used to inform quality improvement efforts at both national and cancer treatment service levels.

  14. Belief in divine control, coping, and race/ethnicity among older women with breast cancer.

    Science.gov (United States)

    Umezawa, Yoshiko; Lu, Qian; You, Jin; Kagawa-Singer, Marjorie; Leake, Barbara; Maly, Rose C

    2012-08-01

    Belief in divine control is often assumed to be fatalistic. However, the assumption has rarely been investigated in racial/ethnic minorities. This study aims to examine the association between belief in divine control and coping and how the association was moderated by ethnicity/acculturation in a multi-ethnic sample of breast cancer patients. Latina, African American, and non-Hispanic White older women with newly diagnosed breast cancer (N=257) from a population-based survey completed the scale of Belief in Divine Control and the Brief COPE. Belief in divine control was positively related to approach coping (i.e., positive reframing, active coping, and planning) in all ethnic groups. Belief in divine control was positively related to acceptance and negatively related to avoidance coping (i.e., denial and behavioral disengagement) among low-acculturated Latinas. Negative presumptions about fatalistic implications of belief in divine control should be critically reappraised, especially when such skepticism is applied to racial/ethnic minority patients.

  15. Three-dimensional helical CT for treatment planning of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hiramatsu, Hideko; Enomoto, Kohji; Ikeda, Tadashi [Keio Univ., Tokyo (Japan). School of Medicine] [and others

    1999-01-01

    The role of three-dimensional (3D) helical CT in the treatment planning of breast cancer was evaluated. Of 36 patients examined, 30 had invasive ductal carcinoma, three had invasive lobular carcinoma, one had DCIS, one had DCIS with minimal invasion, and 1 had Paget`s disease. Patients were examined in the supine position. The whole breast was scanned under about 25 seconds of breath-holding using helical CT (Proceed, Yokogawa Medical Systems, or High-speed Advantage, GE Medical Systems). 3D imaging was obtained with computer assistance (Advantage Windows, GE Medical Systems). Linear and/or spotty enhancement on helical CT was considered to suggest DCIS or intraductal spread in the area surrounding the invasive cancer. Of 36 patients, 24 showed linear and/or spotty enhancement on helical CT, and 22 of those 24 patients had DCIS or intraductal spread. In contrast, 12 of 36 patients were considered to have little or no intraductal spread on helical CT, and eight of the 12 patients had little or no intraductal spread on pathological examination. The sensitivity, specificity, and accuracy rates for detecting intraductal spread on MRI were 85%, 80%, and 83%, respectively. 3D helical CT was considered useful in detecting intraductal spread and planning surgery, however, a larger study using a precise correlation with pathology is necessary. (author)

  16. Electric vehicle charge planning using Economic Model Predictive Control

    DEFF Research Database (Denmark)

    Halvgaard, Rasmus; Poulsen, Niels K.; Madsen, Henrik

    2012-01-01

    Economic Model Predictive Control (MPC) is very well suited for controlling smart energy systems since electricity price and demand forecasts are easily integrated in the controller. Electric vehicles (EVs) are expected to play a large role in the future Smart Grid. They are expected to provide...... grid services, both for peak reduction and for ancillary services, by absorbing short term variations in the electricity production. In this paper the Economic MPC minimizes the cost of electricity consumption for a single EV. Simulations show savings of 50–60% of the electricity costs compared...... to uncontrolled charging from load shifting based on driving pattern predictions. The future energy system in Denmark will most likely be based on renewable energy sources e.g. wind and solar power. These green energy sources introduce stochastic fluctuations in the electricity production. Therefore, energy...

  17. Pain Control In Cancer Patients By Opiate Use

    Directory of Open Access Journals (Sweden)

    Mohagheghi M A

    2003-07-01

    current barriers, WHO stepwise model for cancer pain control and palliative care is recommended. Publishing Standard Treatment Guidelines for different levels of health care system is another recommended approach to optimize cancer pain."n 

  18. Pathologic analysis of control plans for air pollution management in tehran metropolis: A qualitative study

    Directory of Open Access Journals (Sweden)

    Narges Salehi Shahrabi

    2013-01-01

    Full Text Available Background: Regarding the importance of air pollution issue for large cities, as Tehran metropolis, many plans, programs, projects and regulations have been developed to manage urban air pollution. However, most of them failed to decline the pollution. The purpose of this study is to pathologically analyze air-pollution control plans in order to offer effective solutions for Tehran metropolis. Methods: A qualitative content analysis and a semi-structured interview with 14 practicing professionals were used to identify key causes and sources of Tehran′s air pollution, to recognize challenges and obstacles towards effective performance of air-pollution control plans in this metropolitan area, and to suggest the most effective controlling solutions. Results: Challenges related to air-pollution control plans can be divided into two major categories: Firstly lack of integrated and organized stewardship and secondly those related to political, economical, social and technical environmental abbreviated as PEST, challenges. For effective control of the Tehran air pollution, the following eight controlling alternatives were identified: Systematization of plan preparation process, organizing the stewardship, standardization and utilization of new technologies and professional experts, cultural and infrastructural development, realization of social justice, developing coordination and controlling mechanisms, improving citizen′s participatory capacity, and focusing on effective management of fuel and energy. Conclusions: Controlling air pollution in Tehran should be considered as a priority for policymakers to make enforcements through applying a systemic cycle of preparation effective and comprehensive plans. Further, implement the enforcements and evaluate the environmental impact of the plans through involving all stakeholders.

  19. New frontiers in translational control of the cancer genome

    Science.gov (United States)

    Truitt, Morgan L.; Ruggero, Davide

    2017-01-01

    The past several years have seen dramatic leaps in our understanding of how gene expression is rewired at the translation level during tumorigenesis to support the transformed phenotype. This work has been driven by an explosion in technological advances and is revealing previously unimagined regulatory mechanisms that dictate functional expression of the cancer genome. In this Review we discuss emerging trends and exciting new discoveries that reveal how this translational circuitry contributes to specific aspects of tumorigenesis and cancer cell function, with a particular focus on recent insights into the role of translational control in the adaptive response to oncogenic stress conditions. PMID:27112207

  20. Exercise habit strength, planning and the theory of planned behaviour: an action control approach

    NARCIS (Netherlands)

    de Bruijn, G.-J.

    2011-01-01

    Objectives Action control refers to the successful translation of intention into behaviour. The purpose of this study was to explore the potential usefulness of extending intention-exercise profiles with past exercise behaviour and exercise habit strength and the potential discriminative effect of

  1. Urinary bladder cancer risk factors: a Lebanese case- control study.

    Science.gov (United States)

    Kobeissi, Loulou Hassan; Yassine, Ibrahim Adnan; Jabbour, Michel Elias; Moussa, Mohamad Ahmad; Dhaini, Hassan Rida

    2013-01-01

    Bladder cancer is the second most incident malignancy among Lebanese men. The purpose of this study was to investigate potential risk factors associated with this observed high incidence. A case-control study (54 cases and 105 hospital-based controls) was conducted in two major hospitals in Beirut. Cases were randomly selected from patients diagnosed in the period of 2002-2008. Controls were conveniently selected from the same settings. Data were collected using interview questionnaire and blood analysis. Exposure data were collected using a structured face-to-face interview questionnaire. Blood samples were collected to determine N-acetyltransferase1 (NAT1) genotype by PCR-RFLP. Analyses revolved around univariate, bivariate and multivariate logistic regression, along with checks for effect modification. The odds of having bladder cancer among smokers was 1.02 times significantly higher in cases vs. controls. The odds of exposure to occupational diesel or fuel combustion fumes were 4.1 times significantly higher in cases vs controls. The odds of prostate-related morbidity were 5.6 times significantly higher in cases vs controls. Cases and controls showed different clustering patterns of NAT1 alleles. No significant differences between cases and controls were found for consumption of alcohol, coffee, tea, or artificial sweeteners. This is the first case-control study investigating bladder cancer risk factors in the Lebanese context. Results confirmed established risk factors in the literature, particularly smoking and occupational exposure to diesel. The herein observed associations should be used to develop appropriate prevention policies and intervention strategies, in order to control this alarming disease in Lebanon.

  2. Recommended Practice: Creating Cyber Forensics Plans for Control Systems

    Energy Technology Data Exchange (ETDEWEB)

    Eric Cornelius; Mark Fabro

    2008-08-01

    Cyber forensics has been in the popular mainstream for some time, and has matured into an information-technology capability that is very common among modern information security programs. The goal of cyber forensics is to support the elements of troubleshooting, monitoring, recovery, and the protection of sensitive data. Moreover, in the event of a crime being committed, cyber forensics is also the approach to collecting, analyzing, and archiving data as evidence in a court of law. Although scalable to many information technology domains, especially modern corporate architectures, cyber forensics can be challenging when being applied to non-traditional environments, which are not comprised of current information technologies or are designed with technologies that do not provide adequate data storage or audit capabilities. In addition, further complexity is introduced if the environments are designed using proprietary solutions and protocols, thus limiting the ease of which modern forensic methods can be utilized. The legacy nature and somewhat diverse or disparate component aspects of control systems environments can often prohibit the smooth translation of modern forensics analysis into the control systems domain. Compounded by a wide variety of proprietary technologies and protocols, as well as critical system technologies with no capability to store significant amounts of event information, the task of creating a ubiquitous and unified strategy for technical cyber forensics on a control systems device or computing resource is far from trivial. To date, no direction regarding cyber forensics as it relates to control systems has been produced other than what might be privately available from commercial vendors. Current materials have been designed to support event recreation (event-based), and although important, these requirements do not always satisfy the needs associated with incident response or forensics that are driven by cyber incidents. To address these

  3. Abortion and breast cancer: case-control study.

    Science.gov (United States)

    Ilic, Milena; Vlajinac, Hristina; Marinkovic, Jelena; Sipetic-Grujicic, Sandra

    2013-01-01

    The aim of the present study was to examine if certain aspects of a woman's experience of abortion might be associated with the risk of breast cancer. The case-control study was conducted in Kragujevac (Serbia) during the period 2004-2005. The case group (191 women) consisted of patients with newly diagnosed first primary breast cancer, which was histologically confirmed. The control group (191 women), individually matched by age (± 2 years), hospital admittance and place of residence (rural/urban) to the respective cases, was selected from female patients admitted for other diseases. The analysis was restricted to parous women (168 cases and 171 controls). Breast cancer risk was reduced among women who had a history of any abortion (adjusted OR, 0.46; 95% CI, 0.24-0.88). The protective effect was found for both induced abortion (adjusted OR, 0.47; 95% CI, 0.25-0.90) and spontaneous abortion (adjusted OR, 0.31; 95% CI, 0.10-0.98). It seems that these associations did not depend on the number of abortions, age at first abortion, or gestational age at first aborted pregnancy. Our study suggests that even short pregnancies ending in abortion add to the protection against breast cancer.

  4. Sticky Plans: Inhibition and Binding during Serial-Task Control

    Science.gov (United States)

    Mayr, Ulrich

    2009-01-01

    Recent evidence suggests substantial response-time costs associated with lag-2 repetitions of tasks within explicitly controlled task sequences [Koch, I., Philipp, A. M., Gade, M. (2006). Chunking in task sequences modulates task inhibition. "Psychological Science," 17, 346-350; Schneider, D. W. (2007). Task-set inhibition in chunked task…

  5. On the Inclusion of Externally Controlled Actions in Action Planning

    NARCIS (Netherlands)

    Tsai, C.C.; Knoblich, G.K.; Sebanz, N.

    2011-01-01

    According to ideomotor theories, perceiving action effects produced by others triggers corresponding action representations in the observer. We tested whether this principle extends to actions performed by externally controlled limbs and tools. Participants performed a go-no-go version of a spatial

  6. Fire control planning in the Northern Rocky Mountain region

    Science.gov (United States)

    L. G. Hornby

    1936-01-01

    In the northern Rocky Mountain region a high degree of protection from fire is necessary to perpetuate forest yields and communities industrially dependent upon them. On rugged and inaccessible areas a green, healthy forest cover is needed for recreation, erosion control, and regulation of water resources. Immense conflagrations continue to challenge the forester. In...

  7. Do brief online planning interventions increase physical activity amongst university students? A randomised controlled trial.

    Science.gov (United States)

    Skår, Silje; Sniehotta, Falko F; Molloy, Gerard J; Prestwich, Andrew; Araújo-Soares, Vera

    2011-04-01

    Brief planning interventions, usually delivered within paper and pencil questionnaires, have been found to be effective in changing health behaviours. Using a double-blind randomised controlled trial, this study examined the efficacy of two types of planning interventions (action plans and coping plans) in increasing physical activity levels when they are delivered via the internet. Following the completion of self-reported physical activity (primary outcome) and theory of planned behaviour (TPB) measures at baseline, students (N = 1273) were randomised into one of four conditions on the basis of a 2 (received instructions to form action plans or not) × 2 (received instructions to form coping plans or not) factorial design. Physical activity (primary outcome) and TPB measures were completed again at two-month follow-up. An objective measure (attendance at the university's sports facilities) was employed 6 weeks after a follow-up for a duration of 13 weeks (secondary outcome). The interventions did not change self-reported physical activity, attendance at campus sports facilities or TPB measures. This might be due to low adherence to the intervention protocol (ranging from 58.8 to 76.7%). The results of this study suggest that the planning interventions under investigation are ineffective in changing behaviour when delivered online to a sample of participants unaware of the allocation to different conditions. Possible moderators of the effectiveness of planning interventions in changing health behaviours are discussed.

  8. Usefulness of radiation treatment planning allpied respiration factor for streotatic body radiation therapy in the lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Sung Pil; Kim, Tae Hyung; So, Woon Young; Back, Geum Mun [Dept. of Medical Health Science, Graduate School, Kangwon National University, Chuncheon (Korea, Republic of)

    2016-12-15

    We are evaluated the usefulness of radiation treatment planning applied respiration factor for stereotactic body radiation therapy in the lung cancer. Four dimensional computed tomography images were obtained in 10 patients with lung cancer. The radiation treatment plans were established total lung volume according to respiration images (new method) and conventional method. We was analyzed in the lung volume, radiation absorbed dose of lung and main organs (ribs, tracheobronchus, esophagus, spinal cord) around the tumor, respectively. We were confirmed that lung volume and radiation absorbed dose of lung and main organs around the tumor deference according to applied respiration. In conclusion, radiation treatment planning applied respiration factor seems to be useful for stereotactic body radiation therapy in the lung cancer.

  9. Ultrasonic tissue-type imaging (TTI) for planning treatment of prostate cancer

    Science.gov (United States)

    Feleppa, Ernest J.; Ketterling, Jeffrey A.; Porter, Christopher R.; Gillespie, John; Wuu, Cheng-Shie; Urban, Stella; Kalisz, Andrew; Ennis, Ronald D.; Schiff, Peter B.

    2004-04-01

    Our research is intended to develop ultrasonic methods for characterizing cancerous prostate tissue and thereby to improve the effectiveness of biopsy guidance, therapy targeting, and treatment monitoring. We acquired radio-frequency (RF) echo-signal data and clinical variables, e.g., PSA, during biopsy examinations. We computed spectra of the RF signals in each biopsied region, and trained neural network classifers with over 3,000 sets of data using biopsy data as the gold standard. For imaging, a lookup table returned scores for cancer likelihood on a pixel-by-pixel basis from spectral-parameter and PSA values. Using ROC analyses, we compared classification performance of artificial neural networks (ANNs) to conventional classification with a leave-one-patient-out approach intended to minimize the chance of bias. Tissue-type images (TTIs) were compared to prostatectomy histology to further assess classification performance. ROC-curve areas were greater for ANNs than for the B-mode-based classification by more than 20%, e.g., 0.75 +/- 0.03 for neural-networks vs. 0.64 +/- 0.03 for B-mode LOSs. ANN sensitivity was 17% better than the sensitivity range of ultrasound-guided biopsies. TTIs showed tumors that were entirely unrecognized in conventional images and undetected during surgery. We are investigating TTIs for guiding prostrate biopsies, and for planning radiation dose-escalation and tissue-sparing options, and monitoring prostrate cancer.

  10. Evaluation of volumetric modulated arc therapy (VMAT with Oncentra MasterPlan® for the treatment of head and neck cancer

    Directory of Open Access Journals (Sweden)

    Koelbl Oliver

    2010-11-01

    Full Text Available Abstract Background Several comparison studies have shown the capability of VMAT to achieve similar or better plan quality as IMRT, while reducing the treatment time. The experience of VMAT in a multi vendor environment is limited. We compared the plan quality and performance of VMAT to IMRT and we investigate the effects of varying various user-selectable parameters. Methods IMRT, single arc VMAT and dual arc VMAT were compared for four different head-and-neck tumors. For VMAT, the effect of varying gantry angle spacing and treatment time on the plan quality was investigated. A comparison of monitor units and treatment time was performed. Results IMRT and dual arc VMAT achieved a similar plan quality, while single arc could not provide an acceptable plan quality. Increasing the number of control points does not improve the plan quality. Dual arc VMAT delivery time is about 30% of IMRT delivery time. Conclusions Dual arc VMAT is a fast and accurate technique for the treatment of head and neck cancer. It applies similar number of MUs as IMRT, but the treatment time is strongly reduced, maintaining similar or better dose conformity to the PTV and OAR sparing.

  11. Clinical implementation of coverage probability planning for nodal boosting in locally advanced cervical cancer.

    Science.gov (United States)

    Ramlov, Anne; Assenholt, Marianne S; Jensen, Maria F; Grønborg, Caroline; Nout, Remi; Alber, Markus; Fokdal, Lars; Tanderup, Kari; Lindegaard, Jacob Chr

    2017-04-01

    To implement coverage probability (CovP) for dose planning of simultaneous integrated boost (SIB) of pathologic lymph nodes in locally advanced cervical cancer (LACC). CovP constraints for SIB of the pathological nodal target (PTV-N) with a central dose peak and a relaxed coverage at the perimeter were generated for use with the treatment planning system Eclipse: PTV-N D98 >90%, CTV-N D98 >100% and CTV-N D50 >101.5% of prescribed dose. Dose of EBRT was 45Gy/25 fx with a SIB of 55-57.5Gy depending on expected dose from brachytherapy (BT). Twenty-five previously treated patients with 47 boosted nodes were analysed. Nodes were contoured on cone beam CT (CBCT) and the accumulated dose in GTV-N CBCT and volume of body, pelvic bones and bowel receiving >50Gy (V50) were determined. Nearly all nodes (89%) were visible on CBCT and showed considerable concentric regression during EBRT. Total EBRT and BT D98 was >57 Gy EQD2 in 98% of the visible nodes. Compared to treatment plans aiming for full PTV-N coverage, CovP significantly reduced V50 of body, bones and bowel (p<0.001) CONCLUSION: CovP is clinically feasible for SIB of pathological nodes and significantly decreases collateral SIB dose to nearby OAR. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Nuclear medicine for photodynamic therapy in cancer: Planning, monitoring and nuclear PDT.

    Science.gov (United States)

    Kharroubi Lakouas, Dris; Huglo, Damien; Mordon, Serge; Vermandel, Maximilien

    2017-06-01

    Photodynamic therapy (PDT) is a modality with promising results for the treatment of various cancers. PDT is increasingly included in the standard of care for different pathologies. This therapy relies on the effects of light delivered to photosensitized cells. At different stages of delivery, PDT requires imaging to plan, evaluate and monitor treatment. The contribution of molecular imaging in this context is important and continues to increase. In this article, we review the contribution of nuclear medicine imaging in oncology to PDT for planning and therapeutic monitoring purposes. Several solutions have been proposed to plan PDT from nuclear medicine imaging. For instance, photosensitizer biodistribution has been evaluated with a radiolabeled photosensitizer or with conventional radiopharmaceuticals on positron emission tomography. The effects of PDT delivery have also been explored with specific SPECT or PET radiopharmaceuticals to evaluate the effects on cells (apoptosis, necrosis, proliferation, metabolism) or vascular damage. Finally, the synergy between photosensitizers and radiopharmaceuticals has been studied considering the Cerenkov effect to activate photosensitized cells. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Forest Restoration Monitoring and Erosion Control Work Planning

    OpenAIRE

    HONDA, Kiyoshi; MURAI, Shunji; SHIBASAKI, Ryousuke

    1995-01-01

    [ABSTRACT] This paper describes the qualitative evaluation of forest destruction and erosion control work at Asio copper mine. The vegetation restoration process is grasped using remote sensing and GIS. This data is used to develop the vegetation restoration model.. The vegetation restoration process is expressed by a growth curve that is applied to the vegetation index. The sediment and flood discharge models are also developed which can use the result of the vegetation restoration model. Un...

  14. Action control bridges the planning-behaviour gap: a longitudinal study on physical exercise in young adults.

    Science.gov (United States)

    Reyes Fernández, Benjamín; Fleig, Lena; Godinho, Cristina A; Montenegro Montenegro, Esteban; Knoll, Nina; Schwarzer, Ralf

    2015-01-01

    Maintaining physical exercise levels may not only require motivation and planning but also action control which is supposed to mediate between planning and exercise. Behavioural intention, action planning, coping planning and past behaviour were assessed at baseline, and action control and concurrent exercise were measured one month later in 497 young adults. Three nested structural models were specified to examine different mediation mechanisms. One model reflected the intention-planning-behaviour chain, the other one focused on the intention-action control-behaviour chain and the third model comprised the full sequence. Indirect effects from intentions on exercise involved either planning or action control as mediating variables. In Model 3, all three constructs (action planning, coping planning and action control) were sequential mediators between intentions and later physical exercise levels. Action and coping planning were not directly but indirectly related to exercise via action control. Findings support the sequential mediation for planning and action control as antecedents of physical exercise. Action control is needed for exercise, because planning in itself is not always sufficient. Maintaining exercise levels may be attributed to effective self-regulatory strategies such as action control in combination with planning.

  15. Cancer treatment as a game: integrating evolutionary game theory into the optimal control of chemotherapy

    Science.gov (United States)

    Orlando, Paul A.; Gatenby, Robert A.; Brown, Joel S.

    2012-01-01

    Chemotherapy for metastatic cancer commonly fails due to evolution of drug resistance in tumor cells. Here, we view cancer treatment as a game in which the oncologists choose a therapy and tumors “choose” an adaptive strategy. We propose the oncologist can gain an upper hand in the game by choosing treatment strategies that anticipate the adaptations of the tumor. In particular, we examine the potential benefit of exploiting evolutionary tradeoffs in tumor adaptations to therapy. We analyze a math model where cancer cells face tradeoffs in allocation of resistance to two drugs. The tumor “chooses” its strategy by natural selection and the oncologist chooses her strategy by solving a control problem. We find that when tumor cells perform best by investing resources to maximize response to one drug the optimal therapy is a time-invariant delivery of both drugs simultaneously. However, if cancer cells perform better using a generalist strategy allowing resistance to both drugs simultaneously, then the optimal protocol is a time varying solution in which the two drug concentrations negatively covary. However, drug interactions can significantly alter these results. We conclude that knowledge of both evolutionary tradeoffs and drug interactions is crucial in planning optimal chemotherapy schedules for individual patients. PMID:23197192

  16. 78 FR 58460 - Revision of Air Quality Implementation Plan; California; Placer County Air Pollution Control...

    Science.gov (United States)

    2013-09-24

    ... AGENCY 40 CFR Part 52 Revision of Air Quality Implementation Plan; California; Placer County Air Pollution Control District and Feather River Air Quality Management District; Stationary Source Permits... California as a revision to the Placer County Air Pollution Control District (PCAPCD) and Feather River Air...

  17. 78 FR 12267 - Revision of Air Quality Implementation Plan; California; Placer County Air Pollution Control...

    Science.gov (United States)

    2013-02-22

    ... AGENCY 40 CFR Part 52 Revision of Air Quality Implementation Plan; California; Placer County Air Pollution Control District and Feather River Air Quality Management District; Stationary Source Permits... County Air Pollution Control District (PCAPCD) and Feather River Air Quality Management District (FRAQMD...

  18. 76 FR 64015 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

    Science.gov (United States)

    2011-10-17

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control Techniques Guidelines for Drum and Pail Coatings AGENCY: Environmental Protection Agency... revision meets the requirement to adopt Reasonably Available Control Technology (RACT) for sources covered...

  19. 76 FR 4534 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

    Science.gov (United States)

    2011-01-26

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control Techniques Guidelines for Flat Wood Paneling Coatings AGENCY: Environmental Protection... Processes, and meets the requirement to adopt Reasonably Available Control Technology (RACT) for sources...

  20. 76 FR 48754 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Reasonably Available Control...

    Science.gov (United States)

    2011-08-09

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Ohio; Reasonably Available Control Technology, Oxides of Nitrogen, Cleveland Ozone Non-Attainment AGENCY: Environmental... ) Reasonably Available Control Technology (RACT) for major sources in the former Cleveland-Akron-Lorain...

  1. 77 FR 22676 - Revisions to the Arizona State Implementation Plan, Pinal County Air Quality Control District

    Science.gov (United States)

    2012-04-17

    ... AGENCY 40 CFR Part 52 Revisions to the Arizona State Implementation Plan, Pinal County Air Quality Control District AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY: EPA is finalizing a limited approval and limited disapproval of a revision to the Pinal County Air Quality Control...

  2. 76 FR 10295 - Approval and Promulgation of Air Quality Implementation Plans; Texas; Revisions To Control...

    Science.gov (United States)

    2011-02-24

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Texas; Revisions To Control Volatile Organic Compound Emissions From Consumer Related Sources AGENCY: Environmental Protection..., Control of Air Pollution from Volatile Organic Compounds. The State submitted these revisions on March 4...

  3. 76 FR 27610 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control...

    Science.gov (United States)

    2011-05-12

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Maryland; Adoption of Control Techniques Guidelines for Large Appliance Coatings AGENCY: Environmental Protection Agency... Processes and meets the requirement to adopt Reasonably Available Control Technology (RACT) for sources...

  4. 75 FR 56942 - Revisions to the California State Implementation Plan, San Diego County Air Pollution Control...

    Science.gov (United States)

    2010-09-17

    ... Pollution Control District AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve revisions to the San Diego Air Pollution Control District (SDCAPCD) portion of the California State Implementation Plan (SIP). This revision concerns the definition of...

  5. 75 FR 18142 - Approval and Promulgation of Air Quality Implementation Plans; Texas; Control of Air Pollution...

    Science.gov (United States)

    2010-04-09

    ... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Texas; Control of Air Pollution From Motor Vehicles AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule... Title 30 of the Texas Administrative Code (TAC), Chapter 114, Control of Air Pollution from Motor...

  6. 75 FR 6337 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Control of Carbon...

    Science.gov (United States)

    2010-02-09

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Maryland; Control of... submitted by the State of Maryland for the purpose of replacing the existing requirements for the control of...

  7. The effects of cancer and racial disparities in health-related quality of life among older Americans: a case-control, population-based study.

    Science.gov (United States)

    Pinheiro, Laura C; Wheeler, Stephanie B; Chen, Ronald C; Mayer, Deborah K; Lyons, Jessica C; Reeve, Bryce B

    2015-04-15

    Understanding the impact of the cancer care system on racial/ethnic disparities in health-related quality of life (HRQOL) is increasingly important as the number of cancer survivors in the United States grows. The authors prospectively assessed changes in HRQOL before and after a first cancer diagnosis among non-Hispanic whites (NHWs), African Americans (AAs), Hispanics, and Asians in a cohort of Medicare beneficiaries with and without cancer. Data from the Surveillance, Epidemiology, and End Results linked with the Medicare Health Outcomes Survey were used to identify 1778 individuals aged ≥65 years with prostate, breast, or colorectal cancer from 1998 to 2007. The Medical Outcomes Trust Short Form 36 (SF-36) instrument was used to measure HRQOL. By using propensity scores, each patient with cancer (case) was matched to 5 individuals without cancer (noncancer controls), and differences in HRQOL according to race/ethnicity were assessed. Mixed effects analysis of covariance models was used to assess differences in HRQOL, adjusting for baseline HRQOL, demographics, and self-reported comorbid conditions while controlling for each individual's managed care plan. Stratified analyses were used to assess racial/ethnic disparities between cases and noncancer controls. Before cancer diagnosis, NHWs had better HRQOL scores than AAs and Hispanics on the Role-Physical and Role-Emotional SF-36 subscales. Cancer diagnosis/treatment negatively impacted individuals' lives regardless of race/ethnicity. However, among cases, gaps between racial/ethnic groups narrowed (compared with controls) before and after cancer diagnosis for some SF-36 HRQOL measures. Racial/ethnic HRQOL gaps exist among cancer survivors but may narrow because of exposure to the cancer care system. Further research to understand why this occurs will help inform initiatives to manage the impact of cancer on HRQOL among elderly cancer survivors. © 2014 American Cancer Society.

  8. Case-control study of gastric cancer screening in Venezuela.

    Science.gov (United States)

    Pisani, P; Oliver, W E; Parkin, D M; Alvarez, N; Vivas, J

    1994-06-01

    A screening programme for early gastric cancer was introduced in the state of Tachira, Venezuela, in 1980. Screening was performed by photofluorography, using two mobile units. The efficacy of this programme in reducing mortality from stomach cancer was evaluated by means of a case-control study. Cases were 241 individuals who died from stomach cancer in the period 1985-89. Ten live controls per case were drawn from the electoral rolls, matched by sex, age and residence. Exposure to the screening examination of cases and controls was assessed through individual linkage with the programme's centralised database. After the exclusion of examinations occurring within the 6 months preceding the case's diagnosis, the odds ratio (OR) of dying from stomach cancer for those screened was 1.26 (CI 0.83-1.91) and the OR in females was lower than in males: 0.77 (CI 0.33-1.78) and 1.52 (CI 0.94-2.47) respectively. Odds ratios associated with years since last test and number of tests did not differ significantly from 1. These results show the inefficacy of the programme in reducing mortality from gastric cancer in the area. In an attempt to determine whether this result was due to selection bias, an analysis restricted to subjects who had been screened at least once was performed. When examinations occurring after an index date at various intervals before the case's diagnosis were excluded, the screening test appeared to protect from death, although confidence intervals of the odds ratios are large, for example OR = 0.47 (CI 0.24-0.98) when excluding tests within 1 month.

  9. Physical and biological pretreatment quality assurance of the head and neck cancer plan with the volumetric modulated arc therapy

    Science.gov (United States)

    Park, So-Hyun; Lee, Dong-Soo; Lee, Yun-Hee; Lee, Seu-Ran; Kim, Min-Ju; Suh, Tae-Suk

    2015-09-01

    The aim of this work is to demonstrate both the physical and the biological quality assurance (QA) aspects as pretreatment QA of the head and neck (H&N) cancer plan for the volumetric modulated arc therapy (VMAT). Ten H&N plans were studied. The COMPASS® dosimetry analysis system and the tumor control probability (TCP) and the normal tissue complication probability (NTCP) calculation free program were used as the respective measurement and calculation tools. The reliability of these tools was verified by a benchmark study in accordance with the TG-166 report. For the physical component of QA, the gamma passing rates and the false negative cases between the calculated and the measured data were evaluated. The biological component of QA was performed based on the equivalent uniform dose (EUD), TCP and NTCP values. The evaluation was performed for the planning target volumes (PTVs) and the organs at risks (OARs), including the eyes, the lens, the parotid glands, the esophagus, the spinal cord, and the brainstem. All cases had gamma passing rates above 95% at an acceptance tolerance level with the 3%/3 mm criteria. In addition, the false negative instances were presented for the PTVs and OARs. The gamma passing rates exhibited a weak correlation with false negative cases. For the biological QA, the physical dose errors affect the EUD and the TCP for the PTVs, but no linear correlation existed between them. The EUD and NTCP for the OARs were shown the random differences that could not be attributed to the dose errors from the physical QA. The differences in the EUD and NTCP between the calculated and the measured results were mainly demonstrated for the parotid glands. This study describes the importance and the necessity of improved QA to accompany both the physical and the biological aspects for accurate radiation treatment.

  10. Bivalent Epigenetic Control of Oncofetal Gene Expression in Cancer.

    Science.gov (United States)

    Zaidi, Sayyed K; Frietze, Seth E; Gordon, Jonathan A; Heath, Jessica L; Messier, Terri; Hong, Deli; Boyd, Joseph R; Kang, Mingu; Imbalzano, Anthony N; Lian, Jane B; Stein, Janet L; Stein, Gary S

    2017-12-01

    Multiple mechanisms of epigenetic control that include DNA methylation, histone modification, noncoding RNAs, and mitotic gene bookmarking play pivotal roles in stringent gene regulation during lineage commitment and maintenance. Experimental evidence indicates that bivalent chromatin domains, i.e., genome regions that are marked by both H3K4me3 (activating) and H3K27me3 (repressive) histone modifications, are a key property of pluripotent stem cells. Bivalency of developmental genes during the G 1 phase of the pluripotent stem cell cycle contributes to cell fate decisions. Recently, some cancer types have been shown to exhibit partial recapitulation of bivalent chromatin modifications that are lost along with pluripotency, suggesting a mechanism by which cancer cells reacquire properties that are characteristic of undifferentiated, multipotent cells. This bivalent epigenetic control of oncofetal gene expression in cancer cells may offer novel insights into the onset and progression of cancer and may provide specific and selective options for diagnosis as well as for therapeutic intervention. Copyright © 2017 American Society for Microbiology.

  11. Production planning and control of less emitting production systems

    Energy Technology Data Exchange (ETDEWEB)

    Haasis, H.D. [Bremen Univ. (Germany)

    1995-12-31

    The concept of integral environmental protection has been growing in importance within Western Europe in recent years. Increasingly, it has come to be recognized that no one part of the environment is separate from any other, it functions as a whole. Yet, pollution control was until recently, usually based on an approach which considers emissions to air, water, and land separately. That has begun to change, particularly since the 1987 report by the World Commission on Environment and Development. This can be recognized, for example, within the proposal for a Directive of the Council of the European Union on Integrated Pollution Prevention and Control. By this, the environmental media are placed on an equal legislative footing so that the final result will be that the way in which an installation is operated will be better for the whole environment. In other words, less emission production systems are obtained. Realization of an integral concept or of less emission production systems initially requires technical measures for the avoidance and the minimization of emissions, as well as recovery and recycling of materials and substances

  12. Family History as a Risk for Upper Gastrointestinal Tract Cancer: A Case Control Study

    OpenAIRE

    A Safaee; Moghimi Dehkordi, B; Fatemi, SR; Maserat, E; Ghafarnejad, F; Zali, MR

    2011-01-01

    Background Although, family history of cancer is an important risk factor for upper gastrointestinal cancers development, but limited information is available on the upper gastrointestinal cancers associated with family history in Iran. The purpose of this study was to define upper gastrointestinal cancers risk associated with family history of cancer. Methods This study was conducted as a case control study. A total number of 1,010 cases of upper gastrointestinal cancer and 1,010 healthy con...

  13. Evaluation of plan quality assurance models for prostate cancer patients based on fully automatically generated Pareto-optimal treatment plans.

    Science.gov (United States)

    Wang, Yibing; Breedveld, Sebastiaan; Heijmen, Ben; Petit, Steven F

    2016-06-07

    IMRT planning with commercial Treatment Planning Systems (TPSs) is a trial-and-error process. Consequently, the quality of treatment plans may not be consistent among patients, planners and institutions. Recently, different plan quality assurance (QA) models have been proposed, that could flag and guide improvement of suboptimal treatment plans. However, the performance of these models was validated using plans that were created using the conventional trail-and-error treatment planning process. Consequently, it is challenging to assess and compare quantitatively the accuracy of different treatment planning QA models. Therefore, we created a golden standard dataset of consistently planned Pareto-optimal IMRT plans for 115 prostate patients. Next, the dataset was used to assess the performance of a treatment planning QA model that uses the overlap volume histogram (OVH). 115 prostate IMRT plans were fully automatically planned using our in-house developed TPS Erasmus-iCycle. An existing OVH model was trained on the plans of 58 of the patients. Next it was applied to predict DVHs of the rectum, bladder and anus of the remaining 57 patients. The predictions were compared with the achieved values of the golden standard plans for the rectum D mean, V 65, and V 75, and D mean of the anus and the bladder. For the rectum, the prediction errors (predicted-achieved) were only  -0.2  ±  0.9 Gy (mean  ±  1 SD) for D mean,-1.0  ±  1.6% for V 65, and  -0.4  ±  1.1% for V 75. For D mean of the anus and the bladder, the prediction error was 0.1  ±  1.6 Gy and 4.8  ±  4.1 Gy, respectively. Increasing the training cohort to 114 patients only led to minor improvements. A dataset of consistently planned Pareto-optimal prostate IMRT plans was generated. This dataset can be used to train new, and validate and compare existing treatment planning QA models, and has been made publicly available. The OVH model was highly accurate

  14. Cost-effectiveness analysis of breast cancer control interventions in peru

    NARCIS (Netherlands)

    Zelle, S.G.; Vidaurre, T.; Abugattas, J.E.; Manrique, J.E.; Sarria, G.; Jeronimo, J.; Seinfeld, J.N.; Lauer, J.A.; Sepulveda, C.R.; Venegas, D.; Baltussen, R.

    2013-01-01

    OBJECTIVES: In Peru, a country with constrained health resources, breast cancer control is characterized by late stage treatment and poor survival. To support breast cancer control in Peru, this study aims to determine the cost-effectiveness of different breast cancer control interventions relevant

  15. 77 FR 66469 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Science.gov (United States)

    2012-11-05

    ... HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and... meeting of the aforementioned committee: Name: Breast and Cervical Cancer Early Detection and Control..., regarding the early detection and control of breast and cervical cancer. The committee makes recommendations...

  16. Cost-effectiveness analysis of breast cancer control interventions in Peru

    NARCIS (Netherlands)

    Zelle, S.G.; Vidaurre, T.; Abugattas, J.E.; Manrique, J.E.; Sarria, G.; Jeronimo, J.; Seinfeld, J.N.; Lauer, J.A.; Sepulveda, C.R.; Venegas, D.; Baltussen, R.

    2013-01-01

    OBJECTIVES: In Peru, a country with constrained health resources, breast cancer control is characterized by late stage treatment and poor survival. To support breast cancer control in Peru, this study aims to determine the cost-effectiveness of different breast cancer control interventions relevant

  17. The adaptive role of perceived control before and after cancer diagnosis : A prospective study

    NARCIS (Netherlands)

    Ranchor, A.V.; Wardle, J.; Steptoe, A.; Henselmans, I.; Ormel, J.; Sanderman, R.

    Cancer is generally considered a low-control situation. Stability of perceptions of control before and after cancer was examined, as well as the adaptive value of maintenance versus relinquishment of control in the psychological adjustment to cancer. This study, conducted in the northern

  18. The Effectiveness of Planning Control on Urban Growth: Evidence from Hangzhou, China

    Directory of Open Access Journals (Sweden)

    Yizhou Wu

    2017-05-01

    Full Text Available Urban sprawl presents a serious challenge for sustainable urban land use. Urban planning attempts to guarantee sustainable urban development and proper use of land resources. However, a large gap usually exists between planning and actual development. This paper aims to analyze the evolutionary characteristics of urban form and the spatiotemporal dynamics of urban planning from 1964 to 2013, using the case of Hangzhou, China. We proposed a framework that included remote sensing, landscape metrics, and control effectiveness indexes. The results indicated that urban planning failed to perform effectively in Hangzhou, reflected by the uncontrolled urban sprawl during all the planning periods. The low effectiveness of planning was resulted from multiple factors, including historical economic events that made expansion unexpected, functional orientation of planning which drove fragmented suburbanization, the ineffective methods for forecasting population and land use, and the influences by the market forces. The findings deepen the understanding of the impacts of urban planning, and provide references for making rational urban management decisions and sustainable urban land management.

  19. Cancer control and the communication innovation in South Korea: implications for cancer disparities.

    Science.gov (United States)

    Jung, Minsoo

    2013-01-01

    Over the last 10 years, the number of cancer survivors in South Korea has reached nearly one million with a survival rate of 49.4%. However, integrated supportive care for cancer survivors is lagging. One area in which the current cancer control policy needs updating is in the utilization of information and communication technology (ICT). The remarkable progress in the field of ICT over the past 10 years presents exciting new opportunities for health promotion. Recent communication innovations are conducive to the exchange of meta-information, giving rise to a new service area and transforming patients into active medical consumers. Consequently, such innovations encourage active participation in the mutual utilization and sharing of high-quality information. However, these benefits from new ICTs will almost certainly not be equally available to all, leading to so-called communication inequalities where cancer survivors from lower socioeconomic classes will likely have more limited access to the best means of making use of the health information. Therefore, most essentially, emphasis must be placed on helping cancer survivors and their caregivers utilize such advances in ICT to create a more efficient flow of health information, thereby reducing communication inequalities and expanding social support. Once we enhance access to health information and better manage the quality of information, as a matter of fact, we can expect an alleviation of the health inequalities faced by cancer survivors.

  20. A Matched Case-Control Study of Risk Factors for Breast Cancer Risk in Vietnam

    OpenAIRE

    Nguyen, J.; Le, Q. H.; Duong, B. H.; Sun, P.; Pham, H. T.; Ta, V. T.; Kotsopoulos, J.; Narod, S. A.; Ginsburg, O.

    2016-01-01

    Background. Vietnam has a low age-standardized incidence of breast cancer, but the incidence is rising rapidly with economic development. We report data from a matched case-control study of risk factors for breast cancer in the largest cancer hospital in Vietnam. Methods. 492 incident breast cancer cases unselected for family history or age at diagnosis and 1306 control women age 25–75 were recruited from the National Cancer Hospital (BVK), Hanoi. Structured interviews were conducted and path...

  1. Association between Alcohol Consumption, Folate Intake, and Risk of Pancreatic Cancer: A Case-Control Study

    OpenAIRE

    Winta Yellow; Bamlet, William R.; Ann L Oberg; Anderson, Kristin E.; Olson, Janet E.; Rashmi Sinha; Petersen, Gloria M.; Stolzenberg-Solomon, Rachael Z.; Jansen, Rick J.

    2017-01-01

    Pancreatic cancer is one of the most fatal common cancers affecting both men and women, representing about 3% of all new cancer cases in the United States. In this study, we aimed to investigate the association of pancreatic cancer risk with alcohol consumption as well as folate intake. We performed a case-control study of 384 patients diagnosed with pancreatic cancer from May 2004 to December 2009 and 983 primary care healthy controls in a largely white population (>96%). Our findings sho...

  2. Practical aspects of inverse-planned intensity-modulated radiation therapy for prostate cancer: a radiation treatment planner's perspective.

    Science.gov (United States)

    Parker, William; Patrocinio, Horacio

    2005-06-01

    From a radiation treatment planner perspective, in the treatment of prostate cancer, inverse-planned intensity-modulated radiation therapy (IMRT) differs considerably from conventional, conformal, and forward-planned IMRT. In this work we aim to discuss the rationale behind the use of inverse-planned IMRT for the treatment of prostate cancer, as well as some of the practical aspects, including the differences in planning strategies, dose fractionation and issues in plan evaluation. The primary motivation behind the use of inverse-planned IMRT for prostate cancer radiotherapy is to attempt further dose escalation while maintaining critical structure and healthy tissue sparing at an acceptable level. The sparing of normal tissues is largely dependent on the size of the planning target volume (PTV) defined, and if the PTV overlaps critical structures. Depending on how the PTV is defined it may be impossible to achieve the desired healthy tissue sparing even with IMRT. A second role for the use of IMRT in the treatment of prostate cancer may be to conform the isodose distribution to a complex PTV, such as one that includes the seminal vesicles or the pelvic lymph nodes in the treatment volume. Finally, inverse planned IMRT may be useful in the planning and delivery of simultaneous integrated boosts where different parts of the target structures receive different daily doses. This again has applications for the simultaneous treatment of pelvic lymph nodes with the prostate treatment volume, and presents interesting opportunities for hypo-fractionation. All of these options of course require careful plan evaluation with respect to isodose distributions and dose-volume constraints as well as the radiobiological consequences of using unconventional fractionation. IMRT seems to be the most effective modality for treating complex target geometries and for delivering simultaneous integrated boosts. In particular for prostate cancer, the simultaneous treatment of the prostate

  3. Vitamin D and pancreatic cancer: a pooled analysis from the Pancreatic Cancer Case-Control Consortium.

    Science.gov (United States)

    Waterhouse, M; Risch, H A; Bosetti, C; Anderson, K E; Petersen, G M; Bamlet, W R; Cotterchio, M; Cleary, S P; Ibiebele, T I; La Vecchia, C; Skinner, H G; Strayer, L; Bracci, P M; Maisonneuve, P; Bueno-de-Mesquita, H B; Zaton Ski, W; Lu, L; Yu, H; Janik-Koncewicz, K; Polesel, J; Serraino, D; Neale, R E

    2015-08-01

    The potential role of vitamin D in the aetiology of pancreatic cancer is unclear, with recent studies suggesting both positive and negative associations. We used data from nine case-control studies from the International Pancreatic Cancer Case-Control Consortium (PanC4) to examine associations between pancreatic cancer risk and dietary vitamin D intake. Study-specific odds ratios (ORs) were estimated using multivariable logistic regression, and ORs were then pooled using a random-effects model. From a subset of four studies, we also calculated pooled estimates of association for supplementary and total vitamin D intake. Risk of pancreatic cancer increased with dietary intake of vitamin D [per 100 international units (IU)/day: OR = 1.13, 95% confidence interval (CI) 1.07-1.19, P = 7.4 × 10(-6), P-heterogeneity = 0.52; ≥230 versus vitamin A intake. Increased risk of pancreatic cancer was observed with higher levels of dietary vitamin D intake. Additional studies are required to determine whether or not our finding has a causal basis. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  4. Self-organizing multi-resolution grid for motion planning and control.

    Science.gov (United States)

    Fomin, T; Rozgonyi, T; Szepesvári, C; Lörincz, A

    1996-12-01

    A fully self-organizing neural network approach to low-dimensional control problems is described. We consider the problem of learning to control an object and solving the path planning problem at the same time. Control is based on the path planning model that follows the gradient of the stationary solution of a diffusion process working in the state space. Previous works are extended by introducing a self-organizing multigrid-like discretizing structure to represent the external world. Diffusion is simulated within a recurrent neural network built on this multigrid system. The novelty of the approach is that the diffusion on the multigrid is fast. Moreover, the diffusion process on the multigrid fits well the requirements of the path planning: it accelerates the diffusion in large free space regions while still keeps the resolution in small bottleneck-like labyrinths along the path. Control is achieved in the usual way: associative learning identifies the inverse dynamics of the system in a direct fashion. To this end there are introduced interneurons between neighboring discretizing units that detect the strength of the steady-state diffusion and forward control commands to the control neurons via modifiable connections. This architecture forms the Multigrid Position-and-Direction-to-Action (MPDA) map. The architecture integrates reactive path planning and continuous motion control. It is also shown that the scheme leads to population coding for the actual command vector.

  5. Learning curve of MRI-based planning for high-dose-rate brachytherapy for prostate cancer.

    Science.gov (United States)

    Buus, Simon; Rylander, Susanne; Hokland, Steffen; Søndergaard, Christian Skou; Pedersen, Erik Morre; Tanderup, Kari; Bentzen, Lise

    2016-01-01

    To evaluate introduction of MRI-based high-dose-rate brachytherapy (HDRBT), including procedure times, dose-volume parameters, and perioperative morbidity. Study included 42 high-risk prostate cancer patients enrolled in a clinical protocol, offering external beam radiotherapy + two HDRBT 8.5 Gy boosts. Time was recorded for initiation of anesthesia (A), fixation of needle implant (B), end of MR imaging (C), plan approval (D), and end of HDRBT delivery (E). We defined time A-E as total procedure time, A-B as operating room time, B-C as MRI procedure time, C-D as treatment planning time, and D to E as treatment delivery time. Dose-volume parameters were retrieved from the dose planning system. Results from the first 21 patients were compared with the last 21 patients. Total procedure time, operating room time, MRI procedure time, and treatment planning time decreased significantly from average 7.6 to 5.3 hours (p < 0.01), 3.6 to 2.4 hours (p < 0.01), 1.6 to 0.8 hours (p < 0.01), and 2.0 to 1.3 hours (p < 0.01), respectively. HDRBT delivery time remained unchanged at 0.5 hours. Clinical target volume prostate+3mmD90 fulfilled planning aim in 92% of procedures and increased significantly from average 8.3 to 9.0 Gy (p < 0.01). Urethral D0.1 cm(3) and rectal D2 cm(3) fulfilled planning aim in 78% and 95% of procedures, respectively, and did not change significantly. Hematuria occurred in (95%), hematoma (80%), moderate to strong pain (35%), and urinary retention (5%) of procedures. After introduction of MRI-based HDRBT, procedure times were significantly reduced. D90 Clinical target volumeprostate+3mm fulfilled constraints in most patients and improved over time, but not at expense of an increased urethral or rectal dose. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  6. Repeatability of dose painting by numbers treatment planning in prostate cancer radiotherapy based on multiparametric magnetic resonance imaging

    Science.gov (United States)

    van Schie, Marcel A.; Steenbergen, Peter; Viet Dinh, Cuong; Ghobadi, Ghazaleh; van Houdt, Petra J.; Pos, Floris J.; Heijmink, Stijn W. T. J. P.; van der Poel, Henk G.; Renisch, Steffen; Vik, Torbjørn; van der Heide, Uulke A.

    2017-07-01

    Dose painting by numbers (DPBN) refers to a voxel-wise prescription of radiation dose modelled from functional image characteristics, in contrast to dose painting by contours which requires delineations to define the target for dose escalation. The direct relation between functional imaging characteristics and DPBN implies that random variations in images may propagate into the dose distribution. The stability of MR-only prostate cancer treatment planning based on DPBN with respect to these variations is as yet unknown. We conducted a test-retest study to investigate the stability of DPBN for prostate cancer in a semi-automated MR-only treatment planning workflow. Twelve patients received a multiparametric MRI on two separate days prior to prostatectomy. The tumor probability (TP) within the prostate was derived from image features with a logistic regression model. Dose mapping functions were applied to acquire a DPBN prescription map that served to generate an intensity modulated radiation therapy (IMRT) treatment plan. Dose calculations were done on a pseudo-CT derived from the MRI. The TP and DPBN map and the IMRT dose distribution were compared between both MRI sessions, using the intraclass correlation coefficient (ICC) to quantify repeatability of the planning pipeline. The quality of each treatment plan was measured with a quality factor (QF). Median ICC values for the TP and DPBN map and the IMRT dose distribution were 0.82, 0.82 and 0.88, respectively, for linear dose mapping and 0.82, 0.84 and 0.94 for square root dose mapping. A median QF of 3.4% was found among all treatment plans. We demonstrated the stability of DPBN radiotherapy treatment planning in prostate cancer, with excellent overall repeatability and acceptable treatment plan quality. Using validated tumor probability modelling and simple dose mapping techniques it was shown that despite day-to-day variations in imaging data still consistent treatment plans were obtained.

  7. SU-C-202-02: A Comprehensive Evaluation of Adaptive Daily Planning for Cervical Cancer HDR Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Meerschaert, R; Paul, A; Zhuang, L [Department of Oncology, Radiation Oncology Division, Wayne State University School of Medicine, Detroit, MI (United States); Nalichowski, A [Department of Oncology, Radiation Oncology Division, Karmanos Cancer Institute, Detroit, MI (United States); Burmeister, J; Miller, A [Department of Oncology, Radiation Oncology Division, Wayne State University School of Medicine, Detroit, MI (United States); Department of Oncology, Radiation Oncology Division, Karmanos Cancer Institute, Detroit, MI (United States)

    2016-06-15

    Purpose: To evaluate adaptive daily planning for cervical cancer patients who underwent high-dose-rate intra-cavitary brachytherapy (HDR-ICBT). Methods: This study included 22 cervical cancer patients who underwent 5 fractions of HDR ICBT. Regions of interest (ROIs) including high-risk clinical tumor volume (HR-CTV) and organs-at-risk (OARs) were manually contoured on daily CT images. All patients were treated with adaptive daily plans, which involved ROI delineation and dose optimization at each treatment fraction. Single treatment plans were retrospectively generated by applying the first treatment fraction’s dwell times adjusted for decay and dwell positions of the applicator to subsequent treatment fractions. Various existing similarity metrics were calculated for the ROIs to quantify interfractional organ variations. A novel similarity score (JRARM) was established, which combined both volumetric overlap metrics (DSC, JSC, and RVD) and distance metrics (ASD, MSD, and RMSD). Linear regression was performed to determine a relationship between inter-fractional organ variations of various similarity metrics and D2cc variations from both plans. Wilcoxon Signed Rank Tests were used to assess adaptive daily plans and single plans by comparing EQD2 D2cc (α/β=3) for OARs. Results: For inter-fractional organ variations, the sigmoid demonstrated the greatest variations based on the JRARM and DSC similarity metrics. Comparisons between paired ROIs showed differences in JRARM scores and DSCs at each treatment fraction. RVD, MSD, and RMSD were found to be significantly correlated to D2cc variations for bladder and sigmoid. The comparison between plans found that adaptive daily planning provided lower EQD2 D2cc of OARs than single planning, specifically for the sigmoid (p=0.015). Conclusion: Substantial inter-fractional organ motion can occur during HDR-BT, which may significantly affect D2cc of OARs. Adaptive daily planning provides improved dose sparing for OARs

  8. JWST Wavefront Sensing and Control: Operations Plans, Demonstrations, and Status

    Science.gov (United States)

    Perrin, Marshall; Acton, D. Scott; Lajoie, Charles-Philippe; Knight, J. Scott; Myers, Carey; Stark, Chris; JWST Wavefront Sensing & Control Team

    2018-01-01

    After JWST launches and unfolds in space, its telescope optics will be aligned through a complex series of wavefront sensing and control (WFSC) steps to achieve diffraction-limited performance. This iterative process will comprise about half of the observatory commissioning time (~ 3 out of 6 months). We summarize the JWST WFSC process, schedule, and expectations for achieved performance, and discuss our team’s activities to prepare for an effective & efficient telescope commissioning. During the recently-completed OTIS cryo test at NASA JSC, WFSC demonstrations showed the flight-like operation of the entire JWST active optics and WFSC system from end to end, including all hardware and software components. In parallel, the same test data were processed through the JWST Mission Operations Center at STScI to demonstrate the readiness of ground system components there (such as the flight operations system, data pipelines, archives, etc). Moreover, using the Astronomer’s Proposal Tool (APT), the entire telescope commissioning program has been implemented, reviewed, and is ready for execution. Between now and launch our teams will continue preparations for JWST commissioning, including further rehearsals and testing, to ensure a successful alignment of JWST’s telescope optics.

  9. NRE58/2: Programaci??n del Plan de Control Interno, auditorias y otras actividades a desarrollar por la Oficina de Control Interno durante el 2012

    OpenAIRE

    Universidad de Granada

    2012-01-01

    Programaci??n del Plan de Control Interno, auditorias y otras actividades a desarrollar por la Oficina de Control Interno durante el 2012. Resoluci??n del Rectorado de la Universidad de Granada por la que se aprueba la programaci??n del Plan de Control Interno, auditorias y otras actividades a desarrollar por la Oficina de Control Interno durante el 2012

  10. Attitude-Tracking Control with Path Planning for Agile Satellite Using Double-Gimbal Control Moment Gyros

    Directory of Open Access Journals (Sweden)

    Peiling Cui

    2012-01-01

    Full Text Available In view of the issue of rapid attitude maneuver control of agile satellite, this paper presents an attitude-tracking control algorithm with path planning based on the improved genetic algorithm, adaptive backstepping control as well as sliding mode control. The satellite applies double gimbal control moment gyro as actuator and is subjected to the external disturbance and uncertain inertia properties. Firstly, considering the comprehensive mathematical model of the agile satellite and the double gimbal control moment gyro, an improved genetic algorithm is proposed to solve the attitude path-planning problem. The goal is to find an energy optimal path which satisfies certain maneuverability under the constraints of the input saturation, actuator saturation, slew rate limit and singularity measurement limit. Then, the adaptive backstepping control and sliding mode control are adopted in the design of the attitude-tracking controller to track accurately the desired path comprised of the satellite attitude quaternion and velocity. Finally, simulation results indicate the robustness and good tracking performance of the derived controller as well as its ability to avert the singularity of double gimbal control moment gyro.

  11. Tumour control probability in cancer stem cells hypothesis.

    Science.gov (United States)

    Dhawan, Andrew; Kohandel, Mohammad; Hill, Richard; Sivaloganathan, Sivabal

    2014-01-01

    The tumour control probability (TCP) is a formalism derived to compare various treatment regimens of radiation therapy, defined as the probability that given a prescribed dose of radiation, a tumour has been eradicated or controlled. In the traditional view of cancer, all cells share the ability to divide without limit and thus have the potential to generate a malignant tumour. However, an emerging notion is that only a sub-population of cells, the so-called cancer stem cells (CSCs), are responsible for the initiation and maintenance of the tumour. A key implication of the CSC hypothesis is that these cells must be eradicated to achieve cures, thus we define TCPS as the probability of eradicating CSCs for a given dose of radiation. A cell surface protein expression profile, such as CD44high/CD24low for breast cancer or CD133 for glioma, is often used as a biomarker to monitor CSCs enrichment. However, it is increasingly recognized that not all cells bearing this expression profile are necessarily CSCs, and in particular early generations of progenitor cells may share the same phenotype. Thus, due to the lack of a perfect biomarker for CSCs, we also define a novel measurable TCPCD+, that is the probability of eliminating or controlling biomarker positive cells. Based on these definitions, we use stochastic methods and numerical simulations parameterized for the case of gliomas, to compare the theoretical TCPS and the measurable TCPCD+. We also use the measurable TCP to compare the effect of various radiation protocols.

  12. Control of a robotic convoy through path planning and orientation strategies

    Directory of Open Access Journals (Sweden)

    Giovanni Rodrigo Bermudez-Bohorquez

    2017-09-01

    Full Text Available This paper presents an overview about control methods implemented on robotic convoy systems or cooperative systems on mobile platforms which can be used for path planning, orientation, environment perception, route tracking and control systems in which involve the measurement, analysis, and interpretation of different variables for further implementation. A review was made of investigation articles on bibliographic indexes and databases about control methods used in convoy systems to evidence progress, trends and application methods.

  13. The Individualized Quality Control Plan - Coming Soon to Clinical Microbiology Laboratories Everywhere!

    Science.gov (United States)

    Anderson, Nancy

    2015-11-15

    As of January 1, 2016, microbiology laboratories can choose to adopt a new quality control option, the Individualized Quality Control Plan (IQCP), under the Clinical Laboratory Improvement Amendments of 1988 (CLIA). This voluntary approach increases flexibility for meeting regulatory requirements and provides laboratories the opportunity to customize QC for their testing in their unique environments and by their testing personnel. IQCP is an all-inclusive approach to quality based on risk management to address potential errors in the total testing process. It includes three main steps, (1) performing a risk assessment, (2) developing a QC plan, and (3) monitoring the plan through quality assessment. Resources are available from the Centers for Medicare & Medicaid Services, Centers for Disease Control and Prevention, American Society for Microbiology, Clinical and Laboratory Standards Institute, and accrediting organizations, such as the College of American Pathologists and Joint Commission, to assist microbiology laboratories implementing IQCP.

  14. Social-cognitive antecedents of hand washing: Action control bridges the planning-behaviour gap.

    Science.gov (United States)

    Reyes Fernández, Benjamín; Knoll, Nina; Hamilton, Kyra; Schwarzer, Ralf

    2016-08-01

    To examine motivational and volitional factors for hand washing in young adults, using the Health Action Process Approach (HAPA) as a theoretical framework. In a longitudinal design with two measurement points, six weeks apart, university students (N = 440) completed paper-based questionnaires. Prior hand washing frequency, self-efficacy, outcome expectancies, intention and action planning were measured at baseline, and coping planning, action control and hand washing frequency were measured at follow-up. A theory-based structural equation model was specified. In line with the HAPA, the motivational factors of self-efficacy and outcome expectancies predicted intention, whereas the volitional factors of planning and action control mediated between intention and changes in hand washing frequency. Action control was confirmed as the most proximal factor on hand washing behaviour, thus representing a bridge of the planning-behaviour gap. Both motivational and volitional processes are important to consider in the improvement of hand hygiene practices. Moreover, the statistically significant effects for planning and action control illustrate the importance of these key self-regulatory factors in the prediction of hand hygiene. The current study highlights the importance of adopting models that account for motivational and volitional factors to better understand hand washing behaviour.

  15. A quality improvement plan for hypertension control: the INCOTECA Project (INterventions for COntrol of hyperTEnsion in CAtalonia).

    Science.gov (United States)

    Vallès-Fernandez, Roser; Rosell-Murphy, Magdalena; Correcher-Aventin, Olga; Mengual-Martínez, Lucas; Aznar-Martínez, Núria; Prieto-De Lamo, Gemma; Franzi-Sisó, Alícia; Puig-Manresa, Jordi; Ma Bonet-Simó, Josep

    2009-03-25

    Different studies have shown insufficient blood pressure (BP) control in hypertensive patients. Multiple factors influence hypertension management, and the quality of primary care is one of them. We decided therefore to evaluate the effectiveness of a quality improvement plan directed at professionals of Primary Health Care Teams (PHCT) with the aim to achieve a better control of hypertension. The hypothesis of the study is that the implementation of a quality improvement plan will improve the control of hypertension. The primary aim of this study will be to evaluate the effectiveness of this plan. multicentric study quasi-experimental before - after with control group. The non-randomised allocation of the intervention will be done at PHCT level. 18 PHCT in the Barcelona province (Spain). all patients with a diagnosis of hypertension (population based study). patients with a diagnosis of hypertension made later than 01/01/2006 and patients younger than 18 years. a quality improvement plan, which targets primary health care professionals and includes educational sessions, feedback to health professionals, audit and implementation of recommended clinical practice guidelines for the management of hypertensive patients. age, sex, associated co-morbidity (diabetes mellitus type I and II, heart failure and renal failure). The following variables will be recorded: BP measurement, cardiovascular risk and antihypertensive drugs used. Results will be measured before the start of the intervention and twelve months after the start of the study. Dependent variable: prevalence of hypertensive patients with poor BP control. Chi-square test and Student's t-test will be used to measure the association between independent qualitative and quantitative variables, respectively. Non-parametric tests will be used for the analysis of non-normally distributed variables. Significance level (alpha) will be set at improvement plan might benefit the coordination of different professionals of

  16. Effect of CT contrast on volumetric arc therapy planning (RapidArc and helical tomotherapy) for head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Alan J.; Vora, Nayana [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA (United States); Suh, Steve [Department of Radiation Physics, City of Hope National Medical Center, Duarte, CA (United States); Liu, An, E-mail: aliu@coh.org [Department of Radiation Physics, City of Hope National Medical Center, Duarte, CA (United States); Schultheiss, Timothy E. [Department of Radiation Physics, City of Hope National Medical Center, Duarte, CA (United States); Wong, Jeffrey Y.C. [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA (United States)

    2015-04-01

    The objectives of the study were to evaluate the effect of intravenous contrast in the dosimetry of helical tomotherapy and RapidArc treatment for head and neck cancer and determine if it is acceptable during the computed tomography (CT) simulation to acquire only CT with contrast for treatment planning of head and neck cancer. Overall, 5 patients with head and neck cancer (4 men and 1 woman) treated on helical tomotherapy were analyzed retrospectively. For each patient, 2 consecutive CT scans were performed. The first CT set was scanned before the contrast injection and secondary study set was scanned 45 seconds after contrast. The 2 CTs were autoregistered using the same Digital Imaging and Communications in Medicine coordinates. Tomotherapy and RapidArc plans were generated on 1 CT data set and subsequently copied to the second CT set. Dose calculation was performed, and dose difference was analyzed to evaluate the influence of intravenous contrast media. The dose matrix used for comparison included mean, minimum and maximum doses of planning target volume (PTV), PTV dose coverage, and V{sub 45} {sub Gy}, V{sub 30} {sub Gy}, and V{sub 20} {sub Gy} organ doses. Treatment planning on contrasted images generally showed a lower dose to both organs and target than plans on noncontrasted images. The doses for the points of interest placed in the organs and target rarely changed more than 2% in any patient. In conclusion, treatment planning using a contrasted image had insignificant effect on the dose to the organs and targets. In our opinion, only CT with contrast needs to be acquired during the CT simulation for head and neck cancer. Dose calculations performed on contrasted images can potentially underestimate the delivery dose slightly. However, the errors of planning on a contrasted image should not affect the result in clinically significant way.

  17. Feasibility of preference-driven radiotherapy dose treatment planning to support shared decision making in anal cancer.

    Science.gov (United States)

    Rønde, Heidi S; Wee, Leonard; Pløen, John; Appelt, Ane L

    2017-10-01

    Chemo-radiotherapy is an established primary curative treatment for anal cancer, but clinically equal rationale for different target doses exists. If joint preferences (physician and patient) are used to determine acceptable tradeoffs in radiotherapy treatment planning, multiple dose plans must be simultaneously explored. We quantified the degree to which different toxicity priorities might be incorporated into treatment plan selection, to elucidate the feasible decision space for shared decision making in anal cancer radiotherapy. Retrospective plans were generated for 22 anal cancer patients. Multi-criteria optimization handles dynamically changing priorities between clinical objectives while meeting fixed clinical constraints. Four unique dose distributions were designed to represent a wide span of clinically relevant objectives: high-dose preference (60.2 Gy tumor boost and 50.4 Gy to elective nodes with physician-defined order of priorities), low-dose preference (53.75 Gy tumor boost, 45 Gy to elective nodes, physician-defined priorities), bowel sparing preference (lower dose levels and priority for bowel avoidance) and bladder sparing preference (lower dose levels and priority for bladder avoidance). Plans satisfied constraints for target coverage. A senior oncologist approved a random subset of plans for quality assurance. Compared to a high-dose preference, bowel sparing was clinically meaningful at the lower prescribed dose [median change in V 45Gy : 234 cm 3 ; inter-quartile range (66; 247); p decision space available in anal cancer radiotherapy to incorporate preferences, although tradeoffs are highly patient-dependent. This study demonstrates that preference-informed dose planning is feasible for clinical studies utilizing shared decision making.

  18. Risk Factors for Pancreatic Cancer in China: A Multicenter Case-Control Study.

    Science.gov (United States)

    Zheng, Zhaoxu; Zheng, Rongshou; He, Yutong; Sun, Xibin; Wang, Ning; Chen, Tianhui; Chen, Wanqing

    2016-01-01

    Despite having one of the highest mortality rates of all cancers, the risk factors of pancreatic cancer remain unclear. We assessed risk factors of pancreatic cancer in China. A case-control study design was conducted using data from four hospital-based cancer registries (Henan Provincial Cancer Hospital, Beijing Cancer Hospital, Hebei Provincial Cancer Hospital, and Cancer Hospital of Chinese Academy of Medical Sciences). Controls were equally matched and selected from family members of non-pancreatic cancer patients in the same hospitals. Face-to-face interviews were conducted by trained staff using questionnaires. Conditional logistic regression models were used to assess odd ratios (ORs) and 95% confident intervals (CIs). Among 646 recruited participants, 323 were pancreatic cancer patients and 323 were controls. Multivariate logistic analysis suggested that pancreatic cancer family history (adjusted OR 1.23; 95% CI, 1.11-3.70), obesity (adjusted OR 1.77; 95% CI, 1.22-2.57), diabetes (adjusted OR 2.96; 95% CI, 1.48-5.92) and smoking (adjusted OR 1.78; 95% CI, 1.02-3.10) were risk factors for pancreatic cancer, but that drinking tea (adjusted OR 0.49; 95% CI, 0.25-0.84) was associated with reduced risk of pancreatic cancer. Cigarette smoking, family history, obesity, and diabetes are risk factors of pancreatic cancer, which is important information for designing early intervention and preventive strategies for pancreatic cancer and may be beneficial to pancreatic cancer control in China.

  19. Production planning and control for semiconductor wafer fabrication facilities modeling, analysis, and systems

    CERN Document Server

    Mönch, Lars; Mason, Scott J

    2012-01-01

    Over the last fifty-plus years, the increased complexity and speed of integrated circuits have radically changed our world. Today, semiconductor manufacturing is perhaps the most important segment of the global manufacturing sector. As the semiconductor industry has become more competitive, improving planning and control has become a key factor for business success. This book is devoted to production planning and control problems in semiconductor wafer fabrication facilities. It is the first book that takes a comprehensive look at the role of modeling, analysis, and related information systems

  20. A treatment planning study of the potential of geometrical tracking for intensity modulated proton therapy of lung cancer

    DEFF Research Database (Denmark)

    Munck af Rosenschöld, Per; Aznar, Marianne; Nygaard, Ditte Eklund

    2010-01-01

    Proton therapy of lung cancer holds the potential for a reduction of the volume of irradiated normal lung tissue. In this work we investigate the robustness of intensity modulated proton therapy (IMPT) plans to motion, and evaluate a geometrical tumour tracking method to compensate for tumour...

  1. A treatment planning study of the potential of geometrical tracking for intensity modulated proton therapy of lung cancer

    DEFF Research Database (Denmark)

    af Rosenschöld, Per Munck; Aznar, Marianne C; Nygaard, Ditte E

    2010-01-01

    Proton therapy of lung cancer holds the potential for a reduction of the volume of irradiated normal lung tissue. In this work we investigate the robustness of intensity modulated proton therapy (IMPT) plans to motion, and evaluate a geometrical tumour tracking method to compensate for tumour mot...

  2. Quality of reporting randomized controlled trials in cancer nursing research.

    Science.gov (United States)

    Guo, Jia-Wen; Sward, Katherine A; Beck, Susan L; Staggers, Nancy

    2014-01-01

    Results of randomized controlled trials (RCTs) provide high-level evidence for evidence-based practice (EBP). The quality of RCTs has a substantial influence on providing reliable knowledge for EBP. Little is known about the quality of RCT reporting in cancer nursing. The aim of this study was to assess the quality of reporting in published cancer nursing RCTs from 1984 to 2010. A total of 227 RCTs in cancer nursing published in English-language journals and indexed in PubMed or Cumulative Index to Nursing and Allied Health Literature were reviewed using the Jadad scale, key methodologic index (KMI), and the Consolidated Standards of Reporting Trials (CONSORT) checklist to assess the quality of reporting methodological aspects of research and the overall quality of reporting RCTs. Adherence to reporting metrics was relatively low, based on the Jadad score (M = 1.94 out of 5, SD = 1.01), KMI scores (M = 0.84 out of 3, SD = .87), and adherence to CONSORT checklist items (M =16.92 out of 37, SD = 4.03). Only 11 of 37 items in the CONSORT checklist were reported in 80% or more of the studies reviewed. The quality of reporting showed some improvement over time. Adherence to reporting metrics for cancer nursing RCTs was suboptimal, and further efforts are needed to improve both methodology reporting and overall reporting. Journals are encouraged to adopt the CONSORT checklist to influence the quality of RCT reports.

  3. Leadership in Nigerian health system for cancer prevention and control.

    Science.gov (United States)

    Ogbimi, R I

    2009-06-01

    Unacceptable health system outcomes are often related to problems with leadership because the ultimate responsibility for assigned work rests on leadership. In this paper, proper leadership at micro and macro-levels can have positive impact on the health and well being of citizens. While this may be readily obvious in other spheres, it has not been addressed adequately in the context of health care systems and its impact on health outcomes. In this paper, I discuss types of work and leadership systems in order to highlight the importance of leadership and leadership training in collaborative training and research for cancer management. The complexity of health systems highlight the expanded role of leadership in terms of capacity and capability to control the environmental risk factors for cancer, deploy adequate resources for the management of cancers, and ensure fruitful and productive post treatment life for citizens. Improved community awareness, better training of health care workers, improved working environment based on better interpersonal relationships between all cadres of health care workers, environmental health and safety initiatives and research on cancer are some of the areas where improved leadership can lead to better health outcomes. Effective leadership requires a set of skills that can be acquired with requisite operating environment, political will and adequate funding in order to generate the expected improvements in outcome.

  4. CDC Grand Rounds: Family History and Genomics as Tools for Cancer Prevention and Control.

    Science.gov (United States)

    Rodriguez, Juan L; Thomas, Cheryll C; Massetti, Greta M; Duquette, Debra; Avner, Lindsay; Iskander, John; Khoury, Muin J; Richardson, Lisa C

    2016-11-25

    Although many efforts in cancer prevention and control have routinely focused on behavioral risk factors, such as tobacco use, or on the early detection of cancer, such as colorectal cancer screening, advances in genetic testing have created new opportunities for cancer prevention through evaluation of family history and identification of cancer-causing inherited mutations. Through the collection and evaluation of a family cancer history by a trained health care provider, patients and families at increased risk for a hereditary cancer syndrome can be identified, referred for genetic counseling and testing, and make informed decisions about options for cancer risk reduction (1). Although hereditary cancers make up a small proportion of all cancers, the number of affected persons can be large, and the level of risk among affected persons is high. Two hereditary cancer syndromes for which public health professionals have worked to reduce the burden of morbidity and mortality are hereditary breast and ovarian cancer syndrome (HBOC) and Lynch syndrome.

  5. The Addition of SPECT/CT Lymphoscintigraphy to Breast Cancer Radiation Planning Spares Lymph Nodes Critical for Arm Drainage

    Energy Technology Data Exchange (ETDEWEB)

    Cheville, Andrea L., E-mail: Cheville.andrea@mayo.edu [Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota (United States); Brinkmann, Debra H.; Ward, Shelly B. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Durski, Jolanta [Department of Radiology, Nuclear Medicine Program, Mayo Clinic, Rochester, Minnesota (United States); Laack, Nadia N.; Yan, Elizabeth; Schomberg, Paula J.; Garces, Yolanda I. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Suman, Vera J. [Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota (United States); Petersen, Ivy A. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)

    2013-03-15

    Background: This prospective cohort study was designed to determine whether the amount of radiation delivered to the nonpathological lymph nodes (LNs) that drain the arm can be significantly reduced by integrating single-photon emission computed tomography (SPECT)/computed tomography (CT) scans into radiation treatment planning. Methods: SPECT-CT scans were acquired for the 28 patients with stage I or II breast cancer and fused with the routinely obtained radiation oncology planning CT scans. Arm-draining LNs were contoured with 0.5-cm margins automatically using a threshold of 50% maximum intensity. Two treatment plans were generated: 1 per routine clinical practice (standard; STD) and the second (modified; MOD) with treatment fields modified to minimize dose to the arm-draining LNs visible on SPECT/CT images without interfering with the dosage delivered to target tissues. Participants were treated per the MOD plans. Arm volumes were measured prior to radiation and thereafter at least three subsequent 6-month intervals. Results: Sixty-eight level I-III arm-draining LNs were identified, 57% of which were inside the STD plan fields but could be blocked in the MOD plan fields. Sixty-five percent of arm-draining LNs in the STD versus 16% in the MOD plans received a mean of ≥10 Gy, and 26% in the STD versus 4% in the MOD plans received a mean of ≥40 Gy. Mean LN radiation exposure was 23.6 Gy (standard deviation 18.2) with the STD and 7.7 Gy (standard deviation 11.3) with the MOD plans (P<.001). No participant developed lymphedema. Conclusions: The integration of SPECT/CT scans into breast cancer radiation treatment planning reduces unnecessary arm-draining LN radiation exposure and may lessen the risk of lymphedema.

  6. Developing an interprofessional care plan for an older adult woman with breast cancer: from multiple voices to a shared vision.

    Science.gov (United States)

    Clausen, Christina; Strohschein, Fay Judy; Faremo, Sonia; Bateman, Dianne; Posel, Nancy; Fleiszer, David M

    2012-02-01

    Interprofessional collaboration is central to quality patient care; however, little is known about developing interprofessional care plans, particularly in oncology. This article describes the development of an interprofessional care plan for an older adult woman with breast cancer. Two collaborative expert workshops were used; 15 clinical experts reviewed an online patient case and were asked to prepare a uniprofessional care plan. In workshop 1, participants worked from a draft interprofessional care plan, synthesized from the uniprofessional care plans by research associates, to arrive at consensus on an ideal interprofessional care plan. Using qualitative inductive content analysis of workshop transcripts, specific changes and overall key principles were identified and used to revise the draft plan. Based on these findings, a generalized interprofessional care plan/oncology model was developed. Revisions and proposed model were validated through consensus by participants during workshop 2. Participants highlighted the iterative, cyclical, and multilayered nature of patient care experiences; the importance of central patient profiles, which are contributed to and validated by all healthcare professionals; and the importance of assessing patient understanding. Participation of a patient representative provided an invaluable contribution. The process and model provide a unique framework for interprofessional care plan development in other settings and patient populations.

  7. Quantitative MR imaging in planning and assessing novel cancer treatments Radiotherapy

    CERN Document Server

    Baustert, I C

    2001-01-01

    Novel treatments in cancer, like conformal radiotherapy and anticancer drugs, require new MRI techniques to assess their benefits and potential. In conformal radiotherapy, MRI can be used to measure the shape and dose of the conformed radiation field in dose sensitive gel test-objects thus validating the predicted dose computed by complex programs. In antiangiogenic drug treatment, the vascular dysfunction of the tumour can be assessed by MRI prior to treatment. Response to treatment may also be monitored by measuring the changes in vascular function. In this thesis, MRI of polyacrylamide gels is investigated as a 3D dosimeter for conformal radiotherapy treatment planning. Quantitative MRI sequences capable of measuring the wide range of T2 values typically expected in gel dosimetry, are identified. Different T2 measurement methods are compared in terms of accuracy, signal to noise ratio and acquisition time. Examples of a complex dose distribution in 2D and 3D are presented and compared to the planned dose p...

  8. Setting a health policy research agenda for controlling cancer burden in Korea.

    Science.gov (United States)

    Jang, Sung-In; Cho, Kyoung-Hee; Kim, Sun Jung; Lee, Kwang-Sig; Park, Eun-Cheol

    2015-04-01

    The aim of study was to provide suggestions for prioritizing research in effort to reduce cancer burden in Korea based on a comprehensive analysis of cancer burden and Delphi consensus among cancer experts. Twenty research plans covering 10 topics were selected based on an assessment of the literature, and e-mail surveys were analyzed using a two-round modified Delphi method. Thirty-four out of 79 experts were selected from four organizations to participate in round one, and 21 experts among them had completed round two. Each item had two questions; one regarding the agreement of the topic as a priority item to reduce cancer burden, and the other about the importance of the item on a nine-point scale. A consensus was defined to be an average lower coefficient of variation with less than 30% in importance. Seven plans that satisfied the three criteria were selected as priority research plans for reducing cancer burden. These plans are "research into advanced clinical guidelines for thyroid cancer given the current issue with over-diagnosis," "research into smoking management plans through price and non-price cigarette policy initiatives," "research into ways to measure the quality of cancer care," "research on policy development to expand hospice care," "research into the spread and management of Helicobacter pylori," "research on palliative care in a clinical setting," and "research into alternative mammography methods to increase the accuracy of breast cancer screenings." The seven plans identified in this study should be prioritized to reduce the burden of cancer in Korea. We suggest that policy makers and administrators study and invest significant effort in these plans.

  9. A manned maneuvering unit proximity operations planning and flight guidance display and control system

    Science.gov (United States)

    Gershzohn, Gary R.; Sirko, Robert J.; Zimmerman, K.; Jones, A. D.

    1990-01-01

    This task concerns the design, development, testing, and evaluation of a new proximity operations planning and flight guidance display and control system for manned space operations. A forecast, derivative manned maneuvering unit (MMU) was identified as a candidate for the application of a color, highway-in-the-sky display format for the presentation of flight guidance information. A silicon graphics 4D/20-based simulation is being developed to design and test display formats and operations concepts. The simulation includes the following: (1) real-time color graphics generation to provide realistic, dynamic flight guidance displays and control characteristics; (2) real-time graphics generation of spacecraft trajectories; (3) MMU flight dynamics and control characteristics; (4) control algorithms for rotational and translational hand controllers; (5) orbital mechanics effects for rendezvous and chase spacecraft; (6) inclusion of appropriate navigation aids; and (7) measurement of subject performance. The flight planning system under development provides for: (1) selection of appropriate operational modes, including minimum cost, optimum cost, minimum time, and specified ETA; (2) automatic calculation of rendezvous trajectories, en route times, and fuel requirements; (3) and provisions for manual override. Man/machine function allocations in planning and en route flight segments are being evaluated. Planning and en route data are presented on one screen composed of two windows: (1) a map display presenting a view perpendicular to the orbital plane, depicting flight planning trajectory and time data attitude display presenting attitude and course data for use en route; and (2) an attitude display presenting local vertical-local horizontal attitude data superimposed on a highway-in-the-sky or flight channel representation of the flight planned course. Both display formats are presented while the MMU is en route. In addition to these displays, several original display

  10. Treatment planning for multicatheter interstitial brachytherapy of breast cancer - from Paris system to anatomy-based inverse planning.

    Science.gov (United States)

    Major, Tibor; Polgár, Csaba

    2017-02-01

    In the last decades, treatment planning for multicatheter interstitial breast brachytherapy has evolved considerably from fluoroscopy-based 2D to anatomy-based 3D planning. To plan the right positions of the catheters, ultrasound or computed tomography (CT) imaging can be used, but the treatment plan is always based on postimplant CT images. With CT imaging, the 3D target volume can be defined more precisely and delineation of the organs at risk volumes is also possible. Consequently, parameters calculated from dose-volume histogram can be used for quantitative plan evaluation. The catheter reconstruction is also easier and faster on CT images compared to X-ray films. In high dose rate brachytherapy, using a stepping source, a number of forward dose optimization methods (manual, geometrical, on dose points, graphical) are available to shape the dose distribution to the target volume, and these influence dose homogeneities to different extent. Currently, inverse optimization algorithms offer new possibilities to improve dose distributions further considering the requirements for dose coverage, dose homogeneity, and dose to organs at risk simultaneously and automatically. In this article, the evolvement of treatment planning for interstitial breast implants is reviewed, different forward optimization methods are discussed, and dose-volume parameters used for quantitative plan evaluation are described. Finally, some questions of the inverse optimization method are investigated and initial experiences of the authors are presented.

  11. Treatment planning for multicatheter interstitial brachytherapy of breast cancer – from Paris system to anatomy-based inverse planning

    Directory of Open Access Journals (Sweden)

    Tibor Major

    2017-02-01

    Full Text Available In the last decades, treatment planning for multicatheter interstitial breast brachytherapy has evolved considerably from fluoroscopy-based 2D to anatomy-based 3D planning. To plan the right positions of the catheters, ultrasound or computed tomography (CT imaging can be used, but the treatment plan is always based on postimplant CT images. With CT imaging, the 3D target volume can be defined more precisely and delineation of the organs at risk volumes is also possible. Consequently, parameters calculated from dose-volume histogram can be used for quantitative plan evaluation. The catheter reconstruction is also easier and faster on CT images compared to X-ray films. In high dose rate brachytherapy, using a stepping source, a number of forward dose optimization methods (manual, geometrical, on dose points, graphical are available to shape the dose distribution to the target volume, and these influence dose homogeneities to different extent. Currently, inverse optimization algorithms offer new possibilities to improve dose distributions further considering the requirements for dose coverage, dose homogeneity, and dose to organs at risk simultaneously and automatically. In this article, the evolvement of treatment planning for interstitial breast implants is reviewed, different forward optimization methods are discussed, and dose-volume parameters used for quantitative plan evaluation are described. Finally, some questions of the inverse optimization method are investigated and initial experiences of the authors are presented.

  12. Breast feeding and risk of breast cancer in young women. United Kingdom National Case-Control Study Group.

    Science.gov (United States)

    1993-01-01

    OBJECTIVE--To investigate whether breast feeding is related to subsequent risk of breast cancer. DESIGN--Population based case-control study designed primarily to investigate the relation between oral contraceptives and risk of breast cancer; data obtained from questionnaires administered by interviewers, general practitioner notes, and family planning clinic records. SETTING--11 health regions in Britain. SUBJECTS--Women diagnosed with breast cancer before age 36 living in the defined study areas. One control per case, matched for age, was selected from the list of the case's general practitioner. 755 case-control pairs were interviewed. MAIN OUTCOME MEASURES--Duration of breast feeding each liveborn infant; timing of return of menses; hormone use; other risk factors for breast cancer. RESULTS--Risk of breast cancer fell with increasing duration of breast feeding (relative risk = 0.94 per three months' breast feeding; test for trend p = 0.026) and with number of babies breast fed (relative risk = 0.86; test for trend, p = 0.017). Breast feeding each baby for longer than three months conferred no additional benefit. Breast feeding was more strongly negatively associated with risk of breast cancer than duration of postpartum amenorrhoea (chi 2 test for trend, p = 0.69). Hormonal suppression of lactation was unrelated to risk of breast cancer (relative risk = 0.96 per episode of suppressed lactation; test for trend, p = 0.72). CONCLUSIONS--These results suggest that breast feeding protects against the development of breast cancer in young women. PMID:8343660

  13. Redistributed versus homogenous radiotherapy dose for head and neck cancer; a treatment planning study

    Directory of Open Access Journals (Sweden)

    Jolien Heukelom

    2017-07-01

    Full Text Available Dose redistribution, where radio-resistant parts of the tumour are boosted while the border of the planning target volume receives a lower dose has the potential to increase local control in advanced head and neck squamous cell carcinoma (HNSCC. In this treatment planning study for 20 patients, standard radiotherapy (RT of 70 Gy, was compared to redistributed RT following the ARTFORCE trial protocol (NCT01504815, i.e., a fluorodeoxyglucose-positron emission tomography (FDG-PET based heterogeneous simultaneous-integrated-boost to a total dose of 64–84 Gy. Redistribution marginally increased the mean ipsilateral ⧹contralateral parotid dose by 1.55⧹0.55 Gy but not dose to other organs at risk.

  14. Manganese Superoxide Dismtase Polymorphism and Breast Cancer Recurrence: A Danish Population-Based Case-Control Study of Breast Cancer Patients Treated with Cyclophosphamide Epirubicin and 5-fluorouracil

    DEFF Research Database (Denmark)

    Ording, Anne Gulbech; Cronin Fenton, Deirdre; Christensen, Mariann

    2012-01-01

    Manganese Superoxide Dismtase Polymorphism and Breast Cancer Recurrence: A Danish Population-Based Case-Control Study of Breast Cancer Patients Treated with Cyclophosphamide Epirubicin and 5-fluorouracil...

  15. Layered nanoemulsions as mucoadhesive buccal systems for controlled delivery of oral cancer therapeutics.

    Science.gov (United States)

    Gavin, Amy; Pham, Jimmy Th; Wang, Dawei; Brownlow, Bill; Elbayoumi, Tamer A

    2015-01-01

    Oral cavity and oropharyngeal cancers are considered the eighth most common cancer worldwide, with relatively poor prognosis (62% of patients surviving 5 years, after diagnosis). The aim of this study was to develop a proof-of-concept mucoadhesive lozenge/buccal tablet, as a potential platform for direct sustained delivery of therapeutic antimitotic nanomedicines. Our system would serve as an adjuvant therapy for oral cancer patients undergoing full-scale diagnostic and operative treatment plans. We utilized lipid-based nanocarriers, namely nanoemulsions (NEs), containing mixed-polyethoxylated emulsifiers and a tocopheryl moiety-enriched oil phase. Prototype NEs, loaded with the proapoptotic lipophilic drug genistein (Gen), were further processed into buccal tablet formulations. The chitosan polyelectrolyte solution overcoat rendered NE droplets cationic, by acting as a mucoadhesive interfacial NE layer. With approximate size of 110 nm, the positively charged chitosan-layered NE (+25 mV) vs negatively charged chitosan-free/primary aqueous NE (-28 mV) exhibited a controlled-release profile and effective mucoadhesion for liquid oral spray prototypes. When punch-pressed, porous NE-based buccal tablets were physically evaluated for hardness, friability, and swelling in addition to ex vivo tissue mucoadhesion force and retention time measurements. Chitosan-containing NE tablets were found equivalent to primary NE and placebo tablets in compression tests, yet significantly superior in all ex vivo adhesion and in vitro release assays (P≤0.05). Following biocompatibility screening of prototype chitosan-layered NEs, substantial anticancer activity of selected cationic Gen-loaded NE formulations, against two oropahryngeal carcinomas, was observed. The data strongly indicate the potential of such nanomucoadhesive systems as maintenance therapy for oral cancer patients awaiting surgical removal, or postresection of identified cancerous lesions.

  16. Early rehabilitation of cancer patients – a randomized controlled intervention study

    Directory of Open Access Journals (Sweden)

    Arving Cecilia

    2013-01-01

    Full Text Available Abstract Background Faced with a life-threatening illness, such as cancer, many patients develop stress symptoms, i.e. avoidance behaviour, intrusive thoughts and worry. Stress management interventions have proven to be effective; however, they are mostly performed in group settings and it is commonly breast cancer patients who are studied. We hereby present the design of a randomized controlled trial (RCT evaluating the effectiveness and cost-effectiveness of an individual stress-management intervention with a stepped-care approach in several cancer diagnoses. Method Patients (≥ 18 years with a recent diagnosis of breast cancer, colorectal cancer, lymphoma, prostate cancer or testicle cancer and scheduled for adjuvant/curative oncology treatment, will consecutively be included in the study. In this prospective longitudinal intervention study with a stepped-care approach, patients will be randomized to control, treatment as usual, or an individual stress-management intervention in two steps. The first step is a low-intensity stress-management intervention, given to all patients randomized to intervention. Patients who continue to report stress symptoms after the first step will thereafter be given more intensive treatment at the second step of the programme. In the intervention patients will also be motivated to be physically active. Avoidance and intrusion are the primary outcomes. According to the power analyses, 300 patients are planned to be included in the study and will be followed for two years. Other outcomes are physical activity level, sleep duration and quality recorded objectively, and anxiety, depression, quality of life, fatigue, stress in daily living, and patient satisfaction assessed using valid and standardized psychometric tested questionnaires. Utilization of hospital services will be derived from the computerized patient administration systems used by the hospital. The cost-effectiveness of the intervention will be

  17. Direct use of multivariable normal tissue complication probability models in treatment plan optimisation for individualised head and neck cancer radiotherapy produces clinically acceptable treatment plans.

    Science.gov (United States)

    Kierkels, Roel G J; Korevaar, Erik W; Steenbakkers, Roel J H M; Janssen, Tomas; van't Veld, Aart A; Langendijk, Johannes A; Schilstra, Cornelis; van der Schaaf, Arjen

    2014-09-01

    Recently, clinically validated multivariable normal tissue complication probability models (NTCP) for head and neck cancer (HNC) patients have become available. We test the feasibility of using multivariable NTCP-models directly in the optimiser for inverse treatment planning of radiotherapy to improve the dose distributions and corresponding NTCP-estimates in HNC patients. For 10 HNC cases, intensity-modulated radiotherapy plans were optimised either using objective functions based on the 'generalised equivalent uniform dose' (OFgEUD) or based on multivariable NTCP-models (OFNTCP). NTCP-models for patient-rated xerostomia, physician-rated RTOG grade II-IV dysphagia, and various patient-rated aspects of swallowing dysfunction were incorporated. The NTCP-models included dose-volume parameters as well as clinical factors contributing to a personalised optimisation process. Both optimisation techniques were compared by means of 'pseudo Pareto fronts' (target dose conformity vs. the sum of the NTCPs). Both optimisation techniques resulted in clinically realistic treatment plans with only small differences. For nine patients the sum-NTCP was lower for the OFNTCP optimised plans (on average 5.7% (95%CI 1.7-9.9%, poptimisation parameters and an intrinsic mechanism of individualisation. Treatment plan optimisation using multivariable NTCP-models directly in the OF is feasible as has been demonstrated for HNC radiotherapy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Australasian Gastrointestinal Trials Group (AGITG) Contouring Atlas and Planning Guidelines for Intensity-Modulated Radiotherapy in Anal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Michael, E-mail: mng@radoncvic.com.au [Radiation Oncology Victoria, Victoria (Australia); Leong, Trevor [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Victoria (Australia); University of Melbourne (Australia); Chander, Sarat; Chu, Julie [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Victoria (Australia); Kneebone, Andrew [Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, NSW (Australia); University of Sydney (Australia); Carroll, Susan [Department of Radiation Oncology, Sydney Cancer Centre, Royal Prince Alfred Hospital, NSW (Australia); University of Sydney (Australia); Wiltshire, Kirsty [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Victoria (Australia); Ngan, Samuel [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Victoria (Australia); University of Melbourne (Australia); Kachnic, Lisa [Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA (United States)

    2012-08-01

    Purpose: To develop a high-resolution target volume atlas with intensity-modulated radiotherapy (IMRT) planning guidelines for the conformal treatment of anal cancer. Methods and Materials: A draft contouring atlas and planning guidelines for anal cancer IMRT were prepared at the Australasian Gastrointestinal Trials Group (AGITG) annual meeting in September 2010. An expert panel of radiation oncologists contoured an anal cancer case to generate discussion on recommendations regarding target definition for gross disease, elective nodal volumes, and organs at risk (OARs). Clinical target volume (CTV) and planning target volume (PTV) margins, dose fractionation, and other IMRT-specific issues were also addressed. A steering committee produced the final consensus guidelines. Results: Detailed contouring and planning guidelines and a high-resolution atlas are provided. Gross tumor and elective target volumes are described and pictorially depicted. All elective regions should be routinely contoured for all disease stages, with the possible exception of the inguinal and high pelvic nodes for select, early-stage T1N0. A 20-mm CTV margin for the primary, 10- to 20-mm CTV margin for involved nodes and a 7-mm CTV margin for the elective pelvic nodal groups are recommended, while respecting anatomical boundaries. A 5- to 10-mm PTV margin is suggested. When using a simultaneous integrated boost technique, a dose of 54 Gy in 30 fractions to gross disease and 45 Gy to elective nodes with chemotherapy is appropriate. Guidelines are provided for OAR delineation. Conclusion: These consensus planning guidelines and high-resolution atlas complement the existing Radiation Therapy Oncology Group (RTOG) elective nodal ano-rectal atlas and provide additional anatomic, clinical, and technical instructions to guide radiation oncologists in the planning and delivery of IMRT for anal cancer.

  19. Simultaneous cancer control and diagnosis with magnetic nanohybrid materials

    Directory of Open Access Journals (Sweden)

    Reza Saadat

    2016-01-01

    Full Text Available Coated magnetite nanoparticles were linked to 68Ga complexes used in the positron emission tomography (PET for a new technical approach to detect cancer tissue with radiopharmaceuticals. By substitution of the Ga isotope with an alpha emitter the same compound could be used for cancer treatment. Furthermore the nanoparticles were connected to pH-sensitive complexes, enabling a pH-controlled assembly/disassembly and therefore the spreading of the particles in the tissue. With this novel method of combining detection and treatment simultaneously, the amount of medical exposure could be minimized for the patient. The results demonstrate that magnetite nanoparticles can effectively be functionalized with PET isotopes and pH sensitive complexes in order to use them as a new type of radiopharmaceuticals.

  20. 76 FR 30723 - Breast and Cervical Cancer Early Detection and Control Advisory Committee (BCCEDCAC)

    Science.gov (United States)

    2011-05-26

    ... HUMAN SERVICES Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and... Health and Human Services, and the Director, CDC, regarding the early detection and control of breast and... for breast and cervical cancer screening; updates on the National Breast and Cervical Cancer Early...

  1. Development of a dosimetric system for the quality control of breast cancer treatments; Desenvolvimento de um sistema dosimetrico para o controle de qualidade nos tratamentos de cancer de mama

    Energy Technology Data Exchange (ETDEWEB)

    Chaves, Roberio C.; Crispim, Verginia R., E-mail: rchaves@nuclear.ufrj.br, E-mail: verginia@nuclear.ufrj.br [Coordenacao dos Programas de Pos-Graduacao de Engenharia (PEN/COPPE/lUFRJ), RJ (Brazil). Programa de Pos-Graduacao em Engenharia Nuclear; Rosa, Luiz A.R. da, E-mail: Irosa@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN), Rio de Janeiro, RJ (Brazil); Santos, Delano B.V., E-mail: delano@inca.gov.br [Instituto Nacional do Cancer (INCA/MS), Rio de Janeiro, RJ (Brazil)

    2013-11-01

    A system for evaluating the values of absorbed dose in breast teletherapy was developed, using thermoluminescent dosimeters (TLD-100), to compare them to those provided by Therapy planning system. A breast phantom was made to distribute the dosimeters TL shaped chip in breast volume and irradiate it under the same conditions of planning. Three different techniques of teletherapy were considered: one with irradiation from a therapy unit of {sup 60}Co and two with an X-ray beam coming from a 6 MV linear accelerator. Doses measures allowed checking that the performance of the quality control system used in breast cancer treatment is appropriate, since the planned doses differed about 1.5% of the responses provided by TL dosimeters.

  2. SU-E-T-617: A Feasibility Study of Navigation Based Multi Criteria Optimization for Advanced Cervical Cancer IMRT Planning

    Energy Technology Data Exchange (ETDEWEB)

    Ma, C [Shandong Cancer Hospital, Jinan, Shandong (China)

    2014-06-01

    Purpose: This study aims to validate multi-criteria optimization (MCO) against standard intensity modulated radiation therapy (IMRT) optimization for advanced cervical cancer in RayStation (v2.4, RaySearch Laboratories, Sweden). Methods: 10 advanced cervical cancer patients IMRT plans were randomly selected, these plans were designed with step and shoot optimization, new plans were then designed with MCO based on these plans,while keeping optimization conditions unchanged,comparison was made between both kinds of plans including the dose volume histogram parameters of PTV and OAR,and were analysed by pairing-t test. Results: We normalize the plan so that 95% volume of PTV achieved the prescribed dose(50Gy). The volume of radiation 10, 20, 30, and 40 Gy of the rectum were reduced by 14.7%,26.8%,21.1%,10.5% respectively(P≥0.05). The mean dose of rectum were reduced by 7.2Gy(P≤0.05). There were no significant differences for the dosimetric parameters for the bladder. Conclusion: In comparision with standard IMRT optimization, MCO reduces the dose of organs at risk with the same PTV coverage,but the result needs further clinical evalution.

  3. Influence of the intravenous contrast media on treatment planning dose calculations of lower esophageal and rectal cancers.

    Science.gov (United States)

    Nasrollah, Jabbari; Mikaeil, Molazadeh; Omid, Esnaashari; Mojtaba, Seyed Siahi; Ahad, Zeinali

    2014-01-01

    The impact of intravenous (IV) contrast media (CM) on radiation dose calculations must be taken into account in treatment planning. The aim of this study is to evaluate the effect of an intravenous contrast media on dose calculations in three-dimensional conformal radiation therapy (3D-CRT) for lower esophageal and rectal cancers. Seventeen patients with lower esophageal tumors and 12 patients with rectal cancers were analyzed. At the outset, all patients were planned for 3D-CRT based on the computed tomography (CT) scans with IV contrast media. Subsequently, all the plans were copied and replaced on the scans without intravenous CM. The radiation doses calculated from the two sets of CTs were compared. The dose differences between the planning image set using intravenous contrast and the image set without contrast showed an average increase in Monitor Units (MUs) in the lower esophageal region that was 1.28 and 0.75% for 6 and 15 MV photon beams, respectively. There was no statistical significant difference in the rectal region between the two sets of scans in the 3D-CRT plans. The results showed that the dose differences between the plans for the CT scans with and without CM were small and clinically tolerable. However, the differences in the lower esophageal region were significant in the statistical analysis.

  4. A culturally specific dietary plan to manage weight gain among African American breast cancer survivors: a feasibility study.

    Science.gov (United States)

    Griffith, Kathleen A; Royak-Schaler, Renee; Nesbitt, Kim; Zhan, Min; Kozlovsky, Adriane; Hurley, Kristen; Pelser, Colleen; Tkaczuk, Katherine H Rak; Ryan, Alice S

    2012-04-01

    Breast cancer survival rates are lower in African Americans (AAs) than in Caucasians, owing in part to a higher prevalence of obesity in the former, which increases the risk of recurrence and mortality. The Women's Intervention Nutrition Study (WINS) found that Caucasian women who followed a low-fat eating plan experienced a lower rate of cancer recurrence than women who maintained their usual diets. The purpose of this study was to test the feasibility of a WINS plan tailored to the cultural needs of AA breast cancer survivors. This feasibility pilot study was conducted at a university National Cancer Institute-designated comprehensive cancer center outpatient clinic with AA breast cancer survivors. The culturally specific WINS (WINS-c) plan included eight individual counseling sessions, five educational group meetings, and follow-up telephone calls over a 1-year period. Outcome measures included dietary fat, triglyceride, insulin and glucose levels, and fruit and vegetable intake. Participants (n = 8) had a mean age of 61.1 years (standard error of the mean (SEM) 3.1 years) and a mean BMI of 32 kg/m(2) (SEM 4.25 kg/m)(2). Baseline daily fat consumption decreased from 64.6 g (range 36.8-119.6g) to 44.0 g (21.6-73.4g) at 52 weeks (p = 0.07). Mean daily consumption of fruits and vegetables increased by 36% and 15%, respectively. Mean triglyceride levels decreased at 12 months (p improvement of diet quality after breast cancer.

  5. 77 FR 44204 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Control of Iron and...

    Science.gov (United States)

    2012-07-27

    ... the National Ambient Air Quality Standards (NAAQS) for PM 10 (particulate matter consisting of... of particulate matter, continuously monitoring compliance with specified pressure drop and flow rate... AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Maryland; Control of...

  6. Generic Planning and Control of Automated Material Handling Systems: Practical Requirements Versus Existing Theroy.

    NARCIS (Netherlands)

    Haneyah, S.W.A.; Zijm, Willem H.M.; Schutten, Johannes M.J.; Schuur, Peter

    2011-01-01

    This paper discusses the problem of generic planning and control of Automated Material Handling Systems (AMHSs). The paper illustrates the relevance of this research direction, and then addresses three different market sectors where AMHSs are used. These market sectors are: baggage handling,

  7. 75 FR 1284 - Revisions to the California State Implementation Plan, Ventura County Air Pollution Control District

    Science.gov (United States)

    2010-01-11

    ... authority to address, as appropriate, disproportionate human health or environmental effects, using... AGENCY 40 CFR Part 52 Revisions to the California State Implementation Plan, Ventura County Air Pollution... finalizing approval of revisions to the Ventura County Air Pollution Control District (VCAPCD) portion of the...

  8. Combined Log Inventory and Process Simulation Models for the Planning and Control of Sawmill Operations

    Science.gov (United States)

    Guillermo A. Mendoza; Roger J. Meimban; Philip A. Araman; William G. Luppold

    1991-01-01

    A log inventory model and a real-time hardwood process simulation model were developed and combined into an integrated production planning and control system for hardwood sawmills. The log inventory model was designed to monitor and periodically update the status of the logs in the log yard. The process simulation model was designed to estimate various sawmill...

  9. An agile planning and control framework for customer-order driven discrete parts manufacturing environments

    NARCIS (Netherlands)

    van Assen, M.F.; Hans, Elias W.; van de Velde, S.L.

    2000-01-01

    In this paper, we present a planning and control framework for manufacture-to-order environments that enables and supports agile-based discrete parts manufacturing. The characteristic elements of our framework are that it is decentralized, logistics and business oriented, and that it recognizes that

  10. 76 FR 71922 - Revisions to the California State Implementation Plan, Placer County Air Pollution Control...

    Science.gov (United States)

    2011-11-21

    ... AGENCY 40 CFR Part 52 Revisions to the California State Implementation Plan, Placer County Air Pollution... County Air Pollution Control District (PCAPCD) and Sacramento Metropolitan Air Quality Management... following local rules: PCAPCD Rule 236 (Wood Products and Coating Operations), PCAPCD Rule 238 (Factory...

  11. Planning and control of automated material handling systems: The merge module

    NARCIS (Netherlands)

    Haneyah, S.W.A.; Hurink, Johann L.; Schutten, Johannes M.J.; Zijm, Willem H.M.; Schuur, Peter; Hu, Bo; Morasch, Karl; Pickl, Stefan; Siegle, Markus

    2011-01-01

    We address the field of internal logistics, embodied in Automated Material Handling Systems (AMHSs), which are complex installations employed in sectors such as Baggage Handling, Physical Distribution, and Parcel & Postal. We work on designing an integral planning and real-time control architecture,

  12. Scaling Academic Planning in Community College: A Randomized Controlled Trial. REL 2017-204

    Science.gov (United States)

    Visher, Mary G.; Mayer, Alexander K.; Johns, Michael; Rudd, Timothy; Levine, Andrew; Rauner, Mary

    2016-01-01

    Community college students often lack an academic plan to guide their choices of coursework to achieve their educational goals, in part because counseling departments typically lack the capacity to advise students at scale. This randomized controlled trial tests the impact of guaranteed access to one of two alternative counseling sessions (group…

  13. A manufacturing planning and control system for a flexible manufacturing system

    NARCIS (Netherlands)

    Zijm, Willem H.M.; Slomp, J.; Slomp, J.

    1993-01-01

    A flexible manufacturing system (FMS) can offer important advantages in terms of more efficient production, shorter throughput times, lower stocks and a higher quality of work. To realize these advantages, a well designed manufacturing planning and control system (MPCS) is a key condition. In

  14. 75 FR 32858 - Approval and Promulgation of Air Quality Implementation Plans; Delaware; Control of Nitrogen...

    Science.gov (United States)

    2010-06-10

    ... From the Federal Register Online via the Government Publishing Office ] ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 Approval and Promulgation of Air Quality Implementation Plans; Delaware; Control of Nitrogen Oxide Emissions From Industrial Boilers and Process Heaters at Petroleum Refineries Correction In...

  15. Generic planning and control of automated material handling systems : practical requirements versus existing theory

    NARCIS (Netherlands)

    Haneyah, S.W.A.; Schutten, Johannes M.J.; Schuur, Peter; Zijm, Willem H.M.

    2013-01-01

    This paper discusses the problem to design a generic planning and control architecture for utomated material handling systems (AMHSs). We illustrate the relevance of this research direction, and then address three different market sectors where AMHSs are used, i.e., baggage handling, distribution,

  16. Evaluation of superficial dosimetry between treatment planning system and measurement for several breast cancer treatment techniques

    Energy Technology Data Exchange (ETDEWEB)

    Akino, Yuichi; Das, Indra J.; Bartlett, Gregory K.; Zhang Hualin; Thompson, Elizabeth; Zook, Jennifer E. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana 46202 (United States) and Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871 (Japan); Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana 46202 (United States)

    2013-01-15

    Purpose: Dosimetric accuracy in radiation treatment of breast cancer is critical for the evaluation of cosmetic outcomes and survival. It is often considered that treatment planning systems (TPS) may not be able to provide accurate dosimetry in the buildup region. This was investigated in various treatment techniques such as tangential wedges, field-in-field (FF), electronic compensator (eComp), and intensity-modulated radiotherapy (IMRT). Methods: Under Institutional Review Board (IRB) exemption, radiotherapy treatment plans of 111 cases were retrospectively analyzed. The distance between skin surface and 95% isodose line was measured. For measurements, Gafchromic EBT2 films were used on a humanoid unsliced phantom. Multiple layers of variable thickness of superflab bolus were placed on the breast phantom and CT scanned for planning. Treatment plans were generated using four techniques with two different grid sizes (1 Multiplication-Sign 1 and 2.5 Multiplication-Sign 2.5 mm{sup 2}) to provide optimum dose distribution. Films were placed at different depths and exposed with the selected techniques. A calibration curve for dose versus pixel values was also generated on the same day as the phantom measurement was conducted. The DICOM RT image, dose, and plan data were imported to the in-house software. On axial plane of CT slices, curves were drawn at the position where EBT2 films were placed, and the dose profiles on the lines were acquired. The calculated and measured dose profiles were separated by check points which were marked on the films before irradiation. The segments of calculated profiles were stretched to match their resolutions to that of film dosimetry. Results: On review of treatment plans, the distance between skin and 95% prescribed dose was up to 8 mm for plans of 27 patients. The film measurement revealed that the medial region of phantom surface received a mere 45%-50% of prescribed dose. For wedges, FF, and eComp techniques, region around the

  17. Early clinical outcome of coverage probability based treatment planning for simultaneous integrated boost of nodes in locally advanced cervical cancer.

    Science.gov (United States)

    Lindegaard, Jacob Chr; Assenholt, Marianne; Ramlov, Anne; Fokdal, Lars Ulrik; Alber, Markus; Tanderup, Kari

    2017-11-01

    More than 50% of patients with locally advanced cervical cancer (LACC) have pathological nodes. Coverage probability (CovP) is a new planning technique allowing for relaxed dose at the boost periphery minimising collateral irradiation. The aim was to report the first early clinical outcome data for CovP based simultaneous integrated boost (SIB) in LACC. Twenty-three consecutive node positive patients were analysed. FIGO stage IB2/IIB/IIIB/IVA/IVB was 1/14/3/1/4. Treatment was radio(chemo)therapy (RT) delivering 45 Gy/25 fx whole pelvis ± para-aortic region (PAN) using volumetric arc therapy (VMAT) followed by magnetic resonance imaging (MRI) guided brachytherapy. PAN RT (13 pts) was given if >2 nodes or if node(s) were present at the common iliac vessels or PAN. Nodal gross tumour volumes (GTV-N) were contoured on both PET-CT and MRI. Clinical target volume (CTV-N) was formed by fusion of GTV-N CT and GTV-N MRI . A 5-mm isotropic margin was used for planning target volume (PTV-N). Nodes in the small pelvis were boosted to 55.0 Gy/25 fx. Common iliac and para-aortic nodes received 57.5 Gy/25 fx. Planning aims for CovP were PTV-N D 98  ≥ 90%, CTV-N D 98  ≥ 100% and CTV-N D 50  ≥ 101.5%. Seventy-four nodes were boosted. A consistent 5.0 ± 0.7 Gy dose reduction from CTV-N D 98 to PTV-N D 98 was obtained. In total, 73/74 nodes were in complete remission at 3 months PET-CT and MRI. Pelvic control was obtained in 21/23 patients. One patient (IB2, clear cell) had salvageable local disease, while another (IIB) failed in a boosted node. Two patients failed in un-irradiated PAN. One patient age 88 (IIIB) did not receive PAN RT, despite a common iliac node. The other (IIB) recurred above L1. Two further patients (IVB) failed systemically. Since complete remission at 3 months is predictive for favourable long-term nodal control, our study indicates that CovP for SIB is promising.

  18. Shuttle Flight Operations Contract Generator Maintenance Facility Land Use Control Implementation Plan (LUCIP)

    Science.gov (United States)

    Applegate, Joseph L.

    2014-01-01

    This Land Use Control Implementation Plan (LUCIP) has been prepared to inform current and potential future users of the Kennedy Space Center (KSC) Shuttle Flight Operations Contract Generator Maintenance Facility (SFOC; SWMU 081; "the Site") of institutional controls that have been implemented at the Site1. Although there are no current unacceptable risks to human health or the environment associated with the SFOC, an institutional land use control (LUC) is necessary to prevent human health exposure to antimony-affected groundwater at the Site. Controls will include periodic inspection, condition certification, and agency notification.

  19. Using the LHC control system - 2016 retrospective and short term plans

    CERN Document Server

    Crockford, G

    2017-01-01

    The paper will discuss the LHC control system performance during 2016 operation. It aims to answer the following questions: In retrospect, which controls facilities, if any, were missing and what could be improved? How did we perform on follow-up of requests from Evian 2015? Human errors committed while interacting with the control system are discussed and suggestions made for possible mitigation measures. Looking forward to EYETS (the extended year end technical stop), the planned control system changes and their impact will be presented.

  20. Partner- and planning-based interventions to reduce fat consumption: randomized controlled trial.

    OpenAIRE

    Prestwich, A; Conner, MT; Lawton, RJ; Ward, JK; Ayres, K; McEachan, RRC

    2014-01-01

    OBJECTIVE: The research tested the efficacy of partner- and planning-based interventions to reduce dietary fat intake over a 6-month period. DESIGN: Randomized controlled, blinded, parallel trial. METHODS: A computer randomization feature was used to allocate council employees (N = 427, of which 393 completed baseline measures) to one of four conditions (partner + implementation intentions, partner-only, implementation intentions, and control group) before they completed measures at baseline ...

  1. Technical Note: Is bulk electron density assignment appropriate for MRI-only based treatment planning for lung cancer?

    Science.gov (United States)

    Prior, Phil; Chen, Xinfeng; Gore, Elizabeth; Johnstone, Candice; Li, X Allen

    2017-07-01

    MRI-based treatment planning in radiation therapy (RT) is prohibitive, in part, due to the lack of electron density (ED) information within the image. The dosimetric differences between MRI- and CT-based planning for intensity modulated RT (IMRT) of lung cancer were investigated to assess the appropriateness of bulk ED assignment. Planning CTs acquired for six representative lung cancer patients were used to generate bulk ED IMRT plans. To avoid the effect of anatomic differences between CT and MRI, "simulated MRI-based plans" were generated by forcing the relative ED (rED) to water on CT-delineated structures using organ specific values from the ICRU Report 46 and using the mean rED value of the internal target volume (ITV) from the planning CT. The "simulated MRI-based plans" were generated using a research planning system (Monaco v5.09.07a, Elekta, AB) and employing Monte Carlo dose calculation. The following dose-volume-parameters (DVPs) were collected from both the "simulated MRI-based plans" and the original planning CT: D95 , the dose delivered to 95% of the ITV & planning target volume (PTV), D5 and V5 , the volume of normal lung irradiated ≥5 Gy. The percent point difference and relative dose difference were used for comparison with the CT based plan for V5 and D95 respectively. A total of five plans per patient were generated; three with the ITV rED (rEDITV ) = 1.06, 1.0 and the mean value from the planning CT while the lung rED (rEDlung ) was fixed at the ICRU value of 0.26 and two with rEDlung = 0.1 and 0.5 while the rEDITV was fixed to the mean value from the planning CT. Noticeable differences in the ITV and PTV DVPs were observed. Variations of the normal lung V5 can be as large as 9.6%. In some instances, varying the rEDITV between rEDmean and 1.06 resulted in D95 increases ranging from 3.9% to 6.3%. Bulk rED assignment on normal lung affected the DVPs of the ITV and PTV by 4.0-9.8% and 0.3-19.6% respectively. Dose volume histograms were presented

  2. The 5 x 5 plan for asthma control: the green route to asthma control

    African Journals Online (AJOL)

    This is a critical, but sadly often neglected, activity. It can be stated with certainty that an asthmatic who does not know the information outlined in this paper will never be free of asthma symptoms. Education is important at every visit, and is not time consuming or difficult to perform. This plan is also easy to remember and use.

  3. A detailed dosimetric comparison between manual and inverse plans in HDR intracavitary/interstitial cervical cancer brachytherapy.

    Science.gov (United States)

    Trnková, Petra; Baltas, Dimos; Karabis, Andreas; Stock, Markus; Dimopoulos, Johannes; Georg, Dietmar; Pötter, Richard; Kirisits, Christian

    2010-12-01

    The purpose of this study was to compare two inverse planning algorithms for cervical cancer brachytherapy and a conventional manual treatment planning according to the MUW (Medical University of Vienna) protocol. For 20 patients, manually optimized, and, inversely optimized treatment plans with Hybrid Inverse treatment Planning and Optimization (HIPO) and with Inverse Planning Simulated Annealing (IPSA) were created. Dosimetric parameters, absolute volumes of normal tissue receiving reference doses, absolute loading times of tandem, ring and interstitial needles, Paddick and COIN conformity indices were evaluated. HIPO was able to achieve a similar dose distribution to manual planning with the restriction of high dose regions. It reduced the loading time of needles and the overall treatment time. The values of both conformity indices were the lowest. IPSA was able to achieve acceptable dosimetric results. However, it overloaded the needles. This resulted in high dose regions located in the normal tissue. The Paddick index for the volume of two times prescribed dose was outstandingly low. HIPO can produce clinically acceptable treatment plans with the elimination of high dose regions in normal tissue. Compared to IPSA, it is an inverse optimization method which takes into account current clinical experience gained from manual treatment planning.

  4. A detailed dosimetric comparison between manual and inverse plans in HDR intracavitary/interstitial cervical cancer brachytherapy

    Directory of Open Access Journals (Sweden)

    Johannes Dimopoulos

    2010-01-01

    Full Text Available Purpose: The purpose of this study was to compare two inverse planning algorithms for cervical cancer brachytherapy and a conventional manual treatment planning according to the MUW (Medical University of Vienna protocol.Material and methods: For 20 patients, manually optimized, and, inversely optimized treatment plans with Hybrid Inverse treatment Planning and Optimization (HIPO and with Inverse Planning Simulated Annealing (IPSA were created. Dosimetric parameters, absolute volumes of normal tissue receiving reference doses, absolute loading times of tandem, ring and interstitial needles, Paddick and COIN conformity indices were evaluated.Results: HIPO was able to achieve a similar dose distribution to manual planning with the restriction of high dose regions. It reduced the loading time of needles and the overall treatment time. The values of both conformity indices were the lowest. IPSA was able to achieve acceptable dosimetric results. However, it overloaded the needles.This resulted in high dose regions located in the normal tissue. The Paddick index for the volume of two times prescribed dose was outstandingly low.Conclusions: HIPO can produce clinically acceptable treatment plans with the elimination of high dose regions in normal tissue. Compared to IPSA, it is an inverse optimization method which takes into account current clinical experience gained from manual treatment planning.

  5. Diet and pancreatic cancer: a case-control study.

    Science.gov (United States)

    Norell, S E; Ahlbom, A; Erwald, R; Jacobson, G; Lindberg-Navier, I; Olin, R; Törnberg, B; Wiechel, K L

    1986-12-01

    In a population-based case-control study carried out in Sweden in 1982-1984, the authors examined the association of pancreatic cancer with several dietary factors, coffee, alcohol, and tobacco. Analyses were based on 99 cases, 138 population controls, and 163 hospital controls. The cases were persons aged 40-79 years diagnosed with cancer of the exocrine pancreas at three surgical departments in Stockholm and Uppsala. The risk increased with higher consumption frequency of fried and grilled meat in the comparison with each series of controls (e.g., relative risk (RR) = 1.7 (90% confidence interval (CI) = 1.1-2.7) for weekly intake and RR = 13.4 (90% CI = 2.4-74.7) for almost daily intake, in the comparison with population controls). Furthermore, associations were found with other fried or grilled foods, but not with meat other than fried or grilled. The risk also increased with the intake of margarine (e.g., RR = 9.7 (90% CI = 3.1-30.2) for 15+ g of margarine on a slice of bread, in the comparison with population controls). In contrast, no excess risk was associated with high intake of butter. A low risk was associated with frequent consumption of fruits and vegetables, particularly carrots (RR = 0.3 (90% CI = 0.2-0.7)) and citrus fruits (RR = 0.5 (90% CI = 0.3-0.9)) for almost daily intake. No consistent associations were found with coffee, artificial sweeteners or alcohol consumption, but a threefold increase in risk was associated with smoking at least one pack of cigarettes per day.

  6. SU-F-T-241: Reduction in Planning Errors Via a Process Control Developed Using the Eclipse Scripting API

    Energy Technology Data Exchange (ETDEWEB)

    Barbee, D; McCarthy, A; Galavis, P; Xu, A [NYU Langone Medical Center, New York, NY (United States)

    2016-06-15

    Purpose: Errors found during initial physics plan checks frequently require replanning and reprinting, resulting decreased departmental efficiency. Additionally, errors may be missed during physics checks, resulting in potential treatment errors or interruption. This work presents a process control created using the Eclipse Scripting API (ESAPI) enabling dosimetrists and physicists to detect potential errors in the Eclipse treatment planning system prior to performing any plan approvals or printing. Methods: Potential failure modes for five categories were generated based on available ESAPI (v11) patient object properties: Images, Contours, Plans, Beams, and Dose. An Eclipse script plugin (PlanCheck) was written in C# to check errors most frequently observed clinically in each of the categories. The PlanCheck algorithms were devised to check technical aspects of plans, such as deliverability (e.g. minimum EDW MUs), in addition to ensuring that policy and procedures relating to planning were being followed. The effect on clinical workflow efficiency was measured by tracking the plan document error rate and plan revision/retirement rates in the Aria database over monthly intervals. Results: The number of potential failure modes the PlanCheck script is currently capable of checking for in the following categories: Images (6), Contours (7), Plans (8), Beams (17), and Dose (4). Prior to implementation of the PlanCheck plugin, the observed error rates in errored plan documents and revised/retired plans in the Aria database was 20% and 22%, respectively. Error rates were seen to decrease gradually over time as adoption of the script improved. Conclusion: A process control created using the Eclipse scripting API enabled plan checks to occur within the planning system, resulting in reduction in error rates and improved efficiency. Future work includes: initiating full FMEA for planning workflow, extending categories to include additional checks outside of ESAPI via Aria

  7. SU-E-J-125: A Novel IMRT Planning Technique to Spare Sacral Bone Marrow in Pelvic Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    McGuire, S; Bhatia, S; Sun, W; Menda, Y; Ponto, L; Gross, B; Buatti, J [University Of Iowa, Iowa City, IA (United States)

    2015-06-15

    Purpose: Develop an IMRT planning technique that can preferentially spare sacral bone marrow for pelvic cancer patients. Methods: Six pelvic cancer patients (two each with anal, cervical, and rectal cancer) were enrolled in an IRB approved protocol to obtain FLT PET images at simulation, during, and post chemoradiation therapy. Initially, conventional IMRT plans were created to maintain target coverage and reduce dose to OARs such as bladder, bowel, rectum, and femoral heads. Simulation FLT PET images were used to create IMRT plans to spare bone marrow identified as regions with SUV of 2 or greater (IMRT-BMS) within the pelvic bones from top of L3 to 5mm below the greater trochanter without compromising PTV coverage or OAR sparing when compared to the initial IMRT plan. IMRT-BMS plans used 8–10 beam angles that surrounded the subject. These plans were used for treatment. Retrospectively, the same simulation FLT PET images were used to create IMRT plans that spared bone marrow located in the sacral pelvic bone region (IMRT-FAN) also without compromising PTV coverage or OAR sparing. IMRT-FAN plans used 16 beam angles every 12° anteriorly from 90° – 270°. Optimization objectives for the sacral bone marrow avoidance region were weighted to reduce ≥V10. Results: IMRT-FAN reduced dose to the sacral bone marrow for all six subjects. The average V5, V10, V20, and V30 differences from the IMRT-BMS plan were −2.2 ± 1.7%, −11.4 ± 3.6%, −17.6 ± 5.1%, and −19.1 ± 8.1% respectively. Average PTV coverage change was 0.5% ± 0.8% from the conventional IMRT plan. Conclusion: An IMRT planning technique that uses beams from the anterior and lateral directions reduced the volume of sacral bone marrow that receives ≤10Gy while maintaining PTV coverage and OAR sparing. Additionally, the volume of sacral bone marrow that received 20 or 30 Gy was also reduced.

  8. 1997 annual ground control operating plan for the Waste Isolation Pilot Plant

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-02-01

    This plan presents background information and a working guide to assist Mine Operations and Engineering in developing strategies for addressing ground control issues at the Waste Isolation Pilot Plant (WIPP). With the anticipated receipt of waste in late 1997, this document provides additional detail to Panel 1 activities and options. The plan also serves as a foundation document for development and revision of the annual long-term ground control plan. Section 2.0 documents the current status of all underground excavations with respect to location, geology, geometry, age, ground support, operational use, projected life, and physical conditions. Section 3.0 presents the methods used to evaluate ground conditions, including visual observations of the roof, ribs, and floor, inspection of observation holes, and review of instrumentation data. Section 4.0 lists several ground support options and specific applications of each. Section 5.0 discusses remedial ground control measures that have been implemented to date. Section 6.0 presents projections and recommendations for ground control actions based on the information in Sections 2.0 through 5.0 of this plan and on a rating of the critical nature of each specific area. Section 7.0 presents a summary statement, and Section 8.0 includes references. Appendix A provides an overview and critique of ground control systems that have been, or may be, used at the site. Because of the dynamic nature of the underground openings and associated geotechnical activities, this plan will be revised as additional data are incorporated.

  9. Tumour control probability in cancer stem cells hypothesis.

    Directory of Open Access Journals (Sweden)

    Andrew Dhawan

    Full Text Available The tumour control probability (TCP is a formalism derived to compare various treatment regimens of radiation therapy, defined as the probability that given a prescribed dose of radiation, a tumour has been eradicated or controlled. In the traditional view of cancer, all cells share the ability to divide without limit and thus have the potential to generate a malignant tumour. However, an emerging notion is that only a sub-population of cells, the so-called cancer stem cells (CSCs, are responsible for the initiation and maintenance of the tumour. A key implication of the CSC hypothesis is that these cells must be eradicated to achieve cures, thus we define TCPS as the probability of eradicating CSCs for a given dose of radiation. A cell surface protein expression profile, such as CD44high/CD24low for breast cancer or CD133 for glioma, is often used as a biomarker to monitor CSCs enrichment. However, it is increasingly recognized that not all cells bearing this expression profile are necessarily CSCs, and in particular early generations of progenitor cells may share the same phenotype. Thus, due to the lack of a perfect biomarker for CSCs, we also define a novel measurable TCPCD+, that is the probability of eliminating or controlling biomarker positive cells. Based on these definitions, we use stochastic methods and numerical simulations parameterized for the case of gliomas, to compare the theoretical TCPS and the measurable TCPCD+. We also use the measurable TCP to compare the effect of various radiation protocols.

  10. Patient outcomes from lung cancer and diabetes mellitus: a matched case–control study

    OpenAIRE

    Karlin, Nina J; Amin, Shailja B; Buras, Matthew R; Kosiorek, Heidi E; Verona, Patricia M; Cook, Curtiss B

    2017-01-01

    Aim: This case–control study examined the impact of diabetes mellitus (DM) on survival in lung cancer patients and lung cancer on glycemic control in DM. Materials & methods: Patients with a new lung cancer diagnosis and DM (n = 124) were matched to 124 lung cancer patients without DM. Laboratory results and DM and cancer therapies were obtained from electronic records. Results: Five-year overall survival for lung cancer patients with and without DM was 20 versus 29% (p = .12). Glycemic contr...

  11. SU-E-T-620: Planning and Dosimetry for Pulsed Low Dose Rate RT for Recurrent Lung, Spine, GYN and Head and Neck Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Tong, X; Luo, F; Liu, Y; Zhang, W; Xu, Q; Zhang, T; Li, J [3rd Affiliated Hospital of Qiqihar Medical University, Qiqihar (China); Chen, L; Ma, C [Fox Chase Cancer Center, Philadelphia, PA (United States)

    2015-06-15

    Purpose: Extensive in vitro and in vivo studies have shown that pulsed low dose rate (PLDR) radiotherapy has potential to provide significant local tumor control and to reduce normal tissue toxicities. This work investigated the planning and dosimetry of PLDR re-irradiation for recurrent cancers. Methods: We analyzed the treatment plans and dosimetry for 13 recurrent patients who were treated with the PLDR technique in this study. All cases were planned with the 3DCRT technique with optimal beam angle selection. The treatment was performed on a Siemens accelerator using 6MV beams. The target volume ranged between 161 and 703cc. The previous RT dose was 40–60Gy while the re-irradiation dose was 16–60Gy. The interval between previous RT and re-irradiation was 13–336 months, and the follow-up time was up to 27months. The total prescription dose was administered in 2Gy/day fractions with the daily dose delivered in 10 sub-fractions (pulses) of 20cGy with a 3min interval between the pulses to achieve an effective dose rate of 6.7cGy/min. Results: The clinical outcome was analyzed based on the treatment plans. All pulses were kept with Dmax<40cGy. The PLDR treatments were effective (CR: 3 patients, PR: 10 patients). The acute and late toxicities were all acceptable (generally grade II or under). Two patients died three months after the PLDR re-irradiation, one due to massive cerebral infarction and the other due to acute cardiac failure. All others survived more than 8 months. Five patients showed good conditions at the last follow-up. Among them two recurrent lung cancer patients had survived 23 months and one nasopharyngeal cancer patient had survived 27 months. Conclusion: The PLDR technique was effective for the palliative treatment of head and neck, lung, spine and GYN cancers. Further phase II and III studies are warranted to quantify the efficacy of PLDR for recurrent cancers.

  12. Dosimetric impact of mixed-energy volumetric modulated arc therapy plans for high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Shyam Pokharel

    2013-10-01

    Full Text Available Purpose: This study investigated the dosimetric impact of mixing low and high energy treatment plans for prostate cancer treated with volumetric modulated arc therapy (VMAT technique in the form of RapidArc.Methods: A cohort of 12 prostate cases involving proximal seminal vesicles and lymph nodes was selected for this retrospective study. For each prostate case, the single-energy plans (SEPs and mixed-energy plans (MEPs were generated.  First, the SEPs were created using 6 mega-voltage (MV energy for both the primary and boost plans. Second, the MEPs were created using 16 MV energy for the primary plan and 6 MV energy for the boost plan. The primary and boost MEPs used identical beam parameters and same dose optimization values as in the primary and boost SEPs for the corresponding case. The dosimetric parameters from the composite plans (SEPs and MEPs were evaluated. Results: The dose to the target volume was slightly higher (on average <1% in the SEPs than in the MEPs. The conformity index (CI and homogeneity index (HI values between the SEPs and MEPs were comparable. The dose to rectum and bladder was always higher in the SEPs (average difference up to 3.7% for the rectum and up to 8.4% for the bladder than in the MEPs. The mean dose to femoral heads was higher by about 0.8% (on average in the MEPs than in the SEPs. The number of monitor units and integral dose were higher in the SEPs compared to the MEPs by average differences of 9.1% and 5.5%, respectively.Conclusion: The preliminary results from this study suggest that use of mixed-energy VMAT plan for high-risk prostate cancer could potentially reduce the integral dose and minimize the dose to rectum and bladder, but for the higher femoral head dose.-----------------------------------------------Cite this article as:Pokharel S. Dosimetric impact of mixed-energy volumetric modulated arc therapy plans for high-risk prostate cancer. Int J Cancer Ther Oncol 2013;1(1:01011.DOI: http

  13. Enhancing a Cancer Prevention and Control Curriculum through Interactive Group Discussions

    OpenAIRE

    Forsythe, L.P.; Gadalla, S.M.; Hamilton, J G; Heckman-Stoddard, B.M.; Kent, E.E.; Lai, G Y; Lin, S. W.; Luhn, P.; Faupel-Badger, J.M.

    2012-01-01

    The Principles and Practice of Cancer Prevention and Control course (Principles course) is offered annually by the National Cancer Institute Cancer Prevention Fellowship Program. This four-week post-graduate course covers the spectrum of cancer prevention and control research (e.g. epidemiology, laboratory, clinical, social, and behavioral sciences) and is open to attendees from medical, academic, government, and related institutions across the world. In this report, we describe a new additio...

  14. Highly Efficient Training, Refinement, and Validation of a Knowledge-based Planning Quality-Control System for Radiation Therapy Clinical Trials

    Energy Technology Data Exchange (ETDEWEB)

    Li, Nan; Carmona, Ruben [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Sirak, Igor; Kasaova, Linda [Department of Oncology and Radiotherapy, University Hospital, Hradec Kralove (Czech Republic); Followill, David [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Michalski, Jeff; Bosch, Walter; Straube, William [Department of Radiation Oncology, Washington University in St Louis, St Louis, Missouri (United States); Mell, Loren K. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Moore, Kevin L., E-mail: kevinmoore@ucsd.edu [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States)

    2017-01-01

    Purpose: To demonstrate an efficient method for training and validation of a knowledge-based planning (KBP) system as a radiation therapy clinical trial plan quality-control system. Methods and Materials: We analyzed 86 patients with stage IB through IVA cervical cancer treated with intensity modulated radiation therapy at 2 institutions according to the standards of the INTERTECC (International Evaluation of Radiotherapy Technology Effectiveness in Cervical Cancer, National Clinical Trials Network identifier: 01554397) protocol. The protocol used a planning target volume and 2 primary organs at risk: pelvic bone marrow (PBM) and bowel. Secondary organs at risk were rectum and bladder. Initial unfiltered dose-volume histogram (DVH) estimation models were trained using all 86 plans. Refined training sets were created by removing sub-optimal plans from the unfiltered sample, and DVH estimation models… and DVH estimation models were constructed by identifying 30 of 86 plans emphasizing PBM sparing (comparing protocol-specified dosimetric cutpoints V{sub 10} (percentage volume of PBM receiving at least 10 Gy dose) and V{sub 20} (percentage volume of PBM receiving at least 20 Gy dose) with unfiltered predictions) and another 30 of 86 plans emphasizing bowel sparing (comparing V{sub 40} (absolute volume of bowel receiving at least 40 Gy dose) and V{sub 45} (absolute volume of bowel receiving at least 45 Gy dose), 9 in common with the PBM set). To obtain deliverable KBP plans, refined models must inform patient-specific optimization objectives and/or priorities (an auto-planning “routine”). Four candidate routines emphasizing different tradeoffs were composed, and a script was developed to automatically re-plan multiple patients with each routine. After selection of the routine that best met protocol objectives in the 51-patient training sample (KBP{sub FINAL}), protocol-specific DVH metrics and normal tissue complication probability were compared for original

  15. Informal work and formal plans: articulating the active role of patients in cancer trajectories

    Directory of Open Access Journals (Sweden)

    Rikke Juul Dalsted

    2012-12-01

    Full Text Available Introduction: Formal pathways models outline that patients should receive information in order to experience a coherent journey but do not describe an active role for patients or their relatives. The aim of this is paper is to articulate and discuss the active role of patients during their cancer trajectories.   Methods and theory: An in-depth case study of patient trajectories at a Danish hospital and surrounding municipality using individual interviews with patients. Theory about trajectory and work by Strauss was included.   Results: Patients continuously took initiatives to organize their treatment and care. They initiated processes in the trajectories, and acquired information, which they used to form their trajectories.  Patients presented problems to the healthcare professionals in order to get proper help when needed.   Discussion: Work done by patients was invisible and not perceived as work. The patients' requests were not sufficiently supported in the professional organisation of work or formal planning. Patients' insertion and use of information in their trajectories challenged professional views and working processes. And the design of the formal pathway models limits the patients´ active participation. When looking at integrated care from the perspective of patients, the development of a more holistic and personalized approach is needed. Introduction: Formal pathway models outline that patients should receive information in order to experience a coherent journey but do not describe an active role for patients or their relatives. The aim of this is paper is to articulate and discuss the active role of patients during their cancer trajectories. Methods and theory: An in-depth case study of patient trajectories at a Danish hospital and surrounding municipality using individual interviews with patients. Theory about trajectory and work by Strauss was included. Results: Patients continuously took initiatives to organize their

  16. Informal work and formal plans: articulating the active role of patients in cancer trajectories

    Directory of Open Access Journals (Sweden)

    Rikke Juul Dalsted

    2012-12-01

    Full Text Available Introduction: Formal pathways models outline that patients should receive information in order to experience a coherent journey but do not describe an active role for patients or their relatives. The aim of this is paper is to articulate and discuss the active role of patients during their cancer trajectories.  Methods and theory: An in-depth case study of patient trajectories at a Danish hospital and surrounding municipality using individual interviews with patients. Theory about trajectory and work by Strauss was included.  Results: Patients continuously took initiatives to organize their treatment and care. They initiated processes in the trajectories, and acquired information, which they used to form their trajectories.  Patients presented problems to the healthcare professionals in order to get proper help when needed.  Discussion: Work done by patients was invisible and not perceived as work. The patients' requests were not sufficiently supported in the professional organisation of work or formal planning. Patients' insertion and use of information in their trajectories challenged professional views and working processes. And the design of the formal pathway models limits the patients´ active participation. When looking at integrated care from the perspective of patients, the development of a more holistic and personalized approach is needed. Introduction: Formal pathway models outline that patients should receive information in order to experience a coherent journey but do not describe an active role for patients or their relatives. The aim of this is paper is to articulate and discuss the active role of patients during their cancer trajectories. Methods and theory: An in-depth case study of patient trajectories at a Danish hospital and surrounding municipality using individual interviews with patients. Theory about trajectory and work by Strauss was included. Results: Patients continuously took initiatives to organize their

  17. Optimal Trajectory Planning and Coordinated Tracking Control Method of Tethered Space Robot Based on Velocity Impulse

    Directory of Open Access Journals (Sweden)

    Panfeng Huang

    2014-09-01

    Full Text Available The tethered space robot (TSR is a new concept of space robot which consists of a robot platform, space tether and operation robot. This paper presents a multi-objective optimal trajectory planning and a coordinated tracking control scheme for TSR based on velocity impulse in the approaching phase. Both total velocity impulse and flight time are included in this optimization. The non-dominated sorting genetic algorithm is employed to obtain the optimal trajectory Pareto solution using the TSR dynamic model and optimal trajectory planning model. The coordinated tracking control scheme utilizes optimal velocity impulse. Furthermore, the PID controller is designed in order to compensate for the distance measurement errors. The PID control force is optimized and distributed to thrusters and the space tether using a simulated annealing algorithm. The attitude interferential torque of the space tether is compensated a using time-delay algorithm through reaction wheels. The simulation results show that the multi-objective optimal trajectory planning method can reveal the relationships among flight time, fuel consumption, planar view angle and velocity impulse number. This method can provide a series of optimal trajectory according to a number of special tasks. The coordinated control scheme can significantly save thruster fuel for tracking the optimal trajectory, restrain the attitude interferential torque produced by space tether and maintain the relative attitude stability of the operation robot.

  18. Motion planning and actuator specialization in the control of active-flexible link robots

    Science.gov (United States)

    Reis, João C. P.; Sá da Costa, José

    2012-07-01

    Trajectory planning is a well-known open-loop control strategy to minimize residual vibrations in point-to-point tasks of systems featuring mechanical flexibility. However, the major drawback of open-loop control is its limitation in coping with modeling uncertainty. In this paper a novel approach to trajectory planning based on LQR theory is proposed and applied to a single flexible link robot. To improve performance under parameter uncertainty the strategy is combined with collocated vibration control through piezoelectric actuation of the link. This combination raises the issue of the roles and the contribution of each actuator type to the overall performance of the maneuver. An actuator specialization is proposed where the joint controller is responsible for the gross vibrationless motion of the link, while the link actuators are expected to deal only with residual vibrations that may arise from modeling errors. Simulation and experimental results validate the trajectory planning methodology and the combination of the open-loop strategy with collocated vibration control.

  19. Moving from standardized to personalized boxes and pears in radiation planning for cervical cancer.

    Science.gov (United States)

    Mesko, Shane; Kamrava, Mitchell

    2016-02-01

    We reviewed the most recent literature on advancements in external beam radiation therapy, brachytherapy, and stereotactic body radiation therapy (SBRT) in the treatment of cervical cancer. There is a growing transition from three-dimensional-conformal radiation therapy to intensity modulated radiation therapy, and from point A-based two-dimensional prescriptions to three-dimensional volume-based prescriptions in image-guided brachytherapy (IGBT). These advances allow dose-escalation to at-risk regions while sparing normal tissues. Implementation of these techniques is resulting in improved local control and decreased toxicity in patients. With increased local control, the predominant pattern of recurrence is now distant failure, opening the door for SBRT as an emerging treatment option for select patients with limited numbers of metastases (oligometastatic state). The integration of IGBT, as well as dose sculpting with intensity modulated radiation therapy, is improving outcomes in women with locally advanced cervical cancer. The clinical evidence strongly supports moving away from point A-based prescriptions and adopting IGBT techniques. The existing data supporting SBRT for gynecologic oligometastases are more limited and require further research before widespread adoption; however, evidence from other disease sites is promising.

  20. Improving Air Force Command and Control Through Enhanced Agile Combat Support Planning, Execution, Monitoring, and Control Processes

    Science.gov (United States)

    2012-01-01

    Architec- ture for Combat Support Execution Planning and Control, James A. Leftwich, Robert S. Tripp, Amanda B. Geller , Patrick Mills, Tom LaTourrette...influences, such as Program Budget Deci- sion 720, dated November 7, 2006, reducing Air Force manpower end strength and budget cuts , changed the...example of a political objective might be to expel Saddam Hussein from Kuwait. The regional oper- ational objective was to cut off communications and

  1. [The strategy for establishment of comprehensive cervical cancer prevention and control in the world].

    Science.gov (United States)

    Bao, H L; Fang, L W; Wang, L H

    2017-01-06

    Cervical cancer is one of the most common malignancies among women. Screening programs for cervical cancer have been implemented in many developed countries. Comprehensive systems for cervical cancer prevention and control have improved over the past 30 years, which has led to a significant decline in the morbidity and mortality of cervical cancer. Since 2009, the Chinese government has conducted the Cervical Cancer and Breast Cancer Screening Program for Rural Women on a national scale, which has substantially improved cervical cancer prevention and control. However, a comprehensive system for cervical cancer prevention has been not established in China. It is essential to investigate suitable strategies for cervical cancer prevention system in the country by referring to the experiences of developed nations in comparison with the situation in China, with respect to system operations, compatibility with the existing health care system, choice of suitable technologies, and information and evaluation platforms.

  2. Affective science perspectives on cancer control: strategically crafting a mutually beneficial research agenda.

    Science.gov (United States)

    Ferrer, Rebecca A; Green, Paige A; Barrett, Lisa Feldman

    2015-05-01

    Cancer control research involves the conduct of basic and applied behavioral and social sciences to reduce cancer incidence, morbidity, and mortality and improve quality of life. Given the importance of behavior in cancer control, fundamental research is necessary to identify psychological mechanisms underlying cancer risk, prevention, and management behaviors. Cancer prevention, diagnosis, and treatment are often emotionally laden. As such, affective science research to elucidate questions related to the basic phenomenological nature of emotion, stress, and mood is necessary to understand how cancer control can be hindered or facilitated by emotional experiences. To date, the intersection of basic affective science research and cancer control remains largely unexplored. The goal of this article is to outline key questions in the cancer control research domain that provide an ecologically valid context for new affective science discoveries. We also provide examples of ways in which basic affective discoveries could inform future cancer prevention and control research. These examples are not meant to be exhaustive or prescriptive but instead are offered to generate creative thought about the promise of a cancer research context for answering basic affective science questions. Together, these examples provide a compelling argument for fostering collaborations between affective and cancer control scientists. © The Author(s) 2015.

  3. A quality improvement plan for hypertension control: the INCOTECA Project (INterventions for COntrol of hyperTEnsion in CAtalonia

    Directory of Open Access Journals (Sweden)

    Vallès-Fernandez Roser

    2009-03-01

    Full Text Available Abstract Background Different studies have shown insufficient blood pressure (BP control in hypertensive patients. Multiple factors influence hypertension management, and the quality of primary care is one of them. We decided therefore to evaluate the effectiveness of a quality improvement plan directed at professionals of Primary Health Care Teams (PHCT with the aim to achieve a better control of hypertension. The hypothesis of the study is that the implementation of a quality improvement plan will improve the control of hypertension. The primary aim of this study will be to evaluate the effectiveness of this plan. Methods and design Design: multicentric study quasi-experimental before – after with control group. The non-randomised allocation of the intervention will be done at PHCT level. Setting: 18 PHCT in the Barcelona province (Spain. Sample: all patients with a diagnosis of hypertension (population based study. Exclusion criteria: patients with a diagnosis of hypertension made later than 01/01/2006 and patients younger than 18 years. Intervention: a quality improvement plan, which targets primary health care professionals and includes educational sessions, feedback to health professionals, audit and implementation of recommended clinical practice guidelines for the management of hypertensive patients. Measurements: age, sex, associated co-morbidity (diabetes mellitus type I and II, heart failure and renal failure. The following variables will be recorded: BP measurement, cardiovascular risk and antihypertensive drugs used. Results will be measured before the start of the intervention and twelve months after the start of the study. Dependent variable: prevalence of hypertensive patients with poor BP control. Analysis: Chi-square test and Student's t-test will be used to measure the association between independent qualitative and quantitative variables, respectively. Non-parametric tests will be used for the analysis of non

  4. Representation and Integration: Combining Robot Control, High-Level Planning, and Action Learning

    DEFF Research Database (Denmark)

    Petrick, Ronald; Kraft, Dirk; Mourao, Kira

    We describe an approach to integrated robot control, high-level planning, and action effect learning that attempts to overcome the representational difficulties that exist between these diverse areas. Our approach combines ideas from robot vision, knowledgelevel planning, and connectionist machine...... learning, and focuses on the representational needs of these components.We also make use of a simple representational unit called an instantiated state transition fragment (ISTF) and a related structure called an object-action complex (OAC). The goal of this work is a general approach for inducing high......-level action specifications, suitable for planning, from a robot’s interactions with the world. We present a detailed overview of our approach and show how it supports the learning of certain aspects of a high-level lepresentation from low-level world state information....

  5. Adaptive/Nonadaptive Proton Radiation Planning and Outcomes in a Phase II Trial for Locally Advanced Non-small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Koay, Eugene J.; Lege, David [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mohan, Radhe [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Komaki, Ritsuko; Cox, James D. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chang, Joe Y., E-mail: jychang@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-12-01

    Purpose: To analyze dosimetric variables and outcomes after adaptive replanning of radiation therapy during concurrent high-dose protons and chemotherapy for locally advanced non-small cell lung cancer (NSCLC). Methods and Materials: Nine of 44 patients with stage III NSCLC in a prospective phase II trial of concurrent paclitaxel/carboplatin with proton radiation [74 Gy(RBE) in 37 fractions] had modifications to their original treatment plans after re-evaluation revealed changes that would compromise coverage of the target volume or violate dose constraints; plans for the other 35 patients were not changed. We compared patients with adaptive plans with those with nonadaptive plans in terms of dosimetry and outcomes. Results: At a median follow-up of 21.2 months (median overall survival, 29.6 months), no differences were found in local, regional, or distant failure or overall survival between groups. Adaptive planning was used more often for large tumors that shrank to a greater extent (median, 107.1 cm{sup 3} adaptive and 86.4 cm{sup 3} nonadaptive; median changes in volume, 25.3% adaptive and 1.2% nonadaptive; P<.01). The median number of fractions delivered using adaptive planning was 13 (range, 4-22). Adaptive planning generally improved sparing of the esophagus (median absolute decrease in V{sub 70}, 1.8%; range, 0%-22.9%) and spinal cord (median absolute change in maximum dose, 3.7 Gy; range, 0-13.8 Gy). Without adaptive replanning, target coverage would have been compromised in 2 cases (57% and 82% coverage without adaptation vs 100% for both with adaptation); neither patient experienced local failure. Radiation-related grade 3 toxicity rates were similar between groups. Conclusions: Adaptive planning can reduce normal tissue doses and prevent target misses, particularly for patients with large tumors that shrink substantially during therapy. Adaptive plans seem to have acceptable toxicity and achieve similar local, regional, and distant control and overall

  6. Treatment planning with intensity modulated particle therapy for multiple targets in stage IV non-small cell lung cancer

    Science.gov (United States)

    Anderle, Kristjan; Stroom, Joep; Vieira, Sandra; Pimentel, Nuno; Greco, Carlo; Durante, Marco; Graeff, Christian

    2018-01-01

    Intensity modulated particle therapy (IMPT) can produce highly conformal plans, but is limited in advanced lung cancer patients with multiple lesions due to motion and planning complexity. A 4D IMPT optimization including all motion states was expanded to include multiple targets, where each target (isocenter) is designated to specific field(s). Furthermore, to achieve stereotactic treatment planning objectives, target and OAR weights plus objective doses were automatically iteratively adapted. Finally, 4D doses were calculated for different motion scenarios. The results from our algorithm were compared to clinical stereotactic body radiation treatment (SBRT) plans. The study included eight patients with 24 lesions in total. Intended dose regimen for SBRT was 24 Gy in one fraction, but lower fractionated doses had to be delivered in three cases due to OAR constraints or failed plan quality assurance. The resulting IMPT treatment plans had no significant difference in target coverage compared to SBRT treatment plans. Average maximum point dose and dose to specific volume in OARs were on average 65% and 22% smaller with IMPT. IMPT could also deliver 24 Gy in one fraction in a patient where SBRT was limited due to the OAR vicinity. The developed algorithm shows the potential of IMPT in treatment of multiple moving targets in a complex geometry.