Phase I study of twice-weekly gemcitabine and concomitant external-beam radiotherapy in patients with adenocarcinoma of the pancreas

International Nuclear Information System (INIS)

Pipas, J. Marc; Mitchell, Sandra E.; Barth, Richard J.; Vera-Gimon, Raul; Rathmann, Joerg; Meyer, Louise P.; Wagman, Richard S.; Lewis, Lionel D.; McDonnell, Carol; Colacchio, Thomas A.; Perez, Raymond P.

2001-01-01

Purpose: To determine the maximum tolerated dose and dose-limiting toxicity associated with twice-weekly gemcitabine and concomitant external-beam radiotherapy in patients with adenocarcinoma of the pancreas. Methods and Materials: Twenty-one patients with biopsy-proven adenocarcinoma of the pancreas were treated with external-beam radiotherapy to a dose of 50.4 Gy in 28 fractions, concurrent with gemcitabine, infused over 30 min before irradiation on a Monday and Thursday schedule. The dose of gemcitabine was escalated in 5 cohorts of 3-6 patients each. Initial gemcitabine dose was 10 mg/m 2 , with dose escalation until dose-limiting toxicity was observed. Results: The maximum tolerated dose of gemcitabine was 50 mg/m 2 , when given in a twice-weekly schedule with radiation. Dose-limiting toxicity was seen in 2 patients at 60 mg/m 2 , and consisted of severe upper gastrointestinal bleeding approximately 1 month after completion of treatment. Six patients had radiographic evidence of response to treatment, and 5 of these underwent complete surgical resection. Three patients who underwent complete resection had been deemed to have unresectable tumors before enrollment on trial. Four patients are alive, including 2 without evidence of disease more than 1 year after resection. Conclusion: The combination of external-beam radiation and twice-weekly gemcitabine at a dose of 50 mg/m 2 is well tolerated and shows promising activity for the treatment of pancreatic cancer. Our data suggest a higher maximum tolerated dose and different dose-limiting toxicity than previously reported. Further investigation of this regimen is warranted

Social Networking Sites' Influence on Travelers' Authentic Experience a Case Study of Couch Surfing

Science.gov (United States)

Liu, Xiao

2013-01-01

This study explored travelers' experiences in the era of network hospitality 2.0 using CouchSurfing.org as a case study. The following research questions guided this study: 1) what experience does CouchSurfing create for travelers before, during and after their travel? 2) how does couch surfers' experience relate to authenticity in context of…

Poster — Thur Eve — 33: The Influence of a Modeled Treatment Couch on Dose Distributions During IMRT and RapidArc Treatment Delivery

International Nuclear Information System (INIS)

Aldosary, Ghada; Nobah, Ahmad; Al-Zorkani, Faisal; Moftah, Belal; Devic, Slobodan

2014-01-01

Treatment couches have been known to perturb dose delivery in patients. This effect is most pronounced in techniques such as IMRT and RapidArc. Although modern treatment planning systems (TPS) include data for a “default” treatment couch, actual couches are not manufactured identically. Thus, variations in their Hounsfield Unit (HU) values may exist. This study demonstrates a practical and simple method of acquiring reliable HU data for any treatment couch. We also investigate the effects of both the default and modeled treatment couches on absorbed dose. Experimental verifications show that by neglecting to incorporate the treatment couch in the TPS, dose differences of up to 9.5% and 7.3% were present for 4 MV and 10 MV photon beams, respectively. Furthermore, a clinical study based on a cohort of 20 RapidArc and IMRT (brain, pelvis and abdominal) cases is performed. 2D dose distributions show that without the couch in the planning phase, differences ≤ 4.6% and 5.9% for RapidArc and IMRT cases are present for the same cases that the default couch was added to. Additionally, in comparison to the default couch, employing the modeled couch in the calculation process influences dose distributions by ≤ 2.7% and 8% for RapidArc and IMRT cases, respectively. This result was found to be site specific; where an accurate couch proves to be preferable for IMRT brain plans. As such, adding the couch during dose calculation decreases dose calculation errors, and a precisely modeled treatment couch offers higher dose delivery accuracy for brain treatment using IMRT

Poster — Thur Eve — 33: The Influence of a Modeled Treatment Couch on Dose Distributions During IMRT and RapidArc Treatment Delivery

Energy Technology Data Exchange (ETDEWEB)

Aldosary, Ghada [Medical Physics Unit, Montreal General Hospital, McGill University, Montreal, Quebec (Canada); Nobah, Ahmad; Al-Zorkani, Faisal; Moftah, Belal [Biomedical Physics Department, King Faisal Specialist Hospital and Research Center, Riyadh (Saudi Arabia); Devic, Slobodan [Department of Radiation Oncology, Jewish General Hospital, McGill University, Montreal, Quebec (Canada)

2014-08-15

Treatment couches have been known to perturb dose delivery in patients. This effect is most pronounced in techniques such as IMRT and RapidArc. Although modern treatment planning systems (TPS) include data for a “default” treatment couch, actual couches are not manufactured identically. Thus, variations in their Hounsfield Unit (HU) values may exist. This study demonstrates a practical and simple method of acquiring reliable HU data for any treatment couch. We also investigate the effects of both the default and modeled treatment couches on absorbed dose. Experimental verifications show that by neglecting to incorporate the treatment couch in the TPS, dose differences of up to 9.5% and 7.3% were present for 4 MV and 10 MV photon beams, respectively. Furthermore, a clinical study based on a cohort of 20 RapidArc and IMRT (brain, pelvis and abdominal) cases is performed. 2D dose distributions show that without the couch in the planning phase, differences ≤ 4.6% and 5.9% for RapidArc and IMRT cases are present for the same cases that the default couch was added to. Additionally, in comparison to the default couch, employing the modeled couch in the calculation process influences dose distributions by ≤ 2.7% and 8% for RapidArc and IMRT cases, respectively. This result was found to be site specific; where an accurate couch proves to be preferable for IMRT brain plans. As such, adding the couch during dose calculation decreases dose calculation errors, and a precisely modeled treatment couch offers higher dose delivery accuracy for brain treatment using IMRT.

SU-F-T-457: A Filmless Method for Measurement of Couch Translation Per Gantry Rotation and Couch Speed for Tomotherapy Using ArcCheck

International Nuclear Information System (INIS)

Yang, B; Wong, R; Geng, H; Lam, W; Cheung, K; Yu, S

2016-01-01

Purpose: To develop a filmless methodology based on an ArcCheck for QA measurement of the couch translation per gantry rotation and couch speed of a Tomotherapy unit. Methods: Two test plans recommended by TG148 were chosen for this study. A helical plan with 1 cm field size opened the leaves for 180 degrees at the 2nd, 7th and 12th of total 13 rotations and was used to verify if the couch travelled the expected distance per gantry rotation. The other test plan was a static plan with the gantry at 0°, 1cm field width and constant couch movement speed of 0.5mm/s. It was used for couch speed measurement. The ArcCheck was isocentrically set up and recorded movie files which took a snapshot exposure every 50ms. Due to the spiral pattern of diodes distribution, when one of the diodes of the ArcCheck located at the beam center, the dose profile as measured by the row of diodes which surrounded the center diode should have a symmetrical pattern. We divided the profile into left half A and right half B. Then a shape parameter was defined as S=Σ|(A−B)|/Σ(A+B). By searching the local minimum of S parameter, the beam center at different time could be located. The machine trajectory log data were also collected and analyzed for comparison. Results: The mean value of measured couch translation and couch speed by ArcCheck had less than 0.05% deviation from the planned values. For couch speed measurement, our result showed a mean value of 0.5002 with an uncertainty ±0.0031, which agreed very well with both the plan setting of 0.5 mm/s and the machine log data of 0.5005 mm/s. Conclusion: Couch translation measured using ArcCheck is accurate and comparable to the film-based measurement. This filmless method also provides a convenient and independent way for measuring couch speed.

SU-F-T-457: A Filmless Method for Measurement of Couch Translation Per Gantry Rotation and Couch Speed for Tomotherapy Using ArcCheck

Energy Technology Data Exchange (ETDEWEB)

Yang, B; Wong, R; Geng, H; Lam, W; Cheung, K; Yu, S [Hong Kong Sanatorium & Hospital, Hong Kong, N/A, Hong Kong (China)

2016-06-15

Purpose: To develop a filmless methodology based on an ArcCheck for QA measurement of the couch translation per gantry rotation and couch speed of a Tomotherapy unit. Methods: Two test plans recommended by TG148 were chosen for this study. A helical plan with 1 cm field size opened the leaves for 180 degrees at the 2nd, 7th and 12th of total 13 rotations and was used to verify if the couch travelled the expected distance per gantry rotation. The other test plan was a static plan with the gantry at 0°, 1cm field width and constant couch movement speed of 0.5mm/s. It was used for couch speed measurement. The ArcCheck was isocentrically set up and recorded movie files which took a snapshot exposure every 50ms. Due to the spiral pattern of diodes distribution, when one of the diodes of the ArcCheck located at the beam center, the dose profile as measured by the row of diodes which surrounded the center diode should have a symmetrical pattern. We divided the profile into left half A and right half B. Then a shape parameter was defined as S=Σ|(A−B)|/Σ(A+B). By searching the local minimum of S parameter, the beam center at different time could be located. The machine trajectory log data were also collected and analyzed for comparison. Results: The mean value of measured couch translation and couch speed by ArcCheck had less than 0.05% deviation from the planned values. For couch speed measurement, our result showed a mean value of 0.5002 with an uncertainty ±0.0031, which agreed very well with both the plan setting of 0.5 mm/s and the machine log data of 0.5005 mm/s. Conclusion: Couch translation measured using ArcCheck is accurate and comparable to the film-based measurement. This filmless method also provides a convenient and independent way for measuring couch speed.

A dosimetric comparison of real-time adaptive and non-adaptive radiotherapy: A multi-institutional study encompassing robotic, gimbaled, multileaf collimator and couch tracking

DEFF Research Database (Denmark)

Colvill, Emma; Booth, Jeremy; Nill, Simeon

2016-01-01

AND MATERIALS: Ten institutions with robotic(2), gimbaled(2), MLC(4) or couch tracking(2) used common materials including CT and structure sets, motion traces and planning protocols to create a lung and a prostate plan. For each motion trace, the plan was delivered twice to a moving dosimeter; with and without...

Kleinian groups in E(∞) and their connection to particle physics and cosmology

International Nuclear Information System (INIS)

El Naschie, M.S.

2003-01-01

The paper proposes that the geometry and topology of quantum spacetime is shadowed closely by quasi-Fuschian and Kleinian groups and that is the cause behind the phenomena of high energy particle physics. In addition, on the large scale measurement of, for instance, microwave background temperature, the universality of the Merger sponge provides an excellent limit set model for the Charlier-Zeldovich proposal of the fracticality of the universe and the accurate estimate T c =(ln20/ln3)=2.726 K. Finally the golden mean and KAM ensure global stability against Arnold-like diffusion

On Murray Jackson's 1961 'Chair, couch and countertransference'.

Science.gov (United States)

Connolly, Angela

2015-09-01

One of the problems facing psychoanalysts of all schools is that theory has evolved at a much faster pace than practice. Whereas there has been an explosion of theory, practice has remained, at least officially, static and unchanging. It is in this sense that Murray Jackson's 1961 paper is still relevant today. Despite the rise of the new relational and intersubjective paradigms, most psychoanalysts, and not a few Jungian analysts, still seem to feel that the couch is an essential component of the analytical setting and process. If the use of the couch is usually justified by the argument that it favours regression, facilitates analytical reverie and protects the patient from the influence of the analyst, over time many important psychoanalysts have come to challenge this position. Increasingly these analysts suggest that the use of the couch may actually be incompatible with the newer theoretical models. This contention is strengthened by some of the findings coming from the neurosciences and infant research. This underlines the necessity of empirical research to verify the clinical effectiveness of these different positions, couch or face-to-face, but it is exactly this type of research that is lacking. © 2015, The Society of Analytical Psychology.

Boundary layer on a flat plate with suction; Couche limite sur paroi plane poreuse avec aspiration

Energy Technology Data Exchange (ETDEWEB)

Favre, A; Dumas, R; Verollet, E [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires; Institut de Mecanique Statistique de la Turbulence, Faculte des Sciences de Marseille, 13 (France)

1961-07-01

This research done in wind tunnel concerns the turbulent boundary layer of a porous flat plate with suction. The porous wall is 1 m long and begins 1 m downstream of the leading edge. The Reynolds number based on the boundary layer thickness is of the order of 16.300. The suction rate defined as the ratio of the velocity perpendicular to the wall to the external flow velocity ranges from 0 to 2 per cent. The pressure gradient can be controlled. The mean velocity profiles have been determined for various positions and suction rates by means of total pressure probes together with the intensities of the turbulent velocity fluctuations components, energy spectra and correlations by means of hot wire anemometers, spectral analyser and correlator. The stream lines, the values of the viscous and turbulent shear stresses, of the local wall friction, of the turbulent energy production term, with some information on the dissipation of the energy have been derived from these measurements. For these data the integral of equation of continuity in boundary layer have been drawn. The suction effects on the boundary layer are important. The suction thoroughly alters the mean velocity profiles by increasing the viscous shear stresses near the wall and decreasing them far from the wall, it diminishes the longitudinal and transversal turbulence intensities, the turbulent shear stresses, and the production of energy of turbulence. These effects are much stressed in the inner part of the boundary layer. On the other hand the energy spectra show that the turbulence scale is little modified, the boundary layer thickness being not much diminished by the suction. The suction effects can be appreciated by comparing twice the suction rate to the wall friction coefficient (assumed airtight), quite noticeable as soon as the rate is about unity, they become very important when it reaches ten. (author) [French] Ces recherches, effectuees en soufflerie, concernent la couche limite turbulente d

Neurons on the couch.

Science.gov (United States)

Marić, Nadja P; Jašović-Gašić, Miroslava

2010-12-01

A hundred years after psychoanalysis was introduced, neuroscience has taken a giant step forward. It seems nowadays that effects of psychotherapy could be monitored and measured by state-of-the art brain imaging techniques. Today, the psychotherapy is considered as a strategic and purposeful environmental influence intended to enhance learning. Since gene expression is regulated by environmental influences throughout life and these processes create brain architecture and influence the strength of synaptic connections, psychotherapy (as a kind of learning) should be explored in the context of aforementioned paradigm. In other words, when placing a client on the couch, therapist actually placed client's neuronal network; while listening and talking, expressing and analyzing, experiencing transference and counter transference, therapist tends to stabilize synaptic connections and influence dendritic growth by regulating gene-transcriptional activity. Therefore, we strongly believe that, in the near future, an increasing knowledge on cellular and molecular interactions and mechanisms of action of different psycho- and pharmaco-therapeutic procedures will enable us to tailor a sophisticated therapeutic approach toward a person, by combining major therapeutic strategies in psychiatry on the basis of rational goals and evidence-based therapeutic expectations.

SU-E-T-655: Quantifying the Dosimetric Characteristics of a Calypso Compatible Radiotherapy Treatment Couch with Angular Transmission Functions

International Nuclear Information System (INIS)

Duan, J; Shen, S; Wu, X; Popple, R; Cardan, R; Huang, M; Tannazi, F; Brezovich, I

2015-01-01

Purpose: To quantified the dosimetric characteristics of a Calypso compatible radiotherapy couch using continuously scanned transmission factor as a function of gantry angle. Methods: Radiation dose as a function of gantry angle was measured with an ionization chamber at the center of a 30 cm diameter cylindrical phantom placed on Qfix kVue Calypso compatible couch. A 3-D scanner was employed to continuously scan the dose during an arc rotation delivery. Nearly continuous transmission curves of 0.03° step size were obtained from IEC gantry angle 90° to180° for 6 MV and 15 MV photon beams at three couch longitudinal positions (due to longitudinally non-uniform shape of the couch rails) with rails both at the center and on sides. The transmission curves were evaluated to assess the attenuation by the couch. They were also compared to those of a carbon fiber couch top. Results: The scanned transmission curves of the Calypso comptible couch showed fine details of the couch transmission as a function of gantry angle. The attenuation by the couch varied from 2.4% to 12.9% for the 6 MV photo beam and from 1.8% to 8.9% for the 15 MV photon beam depending on the gantry angle. The attenuation by the flat couch top is only approximately 2 to 3%, but by the rail is much more significant. Because the rails are not uniformly shaped in the longitudinal direction, attenuation by the rail for the same gantry angle varied with the rail longitudinal position. The transmission curves of the carbon fiber couch top are nearly identical to those of the Calypso compatible couch top. Conclusion: The Calypso compatible couch attenuates radiation by 2.4%–12.9% and 1.8%–8.9% for 6 MV and 15 MV photon beams, respectively. The attenuation by the rails is much more significant than the flat couch top

Comparison of Dosage Requirement of Erythropoietin Stimulating Agent (ESA in Maintenance of Hemoglobin Concentration in patients undergoing twice weekly versus thrice weekly Hemodialysis in Pakistani Population

Directory of Open Access Journals (Sweden)

Osama Kunwer Naveed

2018-03-01

Full Text Available Anemia is one of the major complications of patients with chronic kidney disease (CKD undergoing hemodialysis (HD and is associated with left ventricular hypertrophy and also increases morbidity and mortality. Anemia in patients with CKD can be due to two major reasons; iron deficiency or erythropoietin insufficiency. Erythropoietin Stimulating Agent (ESAs administration is the mainstay in treating anemia if the patient is iron sufficient. However, higher doses of ESAs have been associated with increased cerebrovascular and cardiovascular events. We conducted this study to see how much erythropoietin is required in our setting in iron sufficient patients to maintain hemoglobin(Hb  level and the effect of dialysis frequency on ESA doses.  Methods and Findings: A cross-sectional study was conducted at the Department of Nephrology at Ziauddin University Hospital. Patients’ charts were reviewed for Hb levels and doses of ESA to maintain Hb between 10-12 mg/dl. Patients were excluded if they had iron deficiency, malignancy, were on immunosuppressive agents, had renal transplant, and with Hb >12 mg/dl or <10 mg/dl and their ferritin levels, transferrin saturation, hemoglobin concentration, frequency of hemodialysis and ESA dosage were monitored. We also compared these variables between patients undergoing hemodialysis thrice weekly with those undergoing hemodialysis twice a week. A total of 105 patients were analyzed. 24 were excluded as they did not match the inclusion criteria. 81 patients were included in the study. 36 (44.4% were males and 45 (55.6% were females. Mean age of the patient was 56.47 ± 11.72 years. The average dose of ESA was 106.91 ± 61.47 for patients undergoing hemodialysis thrice weekly and 183.94 ± 116.71 for patients undergoing hemodialysis twice a week. Significant difference was found to exist between dosage of patients undergoing thrice weekly dialysis versus twice weekly dialysis(p=<0.001.  Our study has limitations

The case of David: on the couch for sixty minutes, nine years of once-a-week treatment.

Science.gov (United States)

Kavaler-Adler, Susan

2005-06-01

This paper illustrates a unique case of object relations psychoanalytic psychotherapy on a once-a-week treatment basis. The work of developmental mourning that would be thought to require two to five sessions a week was accomplished on a once-a-week basis. The analyst adjusted the treatment hour, in this one case, to 60 minutes, as opposed to the 45- or 50-minute hour. When treatment began, the analyst made an intuitive judgment to increase the patient's one session a week--which the patient made clear was all he was ready to do--to 60 minutes. The analyst made time in her practice for this 60-minute session and has continued with the patient using this format for 9 years of treatment. This had led up to the current stage of treatment, which has been so critical to the patient's self-integration process.

'CouchSurfing' : explorations in cosmopolitanism, trust, and resistance

OpenAIRE

Shapiro, Josh D.

2012-01-01

This dissertation is based on qualitative and quantitative research conducted via a case study of CouchSurfing.org, a hybrid online/offline hospitality exchange network that enables travelers to locate locals who offer them free accommodation. Chapter one begins with a statistical analysis of CouchSurfers to determine if they hold a cosmopolitan orientation. My analysis incorporates nationally representative samples from 21 different countries, over 1400 CouchSurfers, and 74,000 respondents t...

Youth Homelessness and Vulnerability: How Does Couch Surfing Fit?

Science.gov (United States)

Curry, Susanna R; Morton, Matthew; Matjasko, Jennifer L; Dworsky, Amy; Samuels, Gina M; Schlueter, David

2017-09-01

Youth homelessness is a problem characterized by high levels of vulnerability. The extent to which couch surfing - moving from one temporary housing arrangement to another - is part of youth homelessness is not well understood. Chapin Hall's Voices of Youth Count, a national research initiative, involves a multicomponent approach to studying youth homelessness. This study reports emerging findings regarding couch surfing and homelessness primarily from a national survey of 13,113 adults with youth ages 13-25 in their households or who are themselves ages 18-25. Findings suggest that couch surfing is relatively common, particularly among the older age group. Among households with 13- to 17-year-olds and 18- to 25-year-olds, 4.0% and 20.5%, respectively, reported that any of them had couch surfed in the last 12 months. There are notable social, economic, and educational differences, on average, between youth reporting homelessness and those reporting only couch surfing. However, most youth who report experiencing homelessness also report couch surfing, and these youth who experience both circumstances present high levels of socioeconomic vulnerability. Couch surfing encompasses a range of experiences, some of which likely include need for services. Interviews currently in the field, and expanded analysis of data, will contribute more nuanced policy insights. © Society for Community Research and Action 2017.

[Method for evaluating the positional accuracy of a six-degrees-of-freedom radiotherapy couch using high definition digital cameras].

Science.gov (United States)

Takemura, Akihiro; Ueda, Shinichi; Noto, Kimiya; Kurata, Yuichi; Shoji, Saori

2011-01-01

In this study, we proposed and evaluated a positional accuracy assessment method with two high-resolution digital cameras for add-on six-degrees-of-freedom radiotherapy (6D) couches. Two high resolution digital cameras (D5000, Nikon Co.) were used in this accuracy assessment method. These cameras were placed on two orthogonal axes of a linear accelerator (LINAC) coordinate system and focused on the isocenter of the LINAC. Pictures of a needle that was fixed on the 6D couch were taken by the cameras during couch motions of translation and rotation of each axis. The coordinates of the needle in the pictures were obtained using manual measurement, and the coordinate error of the needle was calculated. The accuracy of a HexaPOD evo (Elekta AB, Sweden) was evaluated using this method. All of the mean values of the X, Y, and Z coordinate errors in the translation tests were within ±0.1 mm. However, the standard deviation of the Z coordinate errors in the Z translation test was 0.24 mm, which is higher than the others. In the X rotation test, we found that the X coordinate of the rotational origin of the 6D couch was shifted. We proposed an accuracy assessment method for a 6D couch. The method was able to evaluate the accuracy of the motion of only the 6D couch and revealed the deviation of the origin of the couch rotation. This accuracy assessment method is effective for evaluating add-on 6D couch positioning.

Utilization of optical tracking to validate a software-driven isocentric approach to robotic couch movements for proton radiotherapy

International Nuclear Information System (INIS)

Hsi, Wen C.; Zeidan, Omar A.; Law, Aaron; Schreuder, Andreas N.

2014-01-01

Purpose: An optical tracking and positioning system (OTPS) was developed to validate the software-driven isocentric (SDI) approach to control the six-degrees-of-freedom movement of a robotic couch. Methods: The SDI approach to movements rotating around a predefined isocenter, referred to as a GeoIso, instead of a mechanical pivot point was developed by the robot automation industry. With robotic couch-sag corrections for weight load in a traditional SDI approach, movements could be accurately executed for a GeoIso located within a 500 mm cubic volume on the couch for treatments. The accuracy of SDI movement was investigated using the OTPS. The GeoIso was assumed to align with the proton beam isocenter (RadIso) for gantry at the reference angle. However, the misalignment between GeoIso and RadIso was quantitatively investigated by measuring the displacements at various couch angles for a target placed at the RadIso at an initial couch angle. When circular target displacements occur on a plane, a relative isocenter shift (RIS) correction could be applied in the SDI movement to minimize target displacements. Target displacements at a fixed gantry angle without and with RIS correction were measured for 12 robotic couches. Target displacements for various gantry angles were performed on three couches in gantry rooms to study the gantry-induced RadIso shift. The RIS correction can also be applied for the RadIso shift. A new SDI approach incorporating the RIS correction with the couch sag is described in this study. In parallel, the accuracy of SDI translation movements for various weight loads of patients on the couch was investigated during positioning of patients for proton prostate treatments. Results: For a fixed gantry angle, measured target displacements without RIS correction for couch rotations in the horizontal plane varied from 4 to 20 mm. However, measured displacements perpendicular to couch rotation plane were about 2 mm for all couches. Extracted

Utilization of optical tracking to validate a software-driven isocentric approach to robotic couch movements for proton radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Hsi, Wen C., E-mail: Wen.Hsi@Mclaren.org, E-mail: Wenchien.hsi@sphic.org.cn; Zeidan, Omar A., E-mail: omar.zeidan@orlandohealth.com [ProCure Proton Therapy Center, Oklahoma City, Oklahoma 73142 (United States); Law, Aaron; Schreuder, Andreas N., E-mail: niek.schreuder@provisionhp.com [ProCure Training and Development Center, Bloomington, Indiana 47404 (United States)

2014-08-15

Purpose: An optical tracking and positioning system (OTPS) was developed to validate the software-driven isocentric (SDI) approach to control the six-degrees-of-freedom movement of a robotic couch. Methods: The SDI approach to movements rotating around a predefined isocenter, referred to as a GeoIso, instead of a mechanical pivot point was developed by the robot automation industry. With robotic couch-sag corrections for weight load in a traditional SDI approach, movements could be accurately executed for a GeoIso located within a 500 mm cubic volume on the couch for treatments. The accuracy of SDI movement was investigated using the OTPS. The GeoIso was assumed to align with the proton beam isocenter (RadIso) for gantry at the reference angle. However, the misalignment between GeoIso and RadIso was quantitatively investigated by measuring the displacements at various couch angles for a target placed at the RadIso at an initial couch angle. When circular target displacements occur on a plane, a relative isocenter shift (RIS) correction could be applied in the SDI movement to minimize target displacements. Target displacements at a fixed gantry angle without and with RIS correction were measured for 12 robotic couches. Target displacements for various gantry angles were performed on three couches in gantry rooms to study the gantry-induced RadIso shift. The RIS correction can also be applied for the RadIso shift. A new SDI approach incorporating the RIS correction with the couch sag is described in this study. In parallel, the accuracy of SDI translation movements for various weight loads of patients on the couch was investigated during positioning of patients for proton prostate treatments. Results: For a fixed gantry angle, measured target displacements without RIS correction for couch rotations in the horizontal plane varied from 4 to 20 mm. However, measured displacements perpendicular to couch rotation plane were about 2 mm for all couches. Extracted

Utilization of optical tracking to validate a software-driven isocentric approach to robotic couch movements for proton radiotherapy.

Science.gov (United States)

Hsi, Wen C; Law, Aaron; Schreuder, Andreas N; Zeidan, Omar A

2014-08-01

An optical tracking and positioning system (OTPS) was developed to validate the software-driven isocentric (SDI) approach to control the six-degrees-of-freedom movement of a robotic couch. The SDI approach to movements rotating around a predefined isocenter, referred to as a GeoIso, instead of a mechanical pivot point was developed by the robot automation industry. With robotic couch-sag corrections for weight load in a traditional SDI approach, movements could be accurately executed for a GeoIso located within a 500 mm cubic volume on the couch for treatments. The accuracy of SDI movement was investigated using the OTPS. The GeoIso was assumed to align with the proton beam isocenter (RadIso) for gantry at the reference angle. However, the misalignment between GeoIso and RadIso was quantitatively investigated by measuring the displacements at various couch angles for a target placed at the RadIso at an initial couch angle. When circular target displacements occur on a plane, a relative isocenter shift (RIS) correction could be applied in the SDI movement to minimize target displacements. Target displacements at a fixed gantry angle without and with RIS correction were measured for 12 robotic couches. Target displacements for various gantry angles were performed on three couches in gantry rooms to study the gantry-induced RadIso shift. The RIS correction can also be applied for the RadIso shift. A new SDI approach incorporating the RIS correction with the couch sag is described in this study. In parallel, the accuracy of SDI translation movements for various weight loads of patients on the couch was investigated during positioning of patients for proton prostate treatments. For a fixed gantry angle, measured target displacements without RIS correction for couch rotations in the horizontal plane varied from 4 to 20 mm. However, measured displacements perpendicular to couch rotation plane were about 2 mm for all couches. Extracted misalignments of GeoIso and RadIso in

Dose attenuation by a carbon fiber linac couch and modeling with a treatment planning system

International Nuclear Information System (INIS)

Sanchez Galiano, P.; Garcia Sancho, J.M.; Crelgo, D.; Pamos, M.; Fernandez, J.; Vivanco, J.

2010-01-01

The purpose of this work is to investigate the attenuation caused by a carbon fiber linac treatment couch and the ability of a commercial radiotherapy treatment planning system to simulate it. The attenuation caused by an Exact treatment couch in a Varian Clinac 2100 C/D was characterized in detail. Both 6 MV and 18 MV photon beams were studied. The treatment couch was modeled and incorporated to Elekta XiO treatment planning system. Measured and computed attenuation values were compared. As a result we found that the attenuation caused by this complex treatment couch is strongly dependent on the incidence angle of the beam. The measured attenuation values reach 16% for 6 MV and 10% for 18 MV. The model incorporated to the treatment planning software allows reducing the differences between measured and calculated data below 2.5% and 2.0% for 6 MV and 18 MV respectively. In conclusion, it is strongly recommended accounting for the perturbation caused by this carbon fiber treatment couch when the beam intersects it. The treatment planning system studied can simulate this treatment couch accurately. Clinical implementation of the described method requires a reliable procedure to reproduce the same patient geometry in the treatment delivery and planning. (Author).

Evaluation of a new six degrees of freedom couch for radiation therapy

International Nuclear Information System (INIS)

Schmidhalter, D.; Fix, M. K.; Manser, P.; Wyss, M.; Schaer, N.; Munro, P.; Scheib, S.; Kunz, P.

2013-01-01

Purpose: The aim of this work is to evaluate the geometric accuracy of a prerelease version of a new six degrees of freedom (6DoF) couch. Additionally, a quality assurance method for 6DoF couches is proposed.Methods: The main principle of the performance tests was to request a known shift for the 6DoF couch and to compare this requested shift with the actually applied shift by independently measuring the applied shift using different methods (graph paper, laser, inclinometer, and imaging system). The performance of each of the six axes was tested separately as well as in combination with the other axes. Functional cases as well as realistic clinical cases were analyzed. The tests were performed without a couch load and with a couch load of up to 200 kg and shifts in the range between −4 and +4 cm for the translational axes and between −3° and +3° for the rotational axes were applied. The quality assurance method of the new 6DoF couch was performed using a simple cube phantom and the imaging system.Results: The deviations (mean ± one standard deviation) accumulated over all performance tests between the requested shifts and the measurements of the applied shifts were −0.01 ± 0.02, 0.01 ± 0.02, and 0.01 ± 0.02 cm for the longitudinal, lateral, and vertical axes, respectively. The corresponding values for the three rotational axes couch rotation, pitch, and roll were 0.03°± 0.06°, −0.04°± 0.12°, and −0.01°± 0.08°, respectively. There was no difference found between the tests with and without a couch load of up to 200 kg.Conclusions: The new 6DoF couch is able to apply requested shifts with high accuracy. It has the potential to be used for treatment techniques with the highest demands in patient setup accuracy such as those needed in stereotactic treatments. Shifts can be applied efficiently and automatically. Daily quality assurance of the 6DoF couch can be performed in an easy and efficient way. Long-term stability has to be evaluated in

Development of a QA Phantom for online image registration and resultant couch shifts

International Nuclear Information System (INIS)

Arumugam, S.; Jameson, M.G.; Holloway, L.C.

2010-01-01

Full text: Purpose Recently our centre purchased an Elekta-Synergy accelerator with kV-CBCT and a hexapod couch attachment. This system allows six degrees of freedom for couch lOp shifts, based on registration of on line imaging. We designed and built a phantom in our centre to test the accuracy and precision of this system. The goal of this project was to investigate the accuracy and practical utilisation of this phantom. Method The phantom was constructed from perspex sheets and high density dental putty (Fig. I). Five high density regions (three small regions to simulate prostate seeds and two larger regions to simulate boney anatomy) were incorporated to test the manual and automatic registrations within the software. The phantom was utilised to test the accuracy and precision of repositioning with the hexapod couch and imaging system. To achieve this, the phantom was placed on the couch at known orientations and the shifts were quantified using the registration of verification and reference image data sets. True shifts and those predicted by the software were compared. Results The geometrical accuracy of the phantom was verified with measurements of the CT scan to be with I mm of the intended geometry. The image registration and resultant couch shifts were found to be accurate within I mm and 0.5 degrees. The phantom was found to be practical and easy to use. Conclusion The presented phantom provides a less expensive and effective alternative to commercially available systems for verifying imaging registration and corresponding six degrees of freedom couch shifts. (author)

RETHINKING THE ROLE OF SMALL-GROUP COLLABORATORS AND ADVERSARIES IN THE LONDON KLEINIAN DEVELOPMENT (1914-1968).

Science.gov (United States)

Aguayo, Joseph; Regeczkey, Agnes

2016-07-01

The authors historically situate the London Kleinian development in terms of the small-group collaborations and adversaries that arose during the course of Melanie Klein's career. Some collaborations later became personally adversarial (e.g., those Klein had with Glover and Schmideberg); other adversarial relationships forever remained that way (with A. Freud); while still other long-term collaborations became theoretically contentious (such as with Winnicott and Heimann). After the Controversial Discussions in 1944, Klein marginalized one group of supporters (Heimann, Winnicott, and Riviere) in favor of another group (Rosenfeld, Segal, and Bion). After Klein's death in 1960, Bion maintained loyalty to Klein's ideas while quietly distancing his work from the London Klein group, immigrating to the United States in 1968. © 2016 The Psychoanalytic Quarterly, Inc.

Machine-specific quality assurance procedure for stereotactic treatments with dynamic couch rotations.

Science.gov (United States)

Wilson, Byron; Gete, Ermias

2017-12-01

We present a method in which the treatment couch's accuracy is measured using the electronic portal imaging device (EPID) and a phantom of our own construction. Using this phantom, we were able to quantify the treatment couch walkout, and the rotation angle accuracy for both static and dynamic couch treatments. These measurements were used to provide an accurate measure of the treatment couch isocenter as well as to verify the couch rotation angle recorded in the trajectory log. The phantom was constructed using a polystyrene slab in which five ball bearings of 4 mm diameter are placed on the same plane at varying radii (0, 2.8, 4.4, 5.6, and 6.7 cm). The couch was rotated through its full extent (-90, 90 degrees) while MV images were acquired continuously. The couch rotational accuracy was calculated using a least squares minimization which fit the locations of the BBs to their expected locations relative to reference setup conditions. Using this approach, rotation angle and isocenter walkout was calculated in three dimensions. These measurements were used to quantify the accuracy of the couch as well as to validate the Varian TrueBeam trajectory logs. Additionally, a method for an EPID-based couch star-shot measurement was developed and compared with the traditional film-based method. The measured couch center of rotation consisted of a cloud of points clustered around the room isocenter within 0.7 mm distance. The trajectory log couch angle values agreed with those recorded in the DICOM header of the EPID images to the third significant digit and the couch rotation angles recorded in the trajectory log and DICOM header agreed with the calculated values to 0.08 degrees. Comparison of couch star-shot measurement developed in this study with film-based star-shot measurements gave an agreement to within 0.2 mm. We have developed a quality assurance method for the treatment couch which is simple, accurate, and enables the user to access a multitude of consistent data

Technical problems of TBI in case of the moving couch method

Energy Technology Data Exchange (ETDEWEB)

Tsuda, Masayuki (Tokai Univ., Isehara, Kanagawa (Japan). Hospital)

1991-12-01

In Tokai University Hospital ever since 1982, TBI for bone marrow transplantation has been performed by the moving couch method. In this method, the patient is irradiated from the opposite direction of A-P and P-A in a comfortable supine position as is. This technique has been well studied and greatly improved. For example, the moving speed of the couch is automatically varied depending on the dose rate deviation of the electron linear accelerator, function having variable speed with the dose rate (VSDR). Another function in variable speed with division (VSDV). In addition it has a self-recording function for the actual condition for the dose and couch movement. In such small areas as the eyes and gonad, the shielding effect cannot be effectively used. For the lungs, but it is able to shield and compensate to a sufficient extent. It applied to actual treatment resulting from data obtained from the measurements using a phantom. During the irradiation we must check the reproducibility of the systems which are dose rate, couch position, and so on. This is one reasonable concept of the dose monitor. (author).

SU-F-J-125: Effects of Couch Position Variability On Dosimetric Accuracy with An MRI-Guided Co-60 Radiation Therapy Machine

Energy Technology Data Exchange (ETDEWEB)

Chow, P; Thomas, D; Agazaryan, N; Cao, M; Low, D; Yang, Y; Lamb, J [UCLA, Los Angeles, CA (United States)

2016-06-15

Purpose: Magnetic resonance imaging (MRI) guidance in radiation therapy brings real-time imaging and adaptive planning into the treatment vault where it can account for interfraction and intrafraction movement of soft tissue. The only commercially-available MRI-guided radiation therapy device is a three-head 60Co and MRI system with an integrated treatment planning system (TPS). An up to 20% attenuation of the beam by the couch is well modeled in the TPS. However, variations in the patient’s day-to-day position introduce discrepancies in the actual couch position relative its location as modeled in the treatment plan. For this reason, our institution avoids plans with beams that pass through or near the couch edges. This study looks at plans without restriction on beam angles and investigates the effects of couch shift by simulating shifts of the couch relative to the patient, in order to determine whether couch edge avoidance restrictions can be lifted. Methods: A total of 27 plans from 23 patients were investigated. Couch shifts of 1 and 2 cm were introduced in combinations of lateral and vertical direction to simulate variations in patient positioning on the couch giving 16 shifted plans per reference plan. The shift values of 1 and 2 cm were based on shifts recorded in 320 treatment fractions. Results: Measured couch attenuation versus TPS modeled agreed within 2.1%. Planning Target Volume (PTV) D95 changed less than 1% for 1 and 2 cm couch shifts in only the x-direction and less than 3% for all directions. Conclusion: The dosimetry of all plans with shifts up to ±2 cm was within reasonable clinical tolerances. Robustness of a plan to couch shifts can be tested in the TPS. Inclusion of beams traversing the couch edges should be considered if an improvement in plan quality or delivery time can be achieved.

The geometric accuracy of frameless stereotactic radiosurgery using a 6D robotic couch system

Energy Technology Data Exchange (ETDEWEB)

Takakura, T; Nakata, M; Yano, S; Fujimoto, T [Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto (Japan); Mizowaki, T; Miyabe, Y; Nakamura, M; Hiraoka, M [Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto (Japan)], E-mail: toru1@kuhp.kyoto-u.ac.jp

2010-01-07

The aim of this paper is to assess the overall geometric accuracy of the Novalis system using the Robotic Tilt Module in terms of the uncertainty in frameless stereotactic radiotherapy. We analyzed the following three metrics: (1) the correction accuracy of the robotic couch, (2) the uncertainty of the isocenter position with gantry and couch rotation, and (3) the shift in position between the isocenter and central point detected with the ExacTrac x-ray system. Based on the concept of uncertainty, the overall accuracy was calculated from these values. The accuracy in positional correction with the robotic couch was 0.07 {+-} 0.22 mm, the positional shift of the isocenter associated with gantry rotation was 0.35 mm, the positional shift of the isocenter associated with couch rotation was 0.38 mm and the difference in position between the isocenter and the ExacTrac x-ray system was 0.30 mm. The accuracy of intracranial stereotactic radiosurgery with the Novalis system in our clinic was 0.31 {+-} 0.77 mm. The overall geometric accuracy based on the concept of uncertainty was 0.31 {+-} 0.77 mm, which is within the tolerance given in the American Association of Physicists in Medicine report no. 54.

The geometric accuracy of frameless stereotactic radiosurgery using a 6D robotic couch system

International Nuclear Information System (INIS)

Takakura, T; Nakata, M; Yano, S; Fujimoto, T; Mizowaki, T; Miyabe, Y; Nakamura, M; Hiraoka, M

2010-01-01

The aim of this paper is to assess the overall geometric accuracy of the Novalis system using the Robotic Tilt Module in terms of the uncertainty in frameless stereotactic radiotherapy. We analyzed the following three metrics: (1) the correction accuracy of the robotic couch, (2) the uncertainty of the isocenter position with gantry and couch rotation, and (3) the shift in position between the isocenter and central point detected with the ExacTrac x-ray system. Based on the concept of uncertainty, the overall accuracy was calculated from these values. The accuracy in positional correction with the robotic couch was 0.07 ± 0.22 mm, the positional shift of the isocenter associated with gantry rotation was 0.35 mm, the positional shift of the isocenter associated with couch rotation was 0.38 mm and the difference in position between the isocenter and the ExacTrac x-ray system was 0.30 mm. The accuracy of intracranial stereotactic radiosurgery with the Novalis system in our clinic was 0.31 ± 0.77 mm. The overall geometric accuracy based on the concept of uncertainty was 0.31 ± 0.77 mm, which is within the tolerance given in the American Association of Physicists in Medicine report no. 54.

CouchSurfers' motivations to host travelers in Spain

OpenAIRE

Pietilä, Outi

2011-01-01

This Bachelor thesis examines the online community CouchSurfing, which is a hospitality exchange network that promotes cultural exchange, cultural diversity and tolerance. CouchSurfing members offer each other free accommodation when traveling and share their insight and knowledge of the place. The primary objective of this thesis was to define the CouchSurfers’ motivation factors behind hosting travelers in Spain, as well as produce findings to why alternative ways to travel, such as Cou...

SU-C-207-04: Reconstruction Artifact Reduction in X-Ray Cone Beam CT Using a Treatment Couch Model

Energy Technology Data Exchange (ETDEWEB)

Lasio, G; Hu, E; Zhou, J; Lee, M; Yi, B [University of Maryland School of Medicine, Baltimore, MD (United States)

2015-06-15

Purpose: to mitigate artifacts induced by the presence of the RT treatment couch in on-board CBCT and improve image quality Methods: a model of a Varian IGRT couch is constructed using a CBCT scan of the couch in air. The model is used to generate a set of forward projections (FP) of the treatment couch at specified gantry angles. The model couch forward projections are then used to process CBCT scan projections which contain the couch in addition to the scan object (Catphan phantom), in order to remove the attenuation component of the couch at any given gantry angle. Prior to pre-processing with the model FP, the Catphan projection data is normalized to an air scan with bowtie filter. The filtered Catphan projections are used to reconstruct the CBCT with an in-house FDK algorithm. The artifact reduction in the processed CBCT scan is assessed visually, and the image quality improvement is measured with the CNR over a few selected ROIs of the Catphan modules. Results: Sufficient match between the forward projected data and the x-ray projections is achieved to allow filtering in attenuation space. Visual improvement of the couch induced artifacts is achieved, with a moderate expense of CNR. Conclusion: Couch model-based correction of CBCT projection data has a potential for qualitative improvement of clinical CBCT scans, without requiring position specific correction data. The technique could be used to produce models of other artifact inducing devices, such as immobilization boards, and reduce their impact on patient CBCT images.

Modelling of treatment couch top with prowess panther treatment planning system for external beam radiotherapy

International Nuclear Information System (INIS)

Owusu-Agyapong, Linus

2016-07-01

The aim of this work is to evaluate the attenuation effects of a treatment couch and to alternatively model the couch top material with a Prowess Panther treatment planning system which does not support couch top modelling. The Hounsfield Unit classification of the couch structure was determined using a PMMA phantom by comparing ion chamber measurements with the dose forecasted by the treatment planning system (TPS). The transmission factor (TF) of the couch top was determined and was used as a TF for a treatment accessory that represented the treatment couch in the TPS. A treatment plan was done for various angles with and without the interference of the couch top and a simulated treatment was done using the PMMA phantom. Ion chamber measurement were made and compared with dose predicted by the TPS to evaluate the accuracy of the couch top modelling in the treatment planning system TPS. These investigations were done for various field sizes. The ideal set of HU for the couch was established to be -674. The measured TF was 0.956042 and the TPS calculated Transmission factor was 0.951456. The percentage difference between the measured and calculated TFs was 0.48% and this agrees perfectly with the IAEA recommended tolerance of 2%. Relative attenuation measurements were as high as 54.16% and as low as 0.63% for the beams that exited the couch before interacting with the phantom. In comparing couch modelling by couch simulation and couch TF insert, it was observed that the normalized doses were the same for 5×5 square field but deviated approximately 1% for the other field sizes. The highest deviation was observed at 10×10 square field. This study demonstrates that the couch simulation method of couch modelling is the best method that can be used to account for the effect of the treatment couch top on intersecting posterior beam fields. Thus, the attenuation effects of the treatment couch was effectively evaluated and the couch top material accurately modelled in

Choreographing Couch and Collimator in Volumetric Modulated Arc Therapy

International Nuclear Information System (INIS)

Yang Yingli; Zhang Pengpeng; Happersett, Laura; Xiong Jianping; Yang Jie; Chan, Maria; Beal, Kathryn; Mageras, Gig; Hunt, Margie

2011-01-01

Purpose: To design and optimize trajectory-based, noncoplanar subarcs for volumetric modulated arc therapy (VMAT) deliverable on both Varian TrueBEAM system and traditional accelerators; and to investigate their potential advantages for treating central nervous system (CNS) tumors. Methods and Materials: To guide the computerized selection of beam trajectories consisting of simultaneous couch, gantry, and collimator motion, a score function was implemented to estimate the geometric overlap between targets and organs at risk for each couch/gantry angle combination. An initial set of beam orientations is obtained as a function of couch and gantry angle, according to a minimum search of the score function excluding zones of collision. This set is grouped into multiple continuous and extended subarcs subject to mechanical limitations using a hierarchical clustering algorithm. After determination of couch/gantry trajectories, a principal component analysis finds the collimator angle at each beam orientation that minimizes residual target-organ at risk overlaps. An in-house VMAT optimization algorithm determines the optimal multileaf collimator position and monitor units for control points within each subarc. A retrospective study of 10 CNS patients compares the proposed method of VMAT trajectory with dynamic gantry, leaves, couch, and collimator motion (Tra-VMAT); a standard noncoplanar VMAT with no couch/collimator motion within subarcs (Std-VMAT); and noncoplanar intensity-modulated radiotherapy (IMRT) plans that were clinically used. Results: Tra-VMAT provided improved target dose conformality and lowered maximum dose to brainstem, optic nerves, and chiasm by 7.7%, 1.1%, 2.3%, and 1.7%, respectively, compared with Std-VMAT. Tra-VMAT provided higher planning target volume minimum dose and reduced maximum dose to chiasm, optic nerves, and cochlea by 6.2%, 1.3%, 6.3%, and 8.4%, respectively, and reduced cochlea mean dose by 8.7%, compared with IMRT. Tra-VMAT averaged

The study of online hospitality exchange : The case of couch surfing network

OpenAIRE

Zaki, Taher

2015-01-01

The work presented here firstly aims at creating awareness about the whole concept of ‘couch surfing,’ relatively a new phenomenon when seeking ‘alternative’ and inexpensive ways to travel to new destinations. This particular research work outlines the emphasis and prospects of alternative ways to travel nowadays. It then progresses to explaining about the couch surfing idea, how it functions as well as its benefits and criticisms. The theoretical framework of this research is based on the mo...

Technical Note: Dosimetric effects of couch position variability on treatment plan quality with an MRI-guided Co-60 radiation therapy machine

Energy Technology Data Exchange (ETDEWEB)

Chow, Phillip E., E-mail: pechow@mednet.ucla.edu; Thomas, David H.; Agazaryan, Nzhde; Cao, Minsong; Low, Daniel A.; Yang, Yingli; Steinberg, Michael L.; Lee, Percy; Lamb, James M. [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California 90095 (United States)

2016-08-15

Purpose: Magnetic resonance imaging (MRI) guidance in radiation therapy brings real-time imaging and adaptive planning into the treatment vault where it can account for interfraction and intrafraction movement of soft tissue. The only commercially available MRI-guided radiation therapy device is a three-head {sup 60}Co and MRI system with an integrated treatment planning system (TPS). Couch attenuation of the beam of up to 20% is well modeled in the TPS. Variations in the patient’s day-to-day position introduce discrepancies in the actual couch attenuation as modeled in the treatment plan. For this reason, the authors’ institution avoids plans with beams that pass through or near the couch edges. This study investigates the effects of differential beam attenuation by the couch due to couch shifts in order to determine whether couch edge avoidance restrictions can be lifted. Couch shifts were simulated using a Monte Carlo treatment planning system and ion chamber measurements performed for validation. Methods: A total of 27 plans from 23 patients were investigated. Couch shifts of 1 and 2 cm were introduced in combinations of lateral and vertical directions to simulate patient position variations giving 16 shifted plans per reference plan. The 1 and 2 cm shifts were based on shifts recorded in 320 treatment fractions. Results: Following TG176 recommendations for measurement methods, couch attenuation measurements agreed with TPS modeled attenuation to within 2.1%. Planning target volume D95 changed less than 1% for 1 and 2 cm couch shifts in only the x-direction and less than 3% for all directions. Conclusions: Dosimetry of all plans tested was robust to couch shifts up to ±2 cm. In general, couch shifts resulted in clinically insignificant dosimetric deviations. It is conceivable that in certain cases with large systematic couch shifts and plans that are particularly sensitive to shifts, dosimetric changes might rise to a clinically significant level.

SU-E-T-315: Dosimetric Effects of Couch Top Shift On VMAT Delivery in Absence of Indexing

Energy Technology Data Exchange (ETDEWEB)

Islam, M; Jin, H; Ferguson, S; Ahmad, S [Oklahoma Univ. Health Science Ctr., Oklahoma City, OK (United States)

2015-06-15

Purpose: To investigate dosimetric effects of couch top shift for volumetric-modulated arc therapy (VMAT) in absence of indexing of immobilization devices. Methods: A total of twelve VMAT treatment plans were selected from three regions (lung, abdomen, and pelvis) to account for the variation of the patient position relative to the couch top. The treatment plans were generated using the Varian Eclipse system. A pinpoint ionization chamber (PTW TN31014) was placed at the center of 16-cm solid water phantom and the dose was delivered using the Varian TrueBeam STx with BrainLAB ExacTrac couch top. To simulate the day-to-day variation of the patient position relative to couch top, the couch top was laterally shifted up to 50 mm, with an increment of 5 mm from 0 to 20 mm; and of 10 mm afterwards, and the phantom was moved back to 0 cm shift for measurement. The dose was also delivered using a Varian tennis racket grid insert at 0 cm shift to simulate the absence of couch top. The treatment plans were delivered with 6, 10, and 15 MV photons using the same leaf sequencing to investigate the energy dependence of couch top shift. The dose difference was normalized to 0 cm shift for the regular couch top for comparison. Results: The percent difference of dose was found to increase with lateral shift for all energies; however, the average differences were close to 0% and the maximum difference was within 1% along the lateral shifts. The differences with the absence of couch top were 2.2±0.5% (6MV), 1.7±0.3% (10MV), and 1.6±0.2% (15MV), respectively. Conclusion: The inclusion of couch top is recommended in treatment planning to minimize the dosimetric uncertainty between calculated and delivered dose even in absence of indexing of immobilization devices in VMAT delivery.

Attenuation measures of the BrainLAB imaging couch and validation on the treatment planning system Eclipse; Medidas de atenuacao da mesa BrainLAB imaging couch e validacao no sistema de planejamento Eclipse

Energy Technology Data Exchange (ETDEWEB)

Serante, Alexandre R., E-mail: alexandre.serante@gmail.com [Clinica de Radioterapia Inga, Nitero, RJ (Brazil); Goncalves, Joao G. [Instituto Oncologico, Juiz de Fora, MG (Brazil); Neves-Junior, Wellington F.P.; Leite, Joao Paulo S.; Haddad, Cecilia M.K. [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Servico de Radioterapia. Sociedade Beneficente de Senhoras

2015-12-15

In this work, attenuation measurements were performed for the beams of energy 6 and 15MV for the couch table BrainLAB Imaging Couch, consisting of carbon fiber. The measurements were performed in the Linac Novalis-Tx (Varian) for 5 x 5 and 10 x 10 cm² field sizes, varying gantry positions. The measured data were compared with the values calculated with the treatment planning system Eclipse, calculated with the algorithm AAA, in order to validate the model of the couch included in your library. The highest attenuation for the field size of 10 x 10 cm² was 7,5% and 4,8% for the beams 6 and 15 MV, respectively. With the field size of 5 x 5 cm² the highest attenuation value was 8,1% and 5,3%, for the beams 6 and 15 MV, respectively. Both measured at gantry position 120 deg C. From the attenuation data measured with an ionization chamber, it was possible to modify the model of the couch in Eclipse to obtain the smallest difference between measured and predicted values by the TPS. (author)

A radiotherapeutic clinical trial of twice per week vs. five times per week in oral cancer

International Nuclear Information System (INIS)

Handa, K.; Edoliya, T.N.; Pandey, R.P.; Agarwal, Y.C.; Sinha, N.

1980-01-01

135 cases of oral cancer have been treated by two fractions per week, and the results are compared with 115 approximately identical cases treated by conventional five days a week schedule with other parameters being identical. Radical irradiation was done by 6000 to 6500 rd in 6-6 1/2 weeks (NSD 1800-1900 ret) and palliative dose was 4500 R4 weeks (NSD 1532 ret). Tumour regression was found markedly superior by conventional regime in radically irradiated cases but much less superior for palliative treatment. Acute and late reaction as well as tumour control at 1 year was better with daily treatment, more so in cases treated for radical cure, while in palliative treatment, the superiority of daily regime was less marked. Our study provides evidence that only for palliation in advanced cases, radiation therapy by 2 fractions a week can be alternatively used. (orig.) [de

SU-E-T-84: A Survey On Radiotherapy Table Tolerances and Couch Overrides of Over 350 Institutions

International Nuclear Information System (INIS)

Chinsky, B; Patel, R; Panfil, J; Surucu, M; Roeske, J

2015-01-01

Purpose: Table overrides are relatively common in radiotherapy, yet are a potential safety concern. The goal of this study was to survey current departmental policies on treatment couch overrides and table tolerance values used clinically. Methods: A 25 question electronic survey on couch overrides and tolerances was sent to full members of the AAPM. In the first part of the survey, participants were asked: if table overrides were allowed at their institution, who was allowed to perform these overrides, and if imaging was required with overrides. In the second part of the survey, individuals were asked to provide table tolerance data for the following sites: brain/head & neck, lung, breast, abdomen/pelvis and prostate. Each site was further divided into IMRT/VMAT and 3D conformal techniques. Free-text spaces were provided, allowing respondents to enter any table tolerance data they were unable to specify under the treatment sites listed. Results: A total of 361 individuals responded, of which approximately half participated in the couch tolerances portion of the survey. Overall, 86% of respondents’ institutions allow couch tolerance overrides at treatment. Therapists were the most common staff members permitted to perform overrides, followed by physicists, dosimetrists, and physicians, respectively. Of the institutions allowing overrides, 34% reported overriding daily. More than half of the centers require documentation of the override and/or a setup image (acquired after override) to radiographically verify the treatment site. With respect to table tolerances, groups resulting from the free-text responses were at the two extremes; SRS/SBRT were the tightest, while clinical setup/mets/extremities were the most generous. There was no qualitative difference between IMRT/VMAT and 3D conformal table tolerances. Conclusion: This work is intended to stimulate a discussion within the radiotherapy community. This discussion, supplemented by the survey results provides an

SU-E-T-84: A Survey On Radiotherapy Table Tolerances and Couch Overrides of Over 350 Institutions

Energy Technology Data Exchange (ETDEWEB)

Chinsky, B; Patel, R; Panfil, J; Surucu, M; Roeske, J [Loyola University Medical Center, Maywood, IL (United States)

2015-06-15

Purpose: Table overrides are relatively common in radiotherapy, yet are a potential safety concern. The goal of this study was to survey current departmental policies on treatment couch overrides and table tolerance values used clinically. Methods: A 25 question electronic survey on couch overrides and tolerances was sent to full members of the AAPM. In the first part of the survey, participants were asked: if table overrides were allowed at their institution, who was allowed to perform these overrides, and if imaging was required with overrides. In the second part of the survey, individuals were asked to provide table tolerance data for the following sites: brain/head & neck, lung, breast, abdomen/pelvis and prostate. Each site was further divided into IMRT/VMAT and 3D conformal techniques. Free-text spaces were provided, allowing respondents to enter any table tolerance data they were unable to specify under the treatment sites listed. Results: A total of 361 individuals responded, of which approximately half participated in the couch tolerances portion of the survey. Overall, 86% of respondents’ institutions allow couch tolerance overrides at treatment. Therapists were the most common staff members permitted to perform overrides, followed by physicists, dosimetrists, and physicians, respectively. Of the institutions allowing overrides, 34% reported overriding daily. More than half of the centers require documentation of the override and/or a setup image (acquired after override) to radiographically verify the treatment site. With respect to table tolerances, groups resulting from the free-text responses were at the two extremes; SRS/SBRT were the tightest, while clinical setup/mets/extremities were the most generous. There was no qualitative difference between IMRT/VMAT and 3D conformal table tolerances. Conclusion: This work is intended to stimulate a discussion within the radiotherapy community. This discussion, supplemented by the survey results provides an

'Speaking Kleinian': Susan Isaacs as Ursula Wise and the Inter-War Popularisation of Psychoanalysis.

Science.gov (United States)

Shapira, Michal

2017-10-01

How did the complex concepts of psychoanalysis become popular in early twentieth-century Britain? This article examines the contribution of educator and psychoanalyst Susan Isaacs (1885-1948) to this process, as well as her role as a female expert in the intellectual and medical history of this period. Isaacs was one of the most influential British psychologists of the inter-war era, yet historical research on her work is still limited. The article focuses on her writing as 'Ursula Wise', answering the questions of parents and nursery nurses in the popular journal Nursery World, from 1929 to 1936. Researched in depth for the first time, Isaacs' important magazine columns reveal that her writing was instrumental in disseminating the work of psychoanalyst Melanie Klein in Britain. Moreover, Isaacs' powerful rebuttals to behaviourist, disciplinarian parenting methods helped shift the focus of caregivers to the child's perspective, encouraging them to acknowledge children as independent subjects and future democratic citizens. Like other early psychoanalysts, Isaacs was not an elitist; she was in fact committed to disseminating her ideas as broadly as possible. Isaacs taught British parents and child caregivers to 'speak Kleinian', translating Klein's intellectual ideas into ordinary language and thus enabling their swift integration into popular discourse.

TU-D-9A-01: TG176: Dosimetric Effects of Couch Tops and Immobilization Devices

International Nuclear Information System (INIS)

Olch, A

2014-01-01

The dosimetric impact from devices external to the patient is a complex combination of increased skin dose, reduced tumor dose, and altered dose distribution. Although small monitor unit or dose corrections are routinely made for blocking trays, ion chamber correction factors, or tissue inhomogeneities, the dose perturbation of the treatment couch top or immobilization devices are often overlooked. These devices also increase surface dose, an effect which is also often ignored or underestimated. These concerns have grown recently due to the increased use of monolithic carbon fiber couch tops which are optimal for imaging for patient position verification but cause attenuation and increased surface dose compared to the ‘tennis racket’ style couch top they often replace. Also, arc delivery techniques have replaced stationary gantry techniques which cause a greater fraction of the dose to be delivered from posterior angles. A host of immobilization devices are available and used to increase patient positioning reproducibility, and these also have attenuation and skin dose implications which are often ignored. This report of Task Group 176 serves to present a survey of published data that illustrates the magnitude of the dosimetric effects of a wide range of devices external to the patient. The report also provides methods for modeling couch tops in treatment planning systems so the physicist can accurately compute the dosimetric effects for indexed patient treatments. Both photon and proton beams are considered. A discussion on avoidance of high density structures during beam planning is also provided. An important aspect of this report are the recommendations we make to clinical physicists, treatment planning system vendors, and device vendors on how to make measurements of skin dose and attenuation, how to report these values, and for the vendors, an appeal is made to work together to provide accurate couch top models in planning systems. Learning Objectives

Precision evaluation of the treatment that used coordinates confirmation of couch in case of two forgets adjoined

International Nuclear Information System (INIS)

Seo, Jeong Min; Jeong, Cheon Young; Park, Young Hwan; Song, Ki Won

2003-01-01

Confirming an error to be able to break out in a method to move couch manually while operator sees the skin marks on patient in case of curing head who got 2 targets adjoined, so we analyze coordinates price of couch, evaluate reproducibility and precision of change movements between targets. In radiotherapy, for confirming errors in manual movements by operators by exchanging between two targets to treat patient head, we read coordinates price(vertical, longitudinal, lateral three directions of couch) shown on a monitor of LINAC( CL 2100, Varian, USA) in order to evaluate accuracy about the length that moved in time for moving couch manually. After reading movement length of coordinates recorded in three directions of all treatment, we compared distance between targets recorded in RTP(Pinnacle, ADAC, USA) with reading coordinates price of couch, setting actually done the same patient for ten times, coordinates were recorded, treated for evaluating averages and degrees of errors and standard deviations. In method to confirm skin marks of patient by operators' view and to move couch manually, average standard deviations of movements between two targets are vertical 1.4 mm, longitudinal 0.9 mm, lateral 2.2 mm in each direction. As for the error in straight dimension, it is about 3.6 mm averages and 5.1 mm maximum. The average of errors in each directions was vertical 1mm, longitudinal 0.7 mm, lateral 2.7 mm. The greatest error broke out in lateral direction with 25% of all cases ; to exceed an error average. If operators moved manually couch for changing target points, errors about 3.6 mm average degrees occur. It is important that operators confirm the errors prices of actual couch coordinates for asking a correct movement between the targets adjoined each other ; in case of treatment demanding high precision like 3D conformal therapy or IMRT. Therefore, if we apply couch coordinates confirmation to reproducibility and to precision evaluation of treatment, it

A practical method of modeling a treatment couch using cone-beam computed tomography for intensity-modulated radiation therapy and RapidArc treatment delivery

Energy Technology Data Exchange (ETDEWEB)

Aldosary, Ghada, E-mail: ghada.aldosary@mail.mcgill.ca [Medical Physics Unit, McGill University Health Centre, Montreal, Quebec (Canada); Nobah, Ahmad; Al-Zorkani, Faisal [Biomedical Physics Department, King Faisal Specialist Hospital and Research Center, Riyadh (Saudi Arabia); Devic, Slobodan [Department of Radiation Oncology, Jewish General Hospital, McGill University, Montreal, Quebec (Canada); Moftah, Belal [Medical Physics Unit, McGill University Health Centre, Montreal, Quebec (Canada); Biomedical Physics Department, King Faisal Specialist Hospital and Research Center, Riyadh (Saudi Arabia)

2015-01-01

The effect of a treatment couch on dose perturbation is not always fully considered in intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). In the course of inverse planning radiotherapy techniques, beam parameter optimization may change in the absence of the couch, causing errors in the calculated dose distributions. Although modern treatment planning systems (TPS) include data for the treatment couch components, they are not manufactured identically. Thus, variations in their Hounsfield unit (HU) values may exist. Moreover, a radiotherapy facility may wish to have a third-party custom tabletop installed that is not included by the TPS vendor. This study demonstrates a practical and simple method of acquiring reliable computed tomography (CT) data for the treatment couch and shows how the absorbed dose calculated with the modeled treatment couch can differ from that with the default treatment couch found in the TPS. We also experimentally verified that neglecting to incorporate the treatment couch completely in the treatment planning process might result in dose differences of up to 9.5% and 7.3% for 4-MV and 10-MV photon beams, respectively. Furthermore, 20 RapidArc and IMRT cases were used to quantify the change in calculated dose distributions caused by using either the default or modeled couch. From 2-dimensional (2D) ionization chamber array measurements, we observed large dose distribution differences between the measurements and calculations when the couch was omitted that varied according to the planning technique and anatomic site. Thus, incorporating the treatment couch in the dose calculation phase of treatment planning significantly decreases dose calculation errors.

Statistical process control and verifying positional accuracy of a cobra motion couch using step-wedge quality assurance tool.

Science.gov (United States)

Binny, Diana; Lancaster, Craig M; Trapp, Jamie V; Crowe, Scott B

2017-09-01

This study utilizes process control techniques to identify action limits for TomoTherapy couch positioning quality assurance tests. A test was introduced to monitor accuracy of the applied couch offset detection in the TomoTherapy Hi-Art treatment system using the TQA "Step-Wedge Helical" module and MVCT detector. Individual X-charts, process capability (cp), probability (P), and acceptability (cpk) indices were used to monitor a 4-year couch IEC offset data to detect systematic and random errors in the couch positional accuracy for different action levels. Process capability tests were also performed on the retrospective data to define tolerances based on user-specified levels. A second study was carried out whereby physical couch offsets were applied using the TQA module and the MVCT detector was used to detect the observed variations. Random and systematic variations were observed for the SPC-based upper and lower control limits, and investigations were carried out to maintain the ongoing stability of the process for a 4-year and a three-monthly period. Local trend analysis showed mean variations up to ±0.5 mm in the three-monthly analysis period for all IEC offset measurements. Variations were also observed in the detected versus applied offsets using the MVCT detector in the second study largely in the vertical direction, and actions were taken to remediate this error. Based on the results, it was recommended that imaging shifts in each coordinate direction be only applied after assessing the machine for applied versus detected test results using the step helical module. User-specified tolerance levels of at least ±2 mm were recommended for a test frequency of once every 3 months to improve couch positional accuracy. SPC enables detection of systematic variations prior to reaching machine tolerance levels. Couch encoding system recalibrations reduced variations to user-specified levels and a monitoring period of 3 months using SPC facilitated in detecting

TH-C-12A-05: Dynamic Couch Motion for Improvement of Radiation Therapy Trajectories in DCA and VMAT

Energy Technology Data Exchange (ETDEWEB)

MacDonald, L [Dalhousie University, Halifax, Nova Scotia (Canada); Thomas, Christopher [MCCPM, Capital District Health Authority, Halifax, Nova Scotia (Canada)

2014-06-15

Purpose: To investigate the potential improvement in dosimetric external beam radiation therapy plan quality using an optimized dynamic gantry and couch motion trajectory which minimizes exposure to the organs at risk. Methods: Patient-specific anatomical information of head-and-neck and cranial cancer patients was used to quantify the geometric overlap between target volumes and organs-at-risk (OARs) based on their two-dimensional projection from source to a plane at isocentre as a function of gantry and couch angle. QUANTEC dose constraints were then used as weighting factors for the OARs to generate a map of couch-gantry coordinate space indicating degree of overlap at each point in space. A couch-gantry collision space was generated by direct measurement on a Varian Truebeam linac using an anthropomorphic solid-water phantom. A dynamic, fully customizable algorithm was written to generate a navigable ideal trajectory for the patient specific couch-gantry space. The advanced algorithm includes weighting factors which can be used to balance the implementation of absolute minimum values of overlap, with the clinical practicality of largescale couch motion and delivery time. Optimized trajectories were calculated for cranial DCA treatments and for head-and-neck VMAT treatments and compared to conventional DCA and VMAT treatment trajectories. Results: Comparison of optimized treatment trajectories with conventional treatment trajectories indicates a decrease in dose to the organs-at-risk between 4.64% and 6.82% (2.39 and 3.52 Gy) of the prescription dose per patient per organ at risk. Conclusion: Using simultaneous couch and gantry motion during radiation therapy to minimize the geometrical overlap in the beams-eye-view target volumes and the organs-at-risk can have an appreciable dose reduction to organs-at-risk.

TH-C-12A-05: Dynamic Couch Motion for Improvement of Radiation Therapy Trajectories in DCA and VMAT

International Nuclear Information System (INIS)

MacDonald, L; Thomas, Christopher

2014-01-01

Purpose: To investigate the potential improvement in dosimetric external beam radiation therapy plan quality using an optimized dynamic gantry and couch motion trajectory which minimizes exposure to the organs at risk. Methods: Patient-specific anatomical information of head-and-neck and cranial cancer patients was used to quantify the geometric overlap between target volumes and organs-at-risk (OARs) based on their two-dimensional projection from source to a plane at isocentre as a function of gantry and couch angle. QUANTEC dose constraints were then used as weighting factors for the OARs to generate a map of couch-gantry coordinate space indicating degree of overlap at each point in space. A couch-gantry collision space was generated by direct measurement on a Varian Truebeam linac using an anthropomorphic solid-water phantom. A dynamic, fully customizable algorithm was written to generate a navigable ideal trajectory for the patient specific couch-gantry space. The advanced algorithm includes weighting factors which can be used to balance the implementation of absolute minimum values of overlap, with the clinical practicality of largescale couch motion and delivery time. Optimized trajectories were calculated for cranial DCA treatments and for head-and-neck VMAT treatments and compared to conventional DCA and VMAT treatment trajectories. Results: Comparison of optimized treatment trajectories with conventional treatment trajectories indicates a decrease in dose to the organs-at-risk between 4.64% and 6.82% (2.39 and 3.52 Gy) of the prescription dose per patient per organ at risk. Conclusion: Using simultaneous couch and gantry motion during radiation therapy to minimize the geometrical overlap in the beams-eye-view target volumes and the organs-at-risk can have an appreciable dose reduction to organs-at-risk

SU-E-T-66: A Prototype for Couch Based Real-Time Dosimetry in External Beam Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Ramachandran, P [Peter MacCallum Cancer Centre, Bendigo (Australia)

2015-06-15

Purpose: The main purpose of this study is to design a prototype for couch-based based real time dosimetry system in external beam radiotherapy Methods: A prototype of 100 ionization chambers was designed on a printed circuit board by etching the copper layer and each ionization chamber was wired to a 50 pin connector. The signals from the two 50 pin connectors collected from the ionization chambers were then transferred to a PXI module from National Instruments. The PXI module houses a current amplifier that amplifies the charge collected from the ionization chamber. The amplified signal is then sent to a digital multimeter module for converting the analog signal to digital signal. A software was designed in labview to read and display the signals obtained from the PXI module. A couch attachment frame was designed to house the 100 ionization chamber module. The frame was fixed underneath the treatment couch for measuring the dose during treatment. Resutls: The ionization chamber based prototype dosimetry was tested for simple radiotherapy treatment fields and found to be a useful device for measuring real time dosimetry at the treatment couch plane. This information could be used to assess the delivered dose to a patient during radiotherapy. It could be used as an invivo dosimeter during radiotherapy. Conclusion: In this study, a prototype for couch based real time dosimetry system was designed and tested. The prototype forms a basis for the development of large scale couch based real time dosimetry system that could be used to perform morning QA prior to treatment, assess real time doses delivered to patient and as a device to monitor the output of the treatment beam. Peter MacCallum Cancer Foundation.

SU-E-T-66: A Prototype for Couch Based Real-Time Dosimetry in External Beam Radiotherapy

International Nuclear Information System (INIS)

Ramachandran, P

2015-01-01

Purpose: The main purpose of this study is to design a prototype for couch-based based real time dosimetry system in external beam radiotherapy Methods: A prototype of 100 ionization chambers was designed on a printed circuit board by etching the copper layer and each ionization chamber was wired to a 50 pin connector. The signals from the two 50 pin connectors collected from the ionization chambers were then transferred to a PXI module from National Instruments. The PXI module houses a current amplifier that amplifies the charge collected from the ionization chamber. The amplified signal is then sent to a digital multimeter module for converting the analog signal to digital signal. A software was designed in labview to read and display the signals obtained from the PXI module. A couch attachment frame was designed to house the 100 ionization chamber module. The frame was fixed underneath the treatment couch for measuring the dose during treatment. Resutls: The ionization chamber based prototype dosimetry was tested for simple radiotherapy treatment fields and found to be a useful device for measuring real time dosimetry at the treatment couch plane. This information could be used to assess the delivered dose to a patient during radiotherapy. It could be used as an invivo dosimeter during radiotherapy. Conclusion: In this study, a prototype for couch based real time dosimetry system was designed and tested. The prototype forms a basis for the development of large scale couch based real time dosimetry system that could be used to perform morning QA prior to treatment, assess real time doses delivered to patient and as a device to monitor the output of the treatment beam. Peter MacCallum Cancer Foundation

Getting Started with GEO, CouchDB, and Nodejs

CERN Document Server

Thompson, Mick

2011-01-01

Today's mobile devices have GPS and standard APIs to give you access to coordinates-but what can you do with that data? With this concise book, application developers learn how to work with location data quickly and easily, using Node.js, CouchDB, and other open source tools and libraries. Node.js makes it simple to run event code on the Web, and the CouchDB document-oriented database lets you store location data and perform complex queries on it quickly. You'll learn how to get started with these tools, and then use them together to build an example project called MapChat, using HTML and Ja

Poster - Thur Eve - 38: Review of couch parameters using an FMEA.

Science.gov (United States)

Larouche, R; Doucet, R; Rémy, E; Filion, A; Poirier, L

2012-07-01

To improve patient safety during positioning, we undertook a systematic review of the processes used by our center to obtain couch positions. We used a Failure Mode and Effects Analysis (FMEA) framework and fifteen different possible failures were identified and rated. The three major failures were 1) Loss of planned couch position and bias from the previous day's couch position, 2) DICOM origin or isocenter is different between two plans (imaging or treatment), and 3) Patient shift in opposite direction than intended. The main effect of these failures was to cause an override of couch parameters. Based on these results, we modified our processes, introduced new QA and software checks and developed new tolerance tables so as to improve system robustness and increase our success rate at catching failures before they can affect the patient. It has been a year since we made these modifications. Based on our results, we have reduced the number of overrides at our center from a maximum of 20.5% to a maximum of 6.3%, with an average at 4% of daily treatments. Our results suggest that FMEA is an effective tool in improving treatment quality that could be used in other centers. © 2012 American Association of Physicists in Medicine.

Dynamic trajectory-based couch motion for improvement of radiation therapy trajectories in cranial SRT

Energy Technology Data Exchange (ETDEWEB)

MacDonald, R. Lee [Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia B3H 4R2 (Canada); Thomas, Christopher G., E-mail: Chris.Thomas@cdha.nshealth.ca [Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia B3H 4R2 (Canada); Department of Medical Physics, Nova Scotia Cancer Centre, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia B3H 1V7 (Canada); Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia B3H 4R2 (Canada); Department of Radiology, Dalhousie University, Halifax, Nova Scotia B3H 4R2 (Canada)

2015-05-15

Purpose: To investigate potential improvement in external beam stereotactic radiation therapy plan quality for cranial cases using an optimized dynamic gantry and patient support couch motion trajectory, which could minimize exposure to sensitive healthy tissue. Methods: Anonymized patient anatomy and treatment plans of cranial cancer patients were used to quantify the geometric overlap between planning target volumes and organs-at-risk (OARs) based on their two-dimensional projection from source to a plane at isocenter as a function of gantry and couch angle. Published dose constraints were then used as weighting factors for the OARs to generate a map of couch-gantry coordinate space, indicating degree of overlap at each point in space. A couch-gantry collision space was generated by direct measurement on a linear accelerator and couch using an anthropomorphic solid-water phantom. A dynamic, fully customizable algorithm was written to generate a navigable ideal trajectory for the patient specific couch-gantry space. The advanced algorithm can be used to balance the implementation of absolute minimum values of overlap with the clinical practicality of large-scale couch motion and delivery time. Optimized cranial cancer treatment trajectories were compared to conventional treatment trajectories. Results: Comparison of optimized treatment trajectories with conventional treatment trajectories indicated an average decrease in mean dose to the OARs of 19% and an average decrease in maximum dose to the OARs of 12%. Degradation was seen for homogeneity index (6.14% ± 0.67%–5.48% ± 0.76%) and conformation number (0.82 ± 0.02–0.79 ± 0.02), but neither was statistically significant. Removal of OAR constraints from volumetric modulated arc therapy optimization reveals that reduction in dose to OARs is almost exclusively due to the optimized trajectory and not the OAR constraints. Conclusions: The authors’ study indicated that simultaneous couch and gantry motion

Dynamic trajectory-based couch motion for improvement of radiation therapy trajectories in cranial SRT

International Nuclear Information System (INIS)

MacDonald, R. Lee; Thomas, Christopher G.

2015-01-01

Purpose: To investigate potential improvement in external beam stereotactic radiation therapy plan quality for cranial cases using an optimized dynamic gantry and patient support couch motion trajectory, which could minimize exposure to sensitive healthy tissue. Methods: Anonymized patient anatomy and treatment plans of cranial cancer patients were used to quantify the geometric overlap between planning target volumes and organs-at-risk (OARs) based on their two-dimensional projection from source to a plane at isocenter as a function of gantry and couch angle. Published dose constraints were then used as weighting factors for the OARs to generate a map of couch-gantry coordinate space, indicating degree of overlap at each point in space. A couch-gantry collision space was generated by direct measurement on a linear accelerator and couch using an anthropomorphic solid-water phantom. A dynamic, fully customizable algorithm was written to generate a navigable ideal trajectory for the patient specific couch-gantry space. The advanced algorithm can be used to balance the implementation of absolute minimum values of overlap with the clinical practicality of large-scale couch motion and delivery time. Optimized cranial cancer treatment trajectories were compared to conventional treatment trajectories. Results: Comparison of optimized treatment trajectories with conventional treatment trajectories indicated an average decrease in mean dose to the OARs of 19% and an average decrease in maximum dose to the OARs of 12%. Degradation was seen for homogeneity index (6.14% ± 0.67%–5.48% ± 0.76%) and conformation number (0.82 ± 0.02–0.79 ± 0.02), but neither was statistically significant. Removal of OAR constraints from volumetric modulated arc therapy optimization reveals that reduction in dose to OARs is almost exclusively due to the optimized trajectory and not the OAR constraints. Conclusions: The authors’ study indicated that simultaneous couch and gantry motion

Treatment of local recurrent breast cancer by divided dose electron beam radiation twice a week

International Nuclear Information System (INIS)

Ito, Ichiro; Suzuki, Yoshihiko; Miyaishi, Kazuo; Mitsuhashi, Norio; Kimura, Makoto

1978-01-01

The objectives of this study were to investigate the effects of divided dose electron beam radiation twice a week (with a focal dose of 600 rads at a time) on local recurrent tumors of postoperative breast cancer and to compare it with the conventional photon radiation in the hope that it might be better tolerated by the patients, with less damage to normal skin and lung tissues. Out of 261 patients with breast cancer who came to the Department of Radiology, at Gunma Univ. Hospital, Maebashi, during the period Jan., 1970, through Jun., 1976, 41 patients who received electron beam radiation for local recurrence (in 81 sites) and 31 who received prophylactic radiation over the chest wall postoperatively. Tumors completely disappeared from 73 out of 81 sites irradiated for local recurrence (accounting 90% of the 81 sites). The local recurrent lesions were classified to the ''disseminated'' and the ''focal'' type to compare the effects of the radiation, and it was found that the radiation eliminated the tumors from all (100%) of the 63 sites of the former type, while the radiation was capable of eliminating the tumors from only 10 out of the 18 sites of the latter type (56%). When the focal type tumors were classified by histopathologic typing to compare the effects of the radiation, the radiation was assessed effective in papillotubular carcinoma, medullary tubular carcinoma and scirrhous carcinoma in the decreasing sequence of significance. Pulmonary disorders occurred in 12% of all the observed sites. However, it is possible to further reduce this incidence by the adequate use of the tissue compensating filter, Mix-R. A skin disorder (erosion) was observed in 59% of all the sites observed. However, it may be anticipated that the topical application of a suitable corticoid (Beta-methasone-17-valerate cream) preparation will by prophylactically effective. (auth.)

Effect of a 16-Week Yoga Program on Blood Pressure in Healthy College Students

Science.gov (United States)

Nelson, Debra; Reed, Justy; Buck, Sarah M.

2014-01-01

The purpose of this study was to examine the effect of a 16-week yoga program on blood pressure (BP) in healthy college students. Twenty-five students (Mage = 28.24, SD = 10.64) participated in yoga class twice per week for 16 weeks. Thirty-one students (Mage = 28.77, SD = 7.23) attended a lecture (control condition) at approximately the same time…

SU-E-T-570: New Quality Assurance Method Using Motion Tracking for 6D Robotic Couches

International Nuclear Information System (INIS)

Cheon, W; Cho, J; Ahn, S; Han, Y; Choi, D

2015-01-01

Purpose: To accommodate geometrically accurate patient positioning, a robotic couch that is capable of 6-degrees of freedom has been introduced. However, conventional couch QA methods are not sufficient to enable the necessary accuracy of tests. Therefore, we have developed a camera based motion detection and geometry calibration system for couch QA. Methods: Employing a Visual-Tracking System (VTS, BonitaB10, Vicon, UK) which tracks infrared reflective(IR) markers, camera calibration was conducted using a 5.7 × 5.7 × 5.7 cm 3 cube attached with IR markers at each corner. After positioning a robotic-couch at the origin with the cube on the table top, 3D coordinates of the cube’s eight corners were acquired by VTS in the VTS coordinate system. Next, positions in reference coordinates (roomcoordinates) were assigned using the known relation between each point. Finally, camera calibration was completed by finding a transformation matrix between VTS and reference coordinate systems and by applying a pseudo inverse matrix method. After the calibration, the accuracy of linear and rotational motions as well as couch sagging could be measured by analyzing the continuously acquired data of the cube while the couch moves to a designated position. Accuracy of the developed software was verified through comparison with measurement data when using a Laser tracker (FARO, Lake Mary, USA) for a robotic-couch installed for proton therapy. Results: VTS system could track couch motion accurately and measured position in room-coordinates. The VTS measurements and Laser tracker data agreed within 1% of difference for linear and rotational motions. Also because the program analyzes motion in 3-Dimension, it can compute couch sagging. Conclusion: Developed QA system provides submillimeter/ degree accuracy which fulfills the high-end couch QA. This work was supported by the National Research Foundation of Korea funded by Ministry of Science, ICT & Future Planning. (2013M2A2A7043507

Variation in the human lymphocyte sister chromatid exchange frequency as a function of time: results of daily and twice-weekly sampling

Energy Technology Data Exchange (ETDEWEB)

Tucker, J.D.; Christensen, M.L.; Strout, C.L.; McGee, K.A.; Carrano, A.V.

1987-01-01

The variation in lymphocyte sister chromatid exchange (SCE) frequency was investigated in healthy nonsmokers who were not taking any medication. Two separate studies were undertaken. In the first, blood was drawn from four women twice a week for 8 weeks. These donors recorded the onset and termination of menstruation and times of illness. In the second study, blood was obtained from two women and two men for 5 consecutive days on two separate occasions initiated 14 days apart. Analysis of the mean SCE frequencies in each study indicated that significant temporal variation occurred in each donor, and that more variation occurred in the longer study. Some of the variation was found to be associated with the menstrual cycle. In the daily study, most of the variation appeared to be random, but occasional day-to-day changes occurred that were greater than those expected by chance. To determine how well a single SCE sample estimated the pooled mean for each donor in each study, the authors calculated the number of samples that encompassed that donor's pooled mean within 1 or more standard errors. For both studies, about 75% of the samples encompassed the pooled mean within 2 standard errors. An analysis of high-frequency cells (HFCs) was also undertaken. The results for each study indicate that the proportion of HFCs, compared with the use of Fisher's Exact test, is significantly more constant than the means, which were compared by using the t-test. These results coupled with our previous work suggest that HFC analysis may be the method of choice when analyzing data from human population studies.

SU-F-T-621: Impact of Vacuum and Treatment Couch On Surface Dose in Stereotactic Body Radiation Therapy With and Without a Flattening Filter

Energy Technology Data Exchange (ETDEWEB)

Lan, HT; Lu, SH; Kuo, SH; Tsai, YC; Chen, LH; Wen, SY; Wang, CW [National Taiwan University Hospital, Taipei City, Taiwan (China)

2016-06-15

Purpose: When treating lung cancer patients with stereotactic body radiation therapy (SBRT), better immobilization is needed for accurate delivery of high-dose radiation. However, using a treatment couch (TrueBeamTM) and vacuum bag (BlueBAGTM) may increase the surface dose and skin toxicity. This study investigated the influence of couch and vacuum bag on the surface dose. Methods: The relative surface dose (D{sub 0}/DMAX) was measured in an ion-chamber (Markus-type PTW, 0.05cm{sup 3}) with a solid water phantom and SSD to 100 cm. A comprehensive comparison of different parameter settings, including the different energies (6MV-FFF, 10MV-FF, and 10MV-FFF), field sizes (3 X 3 cm{sup 2}, 5 × 5 cm{sup 2}, 8 × x cm{sup 2} , 10 × 10 cm{sup 2}, and 15 × 15 cm{sup 2}), thickness of the vacuum bag (5mm, 15mm, 30mm, 39mm and 55mm), and couch (with and without), was performed. Results: The FFF increases the surface dose as compared to FF mode. In a similar setting with field of 10 × 10 cm{sup 2}, FFF mode increases the surface dose from 26.0% to 32.8% for 6 MV, and 17.4% to 21.5% for 10 MV. When the beam passes through the couch, the surface dose increases to 3.6, 4.6, 2.9, and 3.7 times for 6 MV-FF, 10 MV-FF, 6 MV-FFF, and 10 MV-FFF, respectively. At the same energy, the surface dose increases to 3.93, 4.11, 4.23, 4.16 and 4.24 times at 5 mm, 15 mm, 30 mm, 39 mm and 55 mm thickness of the vacuum, respectively. Conclusion: Using a couch and vacuum significantly increases the surface dose. For SBRT with a superficial target close to the couch and immobilization vacuum, reduction of vacuum thickness and careful attention to skin dose in planning would be helpful in avoiding severe skin toxicity.

The couch and the chador.

Science.gov (United States)

Movahedi, Siamak; Homayounpour, Gohar

2012-12-01

The authors present a clinical discussion of the psychic functions of the chador, a veil-like outer garment worn in public by some Iranian women. Drawing on Anzieu's theoretical concept of the skin ego, the authors suggest that the chador does not just cover the body; it may also envelop the psyche and function as a second skin for the ego. The maternal function of a holding environment is symbolically displaced on any clothing that 'hides,''covers,''veils,' or 'dresses' the body. The skin's containing functions are extended through sensory and metonymic mediations to clothes, thus providing an imaginary maternal sack for the person. The clinical vignettes presented here suggest that for some Iranian women the chador may work, on one hand, as a second skin ego and a shield against a perceived intrusive world. On the other hand, it may work as a punitive maternal superego, a 'holding cell' in a jail that paralyses the separation/individuation process. Operating in the service of the patient's resistance and defense, the chador may also function as a psychic refuge and a place to hide on the couch. Copyright © 2012 Institute of Psychoanalysis.

Evaluation of accuracy about 2D vs 3D real-time position management system based on couch rotation when non-coplanar respiratory gated radiation therapy

International Nuclear Information System (INIS)

Kwon, Kyung Tae; Kim, Jung Soo; Sim, Hyun Sun; Min, Jung Whan; Son, Soon Yong; Han, Dong Kyoon

2016-01-01

Because of non-coplanar therapy with couch rotation in respiratory gated radiation therapy, the recognition of marker movement due to the change in the distance between the infrared camera and the marker due to the rotation of the couch is called RPM (Real-time The purpose of this paper is to evaluate the accuracy of motion reflections (baseline changes) of 2D gating configuration (two dot marker block) and 3D gating configuration (six dot marker block). The motion was measured by varying the couch angle in the clockwise and counterclockwise directions by 10° in the 2D gating configuration. In the 3D gating configuration, the couch angle was changed by 10° in the clockwise direction and compared with the baseline at the reference 0°. The reference amplitude was 1.173 to 1.165, the couch angle at 20° was 1.132, and the couch angle at 1.0° was 1.083. At 350° counterclockwise, the reference amplitude was 1.168 to 1.157, the couch angle at 340° was 1.124, and the couch angle at 330° was 1.079. In this study, the phantom is used to quantitatively evaluate the value of the amplitude according to couch change

Evaluation of accuracy about 2D vs 3D real-time position management system based on couch rotation when non-coplanar respiratory gated radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Kwon, Kyung Tae; Kim, Jung Soo [Dongnam Health University, Suwon (Korea, Republic of); Sim, Hyun Sun [College of Health Sciences, Korea University, Seoul (Korea, Republic of); Min, Jung Whan [Shingu University College, Sungnam (Korea, Republic of); Son, Soon Yong [Wonkwang Health Science University, Iksan (Korea, Republic of); Han, Dong Kyoon [College of Health Sciences, EulJi University, Daejeon (Korea, Republic of)

2016-12-15

Because of non-coplanar therapy with couch rotation in respiratory gated radiation therapy, the recognition of marker movement due to the change in the distance between the infrared camera and the marker due to the rotation of the couch is called RPM (Real-time The purpose of this paper is to evaluate the accuracy of motion reflections (baseline changes) of 2D gating configuration (two dot marker block) and 3D gating configuration (six dot marker block). The motion was measured by varying the couch angle in the clockwise and counterclockwise directions by 10° in the 2D gating configuration. In the 3D gating configuration, the couch angle was changed by 10° in the clockwise direction and compared with the baseline at the reference 0°. The reference amplitude was 1.173 to 1.165, the couch angle at 20° was 1.132, and the couch angle at 1.0° was 1.083. At 350° counterclockwise, the reference amplitude was 1.168 to 1.157, the couch angle at 340° was 1.124, and the couch angle at 330° was 1.079. In this study, the phantom is used to quantitatively evaluate the value of the amplitude according to couch change.

Technical Note: Direct measurement of continuous TMR data with a 1D tank and automated couch movements.

Science.gov (United States)

Knutson, Nels C; Schmidt, Matthew C; Belley, Matthew D; Nguyen, Ngoc B; Li, H Harold; Sajo, Erno; Price, Michael J

2017-07-01

Real-time dynamic control of the linear accelerator, couch, and imaging parameters during radiation delivery was investigated as a novel technique for acquiring tissue maximum ratio (TMR) data. TrueBeam Developer Mode (Varian Medical Systems, Palo Alto, CA, USA) was used to control the linear accelerator using the Extensible Markup Language (XML). A single XML file was used to dynamically manipulate the machine, couch, and imaging parameters during radiation delivery. A TG-51 compliant 1D water tank was placed on the treatment couch, and used to position a detector at isocenter at a depth of 24.5 cm. A depth scan was performed towards the water surface. Via XML control, the treatment couch vertical position was simultaneously lowered at the same rate, maintaining the detector position at isocenter, allowing for the collection of TMR data. To ensure the detector remained at isocenter during the delivery, the in-room camera was used to monitor the detector. Continuous kV fluoroscopic images during 10 test runs further confirmed this result. TMR data at multiple Source to Detector Distances (SDD) and scan speeds were acquired to investigate their impact on the TMR data. Percentage depth dose (PDD) scans (for conversion to TMR) along with traditional discrete TMR data were acquired as a standard for comparison. More than 99.8% of the measured points had a gamma value (1%/1 mm) < 1 when compared with discrete or PDD converted TMR data. Fluoroscopic images showed that the concurrent couch and tank movements resulted in SDD errors < 1 mm. TMRs acquired at SDDs of 99, 100, and 101 cm showed differences less than 0.004. TrueBeam Developer Mode was used to collect continuous TMR data with the same accuracy as traditionally collected discrete data, but yielded higher sampled resolution and reduced acquisition time. This novel method does not require the modification of any equipment and does not use a 3D tank or reservoir. © 2017 American Association of Physicists in

Cestovní ruch a sociální sítě: Projekt CouchSurfing v Česku

OpenAIRE

Hásová, Adéla

2012-01-01

The master thesis focuses on the virtual social network sites which are concern to be exceptionally actual issue. Moreover the thesis deals with social networks in tourism. The number of various social networks about travelling is high. However, only the community of CouchSurfing (hospitality exchange network) was chosen for the research purposes of the thesis. The research included in the thesis focuses on CouchSurfing because is the greatest hospitality exchange site in these days. It inclu...

Writing and querying MapReduce views in CouchDB

CERN Document Server

Holt, Bradley

2011-01-01

If you want to use CouchDB to support real-world applications, you'll need to create MapReduce views that let you query this document-oriented database for meaningful data. With this short and concise ebook, you'll learn how to create a variety of MapReduce views to help you query and aggregate data in CouchDB's large, distributed datasets. You'll get step-by-step instructions and lots of sample code to create and explore several MapReduce views through the course of the book, using an example database you construct. To work with these different views, you'll learn how to use the Futon web a

Accuracy evaluation of a six-degree-of-freedom couch using cone beam CT and IsoCal phantom with an in-house algorithm.

Science.gov (United States)

Zhang, Qinghui; Driewer, Joseph; Wang, Shuo; Li, Sicong; Zhu, Xiaofeng; Zheng, Dandan; Cao, Yijian; Zhang, Jiaju; Jamshidi, Abolghassem; Cox, Brett W; Knisely, Jonathan P S; Potters, Louis; Klein, Eric E

2017-08-01

The accuracy of a six degree of freedom (6DoF) couch was evaluated using a novel method. Cone beam CT (CBCT) images of a 3D phantom (IsoCal) were acquired with different, known combinations of couch pitch and roll angles. Pitch and roll angles between the maximum allowable values of 357 and 3 degrees were tested in one degree increments. A total of 49 combinations were tested at 0 degrees of yaw (couch rotation angle). The 3D positions of 16 tungsten carbide ball bearings (BBs), each 4 mm in diameter and arranged in a known geometry within the IsoCal phantom, were determined in the 49 image sets with in-house software. The BB positions at different rotation angles were determined using a rotation matrix from the original BB positions at zero pitch and roll angles. A linear least squares fit method estimated the rotation angles and differences between detected and nominal rotation angles were calculated. This study was conducted for the case with and without extra weight on the couch. Couch walk shifts for the system were investigated using eight combinations of rotation, roll and pitch. A total of 49 CBCT images with voxel sizes 0.5 × 0.5 × 1.0 mm 3 were taken for the case without extra weight on the couch. The 16 BBs were determined to evaluate the isocenter translation and rotation differences between the calculated and nominal couch values. Among all 49 calculations, the maximum rotation angle differences were 0.10 degrees for pitch, 0.15 degrees for roll and 0.09 degrees for yaw. The corresponding mean and standard deviation values were 0.028 ± 0.032, -0.043 ± 0.058, and -0.009 ± 0.033 degrees. The maximum translation differences were 0.3 mm in the left-right direction, 0.5 mm in the anterior-posterior direction and 0.4 mm in the superior-inferior direction. The mean values and corresponding standard deviations were 0.07 ± 0.12, -0.05 ± 0.25, and -0.12±0.14 mm for the planes described above. With an 80 kg phantom on the couch, the

Couch height–based patient setup for abdominal radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Ohira, Shingo [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita (Japan); Ueda, Yoshihiro [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita (Japan); Nishiyama, Kinji [Department of Radiation Oncology, Yao Municipal Hospital, Yao (Japan); Miyazaki, Masayoshi; Isono, Masaru; Tsujii, Katsutomo [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Takashina, Masaaki; Koizumi, Masahiko [Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita (Japan); Kawanabe, Kiyoto [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Teshima, Teruki, E-mail: teshima-te@mc.pref.osaka.jp [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan)

2016-04-01

There are 2 methods commonly used for patient positioning in the anterior-posterior (A-P) direction: one is the skin mark patient setup method (SMPS) and the other is the couch height–based patient setup method (CHPS). This study compared the setup accuracy of these 2 methods for abdominal radiation therapy. The enrollment for this study comprised 23 patients with pancreatic cancer. For treatments (539 sessions), patients were set up by using isocenter skin marks and thereafter treatment couch was shifted so that the distance between the isocenter and the upper side of the treatment couch was equal to that indicated on the computed tomographic (CT) image. Setup deviation in the A-P direction for CHPS was measured by matching the spine of the digitally reconstructed radiograph (DRR) of a lateral beam at simulation with that of the corresponding time-integrated electronic portal image. For SMPS with no correction (SMPS/NC), setup deviation was calculated based on the couch-level difference between SMPS and CHPS. SMPS/NC was corrected using 2 off-line correction protocols: no action level (SMPS/NAL) and extended NAL (SMPS/eNAL) protocols. Margins to compensate for deviations were calculated using the Stroom formula. A-P deviation > 5 mm was observed in 17% of SMPS/NC, 4% of SMPS/NAL, and 4% of SMPS/eNAL sessions but only in one CHPS session. For SMPS/NC, 7 patients (30%) showed deviations at an increasing rate of > 0.1 mm/fraction, but for CHPS, no such trend was observed. The standard deviations (SDs) of systematic error (Σ) were 2.6, 1.4, 0.6, and 0.8 mm and the root mean squares of random error (σ) were 2.1, 2.6, 2.7, and 0.9 mm for SMPS/NC, SMPS/NAL, SMPS/eNAL, and CHPS, respectively. Margins to compensate for the deviations were wide for SMPS/NC (6.7 mm), smaller for SMPS/NAL (4.6 mm) and SMPS/eNAL (3.1 mm), and smallest for CHPS (2.2 mm). Achieving better setup with smaller margins, CHPS appears to be a reproducible method for abdominal patient setup.

Relax with CouchDB - Into the non-relational DBMS era of Bioinformatics

Science.gov (United States)

Manyam, Ganiraju; Payton, Michelle A.; Roth, Jack A.; Abruzzo, Lynne V.; Coombes, Kevin R.

2012-01-01

With the proliferation of high-throughput technologies, genome-level data analysis has become common in molecular biology. Bioinformaticians are developing extensive resources to annotate and mine biological features from high-throughput data. The underlying database management systems for most bioinformatics software are based on a relational model. Modern non-relational databases offer an alternative that has flexibility, scalability, and a non-rigid design schema. Moreover, with an accelerated development pace, non-relational databases like CouchDB can be ideal tools to construct bioinformatics utilities. We describe CouchDB by presenting three new bioinformatics resources: (a) geneSmash, which collates data from bioinformatics resources and provides automated gene-centric annotations, (b) drugBase, a database of drug-target interactions with a web interface powered by geneSmash, and (c) HapMap-CN, which provides a web interface to query copy number variations from three SNP-chip HapMap datasets. In addition to the web sites, all three systems can be accessed programmatically via web services. PMID:22609849

Using the Concept of the "Total Situation" in the Analysis of a Borderline Adolescent

Science.gov (United States)

Diem-Wille, Gertraud

2004-01-01

The author discusses two concepts of transference: the broader use of transference as the "total situation", as it was called by Melanie Klein and further elaborated by post-Kleinians, and the narrow use of transference in the traditional sense. Using clinical material from the four-times-a-week analysis of a severely disturbed…

Eating at the table, on the couch and in bed: An exploration of different locus of commensality in the discourses of Brazilian working mothers.

Science.gov (United States)

Scagliusi, Fernanda Baeza; da Rocha Pereira, Patrícia; Unsain, Ramiro Fernandez; de Morais Sato, Priscila

2016-08-01

Commensality is a remarkable human act, and tends to be more present among families. Nevertheless, it is possible that eating at the table is being taking for granted when one refers to family meals. Thus, this paper aims to analyze working mothers' discourses about family meals eaten at the table, on the couch and in the bed/bedroom. The participants were thirty mothers working in public universities of the Brazilian region called Baixada Santista. A qualitative study was conducted, using semi-structured interviews. In the transcripts the words "table", "couch", "bed", "bedroom" were located and the excerpts containing them were extracted and analyzed according to a classical and exploratory content analysis. The table is a significant component of meals that unite the family. While for some the meal at the table is an enjoyable moment, it is a stiff moment for others. Indeed, manners and the notion of hierarchy appeared only for the table. Regarding the couch, it seems that the family chose to eat there, because it is a more casual and relaxed setting. Eating in the bed was related to precarity, intimacy and casualness. In the three settings, watching television was a common practice, replacing or being added to talking. Commensality is such an important practice that appears in different settings and even in precarity contexts. The table emerged as the maximal cornerstone of commensality. However, when it was not present, new arrangements were made. Especially the couch seems to be a new commensal space, less formal and rigid, but able to allow some collective conviviality. Eating in the bed was a less common practice. Finally, the significant role that television assumed in meals is highlighted. Copyright © 2016 Elsevier Ltd. All rights reserved.

MO-D-213-05: Sensitivity of Routine IMRT QA Metrics to Couch and Collimator Rotations

International Nuclear Information System (INIS)

Alaei, P

2015-01-01

Purpose: To assess the sensitivity of gamma index and other IMRT QA metrics to couch and collimator rotations. Methods: Two brain IMRT plans with couch and/or collimator rotations in one or more of the fields were evaluated using the IBA MatriXX ion chamber array and its associated software (OmniPro-I’mRT). The plans were subjected to routine QA by 1) Creating a composite planar dose in the treatment planning system (TPS) with the couch/collimator rotations and 2) Creating the planar dose after “zeroing” the rotations. Plan deliveries to MatriXX were performed with all rotations set to zero on a Varian 21ex linear accelerator. This in effect created TPS-created planar doses with an induced rotation error. Point dose measurements for the delivered plans were also performed in a solid water phantom. Results: The IMRT QA of the plans with couch and collimator rotations showed clear discrepancies in the planar dose and 2D dose profile overlays. The gamma analysis, however, did pass with the criteria of 3%/3mm (for 95% of the points), albeit with a lower percentage pass rate, when one or two of the fields had a rotation. Similar results were obtained with tighter criteria of 2%/2mm. Other QA metrics such as percentage difference or distance-to-agreement (DTA) histograms produced similar results. The point dose measurements did not obviously indicate the error due to location of dose measurement (on the central axis) and the size of the ion chamber used (0.6 cc). Conclusion: Relying on Gamma analysis, percentage difference, or DTA to determine the passing of an IMRT QA may miss critical errors in the plan delivery due to couch/collimator rotations. A combination of analyses for composite QA plans, or per-beam analysis, would detect these errors

Relax with CouchDB--into the non-relational DBMS era of bioinformatics.

Science.gov (United States)

Manyam, Ganiraju; Payton, Michelle A; Roth, Jack A; Abruzzo, Lynne V; Coombes, Kevin R

2012-07-01

With the proliferation of high-throughput technologies, genome-level data analysis has become common in molecular biology. Bioinformaticians are developing extensive resources to annotate and mine biological features from high-throughput data. The underlying database management systems for most bioinformatics software are based on a relational model. Modern non-relational databases offer an alternative that has flexibility, scalability, and a non-rigid design schema. Moreover, with an accelerated development pace, non-relational databases like CouchDB can be ideal tools to construct bioinformatics utilities. We describe CouchDB by presenting three new bioinformatics resources: (a) geneSmash, which collates data from bioinformatics resources and provides automated gene-centric annotations, (b) drugBase, a database of drug-target interactions with a web interface powered by geneSmash, and (c) HapMap-CN, which provides a web interface to query copy number variations from three SNP-chip HapMap datasets. In addition to the web sites, all three systems can be accessed programmatically via web services. Copyright © 2012 Elsevier Inc. All rights reserved.

SU-E-T-64: CG-Based Radiation Therapy Simulator with Physical Modeling for Avoidance of Collisions Between Gantry and Couch Or Patient

International Nuclear Information System (INIS)

Yamanouchi, M; Arimura, H; Yuda, I

2014-01-01

Purpose: It is time-consuming and might cause re-planning to check couch-gantry and patient-gantry collisions on a radiotherapy machine when using couch rotations for non-coplanar beam angles. The aim of this study was to develop a computer-graphics (CG)-based radiation therapy simulator with physical modeling for avoidance of collisions between gantry and couch or patient on a radiotherapy machine. Methods: The radiation therapy simulator was three-dimensionally constructed including a radiotherapy machine (Clinac iX, Varian Medical Systems), couch, and radiation treatment room according to their designs by using a physical-modeling-based computer graphics software (Blender, free and open-source). Each patient was modeled by applying a surface rendering technique to their planning computed tomography (CT) images acquired from 16-slice CT scanner (BrightSpeed, GE Healthcare). Immobilization devices for patients were scanned by the CT equipment, and were rendered as the patient planning CT images. The errors in the collision angle of the gantry with the couch or patient between gold standards and the estimated values were obtained by fixing the gantry angle for the evaluation of the proposed simulator. Results: The average error of estimated collision angles to the couch head side was -8.5% for gantry angles of 60 to 135 degree, and -5.5% for gantry angles of 225 to 300 degree. Moreover, the average error of estimated collision angles to the couch foot side was -1.1% for gantry angles of 60 to 135 degree, and 1.4% for gantry angles of 225 to 300 degree. Conclusion: The CG-based radiation therapy simulator could make it possible to estimate the collision angle between gantry and couch or patient on the radiotherapy machine without verifying the collision angles in the radiation treatment room

Continuous Arc Rotation of the Couch Therapy for the Delivery of Accelerated Partial Breast Irradiation: A Treatment Planning Analysis

International Nuclear Information System (INIS)

Shaitelman, Simona F.; Kim, Leonard H.; Yan Di; Martinez, Alvaro A.; Vicini, Frank A.; Grills, Inga S.

2011-01-01

Purpose: We present a novel form of arc therapy: continuous arc rotation of the couch (C-ARC) and compare its dosimetry with three-dimensional conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), and volumetric-modulated arc therapy (VMAT) for accelerated partial breast irradiation (APBI). C-ARC, like VMAT, uses a modulated beam aperture and dose rate, but with the couch, not the gantry, rotating. Methods and Materials: Twelve patients previously treated with APBI using 3D-CRT were replanned with (1) C-ARC, (2) IMRT, and (3) VMAT. C-ARC plans were designed with one medial and one lateral arc through which the couch rotated while the gantry was held stationary at a tangent angle. Target dose coverage was normalized to the 3D-CRT plan. Comparative endpoints were dose to normal breast tissue, lungs, and heart and monitor units prescribed. Results: Compared with 3D-CRT, C-ARC, IMRT, and VMAT all significantly reduced the ipsilateral breast V50% by the same amount (mean, 7.8%). Only C-ARC and IMRT plans significantly reduced the contralateral breast maximum dose, the ipsilateral lung V5Gy, and the heart V5%. C-ARC used on average 40%, 30%, and 10% fewer monitor units compared with 3D-CRT, IMRT, and VMAT, respectively. Conclusions: C-ARC provides improved dosimetry and treatment efficiency, which should reduce the risks of toxicity and secondary malignancy. Its tangent geometry avoids irradiation of critical structures that is unavoidable using the en face geometry of VMAT.

Phase I dose-escalation study of vinflunine hard capsules administered twice a day for 2 consecutive days every week in patients with advanced/metastatic solid tumors.

Science.gov (United States)

Calvo, E; Vermorken, J B; Hiret, S; Rodon, J; Cortes, J; Senellart, H; Van den Brande, J; Dyck, J; Pétain, A; Ferre, P; Bennouna, J

2012-06-01

Vinflunine is a new microtubule inhibitor of the vinca-alkaloid family. It is marketed in transitional cell carcinoma of urothelial tract as a 20 min infusion given every 3 weeks in Europe. In this phase I study, vinflunine was administered to patients with advanced malignancies as hard capsules given twice a day on days 1-2 every week, with 3 weeks cycles. Serial blood samples were collected during the first cycle for pharmacokinetic investigations. Thirty-six patients (pts) were treated at 6 dose levels 150 (3 pts), 190 (3 pts), 230 (8 pts), 300 mg/day (6 pts) and then 250 (3 pts) and 270 mg/day (13 pts). The Maximal Tolerated Dose (MTD) was reached at 300 mg/day where 2 patients out of 6 experienced a dose limiting toxicity (febrile neutropenia with diarrhea). The lower dose level of 270 mg/day was the recommended dose (RD), the toxicity profile being mainly anaemia, neutropenia, fatigue and constipation. The pharmacokinetic analysis demonstrated the adequacy of the flat-fixed dosing regimen, as no correlation between clearance of vinflunine and body surface area was evidenced. Blood concentrations and exposure increased with dose, and a pharmacokinetic accumulation was observed, which is consistent with the terminal half-life of the compounds. The inter-individual exposure variability at the RD was 35%. Repeated weekly administration of oral vinflunine is feasible and exhibits a moderate inter-individual PK variability. The MTD was achieved at 300 mg/day given for 2 consecutive days. According to the protocol rules, the RD was established at 270 mg/day.

Effect of sprint training on resting serum irisin concentration - Sprint training once daily vs. twice every other day.

Science.gov (United States)

Tsuchiya, Yoshifumi; Ijichi, Toshiaki; Goto, Kazushige

2016-04-01

Exercise twice every other day has been shown to lead to increasing peroxisome proliferator receptor γ coactivator-1α (PGC-1α) expression (up-stream factor of irisin) via lowered muscle glycogen level during second of exercise compared with exercise once daily. This study determined the influence of 4weeks of sprint training (training once daily vs. twice every other day) on the serum irisin concentration. Twenty healthy males (20.9±1.3years) were assigned randomly to either the SINGLE or REPEATED group (n=10 per group). The subjects in the SINGLE group participated in a sprint training session once daily (5days per week), whereas those in the REPEATED group performed two consecutive training sessions on the same day with a 1-h rest between sessions (2-3days per week). Both groups completed 20 training sessions over 4weeks. Each training session consisted of three consecutive 30-s maximal pedaling exercises with a 10-min rest between sets. Blood samples were collected before and after training period (48h after completing the last training session). The serum irisin concentration decreased significantly after training in each group (SINGLE, 338.5±77.8 to 207.6±64.6ng/mL; REPEATED, 329.5±83.9 to 234.2±72.8ng/mL, pevery other day). Copyright © 2016 Elsevier Inc. All rights reserved.

Preliminary results using twice-a-day fractionation in the radiotherapeutic management of advanced cancers of the head and neck

International Nuclear Information System (INIS)

Jampolis, S.; Pipard, G.; Horiot, J.C.; Bolla, M.; Le Dorze, C.

1977-01-01

Twenty-four cases of advanced T4 cancers of the head and neck were treated using a twice-a-day treatment fractionation delivering a 1,200 rad weekly tumor dose and 7,000 rad total tumor dose in 5 1 / 2 to 6 weeks. Acute normal mucosal reactions and skin reactions were plotted weekly and corresponded to reactions observed when delivering 1,000 rad per week in five treatment sessions. Chronic problems have been limited to severe neck fibrosis appearing in three of five patients who underwent a planned neck dissection 6 weeks after the completion of radiotherapy. Local control was observed in 14 of 23 patients (61%) and regional control in 22 of 23 patients

Influences on my clinical practice and identity. Jungian analysis on the couch-what and where is the truth of it?

Science.gov (United States)

Schmidt, Martin

2014-11-01

The author considers the various influences that have shaped his clinical practice and particular identity as a Jungian analyst. It is hoped that the sharing of these observations will, like a shard of a hologram, reflect aspects of the Jungian community as a whole. The author also attempts to put Jungian analysis 'on the couch' by looking at the current debate in the Journal between traditional and relational psychoanalysis. This is compared to the discourse that philosophy has been struggling with for centuries concerning the nature of truth. © 2014, The Society of Analytical Psychology.

SU-E-J-244: Validation of a 6D-Robotic-Couch and Image Guidance Radiation Therapy (IGRT) System for Localization in World's First Single-Room Proton Therapy System

Energy Technology Data Exchange (ETDEWEB)

Rankine, L; Klein, E [Washington University, Saint Louis, MO (United States); Grantham, K [University of Missouri, Columbia, MO (United States); Goddu, S [Washington University, St. Louis, MO (United States); Cessac, R [Mevion Medical Systems, Littleton, MA (United States); Baker, K [Barne-Jewish Hospital, St. Louis, MO (United States); Santanam, L [Washington University School of Medicine, St.louis, MO (United States)

2014-06-01

Purpose: The Mevion S250 proton therapy unit is equipped with a 6D-robotic couch and IGRT system (Verity). The patient alignment process allows corrections in six degrees of freedom: translation (x,y,z), pitch, roll, and yaw (θ,ϑ,ψ). Geometric accuracy of couch corrections and imaging vs. radiation isocenter coincidence were quantified before clinical implementation. Methods: A commercial phantom with sixteen 2mm tungsten BBs was rigidly couch-mounted and imaged with CT. Seventeen rigid translations/rotations of known magnitude were digitally applied to the original CT image using commercial software, validated with Varian OBI system. For each altered image, phantom was mounted on robotic couch in original position, then Verity 2D:2D match (PA-LLAT) was performed using DRRs from altered images. Corrections were recorded and applied, phantom was imaged a second time and residual corrections recorded. Physical measurements verified that applied couch corrections coincided with both physical couch shifts/rotations and known CT image translations/rotations. Additionally, image vs. radiation isocenter coicidence was quantified over couch treatment angles (±90° from setup position) using radiochromic film and an image-guided couch star-shot. Posterior-anterior and left-lateral kV radiographs were taken before each beam was delivered to verify imaging/radiation isocentricity. Results: Verity suggested couch corrections and known CT shifts/rotations agreed within ±1mm (average: Δ lat=0.5mm; Δ vert=0.4mm; Δ long=0.3mm) and ± 0.4° (average: Δ pitch=0.24° Δ roll=0.01°; Δ yaw=0.10°). Physical couch measurements and Verity applied corrections agreed within ± 1mm (average: Δlat=0.5mm; Δvert=0.4mm; Δlong=0.2mm) and ±0.2° (average: Δpitch=0.03°; Δ roll=0.04°; Δ yaw=0.04°). The directionality of all translations and rotations were qualitatively verified. The image vs. radiation isocenter coincidence was <1mm and radiation-isocenter precision was <1mm

The thin layer technique and its application to electron microscopy; La technique des couches minces et son application a la microscopie electronique

Energy Technology Data Exchange (ETDEWEB)

Ranc, G. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1957-10-15

This work deals with the technique of thin layers obtained by evaporation under vacuum, in the thickness range extending from a few monoatomic layers to several hundred angstroms. The great theoretical and practical interest of these layers has, it is well known, given rise to many investigations from Faraday onwards. Within the necessarily restricted limits of this study, we shall approach the problem more particularly from the point of view of: - their production; - their use in electron microscopy. A critical appraisal is made, in the light of present-day knowledge, based on our personal experience and on an extensive bibliography which we have collected on the subject. (author) [French] Le present travail concerne la technique des couches minces obtenues par evaporation sous vide, dans le domaine d'epaisseur qui s'etend de quelques couches monoatomiques a plusieurs centaines d'angstroms. L'interet theorique et pratique considerable de ces couches a suscite, comme on sait, de nombreux travaux depuis Faraday. Dans le cadre necessairement restreint de cette these, nous aborderons plus particulierement le point de vue de: - leur obtention; - leur utilisation en microscopie electronique. Il s'agit d'une mise au point critique, a la lumiere des connaissances actuelles, appuyee sur notre experience personnelle et sur une importante bibliographie, qu'il nous a ete donne de reunir a ce sujet. (auteur)

The thin layer technique and its application to electron microscopy; La technique des couches minces et son application a la microscopie electronique

Energy Technology Data Exchange (ETDEWEB)

Ranc, G [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1957-10-15

This work deals with the technique of thin layers obtained by evaporation under vacuum, in the thickness range extending from a few monoatomic layers to several hundred angstroms. The great theoretical and practical interest of these layers has, it is well known, given rise to many investigations from Faraday onwards. Within the necessarily restricted limits of this study, we shall approach the problem more particularly from the point of view of: - their production; - their use in electron microscopy. A critical appraisal is made, in the light of present-day knowledge, based on our personal experience and on an extensive bibliography which we have collected on the subject. (author) [French] Le present travail concerne la technique des couches minces obtenues par evaporation sous vide, dans le domaine d'epaisseur qui s'etend de quelques couches monoatomiques a plusieurs centaines d'angstroms. L'interet theorique et pratique considerable de ces couches a suscite, comme on sait, de nombreux travaux depuis Faraday. Dans le cadre necessairement restreint de cette these, nous aborderons plus particulierement le point de vue de: - leur obtention; - leur utilisation en microscopie electronique. Il s'agit d'une mise au point critique, a la lumiere des connaissances actuelles, appuyee sur notre experience personnelle et sur une importante bibliographie, qu'il nous a ete donne de reunir a ce sujet. (auteur)

Combined Chemoradiation Therapy With Twice-Weekly Gemcitabine and Cisplatin for Organ Preservation in Muscle-Invasive Bladder Cancer: Long-Term Results of a Phase 1 Trial

Energy Technology Data Exchange (ETDEWEB)

Azria, David, E-mail: david.azria@icm.unicancer.fr [Department of Radiation Oncology and Radiophysics Unit, Montpellier Cancer Institute (ICM), Montpellier (France); INSERM, U896, IRCM, Montpellier (France); Riou, Olivier [Department of Radiation Oncology and Radiophysics Unit, Montpellier Cancer Institute (ICM), Montpellier (France); Rebillard, Xavier [Department of Urology, Clinique Beausoleil, Montpellier (France); Thezenas, Simon [Biostatistics Unit, Montpellier Cancer Institute, Montpellier (France); Thuret, Rodolphe [Department of Urology, Montpellier University Hospital, Montpellier (France); Fenoglietto, Pascal [Department of Radiation Oncology and Radiophysics Unit, Montpellier Cancer Institute (ICM), Montpellier (France); Pouessel, Damien; Culine, Stephane [Department of Medical Oncology, AP-HP Saint-Louis, Paris (France)

2014-03-15

Purpose: Concomitant treatment with radiation therapy and cisplatin (CDDP) remains the gold standard for bladder preservation in the treatment of muscle-invasive bladder cancer (MIBC). We present the long-term results of a phase 1 clinical trial to assess the association of twice-weekly gemcitabine with CDDP and radiation therapy in this setting. Methods and Materials: Patients with pT2-pT4N0M0 MIBC without hydronephrosis or diffuse carcinoma in situ were enrolled in this study. After maximal transurethral resection of the bladder tumor, patients received concomitant radiation therapy (63 Gy in 1.8 fractions) and chemotherapy (CDDP 20 mg/m²/day over 4 days every 21 days and gemcitabine twice a week). The starting dose of gemcitabine was 15 mg/m² with dose escalation to 20, 25, and 30 mg/m². The primary endpoint was the maximum tolerated dose (MTD). Secondary endpoints included toxicity and tumor control. Results: Fourteen patients were enrolled. Dose-limiting toxicity occurred in 2 patients treated with 30 mg/m² gemcitabine (grade 4 thrombocytopenia and severe impairment of World Health Organization performance status, respectively). Nine patients received the complete chemoradiation therapy protocol. The recommended dose of gemcitabine was 25 mg/m². The median follow-up time was 53 months, and the overall and disease-specific 5-year survival rates were 62% and 77%, respectively. Among the patients who received the complete treatment, bladder-intact survival was 76% at 5 years, and the median overall survival was 69.6 months. Conclusions: This regimen was well tolerated. The gemcitabine MTD was 25 mg/m². Bladder preservation and disease control were promising. A multicenter phase 2 randomized trial is ongoing.

A validation of carbon fiber imaging couch top modeling in two radiation therapy treatment planning systems: Philips Pinnacle3 and BrainLAB iPlan RT Dose

International Nuclear Information System (INIS)

Njeh, Christopher F; Parker, Jason; Spurgin, Joseph; Rhoe, Elizabeth

2012-01-01

Carbon fiber (CF) is now the material of choice for radiation therapy couch tops. Initial designs included side metal bars for rigidity; however, with the advent of IGRT, involving on board imaging, new thicker CF couch tops without metal bars have been developed. The new design allows for excellent imaging at the expense of potentially unacceptable dose attenuation and perturbation. We set out to model the BrainLAB imaging couch top (ICT) in Philips Pinnacle 3 treatment planning system (TPS), to validate the already modeled ICT in BrainLAB iPlan RT Dose treatment planning system and to compute the magnitude of the loss in skin sparing. Using CF density of 0.55 g/cm 3 and foam density of 0.03 g/cm 3 , we demonstrated an excellent agreement between measured dose and Pinnacle 3 TPS computed dose using 6 MV beam. The agreement was within 1% for all gantry angle measured except for 120 o , which was 1.8%. The measured and iPlan RT Dose TPS computed dose agreed to within 1% for all gantry angles and field sizes measured except for 100 o where the agreement was 1.4% for 10 cm × 10 cm field size. Predicted attenuation through the couch by iPlan RT Dose TPS (3.4% - 9.5%) and Pinnacle 3 TPS (2% - 6.6%) were within the same magnitude and similar to previously reported in the literature. Pinnacle 3 TPS estimated an 8% to 20% increase in skin dose with increase in field size. With the introduction of the CF couch top, it estimated an increase in skin dose by approximately 46 - 90%. The clinical impact of omitting the couch in treatment planning will be dependent on the beam arrangement, the percentage of the beams intersecting the couch and their angles of incidence. We have successfully modeled the ICT in Pinnacle 3 TPS and validated the modeled ICT in iPlan RT Dose. It is recommended that the ICT be included in treatment planning for all treatments that involve posteriors beams. There is a significant increase in skin dose that is dependent on the percentage of the beam

The Return of the Freudian Couch®: Managing Affectivity through Technologies of Comfort

Science.gov (United States)

Juelskjaer, Malou; Staunaes, Dorthe; Ratner, Helene

2013-01-01

This article explores how the affective "set-up" of Freud's legendary couch has been exported into modern education relations. The so-called psy-sciences from pedagogy, psychology, and psychiatry have informed self-management in school. Managing self-management has a material-affective dimension. Through affective encounters with the…

The dehydration stress of couch grass is associated with its lipid metabolism, the induction of transporters and the re-programming of development coordinated by ABA.

Science.gov (United States)

Janská, Anna; Svoboda, Pavel; Spiwok, Vojtěch; Kučera, Ladislav; Ovesná, Jaroslava

2018-05-02

The wild relatives of crop species represent a potentially valuable source of novel genetic variation, particularly in the context of improving the crop's level of tolerance to abiotic stress. The mechanistic basis of these tolerances remains largely unexplored. Here, the focus was to characterize the transcriptomic response of the nodes (meristematic tissue) of couch grass (a relative of barley) to dehydration stress, and to compare it to that of the barley crown formed by both a drought tolerant and a drought sensitive barley cultivar. Many of the genes up-regulated in the nodes by the stress were homologs of genes known to be mediated by abscisic acid during the response to drought, or were linked to either development or lipid metabolism. Transporters also featured prominently, as did genes acting on root architecture. The resilience of the couch grass node arise from both their capacity to develop an altered, more effective root architecture, but also from their formation of a lipid barrier on their outer surface and their ability to modify both their lipid metabolism and transporter activity when challenged by dehydration stress. Our analysis revealed the nature of dehydration stress response in couch grass. We suggested the tolerance is associated with lipid metabolism, the induction of transporters and the re-programming of development coordinated by ABA. We also proved the applicability of barley microarray for couch grass stress-response analysis.

SU-E-J-258: Inter- and Intra-Fraction Setup Stability and Couch Change Tolerance for Image Guided Radiation Therapy

International Nuclear Information System (INIS)

Teboh, Forbang R; Agee, M; Rowe, L; Creasy, T; Schultz, J; Bell, R; Wong, J; Armour, E

2014-01-01

Purpose: Immobilization devices combine rigid patient fixation as well as comfort and play a key role providing the stability required for accurate radiation delivery. In the setup step, couch re-positioning needed to align the patient is derived via registration of acquired versus reference image. For subsequent fractions, replicating the initial setup should yield identical alignment errors when compared to the reference. This is not always the case and further couch re-positioning can be needed. An important quality assurance measure is to set couch tolerances beyond which additional investigations are needed. The purpose of this work was to study the inter-fraction couch changes needed to re-align the patient and the intra-fraction stability of the alignment as a guide to establish the couch tolerances. Methods: Data from twelve patients treated on the Accuray CyberKnife (CK) system for fractionated intracranial radiotherapy and immobilized with Aquaplast RT, U-frame, F-Head-Support (Qfix, PA, USA) was used. Each fraction involved image acquisitions and registration with the reference to re-align the patient. The absolute couch position corresponding to the approved setup alignment was recorded per fraction. Intra-fraction set-up corrections were recorded throughout the treatment. Results: The average approved setup alignment was 0.03±0.28mm, 0.15±0.22mm, 0.06±0.31mm in the L/R, A/P, S/I directions respectively and 0.00±0.35degrees, 0.03±0.32degrees, 0.08±0.45degrees for roll, pitch and yaw respectively. The inter-fraction reproducibility of the couch position was 6.65mm, 10.55mm, and 4.77mm in the L/R, A/P and S/I directions respectively and 0.82degrees, 0.71degrees for roll and pitch respectively. Intra-fraction monitoring showed small average errors of 0.21±0.21mm, 0.00±0.08mm, 0.23±0.22mm in the L/R, A/P, S/I directions respectively and 0.03±0.12degrees, 0.04±0.25degrees, and 0.13±0.15degrees in the roll, pitch and yaw respectively. Conclusion

SU-E-J-258: Inter- and Intra-Fraction Setup Stability and Couch Change Tolerance for Image Guided Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Teboh, Forbang R; Agee, M; Rowe, L; Creasy, T; Schultz, J; Bell, R; Wong, J; Armour, E [Johns Hopkins University, Baltimore, MD (United States)

2014-06-01

Purpose: Immobilization devices combine rigid patient fixation as well as comfort and play a key role providing the stability required for accurate radiation delivery. In the setup step, couch re-positioning needed to align the patient is derived via registration of acquired versus reference image. For subsequent fractions, replicating the initial setup should yield identical alignment errors when compared to the reference. This is not always the case and further couch re-positioning can be needed. An important quality assurance measure is to set couch tolerances beyond which additional investigations are needed. The purpose of this work was to study the inter-fraction couch changes needed to re-align the patient and the intra-fraction stability of the alignment as a guide to establish the couch tolerances. Methods: Data from twelve patients treated on the Accuray CyberKnife (CK) system for fractionated intracranial radiotherapy and immobilized with Aquaplast RT, U-frame, F-Head-Support (Qfix, PA, USA) was used. Each fraction involved image acquisitions and registration with the reference to re-align the patient. The absolute couch position corresponding to the approved setup alignment was recorded per fraction. Intra-fraction set-up corrections were recorded throughout the treatment. Results: The average approved setup alignment was 0.03±0.28mm, 0.15±0.22mm, 0.06±0.31mm in the L/R, A/P, S/I directions respectively and 0.00±0.35degrees, 0.03±0.32degrees, 0.08±0.45degrees for roll, pitch and yaw respectively. The inter-fraction reproducibility of the couch position was 6.65mm, 10.55mm, and 4.77mm in the L/R, A/P and S/I directions respectively and 0.82degrees, 0.71degrees for roll and pitch respectively. Intra-fraction monitoring showed small average errors of 0.21±0.21mm, 0.00±0.08mm, 0.23±0.22mm in the L/R, A/P, S/I directions respectively and 0.03±0.12degrees, 0.04±0.25degrees, and 0.13±0.15degrees in the roll, pitch and yaw respectively. Conclusion

A validation of carbon fiber imaging couch top modeling in two radiation therapy treatment planning systems: Philips Pinnacle3 and BrainLAB iPlan RT Dose

Directory of Open Access Journals (Sweden)

Njeh Christopher F

2012-11-01

Full Text Available Abstract Background Carbon fiber (CF is now the material of choice for radiation therapy couch tops. Initial designs included side metal bars for rigidity; however, with the advent of IGRT, involving on board imaging, new thicker CF couch tops without metal bars have been developed. The new design allows for excellent imaging at the expense of potentially unacceptable dose attenuation and perturbation. Objectives We set out to model the BrainLAB imaging couch top (ICT in Philips Pinnacle3 treatment planning system (TPS, to validate the already modeled ICT in BrainLAB iPlan RT Dose treatment planning system and to compute the magnitude of the loss in skin sparing. Results Using CF density of 0.55 g/cm3 and foam density of 0.03 g/cm3, we demonstrated an excellent agreement between measured dose and Pinnacle3 TPS computed dose using 6 MV beam. The agreement was within 1% for all gantry angle measured except for 120o, which was 1.8%. The measured and iPlan RT Dose TPS computed dose agreed to within 1% for all gantry angles and field sizes measured except for 100o where the agreement was 1.4% for 10 cm × 10 cm field size. Predicted attenuation through the couch by iPlan RT Dose TPS (3.4% - 9.5% and Pinnacle3 TPS (2% - 6.6% were within the same magnitude and similar to previously reported in the literature. Pinnacle3 TPS estimated an 8% to 20% increase in skin dose with increase in field size. With the introduction of the CF couch top, it estimated an increase in skin dose by approximately 46 - 90%. The clinical impact of omitting the couch in treatment planning will be dependent on the beam arrangement, the percentage of the beams intersecting the couch and their angles of incidence. Conclusion We have successfully modeled the ICT in Pinnacle3 TPS and validated the modeled ICT in iPlan RT Dose. It is recommended that the ICT be included in treatment planning for all treatments that involve posteriors beams. There is a significant

Couching Techniques for Cataract Treatment in Osogbo, South West ...

African Journals Online (AJOL)

Objectives: To find out the different techniques of couching, highlight the unacceptable poor visual sequelae and assess knowledge, attitudes, and practices of subjects. Settings and Design: Clinic based and prospective observational study. Methods and Material: Structured interview and clinical examination of consecutive ...

Maintenance of heartburn relief after step-down from twice-daily proton pump inhibitor to once-daily dexlansoprazole modified release.

Science.gov (United States)

Fass, Ronnie; Inadomi, John; Han, Cong; Mody, Reema; O'Neil, Janet; Perez, M Claudia

2012-03-01

Many patients with gastroesophageal reflux disease (GERD) take a proton pump inhibitor (PPI) twice daily to control symptoms. Once-daily dexlansoprazole modified release (MR) has a dual-delayed release formulation, making it attractive for step-down management of patients whose symptoms are well controlled on twice-daily PPIs. We investigated whether step-down to once-daily dexlansoprazole controls heartburn in patients with GERD who were receiving twice-daily PPI therapy. Patients 18 years and older taking a twice-daily PPI for symptom control were enrolled (n = 178) in a single-blind, multicenter study; 163 patients completed the study and 142 patients met criteria for the efficacy analysis. During the 6-week screening and treatment periods, patients recorded the presence of heartburn symptoms twice daily in electronic diaries. Patients' heartburn was considered well controlled if they had an average of 1 symptom or fewer per week during the last 4 weeks of screening and treatment. After screening, qualified patients were switched to masked dexlansoprazole MR 30 mg and placebo for 6 weeks. The primary efficacy end point was the proportion of patients whose heartburn remained well controlled after step-down. GERD-related symptoms and quality of life (QOL) also were evaluated using the Patient Assessment of Upper Gastrointestinal Disorders Symptom Severity Index (PAGI-SYM) and the PAGI-QOL questionnaires, respectively. After step-down to once-daily dexlansoprazole MR 30 mg, heartburn remained well controlled in 88% of patients (125 of 142). These patients were able to maintain their GERD-related symptom severity and QOL, indicated by marginal changes in the PAGI-SYM and PAGI-QOL total and subscale scores, respectively. Most patients with GERD who take twice-daily PPI to control heartburn are able to successfully step down to once-daily dexlansoprazole 30 mg. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

Traditional couching is not an effective alternative procedure for cataract surgery in Mali.

Science.gov (United States)

Schémann, J F; Bakayoko, S; Coulibaly, S

2000-12-01

In Mali, more cataract patients receive sight-restoring surgery using a traditional "couching" procedure (the lens inside the vitreous body) than by modern cataract surgery. In order to evaluate the relative effectiveness and other outcomes of the traditional procedure compared to the modern surgical intervention, we conducted a population-based survey in a rural district of Mali in 1996. A total of 99,800 persons from 160 villages were eligible to be included in the sample. All individuals operated for cataract by a modern procedure were checked for visual acuity and questioned regarding their clinical history, the cost of the surgery and their satisfaction with the surgery immediately following the operation and presently. Each patient was paired with one person operated by a traditional cataract surgical procedure. From a total population of 99,800 we found 85 individuals (0.085%) who had been operated by intracapsular extraction (ICCE) without lens implantation and we paired these with 82 individuals operated by the traditional method and by a local healer. In both groups, males were predominant (74.4% in the modern group and 61.3% in the traditional) and the median age was 65 and 68 years, respectively. Men with a higher social status (defined as administrative or religious authority) were slightly more common among those operated by ICCE (18.9%) than among those operated by the traditional healer (4.4%). Nearly half (47.6%) of the patients operated by couching did not know that a modern alternative existed. The mean cost to the patient of the two procedures was similar; with traditional couching costing on average US$ 42.10 and modern surgery (including transport and drugs) costing US$ 52.40. The traditional healer was often paid partially in kind and the price paid varied according to the patient's ability to pay. The clinical results differed greatly between the two methods. After aphakic correction of eyes operated by ICCE, 5.3% had good vision (33/18), 76

Efficacy and tolerability of the new autoinjected suspension of exenatide once weekly versus exenatide twice daily in patients with type 2 diabetes.

Science.gov (United States)

Wysham, Carol H; Rosenstock, Julio; Vetter, Marion L; Dong, Fang; Öhman, Peter; Iqbal, Nayyar

2018-01-01

To simplify administration of aqueous exenatide once weekly, which requires reconstitution, the exenatide microspheres have been reformulated in a ready-to-use autoinjector with a Miglyol diluent (exenatide QWS-AI). This study compared the efficacy and safety of exenatide QWS-AI with the first-in-class glucagon-like peptide-1 receptor agonist exenatide twice daily (BID). This randomized, open-label, controlled study in patients with type 2 diabetes using diet and exercise or taking stable oral glucose-lowering medication randomized patients 3:2 to either exenatide QWS-AI (2 mg) or exenatide BID (10 μg) for 28 weeks. The primary outcome was the 28-week change in glycated haemoglobin (HbA1c). A subset of patients completed a standardized meal test for postprandial and pharmacokinetic assessments. A total of 375 patients (mean HbA1c, 8.5% [69 mmol/mol]; body mass index, 33.2 kg/m 2 ; diabetes duration, 8.5 years) received either exenatide QWS-AI (n = 229) or exenatide BID (n = 146); HbA1c was reduced by -1.4% and -1.0%, respectively (least-squares mean difference, -0.37%; P = .0072). More patients achieved HbA1c <7.0% with exenatide QWS-AI (49.3%) than with exenatide BID (43.2%; P = .225). Body weight was reduced in both groups (P = .37 for difference). Gastrointestinal adverse events (AEs) were reported in 22.7% (exenatide QWS-AI) and 35.6% (exenatide BID) of patients; fewer patients in the exenatide QWS-AI group withdrew because of AEs than in the exenatide BID group. Minor hypoglycaemia occurred most often with concomitant sulfonylurea use. Exenatide QWS-AI was associated with a greater reduction in HbA1c, similar weight loss and a favorable gastrointestinal AE profile compared with exenatide BID. © 2017 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Efficacy and Safety of Once-Daily Minoxidil Foam 5% Versus Twice-Daily Minoxidil Solution 2% in Female Pattern Hair Loss: A Phase III, Randomized, Investigator-Blinded Study.

Science.gov (United States)

Blume-Peytavi, Ulrike; Shapiro, Jerry; Messenger, Andrew G; Hordinsky, Maria K; Zhang, Paul; Quiza, Carlos; Doshi, Uday; Olsen, Elise A

2016-07-01

A once-daily minoxidil topical foam (MTF) has been developed to treat female pattern hair loss. Determine noninferiority of once-daily 5% MTF versus twice-daily 2% minoxidil topical solution (MTS) based on the change from baseline in target area hair count (TAHC) at 24 weeks. In a randomized, phase III trial, women with female pattern hair loss received once-daily 5% MTF (n=161) or twice-daily 2% MTS (n=161) for 52 weeks. Primary endpoint was change from baseline in TAHC at 24 weeks. Secondary endpoint was change from baseline in TAHC at 12 weeks. Exploratory endpoints included change in total unit area density and change in overall scalp coverage. Once-daily 5% MTF increased TAHC from baseline (adjusted mean ± standard error) by 23.9 ± 2.1 hairs/cm2 at week 24. Twice-daily 2% MTS increased TAHC 24.2 ± 2.1 hairs/cm2 at week 24. The treatment difference was -0.3 hairs/cm2 (95% CI = -6.0, 5.4). Since the lower bound of the 95% CI was less than -5.0, the prespecified noninferiority goal was not met. Both treatments were well tolerated. Once-daily 5% MTF and twice-daily 2% MTS induced hair regrowth in female pattern hair loss, but prespecified noninferiority criteria were not met. ClinicalTrials.gov identifier: NCT01145625 J Drugs Dermatol. 2016;15(7):883-889.

SU-F-T-515: Increased Skin Dose in Supine Craniospinal Irradiation Due to Carbon Fiber Couch and Vacuum Bag Immobilization Device

Energy Technology Data Exchange (ETDEWEB)

Robertson, D; Zhao, Z; Wang, X; Yang, J [UT MD Anderson Cancer Center, Houston, TX (United States)

2016-06-15

Purpose: To measure the surface dose for supine craniospinal irradiation employing posterior beams, treating through an imaging couch and BlueBag immobilization device. Methods: The percentage depth dose (PDD) in the buildup region of a clinical 6 MV photon beam was measured using an Advanced Markus parallel plate ionization chamber in a solid water phantom. The PDD from a 10×10 cm{sup 2} anterior beam was measured at 100 cm SSD, simulating a traditional prone craniospinal technique. The measurements were compared to commissioning and treatment planning system data. The PDD was also measured in a posterior setup with the phantom surface laying directly on the Brainlab carbon fiber imaging couch, with the phantom surface 100 cm from the source, simulating a supine craniospinal setup. The posterior measurements were repeated with a BlueBag vacuum immobilization device between the couch and phantom, with thicknesses of 1.7 cm and 5 cm. The PDD from a 10×10 cm{sup 2} field and a typical 6×30 cm{sup 2} craniospinal field were also compared. The PDDs were normalized at 5 cm to reflect typical craniospinal prescription dose normalization. Results: The measured PDD curve from the anterior setup agreed well with commissioning and treatment planning data, with surface doses of 19.9%, 28.8% and 27.7%, respectively. The surface doses of the 10×10 cm{sup 2} and 6×30 cm{sup 2} fields delivered through the imaging couch were both 122.4%. The supine setup yielded surface doses of 122.4%, 121.6%, and 119.6% for the couch only, 1.7 cm bag, and 5 cm bag setups, respectively. Conclusion: Delivering craniospinal irradiation through a carbon fiber couch removes the majority of skin sparing. The addition of a vacuum bag immobilization device restores some skin sparing, but the magnitude of this effect is negligible.

Dose attenuation by a carbon fiber linac couch and modeling with a treatment planning system; Medida de la atenuacion producida por la mesa de tratamiento de un acelerador lineal y su modelado en un sistema de planificacion

Energy Technology Data Exchange (ETDEWEB)

Sanchez Galiano, P.; Garcia Sancho, J.M.; Crelgo, D.; Pamos, M.; Fernandez, J.; Vivanco, J.

2010-07-01

The purpose of this work is to investigate the attenuation caused by a carbon fiber linac treatment couch and the ability of a commercial radiotherapy treatment planning system to simulate it. The attenuation caused by an Exact{copyright} treatment couch in a Varian{copyright} Clinac{copyright} 2100 C/D was characterized in detail. Both 6 MV and 18 MV photon beams were studied. The treatment couch was modeled and incorporated to Elekta{copyright} XiO{copyright} treatment planning system. Measured and computed attenuation values were compared. As a result we found that the attenuation caused by this complex treatment couch is strongly dependent on the incidence angle of the beam. The measured attenuation values reach 16% for 6 MV and 10% for 18 MV. The model incorporated to the treatment planning software allows reducing the differences between measured and calculated data below 2.5% and 2.0% for 6 MV and 18 MV respectively. In conclusion, it is strongly recommended accounting for the perturbation caused by this carbon fiber treatment couch when the beam intersects it. The treatment planning system studied can simulate this treatment couch accurately. Clinical implementation of the described method requires a reliable procedure to reproduce the same patient geometry in the treatment delivery and planning. (Author).

Radiation therapy and concurrent fixed dose amifostine with escalating doses of twice-weekly gemcitabine in advanced pancreatic cancer

International Nuclear Information System (INIS)

Yavuz, A. Aydin; Aydin, Fazil; Yavuz, Melek N.; Ilis, Esra; Ozdemir, Feyyaz

2001-01-01

Purpose: To determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of twice-weekly gemcitabine (TW-G) when administered in conjunction with fixed dose amifostine (A) during external radiotherapy (RT) in patients with advanced pancreatic cancer. Methods and Materials: Ten patients with previously untreated, locally advanced, or asymptomatic-metastatic pancreatic adenocarcinoma were enrolled in this study. RT was delivered by using the standard four-field technique (1.8 Gy daily fractions, 45 Gy followed by a boost of 5.4 Gy, in 5-1/2 weeks). The starting dose of TW-G was 60 mg/m 2 (i.v., 30-min infusion), which is equal to the upper limit of previously reported MTD of TW-G when given without A during RT. A was given just before the TW-G, at a fixed dose of 340 mg/m 2 (i.v., rapid infusion). TW-G doses were escalated by 30-mg/m 2 increments in successive cohorts of 3 to 6 additional patients until DLT was observed. Toxicities were graded using the Radiation Therapy Oncology Group and National Cancer Institute Common Toxicity Criteria, version 2.0. Results: In general, therapy was well tolerated in patients treated at the first two dose levels of 60 mg/m 2 and 90 mg/m 2 . The DLT of TW-G given in conjunction with A during RT were neutropenia, thrombocytopenia, and nausea/vomiting at the dose level of 120 mg/m 2 . Of the 10 patients eligible for a median follow-up of 10 months, 5 remain alive; 1 complete responder, 3 partial responders, and 1 with stable disease. Conclusion: A dose of TW-G at a level of 90 mg/m 2 produced tolerable toxicity and it may possess significant activity when delivered in conjunction with 340 mg/m 2 dose of A during RT of the upper abdomen. Due to the higher MTD of TW-G seen in our study, we consider that the A supplementation may optimize the therapeutic index of TW-G-based chemoradiotherapy protocols in patients with pancreatic carcinoma

Once-daily dose regimen of ribavirin is interchangeable with a twice-daily dose regimen: randomized open clinical trial

Directory of Open Access Journals (Sweden)

Balk JM

2015-08-01

Full Text Available Jiska M Balk,1 Guido RMM Haenen,1 Özgür M Koc,2 Ron Peters,3 Aalt Bast,1 Wim JF van der Vijgh,1 Ger H Koek,4 1Department of Toxicology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, 2Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, 3DSM Resolve, Geleen, 4Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, the Netherlands Background: The combination of ribavirin (RBV and pegylated interferon (PEG-IFN is effective in the treatment of chronic hepatitis C infection. Reducing the frequency of RBV intake from twice to once a day will improve compliance and opens up the opportunity to combine RBV with new and more specific direct-acting agents in one pill. Therefore, the purpose of this study was to evaluate the pharmacokinetic profile of RBV in a once-daily to twice-daily regimen. The secondary aim was to determine tolerability as well as the severity and differences in side effects of both treatment regimens. Methods: In this randomized open-label crossover study, twelve patients with chronic type 1 hepatitis C infection and weighing more than 75 kg were treated with 180 µg of PEG-IFN weekly and 1,200 mg RBV daily for 24 weeks. The patients received RBV dosed as 1,200 mg once-daily for 12 weeks followed by RBV dosed as 600 mg twice-daily for 12 weeks, or vice versa. In addition to the pharmacokinetic profile, the hematological profile and side effects were recorded. The RBV concentrations in plasma were determined using liquid chromatography-tandem mass spectrometry. Results: Eight of twelve patients completed the study. Neither the time taken for RBV to reach peak plasma concentration nor the AUC0-last (adjusted for difference in dose was significantly different between the two groups (P>0.05. Furthermore, the once-daily regimen did not give more side effects than the twice-daily regimen (P>0

SU-F-T-470: Implementation of a Daily Quality Assurance Phantom for Six Degrees-Of-Freedom Couch Testing

Energy Technology Data Exchange (ETDEWEB)

Gaballa, H; O’Brien, M; Riegel, A; Jamshidi, A; Klein, E [Northwell Health, Lake Success, NY (United States)

2016-06-15

Purpose: To develop a daily quality assurance (QA) device that can test the 6DoF (degrees of freedom) couch repositioning accuracy, prior to SBRT treatment deliveries, with an accuracy of ±0.3 degrees and ±0.3 mm. Methods: A daily QA phantom is designed with a focus on the derived center of projections of its markers, rather than tracking its individual markers one at a time. This approach can be the most favorable to address the intended machining accuracy of the QA phantom and the CBCT spatial resolution limitations, primarily 1 mm min slice thickness, simultaneously. With the current design, ±0.1 mm congruence of the resultant center of gravity of the markers with reference CT (0.6 mm minimum slice thickness) vs CBCT (1.0 mm minimum slice thickness) can be achieved. If successful, the QA device should be qualified to test 6DoF couch performance with a gauged accuracy of ±0.3 degrees/±0.3 mm. Testing is performed for the Varian True Beam 2.0 6DoF system. Results: Once the QA phantom is constructed and tested, agreement of the center of gravity of the reference CT scan and the CBCT scan of ±0.1 mm is achieved. This has translated into a consistent 3D-3D match on the treatment machine, CT vs CBCT, with a repetitive ±0.1 mm variation, thus exceeding our expectations. We have deployed the phantom for daily QA on one of our accelerators, and found that the QA time has increased by only 10 minutes. Conclusion: A 6DoF phantom has been designed (patent pending) and built with a realistic work flow in mind where the daily couch accuracy QA checks taking less than 10 minutes. Current developments include integration with the Varian’s Machine Performance Check consistency module.

SU-F-BRE-10: Methods to Simulate and Measure the Attenuation for Modeling a Couch Top with Rails for FFF Treatment Delivery On the Varian Edge Linac

International Nuclear Information System (INIS)

Gulam, M; Gardner, S; Zhao, B; Snyder, K; Song, K; Li, H; Gordon, J; Wen, N; Chetty, I; Kearns, W

2014-01-01

Purpose: To measure attenuation for modelling of the KVue Couchtop for 6X and 10X FFF SRS/SBRT treatment Methods: Treatment planning simulation studies were done using 6X FFF beams to estimate the dosimetric impact of KVue couchtops (including the Q-Fix IGRT [carbon fiber] and Calypso [nonconductive Kevlar material]) with a structure model obtained from a research workstation (Eclipse, advanced planning interface (API) v13). Prior to installation on the Varian Edge linac, the couchtop along with (Kevlar) rails were CT scanned with the rails at various positions. An additional scan with the couchtop 15cm above the CT table top was obtained with 20cm solid water to facilitate precised/indexed data acquisition. Measurements for attenuation were obtained for field sizes of 2, 4 and 10 cm 2 at 42 gantry angles including 6 pairs of opposing fields and other angles for oblique delivery where the beams traversed the couchtop and or rails. The delivery was fully automated with xml scripts running in developer mode. The results were then used to determine an accurate structure model for AAA (Eclipse v11) planning of IMRT and RapidArc delivery. Results: The planning simulation relative dose attenuation for oblique entry was not significantly different than the Exact IGRT or BrainLab iBeam couch except that the rails added 6% additional attenuation. The relative attenuation measurements for PA, PA (rails: inner position), oblique, oblique (rails: outer position), oblique (rails: inner position) were: −2.0%, −2.5%, −15.6%, −2.5%, −5.0% for 6X FFF and −1.4%, −1.5%, −12.2%, − 2.5%, −5.0% for 10X FFF with slight decrease in attenuation versus field size. A Couch structure model (with HU values) was developed. Calculation compared to measurement showed good agreement except for oblique (rails: outer position) where differences approached a magnitude of 6%. Conclusion: A model of the couch structures has been developed accounting for attenuation for FFF beams

From ISIS to CouchDB: Databases and Data Models for Bibliographic Records

Directory of Open Access Journals (Sweden)

Luciano Ramalho

2011-04-01

Full Text Available For decades bibliographic data has been stored in non-relational databases, and thousands of libraries in developing countries still use ISIS databases to run their OPACs. Fast forward to 2010 and the NoSQL movement has shown that non-relational databases are good enough for Google, Amazon.com and Facebook. Meanwhile, several Open Source NoSQL systems have appeared. This paper discusses the data model of one class of NoSQL products, semistructured, document-oriented databases exemplified by Apache CouchDB and MongoDB, and why they are well-suited to collective cataloging applications. Also shown are the methods, tools, and scripts used to convert, from ISIS to CouchDB, bibliographic records of LILACS, a key Latin American and Caribbean health sciences index operated by the Pan-American Health Organization.

Novel and high volume use flame retardants in US couches reflective of the 2005 PentaBDE phase out.

Science.gov (United States)

Stapleton, Heather M; Sharma, Smriti; Getzinger, Gordon; Ferguson, P Lee; Gabriel, Michelle; Webster, Thomas F; Blum, Arlene

2012-12-18

California's furniture flammability standard Technical Bulletin 117 (TB 117) is believed to be a major driver of chemical flame retardant (FR) use in residential furniture in the United States. With the phase-out of the polybrominated diphenyl ether (PBDE) FR mixture PentaBDE in 2005, alternative FRs are increasingly being used to meet TB 117; however, it was unclear which chemicals were being used and how frequently. To address this data gap, we collected and analyzed 102 samples of polyurethane foam from residential couches purchased in the United States from 1985 to 2010. Overall, we detected chemical flame retardants in 85% of the couches. In samples purchased prior to 2005 (n = 41) PBDEs associated with the PentaBDE mixture including BDEs 47, 99, and 100 (PentaBDE) were the most common FR detected (39%), followed by tris(1,3-dichloroisopropyl) phosphate (TDCPP; 24%), which is a suspected human carcinogen. In samples purchased in 2005 or later (n = 61) the most common FRs detected were TDCPP (52%) and components associated with the Firemaster550 (FM 550) mixture (18%). Since the 2005 phase-out of PentaBDE, the use of TDCPP increased significantly. In addition, a mixture of nonhalogenated organophosphate FRs that included triphenyl phosphate (TPP), tris(4-butylphenyl) phosphate (TBPP), and a mix of butylphenyl phosphate isomers were observed in 13% of the couch samples purchased in 2005 or later. Overall the prevalence of flame retardants (and PentaBDE) was higher in couches bought in California compared to elsewhere, although the difference was not quite significant (p = 0.054 for PentaBDE). The difference was greater before 2005 than after, suggesting that TB 117 is becoming a de facto standard across the U.S. We determined that the presence of a TB 117 label did predict the presence of a FR; however, lack of a label did not predict the absence of a flame retardant. Following the PentaBDE phase out, we also found an increased number of flame retardants on the

Effectiveness of couch height-based patient set-up and an off-line correction protocol in prostate cancer radiotherapy

International Nuclear Information System (INIS)

Lin, Emile N.J.Th. van; Nijenhuis, Edwin; Huizenga, Henk; Vight, Lisette van der; Visser, Andries

2001-01-01

Purpose: To investigate set-up improvement caused by applying a couch height-based patient set-up method in combination with a technologist-driven off-line correction protocol in nonimmobilized radiotherapy of prostate patients. Methods and Materials: A three-dimensional shrinking action level correction protocol is applied in two consecutive patient cohorts with different set-up methods: the traditional 'laser set-up' group (n=43) and the 'couch height set-up' group (n=112). For all directions, left-right, ventro-dorsal, and cranio-caudal, random and systematic set-up deviations were measured. Results: The couch height set-up method improves the patient positioning compared to the laser set-up method. Without application of the correction protocol, both systematic and random errors reduced to 2.2-2.4 mm (1 SD) and 1.7-2.2 mm (1 SD), respectively. By using the correction protocol, systematic errors reduced further to 1.3-1.6 mm (1 SD). One-dimensional deviations were within 5 mm for >90% of the measured fractions. The required number of corrections per patient in the off-line correction protocol was reduced significantly during the course of treatment from 1.1 to 0.6 by the couch height set-up method. The treatment time was not prolonged by application of the correction protocol. Conclusions: The couch height set-up method improves the set-up significantly, especially in the ventro-dorsal direction. Combination of this set-up method with an off-line correction strategy, executed by technologists, reduces the number of set-up corrections required

Tofacitinib in patients with ankylosing spondylitis: a phase II, 16-week, randomised, placebo-controlled, dose-ranging study.

Science.gov (United States)

van der Heijde, Désirée; Deodhar, Atul; Wei, James C; Drescher, Edit; Fleishaker, Dona; Hendrikx, Thijs; Li, David; Menon, Sujatha; Kanik, Keith S

2017-08-01

To compare efficacy and safety of various doses of tofacitinib, an oral Janus kinase inhibitor, with placebo in patients with active ankylosing spondylitis (AS, radiographic axial spondyloarthritis). In this 16-week (12-week treatment, 4-week washout), phase II, multicentre, dose-ranging trial, adult patients with active AS were randomised (N=51, 52, 52, 52, respectively) to placebo or tofacitinib 2, 5 or 10 mg twice daily. The primary efficacy endpoint was Assessment of SpondyloArthritis International Society 20% improvement (ASAS20) response rate at week 12. Secondary endpoints included objective measures of disease activity, patient-reported outcomes and MRI of sacroiliac joints and spine. Safety was monitored. Emax model analysis of the primary endpoint predicted a tofacitinib 10 mg twice daily ASAS20 response rate of 67.4%, 27.3% higher than placebo. Supportive normal approximation analysis demonstrated tofacitinib 5 mg twice daily ASAS20 response rate significantly higher than placebo (80.8% vs 41.2%; ptofacitinib 2 and 10 mg twice daily demonstrated greater response rate than placebo (51.9% and 55.8%, respectively; not significant). Secondary endpoints generally demonstrated greater improvements with tofacitinib 5 and 10 mg twice daily than placebo. Objective (including MRI) endpoints demonstrated clear dose response. Adverse events were similar across treatment groups with no unexpected safety findings. Dose-dependent laboratory outcome changes returned close to baseline by week 16. Tofacitinib 5 and 10 mg twice daily demonstrated greater clinical efficacy versus placebo in reducing signs, symptoms and objective endpoints of active AS in adult patients with a similar 12-week safety profile as reported in other indications. NCT01786668. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Twice-daily versus once-daily applications of pimecrolimus cream 1% for the prevention of disease relapse in pediatric patients with atopic dermatitis.

Science.gov (United States)

Ruer-Mulard, Mireille; Aberer, Werner; Gunstone, Anthony; Kekki, Outi-Maria; López Estebaranz, Jose Luis; Vertruyen, André; Guettner, Achim; Hultsch, Thomas

2009-01-01

The aim of this study is to compare twice-daily and once-daily applications of pimecrolimus cream 1% for prevention of atopic dermatitis relapses in pediatric patients. This multicenter trial enrolled 300 outpatients aged 2 to 17 years, with mild-to-severe atopic dermatitis. The patients were initially treated with twice-daily topical pimecrolimus until complete clearance or for up to 6 weeks (open-label period). Those who achieved a decrease of at least 1 point in the Investigator's Global Assessment score were then randomized to double-blind treatment with pimecrolimus cream 1% either twice daily or once daily for up to 16 weeks. Study medication was discontinued during periods of disease remission (Investigator's Global Assessment = 0). The primary efficacy end point of the double-blind phase was disease relapse (worsening requiring topical corticosteroids or additional/alternative therapy and confirmed by Investigator's Global Assessment score > or = 3 and pruritus score > or = 2). Of the 300 patients enrolled in the study, 268 were randomized to treatment with pimecrolimus cream 1% either twice daily or once daily (n = 134 in each group). The relapse rate was lower in the twice-daily dose group (9.9%) than that in the once-daily dose group (14.7%), but analysis of the time to disease relapse, using a Cox proportional model to adjust for confounding variables, did not show a statistically significant difference between treatment arms (hazard ratio: 0.64; 95% CI: 0.31-1.30). Treatment of active atopic dermatitis lesions with pimecrolimus cream 1% twice daily, followed by the once-daily dosing regimen, was sufficient to prevent subsequent atopic dermatitis relapses over 16 weeks in pediatric patients.

A method for detection of mechanical collisions and couch-beam intersections; Un metodo para la prediccion de colisiones mecanicas y de intersecciones del haz con la mesa de tratamiento

Energy Technology Data Exchange (ETDEWEB)

Sanchez Galiano, P.; Crelgo Alonso, D.; Gonzalez Sancho, J. M.; Vivanco Parellada, J.; Fernandez Garcia, J.; Barbes Fernandez, B.; Pamos Urena, M.; Monserrat Fuertes, T.

2009-07-01

Two software applications for avoiding mechanical collisions and beam blocking by the couch are described. The method used is based on a simplified model of the couch cross-sections and a very simple routine. The algorithms employed and the graphical interfaces developed are described, along with several software implementation tests. The accuracy of predictions was within 5 mm, therefore the results are satisfactory despite the simple approach assumed. (Author) 11 refs.

Improvement of VMAT plan quality for head and neck cancer with high resolution fluences generated by couch shift between arcs.

Science.gov (United States)

Park, Jong Min; Park, So-Yeon; Wu, Hong-Gyun; Kim, Jung-In

2018-02-01

To investigate the changes in quality of the volumetric modulated arc therapy (VMAT) plans with couch-shift between arcs by half of a multi-leaf collimator (MLC) leaf width. A total of 22 patients with head-and-neck cancer were retrospectively selected. Since the smallest MLC leaf width was 5 mm in this study, the couch was shifted by 2.5 mm in the longitudinal-direction between arcs to increase the resolution of fluence map. A total of three types of VMAT plans were generated for each patient; the three types of plans were a two-full-arc plan without couch-shift (NS plan), a two-half-arc-pair plan with couch-shift (HAS plan), and a two-full-arc pair plan with couch-shift (FAS plan). Changes in the dose-volumetric parameters were investigated. The FAS plan showed the best plan quality for the target volumes and organs at risk compared to the NS and HAS plans. However, the magnitudes of differences among the three types of plans were minimal, and every plan was clinically acceptable. The average integral doses of the NS, HAS, and FAS plans were 160,549 ± 37,600 Gy-cc, 147,828 ± 33,343 Gy-cc, and 156,030 ± 36,263 Gy-cc, respectively. The average monitor unit of the NS, HAS, and FAS plans were 717 ± 120 MU, 648 ± 100 MU, and 763 ± 158 MU, respectively. The HAS plan was better than the others in terms of normal tissue sparing and plan efficiency. By shifting the couch by half of the MLC leaf width in the longitudinal direction between arcs, the VMAT plan quality could be improved. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

[Phytopathogenic bacteria of couch-grass in the crops of wheat].

Science.gov (United States)

Iakovleva, L M; Patyka, V F; Gvozdiak, R I; Shcherbina, T N

2009-01-01

Bacterialdiseases of weeds in the crops of wheat on the fields of Kyiv and Vinnytsya regions of Ukraine Elytrigia repens (L.) Nevski Agropyrum repens L. were revealed. The following symptoms of bacterial affections: the leaves wither, oval or hatched necrotic spots on green leaves, necroses on the stalks, empty-ears, partial blackening of the ear axes, awns, caryopsises, scales, water-soaked or dark brown with violet shade spots on the rhizomes were found. During the vegetation period bacteria were isolated from the affected plants which caused pathological process in the couch-grass and wheat. The pathogenic bacteria were identified as Pseudomonas syringae, P. viridiflava, Pseudomonas sp., Erwinia carotovora pv. carotovora, Pantoea agglomerans, the part of yellow-pigmentary isolates were not identified. Some Psyringae were isolated from the rhizomes during winterthawing. The paper is presented in Ukrainian.

Virtual couch shift (VCS): accounting for patient translation and rotation by online IMRT re-optimization

International Nuclear Information System (INIS)

Bol, G H; Lagendijk, J J W; Raaymakers, B W

2013-01-01

When delivering conventional intensity modulated radiotherapy (IMRT), discrepancies between the pre-treatment CT/MRI/PET based patient geometry and the daily patient geometry are minimized by performing couch translations and/or small rotations. However, full compensation of, in particular, rotations is usually not possible. In this paper, we introduce an online ‘virtual couch shift (VCS)’: we translate and/or rotate the pre-treatment dose distribution to compensate for the changes in patient anatomy and generate a new plan which delivers the transformed dose distribution automatically. We show for a phantom and a cervical cancer patient case that VCS accounts for both translations and large rotations equally well in terms of DVH results and 2%/2 mm γ analyses and when the various aspects of the clinical workflow can be implemented successfully, VCS can potentially outperform physical couch translations and/or rotations. This work is performed in the context of our hybrid 1.5 T MRI linear accelerator, which can provide translations and rotations but also deformations of the anatomy. The VCS is the first step toward compensating all of these anatomical changes by online re-optimization of the IMRT dose distribution. (paper)

Manipulating Carbohydrate Availability Between Twice-Daily Sessions of High-Intensity Interval Training Over 2 Weeks Improves Time-Trial Performance.

Science.gov (United States)

Cochran, Andrew J; Myslik, Frank; MacInnis, Martin J; Percival, Michael E; Bishop, David; Tarnopolsky, Mark A; Gibala, Martin J

2015-10-01

Commencing some training sessions with reduced carbohydrate (CHO) availability has been shown to enhance skeletal muscle adaptations, but the effect on exercise performance is less clear. We examined whether restricting CHO intake between twice daily sessions of high-intensity interval training (HIIT) augments improvements in exercise performance and mitochondrial content. Eighteen active but not highly trained subjects (peak oxygen uptake [VO2peak] = 44 ± 9 ml/kg/min), matched for age, sex, and fitness, were randomly allocated to two groups. On each of 6 days over 2 weeks, subjects completed two training sessions, each consisting of 5 × 4-min cycling intervals (60% of peak power), interspersed by 2 min of recovery. Subjects ingested either 195 g of CHO (HI-HI group: ~2.3 g/kg) or 17 g of CHO (HI-LO group: ~0.3 g/kg) during the 3-hr period between sessions. The training-induced improvement in 250-kJ time trial performance was greater (p = .02) in the HI-LO group (211 ± 66 W to 244 ± 75 W) compared with the HI-HI group (203 ± 53 W to 219 ± 60 W); however, the increases in mitochondrial content was similar between groups, as reflected by similar increases in citrate synthase maximal activity, citrate synthase protein content and cytochrome c oxidase subunit IV protein content (p > .05 for interaction terms). This is the first study to show that a short-term "train low, compete high" intervention can improve whole-body exercise capacity. Further research is needed to determine whether this type of manipulation can also enhance performance in highly-trained subjects.

Conserved binding of GCAC motifs by MEC-8, couch potato, and the RBPMS protein family

Science.gov (United States)

Soufari, Heddy

2017-01-01

Precise regulation of mRNA processing, translation, localization, and stability relies on specific interactions with RNA-binding proteins whose biological function and target preference are dictated by their preferred RNA motifs. The RBPMS family of RNA-binding proteins is defined by a conserved RNA recognition motif (RRM) domain found in metazoan RBPMS/Hermes and RBPMS2, Drosophila couch potato, and MEC-8 from Caenorhabditis elegans. In order to determine the parameters of RNA sequence recognition by the RBPMS family, we have first used the N-terminal domain from MEC-8 in binding assays and have demonstrated a preference for two GCAC motifs optimally separated by >6 nucleotides (nt). We have also determined the crystal structure of the dimeric N-terminal RRM domain from MEC-8 in the unbound form, and in complex with an oligonucleotide harboring two copies of the optimal GCAC motif. The atomic details reveal the molecular network that provides specificity to all four bases in the motif, including multiple hydrogen bonds to the initial guanine. Further studies with human RBPMS, as well as Drosophila couch potato, confirm a general preference for this double GCAC motif by other members of the protein family and the presence of this motif in known targets. PMID:28003515

A randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in women.

Science.gov (United States)

Blume-Peytavi, Ulrike; Hillmann, Kathrin; Dietz, Ekkehart; Canfield, Douglas; Garcia Bartels, Natalie

2011-12-01

Although twice-daily application of propylene glycol-containing 2% minoxidil topical solution (MTS) stimulates new hair growth, higher concentrations of minoxidil in a once-daily, propylene glycol-free formulation may improve efficacy and reduce unpleasant side effects. We sought to compare the efficacy, safety, and acceptability and to show noninferiority of once-daily 5% minoxidil topical foam (MTF) with twice-daily 2% MTS in women with androgenetic alopecia. A total of 113 women with androgenetic alopecia were randomized to 24 weeks of treatment with 5% MTF or 2% MTS. The primary efficacy parameter was change from baseline in nonvellus target area hair count at week 24. Secondary end points included change in nonvellus target area hair width, overall efficacy by global photographic review as assessed by treatment-blinded evaluators and the subject herself, adverse events, and participants' assessment of product aesthetics. After 24 weeks, women randomized to 5% MTF once daily showed noninferior target area hair count and target area hair width and experienced greater, but nonsignificant, improvements in target area hair count, target area hair width, and overall efficacy by global photographic review than those randomized to 2% MTS used twice daily. 5% MTF was significantly superior to 2% MTS in participants' agreement with "the treatment does not interfere with styling my hair" (P = .002). Women randomized to 5% MTF experienced significantly lower rates of local intolerance (P = .046) especially in pruritus and dandruff compared with 2% MTS. Because of differences in the formulations tested, study participants were not blinded to treatment. Once-daily 5% MTF is noninferior and as effective for stimulating hair growth as twice-daily 2% MTS in women with androgenetic alopecia and is associated with several aesthetic and practical advantages. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Effects of a Baking Soda Gum on extrinsic dental stain: results of a longitudinal 4-week assessment.

Science.gov (United States)

Soparkar, P; Newman, M B

2001-07-01

An evaluation of the effects of ARM & HAMMER DENTAL CARE The Baking Soda Gum (AHDC) on extrinsic dental stain was made in 48 subjects presenting with measurable extrinsic stain. The subjects were randomized to use either the baking soda gum or a non-baking soda placebo gum for 20 minutes twice daily after lunch and dinner while brushing once daily. The procedure of limited brushing was chosen to simulate the level of hygiene normally practiced by participants entering a clinical study. After 4 weeks, the reduction in measurable extrinsic stain in the baking soda gum group was statistically significant (P = .0044) relative to baseline. Statistical analysis of the placebo gum group revealed no significant change in extrinsic stain from baseline. The magnitude of the unadjusted longitudinal reduction in extrinsic stain in the baking soda gum group was 29.7% at 4 weeks.

Host status of barley to Puccinia coronata from couch grass and P. striiformis from wheat and brome

Science.gov (United States)

The pathogenicity and identity of a field sample (PcE) of crown rust fungus Puccinia coronata collected in Hungary on wild couch grass (Elytrigia repens) and of a field sample (Psb) of stripe rust (P. striiformis) collected in the Netherlands on California brome (Bromus carinatus) was studied. We fo...

Host status of barley to Puccinia coronata from couch grass and P. striiformis from wheat and brome

NARCIS (Netherlands)

Niks, R.E.; Heyzen, van S.; Szabo, L.J.; Alemu, S.K.

2013-01-01

The pathogenicity and identity was studied of a field sample (PcE) of crown rust fungus Puccinia coronata collected in Hungary on wild couch grass (Elymus repens) and of a field sample (Psb) of stripe rust (P. striiformis) collected in the Netherlands on California brome (Bromus carinatus). We

Study on Pb Content in 3 Week and 6 Week Old Kangkung (Ipomoea reptans Poir Planted in Pb containing Media

Directory of Open Access Journals (Sweden)

Poppy Hartatie Hardjo

2005-11-01

Full Text Available A study on the content of Pb in kangkung has been conducted. Land kangkung (Ipomoea reptans was used as the sample, and was planted in hydrophonic media, and watered with Multigrow Complete Plant Food (2000 mg/L and Pb solution (2 mg/L twice a day. Samples were taken based on the age (3 and 6 week old, and part of the plant (root and all parts without root. Inductively Coupled Plasma Spectrometer (ICPS Fison 3410+ was used to measure the Pb content. It was shown that in the plant the accumulation was mostly happened in the root. The 6 week-old plant contained Pb not just in the root (3.36 mg/kg sample but also in the other part of the plant (2.09 mg/kg sample and those were exceeded the maximum dietary allowance (2 mg/kg sample regulated by the Indonesian FDA; while in the 3 week-old plant the Pb content in the root was 1.86 mg/kg sample and in the other part of the plan was 1.13 mg/kg, which is not exceeded the dietary allowance. So it is advisable to harvest the kangkung vegetable at the most of 3 week-old.

SU-E-T-234: Daily Quality Assurance for a Six Degrees of Freedom Couch Using a Novel Phantom

Energy Technology Data Exchange (ETDEWEB)

Woods, K; Woollard, J; Ayan, A; Sandu, A; Sommerfeld, J; Gupta, N [Ohio State Univ, Columbus, OH (United States); Laurel, A [Memorial Medical Center, Modesto, CA (United States)

2015-06-15

Purpose: To test the accuracy and reproducibility of both translational and rotational movements for a couch with six degrees of freedom (6DoF) using a novel phantom design Methods: An end-to-end test was carried out using two different phantoms. A 6 cm3 cube with a central fiducial BB (WL-QA Sun Nuclear) and a custom fabricated rectangular prism (31 cm x 8 cm x 8 cm), placed on a baseplate with known angular offsets for pitch, roll and yaw with a central fiducial BB and unique surface structures for registration purposes, were used. The end-to-end test included an initial CT simulation for a reference study, setup to an offset mark on each phantom, registration of the reference CT to the acquired cone-beam CT, and final Winston-Lutz delivery at four cardinal gantry angles. Results for both translational and rotational movements were recorded and compared for both phantoms. Results: Translational and rotational measurements were performed with a PerfectPitch (Varian) couch for 10 trials for both phantoms. Distinct translational shifts were [−5.372±0.384mm, −10.183±0.137mm, 14.028±0.155mm] for the cube and [7.520±0.159mm, −9.117±0.101mm, 16.273±0.115mm] for the prototype phantom for lateral, longitudinal, and vertical shifts, respectively. Distinct rotational adjustments were [1.121±0.102o, −1.067±0.235o, −2.662±0.380o] for the cube and [2.534±0.059o, 1.994±0.025o, 2.094±0.076o] for the prototype for pitch, roll, and yaw, respectively. Winston-Lutz test results performed after 6DoF couch correction from each cardinal gantry angle ranged from 0.26–0.72mm for the cube and 0.55–0.86mm for the prototype. Conclusion: The prototype phantom is more precise for both translational and rotational adjustments compared to a commercial phantom. The design of the prototype phantom allows for a more discernible visual confirmation of correct translational and rotational adjustments with the prototype phantom. Winston-Lutz results are more accurate for the

SU-E-T-234: Daily Quality Assurance for a Six Degrees of Freedom Couch Using a Novel Phantom

International Nuclear Information System (INIS)

Woods, K; Woollard, J; Ayan, A; Sandu, A; Sommerfeld, J; Gupta, N; Laurel, A

2015-01-01

Purpose: To test the accuracy and reproducibility of both translational and rotational movements for a couch with six degrees of freedom (6DoF) using a novel phantom design Methods: An end-to-end test was carried out using two different phantoms. A 6 cm3 cube with a central fiducial BB (WL-QA Sun Nuclear) and a custom fabricated rectangular prism (31 cm x 8 cm x 8 cm), placed on a baseplate with known angular offsets for pitch, roll and yaw with a central fiducial BB and unique surface structures for registration purposes, were used. The end-to-end test included an initial CT simulation for a reference study, setup to an offset mark on each phantom, registration of the reference CT to the acquired cone-beam CT, and final Winston-Lutz delivery at four cardinal gantry angles. Results for both translational and rotational movements were recorded and compared for both phantoms. Results: Translational and rotational measurements were performed with a PerfectPitch (Varian) couch for 10 trials for both phantoms. Distinct translational shifts were [−5.372±0.384mm, −10.183±0.137mm, 14.028±0.155mm] for the cube and [7.520±0.159mm, −9.117±0.101mm, 16.273±0.115mm] for the prototype phantom for lateral, longitudinal, and vertical shifts, respectively. Distinct rotational adjustments were [1.121±0.102o, −1.067±0.235o, −2.662±0.380o] for the cube and [2.534±0.059o, 1.994±0.025o, 2.094±0.076o] for the prototype for pitch, roll, and yaw, respectively. Winston-Lutz test results performed after 6DoF couch correction from each cardinal gantry angle ranged from 0.26–0.72mm for the cube and 0.55–0.86mm for the prototype. Conclusion: The prototype phantom is more precise for both translational and rotational adjustments compared to a commercial phantom. The design of the prototype phantom allows for a more discernible visual confirmation of correct translational and rotational adjustments with the prototype phantom. Winston-Lutz results are more accurate for the

Whole-abdomen radiotherapy for non-Hodgkin's lymphoma using twice-daily fractionation

International Nuclear Information System (INIS)

Liauw, Stanley L.; Yeh, Alexander M.; Morris, Christopher G.; Olivier, Kenneth R.; Mendenhall, Nancy Price

2006-01-01

Purpose: To report the tolerability and efficacy of twice-daily whole-abdomen irradiation (WAI) for non-Hodgkin's lymphoma (NHL). Methods and Materials: Of 123 patients treated for NHL with WAI, 37% received previous chemotherapy, 28% received WAI as part of comprehensive lymphatic irradiation (CLI), and 32% received WAI for palliation. The median dose to the whole abdomen was 25.0 Gy, followed by a median tumor boost of 9.8 Gy in 58 patients. Fractionation was 1.0 Gy once daily (54%) or 0.8 Gy twice daily (46%). Blood counts were measured weekly. Results: At a median follow-up of 4.3 years, local control was 72% and overall survival was 55% at 5 years. Median time of WAI was 42 days for once-daily treatment and 32 days for twice-daily treatment. Patients receiving twice-daily WAI did not have a significantly higher rate of acute side effects (e.g., nausea, diarrhea, platelet or red blood cell toxicity). Overall, acute thrombocytopenia was the most frequent side effect of treatment; 24 of 96 patients (25%) with available hematologic data had Grade 3+ toxicity. There was no acute Grade 3 gastrointestinal toxicity and no late small bowel obstruction. Multiple regression indicated that patients with four or less involved sites and disease size ≤6 cm had improved local control and overall survival. Conclusions: Twice-daily WAI using 0.8 Gy/fraction does not appear to have any greater toxicity compared with once-daily treatment using 1 Gy/fraction. Small doses per fraction (0.8-1 Gy/fx) are effective, tolerated well in the acute setting, and associated with a low rate of late toxicity

The Effects of Four-Week Multivitamin Supplementation on Mood in Healthy Older Women: A Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Helen Macpherson

2016-01-01

Full Text Available Objective. Nutritional deficiencies have been associated with cognitive decline and mood disturbances. Vitamin intake can influence mood and randomized controlled trials have demonstrated that multivitamin supplements are capable of reducing mild symptoms of mood dysfunction. However, few studies have focussed on healthy older women. Methods. This study investigated the effects of four weeks’ multivitamin supplementation on mood in 76 healthy women aged 50–75 years. Mood was assessed before and after intervention in the laboratory using measures of current mood and retrospective experiences of mood over the past week or longer. Mobile phones were used to assess changes in real-time mood ratings, twice weekly in the home. Results. There were no multivitamin-related benefits identified for measures of current mood or reflections of recent mood when measured in the laboratory. In-home assessments, where mood was rated several hours after dose, revealed multivitamin supplementation improved ratings of stress, with a trend to reduce mental fatigue. Conclusions. Over four weeks, subtle changes to stress produced by multivitamin supplementation in healthy older women may not be detected when only pre- and posttreatment mood is captured. In-home mobile phone-based assessments may be more sensitive to the effects of nutritional interventions compared to traditional in-laboratory assessments.

Megavoltage photon beam attenuation by carbon fiber couch tops and its prediction using correction factors

International Nuclear Information System (INIS)

Hayashi, Naoki; Shibamoto, Yuta; Obata, Yasunori; Kimura, Takashi; Nakazawa, Hisato; Hagiwara, Masahiro; Hashizume, Chisa I.; Mori, Yoshimasa; Kobayashi, Tatsuya

2010-01-01

The purpose of this study was to evaluate the effect of megavoltage photon beam attenuation (PBA) by couch tops and to propose a method for correction of PBA. Four series of phantom measurements were carried out. First, PBA by the exact couch top (ECT, Varian) and Imaging Couch Top (ICT, BrainLAB) was evaluated using a water-equivalent phantom. Second, PBA by Type-S system (Med-Tec), ECT and ICT was compared with a spherical phantom. Third, percentage depth dose (PDD) after passing through ICT was measured to compare with control data of PDD. Forth, the gantry angle dependency of PBA by ICT was evaluated. Then, an equation for PBA correction was elaborated and correction factors for PBA at isocenter were obtained. Finally, this method was applied to a patient with hepatoma. PBA of perpendicular beams by ICT was 4.7% on average. With the increase in field size, the measured values became higher. PBA by ICT was greater than that by Type-S system and ECT. PBA increased significantly as the angle of incidence increased, ranging from 4.3% at 180 deg to 11.2% at 120 deg. Calculated doses obtained by the equation and correction factors agreed quite well with the measured doses between 120 deg and 180 deg of angles of incidence. Also in the patient, PBA by ICT was corrected quite well by the equation and correction factors. In conclusion, PBA and its gantry angle dependency by ICT were observed. This simple method using the equation and correction factors appeared useful to correct the isocenter dose when the PBA effect cannot be corrected by a treatment planning system. (author)

The Effect of an 8-Week Tai Chi Exercise Program on Physical Functional Performance in Middle-Aged Women.

Science.gov (United States)

Zacharia, Susan; Taylor, E Laurette; Hofford, Craig W; Brittain, Danielle R; Branscum, Paul W

2015-08-01

The purpose of this study was to determine the effectiveness of an 8-week Tai Chi Chih exercise program on physical functional performance (PFP) among women aged 45 to 65 years. A quasi-experimental design with a nonequivalent comparison group was used. Forty-one healthy inactive women were assigned to either an intervention group (n = 19) or a comparison group (n = 19). A 60-min Tai Chi Chih exercise class was conducted twice a week for 8 weeks. PFP was measured at baseline and postintervention using the Continuous Scale Physical Functional Performance-10 (CS-PFP 10). Between-group differences were analyzed using one-way analysis of covariance (ANCOVA). After participating in the 8-week program, intervention group participants showed greater improvement in the CS-PFP measures (p .06). However, the comparison group had little changes. The findings from this study suggest that participation in an 8-week Tai Chi Chih exercise program can improve PFP in healthy, community-dwelling middle-aged women. © The Author(s) 2013.

Comparative Efficacy of a Soft Toothbrush with Tapered-tip Bristles to an ADA Reference Toothbrush on Gingival Abrasion over a 12-Week Period.

Science.gov (United States)

Gallob, John; Petrone, Dolores M; Mateo, Luis R; Chaknis, Patricia; Morrison, Boyce M; Panagakos, Foti; Williams, Malcolm

2016-06-01

Evaluation of the impact of a soft toothbrush with tapered-tip (Test Toothbrush) bristles and an ADA reference toothbrush (ADA Toothbrush) on gingival abrasion over a 12-week period. This was a randomized, single-center, examiner-blind, two-cell, parallel clinical research study and used the Danser Gingival Abrasion Index to assess the level of gingival abrasion after a single brushing, as well as after six weeks and 12 weeks of twice-daily brushing. Adult male and female subjects from the Central New Jersey, USA area refrained from all oral hygiene procedures for 24 hours. They reported to the study site after refraining from eating, drinking, and smoking for four hours. Following a qualifying examination using plaque and gingivitis scores along with a baseline gingival abrasion examination, subjects were randomized into two balanced groups, each group using one of the two study toothbrushes. Subjects were instructed to brush their teeth for one minute, under supervision, with their assigned toothbrush and a commercially available fluoride toothpaste (Colgate© Cavity Protection Toothpaste), after which they were again evaluated for gingival abrasion. Subjects were dismissed from the study site with their assigned toothbrush and toothpaste, and instructed to brush twice daily at home for the next 12 weeks. The subjects were instructed to brush for one minute during each tooth brushing. The subjects reported to the study site after six weeks and 12 weeks of product use, at which time they were evaluated for gingival abrasion. Seventy-one (71) subjects complied with the protocol and completed the clinical study. The results of this study showed that the Test Toothbrush provided statistically significantly (p ADA Toothbrush after a single tooth brushing, after six weeks, and after 12 weeks of product use (75.0%, 85.5%, 73.9%, respectively). The soft toothbrush with tapered-tip bristles produced significantly less gingival abrasion after 12 weeks of product use as

Effect of sprint training: training once daily versus twice every second day.

Science.gov (United States)

Ijichi, Toshiaki; Hasegawa, Yuta; Morishima, Takuma; Kurihara, Toshiyuki; Hamaoka, Takafumi; Goto, Kazushige

2015-01-01

This study compared training adaptations between once daily (SINGLE) and twice every second day (REPEATED) sprint training, with same number of training sessions. Twenty physically active males (20.9 ± 1.3 yr) were assigned randomly to the SINGLE (n = 10) or REPEATED (n = 10) group. The SINGLE group trained once per day (5 days per week) for 4 weeks (20 sessions in total). The REPEATED group conducted two consecutive training sessions on the same day, separated by a rest period of 1 h (2-3 days per week) for 4 weeks (20 sessions in total). Each training session consisted of three consecutive 30-s maximal pedalling sets with a 10-min rest between sets. Before and after the training period, the power output during two bouts of 30-s maximal pedalling, exercise duration during submaximal pedalling and resting muscle phosphocreatine (PCr) levels were evaluated. Both groups showed significant increases in peak and mean power output during the two 30-s bouts of maximal pedalling after the training period (P every second day improved OBLA during endurance exercise more than the same training once daily.

Comparative Efficacy of a Soft Toothbrush with Tapered-tip Bristles and an ADA Reference Toothbrush on Established Gingivitis and Supragingival Plaque over a 12-Week Period.

Science.gov (United States)

Gallob, John; Petrone, Dolores M; Mateo, Luis R; Chaknis, Patricia; Morrison, Boyce M; Williams, Malcolm; Panagakos, Foti

2016-06-01

Evaluation of the efficacy of a soft toothbrush with tapered-tip bristles (Test Toothbrush) and an ADA reference soft toothbrush (ADA Toothbrush) on established gingivitis and supragingival plaque over a 12-week period. This randomized, single-center, examiner-blind, two-cell, parallel clinical research study assessed plaque removal by the comparison of pre- to- post-brushing after a single use, and again after six- and 12-weeks' use, using the Quigley-Hein Plaque Index, Turesky Modification. The study also assessed gingivitis after six weeks and 12 weeks using the Löe & Silness Gingival Index. Adult male and female subjects from the Central New Jersey, USA area refrained from all oral hygiene procedures for 24 hours. They reported to the study site after refraining from eating, drinking, and smoking for four hours. Subjects had the study procedure explained to them both orally and by written instructions. Subjects then gave written consent to participate before entry into the study. Following an examination for plaque (pre-brushing) and gingivitis (baseline), the subjects were randomized into two balanced groups, each group assigned to one of the two study toothbrushes. Subjects were instructed to brush their teeth for one minute under supervision with their assigned toothbrush and a commercially available fluoride toothpaste (Colgate© Cavity Protection Toothpaste), after which they were again evaluated for plaque (post-brushing). Subjects were dismissed from the study site with their assigned toothbrush and toothpaste, and instructed to brush twice daily at home for the next 12 weeks. The subjects were instructed to brush for one minute during each tooth brushing. The subjects reported to the study site after six weeks and 12 weeks of product use, at which time they were evaluated for plaque and gingivitis. Seventy-one (71) subjects complied with the protocol and completed the clinical study. Compared to the ADA Toothbrush, the Test Toothbrush provided

Pharmacokinetic and tolerability of i.m. disodium clodronate 200 mg/lidocaine 1%, given twice monthly, in comparison with i.m. disodium clodronate 100 mg/lidocaine 1%, given weekly, in healthy postmenopausal female patients.

Science.gov (United States)

Radicioni, Milko; Cremonesi, Giovanni; Baraldi, Enrica; Leuratti, Chiara; Mariotti, Fabrizia

2013-04-01

Clodronate is a bisphosphonate effective in the prevention and treatment of osteoporosis in postmenopausal women. Non-adherence to bisphosphonates, however, is a major issue in clinical practice. Simplifying dose regimens may increase compliance. To assess bioequivalence between an intramuscular (i.m.) clodronate 200 mg/lidocaine 1% twice-a-month formulation and a clodronate 100 mg/lidocaine 1% weekly formulation in 32 postmenopausal women. In this double-blind, randomized, two-way crossover study, test and reference formulations were administered in single dose, with a 2-week wash-out between administrations. The primary endpoint was clodronic acid cumulative excretion in the first 24 hours after injection (Xu0-24h). Cumulative excretion in the 72 hours post-dose (Xu0-72h) and maximum excretion rate (Ratemax) were also evaluated. Bioequivalence was assumed if the 90% confidence intervals (CIs) of the geometric means ratios of the dose-normalized parameters were within the 80.00 - 125.00% range. Local tolerability was evaluated. Mean Xu0-24h values were 114.03 ±23.13 mg and 55.22 ±9.73 mg for clodronate 200 mg and 100 mg. The 90% CIs for dose-normalized Xu0-24h, Xu0-72h and Ratemax ere 95 -110%, 94 -107% and 95 - 113%. Local tolerability of both treatments was good. The differences in pain intensity between formulations were not sigificantly different at most assessment times. Headache was the only treatment-related adverse event. Bioequivalence of the two formulations was confirmed in terms of dose-normalized rate and amount of clodronic acid excretion. This result, together with the favorable tolerability of the novel 200 mg formulation, suggests the possibility of reducing the number of i.m. administrations from once-a-week to twice-a-month.

Comparative study of {beta} decays and of the model of the layers for the nucleus with odd a; Etude comparee des desintegrations {beta} et du modele des couches pour les noyaux de a impair

Energy Technology Data Exchange (ETDEWEB)

Trocheris, M [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1953-07-01

The systematic comparison of {beta} decays of the cores of number of odd mass with the predictions of the modal of Mrs. Mayer on spins and parities, has already been made by several authors. It is taken in the present work with more recent experimental data and with a method of classification of the {beta} transitions. A simultaneous comparison to the experience of the model of the layers and the theory of the {beta} transitions can serve to verify one and the other too. In the present work, it appeared more fruitful to try to verify the model of the layers with the help of the very established theory of the {beta} transitions. One will look to verify and perfect the models of the layers for transitions between fundamental states or isomers of the cores. (M.B.) [French] La comparaison systematique des desintegrations {beta} des noyaux de nombre de masse impair avec les predictions du modale de Mme MAYER sur les spins et les parites, a deja ete faite par plusieurs auteurs. Elle est reprise dans le present travail avec des donnees experimentales plus recentes et avec une methode de classification des transitions {beta}. Une comparaison simultanee a l'experience du modele des couches et de la theorie des transitions {beta} peut, a priori, servir a verifier egalement l'un et l'autre. Dans le present travail, il a paru plus fructueux de chercher a verifier le modele des couches a l'aide de la theorie bien etablie des transitions {beta}. On cherchera de verifier et de perfectionner le modele des couches pour les transitions entre etats fondamentaux ou isomeres des noyaux. (M.B.)

Intellectual Couch Potato?

Science.gov (United States)

Mason, Diana S.

2002-08-01

What does this say for where we've been and where we're going? The Information Age has brought us closer together. I know more about more people and events than I have ever known. I see this as a good thing. It is easy to keep in touch with friends. It is easy to buy and sell over the Internet, to seek answers on various questions, to gather facts, to improve your mind, etc. However, Joshua Benton of The Dallas Morning News1 cites a U.S. Department of Education report as stating, "Too many teachers make it into American classrooms without knowing the material they're teaching...". This concerns me greatly. With all the advantages afforded to us in an affluent society, then how/why can this be true? Other things in the report mentioned by Benton include (1) criticism of the states for setting low standards for new teachers; (2) colleges of education spending too much time on classroom management and teaching techniques and not enough on subject area content in mathematics, literature, and science; and (3) a call to the states to make it easier for professionals to switch careers into teaching through alternative programs. On the other side of the debate, how can 3 4 months of training in an alternative program bring successful teaching practices into the classroom? Yes, we need more teachers, especially in mathematics and science. Getting the content to these prospective teachers is not a problem. There is the Web, there are many online courses available (more on the way) both in subject areas and pedagogy, and the number of conferences and workshops offered abound. The following pages go into great depth regarding all the wonderful talks, workshops, and entertaining events that you can attend at the Fall 2002, ACS National Meeting, August 18 20. However, you've got to get off the couch and attend! The High School Program is Monday, August 19, from 8:30 until 3:00 at the Park Plaza Hotel. Preregistration is $30. Mahatma Gandhi said, "Live as if you were to die

Comportement à la corrosion intrinsèque de couches minces à base ...

African Journals Online (AJOL)

Comportement à la corrosion intrinsèque de couches minces à base d'aluminium (Al-M: M=Mo, Mg, ... Département de Physique, Université Badji Mokhtar, BP 12, Annaba 23000, Algérie. .... dépôts réalisés sur substrat en verre servent pour la ...

Positioning accuracy during VMAT of gynecologic malignancies and the resulting dosimetric impact by a 6-degree-of-freedom couch in combination with daily kilovoltage cone beam computed tomography.

Science.gov (United States)

Yao, Lihong; Zhu, Lihong; Wang, Junjie; Liu, Lu; Zhou, Shun; Jiang, ShuKun; Cao, Qianqian; Qu, Ang; Tian, Suqing

2015-04-26

To improve the delivery of radiotherapy in gynecologic malignancies and to minimize the irradiation of unaffected tissues by using daily kilovoltage cone beam computed tomography (kV-CBCT) to reduce setup errors. Thirteen patients with gynecologic cancers were treated with postoperative volumetric-modulated arc therapy (VMAT). All patients had a planning CT scan and daily CBCT during treatment. Automatic bone anatomy matching was used to determine initial inter-fraction positioning error. Positional correction on a six-degrees-of-freedom (6DoF) couch was followed by a second scan to calculate the residual inter-fraction error, and a post-treatment scan assessed intra-fraction motion. The margins of the planning target volume (MPTV) were calculated from these setup variations and the effect of margin size on normal tissue sparing was evaluated. In total, 573 CBCT scans were acquired. Mean absolute pre-/post-correction errors were obtained in all six planes. With 6DoF couch correction, the MPTV accounting for intra-fraction errors was reduced by 3.8-5.6 mm. This permitted a reduction in the maximum dose to the small intestine, bladder and femoral head (P=0.001, 0.035 and 0.032, respectively), the average dose to the rectum, small intestine, bladder and pelvic marrow (P=0.003, 0.000, 0.001 and 0.000, respectively) and markedly reduced irradiated normal tissue volumes. A 6DoF couch in combination with daily kV-CBCT can considerably improve positioning accuracy during VMAT treatment in gynecologic malignancies, reducing the MPTV. The reduced margin size permits improved normal tissue sparing and a smaller total irradiated volume.

Control of a HexaPOD treatment couch for robot-assisted radiotherapy.

Science.gov (United States)

Hermann, Christian; Ma, Lei; Wilbert, Jürgen; Baier, Kurt; Schilling, Klaus

2012-10-01

Moving tumors, for example in the vicinity of the lungs, pose a challenging problem in radiotherapy, as healthy tissue should not be irradiated. Apart from gating approaches, one standard method is to irradiate the complete volume within which a tumor moves plus a safety margin containing a considerable volume of healthy tissue. This work deals with a system for tumor motion compensation using the HexaPOD® robotic treatment couch (Medical Intelligence GmbH, Schwabmünchen, Germany). The HexaPOD, carrying the patient during treatment, is instructed to perform translational movements such that the tumor motion, from the beams-eye view of the linear accelerator, is eliminated. The dynamics of the HexaPOD are characterized by time delays, saturations, and other non-linearities that make the design of control a challenging task. The focus of this work lies on two control methods for the HexaPOD that can be used for reference tracking. The first method uses a model predictive controller based on a model gained through system identification methods, and the second method uses a position control scheme useful for reference tracking. We compared the tracking performance of both methods in various experiments with real hardware using ideal reference trajectories, prerecorded patient trajectories, and human volunteers whose breathing motion was compensated by the system.

CONTROLE DES CENTRES F+ DANS LES COUCHES MINCES D’OXYDE DE ZINC

Directory of Open Access Journals (Sweden)

A DJELLOUL

2000-12-01

Il est établi que la concentration des lacunes  peut être régulée à la limite de l’ordre deux pour des températures ne dépassant pas 980 K. Au-delà de cette température, se crée un autre type de défaut dans les couches de ZnO, qui est le zinc interstitiel.

Efficacy and safety of twice-weekly administration of three RDAs of iron and folic acid with and without complement of 14 essential micronutrients at one or two RDAs: a placebo-controlled intervention trial in anemic Cambodian infants 6 to 24 months of age.

Science.gov (United States)

Schümann, K; Longfils, P; Monchy, D; von Xylander, S; Weinheimer, H; Solomons, N W

2009-03-01

To determine the differential efficacy and safety of twice-weekly administration of 3 RDAs of iron and folic acid, with and without a complement of 2 RDAs of 11, and 1 RDA of 3 additional essential micronutrients as compared to a placebo control (PlbCON) given as foodLETs. A total of 250 children aged 6-24 months were enrolled after recruitment by village health workers; 19 of them dropped out during the trial. Children were assigned to one of three treatment arms and followed for 20.5 weeks; 41 supervised twice-weekly dosings of 30 mg of iron plus folic acid, either with or without accompanying micronutrients or placebo were given as foodLETs, a tool for ready-to-eat fortification in infant food. Initial and final measurements of anthropometry and blood biomarkers for hematological, iron stores and inflammatory status, as well as for abnormal hemoglobin (Hb), were obtained. Symptoms of listlessness, vomiting, watery stools and acute respiratory infections were monitored weekly. Iron-containing supplements increased Hb concentrations significantly (P<0.0001) and virtually eradicated any IDA, as compared to no change in hematological status in the PlbCON group (P=0.011). Iron stores, as reflected by ferritin, increased significantly with iron-containing treatments (P<0.0001). Responses were as effective in individuals with HbE as in those with exclusively HbA phenotypes. Watery stools (P=0.002) and listlessness (P=0.001) were significantly more frequent in those receiving iron and folic acid alone than in the PlbCON group. In contrast, acute respiratory infections (P=0.014) and listlessness (P=0.001) were significantly less frequent in those receiving the multiple micronutrient formulation than in the PlbCON group. Supplementation of micronutrients along with iron and folic acid mitigates the excess morbidity of iron-folate alone, without reducing its efficacy in correcting anemia and building iron stores. FoodLETs are a suitable vehicle to provide micronutrient

The effect of high-resolution fluences by couch shift between arcs on the VMAT plan quality

Energy Technology Data Exchange (ETDEWEB)

Kim, Jung In; Park, So Yeon; Choi, Chang Heon; Park, Jong Min [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of); Wu, Hong Gyun [Dept. of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

2016-12-15

Various studies have demonstrated the dosimetric advantages of multi-leaf collimators (MLCs) with fine leaf widths for both intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT), which can generate high resolution fluences. However, a practical disadvantage of MLCs with fine leaf widths is a limited field length in the longitudinal direction. This is because the numbers of leaves and motors are limited due to spatial constraints within the treatment head. We propose an alternative way to generate high resolution fluences of a VMAT plan without MLCs with fine leaf widths for the treatment of large H and N target volumes. With the Millennium 120 MLC with inner leaf widths of 5 mm, we simulate 2.5 mm inner leaf widths by a 2.5 mm shift of the patient couch in the longitudinal direction between arcs. In this way, we acquire not only the improved dosimetric effects of the MLCs with fine leaf widths, but also the full coverage of the H and N target volumes. The HAS plan was better than the others in terms of normal tissue sparing and plan efficiency.

A new shielding calculation method for X-ray computed tomography regarding scattered radiation.

Science.gov (United States)

Watanabe, Hiroshi; Noto, Kimiya; Shohji, Tomokazu; Ogawa, Yasuyoshi; Fujibuchi, Toshioh; Yamaguchi, Ichiro; Hiraki, Hitoshi; Kida, Tetsuo; Sasanuma, Kazutoshi; Katsunuma, Yasushi; Nakano, Takurou; Horitsugi, Genki; Hosono, Makoto

2017-06-01

The goal of this study is to develop a more appropriate shielding calculation method for computed tomography (CT) in comparison with the Japanese conventional (JC) method and the National Council on Radiation Protection and Measurements (NCRP)-dose length product (DLP) method. Scattered dose distributions were measured in a CT room with 18 scanners (16 scanners in the case of the JC method) for one week during routine clinical use. The radiation doses were calculated for the same period using the JC and NCRP-DLP methods. The mean (NCRP-DLP-calculated dose)/(measured dose) ratios in each direction ranged from 1.7 ± 0.6 to 55 ± 24 (mean ± standard deviation). The NCRP-DLP method underestimated the dose at 3.4% in fewer shielding directions without the gantry and a subject, and the minimum (NCRP-DLP-calculated dose)/(measured dose) ratio was 0.6. The reduction factors were 0.036 ± 0.014 and 0.24 ± 0.061 for the gantry and couch directions, respectively. The (JC-calculated dose)/(measured dose) ratios ranged from 11 ± 8.7 to 404 ± 340. The air kerma scatter factor κ is expected to be twice as high as that calculated with the NCRP-DLP method and the reduction factors are expected to be 0.1 and 0.4 for the gantry and couch directions, respectively. We, therefore, propose a more appropriate method, the Japanese-DLP method, which resolves the issues of possible underestimation of the scattered radiation and overestimation of the reduction factors in the gantry and couch directions.

Lessons learned from the scaling-up of a weekly multimicronutrient supplementation program in the integrated food security program (PISA).

Science.gov (United States)

Lechtig, Aarón; Gross, Rainer; Vivanco, Oscar Aquino; Gross, Ursula; López de Romaña, Daniel

2006-01-01

Weekly multimicronutrient supplementation was initiated as an appropriate intervention to protect poor urban populations from anemia. To identify the lessons learned from the Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]) weekly multimicronutrient supplementation program implemented in poor urban populations of Chiclayo, Peru. Data were collected from a 12-week program in which multimicronutrient supplements were provided weekly to women and adolescent girls 12 through 44 years of age and children under 5 years of age. A baseline survey was first conducted. Within the weekly multimicronutrient supplementation program, information was collected on supplement distribution, compliance, biological effectiveness, and cost. Supplementation, fortification, and dietary strategies can be integrated synergistically within a micronutrient intervention program. To ensure high cost-effectiveness of a weekly multimicronutrient supplementation program, the following conditions need to be met: the program should be implemented twice a year for 4 months; the program should be simultaneously implemented at the household (micro), community (meso), and national (macro) levels; there should be governmental participation from health and other sectors; and there should be community and private sector participation. Weekly multimicronutrient supplementation programs are cost effective options in urban areas with populations at low risk of energy deficiency and high risk of micronutrient deficiencies.

Influence de la protection cathodique sur le comportement électrochimique des couches de corrosion d'acier au carbone

OpenAIRE

Tran Tron Long , Mai; Sutter , Eliane; Tribollet , Bernard

2013-01-01

11 pages, www.mattech-journal.org; International audience; Les propriétés électrochimiques de la couche de dépôts de corrosion formée à la surface des coupons d'acier E24 immergés pendant plusieurs années dans l'eau de mer sous différentes conditions de protection cathodique ont éteé'tudiées à l'aide de la spectroscopie d'impédance électrochimique et de mesures globale et locale de courant. Les résultats obtenus montrent que la couche de dépôts dont le comportement est déterminé par sa sous-c...

SU-F-T-642: Sub Millimeter Accurate Setup of More Than Three Vertebrae in Spinal SBRT with 6D Couch

International Nuclear Information System (INIS)

Wang, X; Zhao, Z; Yang, J; Yang, J; McAleer, M; Brown, P; Li, J; Ghia, A

2016-01-01

Purpose: To assess the initial setup accuracy in treating more than 3 vertebral body levels in spinal SBRT using a 6D couch. Methods: We retrospectively analyzed last 20 spinal SBRT patients (4 cervical, 9 thoracic, 7 lumbar/sacrum) treated in our clinic. These patients in customized immobilization device were treated in 1 or 3 fractions. Initial setup used ExacTrac and Brainlab 6D couch to align target within 1 mm and 1 degree, following by a cone beam CT (CBCT) for verification. Our current standard practice allows treating a maximum of three continuous vertebrae. Here we assess the possibility to achieve sub millimeter setup accuracy for more than three vertebrae by examining the residual error in every slice of CBCT. The CBCT had a range of 17.5 cm, which covered 5 to 9 continuous vertebrae depending on the patient and target location. In the study, CBCT from the 1st fraction treatment was rigidly registered with the planning CT in Pinnacle. The residual setup error of a vertebra was determined by expanding the vertebra contour on the planning CT to be large enough to enclose the corresponding vertebra on CBCT. The margin of the expansion was considered as setup error. Results: Out of the 20 patients analyzed, initial setup accuracy can be achieved within 1 mm for a span of 5 or more vertebrae starting from T2 vertebra to inferior vertebra levels. 2 cervical and 2 upper thoracic patients showed the cervical spine was difficult to achieve sub millimeter accuracy for multi levels without a customized immobilization headrest. Conclusion: If the curvature of spinal columns can be reproduced in customized immobilization device during treatment as simulation, multiple continuous vertebrae can be setup within 1 mm with the use of a 6D couch.

SU-F-T-642: Sub Millimeter Accurate Setup of More Than Three Vertebrae in Spinal SBRT with 6D Couch

Energy Technology Data Exchange (ETDEWEB)

Wang, X; Zhao, Z; Yang, J; Yang, J; McAleer, M; Brown, P; Li, J; Ghia, A [MD Anderson Cancer Center, Houston, TX (United States)

2016-06-15

Purpose: To assess the initial setup accuracy in treating more than 3 vertebral body levels in spinal SBRT using a 6D couch. Methods: We retrospectively analyzed last 20 spinal SBRT patients (4 cervical, 9 thoracic, 7 lumbar/sacrum) treated in our clinic. These patients in customized immobilization device were treated in 1 or 3 fractions. Initial setup used ExacTrac and Brainlab 6D couch to align target within 1 mm and 1 degree, following by a cone beam CT (CBCT) for verification. Our current standard practice allows treating a maximum of three continuous vertebrae. Here we assess the possibility to achieve sub millimeter setup accuracy for more than three vertebrae by examining the residual error in every slice of CBCT. The CBCT had a range of 17.5 cm, which covered 5 to 9 continuous vertebrae depending on the patient and target location. In the study, CBCT from the 1st fraction treatment was rigidly registered with the planning CT in Pinnacle. The residual setup error of a vertebra was determined by expanding the vertebra contour on the planning CT to be large enough to enclose the corresponding vertebra on CBCT. The margin of the expansion was considered as setup error. Results: Out of the 20 patients analyzed, initial setup accuracy can be achieved within 1 mm for a span of 5 or more vertebrae starting from T2 vertebra to inferior vertebra levels. 2 cervical and 2 upper thoracic patients showed the cervical spine was difficult to achieve sub millimeter accuracy for multi levels without a customized immobilization headrest. Conclusion: If the curvature of spinal columns can be reproduced in customized immobilization device during treatment as simulation, multiple continuous vertebrae can be setup within 1 mm with the use of a 6D couch.

A Comparison of Betamethasone Valerate 0.1% Cream Twice Daily Plus Oral Simvastatin Versus Betamethasone Valerate 0.1% Cream Alone in the Treatment of Vitiligo Patients

Directory of Open Access Journals (Sweden)

Fariba Iraji

2017-01-01

Full Text Available Background: Vitiligo, a common disorder of depigmentation, is often difficult to treat. Corticosteroids are known to be effective, but with modest results. Although simvastatin has been reported to be effective for immunorelated dermatologic disorders including vitiligo, controlled trials are lacking. This study was conducted to compare the efficacy of topical betamethasone valerate 0.1% cream (as a standard method of treatment for vitiligo versus a combination of betamethasone valerate plus oral simvastatin in the treatment of vitiligo. Materials and Methods: Eighty-eight subjects with symmetric vitiligo who had body surface involvement up to 20% were divided randomly into two groups. Group A were treated with betamethasone valerate 01% cream twice daily and Group B with betamethasone valerate 01% cream twice daily and oral simvastatin 80 mg daily for 12 weeks. Finally, 46 patients completed treatment after 12 weeks in both groups. The results were evaluated by a blind dermatologist using Vitiligo Area Scoring Index (VASI score at baseline, 4th, 8th, and 12th week of treatment. In a similar way, subjective assessment performed by patients based on photo evaluation at the end of the study. Results: Despite a continuous reduction in VASI score in both groups, according to both physician (P = 0.13 and patient (P = 0.374 assessment oral simvastatin was not statistically more effective than conventional treatment of vitiligo. Conclusion: This study indicates that oral simvastatin is not associated with significant impacts in the treatment of vitiligo as compared to other inflammatory dermatologic conditions such as psoriasis. Indeed, other studies should be initiated regarding exact molecular and cellular effects of statins in the treatment of vitiligo.

A Comparison of Betamethasone Valerate 0.1% Cream Twice Daily Plus Oral Simvastatin Versus Betamethasone Valerate 0.1% Cream Alone in the Treatment of Vitiligo Patients.

Science.gov (United States)

Iraji, Fariba; Banihashemi, Seyed Hossin; Faghihi, Gita; Shahmoradi, Zabihollah; Tajmirriahi, Nabet; Jazi, Safoura Bokaie

2017-01-01

Vitiligo, a common disorder of depigmentation, is often difficult to treat. Corticosteroids are known to be effective, but with modest results. Although simvastatin has been reported to be effective for immunorelated dermatologic disorders including vitiligo, controlled trials are lacking. This study was conducted to compare the efficacy of topical betamethasone valerate 0.1% cream (as a standard method of treatment for vitiligo) versus a combination of betamethasone valerate plus oral simvastatin in the treatment of vitiligo. Eighty-eight subjects with symmetric vitiligo who had body surface involvement up to 20% were divided randomly into two groups. Group A were treated with betamethasone valerate 01% cream twice daily and Group B with betamethasone valerate 01% cream twice daily and oral simvastatin 80 mg daily for 12 weeks. Finally, 46 patients completed treatment after 12 weeks in both groups. The results were evaluated by a blind dermatologist using Vitiligo Area Scoring Index (VASI) score at baseline, 4 th , 8 th , and 12 th week of treatment. In a similar way, subjective assessment performed by patients based on photo evaluation at the end of the study. Despite a continuous reduction in VASI score in both groups, according to both physician ( P = 0.13) and patient ( P = 0.374) assessment oral simvastatin was not statistically more effective than conventional treatment of vitiligo. This study indicates that oral simvastatin is not associated with significant impacts in the treatment of vitiligo as compared to other inflammatory dermatologic conditions such as psoriasis. Indeed, other studies should be initiated regarding exact molecular and cellular effects of statins in the treatment of vitiligo.

Designing Inclusive Learning for Twice Exceptional Students in Minecraft

Science.gov (United States)

O'Sullivan, Muireann; Robb, Nigel; Howell, Stephen; Marshall, Kevin; Goodman, Lizbeth

2017-01-01

Twice exceptional learners are intellectually or creatively gifted yet also experience one or more learning difficulties. These students face a unique set of challenges in educational settings. Recommended strategies for accommodating twice exceptional learners focus on--among other things--(1) providing freedom and variety, so that students can…

Reflections on Klein's radical notion of phantasy and its implications for analytic practice.

Science.gov (United States)

Blass, Rachel B

2017-06-01

Analysts may incorporate many of Melanie Klein's important contributions (e.g., on preoedipal dynamics, envy, and projective identification) without transforming their basic analytic approach. In this paper I argue that adopting the Kleinian notion of unconscious phantasy is transformative. While it is grounded in Freud's thinking and draws out something essential to his work, this notion of phantasy introduces a radical change that defines Kleinian thinking and practice and significantly impacts the analyst's basic clinical approach. This impact and its technical implications in the analytic situation are illustrated and discussed. Copyright © 2017 Institute of Psychoanalysis.

Trajectory optimization for dynamic couch rotation during volumetric modulated arc radiotherapy

Science.gov (United States)

Smyth, Gregory; Bamber, Jeffrey C.; Evans, Philip M.; Bedford, James L.

2013-11-01

Non-coplanar radiation beams are often used in three-dimensional conformal and intensity modulated radiotherapy to reduce dose to organs at risk (OAR) by geometric avoidance. In volumetric modulated arc radiotherapy (VMAT) non-coplanar geometries are generally achieved by applying patient couch rotations to single or multiple full or partial arcs. This paper presents a trajectory optimization method for a non-coplanar technique, dynamic couch rotation during VMAT (DCR-VMAT), which combines ray tracing with a graph search algorithm. Four clinical test cases (partial breast, brain, prostate only, and prostate and pelvic nodes) were used to evaluate the potential OAR sparing for trajectory-optimized DCR-VMAT plans, compared with standard coplanar VMAT. In each case, ray tracing was performed and a cost map reflecting the number of OAR voxels intersected for each potential source position was generated. The least-cost path through the cost map, corresponding to an optimal DCR-VMAT trajectory, was determined using Dijkstra’s algorithm. Results show that trajectory optimization can reduce dose to specified OARs for plans otherwise comparable to conventional coplanar VMAT techniques. For the partial breast case, the mean heart dose was reduced by 53%. In the brain case, the maximum lens doses were reduced by 61% (left) and 77% (right) and the globes by 37% (left) and 40% (right). Bowel mean dose was reduced by 15% in the prostate only case. For the prostate and pelvic nodes case, the bowel V50 Gy and V60 Gy were reduced by 9% and 45% respectively. Future work will involve further development of the algorithm and assessment of its performance over a larger number of cases in site-specific cohorts.

On a connection between the limit set of the Moebius-Klein transformation, periodic continued fractions, El Naschie's topological theory of high energy particle physics and the possibility of a new axion-like particle

International Nuclear Information System (INIS)

Marek-Crnjac, L.

2004-01-01

In the present work we first give a general representation of the derivatives of the irrational number phi, for instance ((1)/(phi)), ((1)/(phi 2 )), ((1)/(phi 3 )) etc., as periodic continued fractions. Any irrational number can then be expanded in an infinite continued fraction. The limit set of the Kleinian transformation acting on the E-infinity Cantorian spacetime turned out to be this set of periodic continued fractions, consequently the vacuum of the E-infinity is described by this limit set. As discussed by El Naschie, every particle can be interpreted geometrically as a scaling of another. This is done using the topology of hyperbolic Kleinian space of VAK, which is nothing but our limit set. Here we will present the ratios of the theoretical masses of certain elementary particles to that of some chosen particles in term of phi. Many of these masses are quite close to integer multiples of the mass of a chosen particle. Finally we discuss the possibility of new transfinite, axion-like particles as discussed recently by Krauss and El Naschie [Quintessence, Vintage, London, 1999

Local control and functional results after twice-daily radiotherapy for Ewing's sarcoma of the extremities

International Nuclear Information System (INIS)

Bolek, Timothy W.; Marcus, Robert B.; Mendenhall, Nancy Price; Scarborough, Mark T.; Graham-Pole, John

1996-01-01

Purpose: Radiotherapy (RT) has been the predominant local treatment for Ewing's sarcoma of bone at the University of Florida. Twice-daily hyperfractionated RT was initiated in 1982 to improve local control and functional outcome. This retrospective review compares the results of once-daily vs. twice-daily RT in patients with primary Ewing's sarcoma of an extremity, with emphasis on functional outcome. Methods and Materials: Between June 1971 and January 1990, 37 patients were treated at the University of Florida for nonmetastatic Ewing's sarcoma of bone with a primary lesion in an extremity. Three patients underwent amputation. Of 34 patients treated with RT, 31 had RT alone and 3 had a combination of RT and local excision. Before 1982, 14 patients received once-daily RT; since 1982, 17 patients have received twice-daily RT. Doses of once-daily RT varied from 47 to 61 Gy at 1.8-2 Gy per fraction. Doses of twice-daily RT varied, depending on the response of the soft-tissue component of the tumor to chemotherapy, and ranged from 50.4 to 60 Gy at 1.2 Gy per fraction. Some patients in the twice-daily RT group also received total body irradiation 1-3 months after local RT as part of a conditioning regimen before marrow-ablative therapy with stem cell rescue. They received either 8 Gy in two once-daily fractions or 12 Gy in six twice-daily fractions. The six patients who received surgery were excluded from local control analysis. Local control rates were calculated using the Kaplan-Meier (actuarial) method. Fifteen patients had a formal functional evaluation. Results: In the 31 patients treated with RT alone, the actuarial local control rate at 5 years was 81% for patients treated twice daily and 77% for those treated once daily (p = NS). No posttreatment pathologic fractures occurred in patients treated twice daily, whereas five fractures occurred in those treated once daily (p = 0.01). On functional evaluation, less loss in range of motion (15 deg. vs. 28 deg. of loss

Efficacy and safety of concurrent chemoradiation with weekly cisplatin ± low-dose celecoxib in locally advanced undifferentiated nasopharyngeal carcinoma: a phase II-III clinical trial.

Science.gov (United States)

Mohammadianpanah, Mohammad; Razmjou-Ghalaei, Sasan; Shafizad, Amin; Ashouri-Taziani, Yaghoub; Khademi, Bijan; Ahmadloo, Niloofar; Ansari, Mansour; Omidvari, Shapour; Mosalaei, Ahmad; Mosleh-Shirazi, Mohammad Amin

2011-01-01

This is the first study that aimed to determine the efficacy and safety of concurrent chemoradiation with weekly cisplatin ± celecoxib 100 mg twice daily in locally advanced undifferentiated nasopharyngeal carcinoma. Eligible patients had newly diagnosed locally advanced (T3-T4, and/or N2-N3, M0) undifferentiated nasopharyngeal carcinoma, no prior therapy, Karnofsky performance status ≥ 70, and normal organ function. The patients were assigned to receive 7 weeks concurrent chemoradiation (70 Gy) with weekly cisplatin 30 mg/m 2 with either celecoxib 100 mg twice daily, (study group, n = 26) or placebo (control group, n = 27) followed by adjuvant combined chemotherapy with cisplatin 70 mg/m 2 on day 1 plus 5-fluorouracil 750 mg/m 2 /d with 8-h infusion on days 1-3, 3-weekly for 3 cycles. Overall clinical response rate was 100% in both groups. Complete and partial clinical response rates were 64% and 36% in the study group and 44% and 56% in the control group, respectively (P > 0.25). The addition of celecoxib to concurrent chemoradiation was associated with improved 2-year locoregional control rate from 84% to 100% (P = 0.039). The addition of celecoxib 100 mg twice daily to concurrent chemoradiation improved 2-year locoregional control rate.

Effect of twice quenching and tempering on the mechanical properties and microstructures of SCRAM steel for fusion application

Energy Technology Data Exchange (ETDEWEB)

Xiong Xuesong; Yang Feng; Zou Xingrong [State Key Laboratory of Mould Technology, Institute of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan 430074 (China); Suo Jinping, E-mail: jpsuo@yahoo.com.cn [State Key Laboratory of Mould Technology, Institute of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan 430074 (China)

2012-11-15

The effect of twice quenching and tempering on the mechanical properties and microstructures of SCRAM steel was investigated. The results from tensile tests showed that whether twice quenching and tempering processes(1253 K/0.5 h/W.C(water cool) + 1033 K/2 h/A.C(air cool) + 1233 K/0.5 h/W.C + 1033 K/2 h/A.C named after 2Q and 2TI, and 1253 K/0.5 h/W.C + 1033 K/2 h/A.C + 1233 K/0.5 h/W.C + 1013 K/2 h/A.C named after 2Q and 2TII)increased strength of steel or not depended largely on the second tempering temperature compared to quenching and tempering process(1253 K/0.5 h/W.C + 1033 K/2 h/A.C named after 1Q and 1T). Charpy V-notch impact tests indicated that twice quenching and tempering processes reduced the ductile brittle transition temperature (DBTT). Microstructure inspection revealed that the prior austenitic grain size and martensite lath width were refined after twice quenching and tempering treatments. Precipitate growth was inhibited by a slight decrease of the second tempering temperature from 1033 to 1013 K. The finer average size of precipitates is considered to be the main possible reason for the higher strength and lower DBTT of 2Q and 2TII compared with 2Q and 2TI.

The evaluation for the usability of the Varian Standard Couch modelingusing Treatment Planning System

Energy Technology Data Exchange (ETDEWEB)

Yang, Yong Mo; Song, Yong Min; Kim, Jin Man; Choi, Ji Min; Choi, Byeung Gi [Dept. of Radiation Oncology, Samsung Medical Center, Seoul (Korea, Republic of)

2016-06-15

When a radiation treatment, there is an attenuation by Carbon Fiber Couch. In this study, we tried to evaluate the usability of the Varian Standard Couch(VSC) by modeling with Treatment Planning System (TPS) VSC was scanned by CBCT(Cone Beam Computed Tomography) of the Linac(Clinac IX, VARIAN, USA), following the three conditions of VSC, Side Rail OutGrid(SROG), Side Rail InGrid(SRIG), Side Rail In OutSpine Down Bar(SRIOS). After scan, the data was transferred to TPS and modeled by contouring Side Rail, Side Bar Upper, Side Bar Lower, Spine Down Bar automatically. We scanned the Cheese Phantom(Middelton, USA) using Computed Tomography(Light Speed RT 16, GE, USA) and transfer the data to TPS, and apply VSC modeled previously with TPS to it. Dose was measured at the isocenter of Ion Chamber(A1SL, Standard imaging, USA) in Cheese Phantom using 4 and 10 MV radiation for every 5° gantry angle in a different filed size(3 X 3 cm{sup 2},10 X 10cm{sup 2}) without any change of MU(=100), and then we compared the calculated dose and measured dose. Also we included dose at the 127° in SRIG to compare the attenuation by Side Bar Upper. Results : The density of VSC by CBCT in TPS was 0.9g/cm{sup 3}, and in the case of Spine Down Bar, it was 0.7g/cm{sup 3}. The radiation was attenuated by 17.49%, 16.49%, 8.54%, and 7.59% at the Side Rail, Side Bar Upper, Side Bar Lower, and Spine Down Bar. For the accuracy of modeling, calculated dose and measured dose were compared. The average error was 1.13% and the maximum error was 1.98% at the 170° beam crossing the Spine Down Bar. To evaluate the usability for the VSC modeled by TPS, the maximum error was 1.98% as a result of compassion between calculated dose and measured dose. We found out that VSC modeling helped expect the dose, so we think that it will be helpful for the more accurate treatment.

Stereotaxic external irradiation for brain tumors

International Nuclear Information System (INIS)

Kim, Y.H.; Fayos, J.V.; Houdek, P.V.; Landy, H.; Van Buren, J.

1987-01-01

A system has been developed to deliver precision radiation therapy to a limited volume of brain tissue. A CT-compatible nonmetallic headband, or ''halo,'' is secured to the skull with screw pins. A metal frame attached to the CT couch and the patient's head is secured to the couch by temporarily affixing the halo to the frame. A CT scan is obtained to determine the x,y,z coordinates of the brain lesion. The same halo, frame, and coordinates are used in daily treatment with 10-MVX accelerator and a coplanar arc rotation technique. Field size is determined to cover the target volume with the 90% isodose line. Verification films are obtained twice a week. On completion of treatment, the halo is removed. From December 1982 to January 1986, 14 patients were treated with this system. Six had pituitary tumors, two had craniopharyngiomas, and six had astrocytomas. The dose delivered ranged from 3,600 rad in 12 fractions to 6,250 rad in 25 fractions at a rate of one fraction per day, 5 days a week. Judging from the verification films, daily administration of intended radiation was extremely good. Superficial infection of the screw-pin sites healed without sequelae. All patients were alive at the last follow-up. This system is relatively simple yet able to deliver precision irradiation without any remarkable complications

Les mécanismes d'action des détergents et les doubles couche électriques aux interfaces Action Mechanisms of Detergents and Double Electric Layer At Interfaces

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Briant J.

2006-11-01

Full Text Available Les doubles couches électriques aux interfaces jouent un rôle important dans l'action des additifs détergents ioniques, surtout dans la stabilisation des suspensions. Les phénomènes électrocinétiques aux interfaces : électroosmose, potentiel d'écoulement, électrophorèse, potentiel de sédimentation permettent de mettre en évidence la double couche électrique et d'en déterminer certaines caractéristiques signe de la charge de la couche mobile, potentiel électrocinétique, etc. Les relations entre la stabilité des suspensions et l'interaction des doubles couches électriques ont fait l'objet d'études approfondies de Deriaguin, Verwey et Overbeek. Ces auteurs ont analysé le mécanisme d'action des doubles couches électriques et la façon dont elles pouvaient créer des forces de répulsion capables de surmonter les forces d'attraction de Van der Waals entre particules. Leur analyse permet d'expliquer les observations faites sur les effets de la charge des particules, la nature des ions fixés, la concentration de la phase dispersante en produits actifs. Le mécanisme d'action des doubles couches électriques permet peut-être d'appréhender mieux le mécanisme d'action des additifs non ioniques. Double electric loyers at interfaces play an important part in the action of ionic detergent additives, especially in the stability of suspensions. Electrokinetic phenomena at interfaces (electroosmosis,flow potential, electrophoresis, sedimentation potential can be used to reveal the double electric layer and to determine various properties such as the sign of the charge of the mobile loyer, the electrokinetic potential, etc. The relations between the stabillity of suspensions and the interaction of double electric loyers have been the subject of in-depth research by Deriaguin, Verwey and Overbeek. The authors have analyzed the action mechanism of double electric loyers and the way they can create repulsion forces capable of overcoming

The effects of interday rest on adaptation to 6 weeks of plyometric training in young soccer players.

Science.gov (United States)

Ramírez-Campillo, Rodrigo; Meylan, César M P; Álvarez-Lepín, Cristian; Henriquez-Olguín, Carlos; Martinez, Cristian; Andrade, David C; Castro-Sepúlveda, Mauricio; Burgos, Carlos; Baez, Eduardo I; Izquierdo, Mikel

2015-04-01

The purpose of this study was to determine the effects of short-term plyometric training interposed with 24 or 48 hours of rest between training sessions on explosive and endurance adaptations in young soccer players. A total of 166 players, between 10 and 17 years of age, were randomly divided into 3 groups: a control group (CG; n = 55) and 2 plyometric training groups with 24 hours (PT24; n = 54) and 48 hours (PT48; n = 57) of rest between training sessions. Before and after intervention, players were measured in squat jump, countermovement jump, 20 (RSI20) cm drop jump reactive strength index, broad long jump, 20-m sprint time, 10 × 5-m agility time, 20-m multistage shuttle run test, and sit-and-reach test. The plyometric training program was applied during 6 weeks, 2 sessions per week, with a load from 140 to 260 jumps per session, replacing some soccer-specific drills. After intervention, the CG did not show significant performance changes. PT24 and PT48 groups showed a small-to-moderate significant improvement in all performance tests (p plyometric drills should not be conducted on consecutive days, the study shows that plyometric training applied twice weekly on consecutive or nonconsecutive days results in similar explosive and endurance adaptations in young male soccer players.

Histochemical responses of rats exercised in two weekly frequencies and ingesting standard or hypercaloric diet

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FI Freitas

2009-07-01

Full Text Available This study investigated if overfed rats present morphological and histochemical muscle adaptation similar to normally fed, both submitted to two different weekly frequencies of training. Thirty male Wistar rats were fed either with standard chow (SCØ or with hypercaloric diet (HCØ. They were subdivided into six subgroups: sedentary (SCØ and HCØ, trained twice/week (SC2 and HC2 and trained five times/week (SC5 and HC5. The trained groups swam 60 min/day, during 10 weeks. Twenty four hours after the last training, samples of Gastrocnemius were excised and stained with HE, NADH-TR and m-ATPase, and the capillary density was calculated. Total heart mass (HM and the mass of atrium (AM, left (LV and right (RV ventricles were excised and weighted. The comparisons were made by ANOVA and by Covariance analysis, adjusting the variables by body weight. The results showed that the HCØ achieved higher BM, however, absolute HM did not differ post training. Irrespective of the diet, rats that were trained twice a week presented significantly greater increase in the AM. In general, the SC5 and HC5 groups showed higher HM, LV, RV, proportion of oxidative fibres and capillary density, compared to the sedentary and twice week trained groups. A higher proportion of injuries (splitting was noted in the HC2 and HC5 compared to SC2 and SC5. These results indicate that the frequency of training influenced the skeletal and heart adaptation and larger changes were observed in the 5x/week group, which ingested the standard diet. The 5x/week training groups also presented large amount of muscle fibres damage.

The Advocacy Experiences of Parents of Elementary Age, Twice-Exceptional Children

Science.gov (United States)

Besnoy, Kevin D.; Swoszowski, Nicole C.; Newman, Jane L.; Floyd, Amanda; Jones, Parrish; Byrne, Caitlin

2015-01-01

For many parents, successfully advocating for their twice-exceptional child can be intimidating and overwhelming. Using grounded theory, we conducted a study with parents (n = 8) of elementary age, twice-exceptional children to learn about their advocacy experiences. Findings revealed that parents simultaneously advocated for their child's…

Through a Different Lens: Reflecting on a Strengths-Based, Talent-Focused Approach for Twice-Exceptional Learners

Science.gov (United States)

Baum, Susan M.; Schader, Robin M.; Hébert, Thomas P.

2014-01-01

This study sought to understand the experiences of a cohort of students who entered a strengths-based private school for twice-exceptional students during middle school and successfully completed graduation requirements. Using a case study design, the researchers analyzed data collected from student and teacher interviews, parent focus groups,…

What Is the Most Effective Way of Increasing the Bioavailability of Dietary Long Chain Omega-3 Fatty Acids—Daily vs. Weekly Administration of Fish Oil?

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Samaneh Ghasemifard

2015-07-01

Full Text Available The recommendations on the intake of long chain omega-3 polyunsaturated fatty acids (n-3 LC-PUFA vary from eating oily fish (“once to twice per week” to consuming specified daily amounts of eicosapentaenoic acid (EPA and docosahexaenoic acid (DHA (“250–500 mg per day”. It is not known if there is a difference in the uptake/bioavailability between regular daily consumption of supplementsvs. consuming fish once or twice per week. In this study, the bioavailability of a daily dose of n-3 LC-PUFA (Constant treatment, representing supplements, vs. a large weekly dose of n-3 LC-PUFA (Spike treatment, representing consuming once or twice per week, was assessed. Six-week old healthy male Sprague-Dawley rats were fed either a Constant treatment, a Spike treatment or Control treatment (no n-3 LC-PUFA, for six weeks. The whole body, tissues and faeces were analysed for fatty acid content. The results showed that the major metabolic fate of the n-3 LC-PUFA (EPA+docosapentaenoic acid (DPA + DHA was towards catabolism (β-oxidation accounting for over 70% of total dietary intake, whereas deposition accounted less than 25% of total dietary intake. It was found that significantly more n-3 LC-PUFA were β-oxidised when originating from the Constant treatment (84% of dose, compared with the Spike treatment (75% of dose. Conversely, it was found that significantly more n-3 LC-PUFA were deposited when originating from the Spike treatment (23% of dose, than from the Constant treatment (15% of dose. These unexpected findings show that a large dose of n-3 LC-PUFA once per week is more effective in increasing whole body n-3 LC-PUFA content in rats compared with a smaller dose delivered daily.

SaniTwice: a novel approach to hand hygiene for reducing bacterial contamination on hands when soap and water are unavailable.

Science.gov (United States)

Edmonds, Sarah L; Mann, James; McCormack, Robert R; Macinga, David R; Fricker, Christopher M; Arbogast, James W; Dolan, Michael J

2010-12-01

The risk of inadequate hand hygiene in food handling settings is exacerbated when water is limited or unavailable, thereby making washing with soap and water difficult. The SaniTwice method involves application of excess alcohol-based hand sanitizer (ABHS), hand "washing" for 15 s, and thorough cleaning with paper towels while hands are still wet, followed by a standard application of ABHS. This study investigated the effectiveness of the SaniTwice methodology as an alternative to hand washing for cleaning and removal of microorganisms. On hands moderately soiled with beef broth containing Escherichia coli (ATCC 11229), washing with a nonantimicrobial hand washing product achieved a 2.86 (±0.64)-log reduction in microbial contamination compared with the baseline, whereas the SaniTwice method with 62 % ethanol (EtOH) gel, 62 % EtOH foam, and 70 % EtOH advanced formula gel achieved reductions of 2.64 ± 0.89, 3.64 ± 0.57, and 4.61 ± 0.33 log units, respectively. When hands were heavily soiled from handling raw hamburger containing E. coli, washing with nonantimicrobial hand washing product and antimicrobial hand washing product achieved reductions of 2.65 ± 0.33 and 2.69 ± 0.32 log units, respectively, whereas SaniTwice with 62 % EtOH foam, 70 % EtOH gel, and 70 % EtOH advanced formula gel achieved reductions of 2.87 ± 0.42, 2.99 ± 0.51, and 3.92 ± 0.65 log units, respectively. These results clearly demonstrate that the in vivo antibacterial efficacy of the SaniTwice regimen with various ABHS is equivalent to or exceeds that of the standard hand washing approach as specified in the U.S. Food and Drug Administration Food Code. Implementation of the SaniTwice regimen in food handling settings with limited water availability should significantly reduce the risk of foodborne infections resulting from inadequate hand hygiene.

A computer aided treatment event recognition system in radiation therapy

International Nuclear Information System (INIS)

Xia, Junyi; Mart, Christopher; Bayouth, John

2014-01-01

Purpose: To develop an automated system to safeguard radiation therapy treatments by analyzing electronic treatment records and reporting treatment events. Methods: CATERS (Computer Aided Treatment Event Recognition System) was developed to detect treatment events by retrieving and analyzing electronic treatment records. CATERS is designed to make the treatment monitoring process more efficient by automating the search of the electronic record for possible deviations from physician's intention, such as logical inconsistencies as well as aberrant treatment parameters (e.g., beam energy, dose, table position, prescription change, treatment overrides, etc). Over a 5 month period (July 2012–November 2012), physicists were assisted by the CATERS software in conducting normal weekly chart checks with the aims of (a) determining the relative frequency of particular events in the authors’ clinic and (b) incorporating these checks into the CATERS. During this study period, 491 patients were treated at the University of Iowa Hospitals and Clinics for a total of 7692 fractions. Results: All treatment records from the 5 month analysis period were evaluated using all the checks incorporated into CATERS after the training period. About 553 events were detected as being exceptions, although none of them had significant dosimetric impact on patient treatments. These events included every known event type that was discovered during the trial period. A frequency analysis of the events showed that the top three types of detected events were couch position override (3.2%), extra cone beam imaging (1.85%), and significant couch position deviation (1.31%). The significant couch deviation is defined as the number of treatments where couch vertical exceeded two times standard deviation of all couch verticals, or couch lateral/longitudinal exceeded three times standard deviation of all couch laterals and longitudinals. On average, the application takes about 1 s per patient when

A computer aided treatment event recognition system in radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Xia, Junyi, E-mail: junyi-xia@uiowa.edu; Mart, Christopher [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Bayouth, John [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242 and Department of Human Oncology, University of Wisconsin - Madison, 600 Highland Avenue, K4/B55, Madison, Wisconsin 53792-0600 (United States)

2014-01-15

Purpose: To develop an automated system to safeguard radiation therapy treatments by analyzing electronic treatment records and reporting treatment events. Methods: CATERS (Computer Aided Treatment Event Recognition System) was developed to detect treatment events by retrieving and analyzing electronic treatment records. CATERS is designed to make the treatment monitoring process more efficient by automating the search of the electronic record for possible deviations from physician's intention, such as logical inconsistencies as well as aberrant treatment parameters (e.g., beam energy, dose, table position, prescription change, treatment overrides, etc). Over a 5 month period (July 2012–November 2012), physicists were assisted by the CATERS software in conducting normal weekly chart checks with the aims of (a) determining the relative frequency of particular events in the authors’ clinic and (b) incorporating these checks into the CATERS. During this study period, 491 patients were treated at the University of Iowa Hospitals and Clinics for a total of 7692 fractions. Results: All treatment records from the 5 month analysis period were evaluated using all the checks incorporated into CATERS after the training period. About 553 events were detected as being exceptions, although none of them had significant dosimetric impact on patient treatments. These events included every known event type that was discovered during the trial period. A frequency analysis of the events showed that the top three types of detected events were couch position override (3.2%), extra cone beam imaging (1.85%), and significant couch position deviation (1.31%). The significant couch deviation is defined as the number of treatments where couch vertical exceeded two times standard deviation of all couch verticals, or couch lateral/longitudinal exceeded three times standard deviation of all couch laterals and longitudinals. On average, the application takes about 1 s per patient when

Effects of 16-weeks of Pilates on health perception and sleep quality among elderly women.

Science.gov (United States)

Curi, V S; Vilaça, J; Haas, A N; Fernandes, H M

2018-01-01

The objective of this study was to determine the effect of 16 weeks of mat-based Pilates training on health perception and sleep quality among elderly women. A randomized and controlled trial was conducted in Caxias do Sul, Brazil, in 2015, in which 61 healthy older women were divided into two groups: experimental group (EG; n=31, average of 64.25 years old, SD 0.14) and control group (CG; n=30, average of 63.75 years old, SD 0.08). The EG participants performed mat-based Pilates exercises twice a week in 60-min sessions, whereas the CG did not train. All participants completed Brazilian-adapted and validated versions of the Pittsburgh Sleep Quality Index (PSQI-BR) and General Health Questionnaire (GHQ-12) at baseline and after 16 weeks. Significant time x group interaction effects were found for the GHQ-12 total score (pPilates EG when compared to the CG. All significant effects were classified as moderate to high. These results indicate that 16 weeks of mat-based Pilates training significantly improves the perceived health status and some sleep quality indices among elderly women. However, more studies are needed to assess the effectiveness of equipment-based Pilates exercises among this population. Copyright © 2017 Elsevier B.V. All rights reserved.

The Effect of Intermittent Antenatal Iron Supplementation on Maternal and Infant Outcomes in Rural Viet Nam: A Cluster Randomised Trial

Science.gov (United States)

Hanieh, Sarah; Ha, Tran T.; Simpson, Julie A.; Casey, Gerard J.; Khuong, Nguyen C.; Thoang, Dang D.; Thuy, Tran T.; Pasricha, Sant-Rayn; Tran, Thach D.; Tuan, Tran; Dwyer, Terence; Fisher, Jane; Biggs, Beverley-Ann

2013-01-01

Background Anemia affects over 500 million women, and in pregnancy is associated with impaired maternal and infant outcomes. Intermittent antenatal iron supplementation is an attractive alternative to daily dosing; however, the impact of this strategy on infant outcomes remains unclear. We compared the effect of intermittent antenatal iron supplementation with daily iron supplementation on maternal and infant outcomes in rural Viet Nam. Methods and Findings This cluster randomised trial was conducted in Ha Nam province, Viet Nam. 1,258 pregnant women (<16 wk gestation) in 104 communes were assigned to daily iron–folic acid (IFA), twice weekly IFA, or twice weekly multiple micronutrient (MMN) supplementation. Primary outcome was birth weight. Mean birth weight was 3,148 g (standard deviation 416). There was no difference in the birth weights of infants of women receiving twice weekly IFA compared to daily IFA (mean difference [MD] 28 g; 95% CI −22 to 78), or twice weekly MMN compared to daily IFA (MD −36.8 g; 95% CI −82 to 8.2). At 32 wk gestation, maternal ferritin was lower in women receiving twice weekly IFA compared to daily IFA (geometric mean ratio 0.73; 95% CI 0.67 to 0.80), and in women receiving twice weekly MMN compared to daily IFA (geometric mean ratio 0.62; 95% CI 0.57 to 0.68), but there was no difference in hemoglobin levels. Infants of mothers who received twice weekly IFA had higher cognitive scores at 6 mo of age compared to those who received daily IFA (MD 1.89; 95% CI 0.23 to 3.56). Conclusions Twice weekly antenatal IFA or MMN did not produce a clinically important difference in birth weight, when compared to daily IFA supplementation. The significant improvement in infant cognitive outcomes at 6 mo of age following twice weekly antenatal IFA requires further exploration, and provides additional support for the use of intermittent, rather than daily, antenatal IFA in populations with low rates of iron deficiency. Trial registration

Accuracy of Real-time Couch Tracking During 3-dimensional Conformal Radiation Therapy, Intensity Modulated Radiation Therapy, and Volumetric Modulated Arc Therapy for Prostate Cancer

International Nuclear Information System (INIS)

Wilbert, Juergen; Baier, Kurt; Hermann, Christian; Flentje, Michael; Guckenberger, Matthias

2013-01-01

Purpose: To evaluate the accuracy of real-time couch tracking for prostate cancer. Methods and Materials: Intrafractional motion trajectories of 15 prostate cancer patients were the basis for this phantom study; prostate motion had been monitored with the Calypso System. An industrial robot moved a phantom along these trajectories, motion was detected via an infrared camera system, and the robotic HexaPOD couch was used for real-time counter-steering. Residual phantom motion during real-time tracking was measured with the infrared camera system. Film dosimetry was performed during delivery of 3-dimensional conformal radiation therapy (3D-CRT), step-and-shoot intensity modulated radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT). Results: Motion of the prostate was largest in the anterior–posterior direction, with systematic (∑) and random (σ) errors of 2.3 mm and 2.9 mm, respectively; the prostate was outside a threshold of 5 mm (3D vector) for 25.0%±19.8% of treatment time. Real-time tracking reduced prostate motion to ∑=0.01 mm and σ = 0.55 mm in the anterior–posterior direction; the prostate remained within a 1-mm and 5-mm threshold for 93.9%±4.6% and 99.7%±0.4% of the time, respectively. Without real-time tracking, pass rates based on a γ index of 2%/2 mm in film dosimetry ranged between 66% and 72% for 3D-CRT, IMRT, and VMAT, on average. Real-time tracking increased pass rates to minimum 98% on average for 3D-CRT, IMRT, and VMAT. Conclusions: Real-time couch tracking resulted in submillimeter accuracy for prostate cancer, which transferred into high dosimetric accuracy independently of whether 3D-CRT, IMRT, or VMAT was used.

Outcomes of microvascular free tissue transfer in twice-irradiated patients.

Science.gov (United States)

Clancy, Kate; Melki, Sami; Awan, Musaddiq; Li, Shawn; Lavertu, Pierre; Fowler, Nicole; Yao, Min; Rezaee, Rod; Zender, Chad A

2017-09-01

Patients may require microvascular free tissue transfer (MFTT) following re-irradiation for recurrent cancer or radiation complications. The objective of this study was to describe the indications for and outcomes of free flaps performed in twice-radiated patients. A retrospective chart review identified the indications for and outcomes of 36 free flaps performed on 29 twice-irradiated patients. The free flap success rate was 92%. The most common indications requiring MFTT were cancer recurrence and osteoradionecrosis. Sixty-one percent experienced postoperative complications, most commonly wound infection (33%). Twenty-five percent of the procedures required return to the operating room due to postoperative complication. MFTT can be successfully performed in the twice-irradiated patient population with a success rate comparable to singly-radiated patients. Despite a high success rate, there is also a high rate of surgical site complications, especially infection. © 2017 Wiley Periodicals, Inc.

Effects of a 4-week high-intensity interval training on pacing during 5-km running trial

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R. Silva

2017-10-01

Full Text Available This study analyzed the influence of a 4-week high-intensity interval training on the pacing strategy adopted by runners during a 5-km running trial. Sixteen male recreational long-distance runners were randomly assigned to a control group (CON, n=8 or a high-intensity interval training group (HIIT, n=8. The HIIT group performed high-intensity interval-training twice per week, while the CON group maintained their regular training program. Before and after the training period, the runners performed an incremental exercise test to exhaustion to measure the onset of blood lactate accumulation, maximal oxygen uptake (VO2max, and peak treadmill speed (PTS. A submaximal constant-speed test to measure the running economy (RE and a 5-km running trial on an outdoor track to establish pacing strategy and performance were also done. During the 5-km running trial, the rating of perceived exertion (RPE and time to cover the 5-km trial (T5 were registered. After the training period, there were significant improvements in the HIIT group of ∼7 and 5% for RE (P=0.012 and PTS (P=0.019, respectively. There was no significant difference between the groups for VO2max (P=0.495 or onset of blood lactate accumulation (P=0.101. No difference was found in the parameters measured during the 5-km trial before the training period between HIIT and CON (P>0.05. These findings suggest that 4 weeks of HIIT can improve some traditional physiological variables related to endurance performance (RE and PTS, but it does not alter the perception of effort, pacing strategy, or overall performance during a 5-km running trial.

Twice-daily dosing of esomeprazole effectively inhibits acid secretion in CYP2C19 rapid metabolisers compared with twice-daily omeprazole, rabeprazole or lansoprazole.

Science.gov (United States)

Sahara, S; Sugimoto, M; Uotani, T; Ichikawa, H; Yamade, M; Iwaizumi, M; Yamada, T; Osawa, S; Sugimoto, K; Umemura, K; Miyajima, H; Furuta, T

2013-11-01

Twice-daily dosing of proton pump inhibitors (PPIs) is used to treat Helicobacter pylori or acid-related diseases, such as gastro-oesophageal reflux disease (GERD) refractory to standard dose of a PPI. Genetic polymorphisms of CYP2C19 are involved to different extents in the metabolism of four kinds of PPIs (omeprazole, lansoprazole, rabeprazole and esomeprazole) available in Japan. To compare acid-inhibitory effects of the four PPIs dosed twice daily in relation to CYP2C19 genotype. We performed 24-h pH monitoring studies on Day 7 of PPI treatment for 40 Japanese H. pylori-negative volunteers [15 CYP2C19 rapid metabolisers (RMs), 15 intermediate metabolisers (IMs) and 10 poor metabolisers (PMs)] using a randomised four-way crossover design: omeprazole 20 mg, esomeprazole 20 mg, lansoprazole 30 mg and rabeprazole 10 mg twice daily. Although median pH values with esomeprazole, omeprazole, lansoprazole and rabeprazole were 5.7 (3.5-7.2), 5.5 (2.4-7.2), 5.5 (3.7-7.3) and 5.2 (2.5-7.3), respectively (no statistically significant differences), CYP2C19 genotype-dependent differences were smaller for esomeprazole and rabeprazole compared with values for omeprazole and lansoprazole. In CYP2C19 RMs, the median pH with esomeprazole [5.4 (3.5-6.8)] was significantly higher than those with omeprazole [5.0 (2.4-5.9), P = 0.018], lansoprazole [4.7 (3.7-5.5), P = 0.017] or rabeprazole [4.8 (2.5-6.4), P = 0.002]. In IMs and PMs, the median pH was >5.0 independent of the PPI. In intermediate and rapid metabolisers of CYP2C19, PPIs dosed twice daily could attain sufficient acid suppression, while in CYP2C19 RMs, esomeprazole 20 mg twice daily caused the strongest inhibition of the four PPIs. Therefore, esomeprazole may be effective in Japanese population when dosed twice daily. © 2013 John Wiley & Sons Ltd.

Unruly Affect in the Kindergarten Classroom: A Critical Analysis of Social-Emotional Learning

Science.gov (United States)

Stearns, Clio

2018-01-01

This article offers a critique of social-emotional learning programs through the lens of psychoanalytic theory and with a particular focus on the theoretical contributions of Kleinian psychoanalysis. In particular, the article draws on concepts of affective positions to show that social-emotional learning is mired in a paranoid-schizoid mentality…

Extinction phenomena: A biologic perspective on how and why psychoanalysis works

Directory of Open Access Journals (Sweden)

Linda A.W. Brakel

2011-09-01

Full Text Available This article presents the view that much of the success of classical psychoanalysis is centrally predicated on its biological potency; focusing not on neuropsychology, but on the biology of conditioning. The argument suggests that features of classic psychoanalytic technique--the couch, meetings several times per week with both parties present, and free association--uniquely facilitate intense transferences of various sorts, and that these in turn constitute the multiple and diverse extinction trials necessary to best approximate extinction.

Reirradiation of head and neck neoplasms using twice-a-day scheduling

International Nuclear Information System (INIS)

Tercilla, O.F.; Schmidt-Ullrich, R.; Wazer, D.E.

1993-01-01

Between 1985 and 1988, we have explored the value of twice-a-day (BID) irradiation for the retreatment of head and neck neoplasms. In this pilot study of ten patients we used a schedule of BID irradiation at fraction sizes between 1.4 and 1.6 Gy separated by at least 6 h. Of the four patients were treated with curative intent, three patients received 30 Gy in 20 fractions over twelve days followed within ten days by an interstitial/intracavitary Ir-192 implant boost to doses of 30 to 40 Gy and one patient was treated with a 32 Gy BID boost. Four patients were reirradiated with aggressive palliation and received 45 Gy in 30 fractions over 26 days including a break in the third week. The remaining two patients were treated with palliative intent to 30 Gy in 20 fractions over twelve days. Eight patients were treated for recurrent/persistent or second carcinomas, one for a recurrent glomus jugulare tumor. At a median follow-up of 36 months, ranging from six to 61 months, nine of ten patients experienced excellent symptomatic relief. Five patients are alive and free of tumor, one patient is alive with distant metastases, and two each are dead from local or systemic tumor progression. All four patients retreated for cure are alive with no evidence of local disease. The tolerance and tumor control rate of the BID reirradition schedule were good with severe late sequelae in only one patient. (orig.) [de

Twice-monthly administration of a lower dose of epoetin beta pegol can maintain adequate hemoglobin levels in hemodialysis patients.

Science.gov (United States)

Morikami, Yuki; Fujimori, Akira; Okada, Shioko; Kumei, Mai; Mizobuchi, Noriko; Sakai, Makoto

2015-04-01

Epoetin beta pegol is a continuous erythropoietin receptor activator (CERA) with a long half-life. Although CERA has been shown to maintain adequate hemoglobin (Hb) levels at prolonged dosing intervals, the optimal dosing schedule remains unclear. We therefore compared the efficacy of maintaining hemoglobin levels with administration of twice-monthly CERA (TWICE) versus once-monthly CERA (ONCE). Twenty hemodialysis patients receiving epoetin beta (EPO) were enrolled in this crossover study. Patients were assigned to either the TWICE or the ONCE group based on matching Hb levels and EPO doses. After 6 months of treatment, the CERA dosage was interchanged between the groups and the study was continued for an additional 6 months. The effect of the different regimens on iron metabolism was also assessed during the first 6 months of the study. Hb levels significantly increased in the TWICE group, allowing for a reduction in CERA dosage, while the dose of CERA required to maintain Hb levels in the ONCE group remained unchanged. After the interchange, a decrease in Hb levels with incremental increase in CERA dosage was observed in the TWICE→ONCE group, with the opposite effect observed in the ONCE→TWICE group. Although increases in ferritin and hepcidin-25 levels in the ONCE group were noted at one month, they disappeared at 6 months. Although Hb levels were maintained in both the ONCE and TWICE groups, a twice-monthly administration was advantageous, as it required a lower dose of CERA. © 2014 The Authors. Therapeutic Apheresis and Dialysis © 2014 International Society for Apheresis.

Pregnancy Calendar: A Week-by-Week Guide

Science.gov (United States)

... Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español A Week-by-Week Pregnancy Calendar KidsHealth / For Parents / A Week-by-Week ...

EFFET DES TRAITEMENTS THERMIQUES SUR LA REACTION ENTRE DES COUCHES MINCES DE TITANE ET DES SUBSTRATS EN ACIER

Directory of Open Access Journals (Sweden)

D Slimani

2015-06-01

Full Text Available Des couches minces du titane pur ont été déposées avec la méthode de pulvérisation cathodique sur des substrats en acier, type FF80 K-1 contenants ~1% mass. en carbone. La réaction entre les deux parties du système substrat-couche mince est activée avec des traitements thermiques sous vide dans l’intervalle de températures de 400 à900°Cpendant 30 minutes. Les Spectres de diffraction de rayons x confirment l’inter- diffusion des éléments  chimiques du système résultants la formation et la croissance des nouvelles phases en particulier le carbure binaire TiC ayant des caractéristiques thermomécaniques importantes. L’analyse morphologique des échantillons traités  avec le microscope électronique à balayage (MEB montre l’augmentation du flux de diffusion atomique avec la température de recuit, notamment la diffusion du manganèse et du fer vers la surface libre des échantillons aux températures élevées provoquant la dégradation des propriétés mécaniques des revêtements contrairement au premiers stades d’interaction où on a obtenu des bonnes valeurs de la microdureté.

Heartburn treatment in primary care: randomised, double blind study for 8 weeks

Science.gov (United States)

Hatlebakk, Jan G; Hyggen, Arild; Madsen, Per H; Walle, Per O; Schulz, Tom; Mowinckel, Petter; Bernklev, Tomm; Berstad, Arnold

1999-01-01

Objective To compare the effects and tolerability of omeprazole and cisapride with that of placebo for control of heartburn in primary care patients. Design Randomised, double blind, placebo controlled study. Setting 65 primary care practices in Norway. Participants 483 untreated patients with complaints of heartburn ⩾3 days a week, with at most grade 1 reflux oesophagitis. Interventions Omeprazole 20 mg once daily, cisapride 20 mg twice daily, or placebo for 8 weeks. Main outcome measures Adequate control of heartburn, defined as ⩽1 day of the past 7 days with no more than mild heartburn, after 4 weeks of treatment. Results In the all patients treated analysis, adequate control of heartburn was achieved in 71% of patients taking omeprazole, 22% taking cisapride, and 18% taking placebo after 4 weeks of treatment (omeprazole v cisapride and placebo, Pheartburn whereas cisapride 20 mg twice daily was not significantly more effective than placebo. Key messagesIn primary care patients, heartburn is commonly treated empiricallyMost randomised clinical trials of treatment for heartburn have been conducted in specialist care, and documentation for empirical treatment is limitedOmeprazole was significantly more effective than cisapride or placebo in controlling heartburn and other symptoms of gastro-oesophageal reflux after 2, 4, and 8 weeks, whereas cisapride did not differ significantly from placeboOmeprazole should be considered as a first choice for empirical treatment of heartburn in primary care PMID:10463897

Effects of 28 weeks of high-intensity interval training during physical education classes on cardiometabolic risk factors in Chilean schoolchildren: a pilot trial.

Science.gov (United States)

Delgado-Floody, Pedro; Espinoza-Silva, Miguel; García-Pinillos, Felipe; Latorre-Román, Pedro

2018-04-21

The purpose of this investigation was to determine the effects of 28 weeks of high-intensity interval training (HIIT) during physical education classes on the weight status, cardiorespiratory capacity, and blood pressure of overweight and obese schoolchildren. The participants included 197 schoolchildren (108 girls and 89 boys) aged between 6 and 11 years (8.39 ± 1.15 years) in four groups: experimental group 1 (EG1) = 59 overweight schoolchildren; experimental group 2 (EG2) = 92 obese schoolchildren; control group 1 (CG1) = 17 overweight children; and control group 2 (CG2) = 29 obese schoolchildren. The participants in the EGs carried out HIIT twice per week for 28 weeks. After the 28-week intervention, the participants showed significant reductions in body mass index (p HIIT program caused significant improvements in the cardiorespiratory capacity, anthropometric variables, and blood pressure levels of overweight and obese children. What is Known: • High-intensity interval training (HIIT) programs improve health, but investigations have used relatively short intervention periods. What is New: • The 28-week period (a large intervention period) of HIIT-based games during physical education classes caused significant improvements in cardiorespiratory capacity, anthropometric variables, and blood pressure levels of overweight and obese schoolchildren.

Quality assurance system to correct for errors arising from couch rotation in linac-based stereotactic radiosurgery

International Nuclear Information System (INIS)

Brezovich, Ivan A.; Pareek, Prem N.; Plott, W. Eugene; Jennelle, Richard L. S.

1997-01-01

Purpose: The purpose of this project was the development of a quality assurance (QA) system that would provide geographically accurate targeting for linac-based stereotactic radiosurgery (LBSR). Methods and Materials: The key component of our QA system is a novel device (Alignment Tool) for expedient measurement of gantry and treatment table excursions (wobble) during rotation. The Alignment Tool replaces the familiar pencil-shaped pointers with a ball pointer that is used with the field light of the accelerator to indicate alignment of beam and target. Wobble is measured prior to each patient treatment and analyzed together with the BRW coordinates of the target by a spreadsheet. The corrections required to compensate for any imprecision are identified, and a printout generated indicating the floor stand coordinates for each couch angle used to place the target at isocenter. Results: The Alignment Tool has an inherent accuracy of measurement better than 0.1 mm. The overall targeting error of our QA method, found by evaluating 177 target simulator films of 55 foci in 40 randomly selected patients, was 0.47 ± 0.23 mm. The Alignment Tool was also valuable during installation of the floor stand and a supplemental collimator for the accelerator. Conclusions: The QA procedure described allows accurate targeting in LBSR, even when couch rotation is imprecise. The Alignment Tool can facilitate the installation of any stereotactic irradiation system, and can be useful for annual QA checks as well as in the installation and commissioning of new accelerators

Eight weeks of a combination of high intensity interval training and conventional training reduce visceral adiposity and improve physical fitness: a group-based intervention.

Science.gov (United States)

Giannaki, Christoforos D; Aphamis, George; Sakkis, Panikos; Hadjicharalambous, Marios

2016-04-01

High intensity interval training (HIIT) has been recently promoted as an effective, low volume and time-efficient training method for improving fitness and health related parameters. The aim of the current study was to examine the effect of a combination of a group-based HIIT and conventional gym training on physical fitness and body composition parameters in healthy adults. Thirty nine healthy adults volunteered to participate in this eight-week intervention study. Twenty three participants performed regular gym training 4 days a week (C group), whereas the remaining 16 participants engaged twice a week in HIIT and twice in regular gym training (HIIT-C group) as the other group. Total body fat and visceral adiposity levels were calculated using bioelectrical impedance analysis. Physical fitness parameters such as cardiorespiratory fitness, speed, lower limb explosiveness, flexibility and isometric arm strength were assessed through a battery of field tests. Both exercise programs were effective in reducing total body fat and visceral adiposity (Ptraining improved cardiorespiratory fitness levels (Ptraining (Ptraining improve various physical fitness parameters and reduce both total and visceral fat levels. This type of training was also found to be superior compared with conventional exercise training alone in terms of reducing more visceral adiposity levels. Group-based HIIT may consider as a good methods for individuals who exercise in gyms and craving to acquire significant fitness benefits in relatively short period of time.

Radiation-Free Weekend Rescued! Continuous Accelerated Irradiation of 7-Days per Week Is Equal to Accelerated Fractionation With Concomitant Boost of 7 Fractions in 5-Days per Week: Report on Phase 3 Clinical Trial in Head-and-Neck Cancer Patients

Energy Technology Data Exchange (ETDEWEB)

Skladowski, Krzysztof, E-mail: skladowski@io.gliwice.pl [Maria Sklodowska-Curie Memorial Cancer Center and the Institute of Oncology, Branch in Gliwice (Poland); Hutnik, Marcin; Wygoda, Andrzej; Golen, Maria; Pilecki, Boleslaw; Przeorek, Wieslawa; Rutkowski, Tomasz; Lukaszczyk-Widel, Beata; Heyda, Alicja; Suwinski, Rafal; Tarnawski, Rafal; Maciejewski, Boguslaw [Maria Sklodowska-Curie Memorial Cancer Center and the Institute of Oncology, Branch in Gliwice (Poland)

2013-03-01

Purpose: To report long-term results of randomized trial comparing 2 accelerated fractionations of definitive radiation therapy assessing the need to irradiate during weekend in patients with head and neck squamous cell carcinoma. Methods and Materials: A total of 345 patients with SCC of the oral cavity, larynx, and oro- or hypo-pharynx, stage T2-4N0-1M0, were randomized to receive continuous accelerated irradiation (CAIR: once per day, 7 days per week) or concomitant accelerated boost (CB: once per day, 3 days per week, and twice per day, 2 days per week). Total dose ranged from 66.6-72 Gy, dose per fraction was 1.8 Gy, number of fractions ranged from 37-40 fractions, and overall treatment time ranged from 37-40 days. Results: No differences for all trial end-points were noted. At 5 and 10 years, the actuarial rates of local-regional control were 63% and 60% for CAIR vs 65% and 60% for CB, and the corresponding overall survival were 40% and 25% vs 44% and 25%, respectively. Confluent mucositis was the main acute toxicity, with an incidence of 89% in CAIR and 86% in CB patients. The 5-year rate of grade 3-4 late radiation morbidity was 6% for both regimens. Conclusions: Results of this trial indicate that the effects of accelerated fractionation can be achieve by delivering twice-per-day irradiation on weekday(s). This trial has also confirmed that an accelerated, 6-weeks schedule is a reasonable option for patients with intermediate-stage head-and-neck squamous cell carcinoma because of the associated high cure rate and minimal severe late toxicity.

Study of once and twice forbidden {beta} transitions; Contribution a l'etude de transitions {beta} une fois et deux fois interdites

Energy Technology Data Exchange (ETDEWEB)

Hocquenghem, J C [Commissariat a l' Energie Atomique, Grenoble (France). Centre d' Etudes Nucleaires

1967-09-01

The realisation of an experimental set up for directional angular correlation measurements allowed us to determine {beta} - {gamma} angular correlations. These measurements together with the determination of the {beta} shape-factor have been made for the following transitions: the first forbidden {beta}{sup -} transitions of 386 keV in the {sup 177}Lu disintegration and of 352 keV in the {sup 175}Yb disintegration. The experimental results have been compared with theoretical predictions of the Nilsson's model; the twice forbidden {beta}{sup -} transition of 473 keV in the {sup 94}Nb disintegration. The {beta} transition nuclear matrix elements have been extracted from the experimental results. Comparison have been made with the theoretical values calculated by taking for nuclear wavefunctions those obtained by diagonalization of the residual interaction and assuming that protons and neutrons outside the {sup 90}Zr core are respectively on the 1 g 9/2 and 2 d 5/2 orbits. (author) [French] La realisation d'un ensemble de mesures de correlations angulaires directionnelles nous a permis la mesure de correlations {beta} - {gamma} en fonction de l'energie. En completant celles-ci par la mesure du facteur de forme du spectre {beta}, nous avons pu etudier ainsi: d'une part, les transitions {beta}{sup -} une fois interdites de 386 keV de la desintegration de {sup 177}Lu et de 352 keV de la desintegration de {sup 175}Yb, Les resultats experimentaux ont ete compares aux valeurs calculees dans le modele de Nilsson; d'autre part, la transition {beta}- deux fois interdite de 473 keV de la desintegration de {sup 94}Nb. Les elements de matrice nucleaire de la transition {beta}, extraits des resultats experimentaux, ont ete compares aux valeurs theoriques calculees. Les fonctions d'ondes nucleaires utilisees ont ete obtenues par diagonalisation de l'interaction residuelle en supposant que les protons et les neutrons, en dehors du coeur forme par le {sup 90}Zr, sont respectivement

Eat Seafood Twice a Week: 10 Tips to Help You Eat More Seafood

Science.gov (United States)

... Pacific mackerel, herring on a salad, or oven-baked pollock. 7 put it on a salad or in a sandwich Top a salad with grilled scallops, shrimp, or crab in place of steak or chicken. Use canned tuna or salmon for sandwiches in place of deli meats, which ...

Cultural Considerations for Twice-Exceptional Children from Asian Families

Science.gov (United States)

Park, Soeun

2015-01-01

Since the term twice-exceptional has been entered to the field of gifted education, many studies have investigated the population of students who possess both giftedness and disabilities. It has been shown that there are some challenges to recognizing twice-exceptional children due to current screening and identification process. For this reason,…

Technical Note: Output and energy fluctuations of the tomotherapy Hi-Art helical tomotherapy system

International Nuclear Information System (INIS)

Mahan, Stephen L.; Chase, Daniel J.; Ramsey, Chester R.

2004-01-01

The output and energy calibrations for the first clinical Hi-Art 2.0 helical tomotherapy system have been reviewed. Fixed-gantry/fixed-couch and rotational-gantry/fixed-couch measurements were made on a daily basis over a period of 20 weeks to investigate system stability. Static gantry measurements were taken at 10 cm depth in a rectangular stack of Virtual Water at an SSD distance of 90 cm and a field size of 5x40 cm. Rotational gantry measurements were taken in a cylindrical phantom Virtual Water phantom for a field size of 5x40 cm. The Hi-Art 2.0 system has maintained its calibration to within ±2% and energy to within ±1.5% over the initial 20 week period

A four-week clinical study to evaluate and compare the effectiveness of a baking soda dentifrice and an antimicrobial dentifrice in reducing plaque.

Science.gov (United States)

Ghassemi, Annahita; Vorwerk, Linda M; Hooper, William J; Putt, Mark S; Milleman, Kimberly R

2008-01-01

To evaluate and compare the effectiveness in reducing plaque of a fluoride dentifrice containing baking soda and a non-baking soda fluoride dentifrice containing an antimicrobial (triclosan/copolymer) system after a single brushing and over a four-week period of daily brushing. A total of 207 subjects completed this randomized, blinded, parallel-group clinical study. Twenty-four hour plaque buildup was scored at baseline and after two and four weeks of twice-daily use of the products. Additionally, controlled single brushing with the assigned dentifrice, followed by post-brushing plaque assessment, was performed at the start (baseline visit) and end (Week-4 visit) of the study. Plaque was scored using the Turesky, et al. modification of Quigley-Hein Index at six sites per tooth, according to Soparkar's modification. Mean baseline whole mouth plaque scores for the baking soda and triclosan dentifrice groups were 2.90 +/- 0.40 and 2.90 +/- 0.39, respectively, and the difference was not statistically significant. Within-group analysis showed that both products significantly reduced the amount of plaque over the four-week period (p baking soda dentifrice exhibited significantly greater reduction in plaque scores (p baking soda dentifrice group (0.34 +/- 0.32) was 2.22-fold greater than that observed for the triclosan dentifrice group (0.15 +/- 0.24). Similarly, single brushing with the baking soda dentifrice showed a 1.88- to 2.08-fold greater pre- to post-brushing plaque difference as compared to the triclosan dentifrice at the baseline visit (mean plaque reduction: baking soda 0.54 +/- 0.26; triclosan 0.28 +/- 0.18; ratio 1.88X) and Week-4 visit (baking soda 0.47 +/- 0.21; triclosan 0.23 +/- 0.15; ratio 2.08X). Similar to the whole mouth scores, evaluation of various tooth sites (facial, lingual, proximal, and gingival) showed a significantly greater reduction in plaque scores for brushing with the baking soda dentifrice as compared to brushing with the triclosan

SU-D-BRD-01: An Automated Physics Weekly Chart Checking System Supporting ARIA

Energy Technology Data Exchange (ETDEWEB)

Chang, X; Yang, D [Washington University in St Louis, St Louis, MO (United States)

2015-06-15

Purpose: A software tool was developed in this study to perform automatic weekly physics chart check on the patient data in ARIA. The tool accesses the electronic patient data directly from ARIA server and checks the accuracy of treatment deliveries, and generates reports which summarize the delivery history and highlight the errors. Methods: The tool has four modules. 1) The database interface is designed to directly access treatment delivery data from the ARIA database before reorganizing the data into the patient chart tree (PCT). 2) PCT is a core data structure designed to store and organize the data in logical hierarchies, and to be passed among functions. 3) The treatment data check module analyzes the organized data in PCT and stores the checking results into PCT. 4) Report generation module generates reports containing the treatment delivery summary, chart checking results and plots of daily treatment setup parameters (couch table positions, shifts of image guidance). The errors that are found by the tool are highlighted with colors. Results: The weekly check tool has been implemented in MATLAB and clinically tested at two major cancer centers. Javascript, cascading style sheets (CSS) and dynamic HTML were employed to create the user-interactive reports. It takes 0.06 second to search the delivery records of one beam with PCT and compare the delivery records with beam plan. The reports, saved in the HTML files on shared network folder, can be accessed by web browser on computers and mobile devices. Conclusion: The presented weekly check tool is useful to check the electronic patient treatment data in Varian ARIA system. It could be more efficient and reliable than the manually check by physicists. The work was partially supported by a research grant from Varian Medical System.

SU-D-BRD-01: An Automated Physics Weekly Chart Checking System Supporting ARIA

International Nuclear Information System (INIS)

Chang, X; Yang, D

2015-01-01

Purpose: A software tool was developed in this study to perform automatic weekly physics chart check on the patient data in ARIA. The tool accesses the electronic patient data directly from ARIA server and checks the accuracy of treatment deliveries, and generates reports which summarize the delivery history and highlight the errors. Methods: The tool has four modules. 1) The database interface is designed to directly access treatment delivery data from the ARIA database before reorganizing the data into the patient chart tree (PCT). 2) PCT is a core data structure designed to store and organize the data in logical hierarchies, and to be passed among functions. 3) The treatment data check module analyzes the organized data in PCT and stores the checking results into PCT. 4) Report generation module generates reports containing the treatment delivery summary, chart checking results and plots of daily treatment setup parameters (couch table positions, shifts of image guidance). The errors that are found by the tool are highlighted with colors. Results: The weekly check tool has been implemented in MATLAB and clinically tested at two major cancer centers. Javascript, cascading style sheets (CSS) and dynamic HTML were employed to create the user-interactive reports. It takes 0.06 second to search the delivery records of one beam with PCT and compare the delivery records with beam plan. The reports, saved in the HTML files on shared network folder, can be accessed by web browser on computers and mobile devices. Conclusion: The presented weekly check tool is useful to check the electronic patient treatment data in Varian ARIA system. It could be more efficient and reliable than the manually check by physicists. The work was partially supported by a research grant from Varian Medical System

Differential therapeutic effects of 12-week treatment of atomoxetine and methylphenidate on drug-naïve children with attention deficit/hyperactivity disorder: A counting Stroop functional MRI study.

Science.gov (United States)

Chou, Tai-Li; Chia, Seng; Shang, Chi-Yung; Gau, Susan Shur-Fen

2015-12-01

Methylphenidate and atomoxetine are effective in treating attention-deficit/hyperactivity disorder (ADHD) with underlying distinct pharmacological mechanisms. To relate neural mechanisms to clinical response, we conducted a comparative trial to differentiate the changes in brain activation of drug-naïve children with ADHD when performing neuropsychological tasks after 12 weeks of pharmacotherapy. We randomized 50 drug-naïve children with ADHD, aged 7-17, to treatment with methylphenidate (n=25) or atomoxetine (n=25). These children were scanned twice with functional magnetic resonance imaging (fMRI) during the counting Stroop task before and after treatment. Focused attention and impulsivity were assessed twice by using the Conner's Continuous Performance Test (CCPT). The final sample for fMRI analysis comprised 20 in the methylphenidate group and 22 in the atomoxetine group. Atomoxetine decreased activations in the dorsal anterior cingulate cortex and dorsolateral prefrontal cortex, which correlated with improvement in focused attention assessed by the CCPT. In contrast, methylphenidate increased activations in the inferior frontal gyrus, which correlated with the decreasing severity of impulsivity assessed by the CCPT. The current findings suggest that differential therapeutic effects on neuronal changes induced by 12-week treatment atomoxetine and methylphenidate may contribute to behavioral improvement. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.

Once versus twice daily gentamicin dosing for infective endocarditis

DEFF Research Database (Denmark)

Buchholtz, Kristine; Larsen, Carsten Toftager; Schaadt, Bente

2011-01-01

Objectives: The aim of this randomized study was to investigate the effects of once versus twice daily gentamicin dosing on renal function and measures of infectious disease in a population with infective endocarditis (IE). Methods: Seventy-one IE patients needing gentamicin treatment according...

Effects of chair yoga therapy on physical fitness in patients with psychiatric disorders: A 12-week single-blind randomized controlled trial.

Science.gov (United States)

Ikai, Saeko; Uchida, Hiroyuki; Mizuno, Yuya; Tani, Hideaki; Nagaoka, Maki; Tsunoda, Kenichi; Mimura, Masaru; Suzuki, Takefumi

2017-11-01

Since falls may lead to fractures and have serious, potentially fatal outcomes, prevention of falls is an urgent public health issue. We examined the effects of chair yoga therapy on physical fitness among psychiatric patients in order to reduce the risk of falls, which has not been previously reported in the literature. In this 12-week single-blind randomized controlled trial with a 6-week follow-up, inpatients with mixed psychiatric diagnoses were randomly assigned to either chair yoga therapy in addition to ongoing treatment, or treatment-as-usual. Chair yoga therapy was conducted as twice-weekly 20-min sessions over 12 weeks. Assessments included anteflexion in sitting, degree of muscle strength, and Modified Falls Efficacy Scale (MFES) as well as QOL, psychopathology and functioning. Fifty-six inpatients participated in this study (36 men; mean ± SD age, 55.3 ± 13.7 years; schizophrenia 87.5%). In the chair yoga group, significant improvements were observed in flexibility, hand-grip, lower limb muscle endurance, and MFES at week 12 (mean ± SD: 55.1 ± 16.6 to 67.2 ± 14.0 cm, 23.6 ± 10.6 to 26.8 ± 9.7 kg, 4.9 ± 4.0 to 7.0 ± 3.9 kg, and 114.9 ± 29.2 to 134.1 ± 11.6, respectively). Additionally, these improvements were observable six weeks after the intervention was over. The QOL-VAS improved in the intervention group while no differences were noted in psychopathology and functioning between the groups. The intervention appeared to be highly tolerable without any notable adverse effects. The results indicated sustainable effects of 20-min, 12-week, 24-session chair yoga therapy on physical fitness. Chair yoga therapy may contribute to reduce the risk of falls and their unwanted consequences in psychiatric patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

The comparison between effect of chemoradiation with weekly cisplatin with or without celecoxib in treatment of nasopharyngeal carcinoma: A phase III clinical trial

Directory of Open Access Journals (Sweden)

Mohamad Mohammadianpanah

2009-07-01

Full Text Available Introduction: Concurrent cisplatin-based chemoradiation is currently considered the treatment of choice for locoregional nasopharyngeal carcinoma. Celecoxib is a selective cyclooxygenase-2 (COX-2 inhibitor which can potentially enhance the effect of radiotherapy. The aim of this study was to determine the efficacy and safety of celecoxib in nasopharyngeal carcinoma. Materials and Methods: Patients with newly diagnosed locoregional nasopharyngeal carcinoma were included in this clinical trial study. The patients were assigned to receive 7 weeks concurrent chemoradiation with weekly cisplatin and either celecoxib 100 mg twice daily or placebo. After completion of chemoradiation, all patients received combined chemotherapy with cisplatin plus 5-Fu every 3 weeks for 3 cycles. Clinical response rates and treatment-related toxicity were the primary and secondary end-point of the study. Results: Total of 50 eligible patients with the median age of 43 years were enrolled in the trial. Overall (complete and partial clinical response rate was 100% in both groups. Complete and partial clinical response rates were 64% and 36% in study group and 44% and 56% in control group respectively (P>0.25. There was no difference in terms of treatment-related toxicity rates between two groups. Conclusions: This clinical trial showed that addition of celecoxib 100 mg twice daily to concurrent chemoradiation does not increase the response rates and treatment-related toxicities in patients with locoregional nasopharyngeal carcinoma.

SU-E-J-138: An IGRT QA Device for Measuring with Tenths-Millimeter Accuracy KV and MV Isocenter Congruence, Couch Travel and Laser Alignment of Accelerators Used for SRS and SBRT

Energy Technology Data Exchange (ETDEWEB)

Brezovich, I; Popple, R; Duan, J; Huang, M; Benhabib, S; Shen, S; Cardan, R; Wu, X [University of Alabama Birmingham, Birmingham, AL (United States)

2014-06-01

Purpose: To develop a practical device having sufficient accuracy for daily QA tests of accelerators used for SRS and SBRT. Methods: The UAB (Universal Alignment Ball) consists of a 6.35 mm (1/4 inch) diameter tungsten sphere located concentrically within a 25.4 mm (1 inch) diameter acrylic plastic (PMMA) sphere. The spheres are embedded in polystyrene foam, which, in turn, is surrounded by a cylindrical PMMA shell. The UAB is placed on the couch and aligned with wall lasers according to marks that have known positions in relation to the center of the spheres. Using planar and cone beam images the couch is shifted till the surface of the PMMA sphere matches Eclipse-generated circular contours. Anterior and lateral MV images taken with small MLC openings allow measurement of distance between kV and MV isocenter, laser and MLC alignment. Measurements were taken over a one-month period. Results: Artifacts from the tungsten sphere were confined within the PMMA sphere and did not affect cone beam localization of the sphere boundary, allowing 0.1 mm precise alignment with a computer-generated circle centered at kV isocenter. In tests extending over a one-month period, the distance between kV and MV isocenters along the vertical, longitudinal and lateral directions was 0.125 +/−0.06, 0.19 +/−0.08, and 0.02 +/−0.08 mm, respectively. Laser misalignment along these directions was 0.34 +/- 0.15, 0.74 +/−0.29, and 0.49 +/−0.22 mm. Automated couch shifts moved the spheres to within 0.1 mm of the selected position. The center of a 1cmx1cm MLC-defined field remained within +/−0.2 mm of the tungsten sphere center as the gantry was rotated. Conclusion: The UAB is practical for daily end-to-end QA tests of accelerator alignment. It provides tenths-mm accuracy for measuring agreement of kV and MV isocenters, couch motions, gantry flex and laser alignment.

Effects of four weeks of repeated sprint training on physiological indices in futsal players

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Paulo Cesar do Nascimento

2014-12-01

Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2015v17n1p91   The aim of this study was to investigate the effects of short repeated-sprint ability (RSA training on the neuromuscular and physiological indices in U17 futsal players during the competitive period. Fourteen players were divided into two groups: intervention group (n = 8 and control group (n = 6. Both groups performed a repeated maximal sprint test (40-m MST, intermittent shuttle-running test (Carminatti’s test and vertical jumps before and after the training period. The intervention group was submitted to an additional four-week repeated sprints program, twice a week, while the control group maintained their normal training routine. There was no significant interaction between time and groups for all variables analysed (p > 0.05. However, a significant main effect was observed for time (p < 0.01 indicating an increase on speed at heart rate deflection point (VHRDP and the continuous jump performance while the peak lactate (40m-LACpeak and sprint decrement decreased after training, in both groups. Still, based on effect sizes (ES the greater changes with practical relevance were verified for intervention group in important variables such as peak velocity (ES = 0,71, VHRDP (ES = 0,83 and 40m-LACpeak (ES = 1,00. This study showed that RSA-based and normal training routine are equally effective in producing changes in the analysed variables during a short period of intervention. However, the effect size suggests that four weeks of RSA training would be a minimum time that could induce the first changes of futsal player’s physical fitness.

Prophylaxis vs. on-demand treatment with BAY 81-8973, a full-length plasma protein-free recombinant factor VIII product: results from a randomized trial (LEOPOLD II).

Science.gov (United States)

Kavakli, K; Yang, R; Rusen, L; Beckmann, H; Tseneklidou-Stoeter, D; Maas Enriquez, M

2015-03-01

BAY 81-8973 is a new full-length human recombinant factor VIII product manufactured with technologies to improve consistency in glycosylation and expression to optimize clinical performance. To demonstrate superiority of prophylaxis vs. on demand therapy with BAY 81-8973 in patients with severe hemophilia A. In this multinational,randomized, open-label crossover study (LEOPOLD II;ClinicalTrials.gov identifier: NCT01233258), males aged 12–65 years with severe hemophilia A were randomized to twice-weekly prophylaxis (20-30 IU kg(-1)), 3-times-weekly prophylaxis (30-40 IU kg(-1)), or on-demand treatment with BAY 81-8973. Potency labeling for BAY 81-8973 was based on the chromogenic substrate assay or adjusted to the one-stage assay. Primary efficacy endpoint was annualized number of all bleeds (ABR). Adverse events (AEs)and immunogenicity were also assessed. Eighty patients (on demand, n = 21; twice-weekly prophylaxis, n = 28; 3-times-weekly prophylaxis, n = 31) were treated and analyzed. Mean ± SD ABR was significantly lower with prophylaxis (twice-weekly, 5.7 ± 7.2; 3-times-weekly, 4.3 ± 6.5; combined, 4.9 ± 6.8) vs. on-demand treatment (57.7 ± 24.6; P demand treatment (60.0). Median ABR was higher with twice-weekly vs. 3-times-weekly prophylaxis during the first 6-month treatment period (4.1 vs. 2.0) but was comparable in the second 6-month period (1.1 vs. 2.0). Few patients reported treatment-related AEs (4%); no treatment-related serious AEs or inhibitors were reported. Twice weekly or 3-times-weekly prophylaxis with BAY 81-8973 reduced median ABR by 97% compared with on-demand therapy, confirming the superiority of prophylaxis. Treatment with BAY 81-8973 was well tolerated.

Italian singer Annalisa at CERN for a week of filming

CERN Multimedia

Stefania Pandolfi

2015-01-01

CERN welcomed Italian singer-songwriter Annalisa for a week-long visit to the Laboratory to shoot an Italian television production about the Laboratory.   Annalisa in the CERN Control Centre.   The Italian artist has a degree in physics from the University of Turin, Italy. She is a singer and songwriter, famous for her successful participation in the Italian talent show, Amici di Maria De Filippi. She has recorded four albums as solo artist and has participated twice in the Sanremo Music Festival, the most important Italian song contest. She has also received numerous Italian music awards, and has earned international recognition. Thanks to her knowledge of physics and her great influence with the Italian youth, Annalisa was selected to host an Italian television production about CERN aimed at young people. 

Future School Counselors' Perceptions of Twice-Exceptionality: An Exploratory Study

Science.gov (United States)

Leggett, Debra; Shea, Irene; Leggett, Joanna

2011-01-01

An exploratory survey was given to school counselors-in-training to gather preliminary information about their perceptions regarding students with twice-exceptionalities, their professional roles concerning service provision, and the roles of other helpers in assisting twice-exceptional students in the school setting. Thirty-seven participants…

Compliance, clinical outcome, and quality of life of patients with stable angina pectoris receiving once-daily betaxolol versus twice daily metoprolol: a randomized controlled trial

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Przemyslaw Kardas

2007-05-01

Full Text Available Przemyslaw KardasThe First Department of Family Medicine, Medical University of LodzBackground: A randomized, controlled trial was conducted in an outpatient setting to examine the effect of beta-blocker dosing frequency on patient compliance, clinical outcome, and health-related quality of life in patients with stable angina pectoris.Methods: One hundred and twelve beta-blockers-naive outpatients with stable angina pectoris were randomized to receive betaxolol, 20 mg once daily or metoprolol tartrate, 50 mg twice daily for 8 weeks. The principal outcome measure was overall compliance measured electronically, whereas secondary outcome measures were drug effectiveness and health-related quality of life.Results: The overall compliance was 86.5 ± 21.3% in the betaxolol group versus 76.1 ± 26.3% in the metoprolol group (p < 0.01, and the correct number of doses was taken on 84.4 ± 21.6% and 64.0 ± 31.7% of treatment days, respectively (p < 0.0001. The percentage of missed doses was 14.5 ± 21.5% in the once-daily group and 24.8 ± 26.4% in the twice-daily group (p < 0.01. The percentage of doses taken in the correct time window (58.6% vs 42.0%, p = 0.01, correct interdose intervals (77.4% v 53.1%, p < 0.0001, and therapeutic coverage (85.6% vs 73.7%, p < 0.001 were significantly higher in the once-daily group. Both studied drugs had similar antianginal effectiveness. Health-related quality of life improved in both groups, but this increase was more pronounced in the betaxolol arm in some dimensions.Conclusions: The study demonstrates that patient compliance with once-daily betaxolol is significantly better than with twice daily metoprolol. Similarly, this treatment provides better quality of life. These results demonstrate possible therapeutic advantages of once-daily over twice-daily beta-blockers in the treatment of stable angina pectoris.Keywords: patient compliance, quality of life, stable angina pectoris, randomized controlled trial

Step by step: The feasibility of a 16-week workplace lunchtime walking intervention for physically inactive employees.

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Thøgersen-Ntoumani, Cecilie; Loughren, Elizabeth; Duda, Joan; Fox, Kenneth Richard

2014-09-01

A 16-week lunchtime walking intervention was designed to increase physical activity in physically inactive University employees. The program was delivered and monitored twice over 7 months to examine feasibility across different seasons. Seventy-five participants (n = 69 females, n = 6 males; mean age = 47.68) were randomly allocated into a Winter (February start) or Spring group (May start). Participants were asked to complete 3 weekday lunchtime walks and 2 weekend walks. Weeks 1 to 10 were led by walk leaders (group phase) while the participants self-organized their walks during weeks 11 to 16 (independent phase). Yamax pedometers recorded daily step counts and walk group leaders recorded participant attendance in the group phase. Acceptability was assessed via a satisfaction survey and 2 focus groups with participants. A participant pool representative by ethnicity, but not gender was recruited using a range of strategies. The program demonstrated good retention across both groups (73%). The intervention was acceptable to participants. More steps were accumulated in the group-led versus the independent phase. The intervention is feasible in this workplace setting across different seasonal periods. In the future, researchers should examine if the findings can be replicated in a definitive trial and generalize to other workplace settings.

Subchronic (26- and 52-week) toxicity and irritation studies of a novel microbicidal gel formulation containing sodium lauryl sulfate in animal models.

Science.gov (United States)

Piret, Jocelyne; Laforest, Geneviève; Bussières, Martin; Bergeron, Michel G

2008-03-01

The safety of an ethylene oxide/propylene oxide gel formulation containing sodium lauryl sulfate (2%, w/w), that could be a potent candidate as a topical microbicide, has been evaluated. More specifically, the subchronic (26- and 52-week) toxicity of the formulation when applied intravaginally as well as its irritating potential for the rectal, penile, eye, skin and buccal mucosa have been examined in animal models. The results showed that the vaginal administration of the gel formulation containing sodium lauryl sulfate once and twice daily (with doses 12 +/- 2 h apart) for 26 weeks to rats and for 52 weeks to rabbits induced slight to moderate histopathological alterations. When the formulation was applied intrarectally to male and female rabbits once and twice daily (with doses 12 +/- 2 h apart) for 14 days, no macroscopic or microscopic changes were reported. For both vaginal and rectal dosing, no effect was seen on the haematology, coagulation and serum chemistry parameters as well as on the body weight of animals and the relative organ weights. Other sporadic macroscopic and histopathological findings were incidental in origin and of no toxicological significance. The gel formulation containing sodium lauryl sulfate was considered as mildly irritating for the penile mucosa of rabbits, non-irritating for the eye of rabbits, mildly irritating for the skin in a rabbit model and non-irritating for the hamster cheek pouch. It is suggested that the gel formulation containing sodium lauryl sulfate is safe for most tissues that could be exposed to the product under normal use.

The Effect of Weekly Progress Reports on Academic Achievement.

Science.gov (United States)

Armour, Katherine S.

This study investigated the effect of weekly progress reports on the academic achievement of seventh grade language arts students. It also investigated the effects of weekly progress reports on locus of control attribution and the relationship between academic achievement and locus of control attribution. The study took place in a suburban school…

Changes in body weight, blood pressure and selected metabolic biomarkers with an energy-restricted diet including twice daily sweet snacks and once daily sugar-free beverage

OpenAIRE

Nickols-Richardson, Sharon M.; Piehowski, Kathryn E.; Metzgar, Catherine J.; Miller, Debra L.; Preston, Amy G.

2014-01-01

BACKGROUND/OBJECTIVES The type of sweet snack incorporated into an energy-restricted diet (ERD) may produce differential effects on metabolic improvements associated with body weight (BW) loss. This study compared effects of incorporating either twice daily energy-controlled dark chocolate snacks plus once daily sugar-free cocoa beverage (DC) to non-chocolate snacks plus sugar-free non-cocoa beverage (NC) into an ERD on BW loss and metabolic outcomes. MATERIALS/METHODS In an 18-week randomize...

Comparison of health care resource utilization and costs among patients with GERD on once-daily or twice-daily proton pump inhibitor therapy

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Mody R

2013-04-01

Full Text Available Reema Mody,1 Debra Eisenberg,2 Likun Hou,2 Siddhesh Kamat,2 Joseph Singer,2 Lauren B Gerson3 1Takeda Pharmaceuticals International Inc, Deerfield, IL, 2HealthCore Inc, Wilmington, DE, 3Stanford University School of Medicine, Stanford, CA, USA Background: The purpose of this study was to assess differences in health care resource utilization and costs associated with once-daily and twice-daily proton pump inhibitor (PPI therapy. Most patients with gastroesophageal reflux disease (GERD achieve symptom control on once-daily PPI therapy, but approximately 20%–30% require twice-daily dosing. Methods: Patients were ≥18 years of age with at least one medical claim for GERD and at least two PPI claims from HealthCore's Integrated Research Database (HIRDSM during 2004–2009. Patients were continuously eligible for 12 months before and after the index date (date of first PPI claim. Based on PPI dosing throughout the post-index period (quantity of medication dispensed/number of days supply, patients were classified as once-daily (dose ≤ 1.5 pills per day or twice-daily (≥1.5 PPI users. Results: The study cohort included 248,386 patients with GERD (mean age 52.8 ± 13.93 years, 56% females of whom 90% were once-daily and 10% were twice-daily PPI users. The Deyo-Charlson Comorbidity Index for once-daily and twice-daily PPI users was 0.70 ± 1.37 and 0.89 ± 1.54, respectively (P < 0.05. More once-daily patients had claims for Barrett's esophagus (5% versus 2%, P < 0.0001 than twice-daily patients. Post-index, higher proportions of twice-daily patients had at least one GERD-related inpatient visit (7% versus 5%, outpatient visit (60% versus 49%, and office visit (48% versus 38% versus once-daily patients (P < 0.0001. Mean total GERD-related health care costs were $2065 ± $6636 versus $3749 ± $11,081 for once-daily and twice-daily PPI users, respectively (P < 0.0001. Conclusion: Patients receiving twice-daily PPI therapy were likely to have more

CONSEQUENCES OF INCREASING THE MINIMUM WAGE IN UKRAINE TWICE

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Volodymyr Boreiko

2017-03-01

Full Text Available In the article the views of scientists on the role of incomes of the poorest people in providing of economic development of the country and consequences of increasing the minimum wage in Ukraine twice are investigated; the dynamics of change in Ukraine minimum wage during a decade are analyzed and decline in living standards of population during this period is shown; measures, which should be taken for non-inflationary growth in incomes of the population, are grounded; it is disclosed that such measures should include unification of income tax for individuals and single social contribution and restoration of a progressive taxation of incomes of the working population. Key words: minimum wage, household income, the poorest part of the population, the economy of country, tax system.

Efficacy of tofacitinib for the treatment of nail psoriasis: Two 52-week, randomized, controlled phase 3 studies in patients with moderate-to-severe plaque psoriasis.

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Merola, Joseph F; Elewski, Boni; Tatulych, Svitlana; Lan, Shuping; Tallman, Anna; Kaur, Mandeep

2017-07-01

Tofacitinib is an oral Janus kinase inhibitor. Efficacy and safety of tofacitinib in patients with moderate-to-severe plaque psoriasis have been demonstrated. We sought to assess the efficacy of tofacitinib for the treatment of nail psoriasis over a period of 52 weeks. In 2 identical phase 3 studies (OPT Pivotal 1 and 2), patients were randomized 2:2:1 to receive tofacitinib 5 mg, tofacitinib 10 mg, or placebo, twice daily. At week 16, placebo-treated patients were re-randomized to tofacitinib. This post hoc analysis of patients with existing nail psoriasis assessed the Nail Psoriasis Severity Index (NAPSI) score and proportions of patients achieving ≥50% reduction in NAPSI from baseline (NAPSI50), NAPSI75, or NAPSI100. Baseline mean NAPSI scores for patients treated with tofacitinib 5 mg (N = 487), tofacitinib 10 mg (N = 476), and placebo (N = 233) twice daily were 27.0, 27.3, and 26.9, respectively. At week 16, significantly (all P psoriasis versus placebo at week 16; improvements were maintained over 52 weeks [NCT01276639; NCT01309737]. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Predictors of hangover during a week of heavy drinking on a holiday

DEFF Research Database (Denmark)

Hesse, Morten; Tutenges, Sébastien

2010-01-01

units in the whole sample. The severity of hangover increased significantly during a week of heavy drinking and there was a time * number of drinks interaction, indicating that the impact of alcohol consumed on hangover became more pronounced later in the week. Levels of drinking before the holiday did...